Author have experienced 3 cases of intractable total traumatic hyphema on conservative medical treatment and have good results after surgical management by using Model 800(A) Ocutome vitrectomy instrument. For evacuation of blood clot in anterior chamber. The conclusion were as follow; 1. We experienced no significant intraoperative complication. 2. All 3 cases achieved intraocular presure controls in early post operative state and these controls were sustained till now without any antiglaucomatous agent. 3. Good final visual acuity was obtained in pure total hyphema in which there was no other associated intraocular injury at the time of trauma.
Anterior Chamber ; Hyphema* ; Intraoperative Complications ; Visual Acuity ; Vitrectomy

No abstract available.
Spinal Cord Injuries* ; Spinal Cord*

Heart failure is a recognized, although uncommon, cause of massive liver cell necrosis, the clinical consequence of which are intermingled with those of cardiac insufficiency in most case. But, hepatic coma is rerely caused by hepatic congestion only. We report the three cases with heart failure resulted in massive liver cell necrosis and fulminant hepatic failure. The manifestations of fulminant hepatic failure were hepatic encephalopathy, jaundice, marked increase of prothrombin time and serum transaminase and there were no evidences of viral hepatitis and toxic hepatitis as a cause of liver failure.
Drug-Induced Liver Injury ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hepatic Encephalopathy ; Hepatitis ; Jaundice ; Liver ; Liver Failure ; Liver Failure, Acute* ; Necrosis ; Prothrombin Time

BACKGROUND: Abdominal pain is one of the most common complaints in the emergency department and the evaluation presents an extraordinary challenge to the emergency physician's skill. C-reactive protein, an acute phase protein which is increased in the presence of inflammation in various clinical conditions, has been proven useful in assessing disease severity, in monitoring the development of complications, and in evaluating the response to specific treatments. So we tried to determine whether CRP offers an advantage over other clinical or laboratory variables for decision-making in the management of acute abdominal pain in the emergency department. METHOD: Patients who came to a University Hospital ED with acute abdominal pain, between september 1, 1998 and November 30, 1998, were included in this study, Data collection included age, sex, duration of symptom, location of pain, and laboratory dta(white blood cell count, portion of neutrophils, ESR, CRP, amylase). RESULT: This study included 85 patients, 34 of whom were men. The mean age was 36.9+/-19.1 years. CRP might be useful to detect the serious condition, sensitivity 81%, but more useful to differentiate normal condition from serious condition in acute abdominal pain patients, specificity 83%. CONCLUSION: CRP is an useful indicator of decision-making to abdominal patients in the emergency department. Hospitalization or operation is very unlikely when CRP value is normal.
Abdominal Pain* ; Acute-Phase Proteins ; Blood Cell Count ; C-Reactive Protein* ; Data Collection ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Hospitals ; Humans ; Inflammation ; Male ; Neutrophils ; Sensitivity and Specificity

A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine

Reiters syndrome is an unusual disease characterized a triad of nongonococcal urethritis, conjunctivitis, and arthritis in association with the mircoutaneous lesions of keratoderma blenorrhagica and balarintis circinata. We present herein a case of Reiters syndome combined yiti lung cancer. A 39-year-old man has experienced naigrating polyarthralgia and high fever ilitermittently for about 20 years, Hyperkeratotic erythemnous patches and plaques, which dyeliped about 1 year ago, have aggravated and expanded to the whole body. Histopathologic sections from the plaque on the right forc ari showed characteristic findings including thickened parakeratotic horny layer and spongiform micropustules of Kogoji He was associated with HLA-B27. On the chest X-ray, a thumbtip size mass was incidently found. Chest CT and bone scan findings supported lung cancer and multiele metastases.
Adult ; Arthralgia ; Arthritis ; Conjunctivitis ; Fever ; HLA-B27 Antigen ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis ; Thorax ; Tomography, X-Ray Computed ; Urethritis

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*

Pneumomediastinum is a relatively uncommon, infrequently reported entity, In the evaluation of these entity, it is important to exclude pathological causes, including Boerhaave's syndrome which carries a high mortality. Spontaneous pneumomediastinum is related to excessive intraalveolar pressure leading to rupture of perivascular alveoli in the setting of a Valsalva maneuver without communication to gut material. So, it has a benign self-limited course and rarely requires medical intervention. On the contrary, secondary pneumomediastinum caused by instrumental, traumatic, and spontaneous perforation of esophagus. Although the prognosis have been improved since the advent of broad-spectrum antibiotics and nutritional support, pneumomediastinum due to esophageal perforation still has a high morbidity and mortality. The most important prognostic factor is the time interval between perforation and initiation of therapy, and an awareness and a high clinical suspicion is critical in the early diagnosis and treatment. Recently, we have experienced 2 cases of pneumomediastinum, one case was spontaneous pneumomediastinum and the other may be caused by instrumental esophageal perforation. We report the clinical course of the patients with a current literature review.
Anti-Bacterial Agents ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Fibrinogen ; Humans ; Mediastinal Emphysema* ; Mortality ; Nutritional Support ; Prognosis ; Rupture ; Valsalva Maneuver

PURPOSE: In order to compare stone metabolic risk factors in recurrent stone formers, we researched lithogenic factors according to sex and age. MATERIALS AND METHODS: We performed stone metabolic studies on recurrent stone formers (77 men, 33 women) and grouped them according to age; under 40 (n=38), from 40 to 59 (n=56) and over 60 (n=16). We evaluated excretion rate differences of lithogenic and inhibitory constituents such as volume, sodium, uric acid, calcium, oxalate, and citrate from 24-hour urine samples, and calcium, sodium, uric acid, phosphate, potassium, and chloride from serum samples. We analyzed the incidence of stone metabolic risk factors between the age groups and the sexes. RESULTS: The most common detectable risk factor in all groups of recurrent stone formers was hypocitraturia. This finding was more remarkable in males aged under 60. The incidence of hypocitraturia was higher in males and in the younger group, whereas hypercalciuria was more frequent in the elder group. CONCLUSIONS: The most important cause of urolithiasis was hypocitraturia in recurrent stone formers, and this was apparent in males aged under 60.
Calcium ; Citric Acid ; Humans ; Hypercalciuria ; Incidence ; Male ; Potassium ; Risk Factors* ; Sodium ; Uric Acid ; Urolithiasis

BACKGROUND: Common environmental allergens play a role in the pathogenesis of urticaria via type I hypersensitivity reaction. Changes in the number of eosinophils and serum IgE in circulating blood in various allergic disorders have been reported by several investigators. However, there are only a few reports about the measurement of those numbers according to a clinical type of urticaria. OBJECTIVE: This study was undertaken to measure the peripheral blood eosinophil and serum IgE levels in 514 patients with different types of urticaria. METHOD: We measured the peripheral blood eosinophil and serum IgE levels in 514 patients who visited the Department of Dermatology, Kyungpook National University Hospital from November 1993 to December 1996. Of these patients there were 122 with acute urticaria (23.7%), 160 with chranic urticaria (31.2%), 164 with dermographism (31.9%), 11 with acute urticaria plus dermographism (2.1%) and 57 with chronic urticaria plus dermographism (11.1%).
Allergens ; Dermatology ; Eosinophils* ; Gyeongsangbuk-do ; Humans ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Research Personnel ; Urticaria*