Catatracts are an infrequent but well-known complication of electrical injury, remains poorly understood. We report two cases of electric cataract with maculopathy experienced recently. The first case was a 58-year-old man who had exposed to 22000 voltage current and sustained third degree, 15% burn. 54th day after burn, the lenticular changes showed total opacity of both eyes and the intraocular pressure of left eye was 28 mmHg. 65th day after burn, extracapsular cataract extraction with posterior chamber lens implantation on left eye was performed. After the operation, naked vision was 1.0, but hard exudates were showed in macular area. The second case was a 23-year-old man who had exposed to 54000 voltage current and sustained third degree, 20% burn. 82th day after burn, the lenticular changes showed moderate opacities in the anterior and posterior subcapsular area of both eyes. 137th day after burn, extracapsular cataract extraction with posterior chamber lens implantation on right eye was performed. The final corrected visual acuity was 0.5 on 7th week after the operation due to lamellar macular hole.
Male ; Humans

Spontaneous pneumothorax is a known, but relatively rare complication of pulmonary metastases of sarcoma. A 19-year-old man was presented with chest pain and dyspnea for three days and was diagnosed as left pneumothorax. After bleb resection, microscopic examination revealed metastatic osteosarcoma forming subpleural fistula and dystrophic calcification. Four years ago, he had had limb salvage operation and chemotherapy for osteosarcoma of left femur. After two and a half years he had a bleb resection for right pneumothorax without any evidence of metastasis. Six months later, he was found to have a 4x3cm sized lung mass in the right lower lobe. After lobectomy, he was diagnosed as pulmonary metastasis of osteosarcoma. Pneumothorax is the common complication of metastatic osteosarcoma to the lung and it may be presented before the pulmonary metastasis is clinically evident. It is important to recognize a pneumothorax of the patients with osteosarcoma as a possible sign of metastases.
Blister ; Chest Pain ; Drug Therapy ; Dyspnea ; Femur ; Fistula ; Humans ; Limb Salvage ; Lung ; Neoplasm Metastasis* ; Osteosarcoma* ; Pneumothorax* ; Sarcoma ; Young Adult

PURPOSE: The present study was conducted to develop a mild vascular cognitive impairment (MVCI) assessment tool for patients with stroke and to examine its validity, reliability, and clinical adequacy. METHODS: Items of this tool were developed based on previously verified cognitive assessment tools. Face, content, and criterion (concurrent) validities, optimal cut-off score for differentiation of MVCI and normal cognitive function, clinical adequacy, internal consistency, and inter-rater reliability of the assessment tool were determined in 60 stroke patients at a university hospital located in Incheon, South Korea. RESULTS: The devised MVCI assessment tool contains 20 items which were designed to assess seven cognitive domains: orientation, memory, language, attention, reasoning/abstraction, visuospatial perception, and executive function/problem solving. Content, face, and construct validities were well supported. Clinical adequacy testing revealed that the overall probability of correctly discriminating MVCI using the MVCI assessment tool for stroke was 90.0%, which was statistically significant. Furthermore, a score of 23 was found to be the optimal cut-off score for MVCI. Internal consistency and inter-rater reliability were also well supported. CONCLUSIONS: The findings of this study indicate that the developed MVCI assessment tool for stroke could serve as a clinically useful tool for detecting MVCI and for properly assessing degree of cognitive impairment in stroke patients.
Aged ; Female ; Humans ; Male ; Middle Aged ; *Mild Cognitive Impairment/complications/diagnosis ; Neuropsychological Tests/*standards ; Psychometrics/*methods ; Reproducibility of Results ; Republic of Korea ; Sensitivity and Specificity ; Stroke/*complications

OBJECTIVE: To understand the difference of defecation physiology between postpartum and postoperative women. METHODS: Between July 1998 to April 1999, we performed defecogram and pudendal nerve motor latency to 31 women, who were 8 postoperative women, 9 post cesarean-section state women, and 14 normal vaginal delivery-state women. RESULTS: According to the defecogram results, only squeezing angles of the anorectal angle were significantly increased(96.0 vs 72.3, 74.9 degree) in normal vaginal delivery-state women compared to post cesarean-section state and postoperative women, but rest and evacuation angles were not. And to pudendal nerve latency, there were no statistically significant difference. CONCLUSION: We concluded that the pudendal plexus was damaged during labor, therefore its ability to control puborectalis muscle was damaged. So, the anorectal angles of squeezing of postpartum women were significantly increased, compared to those of post cesarean section women or postoperative women.
Cesarean Section ; Defecation* ; Female ; Humans ; Physiology* ; Postpartum Period* ; Pregnancy ; Pudendal Nerve*

No abstract available.
Granulomatous Disease, Chronic* ; Trimethoprim-Sulfamethoxazole Combination

PURPOSE: This study was conducted to test criterion-related validity of the Critical Patients' Severity Classification System (CPSCS) developed by the Hospital Nurses' Association by examining relationships with brain injury severity measured by Glasgow Coma Scale (GCS), recovery state measured by Glasgow Outcome Scale (GOS), and days of stay in ICU of brain injury patients. METHODS: Prospective correlational research design was adopted by including 194 brain injury patients admitted to ICU of one university hospital. RESULTS: The score of CPSCS appeared to significantly discriminate the severity of brain injury. Among nursing activities in CPSCS, Respiratory therapy, IV Infusion and Medication, Monitoring, Activities of Daily Living (ADL), Treatment and Procedure were significant to discriminate the severity of brain injury. Respiratory therapy, Vital Signs, and Monitoring appeared to significantly discriminate the recovery states of 1- and 3-months. Nursing activities significantly contributed to predict the days of ICU stay were Respiratory therapy, ADL, and Teaching and Emotional Support. CONCLUSION: CPSCS developed by the Hospital Nurses Association appeared to be valid to discriminate or predict brain injury severity, recovery states, and days of stay in ICU for brain injury patients.
Activities of Daily Living ; Brain Injuries ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Prospective Studies ; Research Design ; Respiratory Therapy ; Vital Signs

PURPOSE: Interleukin-6 (IL-6) can stimulate a variety of tumors including prostatic carcinoma. Research has recently shown that IL-6 may act to stimulate the progression of prostatic cancer. IL-6 is elevated in the sera of patients with metastatic prostatic cancer and it has been shown to be a candidate marker of disease activity. To date, little work has been performed to characterize the nature of granulocyte macrophage colony-stimulating factor (GM-CSF) and the expression of IL-6. The aim of this study is to evaluate the effects of GM-CSF on the expression of IL-6 in PC-3 cells. MATERIALS AND METHODS: The bone-derived PC-3 cell line was used in this study. Reverse transcription polymerase chain reaction (RT-PCR) was performed to detect the GM-CSF and also the IL-6 mRNA expression. The IL-6 protein was measured by enzyme-linked immunosorbent assay (ELISA) after treatments with the hGM-CSF. RESULTS: hGM-CSF was expressed in the PC-3 cell line. Our data indicated that the IL-6 mRNA expression was not increased at 4, 8 and 12 hours by the hGM-CSF in comparison to the control group, but it was slightly increased at 24 and 48 hours. The expression of IL-6 protein was increased at 4, 8, 12, 24 and 48 hours after hGM-CSF treatment, in comparison with the control group. CONCLUSIONS: The IL-6 mRNA expression was slightly increased by hGM-CSF at 24 and 48 hours in comparison to the control group. Yet the IL-6 protein expression increased before the IL-6 mRNA expression. Therefore, hGM-CSF may modulate the post-transcription pathway of the IL-6 expression in prostate carcinoma cells. Our data suggest that GM-CSF may have a possible IL-6 mediated pathophysiologic role in prostate cancer.
Cell Line* ; Enzyme-Linked Immunosorbent Assay ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Humans ; Interleukin-6* ; Macrophage Colony-Stimulating Factor* ; Macrophages* ; Polymerase Chain Reaction ; Prostate* ; Prostatic Neoplasms* ; Reverse Transcription ; RNA, Messenger

BACKGROUND: Concerns regarding increasing microbial resistance to vancomycin have resulted in recommendations for a higher trough serum vancomycin concentration. This study aimed to assess the dosage guidelines targeting vancomycin trough concentrations of 15-20 mg/L. METHODS: About 216 adult patients (age, >60 yr) were treated with intravenous vancomycin. The patients were divided into 2 groups according to their target vancomycin trough concentrations: the previous guideline group (n=108) treated with targeted vancomycin trough concentrations of 5-15 mg/L from Jan 2009 through April 2011 and the new guideline group (n=108) treated with targeted concentrations of 15-20 mg/L from November 2011 through July 2012. RESULTS: The 2 groups were not significantly different with respect to age, weight, initial serum creatinine, initial creatinine clearance, predictive trough levels, doses, serum drug concentrations, and area under the curve/minimal inhibitory concentrations. Regarding the proportions of vancomycin trough concentrations, the target range was achieved in 50% in the previous guideline group and in 16% in the new guideline group. In the previous and new guideline groups, the trough concentrations of 10-20 mg/dL were observed in 32.4% and 52.8% patients, respectively, and those of <10 mg/L were observed in 45.4% and 29.6%, respectively. CONCLUSIONS: Compared to the previous guideline group, the new guideline group showed higher proportions in the therapeutic range of 10-20 mg/L and lower proportions in trough concentrations <10 mg/L. The strictly managed vancomycin therapeutic drug monitoring in the new guideline group was assessed as more effective.
Aged ; *Drug Monitoring ; Female ; Gram-Positive Bacterial Infections/drug therapy ; Guidelines as Topic ; Half-Life ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Vancomycin/*blood/pharmacokinetics/therapeutic use

Photodynamic therapy is a promising modality for the palliation of advanced upper gastrointestinal cancer and for the eradication of early neoplastic and pre-neoplastic lesions. It is based on the combination of a photosensitizer that is selectively localized in the target tissue and illumination of the lesion with visible light, resulting in photodamage and subsequent cell death. For early esophageal cancer, esophagectomy has been a standard modality of curative intent. However, accumulated data supports the possibility of PDT replacing surgery as a curative modality. We experienced a case of early esophageal cancer that recurred after esophagectomy. The patient was successfully treated with photodynamic therapy using porfimer sodium as a photosensitizer.
Endoscopy, Gastrointestinal ; Esophageal Neoplasms/*drug therapy/pathology/surgery ; *Esophagectomy ; Humans ; Male ; Middle Aged ; *Photochemotherapy ; Photosensitizing Agents/administration & dosage/*therapeutic use

BACKGROUND: The margin of safety is the length of the mainstem bronchi, over which double-lumen endotracheal tubes (DLTs) can be moved and still be correctly positioned. A negative value of margin of safety means that DLTs may not be safe. We measured the length of the left and right mainstem bronchi and margin of safety in Korean adults. METHODS: One hundred and fifty-six ASA I or II adult patients undergoing an elective surgery were examined. After nduction of general anesthesia, we measured the lengths from the upper incisor to the tracheal carina, to the proximal margin of the left and right upper lobe bronchial opening using a fiberoptic bronchoscope. We calculated the lengths of the left and right mainstem bronchi and margin of safety using the measured lengths. RESULTS: In Korean adults, the average margin of safety of left-sided DLTs of males and females was 2.4 +/- 1.0 cm and 1.9 0.7 cm and right-sided DLTs of males and females was 1.0 +/- 0.9 cm and 0.8 +/- 0.3 cm, respectively. The percentage of a negative value of the margin of safety in positioning right-sided DLTs was 10.4% in males and 8.6% in females. However, all values of the margin of safety in left-sided DLTs were positive. CONCLUSIONS: Using left-sided DLTs, regardless of the operative side, is better than right-sided DLTs because left-sided DLTs have a greater margin of safety in positioning. If we use right-sided DLTs, we should confirm the proper position of tubes using a fiberoptic bronchoscope.
Adult* ; Anesthesia, General ; Bronchi ; Bronchoscopes* ; Female ; Humans ; Incisor ; Male ; One-Lung Ventilation