No abstract available.
Emergencies* ; Humans

To evaluate the efficacy and safety of intravitreally removing the crystalline lens completely dislocated into the vitreous cavity with intact capsule, we reviewed the patients undergone pars plana vitrectomy for the treatment of intravitreal crystalline lens. The crystalline lenses were spontaneously dislocated in 4 and traumatically dislocated in 10 of all 14 eyes. Combined ocular conditions were 10 eyes of cataract, 5 of vitreous hemorrhage, 5 of increased intraocular pressure (IOP) and 2 of iridodialysis. All 14 eyes had undergone pars plana vitrectomy, intravitreal removal of the crystalline lens and scleral fixation of the intraocular lens whereas 3 had undergone trabeculectomy, 2 retinal cryopexy and injection of sulfur hexafluoride intraocular gas, and 1 iridoplasty. The lens was aspirated only with vitrectomy cutter in 1 eye; phacofragmentor was used in 13 eyes and perfluorocarbone liquid was injected in 5 eyes. Mean follow-up time was 7.42 months. On the last follow-up, visual acuity was 0.5 or better in 11 eyes and counting fingers in 1 eye with optic nerve atrophy. Retinal detachment was never found, and increased IOP sustained in 1 eye. The result suggests intravitreal removal of the crystalline lens combined with pars plana vitrectomy seems effective and safe.
Atrophy ; Cataract ; Crystallins* ; Fingers ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lens Subluxation ; Lens, Crystalline* ; Lenses, Intraocular ; Optic Nerve ; Retinal Detachment ; Retinaldehyde ; Sulfur Hexafluoride ; Trabeculectomy ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

We experienced a case of candida albicans cystitis resembling a bladder tumor. The case involved a 75 year-old female patient who complained lower abdominal pain and voiding difficulty. A pelvic ultrasonograph, a pelvic CT and the cystoscopic findings indicated a bladder tumor. The mass lesion was diagnosed from a cystoscopic biopsy as candida albicans cystitis. The mass disappeared and the voiding symptoms improved two weeks later after Itraconazole (Sporanox ) oral medication.
Abdominal Pain ; Aged ; Biopsy ; Candida albicans* ; Candida* ; Cystitis* ; Female ; Humans ; Itraconazole ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Clinical observarions were done on 616 cases of cerebrovasculae accidents treated as inpatients at the Sung-Sim hospital, Chung-Ang university over a period of 8 years, from January, 1981 to Agust, 1988. The results were as follows; 1) Of 616 cases of cerebrovascular accidents, cerebral hemorrhage was presented in 56.82%, cerebral thrombosis in 28.57%, subarachnoid hemorrhage in 12.66%, cerebral embolism in 1.95%. 2) The ratio of male to female was 1.01:1. 3) The cerebrovascular accidents were most common in the sixth decade and followed by the fifth and fourth in turn. 4) The seasonal incidence was in order of frequency of Spring, Winter, Autumn and Summer. 5) Among disease preceding the onset of cerebrovascular accidents, hypertension was noted at 75% in cases of cerebral hemorrhge, 61% in cerebral thrombosis and 73% in subarachnoid hemorrhge. 6) The mean duration of underlying hypertension was 13.7 years in cerebral emorrhge, 15.3 years in cerebral thrombosis, 12.2 years in subarachnoid hemorrhage and 14.8 years in cerebral embolism. 7) Major precipitating factor in cerebral hemorrhage and subarachnoid hemorrhage was thought to be physical activity, whereas cerebral thrombosis and cerebral embolism frequently occured during sleeping or resting state. 8) The mean cholesterol level were 204.1mg% in cerebral hemorrhage, 214.9mg% in cerebral thrombosis, 211.7mg% in subaraachnoid hemorrhage and 217.0mg% in cerebral embolism. 9) The mortality rate was 12.2% in total, 16.6% in cerebral hemorrhage 2.3% in cerebral thrombosis, 15.45 in subarachnoid hemorrhage and 25% in cerebral embolism.
Cerebral Hemorrhage ; Cholesterol ; Female ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Inpatients ; Intracranial Embolism ; Intracranial Thrombosis ; Male ; Mortality ; Motor Activity ; Precipitating Factors ; Seasons ; Stroke* ; Subarachnoid Hemorrhage

BACKGROUND: Recently Umeyama et al. reported that cerebral blood flow is definitely increased on the ipsilateral side after the blockade of stellate ganglion. Considering that the most obvious solution to the problem of poor cerebral blood flow is to augment the flow, cervical sympathectomy may reduce the volume and extent of the brain damage by increasing the cerebral blood flow. We studied the effects of cervical sympathectomy on ischemic brain damage in a middle cerebral artery occlusion model in rats. METHOD: The experimental animals were divided into three groups. In the sham-operated control group (n=7), middle cerebral artery was occluded without cervical sympathectomy. In the experimental group I (n=7), cervical sympathectomy was performed 5 minutes before middle cerebral artery occlusion. In the experimental group II (n=7), cervical sympathectomy was performed 5 minutes after middle cerebral artery occlusion. The neurological grade of each experimental animal was evaluated at 24 hours post occlusion and then the animals were sacrificed. The brain was cut into coronal sections. The volume of infarct was computed and the edema volume was calculated. RESULTS: 1. There were no differences in the physiological variables in all groups. 2. Cervical sympathectomy, compared with the controls, significantly reduced the volume of infarct (P<0.05). 3. There was no significant difference in ischemic brain edema between each group. 4. The neurologic deficit was less severe in sympathectomized groups compared with the control group (P<0.05). And neurological grades were significantly correlated with the volume of infarction (P<0.05). CONCLUSION: These results suggest that cervical sympathectomy may improve the neurologocal deficit and reduce the infarct volume measured 24 hours following induction of focal cerebral infarction.
Animals ; Brain Edema ; Brain* ; Cerebral Infarction* ; Edema ; Infarction ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Neurologic Manifestations ; Rats* ; Stellate Ganglion ; Sympathectomy*

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

The glutamate receptors (GluRs) are key receptors for modulatory synaptic events in the central nervous system. It has been reported that glutamate increases the intracellularCa (2+) concentration ([Ca2+]i) and induces cytotoxicity. In the present study, we investigated whether the glutamate-induced[Ca2+]i increase was associated with the activation of ionotropic (iGluR) and metabotropic GluRs (mGluR) in substantia gelatinosa neurons, using spinal cord slice of juvenile rats (10~21 day) .[Ca2+]i was measured using conventional imaging techniques, which was combined with whole-cell patch clamp recording by incorporating fura-2 in the patch pipette. At physiological concentration of extracellularCa (2+), the inward current and[Ca2+]i increase were induced by membrane depolarization and application of glutamate. Dose-response relationship with glutamate was observed in bothCa (2+) signal and inward current. The glutamate-induced[Ca2+]i increase at holding potential of 70 mV was blocked by CNQX, an AMPA receptor blocker, but not by AP-5, a NMDA receptor blocker. The glutamate-induced[Ca2+]i increase inCa (2+) free condition was not affected by iGluR blockers. A selective mGluR (group I) agonist, RS-3, 5-dihydroxyphenylglycine (DHPG), induced[Ca2+]i increase at holding potential of 70 mV in SG neurons. These findings suggest that the glutamate-induced[Ca2+]i increase is associated with AMPA-sensitive iGluR and group I mGluR in SG neurons of rats.
6-Cyano-7-nitroquinoxaline-2,3-dione ; Animals ; Central Nervous System ; Fura-2 ; Glutamic Acid ; Membranes ; N-Methylaspartate ; Neurons* ; Rats* ; Receptors, AMPA ; Receptors, Glutamate ; Receptors, Metabotropic Glutamate ; Spinal Cord ; Substantia Gelatinosa*

PURPOSE: to assess the role of MR imaging in determining of the atrial situs in complicated congenital heart disease with situs ambiguus. MATERIALS AND METHODS: In order to classify the situs, the morphology of atrial appendages, on bronchial length ratio, the superior-inferior relation of the pulmonary artery (PA) and main bronchi on each side, and splenic abnormality were evaluated by MR imaging in 22 patients (12 boys and 10 girls), and the results were compared. RESULTS: In all patients, the superior-inferior relation of the PA and main bronchi tended to lateralize, and in one, bronchial length ratio was not consistent with the relation between the PA and bronchus. Bronchial and atrial situs, as determined by appendage morphology, were consistent in ten of 13 right isomerism patients, and in only three of nine of these with left isomerism. All 13 right isomerism patients, classified by the relation of the PA and main bronchi, showed asplenia, whereas eight of nine of these with left isomerism had polysplenia. CONCLUSION: In the assessment of atrial situs by MR imaging, the positional relation of a bronchus and the PA, bronchial length ratio, and splenic abnormality are constant and reliable. The accuracy of classification of situs on the basis of atrial appendage morphology is, however, limited.
Atrial Appendage ; Bronchi ; Classification ; Heart Defects, Congenital* ; Heterotaxy Syndrome* ; Humans ; Isomerism ; Magnetic Resonance Imaging* ; Pulmonary Artery

PURPOSE: In order to establish therapeutic guidelines for TASC C & D iliac lesions, we compared outcomes of surgical and endovascular treatment. METHODS: From May 2002 to April 2007, 27 limbs of 18 patients underwent bypass operation and 23 limbs of 21 patients underwent stent placement for TASC C & D iliac lesions at Dongsan Medical Center. Age, sex, risk factor, combined diseases, clinical symptoms, treatment method, and patency rate were reviewed retrospectively. RESULTS: Technical and clinical success was achieved in all patients of the bypass group and in 95.8% of patients in the stent group. There were no complications in the surgical group, but 4 major complications in the stent group: 3 distal embolizations, and 1 arterial rupture. The primary patency rates at 6 months, 1, 2, and 3 years were all 90% in the bypass group and 95%, 89%, 89%, and 89%, respectively, in the stent group (P=0.99). The respective secondary patency rates were all 90% in the bypass group and 100%, 94%, 94%, and 94% in the stent group (P=0.56). CONCLUSION: Arterial bypass and stent placement are technically safe and effective treatment modalities in TASC C & D lesions of the iliac artery. A liberal posture to open arterial reconstruction extends the ability to treat diffuse TASC C & D lesions via endovascular means.
Extremities ; Humans ; Iliac Artery ; Posture ; Retrospective Studies ; Risk Factors ; Rupture ; Stents

Symptomatic pacing lead-associated thrombosis is very uncommon occurring in 0.5-3.5% of pacemaker implants. Especially thrombisis-induced total occlusion occures almost in late stage over several months to years but acute thrombosis occurring several days after venous pacing has not been reported. In this case, We performed upper limb venography in the patient who presented edema and pain of neck, left upper limb and headache as well as intermittent cough occurring in bending forward. A venogram confirmed acute thrombus completely occluding the left brachiocephalic vein and the patient received intravenous heparin and was maintained on warfarin. Repeated veno- graphy after treatment for 30 days revealed persistent thrombus with total occlusion which not be improved signi- ficantly copmpared to previous venogram and collateral veins diverting the blood to the contralateral side and into the superior vena cava was developed. The patient's symptoms resolved almost and that is likely to be due to the development of collateral venous channels.
Brachiocephalic Veins* ; Cough ; Edema ; Headache ; Heparin ; Humans ; Neck ; Phlebography ; Thrombosis* ; Upper Extremity ; Veins ; Vena Cava, Superior ; Warfarin