No abstract available.
Humans

Purpose: To investigate the clinical results of vitrectomy alone as the primary treatment for rhegmatogenous retinal detachment (RD) in patients with atopic dermatitis (AD). Methods: The medical records of patients with AD treated for rhegmatogenous retinal detachment (RD) were retrospectively reviewed. We investigated the characteristics of retinal breaks and detachments, applied surgical methods, and results. Results: Twenty eyes of 14 patients with AD who presented with rhegmatogenous RD and treated by vitrectomy were included in this analysis. Sixteen eyes (80%) were treated with vitrectomy, either alone or in combination with cataract surgery, and the retina was successfully attached to 94% of the eyes. There were four cases in which vitrectomy was combined with encircling. Reoperation was needed in half of the eyes that received vitrectomy with encircling, which presented nearly total detachment, severe proliferative vitreoretinopathy, and pseudophakia. Conclusions Vitrectomy alone, in combination with cataract surgery, may be sufficient to treat rhegmatogenous RD in patients with AD. Additional encircling or buckling should still be considered in complicated cases.

The intensive care unit(ICU) of our hospital is a 12 bed multidisciplinary ICU which is under the auspices of the Department of Anesthesiology. The ICU is essentially a respiratory ICU in which all hospital patients requiring ventilatory support are cared for. The patient population encompasses all causes of respiratory failure, medical and surgical. Another source of referral (surgical and medical) is a large group of critically ill patients with multiorgan failure, especially due to traums. Our experience of intensive care therapy began in the recovery room starting in 1959. Since that time the size and facilities of the ICU have been enlarged. We analyzed 4,514ICU patients admitted between Mar. 1980 and Feb. 1984, to obtain better guidance and management in the ICU. The results of patients was 4,514; 874 patients in 1980, 832 patients in 1981, 895 patients in 1982, 862 patients in 1983 and 1,051 patients in 1984. The ratio of male to female patients was nearly 2:1/ 2) Total Total admission time in the ICU was 17.473 days. The average patient stay was 3.9 days. The number of patients staying in the ICU more than 9 days increased from 54 cases(6%) in 1980 to 101 cases(10%) in 1984. 3) The forty year age group outrumbered the order age group and was 20.5%. The mortality rate of the pre-teen age group was the hightest(19.7%) and the overall mortality was 14.2%(640 cases) during these 5 years. 4) The number of patients admitted to the ICU from the Department of Neurosurgery was 1,218(27%) being the highest among all departments. Oct of 232 patients who died, the Department of Neurosurgery had the highest mortality rate, 19.1%. From the above results, it can be seen that the number of patients admitted to the ICU. the mortality rate and the patients staying more than 9 days in the ICU has increased annually it is claimed that more facilities allowing for monitoring and support, special qualified staffs and a co-ordinated organization will reduce the mortality rate, particularly in the pre-teen age group.
Anesthesiology ; Critical Illness ; Female ; Gangwon-do* ; Humans ; Intensive Care Units* ; Critical Care* ; Male ; Mortality ; Neurosurgery ; Recovery Room ; Referral and Consultation ; Respiratory Insufficiency

The diffuse large B-cell lymphoma category of the Revised European American Classification of Lymphoid Neoplasms (REAL) encompasses different morphologic lymphoma subtypes in a single entity, especially the diffuse large cell (DLC) and the immunoblastic (IBL) subtypes by Working Formulation (WF). The aim of this study is to determine the influence of the morphologic subdivision within this category with respect to clinical outcome and proliferative index using Ki-67 immunostainig combined with image analysis. We retrospectively reviewed 74 patients from 1990 to 1996, who were diagnosed with diffuse large B-cell lymphoma. All cases were reclassified according to REAL and Working Formulation (WF), and Ki-67 immunostaining was performed in all the cases. Fifty-eight cases (78.4%) were classified as DLC and 16 cases (21.6%) as IBL, according to WF. Twenty one cases (28.4%) showed nodal involvement and 53 cases (71.6%), extranodal involvement. All cases were found to display a variable degree of nuclear Ki-67 staining. A proliferative index of 50% or higher identified a group of patients (77%) who had poor clinical results. Overall survival was significantly reduced in these patients displaying high Ki-67 associated proliferative index compared to those with a low proliferative index (p=0.007). 5-year survival estimates were 93% in the low proliferative index group and 55% in the high proliferative index group. A multivariate regression analysis incorporating commonly used clinical prognostic factors confirmed the independent effect of proliferation index on survival. Moreover, all of the 16 IBL cases showed Ki-67 positivity of 50% or higher, which correlates with the poor clinical outcome compared to 70.7% of DLC (p=0.014). We conclude that subdivision of the diffuse large B-cell lymphoma category of the REAL classification is necessary in terms of prognostic significance in correlation with Ki-67 proliferative index.
B-Lymphocytes* ; Classification ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Retrospective Studies

Hemangiomas are common benign soft tissue tumors found in pediatrics. Knowledge of prenatal image findings for hemangiomas can be essential for ensuring optimal antepartum and postpartum care. In this study, we provide a report the MR findings of a congenital hemangioma in the posterior neck region, which was different from the pre and postnatal image findings as well as a literature review.
Fetal Diseases ; Fetus ; Hemangioma* ; Neck ; Pediatrics ; Postnatal Care ; Prenatal Diagnosis

BACKGROUND AND PURPOSE: Manganese could be toxic to the human nervous system. Therefore, it is important to detect the over-exposed patients in their early course of intoxication. The aim of this study is to find a valuable methods of clinical examination and applicable parameters for early detection of manganese intoxication. METHODS: we investigated the 35 men who had been exposed to manganese over 5 years. All the subjects were examined and video monitored by three physicians. We separated them into the two groups(Group A: clinically suspicious, Group B: clinically normal) in terms of their motor functions, gait, posture, expression. Motor functions(finger and foot tapping, rapid alternating movement, pegboard exam, writing and walking velocity etc.), MRIs, and biochemical data were measured and compared. RESULTS: No one showed significant effects of manganese intoxication . Also there were no significant differences between the two groups for their biochemical data except for elevated serum Adenosine deaminase(ADA) in clinically suspicious group. But there was a trend that motor functions were decreased especially for the finger and foot tapping, walking velocity and stride, writing velocity. A large number of subjects showed MRI changes in both groups. So MRI is not necessarily correlated with clinical findings and not a specific diagnostic tool for manganese intoxication but a sensitive one for the exposed subjects to manganese. CONCLUSION: From this study, the decreased motor functions were the only clinically significant neurologic manifestation in those who over-exposed subjects to manganese. The level of serum ADA and brain MRI could be a helpful supportive diagnostic tools for the over-exposure. Even if the subjects with these positive results do not show any significant sign of intoxication , we ought to modify their working environment to reduce further exposure.
Adenosine ; Brain ; Fingers ; Foot ; Gait ; Humans ; Magnetic Resonance Imaging ; Male ; Manganese* ; Nervous System ; Neurologic Manifestations ; Posture ; Walking ; Writing

BACKGROUND: To evaluate the effects of thoracic epidural anesthesia, with or without bilateral vagotomy, epinephrine-induced arrhythmias were studied in 31 rabbits anesthetized with 1 MAC enflurane. METHODS: Logdose protocol was used for the infusion of epinephrine; its arrhythmic dose being defined as the smallest infusion rate produced four or more continuous or intermittent arrhythmias within 15 seconds. RESULTS: The values (geometric mean) of arrhythmic doses and the plasma concentration of epinephrine during arrhythmia were as follows: 10.21 g.kg 1.min 1 and 83.16 ng/ml in epidural control group; 118.90 g.kg 1.min 1 and 677.76 ng/ml in epidural lidocaine group (p<0.05); 6.34 g.kg-1.min 1 and 96.42 ng/ml in intravenous lidocaine group; 8.65 g.kg 1.min-1 and 44.64 ng/ml in vagotomized-epidural control group; and 12.03 g.kg 1.min 1 and 95.35 ng/ml in vagotomized- epidural lidocaine group. CONCLUSIONS: The data suggest that thoracic epidural anesthesia raises the threshold for enflurane- epinephrine arrhythmias in rabbits and that this effect is eliminated by bilateral vagotomy.
Anesthesia, Epidural* ; Arrhythmias, Cardiac* ; Enflurane ; Epinephrine ; Lidocaine ; Plasma ; Rabbits* ; Vagotomy*

Phospholipase C (PLC) isozymes play significant roles in transmembrane signal transduction. PLC- 1 is one of the key regulatory enzymes in signal transduction for cellular proliferation and differentiation. The exact mechanisms of this signal transduction of tissue damage and subsequent regeneration, however, were not clearly documented. This study was planned to determine the biological significance of PLC isozymes following irradiation in rat small intestine. Sprague-Dawley rats were irradiated to the entire body by a single dose of 8 Gy. The rats were divided into 5 groups according to the sacrifice days after irradiation. The expression of PLCs in each group was examined by the immunohistochemistry and immunoblotting. The histologic findings were observed using hematoxylin and eosin staining. The regenerative activity, which was estimated by mitotic count and proliferatin cell nuclear antigen (PCNA) immunostaining, was highest in Group III (5th day after irradiation). By the immunohistochemistry, the expression of PLC- 1 was higher in Group III and Group II (3rd day after irradiation), and was found in the regenerative zone of the mucosa. The expression of PLC- 1 was highest in Group I (1st day after irradiation) and was dominantly in the damaged surface epithelium. The immunostaining of PLC- 1 was negative in all groups. The results of the immunoblotting study was compatible to that of the immunohistochemical study. Group II and III showed positive bands for PLC- 1, and group I and II for PLC- 1. These results suggest that PLC- 1 plays a significant role in mucosal regeneration following irradiation. PLC- 1 may play a role in radiation - induced mucosal damage.
Animals ; Cell Proliferation ; Eosine Yellowish-(YS) ; Epithelium ; Hematoxylin ; Immunoblotting ; Immunohistochemistry ; Intestine, Small* ; Isoenzymes* ; Mucous Membrane ; Phospholipases* ; Rats ; Rats, Sprague-Dawley ; Regeneration* ; Signal Transduction ; Type C Phospholipases*

A clinical study was performed of the respiratory care of 1309 critically ill patients who had been admitted to respiratory intensive care units (RICU) in 1986 and 1987. 1) The number of patients who needed respiratory care was 691 and the mortality in RICU was 1.45% (10 case) in 1986, and 618 and 2.59% (16 cases) in 1987, respectively. 2) The average duration of ventilatory support was 2.1 days in 1986, and 1.9 days in 1987. The patients of thoracic surgery needed respiratory support for 2.6 days in 1986, and 2.3 days in 1987. 3) The mortalities according to department were:1.42% (6 of 424 cases) in thoracic surgery, 1.89% (2 of 107 cases) in general surgery, 20% (1 of 5 cases) in pediatry surgery, and 7.14% (1 of 14 cases) in gynecology in 1986. In 1987, 2.56% (8 of 312 cases) in thoracic surgery, 4.0% (6 of 150 cases) in neurosurgery, 0.96% (1 of 104 cases) in general surgery, and 7.69% (1 of 13 cases) in urology. 4) The most frequently used ventilator was Bear II, followed by Benett MA-I. 5) The major causes of death in RICU were low cardiac output syndrome, sepsis, respiratory failure, and brain damage.
Brain ; Cardiac Output, Low ; Cause of Death ; Critical Illness* ; Gynecology ; Humans ; Intensive Care Units ; Critical Care* ; Mortality ; Neurosurgery ; Respiratory Insufficiency ; Sepsis ; Thoracic Surgery ; Urology ; Ventilators, Mechanical

BACKGROUND: Ideal Body Weight(IBW) is commonly used to determine obesity levels because of its usefulness as target weight. This study was attempted to evaluate the comparative consistency between standards of determining obesity levels using the BMI and IBW. And the authors here provide a definition of IBW and attempt to suggest a new classification of obesity by IBW. METHODS: The test subjects for the research were 24,816 patients who received treatment at the SNUH Health Promotion Center between May 1, 1996 and December 31, 1999. The comparative consistency between standards of determining obesity levels using the BMI and IBW were analyzed calculating the kappa value. RESULTS: The IBW from the Broca method produced a kappa value of 0.668(p<0.001), while the calculation method for IBW recommended by the Japan Obesity Institute produced a kappa value of 0.664(p<0.001). On the other hand, an IBW calculated as 21(kg/m2)X[height(m)]2 (kg) produced the highest value of consistency at a kappa value of 0.911(p<0.001). After calculating IBW as 21(kg/m2)X[height(m)]2 (kg) and comparing the kappa values while adjusting the boundary zone standards, it was found that defining underweight as below 88% of IBW and obesity as above 145% produced the highest value of concurrence at a kappa value of 0.935(p<0.001). CONCLUSION: The validity and confidence with respect to the definition of IBW and the determination method for obesity as proposed by the authors may be confirmed through the methods high level of consistency [kappa value=0.935(p<0.001)] with determination methods using the BMI.
Body Mass Index* ; Classification ; Hand ; Health Promotion ; Humans ; Ideal Body Weight* ; Japan ; Obesity* ; Thinness