23 eyes of 23 patients who underwent conventional vitreoretinal surgery with high specific gravity perfluorocarbon liquid, perfluorophenanthrene, for complicated retinal detachment were evaluated retrospectively. Preoperative vitreoretinal findings showed grade C2 PVR in 4 eyes and C3 in 1 eye and C4 in 10 eyes and C5 in 8 eyes. As a result, 17 eyes(74%) showed anatomical success, completely reattached in 15 eyes, partially reattached in 2 eyes, and 12 eyes(52%) showed functional success (corrected visual acuity 5/200 or better). Follow-up period was over 6 months in all cases. Postoperative complications includes keratopathy in 6 eyes, hypotony in 5 eyes, cataract in 2 eyes, transient vitreous hemorrhage in 1 eye, acute increased IOP in 1 eye, posterior synechiae in 1 eye, cystoid macular edema in 1 eye, and pupillary membrane in 1 eye. Consequently, perfluorophenanthrene can be used beneficially in yield of surgical field and mechanical stabilization of retina in complicated retinal detachment surgery.
Cataract ; Follow-Up Studies ; Humans ; Macular Edema ; Membranes ; Postoperative Complications ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Specific Gravity ; Visual Acuity ; Vitreoretinal Surgery ; Vitreous Hemorrhage

We present one case report of anterior urethral diverticulum in a male with giant calculi. The patient was a 56-year-old male with the complaints of base-ball sized palpable scrotal mass and post-void dribbling for 15-16 years. The diverticulum was filled with multiple whitish-yellow stones. The largest one was 8X7X6cm in size.
Calculi* ; Diverticulum* ; Humans ; Male* ; Middle Aged

PURPOSE: A retrospective study was undertaken to determine the role of conventional radiotherapy with or without surgery for treating a supraglottic carcinoma in terms of the local control and survival. MATERIALS AND METHODS: From Jan. 1986 to Oct. 1996, a total of 134 patients were treated for a supraglottic carcinoma by radiotherapy with or without surgery. Of them, 117 patients who had completed the radiotherapy formed the base of this study. The patients were redistributed according to the revised AJCC staging system (1997). The number of patients of stage I, II, III, IVA, IVB were 6 (5%), 16 (14%), 53 (45 %), 32 (27%), 10 (9%), respectively. Eighty patients were treated by radical radiotherapy in the range of 61.2~79.2 Gy (mean : 69.2 Gy) to the primary tumor and 45.0~93.6 Gy (mean : 54.0 Gy) to regional lymphatics. All patients with stage I and IVB were treated by radiotherapy alone. Thirty-seven patients underwent surgery plus postoperative radiotherapy in the range of 45.0~68.4 Gy (mean : 56.1 Gy) to the primary tumor bed and 45.0~59.4 Gy (mean : 47.2 Gy) to the regional lymphatics. Of them, 33 patients received a total laryngectomy (+-lymph node dissection), three had a supraglottic horizontal laryngectomy (+-lymph node dissection), and one had a primary excision alone. RESULTS: The 5-year survival rate (5YSR) of all patients was 43%. The 5YSRs of the patients with stage I+I, III+V were 49.9%, 41.2%, respectively (p=0.27). However, the disease-specific survival rate of the patients with stage I (n=6) was 100%. The 5YSRs of patients who underwent surgery plus radiotherapy (S+T) vs radiotherapy alone (RT) in stage II, III, IVA were 100% vs 43% (p=0.17), 62% vs 52% (p=0.32), 58% vs 6% (P<0.001), respectively. The 5-year actuarial locoregional control rate (5YLCR) of all the patients was 57%. The 5YLCR of the patients with stage I, II, III, IVA, IVB was 100%, 74%, 60%, 44%, 30%, respectively (p=0.008). The 5YLCR of the patients with S+T vs RT in stage II, III, IVA was 100% vs 68% (p=0.29), 67% vs 55% (p=0.23), 81% vs 20% (P<0.001), respectively. In the radiotherapy alone group, the 5YLCR of the patients with a complete, partial, and minimal response were 76%, 20%, 0%, respectively (P<0.001). In all patients, multivariate analysis showed that the N-stage, surgery or not, and age were significant factors affecting the survival rate and that the N-stage, surgery or not, and the ECOG performance index were significant factors affecting the locoregional control. In the radiotherapy alone group, multivariate analysis showed that the radiation response and N-stage were significant factors affecting the overall survival rate as well as locoregional control. CONCLUSION: In early stage supraglottic carcinoma, conventional radiotherapy alone is an equally effective modality compared to surgery plus radiotherapy and could preserve the laryngeal function. However, in the advanced stages, radiotherapy combined with concurrent chemotherapy for laryngeal preservation or surgery should be considered. In bulky neck disease, all the possible planned neck dissections after induction chemotherapy or before radiotherapy should be attempted.
Drug Therapy ; Humans ; Induction Chemotherapy ; Laryngectomy ; Multivariate Analysis ; Neck ; Neck Dissection ; Radiotherapy* ; Retrospective Studies ; Survival Rate

No abstract available.
Animals ; Dopamine* ; Models, Animal* ; Parkinsonian Disorders* ; Rats* ; Receptors, Dopamine*

Mitral stenosis is characterized by chronic pulmonary arterial hypertension. Although it is well recognized that right ventricle can be affected by pressure-overload in patients with mitral stenosis, the study for effects on right ventricular function after relief of pressure overload was difficult after open heart surgery due to paradoxical septal motion and scarring change of pericardium. Recently, percutaneous mitral valvuloplasty(PMV) has been used in patients with mitral stenosis as an alternative to surgical mitral commissurotomy. The present study was designed to demonstrate the difference of right ventricle between normal subjects and patients with mitral stenosis, as well as to investigate the changes of right ventricle before and after PMV with Doppler- echocardiography and isovolumic indices. The results were summarized as follows : 1) Right ventricular emptying fraction which was assumed to be proportional to right ventricular ejection fraction was depressed significantly in patients with mitral stenosis than those of normal subjects. However, there were no sighificant differences in Vpm between the two groups. 2) Right atrial and ventricular areas of patients with mitral stenosis were enlarged significantly than those of normal subjects. Right ventricular diastolic function measured by transtricuspid pulsed Doppler showed relaxation abnormality pattern in patients with mitral stenosis. 3) Enlarged right atrium and ventricular area were decreased significantly after PMV. Depressed right ventricular sytolic and diastolic function were recovered after relief of pressure-overload by PMV. However, there were no significant changes in Vpm after PMV. 4) Right ventricular emptying fraction was inversely correlated with mean pulmonary artery pressure and right ventricular end-diastolic area. Discriminant factor between group with right ventricular diastolic dysfunction and group without diastolic dysfunction was pulmonary vascular resistance. In conclusion, there were right ventricular systolic and diastolic dysfunction without abnormal right ventricular contractility in patients with mitral stenosis, moderate pulmonary hypertension and normal sinus rhythm, and these functional abnormalities were largery reversible after relief of pressure-overload on the right ventricle by PMV.
Cicatrix ; Echocardiography ; Heart Atria ; Heart Ventricles ; Humans ; Hypertension ; Hypertension, Pulmonary ; Mitral Valve Stenosis* ; Pericardium ; Pulmonary Artery ; Relaxation ; Stroke Volume ; Thoracic Surgery ; Vascular Resistance ; Ventricular Function, Right*

Stroke is a rare but serious complication of acute myocardial infarction (AMI). Currently, glycoprotein (GP) IIb/IIIa inhibitor is used in clinical practice for acute coronary syndromes and percutaneous coronary interventions (PCIs). The incidence of stroke in patients receiving GP IIb/IIIa inhibitor during PCIs is very low. We report the case of a 47-year-old man who presented with AMI and suffered an acute cerebral infarction after infusion of a GP IIb/IIIa inhibitor following primary PCI.
Acute Coronary Syndrome ; Cerebral Infarction ; Glycoproteins ; Humans ; Incidence ; Middle Aged ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stroke

PURPOSE: To evaluate the role of curative radiotherapy alone in the treatment of uterine cervical carcinomas, by a retrospective analysis with respects to survival and pelvic control, and to find any risk factors of failure MATERIALS AND METHODS: Between Jan. 1990 and Dec. 1995, a total of 187 patients, diagnosed with uterine cervical carcinomas in FIGO stages greater than IA, were treated by curative radiotherapy alone with no chemotherapy. The ages of the patients ranged from 26 to 80 years, with a median of 60 years. The number of patients diagnosed with squamous cell carcinomas were 183 (97.9%). The number of patients with FIGO stage IB1, IB2, IIA, IIB, IIIA, IIIB and IVA were 61 (32.6%), 7 (3.7%), 43 (23.0%), 62 (33.3%), 3 (1.6%), 7 (3.7%) and 4 (2.1%), respectively. External radiotherapy was performed with 6 MV or 10 MV X-rays, with a dose range of 19.8 Gy~ 50.4 Gy (median; 30.6), to whole pelvis. Intracavitary radiation (ICR) was then performed using a high-dose rate remote controlled afterloader with radioisotopes of Co-60 and Cs-137. The fraction size of the ICR was 5 Gy twice a week, and was delivered up to total doses of 10 Gy~ 55 Gy (median; 40). After the ICR, additional pelvic external radiotherapy with midline shielding width of 4 cm was performed with the dose range of 0~30.6 Gy (median; 19.8), and the resultant total doses of A points ranged between 49.8 Gy and 86.0 Gy (median; 70.6). RESULTS: The five-year overall survival rates of FIGO IB1, IB2, IIA, IIB, III and IVA were 88.3%, 83.3%, 86.1%, 65.2%, 60.0% and 50.0%, respectively (p=0.005). The pelvic control rates of each stage were 90.1%, 85.7%, 86.1%, 69.4%, 68.6% and 50.0%, respectively (p=0.03). From the multivariate analysis, the radiation response and tumor diameter were found to be significant factors affecting the overall survival. The significant factors influencing pelvic control were the radiation response and pre-treatment hemoglobin level. CONCLUSION: The radiation response and tumor diameter were significant factors affecting survival, so patients with tumor diameters greater than 4 cm should be considered for a combined modality, such as concurrent chemoradiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Drug Therapy ; Humans ; Multivariate Analysis ; Pelvis ; Radioisotopes ; Radiotherapy* ; Retrospective Studies ; Risk Factors ; Survival Rate

Theophylline has been used for more than 50 years to treat bronchial asthma, and theophylline toxicity continues to be an encountered clinical problem. With suicidal intention, a 61-year-old depressive male patient was sent to the hospital after ingestion of overdose theophylline. He had been followed up for bronchial asthma with about 10 microgram/ mL average plasma theophylline level. On arrival, he complained of dyspnea, palpitation and the plasma theophylline level was 252 microgram/mL. After 2 hours of ingestion, hypotension and tachycardia developed (Systolic blood pressure 50 mmHg, heart rate 190/ min). Other symptoms and signs were stuporous mental state and hypoxemia. Patient's peak plasma theophylline level reached 402 microgram/mL after 3 hours. beta-blocker, dopamine and midazolam were used for control of tachycardia, hypotension and prevention of seizure respectively. After Gastric lavage and administration of charchoal, he was treated with hemoperfusion for 3.5 hours, and serum level decreased. The patient was discharged in good health after 17 days.
Anoxia ; Asthma ; Blood Pressure ; Dopamine ; Dyspnea ; Eating ; Gastric Lavage ; Heart Rate ; Hemoperfusion* ; Humans ; Hypotension ; Intention ; Male ; Midazolam ; Middle Aged ; Plasma ; Seizures ; Stupor ; Tachycardia ; Theophylline*

PURPOSE: The 2010 guidelines for cardiopulmonary resuscitation recommend a ventilation rate of 8 to 10/min for patients with an advanced airway; however, hyperventilation occurs in most cases. This study was conducted as an attempt to determine the effects of feedback under audio tone guidance on performance of positive-pressure ventilation using a bag-valve device and to apply this technique in clinical practice in order to reduce hyperventilation. METHODS: A total of 36 seniors at our medical school participated in the study. After receiving instruction in performance of positive-pressure ventilation using a bag-valve device, they performed ventilation using a cardiac arrest model with an advanced airway (Test 1). After they took Test 1 without any feedback, they were randomly assigned to the feedback group (Group A) and the control group (Group B) and took Test 2. In Group A, a high-pitched sound was delivered every 7 s for guidance of ventilation. RESULTS: In Group A, ventilation rate approximated feedback rate, whereas, in Group B, it showed a significant decrease, from 8.3+/-2.0 to 7.7+/-2.0/min (p<0.01). The mean ventilation volume did not differ between pre- and post-feedback. The mean inspiration time showed a decrease in both groups. However, no significant difference in mean inspiration time was observed between the two groups. CONCLUSION: Audio tone guidance can control the ventilation rate accurately without any significant change in ventilation volume and inspiration time.
Cardiopulmonary Resuscitation ; Heart Arrest ; Humans ; Hyperventilation ; Positive-Pressure Respiration ; Schools, Medical ; Ventilation

OBJECTIVE: In this experimental study, authors evaluated the effect of repeated graft of the fetal midbrain cells on rat model of hemiparkinsonism. MATERIALS AND METHODS: Following injection of the 6-hydroxydopamine into striatum, we examined the behavior (turning response to amphetamine and apomorphine) at 2, 4 and 8 weeks. Their turning behavior persisted until 8 weeks after lesion making. Only those with turning behavior of more than average 6.2turns/minute by amphetamine test were selected for transplantation. Three different methods of transplantation were assigned into three groups and compared with each other to evaluate their efficiencies in improving behavioral responses. In first method, the volume of the transplanted cells were equivalent to that of one fetal midbrain. The volume of the transplanted cells were twice as much as that of one fetal midbrain in a group with second method. The last group consisted of repeated transplantation. Here, we transplanted the same amount of fetal midbrain cells as the in group 2 with two divided doses in one month interval. RESULTS: The second and third group improved from amphetamine test significantly(p<0.05), whereas first group failed to show any significant improvement from same test. The results from second and third group were not significantly different from each other. CONCLUSION: This results suggest that transplantation of two volumes of the fetal midbrain is needed to improve the turning behavior of this model of parkinsonism. This volume can be tansplanted at once or it may be transplanted in two divided volumes with time interval, with similar effect.
Amphetamine ; Animals ; Mesencephalon ; Models, Animal* ; Oxidopamine* ; Parkinsonian Disorders ; Rats* ; Transplants*