No abstract available.
Oculomotor Nerve Diseases ; Oculomotor Nerve

No abstract available.
Cyclophosphamide* ; Doxorubicin* ; Drug Therapy, Combination* ; Etoposide* ; Small Cell Lung Carcinoma*

Psychosis is the most severe psychiatric complication of epilepsy surgery, We report two cases of newly-developed psychosis after temporal lobectomy, First case is a 46-year-old man with mesial temporal lobe epilepsy who presented recurrent postictal psychosis 1 year after right temporal lobectomy. Second case is a 44-years-old woman who presented chronic psychosis 6 month after left temporal lobectomy. Main psychotic symptoms were paranoid persecutory delusion. The common features in both cases were middle age, ling duration of epilepsy, and bilateral independent spike on preoperative EEG. Even if postoperative psychosis is rare, careful observation is needed because temporal lobectomy is an ever-increasing treatment.
Delusions ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe ; Female ; Humans ; Middle Aged ; Psychotic Disorders*

BACKGROUND: Since 1992, we developed the technique for video endoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Compensatory hyperhidrosis, however, is the main cause of patient dissatisfaction after video-assisted thoracoscopic sympathectomy. According to many authors, initial satisfaction rate was high(94-98%), but it was declined with time (66%) due to mainly to embarrassing side effects. MATERIAL AND METHOD: From January 1992 to February 1998, the thoracoscopic T2 sympathicotomy, T2 sympathectomy and T2-4 sympathectomy were performed in 315 patients suffering from Essential hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Eighty-nine patients underwent T2 sympathicotomy, and Eighty-eight patients underwent division T2 sympathectomy. RESULT: All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis. The global rate of compensatory sweating were ; 64.0% in T2 sympathicotomy, 73.8% in T2 sympathectomy and 87.8% in T2-4 sympathectomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathicotomy 15.7%(14/89) and in T2 sympathectomy 32.8%(28/88) than in T2-4 sympathectomy 58.0%(80/138) with significancy in statistic analysis(p<0.05). Video- assisted thoracoscopic sympathectomy is an effective minimally invasive and effective procedure. CONCLUSION: We suggest that the incidence and degree of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy.
Humans ; Hyperhidrosis* ; Incidence ; Korea ; Respiratory Center ; Seoul ; Sweat ; Sweating ; Sympathectomy*

The diagnosis of acute inflammation of the placenta, represented as acute chorioamnionitis, is important in that it is associated with a poor clinical outcome for both the mother and the fetus, including major perinatal morbidities such as sepsis, respiratory distress syndrome, and CNS damage. However, current medical trends in Korea seem to overlook the significance of a histopathological diagnosis of acute placental inflammation, mainly due to the indifferences of clinicians and pathologists. Since late 1993, histopathological examinations have been performed on preterm placentas at Seoul National University. These examinations have demonstrated acute placental inflammation in a significant number of cases. In the present study the incidence of acute placental inflammation was analyzed in 521 placentas which were submitted for pathological examinations in 1995. Examinations were performed to provide basic information on the incidence and profile of acute placental inflammation in this hospital and, thereby, to emphasize the significance of histopathological examinations of the placenta in the routine surgical pathology service. Among the 521 placentas, acute inflammation was found in 194 cases (37.2%). In preterm placentas acute inflammation was found in 39.6% of the cases (67/169), while 36.1% (127/352) of term placentas showed acute inflammation. Taking the delivery mode into account, 26.3% (49/186) of the placentas delivered by cesarean section showed acute inflammation, while 43.3% (145/335) of the transvaginally delivered placentas showed inflammation. The present analysis demonstrates the existence of acute inflammation in a significant proportion of placentas with different clinical settings. The importance of a histopathological examination in routine hospital practice should be emphasized.
Incidence

BACKGROUND: Although hyperbaric oxygen (HBO) -100% oxygen at two to three times the atmospheric pressure at sea level-has a number of beneficial biochemical, cellular, and physiologic effects, it is intrinsically associated with the potential for producing mild to severe toxic effects. The contribution of the cellular adhesion molecules and macrophages in the renal oxygen toxicity is not well understood. Thus, we have investigated the toxic effect of HBO expressed by the analysis of intercellular adhesion molecule-1 (ICAM-1) and infiltration of macrophages in rat kidney. METHODS: Male Sprague-Dawley rats weighing about 250 g were exposed to HBO at 3 ATA of 100% O2 for 4 hours. The expression of ICAM-1 and infiltration of CD68-positive macrophages were serially observed by immunohistochemical analysis. RESULTS: At 3 days after HBO exposure, CD68-positive macrophage counts were increased in glomeruli and tubulointerstitium of kidney. The expression of ICAM-1 was enhanced 1 day after HBO exposure and increased more for 3 days. There was a significant correlation between ICAM-1 expression and macrophage accumulation in the glomeruli. At 7 days after HBO, those alterations recovered to normal status. CONCLUSION: The 4-hour HBO exposure induced ICAM-1 expression and macrophage accumulation in the kidney and these change lasted for 3 days. Therefore, sustained activation of macrophages in renal oxygen toxicity may occur after prolonged (more than 4 hours) or repetitive exposures to HBO.
Animals ; Atmospheric Pressure ; Humans ; Intercellular Adhesion Molecule-1* ; Kidney* ; Macrophages ; Male ; Oxygen* ; Rats* ; Rats, Sprague-Dawley

PURPOSE: This study was conducted to identify prognostic factors in gastric cancer without lymph node metastasis and to specifiy which prognostic factors can be available in detail according to the depth of invasion. MATERIALS AND METHODS: This retrospective study was based on the medial records of 268 gastric cancer patients who received resectional therapy from 1990 to 1999. The patients who revealed pT2NOMO, pT3NOMO, pT4NOMO on postoperative pathologic reports were enrolled. The survival rate was analyzed according to clinicopathologic and therapeutic factors. RESULTS: According to the depth of invasion, the number of patients with pT2a, pT2b, pT3 and pT4 were 86 (32.1%), 56 (20.9%), 108 (40.3%), and 18 (6.7%) respectively. Age, depth of invasion, histological type, Borrmann type, and Lauren classification were statistically significant in the univariate analysis, and the age, the depth of invasion, and Lauren classification were independent prognostic factors identified by multivariate analysis. On multivariate analysis of subgroups according to the depth of invasion, the independent prognostic factors were age, Borrmann type, and Lauren classification in pT2, and age, Lauren classification , and vascular invasion in pT3. The prognostic factors of pT4 patients could not be analyzed due to limited sample size. CONCLUSION: In advanced gastric cancer patients without lymph node metastasis, age, the depth of invasion, and Lauren classification should be checked to predict prognosis. In patients with pT2 lesion among the above patients, the Borrmann type should be added in check-list.
Classification ; Humans ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Metastasis* ; Prognosis ; Retrospective Studies ; Sample Size ; Stomach Neoplasms* ; Survival Rate

The conventional surgical treatment of isolated critical stenosis of the left main coronary artery restores a less physiologic perfusion of the myocardium, leads to occlusion of the left coronary ostium, and consumes an appreciable length of bypass material. From June 1994 to February 1996, eleven patients, three male and eight female, underwent patch angioplasty and additional bypass graft to left anterior descending artery (10 internal mammary artery, 1 saphenous vein) in isolated critical left main coronary artery stenosis. Their ages ranged from 34 to 62 years, mean 44 years. All had 60% to 90% stenosis of the left main coronary artery and Class III angina. The angiogram showed nine osteal lesion and three main stem stenosis. The operation was performed with conventional cardiopulmonary bypass and cold blood cardioplegia. We approached anteriorly and used bovine pericardium as onlay patch in all patients. There were one leg wound dehiscence, but no operative deaths and infarctions. All patients are free of symptoms after a mean follow-up of 15.5 months. Angiographic restudy at an average 14.4 months was obtained in five patients and showed widely patent left main coronary artery with excellent runoff. But additional graft to left anterior descending coronary artery were stenosed in two patients and showed diminutive flow in others. Our preliminary results suggest that angioplasty of the left main coronary artery can be carried out with low operative risks. But additional bypass graft to left anterior descending coronary artery may be unnecessary. The technique appears to be a promising alternative to conventional coronary artery bypass grafting in isolated left main coronary artery stenosis.
Angioplasty* ; Arteries ; Cardiopulmonary Bypass ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Follow-Up Studies ; Heart Arrest, Induced ; Humans ; Infarction ; Inlays ; Leg ; Male ; Mammary Arteries ; Myocardium ; Perfusion ; Pericardium ; Transplants ; Wounds and Injuries

OBJECTIVE: To evaluate the actual condition of management of stump and prosthesis, difficulties with or without prosthesis in the activities of daily living and the present status of cognizance of rehabilitation services in amputees. METHOD: This study was designed as a questionnaire survey. The questionnaire included the general demographic characteristics, causes of amputation, amputation level and time, practical status of fitting and management of prosthesis, satisfaction of prosthesis, difficulties in activities of daily living under prosthesis. The change of recognition of rehabilitation medicine and the degree of acceptance of rehabilitation services followed by duration-after amputation was also investigated. RESULTS: The most common cause of amputation was vehicular accidents and the mean age was 35.6 years old. The results showed that the amputees had low satisfaction in the prosthesis itself and the management. The role of rehabilitation medicine in fitting and management of prosthesis was insignificant. The 69% of amputees answered that the rehabilitation services were provided after the amputation, but only 40% of amputees reported they had known the services were provided by rehabilitation medicine. This discrepancy probably implied the poor recognition of the role of rehabilitation medicine, even though the rehabilitation services provided to the amputees has been significantly increased in recent 5 years. CONCLUSION: There is a little progress of recognition and role of rehabilitation medicine although the acceptants of rehabilitation services were increased. Physiatrists should take an active participation to the amputee community for extension of recognition and role of rehabilitation medicine.
Activities of Daily Living ; Amputation ; Amputees ; Humans ; Prostheses and Implants ; Surveys and Questionnaires

PURPOSE: The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. MATERIAL AND METHODS: Between March 1983 and June 1994, 60 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patints with median follow up duration 50 months (range 6- 162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58%) was the most frequent site of occurrence followed by trunk (20%) and head and neck (12 %). Histologically malignant fibrous histiocytoma (23%), liposarcoma (17%), malignant schwannoma (12%) constitute 52% of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42%) received chemotherapy with various regimen in the postoperative period. RESULTS: Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48%) of local recurrence. Four patients (7%) developed simultaneous local recurrence and distant metastasis and 8 patients (13%) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head andneck primary. This feature is likely explanation for the decreased local control rate. Five of 29 patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 %, 36.6% respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). CONCLUSION: Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.
Disease-Free Survival ; Drug Therapy ; Extremities ; Female ; Follow-Up Studies ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Liposarcoma ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Neurilemmoma ; Postoperative Period ; Recurrence ; Retrospective Studies ; Sarcoma* ; Survival Rate