No abstract available.
Oculomotor Nerve Diseases ; Oculomotor Nerve

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*

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

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*

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

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

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

OBJECTIVES: Premature ovarian failure (POF) is a syndrome defined as the cessation of ovarian function before the age of 40 years that is characterized by amenorrhoea associated with elevated gonadotropin levels. The aim of this study was to compare clinical manifestation of primary amenorrhea and secondary amenorrhea group. METHODS: This study was designed as a retrospective multicenter study of 262 women with premature ovarian failure. Sixty eight women with primary amenorrhea and 194 women with secondary amenorrhea were evaluated and hormonal level, lipid profile, bone mineral density, and pregnancy rates were compared. RESULTS: The estradiol level was markedly lower in primary amenorrhea than secondary amenorrhea. The pregnancy rate of 43.3% before the diagnosis in secondary amenorrhea was markedly higher than the rate of 0% in primary amenorrhea. The pregnancy rates after treatment was 5.9% in primary amenorrhea, but 1.0% after diagnosis and 2.8% after treatment in secondary amenorrhea. The pregnancy rate after hormonal treatment was 3.7% in total, 8.3% in primary amenorrhea, and 2.8% in secondary amenorrhea. In nine cases of pregnancy, seven cases were after estrogen-progestin (EP), one case was after clomiphene citrate and one case was after EP/human menopausal gonodotropin (hMG). And In nine cases of pregnancy, six cases resulted from oocyte donation. The prevalence of osteopenia/osteoporosis was markedly higher in primary amenorrhea than in secondary amenorrhea. CONCLUSION: Premature ovarian failure has negative influences on the physical and psychological health of young patients. Effective management should include earlier diagnosis and intensive medical intervention to relieve symptoms of estrogen deficiency and to treat long-term disease such as osteoporosis and in assisted pregnancy by oocyte donation.
Amenorrhea ; Bone Density ; Clomiphene ; Estradiol ; Estrogens ; Female ; Gonadotropins ; Humans ; Oocyte Donation ; Osteoporosis ; Pregnancy ; Pregnancy Rate ; Prevalence ; Primary Ovarian Insufficiency ; Retrospective Studies