Subretinal fluid drainage produces the indentation of the sclera by facilitating firm adhesion between the retina and either retinal pigment epithelium or Bruch's membrane and has the advantage that show the state of fundus and degree of indentation of sclera accurately during the operation. Becaulse it has complications such as choroidal bleeding, retinal incarceration, iatrogenic retinal break, choroidal detachment and loss of vitreous, it should be done carefully. The authors analyzed the clinical data of 128 cases(137 eyes) of retinal detachment surgery with subretinal fluid drainage at the Department of Ophthalmology, Pusan Paik Hospital, College of medicine, Inje University from May, 1988 to April, 1990. And the results were as follows: 1. The most common operative method of rhegmatogenous retinal detachment were explant buckling and encirclement with subretinal fluid drainage, and the success rate of first operation was 86.13% and the overall success rate of rhegmatogemous retinal detachment was 91.2% in 137 eyes of operation. 2. In 116 cases(92.8%) who were done subretinal fluid drainage, absorption of residual subretinal fluid took in a day. 3. The most common cause of surgical failure was proliferative vitreoretinopathy. 4. The most common complication was choroidal hemorrhage and it was developed 14 eyes(10.2%) mong 137 eyes. 5. The preoperative duration of symptom and extent of detachment were influenced to the surgical success rate and they had statistical significance(p<0.05). 6. The power of refraction was changed to myopia and ERG b-wave amplitude were increased and 89 eyes out of 137 eyes(69.6%) showed an improvement of vision at the three months after retinal detachment surgery.

Subtalar dislocation of the foot is one in which there is simultaneous dislocation of the talonavicular joint and talocalcaneal joint while the tibiotalar relationship is unchanged. It was described first by Judey and Defourest in 1811. It incidence was 1% to 1.3% of all dislocations and 15% of injuries of the talus. We have experienced one case of a medial subtalar dislocation without fracture. In our case which was followed for 14 months, the head of the talus was palpable on the dorsum of the foot and the heel was displaced medially in relation to the leg. Radiographically, on the lateral view, the head of the talus was shown superior to the navicular and on the A-P view, the normal talonavicular relationship was disturbed with the calcaneus being displaced medially. The closed reduction was carried out successfully.
Calcaneus ; Dislocations ; Foot ; Head ; Heel ; Incidence ; Joints ; Leg ; Subtalar Joint ; Talus

No abstract available in English.
Femur ; Fracture Fixation, Intramedullary

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new surgical option using endoscopic advancement to the peritoneal cavity through the stomach, colon, vagina, or urinary bladder without an abdominal wall scar (incision). The aim of this study was to assess the feasibility of transgastric gastroscopic intra-abdominal exploration with gastric incision and closure before the NOTES would be done. METHODS: Under general anesthesia of a female dog, one-channel gastroscope was advanced to the stomach and the lumen was irrigated with anti-bacterial solution. The anterior wall of the antrum was incised by about 1 cm with a needle knife; then, the gastroscope was advanced into the peritoneal cavity. An exploration of the entire intra-abdominal cavity was performed. RESULTS: We were able to evaluate the stomach, the greater omentum, the diaphragm, the peritoneum, the urinary bladder, the bowel, the spleen, the liver, the gallbladder, the uterine horn, the uterine body, and the vagina, but could not evaluate the ovary, the kidney, and the pancreas. The observation of the abdominal cavity was followed by the gastric wall closure with a 135o endoclip. The dog was recovered after confirmation of secure closure of the incision site. CONCLUSIONS: Transgastric incision, closure, and abdominal exploration are feasible without an abdominal wall scar, and the NOTES can be one option for future abdominal operations in humans and needs to be further investigated.
Abdominal Cavity ; Abdominal Wall ; Anesthesia, General ; Animals ; Cicatrix ; Colon ; Diaphragm ; Dogs* ; Female* ; Gallbladder ; Gastroscopes ; Horns ; Humans ; Kidney ; Liver ; Natural Orifice Endoscopic Surgery ; Needles ; Omentum ; Ovary ; Pancreas ; Peritoneal Cavity ; Peritoneum ; Spleen ; Stomach ; Urinary Bladder ; Vagina

No abstract available.
Arthritis, Infectious* ; Knee*

The uterine cervical cancer is the rnost common tumor of malignant gynecologic tumors and complete remission of the cancer has been possible through early diagnosis and treatment. To evaluate the efficacy of tumor markers SCCA and CEA in patients with uterine cervical cancer as markers for monitoring, we analyzed serum SCCA and CEA crncentrations of 43 patients wit.h uterine cervical caner as a study group and 73 patients with benign pelvic disease as a contrnl group, were admitted to depar tment of Obstetncs & Gynecology, College of Medicine, Kyung Hee University from May 1991 to January 1993. The results were as follows ; 1. The distrihution of the clinical stages of 43 cervical cancers were : CIS 9, stage I 11, stage II 12, stageg III 5, stage lV 6. 2. The positive rate of SCCA of control group was 17%, and that of CEA nf control group was 12%. And the positive rate of SCCA of study group was 46.5% and that of CEA of study was 27.9%. 3. The average concentration of SCCA of control group was 0.71ng/ml and that of SCCA of study group was 8.25ng/ml(p<0.05). 4. The average concentration of CEA of control group was 1.95ng/ml and that of CEA of study group was 8.33ng/ml(p<.0.05). 5. The average concentration of SCCA by stage were 1.15ng/rnl for C1S, 1.14ng/ml for stage I, 9.72ng/rnl for stage III, 16.75ng/rnl for stage III, 21.95ng/ml for stage IV. Here, the mean value of SCCA was increased stepwise through cliinical stage, there was a correlation between the clinical stage and the concen tration of serum SCCA (p>0.05). 6.The average concentration of CEA by stage were 3.11ng/ml for CIS, 1.96ng/ml for stage I, 8.11ng/rnl for stage II, 18.92ng/ml for stage III, 19.44ng/ml for stage IV. There was not a correlation between the clinical stage and the concentration of serm CEA. 7. When the cervical cancer was divided by histologic subtypes, the average concentration of SCCA in squamous cell carcinoma of uterine cervix was 11.86ng/ml and the positive rate of SCCA in squamous cell carcinoma was 53.6%(9.46ng/ml & 58.8% in large keratinizing cell type, 15.56ng/ml & 45.5% in large nonkeratinizing cell type). And the average concentration of SCCA in adenocarcinoma was 1.32ng/ml positive rate was 40.0%. The tumor marker SCCA was more sensitive to squamous cell carcinoma rather than adenocarcinoma. 8. The sensitivities of SCCA in preinvasive cancer and invasive cancer were 22.2% and 52.9%, respectively. The average concentration of SCCA in invasive cancer was 10.04ng/ml and was more significantly elevated than of SCCA in preinvasive cancer. 9. Using SCCA & CEA together as markers for monitoring, the positive rate significantly incresaed to 70.6%(p<0.05). But measuring the two tumor marker alone, that not significantly increased. 10) . The diagnostic efficacy of SCCA in cervical cancer was 59.0%, that was higher as compaired with that of CEA. These results suggest that the serum concentration of SCCA is significantly increased stepwise by clinical stage and concomitant measurements of serum SCCA & CEA are more useful in diagnosis of cervical cancer. However measurements of SCCA and/or CEA have little efficacy in the detection of early cervical cancer considering it's low rate of positivity in early cervical cancer. We will evaluate the efficacy of two tumor markers in determining prognosis, therapeutic response and early detection of recurrence for the posttreatment patients in the future.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Female ; Gynecology ; Humans ; Prognosis ; Recurrence ; Selective Estrogen Receptor Modulators ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

PURPOSE: Leptin is the product of the of gene secreted by adipocyte. The serum leptin concentration reflects the amount of adipose tissue in the body. We investigated whether leptin concentration was detectable in cord blood of newboms and assessed the effect of gestational age, birth weight, birth length, placental weight, body mass index and ponderal index on cord blood leptin concentration in full-term and preterm newboms. METHODS: Eighty-two newboms were enrolled in this study. Standard growth curves were used to categorize infants as appropriate (AGA), large (LGA), or small for gestational age (SGA). Gestational age, birth weight, length and placental weight were measured. Maternal age, weight and height were measured. Cord blood and maternal venous samples were collected and serum was separated and stored at -70C. Leptin was measured by radioimmunoassay. RESULTS: The mean leptin concentration in full term babies was 8.9+/-9.6 ng/ml compared with 3.5+/-0.6 ng/ml in preterm babies. Leptin concentrations in cord blood of full term babies were significantly increased in cornparison with those in cord blood of preterm babies. Mean serum leptin concentration of SGA infants was significantly lower than in AGA infants and that of LGA was higher than in AGA infants. In full-term and preterm neonates, there was significant positive correlation of leptin concentrations with birth weight, gestational age, birth length, BMI, ponderal index and placental weight. No gender differences were found in cord blood leptin. Maternal age, maternal body mass index, matemal weight at baseline (before pregnancy) and at birth were not significantly correlated with leptin concentration of full-term and preterm neonates. There was no significant correlation between leptin concentration of cord blood and matemal leptin concentration. CONCLUSION: The serum leptin concentration is highly correlated to the size of adipose tissue mass of newborn infant. Leptin may be responsible for regulation of body mass of human neonates and can be used as marker of the nutritional status and growth of fetal and neonatal period.
Adipocytes ; Adipose Tissue ; Birth Weight ; Body Mass Index ; Body Weight ; Fetal Blood* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Leptin* ; Maternal Age ; Nutritional Status ; Parturition ; Radioimmunoassay

A case of Korean hemorrhagic fevery confirmed by fluorescent antibody technique in a 8years old boy was reported with a brief review of references.
Fluorescent Antibody Technique* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Male