Percutaneous Radiofrequency Ablation of Inoperable Primary Lung Cancer

PURPOSE: To present the initial experience of percutaneous radiofrequency ablation (RFA) of inoperable primary lung cancer, and to assess the technical feasibility and potential complications. MATERIALS AND METHODS: Twenty patients with inoperable lung cancer underwent percutaneous RFA. Nineteen of 20 patients had stage III or IV non-small cell lung cancer, and the remaining one had stage I lung cancer with pulmonary dysfunction. The mean tumor size was 4.6+/-0.4 cm (range, 1.8-8.4 cm). RFA was performed with a single (n=18) or cluster (n=2) cool-tip RF electrode and a generator under CT guidance using local anesthesia and conscious sedation. Twenty tumors were treated in 28 sessions. Patients were assessed by contrast-enhanced CT in all cases at 1 week, 1 month, and 3 months. Eleven patients received chemotherapy (n=10) or radiotherapy (n=1) after RFA. RESULTS: RFA was technically successful and well tolerated in all patients. Complete necrosis was attained in 7 lesions (35%), near complete (90-99%) necrosis in 10 lesions (50%), and partial (50-89%) necrosis in 3 lesions (15%). During the mean follow up of 202 days (21 to 481 days), tumor size was decreased in 13 patients, unchanged in 3, and increased in 4. In the latter four, additional RFA was performed. One patient underwent surgery three months after RFA and the histopathologic findings showed a large cavity with thin fibrotic wall suggestive of complete necrosis. During or after the procedure, pneumothorax (n=10), moderate pain (n=4), blood tinged sputum (n=2), and pneumonia (n=2) were developed. Chest tube drainage was required in only 1 patient due to severe pneumothorax. Other patients were managed conservatively. Seven patients died at 61 to 398 days (mean, 230 days) after RFA. The remaining 13 patients were alive 21 to 481 days (mean, 187 days) after RFA. CONCLUSION: RFA appears to be a technically feasible and relatively safe procedure for the cytoreductive treatment of inoperable, non-small cell lung cancer and warrants further investigation as a complementary treatment to chemotherapy or radiation therapy.

Clinical Results of Keratomileusis-in-situ for High Myopia

In order to investigate the clinical results of keratomileusis-in-situ for high myopia, the effects of the procedure on 54 patients(61 eyes) who were followed up at least for 3 months were analyzed retrospectively. Mean preoperative spherical equivalent(S,E) was -20.32 diopter(D) , while mean postoperative S.E was -3.70 D at 3 months, -4.81 D at 6 months, -5.82 D at 9 months and -6.13 D at 12 months. Postoperative myopic regression was more severe in male than in female patient group(P<0.01). Postoperative cylindrical change was not significant but uncorrected visual acuity was markedly improved. The complications of keratomileusis-in-situ were loss of corneal cap(3 eyes), foreign body in stromal interface(1 eyes), epithelial in growth(6 eyes), increased intraocular pressure (5 eyes), and keratitis(2 eyes). Keratomileusis-in-situ, when performed for severe high myopia with Ruiz nomogram, resulted in undercorrection. And progressive myopic regression was observed until 9 months after surgery especially for young male patients.

A Case of Tuberculosis of Lid

Infection of the lids by the Mycobacterium tuberculosis is uncommon. It usually arises by local extension from the skin adjacent to the lid, but it occasionally arises from the conjunctiva or hematogenous spread. Primary infection of the eyelid by Mycobacterium tuberculosis is very rare. The lid lesion shows brownish red papule that develops into an indurated nodule or plaque; it is occasionally associated with skin ulceration and regional lymphadenopathy. The diagnosis is established through specific histopathologic findings, tuberculin skin testing, and the stain and culture of acid-fast bacilli. It is also done indirectedly through the response to anti-tuberculosis medications. The regimen for treatment of tuberculosis is isoniazid and rifampin taken daily for 6 months. The authors experienced a case of tuberculosis of the lid which occurred in a 4 year-old female whose skin of the upper and lower eyelids showed brownish red nodules and which was treated with anti-tuberculosis medications.

A case of endogenous bacterial endophthalmitis developed in alcoholics patient

Endpgenous bacterial endophthalmitis develops mainly in a extremely ill patient or a immunologically compromised patient. As reported earlier, early suspicion and careful diagnostic evaluation and early aggressive treatment are important to treat endophthalmitis and prevent poor visual acuity. The authors experienced a case of endogenous endophthalmitis developed from pneumonia in chronic alcoholics patient. The pathogen was proved to be a Staphylococcus aureus by the culture of specimen obtained from the aqueous. Systemic, topical, subconjunctival and intravitreal antibiotic therapy were done, but the patient's eye progressed to phthisis state.

A Case of acute Exophthalmos due to Spreading of Chronic Frontal Sinusitis

It is not common that formation of retrobulbar abscess by inflammatory spreading of chronic frontal sinusitis and even rare that the abscess cause acute exophthalmos and ocular pain. But, if the acute exophthalmos with ocular pain arise from the patient associated with chronic rhinitis or paranasal sinusitis, it should be suspected that peri bulbar abscess was formed by spreading of these disease and otorhinologic examination should be taken. The authors experienced a case of acute exophthalmos with ocular pain in a 27-years old woman and founded that abscess arising from the chronic frontal sinusitis disrupted the superomedial wall of orbit and spread to the retrobulbar area by computed tomography and other radiologic evaluation. We had good result by performing incision and drainage and some otorhinologic therapy.

Reoperations for Undercorrected Esotropia

For undercorrected esotropia after bilateral medial rectus(MR) recession, we performed unilateral or bilateral MR rerecession, unilateral rerecession or marginal myotomy of the recessed medial rectus muscle combined with lateral rectus(LR) resection, or unilateral LR resection. The correction of deviation was 15 delta in unilateral 2.0mm MR rerecession. Bilateral 2.0mm MR rerecession corrected 20 to 25 delta of esodeviation, but undercorrection was noted in one case. With unilateral 2.0mm rerecession or marginal myotomy of the recessed medial rectus muscle combined with 5.5mm or 8.0mm LR resection, the correction of deviation was 26 to 29 delta, and there was no under- or overcorrection. The corrective effect of this procedure was therefore greater and more stable than that of bilateral 2.0mm MR rerecession. Unilateral 8.0mm LR resection performed 3 months after bilateral MR recession showed correction of 15 delta, whereas the same procedure performed 3 weeks after bilateral MR rerecession showed correction of 24 delta. Unilateral LR resection procedure seems to be more efficacious for residual esotropia if performed as soos as possible within 3 months after sufficient bilateral MR recession or rerecession.

A case of sacrococcygeal teratoma with spina bifida cystica in newborn

Sacrococcygeal teratoma is a rare tumor, it occurs once in every 40,000 live births. Most of the reported cases appear in female infant (M:F=1:4). They deserve clinical attention because they are potentially malignant and are curable if diagnosed and treated early. The patients may have associated congenital anomalies. This patient has spina bifida cystica in lower sacrum. Brief review of related literature is included in the report.

A case of hemolytic disease of the newborn due to anti-C / 대한수혈학회지

No abstract available.

Pefractive Changes After Encircling Scleral Buckling Surgery

Sixty rhegmatogenous retinal detachment patients who had received retinal detachment surgery by same surgeon at Yongdong Severance Hospital from Feb. 1990 to Feb. 1991 were evaluated prospectively to detect the refractive changes after operation. The authors studied the postoperative retinoscopic findings 3 months after retinal detachment surgery, and compared with preoperative refractive errors. The results were as follows; 1. The encircling scleral buckling with 3mm silicone sponge increased an average induced myopia of -1.63 diopter. 2. The segmental buckling increased an average induced myopia of -0.50 diopter. 3. The combined operation of encircling buckling and radial buckling increased an average induced myopia of -2.75 diopter. 4. The pneumatic retinopexy with SF6 gas caused never postoperative refractive changes.