The authors have studied on the effect of digital pressure on eyeball under the surface anesthesia instead of other reducing agents of intraocular pressure and retrobulbar anesthesia in order to lower the intraocular pressure as a preoperative procedure of cataract extraction in 26 eyeballs of 24 patients and following results were obtained: 1. The authors had intraocular pressure lowered till averaging 10.8 mmHg (average 13.5 ~ 8.0 mmHg) of original pressure by ocular massage. 2. Massage on eyeball was thought to be a satisfactory preoperative procedure to perform cataract extractIon. 3. In operative complications, loss of vitreous and rupture of capsule were noticed 11.5% and 60% respectively. and it was thought to be caused by technical failure in surgeons. In view of this fact we could not find that the loss of vitreous was caused by intraocular pressure below 13.5 mmHg.
Anesthesia ; Cataract Extraction* ; Cataract* ; Humans ; Intraocular Pressure ; Massage* ; Preoperative Care ; Reducing Agents ; Rupture

No abstract available.
Lymphangioma, Cystic*

PURPOSE: The principal cause of treatment failure in osteosarcoma is drug resistance. Multidrug resistance (MDR), mediated by P-glycoprotein (P-gp), is an in vitro phenomenon, resulting in becoming cross-resistant to structurally unrelated drugs. P-gp expression was related to drug resistance, prognosis and recurrence in osteosarcoma. p53 gene regulates genomic stability. Mutant p53 protein causes loss of tumor suppression. Co-expression of mutant p53 protein and P-gp was related to short survival, malignancy and drug resistance in malignant tumors. Wild type p53 protein in SaOS-2 cell line down-regulates the transcription of mdr1 gene. The purpose of this study was to evaluate the expression of mutant p53 protein and P-gp in osteosarcoma and its prognostic significance. MATERIALS AND METHODS: Fifty-two archival pathologic tissues were examined with immunohisto-chemistry. Positive expression was defined if more than 10% of tumor cells were stained. RESULTS: Expression rate of mutant p53 protein was 63% and rate of P-gp was 35%. Correlation between mutant p53 protein and P-gp expression was significant (P=0.0008). Co-expression of mutant p53 protein and P-gp was the strongest prognostic factor for shorter survival by multivariate analysis (P=0.0004). CONCLUSIONS: Nuclear accumulation of mutant p53 protein was significantly related to P-gp expression in osteosarcoma, Co-expression of mutant p53 protein and P-gp is an independent unfavorable prognostic factor in osteosarcoma
Cell Line ; Drug Resistance ; Drug Resistance, Multiple ; Genes, p53 ; Genomic Instability ; Immunohistochemistry ; Multivariate Analysis ; Osteosarcoma* ; P-Glycoprotein* ; Prognosis ; Recurrence ; Survival Analysis ; Treatment Failure

Moyamoya disease is characterized by a bilateral progressive narrowing of the distal internal carotid and proximal portions of the anterior and middle cerebral arteries. The cerebral vessels of the 11 to 14 mm embryonic period are extremely similar to these moyamoya vessels. The vertebral arteries unite with a contralateral homologue to form the basilar artery during embryonic development and rarely, the failure of complete fusion results in duplication of these arteries. It is well known that moyamoya disease sometimes is accompanied by persistent primitive arteries, cerebral aneurysm, or rarely arteriovenous malformation. However, no case of the moyamoya disease with complete duplication of basilar artery has been previously reported. These two types of vascular abnormality are probably associated in certain developmental period, and moyamoya disease causes hemodynamic load in the basilar artery system as a collateral pathway and these effects are also involved in duplication of basilar artery. The relationship between these two varieties of vascular abnormality and possible pathogenesis of the moyamoya disease are discussed.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery* ; Cerebral Arteries ; Embryonic Development ; Female ; Hemodynamics ; Middle Cerebral Artery ; Moyamoya Disease* ; Pregnancy ; Vertebral Artery

BACKGROUND: The circadian rhythm of circulating melatonin is regulated by the endogenous oscillators, the suprachi-asmatic nuclei, and entrained by the light-dark cycle of the environment, but it seems that the rhythm can be affected by variable lesions outside the retina-pineal pathway. We intended to know how acute cerebral infarction affects on the cir-cadian rhythm of plasma melatonin secretion. METHODS: Plasma melatonin level was measured from 64 patients with acute cerebral infarction. On admission, blood samples were collected by venipuncture at 2AM, 4AM, 10AM, and 2PM and melatonin level was measured by radioimmunoassay. The state of consciousness of each patient was assessed clini-cally and the infarction site and size were evaluated clinically and radiographically. RESULTS: Among 64 patients with acute cerebral infarction, dramatic blunting or obliteration of nocturnal melatonin surge in the blood was found in 29 patients. The circadian rhythm of melatonin secretion was absent in 12 of 35 alert patients, in 10 of 20 drowsy patients, and in 5 of 7 stuporous patients. Melatonin secretion into plasma was markedly decreased in all 2 comatose patients. Of 14 patients with brainstem lesions, 8 patients showed decreased melatonin levels with the absence of a nocturnal rise, although most of them were alert. CONCLUSIONS: This study suggests that brainstem and the initial mental state might contribute to the regulation of the circadian rhythm of plasma melatonin even though the lesion does not involve the retina-pineal pathway, but further extensive study is required to elucidate it. (J Korean Neurol Assoc 19(4):359~363, 2001)
Biological Clocks ; Brain Stem ; Cerebral Infarction* ; Circadian Rhythm* ; Coma ; Consciousness ; Humans ; Infarction ; Melatonin* ; Phlebotomy ; Photoperiod ; Pineal Gland ; Plasma ; Radioimmunoassay ; Stupor

Descriptions of symptomatic focal dystonia caused by focal lesions of the central nervous system (CNS) are rare in the literature. We report a 9-year-old child who experienced sudden-onset left-hand dystonia for 6 months. Brain magnetic resonance imaging showed a mass lesion involving the putamen, globus pallidus, head of caudate, and the anterior limb of the internal capsule. Histopathological and immunocytochemical examinations of the mass revealed features characteristic of malignant germinoma. CNS germinoma in the basal ganglia is very rare. Combining previous reports in the literature with the anatomical and clinical presentation of our case suggests that this phenomenon results from disruption of the pathways within and adjacent to the basal ganglia.
Basal Ganglia* ; Brain ; Central Nervous System ; Child ; Dystonia* ; Dystonic Disorders ; Extremities ; Germinoma* ; Globus Pallidus ; Hand* ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Putamen

Descriptions of symptomatic focal dystonia caused by focal lesions of the central nervous system (CNS) are rare in the literature. We report a 9-year-old child who experienced sudden-onset left-hand dystonia for 6 months. Brain magnetic resonance imaging showed a mass lesion involving the putamen, globus pallidus, head of caudate, and the anterior limb of the internal capsule. Histopathological and immunocytochemical examinations of the mass revealed features characteristic of malignant germinoma. CNS germinoma in the basal ganglia is very rare. Combining previous reports in the literature with the anatomical and clinical presentation of our case suggests that this phenomenon results from disruption of the pathways within and adjacent to the basal ganglia.
Basal Ganglia* ; Brain ; Central Nervous System ; Child ; Dystonia* ; Dystonic Disorders ; Extremities ; Germinoma* ; Globus Pallidus ; Hand* ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Putamen

Ovarian cysts in the newborn are uncormnon. Fetal ovarian cysts are being diagnosed with inaeasing fiequency with development of obstetrical sonography. Most of these cysts are found within the first few months of life and have no clinical significance. But, a large ovarian cyst would be founded antenatally with sonography. A large ovarian cyst can cause life-theatening complications during parturition and in the neonatal period. We have experienced a case of fetal ovarian cyst in a 32-year-old primiparous woman with antenatal sonography and report our experience with a brief review of literatures.
Adult ; Female ; Humans ; Infant, Newborn ; Ovarian Cysts* ; Parturition ; Ultrasonography

Some researchers tried to use Tc-99m MIBI scintigraphy for evaluating breast cancer patients Early reports revealed that Tc-99m MIBI breast scintigraphy is useful in distinguishing malignancies from benign masses in patients who have difficulty in mammographic evaluation. Further studies suggested that the functional imaging with Tc-99m MIBI in breast cancer seems to be correlated with levels of P-glycoprotein (Pgp) expression and angiogenesis in cancer tissues. So we evaluated whether there is an actually significant relationship between the pattern of Tc-99m MIBI uptake in tumor tissue and tumoric factors including Pgp expression and angiogenesis. Thirty one untreated breast cancer patients (pathologically proved to invasive ductal carcinoma later) were prospectively studied by both Tc-99m MIBI scintigraphy and immunohistochemical analysis of angiogenesis and Pgp expression on sugically removed tumor tissues. Both lateral and anterior planar images were obtained at 10 minutes and 3 hours after intravenous injection of 740 MBq Tc-99m MIBI. Tumor-to-normal breast ratio(T/N) and washout index (WI, early T/N minus late T/N divided by early T/N) were calcuated. The results were follows; A significant correlation was found between T/N at early and late images(r=0.54, p=0.002 on early images, r=0.47, p=0.008 on late images). T/N of early images were not different among different groups of Pgp expression(p=0.3696), while those of late images were significantly different among groups(p=0.0276). Even more significant difference of WI among the groups were noted (p=0.0015). A significant negative correlation was noted between T/N of late images and Pgp expression (p=0.00276). A even stronger correlation was found between WI and Pgp expression (r=0.68, p=0.001). In conclusion, the tumoral uptake and washout of Tc-99m MIBI can be used as a simple functional test for angiogenesis and P-glycoprotein expression in untreated breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Humans ; Injections, Intravenous ; P-Glycoprotein ; Population Characteristics* ; Prospective Studies ; Radionuclide Imaging*

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier's disease, is a common disorder characterized by ossification and calcification of soft tissues such as the enthuses and joint capsules, particularly affecting the spine. This condition affects approximately 3~30% of men older than 50 years of age. We present the case of a 39-year-old woman diagnosed with DISH combined with extensive ossification of the posterior longitudinal ligament (OPLL) and ossification of ligamentum flavum (OLF). The emergency physician should understand the typical radiologic findings associated with DISH and its clinical presentations in order to diagnose and treat this problem.
Adult ; Emergencies ; Female ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal ; Joint Capsule ; Ligamentum Flavum ; Longitudinal Ligaments ; Lower Extremity ; Male ; Ossification of Posterior Longitudinal Ligament ; Paralysis ; Spine