Korean hemorrhagic fever is an acute febrile illness which causes hemorrhagic nerrosis of multiple internal organs. Some orular symptoms are described by physicians without ophthalmic examination. The authors evaluated early ocular manifestations in 21 patients (42 eyes) with Korean hemorrhagic fever, who were admitted from Oct. to Nov. in 1984. The results are summarized as follows: 1. In eleven patients (22 eyes, 52.4%), visual disturbances caused by transitory myopia were observed. 2. During the period of transitory myopic change, the intraocular pressure in the group of refrartive change was significantly raised compared to that in the group of non-refrartive change. 3. In the group of refractive change, increasing intraocular pressure and a shallowing of the anterior chamber were observed accompanied by transitory myopic change. 4. During the earIy phase of the illness, lid edema, chemosis, conjunctival injection, subconjunctival hemorrhage, and macular edema were observed.
Eye Diseases/etiology ; Eyelid Diseases/etiology ; Hemorrhagic Fever with Renal Syndrome/*complications ; Humans ; *Intraocular Pressure ; Myopia/*etiology

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

OBJECTIVE: To understand the difference of defecation physiology between postpartum and postoperative women. METHODS: Between July 1998 to April 1999, we performed defecogram and pudendal nerve motor latency to 31 women, who were 8 postoperative women, 9 post cesarean-section state women, and 14 normal vaginal delivery-state women. RESULTS: According to the defecogram results, only squeezing angles of the anorectal angle were significantly increased(96.0 vs 72.3, 74.9 degree) in normal vaginal delivery-state women compared to post cesarean-section state and postoperative women, but rest and evacuation angles were not. And to pudendal nerve latency, there were no statistically significant difference. CONCLUSION: We concluded that the pudendal plexus was damaged during labor, therefore its ability to control puborectalis muscle was damaged. So, the anorectal angles of squeezing of postpartum women were significantly increased, compared to those of post cesarean section women or postoperative women.
Cesarean Section ; Defecation* ; Female ; Humans ; Physiology* ; Postpartum Period* ; Pregnancy ; Pudendal Nerve*

BACKGROUND: Positive rate of HCV RNA in anti-HCV immunoblot indeterminate samples from Korean blood donors was investigated in this study. Futhermore, reactivity of enzyme immunoassay kits was evaluated according to patterns of band reactivity and RNA positivity of indeterminate samples. METHODS: HCV RNA was tested from a total of 180 samples that had been repeatedly reactive to LG HCD 3.0 or DONG-A HCV 3.0 and further confirmed to be indeterminate by LG HCD CONFIRM at 14 Korean Red Cross Blood Centers in 1997. Correlation between HCV RNA and reactivity to each recombinant antigens was analysed. Three kinds of EIA kits such as HCD 3.0, DONG-A HCV 3.0 and Cobas Core Anti-HCV EIA kits were tested of their reactivity to 56 samples that had shown single band positivity on LG HCD CONFIRM. RESLUTS: HCV RNA was detected in 11 (6.1%) of 180 samples. Positivity of 897 band showed positive correlation with HCV RNA positivity (p<0.001), while Core518 showed negative correlation (p<0.001). DONG-A HCV 3.0 showed negative reaction to two samples with anti-897 specificity and HCV RNA, while LG HCD 3.0 and Cobas Core HCV showed negative reaction to one sample with anti-EIE2NS4 and HCV RNA. CONCLUSION: Positive rate of anti-HCV immunoblot indeterminate samples from Korean blood donors was 6.1%. In case of indeterminate results by LG HCD CONFIRM, positive reaction to 897 band highly suggests the presence of HCV RNA, while Core518 the absence of HCV RNA. It is highly recommended that specificity of Core518 antigen be increased in LG HCD 3.0 or LG HCD CONFIRM and sensitivity of recombinant antigen from the 3rd non-structural region of HCV genome be increased in DONG-A HCV 3.0.
Blood Donors* ; Genome ; Humans ; Immunoenzyme Techniques* ; Red Cross ; RNA* ; Sensitivity and Specificity

Primitive neuroectodermal tumors(PNETs) are a group of small round cell tumors that may arise in the central or peripheral nervous system. In the extracranial location, these neoplasms may occur anywhere and at any age group, but most likely in the bone and soft tissue of children and young adults. The incidence of adrenal gland involvement is very rare. This tumor is diagnosed by histopathological, immunohistochemical, and molecular pathological examinations. PNETs are highly aggressive tumors, locally recurrent and rapidly metastasizing to lung, liver, lymph node, and brain. The outcome is poor with a 5 year survival rate below 40% in spite of aggressive combined treatment including surgery, chemotherapy, and radiation therapy. We experienced a case of PNET of adrenal gland, mimicking ruptured Wilms tumor on the US and CT scan.
Adrenal Glands* ; Brain ; Child ; Drug Therapy ; Humans ; Incidence ; Liver ; Lung ; Lymph Nodes ; Neural Plate ; Neuroectodermal Tumors, Primitive* ; Peripheral Nervous System ; Survival Rate ; Tomography, X-Ray Computed ; Wilms Tumor ; Young Adult

Dural carotid-cavernous fistula (CCF) is characterized by arteriovenous communications between the meningeal branches of the internal or external carotid arteries and the cavernous sinus. Although the triad of chemosis, proptosis, and ocular bruit has been regarded as a classic sign of CCF, dural CCF often lacks these features. Dural CCF is a rare cause of ophthalmoplegia, and so it may be overlooked when the classic symptoms are absent. We report herein a case of bilateral dural CCF that presented as unilateral isolated abducens nerve palsy.
Abducens Nerve ; Abducens Nerve Diseases ; Carotid Artery, External ; Cavernous Sinus ; Caves ; Diplopia ; Exophthalmos ; Fistula ; Ophthalmoplegia

Central pontine myelinolysis (CPM) is a neurologic disorder that is usually related to rapid correction of hyponatremia and chronic alcoholism. CPM involves concentrated, symmetric, noninflammatory demyelination within the central pons; this pathology also occurs in extrapontine regions. Frequently observed clinical manifestations are sudden weakness, dysphagia, dysarthria, loss of consciousness, and locked-in syndrome. We describe herein a case of CPM predominated by cerebellar signs without typical symptoms, but with involvement of the cerebellum or cerebellar peduncle.
Alcoholism ; Cerebellar Ataxia ; Cerebellum ; Deglutition Disorders ; Demyelinating Diseases ; Dysarthria ; Hyponatremia ; Myelinolysis, Central Pontine ; Nervous System Diseases ; Quadriplegia ; Unconsciousness

OBJECTIVE: The measurement of liver size can be used for the diagnosis of the fetal growth abnormality (FGR, macrosomia etc.). The purpose of this study was to evaluate a mathematical relationship between the fetal liver size(liver length or volume) and the gestational age in the normal pregnancies. Brief comparisons were also tried on the base of the degree of the correlation between liver length and its volume. METHODS: We collected 54 singleton pregnancies of 20 to 36weeks of gestation for measuring fetal liver length and 57 singleton pregnancies for measuring fetal liver volume. We used Combison 530 utrasonic machine(Kreztechnik AG, Zipf, Austria). RESULTS: There was significant correlation between liver size( length and volume) and gestation age. And the liver volume better correlated with gestational age than liver length(r=0.93 : r=0.78, p<0.0001, p<0.0001). CONCLUSION: Ultrasonic measurement of fetal liver size is a reliable indicator of fetal growth, especially liver volume. Therefore these data may have a potential value for the prediction of abnormal fetal growth(FGR, macrosomia).
Diagnosis ; Fetal Development ; Gestational Age* ; Liver* ; Pregnancy* ; Ultrasonics

The idiopathic hypereosinophilic syndrome (IHES) is a heterogenous spectrum of disorders, characterized by a long lasting hypereosinophilia without identifiable underlying cause and by the presence of various end-organ dysfunction. The neurologic manifestations of IHES can be encephalopathy, organic psycho syndrome and polyneuropathy and in rare cases polymyositis. Central nervous system involvement is the second mostclinically important complication of the hypereosinophilic syndrome as it is associated with chronic disability and a poor prognosis. In this report, we describe two patients of IHES who presented anisolated third nerve palsy with pupillary involvement and were improved by corticosteroid therapy. They satisfied the criteria of IHES and the third cranial nerve was the only site of neurologic involvement. Early recognition of neurologic involvement in IHES and prompt treatment could lead to good outcome
Central Nervous System ; Humans ; Hypereosinophilic Syndrome* ; Neurologic Manifestations ; Oculomotor Nerve ; Oculomotor Nerve Diseases* ; Polymyositis ; Polyneuropathies ; Prognosis

OBJECTIVE: Our purpose was to investigate the distribution of the result of 17,744 cervicovaginal smears and their pathologic results in Inha University Hospital to make a reference data. METHODS: During 28 months, May 1996 to August 1998, we performed 17,774 cervicovaginal smears and arranged them by the Bethesda system and compared them with their pathologic results. RESULTS: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. Among ASCUS, the high grade histologic outcome was composed 4.0%. Among LSIL, there were 15.7%, and HSIL 48.0%, SCC 56.1%, AGUS 9.3%, and Adenocarcinoma, the results was 69.2%. CONCLUSION: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. These results were very similar to other data and we would like to add our data to them as a reference. And the worse the smear results were, the worse the pathologic results were.
Adenocarcinoma