No abstract available.
Breast Neoplasms* ; Breast* ; Lymph Nodes* ; Neoplasm Metastasis*

PURPOSE: We experienced a case of ocular motility disturbance with esotropia and hypotropia, following implantation of Molteno to the superotemporal quadrant. METHODS: The patient recovered to orthophoria after removal of implant and fibrotic scar tissue with recession and resection. RESULTS: Multiple complications have been reported in association with Molteno implantation, including hypotony, cataract, choroidal hemorrhage, retinal detachment, endophthalmitis, hyphema, phthisis. However ocular motility disturbances have been documented in only a few cases and never in Korea to our knowledge. Therefore, we report this case with the review of related literatures.
Cataract ; Choroid Hemorrhage ; Cicatrix ; Endophthalmitis ; Esotropia ; Humans ; Hyphema ; Korea ; Retinal Detachment ; Strabismus*

Paroxysmal nocturnal hemoglobinuria(PNH) is a rare, acquired disease involving multiple hematopoietic lines. Characteristics of PNH are intrinsic hemolytic anemia, iron deficiency anemia and venous thrombosis. report a case of PNH with characterostoc MR and CT findings. The signal intensity of renal cortex was lower than that of medulla on both T1- and T2- weighted MR imaging. On T2 weighted MR images, the liver showed very low signal intensity but the signal intensity of the spleen was normal. On precontrast CT the attenuation of renal cortex was higher than that of renal medulla and the attenuation of liver was higher than that of the spleen. These findings of MR imaging and CT were the result from the deposition of hemosiderin in the cells of proximal convoluted tubules and transfusional hemosiderosis of liver.
Anemia, Hemolytic ; Anemia, Iron-Deficiency ; Hemoglobinuria, Paroxysmal* ; Hemosiderin ; Hemosiderosis ; Liver ; Magnetic Resonance Imaging ; Spleen ; Venous Thrombosis

From December 1987 to September 1988, clinical evaluation were performed at the Yeungnam University Hospital on 138 patients with exudative pleural effusion comparing with biochemical, bacteriologic, cytologic and pathologic studies. The results were as follows 1. Among these 138 cases, Incidence of tuberculosis was 57.3%, neoplasm 26.8%. High tendency in malignant pleural effusion occurred in elder age. 2. In tuberculosis pleural effusion, the rate of positive smear and culture for acid-fast bacilli in the pleural fluid was 3.7% and positive biopsy for granuloma 75%. 3. In malignant pleural effusion, the rate of positive cytology for cancer cell in the fluid was 42% and positive biopsy 60%. 4. Analysis in tuberculosis and malignancy showed the tendency of high pH, WBC, protein and of low glucose, but there were clinically not significant in differentiating malignant pleural effusion from tuberculous pleural effusion. 5. Among 23 cases in which the pleural tissue findings were chronic nonspecific reaction pathologically, tuberculosis (52.2%), malignancy (26%), and idiopathic (21.8%) eventually in follow up studies.
Biopsy ; Follow-Up Studies ; Glucose ; Granuloma ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Pleural Effusion* ; Pleural Effusion, Malignant ; Tuberculosis

The purpose of this study is to develop social medicine curriculum model and to propose its management device. The study developed the curriculum model and its management plan as follows; First, the social medicine curriculum can be implemented starting from the first semester of first year through the first semester of fourth year, and is splitted up into two semesters for each year of medical school. Second, a semester consists of sixteen weeks, giving two hours course per week. Third, the sixteen weeks curriculum should be composed of sub courses which lasts at least four weeks each. Forth, the elective course of social medicine is of four blocks in total, and runs from second semester of the second year through first semester of the fourth year. This means the elective courses in the first semester are opened to third and fourth year students. And the elective courses in the second semester are opened to second and third year medical students. Fifth, the minimum number of elective courses should be more than four courses per semester. Sixth, the credits for core and elective social medicine courses are one point each for any lectures or laboratories carried out in the following way; one hour course provided for sixteen weeks or two hours course provided for eight weeks. The social medicine education stands firm as one of the core subjects in twenty-first century medical education. Thus, the effectiveness and systematic development of the program as well as running it will be the most important criterion for determining the competency of a medical school.
Curriculum* ; Education ; Education, Medical ; Humans ; Lectures ; Running ; Schools, Medical ; Social Medicine* ; Students, Medical

We examined the variations in the limbus-insertion distance, the width and the insertion shape of 260 horizontal recti muscles in 137 strabismic patients, and evaluated the relationship between insertion shape and postoperative results. The average limbus-insertion distance of medial rectus muscle was 4.72 +/- 0.49mm and that of lateral rectus muscle was 6.29 +/- 0.58mm. The width of medial rectus and lateral rectus mascle was 9.84 +/- 0.83mm and 9.57 +/- 0.84mm. The insertion shapes of horizontal rectus muscle were divided into 5 groups, straight, oblique type I and II, concave and convex patterns. According to insertion shape, insertion shape of the medial rectus muscle had no statistic difference in esotropia and exotropia(P=0.179), but in case of the lateral rectus muscle, it was staistically significant in both exotropia and esotropia(P=0.036). When the deviation angle was larger than 40 delta, the length of limbus width was statistically significant in lateral rectus muscle(P=0.018). The insertion shape divided into straight and non-straight pattern was statistically insignificant on postoperative success rate.
Esotropia ; Exotropia ; Humans ; Muscles

Spontaneous gastric perforation is an important but rare cause of gastrointestinal perforation in neonates. Just over 200 cases have been reported in the literatures. In spite of recent surgical advances in its managements, mortality rate has been reported as high as 25~50%. Because of physiologic differences, immature immune mechanisms, variations in gastrointestinal flora and poor localization of perforation, a neonate with gastric perforation is at high risk. The pathogenesis is greatly debated. Five patients with spontaneous neonatal gastric perforation who were operated upon at the Department of Pediatric Surgery, Seoul National University Hospital from 1980 to 1993 were reviewed. Four patients were male and one female. The first indication of perforation was 1 day to 6 days of life. All of 5 perforations were located along the greater curvature of the stomach. The size of perforation ranged from 2 cm to 10 cm. Debridement and primary closure were performed in all patients. The operative mortality was 40%(2 of 5). The cause of perforation was not identified in all cases. Prematurity and necrotizing enterocolitis, synchronous or metachrotlous, were thought to be crucial prognostic factors. Earlier recognition and surgical intervention are necessary to reduce morbidity and mortality.
Debridement ; Enterocolitis, Necrotizing ; Female ; Gastrointestinal Microbiome ; Humans ; Infant, Newborn ; Male ; Mortality ; Seoul ; Stomach

BACKGROUND: Inhaled nitric oxide therapy causes selective pulmonary vasodilation in congenital heart diseases with pulmonary hypertension. However discontinuation of inhaled nitric oxide therapy may be complicated by abrupt life-threatening rebound pulmonary hypertension(RPH) The purpose of this study was to prevent by comparing group I(without RPH n=13) and group II(with RPH n=6) to determine the risk factors involved inthe development of the RPH. MATERIAL AND METHOD: Between Januarty 6, 1998 and April 14, 1999. we studied 19 consecutive children who were treated with inhaled nitric oxide for clinically significant pulmonary hypertension after an open heart surgery for congenital heart disease. the ratio of males and females was 12:7 ranging in age from 10 days to 6040 days(16 years) To identify the effects of nitric oxide between two groups we measured heart rate mean and systolic pulmonary arterial pressure mean and systolic systemic arterial pressure central venous pressure pH paO2/FiO2 and O2 saturation before and after the initiation and just before the withdrawal of the inhaled nitric oxide. RESULT: In 6 of 19 patients(32%) withdrawal of inhaled nitric oxide caused RPH. In the two groups inhaled nitrix oxide decreased in pulmonary arterial pressure(PAP) without decreasing the systemic arterial pressure(SAP) and increased PaO2/FiO2 Compared with patients who had no RPH(group I) patients who had RPH(group II) were older in age (1204+/-1688 versus 546+/-1654 days p<0.05) received less nitric oxide therapy(34+/-18 versus 67+/-46 hours p<0.05) has shorter weaning process(5+/-3 versus 15-13 hours p<0.05) and received lowerconcentration of initial nitric oxide supply(11+/-8 versus 17+/-8 ppm p>0.05) and lower concentration just before the withdrawal nitric oxide(4.2+/-2.6 versus 5.6+/-2.6 ppm, p>0.05) CONCLUSION: We speculate that older age shorter of nitric oxide therapy shorter weaning process are the risk factors of RPH.
Arterial Pressure ; Central Venous Pressure ; Child ; Female ; Heart Defects, Congenital ; Heart Diseases ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Male ; Nitric Oxide* ; Risk Factors ; Thoracic Surgery ; Vasodilation ; Weaning

Corunal or interstitial pregnancy is very rare and its diagnosis is difficult. It accounts for no more than 2% to 4% of all tubal pregnancy. As ruptured is likely to occur between the end of the second and the end of the fourth month, it causes serious maternal mortality and morbidity. If the contralateral tube is patent, history of ipsilateral salpingectomy may be risk factor for interstitial pregnancy. A 37-year-old woman had laparoscopic right salpingectomy due to tubal pregnancy. One year later she experienced a second ruptured interstitial pregnancy on the same side.
Adult ; Diagnosis ; Female ; Humans ; Maternal Mortality ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Risk Factors ; Salpingectomy*

BACKGROUND: Lipoprotein(a) [Lp(a)] is an atherogenic lipoprotein that is assembled from a low density lipoprotein(LDL) and apolipoprotein(a) [apo(a)]. The variations in Lp(a) concentration tend to be inversely related to the number of kringle IV in apo(a) gene, but other polymorphisms [pentanucleotide(TTTTA) repeats, +93 C/T polymorphism, and Met/Thr polymorphism] of the apo(a) gene are also seems to be related to Lp(a) concentrations. The purpose of this study was to investigate the association of the pentanucleotide repeat polymorphism(PNRP) and Met/Thr polymorphism with the Lp(a) concentrations. METHODS: We studied 197 healthy adults. For genotype analysis of the PNRP and the Met/Thr polymorphism, PCR was performed. Apo(a) phenotyping was performed by SDS-PAGE and immunoblotting. The Lp(a) concentrations were measured by ELISA method. More than two groups were compared using the Kruskal Wallis one-way analysis test. To establish a relationship between gene polymorphisms and Lp(a) concentrations, The linear regression test was performed. RESULTS: Mean Lp(a) concentration was 25.3+/-21.5 mg/dL. Allele frequencies for PNRP, subjects with 8/8 genotype were 114(57.9%) and most frequently observed. The Lp(a) concentrations showed the tendency to decrease as the sum of alleles of PNR increased. Subjects with Met/Thr genotype were 119(60.4%), Met/Met genotype were 71(36.0%) and Thr/Thr genotype were 7(3.6%). CONCLUSIONS: For PNRP, subjects with 8/8 genotype were 114(57.9%) and 8/8 genotype was the most frequently observed. Met/Thr genotype was most frequently observed.
Adult ; Alleles* ; Apoprotein(a) ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Gene Frequency* ; Genotype ; Humans ; Immunoblotting ; Kringles ; Linear Models ; Lipoprotein(a) ; Lipoproteins ; Microsatellite Repeats ; Polymerase Chain Reaction