PURPOSE: To report a case of optic neuritis with incongruous homonymous hemianopia involving optic chiasm. METHODS: A twenty five year old female patient complaining of decreased visual acuity in left eye for 4 days was referred from department of neurology. Best corrected visual acuity was 1.0 in the right eye and counting fingers at 20 cm in the left eye. Left afferent pupillary defect was detected. The conventional magnetic resonance image was normal, however on FLAIR image high signal intensity lesion involving left anterior portion of optic nerve, optic chiasm and both optic tract was noted. However the lesion was not easily detected on T2-weighted image. On enhanced MRI image, the lesion was partially enhanced. Visual field showed incongruous homonymous right hemianopia. VEP showed no evoked potentials in left eye stimulation by checkboard pattern and normal response in right eye stimulation. The patient had normal CSF studies and had been treated with high dose intravenous steroid. After 19 days, visual acuity and magnetic resonance image was markedly improved. RESULTS: We experienced a case of optic neuritis with incongruous homonymous hemianopia involving optic chiasm and report this case with literature review as we believe that our case is the first case in our country.
Evoked Potentials ; Female ; Fingers ; Hemianopsia ; Humans ; Magnetic Resonance Imaging ; Neurology ; Optic Chiasm* ; Optic Nerve ; Optic Neuritis* ; Pupil Disorders ; Visual Acuity ; Visual Fields ; Visual Pathways

The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

PURPOSE: The purpose of this study is to evaluate surgical outcomes of canalicular trephination with lacrimal trephine and endoscopic dacryocystorhinostomy in patiens with common canalicular or canalicular obstruction. METHODS: 35 patients (38 eyes) diagnosed as common canalicular or canalicular obstruction undergoing surgery between December 1999 and August 2003. Patients have been followed up more than 5 months after surgery. RESULTS: The average age of patients was 57.3 years old and the average follow-up period was 7.1 months. The overall success rate was 92.1%. With obstructions within lower canaliculus, the success rate was 75.0%. The success rate of the cases with obstructions within upper canaliculus and upper and lower canaliculus was 100%, and the success rate of the cases with obstructions within common canaliculus was 95.2%. CONCLUSIONS: The surgical success rate of canalicular trephination with lacrimal trephine and endonasal dacryocystorhinostomy was better than canaliculodacryocystorhinostomy and this seems to be adequate as an primary procedure before Jones tube bypass surgery.
Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Trephining*

The clinical value of CT in the diagnosis of pelvic bone fractures is being explored. Conventional radiographic projections, including internal and external oblique views, although very helpful, often cannot provide sufficent jnformation to give a true sense of the fractures. CT conversely displays the anatomy in an axial plane, thereby providing the missing pieces of information and fascilitating classification of these fractures. From January 1983 to June 1986, 34 patients with pelvic bone fractures, admitted to Department of Orthopedic Surgery, Severance Hospital, were given both CT and conventional radiographs. Comparing the conventional radiographic findings with those of CT, the following conclusions were obtained. 1. For patients with multiple trauma who necessitate position changes during conventional radiography, no further change in position was required during CT. 2. CT clearly showed intraarticular loose bodies, anterior wall fractures of the acetabulum, and separations of the saicroiliac joint which were hardly detected on conventional radiographs. 3. CT permitted a better evaluation of the shape, extent, and degree of separation of fracture fragment, so it was very helpful in formulating the treatment plan. 4. Follow-up CT was helpful in evaluating the effectiveness of treatment.
Acetabulum ; Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Joints ; Multiple Trauma ; Orthopedics ; Pelvic Bones ; Radiography

Intramural hematoma(IMH) and penetrating aortic ulcer have been increasingly recognized as causes of acute aortic pathology in addition to aortic dissection. The presence of the intimal tear and a flap traversing the aortic lumen is considered to be a most reliable differential point of aortic dissection and IMH. Transesophageal echocardiography(TEE) has become a valuable modality for the diagnosis, prognosis and management of acute aortic syndrome with the unique advantages of portability and the ability to obtain high-resolution real time images. Endovascular Stent-graft placement over the primary entry tear may be an alternative to open surgery because it can close the intimal tear, which leads to thrombosis of the false lumen, excluding flow through the intimal tear and redirecting aortic flow exclusively into the true lumen. We report 88 year-old male with aortic dissection in descending thoracic aorta, successfully treated with endovascular Stent-graft implantation, which was mimicking intramural hematoma by its appearance and subclinical intimal tear diagnosed exclusively by TEE against other imaging studies.
Aged, 80 and over ; Aorta, Thoracic* ; Diagnosis ; Hematoma* ; Humans ; Male ; Pathology ; Prognosis ; Thrombosis ; Ulcer

The therapeutic efficacy of antipsychotic drugs is generally attributed to their ability to block dopamine D2 receptors. Classical D2 antagonists are not effective to treat negative symptoms and produce extrapyramidal side effects. On the other hand, atypical antipsychotic agents ameliorate negative symptoms without producing extra-pyramidal side effects, and it is reported to be associated with blockade of serotonin 5-HT2 receptors. The purpose of this study was to evaluate the effect of risperidone on neuroreceptors in the rat brain by quantitative autoradiography method. In acute treatment group, risperidone was injected into peritoneal cavity of male Wistar rats with dose of 0, 0.1, 0.25, 0.5, 1,0 and 2.0mg/kg in each Group(5/group), and they were decapitated after 2 hours. In chronic treatment group, risperidone was injected with dose of 0, 0.1, and 1mg/kg(I.P.) for 21 days and decapitated after 24 hours following last treatment. The effect of risperodone on the binding of [3H]spiperone to 5-HT2 and D2 receptors were analysed in 4 discrete regions of the striatum, nucleus accumbens, and frontal cortex by quantitative autoradiography. Acute treatment with risperidone reduced cortical 5-HT2 specific [3H]spiperone binding to 32% of vehicle-treated control. Subcortical 5-HT2 specific [3H]spiperone binding was not affected at all dose groups whereas a significant reduction (57%) in D2 specific [3H]spiperone binding was observed in risperidone treated group at doses of l-2mg/kg. Chronic treatment with risperidone produced a decrease in the maximal number of cortical 5-HT2 receptors to 51% and 46% of control in 0.1mg/kg & 1mg/kg treated group respectively. In conclusion, risperidone is a cortical serotonin receptor antagonist with relatively weak antagonistic action on dopamine receptors. These effects on neuroreceptors may explain the therapeutic effect of risperidone as a atypical antipsychotic agents.
Animals ; Antipsychotic Agents ; Autoradiography ; Brain* ; Dopamine* ; Hand ; Humans ; Male ; Nucleus Accumbens ; Peritoneal Cavity ; Rats* ; Rats, Wistar ; Receptors, Dopamine D2 ; Receptors, Dopamine* ; Receptors, Serotonin, 5-HT2 ; Risperidone* ; Sensory Receptor Cells ; Serotonin*

Since the first report on the blood triglyceride level of normal korean in 1962, more than 12 authors published their normal value ranging from 78.0~151.0mg% as mean value. In an attempt to establish normal triglyceride level in Korean, the timing of sampling and method of sample preservation were reevaluated in terms of quality control. Although the number of samples and tests were too small to make an unequivocal conclusion, the following results were observed. 1. Plasma triglyceride levels were stable on continuing fasting 12~16 hours, slightly decreased thereafter. 2. Samples kept in room temperature were stable up to 3 days and the triglyceride level dropped moderately on the 5th day. 3. No significant change in plasma triglyceride level was found with freezing up to one month. 4. Significant change in plasma triglyceride level was noted with repeated melting and refreezing of specimen. 5. The probable reasons for marked differences in normal value of plasma triglyceride level were discussed.
Fasting ; Freezing ; Plasma* ; Quality Control ; Reference Values ; Triglycerides*

The aortic dissection is an acute aortic syndrome, caused by an intimal tear and subsequent splitting of the media by the pulsatile blood flow. Though there would be differences in the origin of aortic dissection and therapeutic modalities, the intermediate and long-term prognoses are poor. Endovascular Stent-graft implantation is a revolutionary technique in the treatment of aortic dissection. The endovascular stent grafting in aortic dissection is less invasive and feasible method and is an effective tool for closing the entry site and promoting clot formation, reducing the size of the false lumen. Therefore, endovascular Stent-graft implantation makes possible the desirable remodelling of aorta. We report 33 year-old male with aortic dissection in the thoracic aorta, which was treated with endovascular Stent-graft implantation. Over the favorable remodelling, his dissection was healed completely by the endovascular treatment using Stent-graft.
Adult ; Aorta ; Aorta, Thoracic* ; Blood Vessel Prosthesis ; Humans ; Male ; Prognosis

PURPOSE: We analyzed the oncological outcome and prognostic factor of the chondrosarcoma arising from benign bone tumor due to malignant transformation. MATERIALS AND METHODS: From April 1986 to April 2009, 18 cases were considered eligible. We analyzed retrospectively the patient's characteristics and prognostic factors that affect to the local recurrence and distant metastasis. RESULTS: As classified by primary benign bone tumor, 4 cases were solitary osteochondroma, 11 cases were multiple osteochondromatosis and 3 cases were multiple enchondromatosis. The mean follow-up period was 85 months. The 5-year disease free survival rate of 18 patients was 85.9%. Their overall MSTS score was 25.2 (84%). There were local recurrence in 3 cases and no distant metastasis. We found that tumor location and surgical margin affected to the prognosis significantly. CONCLUSION: In secondary chondrosarcoma patients, the prognosis was good relatively and tumor location and surgical margin are important prognosis factor.
Chondrosarcoma ; Disease-Free Survival ; Enchondromatosis ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteochondroma ; Osteochondromatosis ; Prognosis ; Recurrence ; Retrospective Studies

PURPOSE: This study was conducted to investigate the influence of emotional labor, emotional dissonance, and burnout on nurse's turnover intention and examine the effect of job satisfaction on the relationships among emotional labor, emotional dissonance, burnout, and turnover intention. METHODS: The sample consisted of 350 nurses recruited from 6 general hospitals in 2 cities in Korea. A multiple-group analysis was utilized. Data were analyzed using SPSS statistics 23 and AMOS 20. RESULTS: In the path analysis, turnover intention was directly related to burnout in clinical nurses who had a high job satisfaction (β=.24, p=.003), while it was indirectly related to emotional dissonance (β=.13, p=.002). In the multiple-group path analysis, turnover intention was directly related to emotional dissonance (β=.18, p=.033) and burnout (β=.26, p=.002) for nurses with low job satisfaction. CONCLUSION: These results indicate that manuals and guidelines to alleviate the negative effects of emotional labor, emotional dissonance, and burnout, and to increase job satisfaction are strongly required to reduce turnover intention in nurses at the organizational level as well as at the individual level.
Hospitals, General ; Intention* ; Job Satisfaction* ; Korea ; Personnel Turnover