Tono-pne and Perkins tonometer have been widely accepted to measure the intraocular pressure(IOP) of children under the general anesthesia because of their portability. We evaluated the difference of IOP between two devices and the IOP variability in 39 children(77 eyes) under age 13 who had undergone surgery for strabismus or entropin under the general anesthesia. One observer measured the IOP three times alternately, and the order of measurement was randomized. Only 5% of Tono-pens coefficient of variance was considered valuable. The range of Tono-pen IOPs was 9~22mmHg, and the average was 15.41+/-3.23mmHg. The range of Perkins IOPs was 4~20 mmHg, with the average of 12.47+/-3.31mmHg. The difference between two methods on average was 2.94mmHg. Tono-pen IOPs were significantly greater than those recorded by Perkins tonometer, but both were within normal range. The IOP variability was not significantly different between two devices. Therefore both methods can be applied effectively in a clinical setting after sedation or general anesthesia of uncooperative children.
Anesthesia, General* ; Child* ; Humans ; Intraocular Pressure* ; Reference Values ; Strabismus

OBJECTIVE: To evaluate the effects of tibolone on lipid metabolism in comparison to continuous conjugated equine estrogen and medroxyprogesterone acetate in postmenopausal women METHODS: In a randomized, group-comparative study, the effects on lipid profiles (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) were studied between tibolone 2.5 mg/day (N=48) and continuous combined regimen (conjugated equine estrogen 0.625 mg/day combined with medroxyprogesterone acetate 2.5 mg/day, CEE/MPA) (N=46) (CEE/MPA) for 12 month period.Satistical analysis were performed using Student's t-test for paired samples and independent groups. RESULTS: There were no statistical differences in age, age of menopause and body mass index (BMI) of both group before treatment. While treatment with tibolone significantly lowered plasma concentration of triglycerides, there were no significant changes in serum total cholesterol, HDL-cholesterol and LDL-cholesterol levels. In the CEE/MPA group, there were no significant changes of all variables. CONCLUSION: While there a statistically significant decrease in triglyceride concentration in tibolone group. there were no statistically significant differences in total cholesterol, HDL-cholesterol and LDL-cholesterol levels in both tibolone and CEE/MPA group, during 12 months of treatment period.
Body Mass Index ; Cholesterol ; Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Lipid Metabolism* ; Medroxyprogesterone Acetate ; Menopause ; Plasma ; Triglycerides

OBJECTIVE: Our purpose was to evaluate the clinical outcomes of fetuses with a single umbilical artery(SUA). METHODS: We studied 17 fetuses with a single umbilical artery retrospectively. The maternal age, maternal disease, gestational age, fetal sex, Apgar score, fetal weight, perinatal outcome, and fetal blood karyotype were reviewed. RESULTS: 1) Maternal age ranged 24-39 years old, mean age was 29.5 +/- 4.1 years. 2) Mean gestational age at birth was 38.3+/- 2.2 weeks, except one case of preterm labor due to cervical incompetence. 3) In three cases, low Apgar score, under seven, was recorded at one minute, and there was no case where Apgar score was low at five minute, except one case of preterm labor due to cervical incompetence. 4) Intrauterine growth retardation was found in two cases, and associated fetal malformations were noted in seven cases. 5) Among two cases of fetal blood karyotype, one case revealed normal and the other Patau syndrome. CONCLUSION: Our data suggest that fetuses with single umbilical artery may be risky because of its association with growth retardation and malformation including chromosomal anomaly. It is imperative to diagnose the congenital disease as early as possible and conduct appropriate treatment, with an aid of noninvasive diagnostic modality such as ultrasonogram, and through a delicate prenatal care, one should promote good perinatal outcome.
Apgar Score ; Female ; Fetal Blood ; Fetal Growth Retardation ; Fetal Weight ; Fetus* ; Gestational Age ; Karyotype ; Maternal Age ; Obstetric Labor, Premature ; Parturition ; Pregnancy ; Prenatal Care ; Retrospective Studies ; Single Umbilical Artery* ; Ultrasonography

It is improtant that performing prophylaxis procedure on an infected implant surface in order to treat periimplantitis should not change the surface roughness and composition, so that the surface can be recovered to almost same condition as initial implant surface. This thesis, therefore, studied an effect of various oral hygiene instrument on implant surface. A surface roughness measurement instrument and an injection electron microscope were used to observe a change on surface. The purpose of this study was to obtain a clinical guideline during implant care and peri-implantitis treatment. The result were as follows 1. Ra values (surface roughness value) at experimental group 1, group 2, and group 5 were increased significantly as compared with comparison group (p<0.05). 2. When compared experimental group 1 with each exprimental groups at which prohylaxis procedure was performed, mean values of Ra at experimental group 2, group 3, group 6, and group 7 were decreased significantly(p<0.05). 3. Mean value of Ra was lowest at experimental group 2, and highest at experimental group 2, and highest at experimental group 5. 4. Analysis of SEM showed that was significant surface change at experimental group 2, group 3, group 4, group 5, and group 6 as compared with comparison group(X1000). 5. Analysis fo EDX showed that a quantity of Ti on surface for experimental group 6 was very similar to that for comparison group. In conclusion, air-powder abrasive and citric acid, plastic instrument are safe methods to use for performing prophylaxis procedure on implant care or for cleaning and sterilization process on treatment of peri-implantitis, based on the result that those method did not affect implant surface roughness and Ti composition.
Citric Acid ; Oral Hygiene* ; Peri-Implantitis ; Plastics ; Sterilization

Though diagnosis of myelopathy can be easily made by history and neurological examination, modern technologies, such as MRI and evoked potential study (EPS), have played an important role in making the anatomical and pathological diagnosis of myelopathy. To assess the accuracy of clinical diagnosis and the role of the laboratory studies, we prospectively studied 26 patients with myelopathy, admitted to S.N.U.H. We tried to decide, by clinical history and examination, the anatomical location and the pathological diagnosis, and compared them with final diagnosis. 1. The final diagnosis could be made in 23 out of 26 patients. 2. Of 17 patients with the initial clinical diagnosis of intramedullary lesion (IML), two patients turned out to have extramedullary lesions (EML). Final diagnosis could not be made in three patients, and imaging studies and EPS didn't reveal definite local lesions. In another group of nine patients with the initial clinical diagnosis of EML, three patients had IML. 3. The clinically suspected levels of lesions were shown to be accurate within one level in 20 out of 26 patients after MRI. 4. Clinical diagnosis was accurate in 18 out of 26 patients. 5. Among the laboratory tests, MRI helped localize the lesions and make the final diagnosis. EPS was most helpful in making a diagnosis of multiple sclerosis by finding out asymptomatic second lesions. Even with thorough work-up the etiologies of myelopathy in three patients could not be elucidated. 6. Review of wrong diagnosis showed that diagnostic errors were attributed to incomplete history taking or examination, misinterpretation of clinical data, and unusual presentations or unsuspected rare diseases. Therefore, the authors conclude that the physician's clinical examinations in the diagnosis of neurologic diseases are still valuable despite the technology of the laboratory studies is developing further in present days.
Diagnosis ; Diagnostic Errors ; Evoked Potentials ; Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis ; Neurologic Examination* ; Prospective Studies ; Rare Diseases ; Spinal Cord Diseases

In Fanconi syndrome, hypophosphatemic osteomalacia is caused by proximal renal tubule dysfunction which leads to impaired reabsorption of amino acids, glucose, urate, and phosphate. We present a rare case of a 43-year-old Korean male who was found to have insufficiency stress fracture of the femoral neck secondary to osteomalacia due to Fanconi syndrome. He had been receiving low-dose adefovir dipivoxil (ADV, 10 mg/day) for the treatment of chronic hepatitis B virus infection for 7 years and he subsequently developed severe hypophosphatemia and proximal renal tubule dysfunction. The incomplete femoral neck fracture was fixed with multiple cannulated screws to prevent further displacement of the initial fracture. After cessation of ADV and correction of hypophosphatemia with oral phosphorus supplementation, the patient's clinical symptoms, such as bone pain, muscle weakness, and laboratory findings improved.
Adult ; Amino Acids ; Fanconi Syndrome* ; Femoral Neck Fractures* ; Femur Neck* ; Fractures, Spontaneous ; Fractures, Stress ; Glucose ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hypophosphatemia ; Kidney Tubules, Proximal ; Male ; Myalgia ; Osteomalacia ; Phosphorus ; Uric Acid

In Fanconi syndrome, hypophosphatemic osteomalacia is caused by proximal renal tubule dysfunction which leads to impaired reabsorption of amino acids, glucose, urate, and phosphate. We present a rare case of a 43-year-old Korean male who was found to have insufficiency stress fracture of the femoral neck secondary to osteomalacia due to Fanconi syndrome. He had been receiving low-dose adefovir dipivoxil (ADV, 10 mg/day) for the treatment of chronic hepatitis B virus infection for 7 years and he subsequently developed severe hypophosphatemia and proximal renal tubule dysfunction. The incomplete femoral neck fracture was fixed with multiple cannulated screws to prevent further displacement of the initial fracture. After cessation of ADV and correction of hypophosphatemia with oral phosphorus supplementation, the patient's clinical symptoms, such as bone pain, muscle weakness, and laboratory findings improved.
Adult ; Amino Acids ; Fanconi Syndrome* ; Femoral Neck Fractures* ; Femur Neck* ; Fractures, Spontaneous ; Fractures, Stress ; Glucose ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hypophosphatemia ; Kidney Tubules, Proximal ; Male ; Myalgia ; Osteomalacia ; Phosphorus ; Uric Acid

Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized by skin rash, fever, lymph-node enlargement, and internal organ involvement. We describe a 22-year-old male who presented with acute kidney injury and was diagnosed with prolonged cholestatic hepatitis A. The patient also developed DRESS syndrome due to antibiotic and/or antiviral treatment. To our knowledge, this is the first report of histopathologically confirmed DRESS syndrome due to antibiotic and/or antiviral treatment following HAV infection with cholestatic features and renal injury.
Acute Kidney Injury/diagnosis ; Anti-Bacterial Agents/*adverse effects/therapeutic use ; Cefotaxime/adverse effects/therapeutic use ; Cholestasis/complications/*diagnosis ; Cytomegalovirus/genetics ; Cytomegalovirus Infections/drug therapy/virology ; DNA, Viral/analysis ; Eosinophilia/etiology ; Exanthema/*chemically induced/pathology ; Ganciclovir/therapeutic use ; Hepatitis A/complications/*diagnosis/drug therapy ; Humans ; Hydrocortisone/therapeutic use ; Immunoglobulins/therapeutic use ; Male ; Syndrome ; Young Adult

No abstract available.
Leiomyosarcoma* ; Neoplasm Metastasis* ; Scalp* ; Skin

We report a case of pityriasis versicolor atrophicans in a 20-year-old woman who presented with chronic multiple brownish atrophic macules and patches on chest and back. The lesions had developed six years ago and the patient had used topical medication including steroid ointments for the last two years prior to visiting our clinic. KOH examination was positive, so skin biopsy was performed and the diagnosis of pityriasis versicolor atrophicans was made. Since our patient had applied topical steroids for some time, it was difficult to rule out steroid-induced atrophy in a common tinea versicolor. Also, differential diagnosis was performed with respect to other skin diseases manifesting with cutaneous atrophy including anetoderma.
Anetoderma ; Atrophy ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Ointments ; Pityriasis ; Skin ; Skin Diseases ; Steroids ; Thorax ; Tinea Versicolor ; Young Adult