We investigated the effects of panretinal photocoagulation (PRP)on macular microcirculation in diabetic retinopathy. PRP using argon blue green laser was performed in 23 eyes of 15 patients with early proliferative diabetic etinopathy and very severe nonproliferative diabetic retinopathy without significant macular edema. The changes in volume, flow, velocity of macular microcirculation were measured before PRP, 1 hour, 1 day, 1 week, and 1 month following PRP, using Heidelberg Retina Flowmeter(HRF). Mean volume, flow, velocity of macular microcirculation decreased to a maximal degree 1 hour following PRP, from 14.87+/-0.40, 387.45 +/-101.40, 1.40+/-0.28(before PRP)to 12.44+/-1.39, 347. 33+/-100.39, 1.27+/-0.34(p<0.05). From 1hour to 1 month after PRP, macular microcirculation gradually increased. However, throughout this period, all parameters of macular microcirculation remained lower than pre-PRP level(p<0.05). Our study suggests that panretinal photocoagulation reduces the macular microcirculation in diabetic retinopathy.
Argon ; Diabetic Retinopathy ; Humans ; Light Coagulation* ; Macular Edema ; Microcirculation* ; Retina ; Retinaldehyde*

Childhood chronic abdominal pain usually doesn't have an organic etiology. It may cause social impairment and emotional distress in children as well as their families. In view of cognitive and behavioral aspect, passive coping style, maladaptive social modeling, and reinforced secondary gain could contribute to the development and maintenance of pediatric somatization. Integrative etiological model includes biological factors due to the enteric sensitization process, psychosocial factors which encompass family influences, psychodevelomental vulnerability, and life event-related stress. These factors interact with each other and manifest as various psychosomatic symptoms. In the treatment of childhood chronic abdominal pain, multimodal treatment program, which includes cognitive behavioral therapeutic methods, emotional support, family education, selective serotonin reuptake inhibitor, and so on, is known to be most effective.
Abdominal Pain ; Biological Factors ; Child ; Combined Modality Therapy ; Humans ; Serotonin

PURPOSE: This study addressed the feasibility and effect of surgical treatment of metachronous periampullary carcinoma after resection of the primary extrahepatic bile duct cancer. The performance of this secondary curative surgery is not well-documented. METHODS: We reviewed, retrospectively, the medical records of 10 patients who underwent pancreaticoduodenectomy (PD) for secondary periampullary cancer following extrahepatic bileduct cancer resection from 1995 to 2011. RESULTS: The mean age of the 10 patients at the second operation was 61 years (range, 45-70 years). The primary cancers were 7 hilar cholangiocarcinomas, 2 middle common bile duct cancers, and one cystic duct cancer. The secondary cancers were 8 distal common bile duct cancers and 2 carcinomas of the ampulla of Vater. The second operations were 6 Whipple procedures and 4 pylorus-preserving pancreaticoduodenectomies. The mean interval between primary treatment and metachronous periampullary cancer was 20.6 months (range, 3.4-36.6 months). The distal resection margin after primary resection was positive for high grade dysplasia in one patient. Metachronous tumor was confirmed by periampullary pathology in all cases. Four of the 10 patients had delayed gastric emptying (n = 2) or pancreatic fistula (n = 2) after reoperation. There were no perioperative deaths. Median survival after PD was 44.6 months (range, 8.5-120.5 months). CONCLUSION: Based on the postoperative survival rate, PD may provide an acceptable protocol for resection in patients with metachronous periampullary cancer after resection of the extrahepatic bile duct cancer.
Ampulla of Vater ; Bile Ducts, Extrahepatic* ; Cholangiocarcinoma ; Common Bile Duct ; Cystic Duct ; Gastric Emptying ; Humans ; Medical Records ; Neoplasms, Second Primary ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Pathology ; Reoperation ; Retrospective Studies ; Survival Rate

PURPOSE: This study was to investigate the age and sex differences of the fractal dimension of the normal parotid glands in the digitized CT images. MATERIALS AND METHODS: The six groups, which were composed of 42 men and women from 20`s, 40`s and 60`s and over were picked. Each group contained seven people of the same sex. The normal parotid CT images were digitized, and their fractal dimensions were calculated using Scion ImagePC program. RESULTS: The mean of fractal dimensions in males was 1.7292(+/-0.0588) and 1.6329(+/-0.0425) in females. The mean of fractal dimensions in young males was 1.7617, 1.7328 in middle males, and 1.6933 in old males. The mean of fractal dimensions in young females was 1.6318, 1.6365 in middle females, and 1.6303 in old females. There was no statistical difference in fractal dimension between left and right parotid gland of the same subject(p>0.05). Fractal dimensions in male were decreased in older group(p<0.05) and larger than female in same age group(p<0.05). But fractal dimensions in female had a tendency to decrease in older group but no statistical difference between ages(p>0.05). CONCLUSIONS: The fractal dimension of parotid glands in the digitized CT images will be useful to evaluate the age and sex differences.
Female ; Fractals* ; Humans ; Male ; Parotid Gland* ; Sex Characteristics

The neurotoxicity of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in rodents was investigated by measuring the locomotor activity and the changes of brain biogenic amines in MPTP-treated C57BL/6 mice. The mice showed a typical curved spine posture 24 hours after MPTP treatment. Total locomotor activity was reduced and the ratios of stereotyped activity/total locomotor activity were increased 24 hours after MPTP treatment. However no significant changes were observed 7 days after MPTP treatment. MPTP-induced changes of biogenic amines were evident only in corpus striatum, not in frontal lobe, midbrain and hippocampus; the levels of dopamine, dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were reduced by 94%, 76.3% and 60.2% after 24 hours, and 81.9%, 61.3% and 26.1% after 6 days compared to control values respectively. The ratios of DOPAC/dopamine, HVA/dopamine and HVA/DOPAC were increased 24 hours and 7 day after MPTP treatment compared to control valuse in corpus striatum, but the degree of the 7 days was less than the 24 hours. The ratios of 5-HIAA/5-HT were incresed 24 hours and 7 days after MPTP treatment in corpus striatum, but there were no significant changes in the levels of 5-hydroxyindoleacetic acid (5-HIAA) and 5-hydroxtryptamine (5-HT). In conclusion, MPTP produced parkinsonism-like behavioral and biochemical changes in C57BL/ 6 mice.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine* ; Animals ; Biogenic Amines* ; Brain ; Corpus Striatum ; Dopamine ; Frontal Lobe ; Hippocampus ; Homovanillic Acid ; Mesencephalon ; Mice* ; Motor Activity* ; Posture ; Rodentia ; Spine

PURPOSE : To compare the clinical, roentgenographic results and patient self assessment between posterior cruciate retaining TKA and posterior cruciate substituting TKA. MATERIALS AND METHODS : From January 1993 to May 1999, 68 patients (106 knees) were performed total knee arthroplasty using the PFC system. Seventy five PCL retaining and thirty one PCL substituting components were used. Retrospective analysis were done in two groups by the clinical and radiological evaluation system using American Knee Society Scale and patient self assessment using WOMAC score. RESULTS : There were no statistically significant differences in knee score and functional score, improvement of range of motion, and self assesment of the PCL retaining and substituting group. We also observed improvement of pain, knee scores, and functional scores according to flexion contracture in both groups but there were no significant differences statistically. Tibiofemoral angles were corrected in both groups. There was no case of complete radiolucency, osteolysis, and component loosening. CONCLUSION : Surgeons will achieve good result of operation, if they choose proper type of TKA systems according to state of posterior cruciate ligament, degree of deformity, and technique of surgery.
Arthroplasty* ; Congenital Abnormalities ; Contracture ; Equidae ; Humans ; Knee* ; Osteolysis ; Posterior Cruciate Ligament ; Range of Motion, Articular ; Retrospective Studies ; Self-Assessment

Klinefelter' syndrome is a disorder of sexual differentiation in males, characterized by the presence of two or more X-chromosomes, hypogonadism, and lack of secondary sexual characteristics. The association between Klinefelter' syndrome and glomerulonephritis has been reported, while cases of glomerulonephritis associated with Klinefelter' syndrome are rare. We report the Korean case: a 31-year-old man with Klinefelter' syndrome who developed glomerulonephritis. The patient's urine analysis shows microscopic hematuria and the result of kidney biopsy was minimal change disease. The onset and course of his disease might have been influenced by the sex hormone imbalance.
Biopsy ; Glomerulonephritis ; Hematuria ; Humans ; Hypogonadism ; Kidney ; Male ; Nephrosis, Lipoid ; Sex Differentiation

PURPOSE: Surgical resection of isolated hepatic or pulmonary metastases of colorectal cancer is an established procedure, with a 5-year survival rate of about 50%. However, the role of surgical resections in patients with both hepatic and pulmonary metastases is not well established. We aimed to analyze overall survival of these patients and associated factors. METHODS: Data retrospectively collected from 66 patients who underwent both hepatic and pulmonary metastasectomy after colorectal cancer surgery from August 2002 through August 2013 were analyzed. In univariate analysis, the log-rank test compared patient survival between groups. P < 0.1 was considered indicative of significance. Multivariate analysis of the significance data using a Cox proportional hazard model identified factors associated with overall survival. The synchronous group (n = 57) was defined as patients who had metastasectomy within 3 months from primary colorectal cancer surgery. The remaining nine patients constituted the metachronous group. RESULTS: Median follow-up was 126 months from the primary colorectal cancer surgery. The 5-year survival was 73.4%. There was no difference in overall survival between the synchronous and metachronous groups, consistent with previous studies. Distribution (involving one hemiliver or both, P = 0.010 in multivariate analysis) of liver metastases and multiplicity of the pulmonary metastasis (P = 0.039) were predictors of poor prognosis. CONCLUSION: Sequential or simultaneous resection of both hepatic and pulmonary metastasis of colorectal cancer resulted in good long-term survival in selected patients. Thus, an aggressive surgical approach and multidisciplinary decision making with surgeons seems to be justified.
Colorectal Neoplasms* ; Decision Making ; Follow-Up Studies ; Humans ; Liver* ; Lung* ; Metastasectomy ; Multivariate Analysis ; Neoplasm Metastasis* ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Surgeons ; Survival Rate

No abstract available.
Acromegaly* ; Fibrous Dysplasia, Polyostotic*

PURPOSE: Tumors arising from the ampulla of Vater can be benign or malignant. Recently, endoscopic papillectomy has been employed in the management of benign ampulla of Vater tumors; however, surgical resection is the treatment of choice. The aim of this study was to define indications and suggest a role for transduodenal ampullectomy in the management of ampulla of Vater tumors. METHODS: We retrospectively reviewed the medical records of 54 patients treated for ampulla of Vater tumors between January 1999 and December 2008. RESULTS: Twenty-two endoscopic papillectomies and 21 transduodenal ampullectomies were performed. Four patients underwent transduodenal ampullectomy after endoscopic papillectomy due to a recurrent or remnant tumor. Recurrence or a remnant tumor was found in one patient after transduodenal ampullectomy compared to six patients after endoscopic papillectomy. Immediate intraoperative conversion from transduodenal ampullectomy to pancreaticoduodenectomy was performed in five patients based on intraoperative frozen biopsy analysis. CONCLUSION: Transduodenal ampullectomy should be performed to treat ampulla of Vater tumors that are unsuitable for endoscopic papillectomy. Transduodenal ampullectomy can serve as an intermediate treatment option between endoscopic papillectomy and pancreaticoduodenectomy in the management of ampulla of Vater tumors.
Ampulla of Vater ; Biopsy ; Humans ; Medical Records ; Pancreaticoduodenectomy ; Recurrence ; Retrospective Studies