PURPOSE: To investigate the changes of epiblepharon by evaluating the severity of epiblepharon before and after induction of general anesthesia (GA) with a muscle relaxant and total intravenous anesthesia (TIVA) without a muscle relaxant. METHODS: Thirteen pediatric patients (26 eyes) underwent surgery for epiblepharon under GA using a muscle relaxant and 19 pediatric patients (38 eyes) underwent surgery for epiblepharon under TIVA without a muscle relaxant. The severity of epiblepharon in each eye was scored according to skin-fold height (scored 1-4) and area of ciliocorneal touch (scored 1-3) while the patient was in the supine position before induction and after induction of GA. RESULTS: Skin-fold height scores and ciliocorneal touch area scores decreased after induction of GA with a muscle relaxant (skin-fold height score before GA: 2.42 ± 0.86, after GA: 1.87 ± 0.88 p-value < 0.001; ciliocorneal touch area score before GA: 2.05 ± 0.70, after GA: 1.61 ± 0.68, p-value < 0.001). In the TIVA group, skin-fold height scores and ciliocorenal touch area scores were not statistically different before and after GA (skin-fold height score before GA: 2.23 ± 1.18, after GA: 2.38 ± 1.10, p-value = 0.212; ciliocorneal touch area score before GA: 2.06 ± 0.74, after GA: 1.94 ± 0.80, p-value = 0.161). CONCLUSIONS: The change of epiblepharon severity was significantly reduced by induction of TIVA without a muscle relaxant and there was no recurrence of epiblepharon 3 months after surgery. When using TIVA without a muscle relaxant, the change of epiblepharon severity was reduced and thus, this method can help prevent its undercorrection.
Anesthesia, General ; Anesthesia, Intravenous* ; Humans ; Recurrence ; Supine Position

PURPOSE: To investigate the changes of epiblepharon by evaluating the severity of epiblepharon before and after induction of general anesthesia (GA) with a muscle relaxant and total intravenous anesthesia (TIVA) without a muscle relaxant. METHODS: Thirteen pediatric patients (26 eyes) underwent surgery for epiblepharon under GA using a muscle relaxant and 19 pediatric patients (38 eyes) underwent surgery for epiblepharon under TIVA without a muscle relaxant. The severity of epiblepharon in each eye was scored according to skin-fold height (scored 1-4) and area of ciliocorneal touch (scored 1-3) while the patient was in the supine position before induction and after induction of GA. RESULTS: Skin-fold height scores and ciliocorneal touch area scores decreased after induction of GA with a muscle relaxant (skin-fold height score before GA: 2.42 ± 0.86, after GA: 1.87 ± 0.88 p-value < 0.001; ciliocorneal touch area score before GA: 2.05 ± 0.70, after GA: 1.61 ± 0.68, p-value < 0.001). In the TIVA group, skin-fold height scores and ciliocorenal touch area scores were not statistically different before and after GA (skin-fold height score before GA: 2.23 ± 1.18, after GA: 2.38 ± 1.10, p-value = 0.212; ciliocorneal touch area score before GA: 2.06 ± 0.74, after GA: 1.94 ± 0.80, p-value = 0.161). CONCLUSIONS: The change of epiblepharon severity was significantly reduced by induction of TIVA without a muscle relaxant and there was no recurrence of epiblepharon 3 months after surgery. When using TIVA without a muscle relaxant, the change of epiblepharon severity was reduced and thus, this method can help prevent its undercorrection.
Anesthesia, General ; Anesthesia, Intravenous* ; Humans ; Recurrence ; Supine Position

No abstract available.
Dysautonomia, Familial*

No abstract available.
Lymphohistiocytosis, Hemophagocytic*

PURPOSE: Finasteride, an inhibitor of 5alpha-reductase, is used for the treatment of benign prostatic hyperplasia (BPH) and male pattern baldness, by inhibiting the conversion of testosterone to dihydrotestosterone (DHT). We attempted to determine whether finasteride treatment led to a clinical improvement in BPH patients with male pattern baldness. MATERIALS AND METHODS: This was a one year, single blind, prospective study, conducted on BPH patients. Eighty two men participated in the study, and received either 5mg finasteride plus 0.2mg tamsulosin (group I, n=43) or 0.2mg tamsulosin alone (group II, n=39). The efficacies were evaluated, bimonthly, by baldness grade, international prostate symptom score (IPSS) and peak flow rate (PFR), for 12 months. The estimation of baldness grade was based on the modified Norwood's classification (from grades I to VII). Patients with grade IV or higher were categorized as having moderate to severe male pattern baldness. The numbers of moderate to severe male pattern baldness were 11 and 16 in groups I and II, respectively. RESULTS: At the baseline, there were no significant differences in the baldness grade, age and prostatic volume between the two groups. Group I exhibited a gradual and continuous improvement in the baldness grade at 10 and 12 months compared to baseline (p<0.05), while group II displayed no significant change in the baldness grade. Thirteen patients (30.2%) of group I manifested improvements in their baldness grade, whereas none of group II demonstrated an improvement. In group I, of the eleven patients with moderate to severe male pattern baldness, seven (63.6%) showed an improvement in their baldness grade, whereas of the thirty two mild grade patients, six (18.7%) showed an improvement. The improvement in baldness grade from the baseline to 10 and 12 months were statistically significant, but from the baseline to 8 months was insignificant. CONCLUSIONS: The combined treatment of 5mg finasteride and 0.2mg tamsulosin, for BPH patients, resulted in an improvement in male pattern baldness.
Alopecia* ; Classification ; Dihydrotestosterone ; Finasteride* ; Humans ; Male* ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Testosterone

No abstract available.
Osteosarcoma* ; Sphenoid Bone*

No abstract available.
Drainage* ; Humans ; Hydrocephalus*

42 patients with mitral stenosis(MS), diagnosed by M-mode, 2-D sector scan and pulsed Doppler echocardiography, were evaluated. Among them 28 patients were complicated with atrial fibrillation and one foruth was normal sinus rhythm. Pulsed Doppler echocardiographic left ventricular inflow velocity patterns(PELVIVP) were compaired with the EF slop of anterior mitral valve leaflet. The results were as follows; The normal PELVIVP showed a biphasic pattern during diastole. PEVIVP in MS were classified into 5 types and measured EF slop of anterior mitral valve leaflet in each type. Type I was characterized by a biphasic flow pattern showing a relative increase in the atrial contraction wave compared with the rapid filling wave and the prolonged deceleration time. EF slop was 24.7+/-6.1mm/sec. Type II was turbulent scaphoid pattern during diastole. EF slop was 14.5+/-4.4mm/sec. Type IIIa was monophasic with gradual descending slop during diastole. EF slop was 16.9+/-4.0mm/sec. Type IIIb was also turblent monophasic with gradual ascending slop during diastole. EF slop was 8.1+/-2.3mm/sec. Type IV was diastolic turblent and was characterized by dome shaped pattern. EF slop was 7.9+/-1.9mm/sec. There was a significant correlation between the 3 groups(I, II and IIIa, IIIb and IV) of LVIVP in MS and EF slop(P<0.005). This result indicated that type I of the flow pattern was well observed in mild MS, type II and IIIa in moderate MS, and type IIIb and IV in severe MS. Pulsed Doppler flow pattern in MS was alterable in the atrial fibrillation.
Atrial Fibrillation ; Deceleration ; Diastole ; Echocardiography* ; Echocardiography, Doppler, Pulsed ; Humans ; Mitral Valve ; Mitral Valve Stenosis*

Clostridium difficile is the leading cause of hospital-acquired diarrhea. The frequent use of antibiotics and chemotherapeutic agents increases the likelihood of acquiring Clostridium difficile-associated disease. Reactive arthritis is a recognized sequela of infection with a many types of enteric or urogenital pathogens. Although the main bacterial causes of reactive arthritis following enteric infection are Salmonella, Shigella, Campylobacter and Yersinia, Clostridium difficile should be considered as a rare cause of reactive arthritis. We report here on a case of a 63-year-old man who presented with reactive arthritis following an infection with Clostridium difficile.
Anti-Bacterial Agents ; Arthritis, Reactive ; Campylobacter ; Clostridium ; Clostridium difficile ; Diarrhea ; Enterocolitis, Pseudomembranous ; Humans ; Middle Aged ; Salmonella ; Shigella ; Yersinia

BACKGROUND: In the pathogenesis of ulcerative colitis, a defective mucosal barrier to luminal antigens is currently under consideration, and alterations in mucin structure and lectin binding may play an important role in the defect of mucosal barrier. It is also, suggested that the differences in clinical manifestation and complication of ulcerative colitis are associated with the change in glycosylation of colonic mucus glycoconjugates. This study was performed in order to investigate the histochemical properties of the mucin in korean ulcerative colitis. METHODS: The histochemical staining (HID-AB, mild PAS, PBT-KOH-PAS) and the binding of lectin (PNA, DBA, UEA-1, RCA-1, WGA, with avidin-biotin peroxidase complex method) to mucin glycoconjugates were analyzed in paraffin-embedded tissue sections obtained from 14 normal colons and 20 ulcerative colitis. RESULTS: In the ulcerative colitis, number of goblet cell and amount of mucin were decreased, but the expression of its sulphomucin was consistently predominant and strong like normal colon. The expression of N-acetylated sialomucin was more common in the ulcerative colitis(80%) than normal colon(50%) and its grading mildly increased in ulcerative colitis. The expression of O-acetylated sialomucin was present in all cases of normal colon and its staining grade decreased in the ulcerative colitis. Compared to normal colonic mucosa, ulcerative colitis showed the increase in PNA and DBA binding in the supranuclear cytoplasm, the decrease in DBA and RCA-1 binding in the goblet cells, and no change in UEA-1 and WGA binding in both. In the ulcerative colitis, the increase in PNA and DBA binding was mild in the supranuclear cytoplasm and the expression of DBA and RCA-1 binding in goblet cells variably decreased. CONCLUSIONS: This study demonstrates the changes in the mucosal glycoconjugates between the ulcerative colitis and normal colon. The mucinous glycoconjugate expression of korean ulcerative colitis are different from that of western patients. There may be a genetic, racial variation in the glycoconjugate, which may also play a part in the differences in pathogenesis, clinical manifestation, and complication of ulcerative colitis.
Colitis ; Colitis, Ulcerative* ; Colon ; Cytoplasm ; Glycoconjugates ; Glycosylation ; Goblet Cells ; Humans ; Lectins ; Mucins* ; Mucous Membrane* ; Mucus ; Peroxidase ; Phenobarbital ; Sialomucins ; Ulcer*