Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

Human untreated costal cartilage was compared with lyophilized human costal cartilage which was treated with defatting solution for 48 hours and freeze drying for 72 hours (-70degree C, 10??bar) on the tendency of distortion. All cartilages, which were taken from six cadavers, were carved 5x5x30mm in size on principle of the balanced cross section. Their distortions were evaluated by two methods at intervals of one week, one month, three months, six months after experiment. At first, the degree of distortion was grossly graded with four steps: grade O; no distortion / grade I; minimal distortion / grade II; moderate distortion / grade III; severe distortion. Second method is measurement and quantification of distortion in the horizontal and vertical plane of cartilage.Untreated cartilage is shown to be an unsatisfactory material, with only three(12%) of the 25 cartilages being cosmetically acceptable(grade 0 and 1) after 6 months. In lyophilized cartilage, 18(94%) of the 19 cartilages were cosmetically acceptable(grade 0 and 1) at 6 months. This figure is highly significant(p<0.01). In another method, distortion in the horizontal(h) and vertical (v) planes of cartilage were measured, and mean values of ???? were calculated. In untreated group, the mean values of ???? were 0.82 at 1 week, 0.91 at 1 month, 1.13 at 3 months, and 1.31 at 6 months. In lyophilized group, the mean values were 0.27 at 1 week, 0.29 at 1 month, 0.40 at 3 months and 0.47 at 6 months. All values were statistically significant(p<0.01).
Cadaver ; Cartilage* ; Freeze Drying ; Humans

BACKGROUND : Borame hospital nuns geriatric wards with 120 beds (40 beds for patients in Dept. of Internal Medicine, 40 for patients in Dept. of Orthopedics 40 for patients in Dept. of Neurology) from December 1996. We studied clinical characteristics of admissions to acute geriatric wards in Borame hospital in order to assess current status of geriatric wards in Korea. METHODS : 334 patients admitted from December 1996 to May 1997 were studied. By reviewing clinical records of these patients, we studied clinical characteristics of patients in geriatric wards retrospectively. RESULTS : 1) Age distribution: 8.6% of patients were over 85 years old. 16.4% of patients were between age of 80-84. 20.0% between 75-79, 31.3% between 70-74, 26.3% between 65-69, respectively. 2) Disease: 43% of patients have single disease, 67% of patients have multiple disease(23% of patients with 2 disease, 25% with 3 disease, 6% with 4 disease, 3% with over 5 disease respectively). 3) Mortality rate :Total mortality rates were 4.3% with 6.1% of patients in Internal medicine, 3.2% of patients in Neurology. These rates were much higher compared with mortality rates of 2.4% in general wards but similar to those (6.7%) in general wards in Internal medicine. 4) Causes of admission: Malignancies were most common causes of admissions in males, and then cerebrovascular diseases, infectious diseases, musculoskeletal diseases, in order. Musculoskeletal diseases were most common causes, and then diabetes mellitus, infectious diseases, cerebrovascular diseases. CONCLUSION : The elderly patients tend to have multiple diseases, longer hospital stays and higher mortality rates compared with younger patients in general wards. but differences of hospital stays and mortality rates are less than be expected.
Age Distribution ; Aged ; Aged, 80 and over ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Internal Medicine ; Korea ; Length of Stay ; Male ; Mortality ; Musculoskeletal Diseases ; Neurology ; Orthopedics ; Patients' Rooms ; Retrospective Studies

No abstract available.

“Itch” is an unpleasant sensation that elicits a desire to scratch. It is a common complaint among many patients and is associated with a markedly reduced quality of life. The pathogenesis of itch begins with various pruritogens stimulating free nerve endings in the skin, which causes an itch signal to travel through the spinothalamic tract to the brain where the sensation is processed. Scratching an itch initially activates the reward systems in the midbrain and striatum, and this positive reinforcement leads to the repetitive scratching behavior that damages the skin barrier. Mediators such as histamine, serotonin and cytokines are released from the damaged skin, which further aggravates the itch and initiates a vicious “itch-scratch cycle.” Such processes may eventually lead to neural sensitization, where weaker stimuli can cause a more severe pruritic sensation. Chronic itch is one that lasts beyond 6 weeks. Pathologic pruritus can be classified into four different categories based on its cause: dermatologic, systemic, neuropathic, and psychogenic itch. Regardless of the cause, antihistamines are often prescribed as a first-line treatment of chronic itch, but more often than not they prove to be ineffective in bringing symptom relief. Both topical and systemic therapies are used to treat itch, and adequate treatment selection is considered according to symptom severity and chronicity. As the pathogenesis of itch becomes elucidated, more exciting new therapeutic options targeting pruritogenic mediators are becoming increasingly available. This review provides an overview of the pathophysiology, causes and the treatment of chronic itch.

The aim of this study was to determine whether losartan, an angiotensin II (Ang II) type 1 (AT1) receptor could influence the CA release from the isolated perfused model of the rat adrenal medulla. Losartan (5~50 micrometer) perfused into an adrenal vein for 90 min produced dose- and time-dependent inhibition of the CA secretory responses evoked by ACh (5.32 mM), high K+ (56 mM, a direct membrane depolarizer), DMPP (100 micrometer) and McN-A-343 (100 micrometer). Losartan failed to affect basal CA output. Furthermore, in adrenal glands loaded with losartan (15 micrometer) for 90 min, the CA secretory responses evoked by Bay-K-8644 (10 micrometer, an activator of L-type Ca2+ channels), cyclopiazonic acid (10 micrometer, an inhibitor of cytoplasmic Ca2+-ATPase), veratridine (100 micrometer, an activator of Na+ channels), and Ang II (100 nM) were markedly inhibited. However, at high concentrations (150~300 micrometer), losartan rather enhanced the CA secretion evoked by ACh. Collectively, these experimental results suggest that losartan at low concentrations inhibits the CA secretion evoked by cholinergic stimulation (both nicotininc and muscarinic receptors) as well as by membrane depolarization from the rat adrenal medulla, but at high concentration it rather inhibits ACh-evoked CA secretion. It seems that losartan has a dual action, acting as both agonist and antagonist to nicotinic receptors of the rat adrenal medulla, which might be dependent on the concentration. It is also thought that this inhibitory effect of losartan may be mediated by blocking the influx of both Na+ and Ca2+ into the rat adrenomedullary chromaffin cells as well as by inhibiting the Ca2+ release from the cytoplasmic calcium store, which is thought to be relevant to the AT1 receptor blockade, in addition to its enhancement of the CA release.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands ; Adrenal Medulla ; Angiotensin II ; Animals ; Calcium ; Chromaffin Cells ; Cytoplasm ; Dimethylphenylpiperazinium Iodide ; Indoles ; Losartan ; Membranes ; Rats ; Receptors, Nicotinic ; Veins ; Veratridine

Purpose: To analyze the incidence rate and risk factors of intraocular lens dislocation in South Korea from 2002 to 2020 using Health Insurance Review and Assessment Service data. Methods: This study included 15% of patients aged > 40 years had pseudophakia or intraocular lens primary implantation codes during 2002-2020 (737,606 patients). The annual incidence rate and risk factors of intraocular lens dislocation during 2002-2020 were analyzed. Results: The mean annual incidence rate of intraocular lens dislocation during 2002-2020 was 0.20 ± 0.7%. The annual incidence rate increased significantly from 0.17% in 2002 to 0.34% in 2020 (p < 0.001). The annual mean incidence rate for women was 0.1 ± 0.05%, and there was no increasing trend (p > 0.05). The annual mean incidence rate for men was 0.35 ± 0.13% and an increasing trend was found (p < 0.001). High myopia, uveitis, retinitis pigmentosa, glaucoma, pseudoexfoliative glaucoma and previous vitreoretinal surgery significantly increased the risk of intraocular lens dislocation (p < 0.001). Hemodialysis and hypertension were not significant risk factors (p > 0.05). Conclusions The mean annual incidence rate of intraocular lens dislocation in South Korea was 0.2 ± 0.7%, and it showed an increasing trend, among men. High myopia, uveitis, retinitis pigmentosa, glaucoma, pseudoexfoliative glaucoma and previous vitreoretinal surgery significantly increased the risk of intraocular lens dislocation.

Hypotension during spinal anesthesia for cesaresn section remains as a common and serious complication despite the use of uterine displacement and volume preloading. This study was designed to compare the efficacy of the speed of crystalloid preload for reduc- ing the incidence of hypotension during spinal anesthesia for elective cesarean section. Twenty ASA I parturients were randomly allocated to receive 20ml/kg of crystalloid over either 20min (group 1) or 10min(group 2) before spinal anesthesia. Both groups showed a significant increase in central venous pressure during and immediately after preload, but there was no significant difference between the groups. Six patients in group 1 developed hypotension(a decrease in systolic pressure below 100mmHg and a fall of 20% from baseline values) and so did seven patients in group 2. We concluded that rapid crystalloid preloading did not reduce the incidence of hypotension during cesarean section under spinal anesthesia and its effectiveness in questionable.
Anesthesia, Spinal* ; Blood Pressure ; Central Venous Pressure ; Cesarean Section* ; Female ; Humans ; Hypotension* ; Incidence ; Pregnancy

The need for a short-acting non-depolarizing neuromuscular blocking agent to replace succinylcholine chloride(succinylcholine) is recognized widely and attempts to find such a drug have been numerous. Atracurium besylate(atracurium) is one of the new series of neuromuscular blocking agents with little cardiovascular effect and is not dependent on hepatic and renal function for terminating its action because of its self-destroying mechanism. Because succinylchline may occasionally be contraindieated for intubation in parturients we studied the use of atracurium in 23 patients having cesarean section. All patients received 0. 5 mg/kg atracurium for intubation and neuromuscular relaxation. Hemodynamic changes, the time from the injection of atracurium to maximal twitch suppression, the time between atracurium administration and the return to 10% of control twitch height were recorded and observed the degree of vocal cord relaxation and conditions of intubation and evaluated the Apgar scores. 1) Mean arterial pressure and heart rate increased significantly after intubation compared with that of control and just before intubation but there were no significant changes in 5 minutes after intubation. 2) The 90% twitch suppression following atracurium administration was 75.6+/-20.9 seconds. 3) The return of 10% of control twitch height was 2449.3+/-1114.0 seconds. 4) Intubation conditions were excellent for 19 patients. 5) The Apgar scores of 20 neonates were high. These data suggest that the use of atracurium may be a useful alternative for induction for Cesarean section when succinylcholine is contraindicated.
Arterial Pressure ; Atracurium* ; Cesarean Section* ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pregnancy ; Relaxation ; Succinylcholine ; Vocal Cords

BACKGROUND: The basal ganglia plays a major role in regulating motor, cognitive and emotional functions. In addition, it has been proposed that the functions of the basal ganglia is also related to control of sensory discrimination and sensorimotor integration. One possible way to test this hypothesis would be to investigate sensory functions in patients with various diseases affecting basal ganglia functions. Since idiopathic Parkinson's disease (IPD) is caused by selective impairment of basal ganglia functions, it could be a good model for this purpose. METHODS: We measured the grating resolution threshold (GRT) using the JVP (Johnson-Van Boven-Phillips) dome in 52 patients with IPD and 25 age-matched healthy controls. Statistical analysis employed unpaired t-test, paired t-test and simple regression analysis. P-values less than 0.05 were considered as significant. RESULTS: Patients showed significantly higher GRT than controls (3.07 +/- 0.74 vs 2.03 +/- 0.80; p<0.05). In patients, the mean GRT was not different between symptomatically dominant and non-dominant hands (3.10 +/- 0.95 vs 2.93 +/- 0.82). In the patients with hemiparkinsonism, GRT was also significantly higher in asymptomatic hands compared with controls (3.00 +/- 0.71 vs 2.03 +/- 0.80; p<0.05). The severity of sensory dysfunction in patients was not correlated with symptom duration or to symptom severity, measured by the modified Columbia rating scale (MCRS). CONCLUSIONS: The present results demonstrate that spatial discrimination is impaired in IPD, suggesting the basal ganglia plays a role in sensory regulation.
Basal Ganglia ; Discrimination (Psychology)* ; Dopamine ; Hand ; Humans ; Parkinson Disease* ; Regression Analysis ; Sensation