Strabismus fixus is a rare condition in which one or both eyes are anchored, as a rule, in a position of extreme adduction or abduction. The involved eye is "fixed" in this position and cannot be moved, and the forced duction test will confirm the immobility of the eye. The condition generally is thought to be congenital and caused by fibrosis, which would explain the loss of elasticity of the rectus muscle. Divergent forms of strabismus fixus not accompanied by ptosis or generalized fibrosis of the extraocular muscle are even more unusual. The authors experienced one case of divergent strabismus fixus in a 23 year old female patient. We performed complete disinsertion of both lateral rectus muscle and recession of conjunctiva and Tenon's capsule, combined with 11 mm resection of medial rectus muscle of left eye. The result of that surgery, however, was not satisfactory. So we performed 11 mm resection of medial rectus muscle of right eye and temporary fixation of the globes with traction sutures in a position of abbuction on both eyes at 3 days after the first surgery. After 4 weeks, patient was remained 60 delta exodeviation but primary position and ocular motility were improved.
Conjunctiva ; Elasticity ; Exotropia* ; Female ; Fibrosis ; Humans ; Strabismus ; Sutures ; Tenon Capsule ; Traction ; Young Adult

No abstract available.
Cause of Death* ; Fever* ; Humans

As the development of the percutaneous renal surgery, Ureteropelvic junction obstruction can be treated with endourologic technique instead of open surgery. Precutaneous endopyelotomy has been used mainly for the treatment of secondary ureteropelvic junction obstruction. But it was also successful for treatment of primary ureteropelvic junction obstruction. Recently, we performed endopyelotomy for 3 cases of ureteropelvic junction obstruction a 39 years-old male who had renal pelvic stones combined with ureteropelvic junction, a 32 years-old male with ureteropelvic junction obstruction and a 23 years-old male who had horseshoe kidney combined with ureteropelvic junction obstruction and good results were obtained.
Adult ; Humans ; Kidney ; Male ; Young Adult

The diagnostic and prognostic potential of an onco-metabolite, 2-hydroxyglutarate (2HG) as a proton magnetic resonance spectroscopy (1H-MRS) detectable biomarker of the isocitrate dehydrogenase (IDH)-mutated (IDH-MT) gliomas has drawn attention of neuroradiologists recently. However, due to severe spectral overlap with background signals, quantification of 2HG can be very challenging. In this technical review for neuroradiologists, first, the biochemistry of 2HG and its significance in the diagnosis of IDH-MT gliomas are summarized. Secondly, various 1H-MRS methods used in the previous studies are outlined. Finally, wereview previous in vivo studies, and discuss the current status of 1H-MRS in the diagnosis of IDH-MT gliomas.
Biochemistry ; Diagnosis ; Glioma* ; Isocitrate Dehydrogenase ; Magnetic Resonance Spectroscopy ; Proton Magnetic Resonance Spectroscopy* ; Protons*

No abstract available.
Abdominal Pain ; Colonoscopy ; Detergents ; Eating

BACKGROUND: It is debatable whether psychiatric problems are overrepresented in the epileptic patient population. In addition, the significance of MMPI elevations in epileptic patients is still uncertain. This study attempted to find out MMPI profile characteristics of patients with medically refractory epilepsy (MRE). METHODS: MMPI was administered to 172 MRE patients and 139 normal controls. RESULTS: In terms of the mean value of MMPI scales, the MRE patients group had normal mean values comparable to the normal control group. However, the MRE patients could be classified into three subgroups by a multivariate cluster analysis, which include a subgroup with normal profile group (41% of patients), neurotic profile group (elevated Hs-D-Hy scales; 19% of patients), and psychiatric profile group (elevated Pa-Pt- Sc & Hs-D-Hy scales; 40% of patients). CONCLUSIONS: This study shows that the majority of MRE patients have abnormal MMPI profiles and suggests that psychiatric disorders or problems might be common in MRE patients. (J Korean Neurol Assoc 19(3):226~231, 2001)
Epilepsy* ; Humans ; MMPI* ; Psychotic Disorders ; Weights and Measures

Acute aortic occlusion is rare but poses a high mortality and morbidity. Prompt diagnosis and treatment is essential. Typical presentation is rest pain with bilateral absent femoral pulse. When the non-typical symptoms predominate such as paraplegia, acute abdomen or sudden-onset hypertension, diagnosis may be difficult. We experienced a case of acute aortic thrombosis who suddenly developed paraplegia and rapidly deteriorated within several hours. When the paraplegia developed, he was under treatment with heparin and urokinase, was thrombocytopenic, and the femoral arteries were pulsatile. Spinal cord compression due to bleeding complication had to be ruled out. Duplex sonography and lumbar CT scan were not diagnostic. Aortic thrombosis was diagnosed by abdominal CT scan. This case illustrates the need for high suspicion of acute aortic occlusion presenting with paraplegia especially in patients with associated atherosclerotic disease.
Abdomen, Acute ; Aorta ; Diagnosis ; Femoral Artery ; Hemorrhage ; Heparin ; Humans ; Hypertension ; Mortality ; Paraplegia* ; Spinal Cord Compression ; Thrombosis* ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator

Bacteroides fragilis and Escherichia coli, normal colonic inhabitants, are the most frequently isolated bacteria in infected tissues, particularly in intraabdominal abscesses. This study was designed to determine whether enteric bacteria may alter the B. fragilis-induced expression of proinflammatory cytokines in mouse peritoneal tissue (MPT). After C57BL/6 mice were inoculated with abscess-forming mixture containing B. fragilis in the presence or absence of E. coli, RNA was extracted from MPT. Expression of interleukin (IL)-1alpha and tumor necrosis factor (TNF)alpha mRNA was assessed using RT-PCR and standard RNA. Each cytokine protein was also measured by ELISA. The co-inoculation of E. coli into mouse peritoneal cavity advanced the onset of abscess development by B. fragilis infection. When mouse was co-infected with E. coli and B. fragilis intraperitoneally, there was a synergistic increase in the expression of IL-1alpha and TNFalpha mRNA in MPT and this was paralleled by increased cytokine protein secretion. Mixed inoculation of heat-killed E. coli and B. fragilis did not cause a synergistic increase in those cytokine mRNA expression. These results suggest that enteric bacteria may significantly affect proinflammatory cytokine signal produced by host peritoneal cavity in response to B. fragilis infection.
Abscess ; Animals ; Bacteria ; Bacteroides fragilis* ; Bacteroides* ; Coinfection* ; Colon ; Cytokines ; Enterobacteriaceae ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli* ; Escherichia* ; Gene Expression* ; Interleukins ; Mice ; Peritoneal Cavity ; RNA ; RNA, Messenger ; Tumor Necrosis Factor-alpha

PURPOSE: Embryonic stem (ES) cells have been regarded as a powerful resource in cell replacement therapy. In recent reports, mouse ES cells have been successfully applied to the treatment of spinal cord injuries, hereditary myelin disorders of the central nervous system and diabetes mellitus. Various liver diseases are another group that could benefit from the availability of stem cell therapy; however, no previous demonstration has been made that shows the differentiation of ES cells into hepatocytes. METHODS: To investigate the in vivo differentiation potential of mouse ES cells, we injected ES cells into the splenic cortex of immuno-suppressed nude mice. RESULTS: In a histological analysis of the teratomas derived from injected ES cells some areas were shown, due to their morphology, to contain typical hepatocytes. The hepatic nature of these cells was further confirmed by immunohistochemical assays using the antibody against alpha-fetoprotein and hepatocyte-specific antibodies. In addition, periodic acid-Shiff staining revealed a small portion of hepatic area in the ES-derived teratoma produced glycogen, implying these cells are functional hepatocytes. CONCLUSION: Our case demonstrated for the first time that mouse ES cells can differentiate in vivo into a mixed population of hepatocytes with different maturation stati, which could potentially extend the usage of ES cells in cell replacement therapy for various liver diseases.
alpha-Fetoproteins ; Animals ; Antibodies ; Cell Differentiation ; Central Nervous System ; Diabetes Mellitus ; Embryonic Stem Cells* ; Glycogen ; Hepatocytes* ; Liver Diseases ; Mice* ; Mice, Nude ; Myelin Sheath ; Spinal Cord Injuries ; Stem Cell Transplantation ; Stem Cells ; Teratoma

BACKGROUND: We examined whether increases of intra-abdominal pressure would decrease compliance (C) of both lung and chest wall. METHODS: We measured airway and esophageal pressure in 10 anesthetized/paralyzed tracheally intubated patients during mechanical ventilation at the respiratory rate of 10 freq/min and the tidal volume of 10 ml/kg undergoing laparoscopic cholecystectomy. Measurements were made at 0 mmHg intra- abdominal pressure the (Pab) in supine position and at 15 mmHg Pab in 10 head-up (reverse Trendelenburg) position at 0, 5, 10 and 15 min. after CO2 insufflation. RESULTS: We found that abdominal carbon dioxide insufflation caused a marked increase in peak airway pressure, plateau pressure and esophageal pressure (p<0.05); a reduction in compliance of respiratory system and chest wall (p<0.05). CONCLUSION: These changes should be considered in patients such as those with pulmonary disease, undergoing laparoscopic cholecystectomy where increase in impendance may be critical.
Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Compliance* ; Humans ; Insufflation ; Lung ; Lung Diseases ; Respiration, Artificial ; Respiratory Rate ; Respiratory System* ; Supine Position ; Thoracic Wall ; Tidal Volume