No abstract available.
Spina Bifida Occulta*

Ipratropium bromide (IP) is a new anticholinergic bronchodilator. To evaluate its effect on bronchial asthma which is still unknown in Korea, a double blind and randomized study was done on all patients of bronchial asthma who visit out-patients clinic of out department from June to September 197 and showed 75 to 100% of FEV1/FVC ratio on prebronchodilator spirometry (pre BD). The selected patients were given 2 puffs of Fenoterol (FE) or Ipratropium inhalator blindly and Spirometry. The repeated results are: 1. In both FE and IP groups, there was a significant bronchodilatory effect on 5 and 60 minutes after administration. 2. One 5 minutes, effect of FE was significantly greater than IP (FVC p<0.05, FEV1 p<0.01). 3. One 60 minutes, effect of IP was slightly less than FE but statistically non-significant. On the basis of above results, we concluded that onset of effect of IP is slower than FE, but its effect is significant and nearly comparable to FE.
Asthma* ; Fenoterol ; Humans ; Ipratropium* ; Korea ; Nebulizers and Vaporizers ; Outpatients ; Spirometry

Purpose: We report a case of Purtscher-like retinopathy after aortic valve replacement surgery.Case summary: A 52-year-old male with bacteremia suspicious of infectious endocarditis was referred to our department for ophthalmic examination. Inflammatory reaction was evident in both anterior chambers. Fundus examination revealed infiltrative lesions with a Roth spot, and the patient was diagnosed with chorioretinitis. After 3 days, aortic valve replacement surgery was performed in the cardiac surgery department using cardioplegic solutions. Ophthalmologic exams were repeated after the valve surgery. The Roth spot had disappeared and infiltrated, leaving a clear margin. An anterior chamber cell was not noted. However, there were newly developed peripapillary superficial cotton-wool spots and delayed hemorrhagic lesions. Based on the medical history and specific pathognomonic fundus findings, the patient was diagnosed with Purtscher-like retinopathy. Four months later, all characteristic funduscopic features of Purtscher-like retinopathy had disappeared, leaving a remaining retinal nerve fiber defect and central visual field defect without any ophthalmologic treatment. Conclusions Although rare, doctors should be aware of the possibility of Purtscher-like retinopathy after valve replacement surgery. Further studies are needed to understand the unknown pathophysiology of Purtscher-like retinopathy.

Purpose: We report a case of Purtscher-like retinopathy after aortic valve replacement surgery.Case summary: A 52-year-old male with bacteremia suspicious of infectious endocarditis was referred to our department for ophthalmic examination. Inflammatory reaction was evident in both anterior chambers. Fundus examination revealed infiltrative lesions with a Roth spot, and the patient was diagnosed with chorioretinitis. After 3 days, aortic valve replacement surgery was performed in the cardiac surgery department using cardioplegic solutions. Ophthalmologic exams were repeated after the valve surgery. The Roth spot had disappeared and infiltrated, leaving a clear margin. An anterior chamber cell was not noted. However, there were newly developed peripapillary superficial cotton-wool spots and delayed hemorrhagic lesions. Based on the medical history and specific pathognomonic fundus findings, the patient was diagnosed with Purtscher-like retinopathy. Four months later, all characteristic funduscopic features of Purtscher-like retinopathy had disappeared, leaving a remaining retinal nerve fiber defect and central visual field defect without any ophthalmologic treatment. Conclusions Although rare, doctors should be aware of the possibility of Purtscher-like retinopathy after valve replacement surgery. Further studies are needed to understand the unknown pathophysiology of Purtscher-like retinopathy.

PURPOSE: To evaluate clinical usefulness of magnetic resonance angiography(MRA) as a diagnostic modality and for treatment planning of intracranial arteriovenous malformations(AVM). METHODS AND MATERIALS: In 14 patients with intracranial AVM which were confirmed by operations, radiologic studies and clinical evaluations, magnetic resonance imaging(MRI), MRA and conventional angiography(CA) were retrospectively reviewed with specific regards to nidus depiction, detectability of feeding arteries and draining veins, and number and anatomic consistency of these vessles. MRA was obtained by 3 D TOF, 2 D PC, and 3 D methods with adequate VENC selection. RESULTS: Nidus of AVM was well demonstrated in MRI and MRA, and no remarkable difference in detection and size estimation of nidus among MRI, MRA and CA except 2 cases of associated intracranial hemorrhage, in which 3 D PC MRA well depicted nidus that were not visualized on MRI because of subacute hemorrhage. Feeding arteries were well demonstrated on 3 D TOF and 3 D PC MRA. Dilated draining veins were well depicted on 3 D PC MRA by scannig with adequate VENC selection, and the results were no remarkable difference compared with the ones on CA. CONCLUSION: MRA of a consecutive scan after MRI is a excellent modality for evaluation and treatment planning of intracranial AVM, and possible substitutive method for CA except for radiotherapy or transarterial embolization.
Arteries ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations* ; Intracranial Hemorrhages ; Magnetic Resonance Angiography* ; Magnetic Resonance Imaging ; Radiotherapy ; Retrospective Studies ; Veins

PURPOSE: Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our study was designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer perforation, and provide a step-by-step protocol with tips and recommendations for less experienced surgeons. MATERIALS AND METHODS: Between March, 2011 and May, 2012, 21 patients presenting with duodenal ulcer perforation underwent laparoscopic primary repair with omentopexy. There were no contraindications to perform laparoscopic surgery, and the choice of primary repair was decided according to the size of the perforation. The procedure for laparoscopic primary repair with omentopexy consisted of peritoneal lavage, primary suture, and omentopexy using a knot pusher. RESULTS: During the operation, no conversion to open surgery or intra-operative events occurred. The median operation time was 45.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 6 (4~17 days). After surgery, the median hospital stay was 8.0 days (5~27 days). Postoperative complications occurred in one patient, which included a minor leakage. This complication was resolved by conservative management. CONCLUSIONS: Although our study was carried out on a small number of patients at a single institution, we conclude that laparoscopic primary repair can be an effective surgical method in the treatment of duodenal ulcer perforation. We believe that the detailed explanation of our procedure will help beginners to perform laparoscopic primary repair more easily.
Conversion to Open Surgery ; Diet ; Duodenal Ulcer ; Emergencies ; Humans ; Laparoscopy ; Length of Stay ; Peritoneal Lavage ; Postoperative Complications ; Sutures

PURPOSE: Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our study was designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer perforation, and provide a step-by-step protocol with tips and recommendations for less experienced surgeons. MATERIALS AND METHODS: Between March, 2011 and May, 2012, 21 patients presenting with duodenal ulcer perforation underwent laparoscopic primary repair with omentopexy. There were no contraindications to perform laparoscopic surgery, and the choice of primary repair was decided according to the size of the perforation. The procedure for laparoscopic primary repair with omentopexy consisted of peritoneal lavage, primary suture, and omentopexy using a knot pusher. RESULTS: During the operation, no conversion to open surgery or intra-operative events occurred. The median operation time was 45.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 6 (4~17 days). After surgery, the median hospital stay was 8.0 days (5~27 days). Postoperative complications occurred in one patient, which included a minor leakage. This complication was resolved by conservative management. CONCLUSIONS: Although our study was carried out on a small number of patients at a single institution, we conclude that laparoscopic primary repair can be an effective surgical method in the treatment of duodenal ulcer perforation. We believe that the detailed explanation of our procedure will help beginners to perform laparoscopic primary repair more easily.
Conversion to Open Surgery ; Diet ; Duodenal Ulcer ; Emergencies ; Humans ; Laparoscopy ; Length of Stay ; Peritoneal Lavage ; Postoperative Complications ; Sutures

PURPOSE: Congenital hereditary endothelial dystrophy is a rare disease and is usually characterized by diffuse, bilaterally symmetric corneal opacity and edema inherited by autosomal dominant or recessive pattern. We experienced this rare disease and performed PKP. We report the result with a review of the literature. METHODS: We performed PKP on 7 eyes with congenital corneal opacity inherited by autosomal dominant type, and histopathologically confirmed. We checked preoperative visual acuity, potential visual acuity, intraocular pressure and corneal thickness. Then postoperatively visual acuity, intraocular pressure, corneal thickness and endothelial cell count was checked. RESULTS: After the 1 year follow up, all transplanted cornea survived and there were no rejection. Postoperative visual acuities all increased to potential acuity and the postoperative corneal thickness and endothelial cell count all maintained their normal levels. There was no recurrence of the disease at the 1 year follow up, however secondary glaucoma developed in 2 patients(27.5%), and they were treated by glaucoma surgery. CONCLUSION: The PKP performed on patients of congenital hereditary endothelial dystrophy occurred in one family tree, which has not yet been reported in korea, showed good postoperative results.
Cornea ; Corneal Opacity ; Edema ; Endothelial Cells ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Korea ; Pedigree ; Rare Diseases ; Recurrence ; Visual Acuity

CT findings and comparison between clinical and CT staging were reviewed in 45 consecutive patients withbiopsy proven carcinoma of the cervix. CT was done for staging of primary untreted cercial cancer in 36 patientsand for diagnosis of recurrent cervical cancer or follow-up study 14 times in 9 patients . The results are asfollows; 1. As comparing with clinical staging in 36 cases, CT agreed with clinical stage in 19 cases (52.8%),upstaged in 10 cases(27.8%) and downstaged inn 7 cases (19.4%). 2. The main upstaged CT findings are detection ofunsuspected bladder or rectal invasion and paraaortic lymph node metastasis. Inadequate delineation ofintravaginal tumor was the leading causes of understage of CT than clinical one. 3. CT detected all 10 cases ofthe hydronephrosis shown by IVP and detected unsuspected bladder invasion in 3 cases. 4. CT was valuable in thediagnosis of recurrent tumor and follow-up study after treatment. 5. CT offeres distinct advantages over clinicalstaging and can be integrated into the present FIGO classification of uterine cervix carcinoma. CT can served asan initial radiological staging work-up of primary of recurrent cervical carcinoma.
Cervix Uteri ; Chungcheongnam-do ; Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis ; Lymph Nodes ; Neoplasm Metastasis ; Urinary Bladder ; Uterine Cervical Neoplasms

ERCP was performed in 38 cases of clonorchiasis of the liver, which was confirmed by stool egg test withStoll's dilution method from Apr. 1979 to Oct. 1982. The resuls were as follows 1. The sex distribution ofclonorchiasis showed marked male predominance by 97.4% and age distrigution were higher in 5th and 6th decades. 2.Multiple small filling defects in the intrahepatic bile duct was the most characteristic finding in ERCP and widespread irregular stenosis, dilatation of terminal portion, disturbance of peripheral filling, fuziness andraggedness of intrahepatic duct were also noted. 3. The severity of clonorchiasis by ERCP were classifed asfollows; Grade I-7 cases (18.4%), GradeII-9 cases(23.7%) Grade III-12 cases (31.6%) and Grade IV-10 cases(26.3%)4. Chronic cholecystitis 10 cases(26.3%), Billary tree stone 7 cases (18.4%), malignancy of distal CBD 1 case(2.6%) were found with clonorchiasis by ERCP. 5. Three cases, treated with Niclofolan, showed marked improvementof pathology on follow-up ERCP.
Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Follow-Up Studies ; Humans ; Liver ; Male ; Methods ; Niclofolan ; Ovum ; Pathology ; Sex Distribution ; Trees