No abstract available.
Humans ; Somatoform Disorders*

The double pylorus-is a fistulous communication between the gastric antrum and duodenal bulb, usually extending from the lesser curvature of the stomach to the superior aspect of the duodenal bulb, and seperated by septum or bridge of normal mucosa. Although its incidence is rare, reports concerning double pylorus are increasing with the recent development of upper gastrointestinal endoscopy and more awareness of this abnormality. We recently experienced two cases of double pylorus; an aquired one in 72-year old male who had an another opening with healing ulcer at the superior aspect of the original pyloric channel, central erosion with clubbing and fusion of mucosal folds at the greater curvature of the lower body and a 3 x 4 cm sized ulcer at the lesser curvature of the lower body, and the other congenital one in 53-year old male who had an another opening at the superior aspect of the original pyloric channel with histologically intact muscularis mucosa in the pyloric septum with no evidence of chronic peptic ulcer scarring. We report here two cases of double pylorus, one-acquired, and the other-congenital, with a review of the literature.
Aged ; Cicatrix ; Endoscopy, Gastrointestinal ; Humans ; Incidence ; Male ; Middle Aged ; Mucous Membrane ; Peptic Ulcer ; Pyloric Antrum ; Pylorus ; Stomach ; Stomach Ulcer ; Ulcer

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

No abstract available.

PURPOSE: To evaluate the surgical result and complications of scleral fixation of foldable intraocular lenses. METHODS: We reviewed the medical records of 17 patients who had undergone scleral fixation of acrylic three-piece foldable intraocular lens. RESULTS: Uncorrected visual acuity were improved in all eyes with time. Postoperative best corrected visual acuity were better than preoperative best corrected visual acuity in 14 eyes from 1.18+/-0.84 to 0.26 +/-0.25 in logMAR visual acuity. Estimated refractive error were 0.01+/-0.34 diopter in spherical equivalent preoperatively and .0.59+/-1.00 diopter postoperatively (p=0.02, paired t-test). The corneal astigmatic changes (dK) of mild against-the-rule astigmatism decreased as time passed. There was no intraoperative bleeding. There were postoperative complications such as increased intraocular pressure in 2 eyes, corneal epithelial defect in 1 eye. CONCLUSIONS: In cases of scleral fixation, by using acrylic foldable intraocular lens through small incision, we were able to reduce corneal astigmatism and complications due to large incision and therefore, improve visual acuity instantly.
Astigmatism ; Hemorrhage ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Medical Records ; Postoperative Complications ; Refractive Errors ; Visual Acuity

PURPOSE: Narcolepsy is a specific neurologic syndrome consisting of excessive daytime drowsiness, cataplexy, and the additional phenomena of sleep paralysis and intense dreamlike hallucinations at sleep-wake transitions. We are reporting a patient with narcolepsy whose repeated self-injury caused traumatic eyeball perforation. METHODS: A 26-year-old male with narcolepsy injured himself, which resulted in eyeball perforation in his both eyes. We diagnosed him as traumatic corneal laceration, traumatic cataract, and vitreous opacity due to lens material in vitreous in both eyes. RESULTS: After improvement of narcoleptic symptom and healing of corneal perforation, we performed cataract extraction and pars plana vitrectomy under local anesthesia. During operation, we found preretinal gliosis at superior portion of optic disc and subretinal hemorrhage in the right eye. We observed successful improvement in visual acuity through intraocular lens implantation.
Adult ; Anesthesia, Local ; Cataplexy ; Cataract ; Cataract Extraction ; Corneal Perforation ; Gliosis ; Hallucinations ; Hemorrhage ; Humans ; Lacerations ; Lens Implantation, Intraocular ; Male ; Narcolepsy ; Sleep Paralysis ; Sleep Stages ; Visual Acuity ; Vitrectomy

No abstract available.
Gardner Syndrome*

BACKGROUND: The characterization of normal coronary blood flow dynamics should provide crucial guidelines for the accurate functional assessment of diseased coronary artery. However, the regional characteristics of coronary blood flow dynamics in normal human coronary artery have not been fully evaluated. METHODS: We performed proximal and distal segment velocity measurement of angiographically normal left anterior descending(LAD) and right coronary artery(RCA) in 25 patients(14 males, 12 females, age 50+/-10 yesre) with atypical chest pain. Spectral flow velocity parameters including average peak velocity(APV), average diastolic peak velocity(ADPV), average systolic peak velocity(ASPV), and diastolic-to-systolic velocity ratio(DSVR) were measured using 0.014 inch 15MHz Doppler wire at baseline and intracoronary adenosine-induced maximal hyperemic state. Coronary flow reserve(CFR) was calculated from the ratio of hyperemia to baseline APV. RESULTS: Comparison between LAD with RCA. LAD showed significantly higher APV than RCA at baseline(proximal ; 18+/-6cm/s vs 14+/-4cm/s, p<.005, and distal ; 17+/-6 cm/s vs 12+/-4cm/s, p<.005. LAD showed significantly higher ADPV and lower ASPV than RCA, therefore significantly higher DSVR than RCA> CFR was significantly lower in LAD than in RCA(proximal ; 301+/-0.9 vs 3.8+/-1.0 , p<3001, and distal ; 3.1+/-0.7 vs 3.6+/-0.8, p<.05). Comparison between proximal with distal segment. There was significant reduction in APV and ASPV from proximal to distal segment in RCA, but not in LAD. There was significant increase in DSVR from proximal to distal segment in RCA, but not in LAD. There was no difference in CFR between proximal and distal segment in both coronary arteries. CONCLUSION: We measured coronary blood flow velocities in angiographically normal coronary artery to characterized normal coronary blood flow dynamics and provide the reference values for the assessment of coronary artery disease. Significant regional differences of coronary blood flow velocities should be considered when we assess the diseased coronary artery.
Blood Flow Velocity ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels* ; Female ; Humans ; Hyperemia ; Male ; Reference Values

Recently, it has been widely recognized that the newly developed multi focal intraocular lens provides good near and far vision. Therefore, among 70 eyes who underwent 3M multifocal intraocular lens insertion procedure at our hospital from July 1989 to may 1990, 50 eyes that could be closely followed up for at least 3 months postoperatively were chosen as our study subjects. After careful analytical review of data such as postoperative near and far vision, refractory power, spherical equivalent of diopter of spectacles needed for correction of vision, change of vision according to size of pupil as well as relationship between central location of intraocular lens(IOL) and vision, and multifocusing ability of IOL, we have attained the following results. 1. 36(72.0%) males and 14 females(28.0%) have received multifocal IOL. According to age, 16 eyes(32.0%) were in their 40's, comprising the greatest number, followed by those in the 50's(24.0%) and 60's(24.0%). 2. Postoperatively, 23 eyes(46.0%) have attained emmetropia. 12 eyes(24.0%) were hyperopic, and 15 eyes(30.0%) were myopic. Spherical equivalent of corrected spectacles was -0.35D. The number of eyes attaining corrected vision over 1.0 was 36(72.0%),44 eyes over 0.5(88.0%), and 6 eyes less than 0.4(12.0%). 3. The number of near vision J1 with corrected vision over 1.0 were 33 eyes(66.0%), greater than J2 were 36(72.0%), and in the case of vision of 0.9-0.8 J1 and J2 were 2 eyes(4.0%) and 3 eyes(6.0%), respectively; vision of 0.7-0.5 J2 was 1 eye(2.0%), J3 were 2 eyes(4.0%). In vision less than 0.4, J3 and less than J3 were 3 eyes(6.0%) in each cases. 4. Corrected near vision attained by additional diopter in 15 eyes that have a near vision of less than J2 are as follow: 7 eyes of J1(14.0%), 4 eyes of J2(8.0%) 2 eyes of J3(4.0%) and 2 eyes of less than J3(4.0%). Average additional diopter required to obtain J1 was +0.64D. 5. In the group that has corrected vision over 1.0, the number of eyes that had matched center of IOL and center of pupil was 17(34.0%), number of eyes that has a deviation of 0.5 mm was 6(12.0%), 8 eyes with a deviation of 1.0 mm(16.0%), 5 eyes with a deviation of 1.5 mm(10.0%); but, none have affected vision. 6. Change of vision according to the size of pupil was measured. In the case of corrected vision over 1.0, pupil size of 2.0-4.0 mm and dilated pupil size over 5.0 mm occurred in 36 eyes in each case, and a constricted pupil size less than 2.0 mm occurred 35 eyes with no vision change observed. 7. In the case of corrected vision over 1.0, additional use of lens from +1.0D to -3.0D has not affected vision when maintained at a level of over 0.8 but use of any lens out of this range has dramatically decreased vision. 8. After inserting vultifocal IOL, complaints of diplopia, glare, dizziness and seeing rings were observed in 10 eyes(20.0%); but, 5 months later symptoms had disappeared in all cases.
Diplopia ; Dizziness ; Emmetropia ; Eyeglasses ; Glare ; Humans ; Lenses, Intraocular* ; Male ; Miosis ; Pupil