Persistent pupillary membrane ia a congenital anomaly which waa resulted from incomplete atrophy of the fetal vascular arcades and its associated mesodermal tissue derived from the primitive annular vessels. Authors experienced a case (female, 17 years old) of thick persistent pupillary membrane of both eyes which were required complete removal of these membranes under operating microscope. Her corrected vision has improved up to 0.5 (Rt. eye) from 0.1 and 0.7 (Lt eye) from 0.2 without diplopia after operation.
Atrophy ; Diplopia ; Membranes* ; Mesoderm

Pulmonary edema is a rare adverse reaction to the iodinated contrast medium. Complaining of huge abdominal mass, a 52 years-old female was admitted to the Hangang Sungsim Hospital. On physical examination, the patient appeared to be healthy. She had stable vital Signs, i.e. BP: 120/80 mmHg, pulse rate: 80/min. etc. An adult head sized mass was palpated in the left mid and lower abdomen. Otherwise nonspecific. On laboratory studies, the positive findings were 8-10 WBC/HPF in urine, 25.6 mg/dl for BUN and PVC in EKG. It was negative for urine protein, serum creatinine and liver function test. We injected 100ml and 30 ml for Urografin 60 through the abdominal aortadividing 3 times and major branches of the abdominal aorta, respectively. Immediately after completing angiography, interstitial pulmonary edema was found, showing blurring of the vascular margins, perivascular haziness and thickening of the interiobular septal lines in the both lower lung fields. The blood pressure was dropped to 80/60 mmHg, but pulse rate was normal. She did not complian of dyspnea, and cyanosis was not developed. The urine volume was normally maintained. She was treated for pulmonary edema, which was completely absorbed after 20 hours. And the blood pressure was also normalized. We has experienced a case of pulmonary edema developed after intraarterial injection of the iodinated contrast medium without underlying cardiac, renal and hepatic problems, and reviewed the literatures on mechanisms of pulmonary edema caused by intravascular injection of the iodinated contrast materials.
Abdomen ; Adult ; Angiography ; Aorta, Abdominal ; Blood Pressure ; Contrast Media ; Creatinine ; Cyanosis ; Diatrizoate Meglumine ; Dyspnea ; Electrocardiography ; Female ; Head ; Heart Rate ; Humans ; Injections, Intra-Arterial ; Liver Function Tests ; Lung ; Physical Examination ; Pulmonary Edema ; Vital Signs

PURPOSE: In chronic renal failure (CRF), extracellular fluid (ECF) volume is maintained close to normal, often until end-stage renal disease is imminent. This remarkable feat is accomplished by an increase in fractional excretion of sodium (FENa) in inverse proportion to the decline in glomerular filtration rate (GFR). Many researchers have carried out to try to indentify in animal study but human study was not done in Korea. METHODS: The study is an investigation of the changes of plamsa and urine electrolytes and FENa and fractional excretion of potassium (FEK) in 19 patients (13 men and 6 women) with chronic renal failure. Ages of 19 patients were average 54.6 year-old (range, 29-74 years). Underlying renal disease of the CRF was 42.1% in diabetic nephropathy, 31.6% in chronic glomerulonephritis, 10.5% in hydronephrosis with ureter reflux, and 5.3% in IgA nephropathy. RESULTS: In CRF, plasma Na+ is decreased significantly from normal control 141 +/- 2.1 mEq/L to 139.9 +/- 3.2 mEq/L and GFR from 75.9 +/- 42.9 mL/min to 9.7 +/- 6.3 mL/min, but plasma K+ is increased significantly from 4.2 +/- 0.4 mEq/L to 4.7 +/- 0.8 mEq/L. In CRF however, urine Na+ is decreased significantly from normal control 175.4 +/- 68.5 mEq/L to 89.9 +/- 31.6 mEq/L and osmolality from 610.6 +/- 210.9 mOsm/kg to 397.7 +/- 119.1 mOsm/kg, but urine K+ is decreased tendency from control 32.1 +/- 22.7 mEq/L to 24.3 +/- 14.8 mEq/L. FENa, FEK, and transtubular potassium gradient (TTKG) on CRF were 3.4 +/- 5.4%, 15.4 +/- 20.8% 7.1 +/- 6.9% each and 0.6 +/- 0.6%, 2.2 +/- 2.3% 3.2 +/- 2.8% on normal persons. The difference between CRF and normal control in FENa, FEK, TTKG and osmolar clearance were statistically significant. CONCLUSION: These results suggest that renal tubular cells of CRF were responsible for the decreased Na+ and K+ reabsorption and enhance K+ secretion.
Animals ; Diabetic Nephropathies ; Electrolytes ; Extracellular Fluid ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, IGA ; Humans ; Hydronephrosis ; Kidney Failure, Chronic* ; Korea ; Male ; Osmolar Concentration ; Plasma ; Potassium ; Sodium ; Ureter

BACKGROUND AND OBJECTIVES: Pressure monitoring and injection of contrast media after piercing the fossa ovalis are used to avoid life-threatening complications during transseptal procedures. However, when performing those maneuvers, the information provided can only be obtained after having pierced structures that may not have been the intended target. When we injected the contrast media through a Brockenbrough needle before piercing the fossa, the dye that had collected under the membranous septum tented by the transseptal equipment (tenting) was observed on the left anterior oblique (LAO) projection and this indicated the fossa ovalis. This study was performed to evaluate the usefulness and safety of tenting in order to identify the membranous septum during transseptal procedures. SUBJECTS AND METHODS: Contrast injections were performed on the fossa ovalis and the septal wall surrounding it during 64 transseptal procedures. The rates of dye staining and tenting in both the muscular and membranous septums were compared. RESULTS: No areas of the muscular septum exhibited any tenting. Various rates of dye staining of those areas were observed. However, the membrane of the fossa exhibited tenting without dye staining in all 64 cases. The sensitivity of the tenting without dye staining to identify the Fossa was 98%, and the specificity was 100%. CONCLUSION: Tenting without dye staining could differentiate the membranous septum from the muscular one with high diagnostic accuracy. This method could be used as a safe landmark for the fossa ovalis before piercing it during transseptal procedures.
Atrial Septum ; Contrast Media ; Heart Atria ; Membranes ; Needles ; Punctures ; Sensitivity and Specificity

Bronchial Asthma could be developed by occupational origin. 4-16% of bronchial asthmas are known to be related to occupational exposure. However, occupational asthma has not been reported from the periodic occupational health examination, but reported through case report from clinicians. The authors analysed hospital records to find out work-related bronchial asthma and their occupational characteristics at a university hospital in Jnchon. All records which were confirmed as bronchial asthma in adult by an allergist from June, 1996 to May, 1998 were selected. Through record reviewing, any suspected work related asthma was selected and the interview was done by phone or at the out-patient clinic. The possible cases were confirmed by additional tests including specific bronchial provocation test. Sixteen(3. 9%) out of 411 bronchial asthma were confirmed as work-related asthma. Eight cases out of 16 worked at furniture industry, three worked at dye manufacturing and two worked at musical instrument manufacturing industry. Others worked at farm and machinary industry. The confirmed asthmogen were toluene diisocyante(8), reactive dye(3), and grain dust(1). None of the cases was detected as work-related asthma in the periodic health examination. Twelve out of sixteen occupational asthma patients discontinued their work. The results suggested that many patients with occupational asthma were not reported and the periodic health examination was not an effective system for detecting the workrelated asthma. Thus, setting up the surveillance system involving allergist or pulmonologist would be important to detect and prevent occupational asthma.
Adult ; Asthma* ; Asthma, Occupational ; Bronchial Provocation Tests ; Cereals ; Hospital Records ; Humans ; Incheon* ; Interior Design and Furnishings ; Music ; Occupational Exposure ; Occupational Health ; Outpatients ; Toluene

OBJECTIVES: The purpose of this study was to analyze the characteristics of workrelated musculoskeletal diseases, as listed by the Korea Labor Welfare Corporation (KLWC). METHODS: Using the database of the KLWC, we collected information from 410 approved occupational musculoskeletal disease cases, which occurred between 1 January and 31 December 1999 and were approved by 30 June in 2000. We investigated the characteristics of the disease using a mail survey and telephone interviews. The characteristics we investigated included : sex, age, disease-related working duration, process of disease occurrence, type of enterprises, etc. RESULTS: Men accounted for 75.6 % (310 workers) of the approved cases. The most common age group was 30-39 years (n=143, 34.9 %). The mean disease-related working duration was 5.7 years, and the most commonly had a work-duration of 1-5 years (n=108, 36.0 %). The major industrial types of enterprise were manufacturing (235 workers, 57.3 %), transportation (46 workers, 11.2 %), and construction (25 workers, 6.1 %). Within the manufacturing industry, the most common was motor vehicles and trailers manufacturing. Within the group, the most common jobs were plant or machine operators and assemblers (129 workers, 36.5 %), elementary occupations (90 workers, 25.5 %), and craft and related trades workers (63 workers, 17.8 %). The majority of the diseases involved lumbar problems (232 cases, 54.7 %), neck and upper extremity diseases (183 cases, 43.2 %) and lower extremity diseases (9 cases, 2.1 %). In the cases of lumbar disease, the mean age and working duration was 36.5 years and 4.7 years, respectively. Fifty-four cases of lumbar diseases were due to repetitive work and 89 due to non-repetitive work. Bad posture at work was the most common cause for those doing repetitive work(23 cases), and lifting the most common cause of problems in the non-repetitive work cases (27). CONCLUSIONS: We were able to elucidate the characteristics of workers with approved occupational musculoskeletal disease through this study. Many approved cases occurred in women, and workers performing repetitive work, of these herniated nucleus pulposus occurred in many workers performing simple repetitive works without serious external forces. This suggests that a prevention policy for occupational musculoskeletal disease must be established, to focusing on the above-mentioned high-risk groups.
Female ; Humans ; Interviews as Topic ; Korea* ; Lifting ; Lower Extremity ; Male ; Motor Vehicles ; Musculoskeletal Diseases* ; Neck ; Occupations ; Plants ; Postal Service ; Posture ; Transportation ; Upper Extremity

PURPOSE: Post-stroke seizures and epilepsy were mainly studied in adults. Selected groups of children with stroke were studied to evaluate the incidence of seizures and epilepsy and the risk factors of epilepsy after stroke. METHODS: Seventy consecutive stroke children younger than 15 years of age were retrospectively reviewed to evaluate the incidence, times, causes of epilepsy and the risk factors epilepsy after stroke. The number and location of the lesion as imaged on the CT scan, and MRI scan were determined. RESULTS: Epilepsy after stroke was diagnosed in 38(54.3%) of 70 stroke patients:16 (45.7%) of 35 with hemorrhagic stroke and 22(62.9%) of 35 with ischemic stroke. Arteriovenous malformation(18), vitamin K deficiency(7), hemophilia(5) were frequent causes in hemorrhagic stroke, and idiopathic(15), moyamoya disease(11), hemiconvulsion-hemiplegia-epilepsy syndrome(6) were frequent in ischemic stroke. No statistically significant differences were noted with relation to sex, type of stroke, number of the lobar lesions, between cortical and subcortical lesions and onset time of initial seizure. Epilepsy developed more often in patients who had lesions located in the left cerebral hemisphere (76.7%) than on the right(42.3%)(P<0.01). CONCLUSION: Epilepsy developed more often in children who had lesion located in left cerebral hemisphere. No statistically significant differences noted in relation to sex, type of stroke, number of the lobar lesions and between cortical and subcortical lesions.
Adult ; Cerebrum ; Child* ; Epilepsy* ; Humans ; Incidence ; Magnetic Resonance Imaging ; Retrospective Studies ; Risk Factors* ; Seizures ; Stroke* ; Tomography, X-Ray Computed ; Vitamin K

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated polyneuropathy with a relaps-ing or progressive course. Although the occurrence of CIDP is very rare in childhood compared to the occurrence in adulthood, it does occur in children. In childhood CIDP, the main clinical features are somewhat different from that of adults, which includes a more precipitous onset of symptoms, a high frequency of gait abnormalities, and significant neurological dysfunction. Also, the response to immune-modulating therapy is more reliable and rapid in children than in adults. The recognition of childhood CIDP is important as it may mimic hereditary neuropathies which usually pre-sent with progressive gait disturbance associated with pes cavus deformity. A careful history, clinical examination, and electrophysiological study is crucial for the accurate diagnosis of this treatable disease. Here, we report a case of CIDP in a 13-year-old Korean girl whose initial clinical presentation strongly suggested hereditary motor-sensory neuropathy.
Adolescent* ; Adult ; Child ; Congenital Abnormalities* ; Diagnosis ; Female* ; Foot Deformities* ; Gait ; Humans ; Polyneuropathies* ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

PURPOSE: Myoepithelioma of the lacrimal gland is an extremely rare monomorphic adenoma. We report a case of myoepithelioma of the lacrimal gland. METHODS: A 34-year-old woman visited with an asymptomatic palpable mass on the left upper lid for a year. On ophthalmic examination, the visual acuity was 20/20 in both eyes and other ophthalmic examinations were unremarkable. Computed tomographic scan revealed a well-circumscribed, low-attenuated mass lesion in the lacrimal gland. The mass was excised and histopathologic examination and immunohistochemical staining were performed. RESULTS: The lesion consisted of a brown mass, up to 1.5 x 1.0 x 1.0 cm. Histopathologically, there were round, ovoid nuclei associated with an interstitial hyaline deposition. Immunohistochemical staining was strongly positive for S-100 protein and vimentin, intermediately positive for cytokeratin and smooth muscle actin, and negative for glial fibrillary acid protein. Recurrence of the neoplasm was not observed during 5 months of follow-up after surgery. CONCLUSIONS: The case was diagnosed with myoepithelioma of the lacrimal gland on the basis of clinical and histopathological findings. Myoepithelioma of the lacrimal gland is very rare and only a few cases have been reported.
Female ; Humans