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

Menetrier's disease is a protein losing hypertrophic gastropathy characterized by hypoproteinemia, and often is associated with the development of gastric cancer. Though the cause of Menetrier's disease has been unknown, the association with Helicobacter pylori was reported. A 30-year-old man was hospitalized for the evaluation of progressive dyspepsia for 2 years, hypoproteinemia, and recently aggravated epigastric pain with weight loss. Gastroscopy revealed prominent folds and multiple variable sized polypoid eminence in the body and antrum with positive CLO test. Histological findings revealed gastritis with erosions and foveolar hyperplasia. Any other diseases causing protein losing enteropathy were excluded. After the eradication of the H. pylori and long term treatment with proton pump inhibitor, clinical, endoscopic, and biochemical resolution ensued. Thus, we suggest that H. pylori eradication should be tried in patients with Menetrier's disease before invase treatment modalities such as surgical resection.
Adult ; Dyspepsia ; Gastritis ; Gastritis, Hypertrophic* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hyperplasia ; Hypoproteinemia ; Protein-Losing Enteropathies ; Proton Pumps* ; Protons* ; Stomach Neoplasms ; Weight Loss

BACKGROUND: There are many risk factors for osteoporosis in patients with chronic obstructive pulmonary disease(COPD). These include smoking, a low body mass index, insufficient exercise, and the use of glucocortcoids. However, there is lack of data on the incidence of osteoporosis according to the different glucocorticoid administration methods in patients with COPD. This study compared the incidence of osteoporosis according to the different administration methods of glucocorticoid. METHODS: A matched case-controlled study (gender, age, cumulative steroid dose and pack-years of smoking) was conducted. Forty-five patients with documented COPD for at least a 3 year duration and a cumulative glucocorticoid dose above 1,000 mg were enrolled in study. The patients were classified into the following three groups. First, fifteen patients received continuous inhaled glucocorticoid with intermittent oral steroids but had no admission history due to an acute exacerbation(Group I). Secondly, fifteen patients received a multiple course of oral steroids with additional inhaled glucocorticoid but had no admission history due to their acute exacerbation(Group II). Lastly, fifteen patients received intermittent oral or inhaled glucocorticoids and had an admission history due to the acute exacerbation with intravenous steroid treatment for at least 2 weeks per year(Group III). The enrolled patients had apulmonary function test and bone densitometry performed at the lumbar spine and femoral neck. RESULTS: The patients from Group III had significantly high incidence of osteoporosis in the lumbar and femoral neck compared to Group I and Group II (p<0.01). CONCLUSION: The incidence of osteoporosis in patients with COPD appears to be strongly affected by the method of steroid administration. This result suggests that intravenous steroid administration is strongly associated with the risk of osteoporosis.
Body Mass Index ; Case-Control Studies ; Densitometry ; Femur Neck ; Glucocorticoids ; Humans ; Incidence* ; Osteoporosis* ; Pulmonary Disease, Chronic Obstructive* ; Risk Factors ; Smoke ; Smoking ; Spine ; Steroids

OBJECTIVES: The study was carried out to evaluate the work-relatedness and the occupational distribution in 147 carpal tunnel syndrome(CTS) cases diagnosed at a university hospital from May 1996 to May 1998. METHODS: We obtained the information on disease appearance, occupational history including job content and other life style by medical records and telephone interviews. RESULTS: Of the 147 patients with carpal tunnel syndrome, 51 patients(34.7 %) were shown to be work-related. Work-related CTS were most frequent in elementary workers (21 case, 41.2%). The other eases were 15(29.4%) workers in service and shop and market sales, 9(17.6%) workers in craft and related traders, 4(7.8%) workers in skilled agriculture and fishery. Only two workers had claimed to the Industrial Accident Compensation Insurance, but no one has been admitted as an occupational CTS yet. CONCLUSIONS: It is suggested that arrangements of surveillance system for adequate control of occupational CTD is neccessity.
Accidents, Occupational ; Agriculture ; Carpal Tunnel Syndrome* ; Commerce ; Compensation and Redress ; Fisheries ; Humans ; Insurance ; Interviews as Topic ; Life Style ; Medical Records

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

OBJECTIVES: The ambient noise levels in the test rooms affect the workers's hearing threshold. The present study was designed to assess the ambient noise levels in the test rooms to determine if valid hearing tests, both pure-tone air conduction and bone-conduction, could be performed in these environments. METHODS: In the present study, third octave band ambient noise sound pressure levels were measured in 124 audiometric test rooms used for clinical audiometry, and the results were compared with the ANSI third octave band maximum permissible ambient noise levels (MPANLs) for each test condition and frequency range. RESULTS: The ambient noise SPLs were highest in the lower frequencies, and this decreased as the frequency increased. For the "ears covered"condition, about 24.2% of the rooms were in compliance (pass) with the MPANLs for the 125-8000 Hz, 35.5% were in compliance for the 250-8000 Hz range and 55.6% were in compliance for the 500-8000 Hz range. For the "ears not covered"condition, only about 8.1% of the rooms passed for the 125-8000 Hz, 13.7% of the rooms passed for the 250-8000 Hz range and 34.7% of the rooms passed for the 500-8000 Hz range. All 124 rooms met the OSHA MPANLs. CONCLUSIONS: The results of this study strongly indicate that clinical audiometry is being conducted in test rooms having unacceptable or excessive ambient noise levels.
Audiometry ; Compliance ; Hearing ; Hearing Tests ; Noise* ; United States Occupational Safety and Health Administration

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