No abstract available.
Intussusception*

This study was design to evaluate the efficacy of cataract surgery with simultaneous intravitreal bevacizumab injection for wet age-related macular degeneration. Of the patients who underwent anti-vascular endothelial growth factor injections, cataract surgery was performed in 24 eyes (control group), and simultaneous intravitreal bevacizumab injection was performed in 27 eyes (bevacizumab group). Best corrected visual acuity, ocular tonometry, anterior chamber inflammation, and central subfield macular thickness were measured at baseline and 1 week, 1 month, 3 months, and 6 months after surgery. The mean central subfield macular thickness increased 1 month postoperatively in the control group (p = 0.02), whereas there was no significant change in the bevacizumab group. When the preoperative and postoperative differences between the two groups were compared at each time point, the mean best corrected visual acuity improved in the bevacizumab group at 3 months after surgery (p = 0.045), and the mean central subfield macular thickness was more decreased in the bevacizumab group at 1 month after surgery compared to that of the control group (p = 0.032). Additional anti-vascular endothelial growth factor injection was performed after surgery at 1.56 ± 2.05 months and 2.52 ± 2.01 months, in the control and bevacizumab groups, respectively (p = 0.047). Simultaneous cataract surgery and intravitreal bevacizumab injection is considered an effective treatment since it reduces central subfield macular thickness in the short term, and it can delay the timing of additional anti-vascular endothelial growth factor injections after surgery.

The alar cartilage malposition is defined as any displacement of lateral crura from the usual parallel alignment with nostril rims. It has several characteristics including parentheses deformity, notches in alar rims, flat nasal tip, square basal perimeter. It tends to be misdiagnosed as cartilaginous hump or bulbous tip because of its longitudinally prominent lobule. But, exact diagnosis can be easily attained with careful examination and recognition in the clinical diagnosis of bulbous or ambiguous tips. It is confirmed by the resistless collapse of lateral alar rim when light compression is applied by cotton stick. Its incorrect diagnosis can bring about inappropriate tip graft, soft tissue resection, rasping, humpectomy and secondary nasal deformity may develope as a result. Authors performed open approach followed by meticulous dissection of displaced alar cartilages. Each medial portion, corresponding to the cephalic portion of normal lateral crus, was resected. Then, each lateral crus was symmetrically rotated in the infero-lateral direction along the axis of the medial crura. If needed, autocartilage on-lay graft and dorsal augmentation were done for optimal aesthetic result. We believe accurate evaluation of the anatomical variation should be checked out preoperatively and recommend out method for the effective correction of unusual bulbous or broad tips.
Axis, Cervical Vertebra ; Cartilage* ; Congenital Abnormalities ; Diagnosis ; Transplants

Calciphylaxis is a rare disease that appear in patients with secondary hyper-parathyroidism or chronic renal failure or that show defect in calcium phosphate metabolism which is characterized by fibrin deposit or calcification of medial wall of vessels causing gradual ischemic skin necrosis. Calciphylaxis is a disease with poor prognosis as skin necrosis can progress rapidly. If left untreated, calciphylaxis will progress to sepsis with high mortality. The treatment is controversial but kidney transplantation or parathyroidectomy is suggested to recover calcium-phosphate metabolism. The authors have experienced calciphylaxis in a patient with chronic renal failure caused by DM nephropathy with characteristic skin lesion and rapid skin necrosis. We describe this case with documentary reviews.
Amputation ; Calciphylaxis ; Calcium ; Calcium Phosphates ; Diabetes Mellitus ; Diabetic Nephropathies ; Fibrin ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Leg ; Necrosis ; Parathyroidectomy ; Prognosis ; Rare Diseases ; Sepsis ; Skin

Hemophilia, a genetically determined disorder, can be divided into hemophilia A and hemophilia B. Hemophilia A, defined as a sex-linked recessive trait hemorrhagic disease of males characterized by a deficiency of factor VIII occurs about seven times more frequently than hemophilia B which is characterized by a deficiency of factor IX. The complications resulting from hemophilia occurs in virtually every system. This paper is concerned with a rare complication of hemophilia, iliacus hematoma with femoral neuropathy. On case of spontaneous hemorrhage of iliacus muscle with femoral neuropathy in hemophilia was decompressed through a small incision with sump drainage under cover of AHF(Anti-hemophilic factor) concentrated plasma cryoperecipitate followed AHF replacement therapy.
Drainage ; Factor IX ; Factor VIII ; Femoral Neuropathy ; Hematoma ; Hemophilia A ; Hemophilia B ; Hemorrhage ; Humans ; Male ; Plasma

Recently xenotransplantation has been thought as a final solution for the controi of donor organ shortage in allograft. In order to be a ciinicai entity, xenotransplantation has many obstacles such as hyperacute rejection and delayed xenogratt rejection as a potent immunologic reaction, zoonosis and ethical problems. We already reported the eariy immunoiogic events occuring soon after xenograft in animal model, in which natural antibody and complement have a crucial roie in rejection response. As a further step for the prolongation of graft survival, we used anticomplement agent (cobra venom factor, CVF) in the same model. Graft survival in discordant (guinea pig-to-rat) xenogratt was extended from 30.6 minutes to 2 days following singie injection of CVF, which showed similar pattern of rejection with the concordant xenogratt in terms of time of rejection response after grafting. In this setting antibody response in the blood did not show any difference between that of pre CVF and post CVF, even though IgM response was more pronounced than IgG. The complement activity in the blood showed marked suppression following CVF injection. Intragraft complement gene (C3 mRNA) expression in CVF injected discordant showed delayed response in a similar pattern like that of concordant xenograft. Interestingly enough intragraft anticomplement gene expression showed the simiiar pattern of response with the complement. From these results we can conclude that anticomplement agent (CVF) extended the graft survival in discordant xenograft upto the level of concordant xenograft by shifting the complement activation response from that of discordant to concordant xenograft.
Rats ; Animals

BACKGROUND: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. METHODS: Healthy Korean (men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs (such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4 (Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. RESULTS:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels (men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women (men; y=-3.152 * +292.6, r2= 0.8459, P<0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P< 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA-S/cortisol ratio. CONCLUSION: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu (aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index.
Adrenal Cortex ; Aging ; Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Creatinine ; Female ; Hand Strength ; Humans ; Hydrocortisone* ; Hyperlipidemias ; Male ; Plasma* ; Sex Characteristics ; Tobacco Products

PURPOSE: To determine whether the maximum standardized uptake value (SUV) of [18F] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). MATERIALS AND METHODS: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. RESULTS: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR < or = 0.9 (p = 0.01). In a multivariate analysis, including age, performance status, stage, use of chemotherapy, and mSUVR, only performance status (p = 0.05) and mSUVR > 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] < or = 1) and mSUVR < or = 0.9 was significantly better than that for patients with either poor performance (ECOG > 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). CONCLUSION: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lymph Nodes ; Multivariate Analysis ; Positron-Emission Tomography ; Prognosis

BACKGROUND: Chronic acquired hepatocerebral degeneration (CAHD), a slowly progressive neurologic disease characterized by chronic intermittent hepatic encephalopathy, is seen sporadically in patients with chronic hepatic disease. The spectrum of clinical presentations could include neuropsychiatric (apathy, lethargy, excessive somnolence), a movement disorder (ataxia, tremor, chorea, Parkinsonism, myoclonus, dystonia) or both. Unfortunately only a few reports are available concerning the neurological manifestations as well as the findings of brain Magnetic resonance image (MRI) in patients with CAHD in spite of high prevalence of chronic liver disease in Korea. METHODS: We reviewed clinical or laboratory data of 3 patients with CAHD. All patients had evaluations such as neurological examination, mini-mental status examination, liver function test and brain MRI. From sagittal image of their brain MRI, we calculated pallidal signal intensity. RESULTS: The most common neurological findings were cognitive dysfunction, dysarthria, and parkinsonism including tremor, rigidity and bradykinesia. The brain MRI of all three patients showed hyperintensity signal in globus pallidus on T1 weighted image. Some patients also showed similar signal intensity on their brainstem. CONCLUSIONS: We describe three cases of CAHD with clinical, radiological feature.
Brain ; Brain Stem ; Chorea ; Dysarthria ; Globus Pallidus ; Hepatic Encephalopathy ; Hepatolenticular Degeneration* ; Humans ; Hypokinesia ; Korea ; Lethargy ; Liver Diseases ; Liver Function Tests ; Magnetic Resonance Imaging ; Movement Disorders ; Myoclonus ; Neurologic Examination ; Neurologic Manifestations ; Parkinsonian Disorders ; Prevalence ; Tremor