No abstract available.
Diabetes Insipidus, Nephrogenic*

Authors observed two cases in which the formation of glass-like hyaline membranes in the anterior chamber caused by birth trauma. Case 1 revealed a curtain-like glass membrane in the anterior chamber with a central nubecula corneae of right eye (Fig. 1). Case 2 revealed two paralled glass membranes and its stripes extended across the anterior chamber attached at each extremity to the posterior surface of the cornea (Fig. 2).
Anterior Chamber* ; Cornea ; Extremities ; Glass* ; Hyalin ; Membranes ; Parturition*

In spite of the extensive use of antibiotics over several decades, Streptococcus pneumoniae still remains as one of the most serious human bacterial pathogens. In order to clone the pneumococcal genes whose expression is induced when pneumococcus causes infection in mice, S. pneumoniae strain ATCC 6303 was subcultured on blood agar plates (BAP) ten times to reduce the virulence first, and then passaged through BALB/c mice three times to restore the virulence. Subtractive hybridization was performed using the total RNA preparations isolated from BAP-cultured and mouse-passaged strains. Complementary DNAs corresponding to any mRNA species that were differentially expressed in the mouse- passaged strain were used as the probes to screen the genomic library of pneumococcus. Positive recombinants were selected and sequenced partially to identify the genes located within the cloned DNA. GenBank search of the sequence data has identified several genes including two heat shock genes (dnaK and dnap, a transposase-encoding gene, and a sequence which is very homologous to that of the ftsH gene.
Agar ; Animals ; Anti-Bacterial Agents ; Clone Cells* ; Cloning, Organism* ; Databases, Nucleic Acid ; DNA ; DNA, Complementary ; Genomic Library ; Hot Temperature ; Humans ; Mice ; Pneumonia ; RNA ; RNA, Messenger ; Shock ; Streptococcus pneumoniae* ; Streptococcus* ; Virulence

Vascular dementia is one of the few remediable causes of dementia among the eldery. Prevention of the disease can be best achieved by primary or secondary prevention of controllable risk factors for strokes. Therefore, early and accurate diagnosis of vascular cognitive impairment prior to the dementia stage is essential to the prevention and treatment of vascular dementia. Pharmacological and non-pharmacological methods for prevention of vascular dementia are listed in this article. Recent epidemiologic data, suggesting a direct correlation between vascular risk factors and Alzheimer type dementia, emphasized the importance of controlling vascular risk factors in the prevention of dementia. Treatment strategies for patients diagnosed as vascular dementia are also discussed. Several clinical trials for symptomatic improvement of vascular dementia are ongoing and their success can be a hope to patients with vascular dementia.
Alzheimer Disease ; Cognition Disorders ; Dementia ; Dementia, Vascular* ; Diagnosis ; Hope ; Humans ; Risk Factors ; Secondary Prevention ; Stroke

Various techniques for treatment of large bone defects have been reported, instead of using autogenous bone graft. The author have applied and explored for bone repair with polyglactin 910 mesh and fresh fascia late. Full thickness 8x8mm bone defects were made on the frontoparietal bone of rabbits and group 1 defect was covered with polyglactin 910 and group 2 defects with fresh fascia late, but group 3 and 4 were not covered. However the periosteum was left on group 4 but it was not left on group 3. Samples were taken from the operation site for clinical and histological examinations on 2, 4, 8 and 12 weeks after operation, repetitively. The results were as follows ; 1. On the group 1, where ployglactin 910 mesh had been placed, the defects taken in 2, 4 ,8, 12 weeks after operation disclosed osseous regeneration with newly formed bone but the thickness was much less than the original bone. 2. On the group 2, where fresh fascia rata had been placed, the defects taken in 2, 4, 8, 12 weeks after operation disclosed same pattern of group 1. 3. On the group 3 and 4, where membrane had not been placed, the majority of the defects consisted of connective tissue and muscles. 4. On the group 1, resorption of polyglactin 910 mesh was completed after 4 weeks, but on the group 2, the fascial rata still remained intact.
Bone Regeneration* ; Connective Tissue ; Fascia ; Membranes* ; Muscles ; Periosteum ; Polyglactin 910 ; Rabbits* ; Regeneration ; Transplants

PURPOSE: To evaluate the predictive factors of radiation pneumonitis (RP) and associated changes in pulmonary function after definitive concurrent chemoradiotherapy (CCRT) in patients with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Medical records of 60 patients with NSCLC who received definitive CCRT were retrospectively reviewed. Dose volumetric (DV) parameters, clinical factors, and pulmonary function test (PFT) data were analyzed. RP was graded according to the CTCAE ver. 4.0. Percentage of lung volume that received a dose of threshold (Vdose) and mean lung dose (MLD) were analyzed for potential DV predictors. PFT changes were calculated as the difference between pre-RT and post-RT values at 3, 6, and 12 months after RT. RESULTS: Twenty-two patients (37%) developed grade > or =2 RP. Among clinical factors, tumor location in lower lobe was associated with RP. Among the DV parameters, only MLD >15 Gy was associated with grade > or =2 RP. There were statistically significant decreases in PFT at all points compared with pre-RT values in grade > or =2 RP group. MLD was associated with forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) changes at 6 and 12 months. V10 was associated with FVC changes at 12 months. V20 and V30 were associated with FEV1 changes at 6 months and FVC changes at 12 months. CONCLUSION: After definitive CCRT in patients with NSCLC, MLD >15 Gy and lower lobe tumor location were predictors of grade > or =2 RP. Pulmonary functions were decreased after CCRT and the magnitude of changes was associated with DV parameters.
Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Forced Expiratory Volume ; Humans ; Lung ; Medical Records ; Radiation Pneumonitis ; Respiratory Function Tests ; Retrospective Studies ; Vital Capacity

No abstract available.
Intussusception*

PURPOSE: To assess how accurately computed tomography (CY) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. MATERIALS AND METHODS: The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-115 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. RESULTS: With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abonormalities in 67%(4/6), and 29% (4/14), respectively. CONCLUSION: Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings.
Audiometry ; Audiometry, Evoked Response ; Brain Stem ; Ear ; Ear Canal ; Ear, Inner ; Ear, Middle ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Humans ; Temporal Bone* ; Tomography, X-Ray Computed ; Vertigo

Three cases of fatigue fracture were experienced, whose tibia, fibula and femoral neck had been involved. The mechanism of fracture was explained as the result of repeatation of uncustomed stress mainly in lower extremities. Several authors suggested many types of predisposing factors, such as spastic flat foot, short first metatarsal bone and osteoporosis after steroid administration. Two of the cases were treated conservatively and one case with femoral neck fracture treated by open reduction and Sith-Peterson nailing.
Causality ; Femoral Neck Fractures ; Femur Neck ; Fibula ; Flatfoot ; Fractures, Stress ; Lower Extremity ; Metatarsal Bones ; Muscle Spasticity ; Osteoporosis ; Tibia

This study was designed to evaluate the worth of preoperative chemoradiation therapy in the management of locally advanced rectal cancer. Between march 1993 and January 1997, 64 patients with adenocarcinoma of the rectum were treated with preoperative irradiation followed by operation by one surgeon at department of surgery, Chungnam national university hospital. Cancers were treated with high-dose radiation (45 to 54 Gy) with (group 2) or without (group 1) chemotherapy Preoperatively 64 Patients were analysed prospectively, of these, 15 cases were preoperative radiotherapy alone arm and 49 cases were preoperative radiotherapy plus chemotherapy arm. The average age of the patients were 56 years (range 38~67) in group 1 and 57 years (range 27~80) in group 2. Male to female ratio was 8 : 7 in group 1 and 30 : 19 in group 2. Most clinical stage of the primary tumor mass were 73 (80% in Group 1,96% in group 2), being palpated slightly fixed (40% in group 1, 43% in group 2) or fixed (13.3% in group 1, 24.5% in group 2). As to distance of tumor from anal verge, most patients ranged from 4 to 8 cm (53% in group 1, 63.3% in Group 2). Chemotherapy consisted of 2 cycles of 5-fluorouracil (500 mg/m2/day for S days) delivered as a continuous infusion or bolus therapy and low-dose leukovorin (20 mg/m2/day for 5 days). After six weeks resting period of radiation, definitive surgical approach was performed. Overall treatment related toxicity rate was similar in both group except erythema on perineal skin, which was more frequent in group 2 than in group 1. Most frequent postoperative complication was intestinal obstruction (7.8%) followed by wound infection (6.3%), but there was no significant difference between two groups. There was one case of postoperative mortality in group 2 patients at 44 days after operation due to pneumonia and sepsis combined with liver cirrhosis. Tumor depth was downstaged in 38.5% of group 1 and 70% of group 2 patients on preoperative CT staging, and nodal downstaging was more effective on the respect of postoperative pathological report. Overall recurrence rate was 38.5% in group 1 and 20.5% in group 2. Of these, failure occured first as a distant metastasis more frequently than as a local recurrence in both group. These data do suggest that the preoperative chemotherapy and radiotherapy used are as safe as preoperative radiotherapy alone. Futhermore, tumor and lymph node downstaging are more effective in combined arm. Preoperative chemotherapy will more promising in prevention of distant metastasis when treated in the period of least metastatic tumor burden. Whether combined arm will have greater or lesser survival awaits the completion of this relevant study.
Adenocarcinoma ; Arm ; Chungcheongnam-do ; Drug Therapy ; Erythema ; Female ; Fluorouracil ; Humans ; Intestinal Obstruction ; Leucovorin ; Liver Cirrhosis ; Lymph Nodes ; Male ; Mortality ; Neoplasm Metastasis ; Pneumonia ; Postoperative Complications ; Prospective Studies ; Radiotherapy ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sepsis ; Skin ; Tumor Burden ; Wound Infection