We analyzed corneal astigmatism 2 months after extracapsular cataract extraction with posterior chamber intraocular lens implantation using scleral pocket incision to minimize postoperative corneal astigmatism. Among the patients who were operated between July 1993 and April 1994, 25 eyes of 20 patients could be followed up over 2 months. Keratometric and refractive measurements were obtained before and at every week after operation. The mean postoperative refractive astigmatism was +1.42D at 1 week, +0.02D at 8 weeks and mean postoperative keratometric astigmatism was +1.58D at 1 week, -0.17D at 8 weeks. Our results suggest that extracapsular cataract extraction using scleral pocket incision has the advantage of decreasing early postoperative astigmatic change.
Astigmatism ; Cataract Extraction* ; Cataract* ; Humans ; Lens Implantation, Intraocular

We diagnosed 48 babies as retinopathy of prematurity (ROP) among 438 premature infants from April 1995 to March 1996 in Gil General Hospital. Among 48 ROP babies, 16 (30 eyes) infants progressed to stage 3+ ROP. Mean birth weight was 1474.0 gm, mean gestational age was 29.7 weeks and mean oxygen inhalation duration was 471.2 hours. Among 30 eyes of stage 3+ ROP, 25 eyes progressed to threshold stage and 5 eyes regressed spontaneously. Ten eyes were treated with cryotherapy and 15 eyes with diode laser photocoagulation and the treatment depends on random selection. Four eyes progressed to stage 5 ROP in spite of photocoagulation and encircling scleral buckling. Favorable outcome was achieved in all eyes treated with cryotherapy, and in 73. 3% of eyes laser-treated.
Birth Weight ; Cryotherapy ; Gestational Age ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Inhalation ; Lasers, Semiconductor ; Light Coagulation ; Oxygen ; Retinopathy of Prematurity* ; Scleral Buckling

BACKGROUND AND OBJECTIVES: Electrocardiography (ECG) is a cost-effective and useful method for diagnosing left ventricular hypertrophy (LVH) in a large-scale study or in clinical practice. Among ECG criteria, the Cornell product (Cor P) and Sokolow-Lyon criteria were adopted by the European Society of Hypertension-European Society of Cardiology Guidelines but have different performances among races. The aim of this study was to compare the diagnostic performance of two voltage criteria in Korean patients. SUBJECTS AND METHODS: Electrocardiography and echocardiographic LV mass of 332 (159 male, 173 female) consecutive patients were analyzed. Cornell voltage criteria and the Cor P were compared with Sokolow-Lyon voltage (Sok V) and the Sokolow-Lyon product (Sok P). The sensitivities and specificities were estimated using a receiver-operating characteristics (ROC) curve in relation to the LVH diagnosis. The sensitivities and revised cut-off values were derived at specificity levels of 90, 95, and 100%. RESULTS: The Cornell-based criteria generally showed better performance than that of the Sok V criteria and Sok P in the area under the ROC curve analysis. The revised cut-off values for the Cornell voltage criteria (20 and 16 mm for males and females, respectively) showed an improved sensitivity (19.7 and 30.3% for males and females, respectively), with a high specificity of 95%. CONCLUSION: The Cornell-based criteria had better performance than that of the Sokolow-Lyon criteria in both Korean men and women. However, revised cut-off values are needed to improve accuracy.
Cardiology ; Continental Population Groups ; Echocardiography ; Electrocardiography ; Female ; Humans ; Hypertrophy, Left Ventricular ; Male ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Hepatocyte growth factor (HGF) is a potent mitogenic cytokine. C-met protein, which is known to be the HGF receptor has transmembrane tyrosine kinase activity and is encoded by the c-met oncogene. The HGF/c-met signaling pathway may play various roles in the carcinogenesis of various organs. METHODS: We examined HGF and c-met mRNA expression by utilizing reverse transcription polymerase chain reaction on 40 surgically resected intracranial meningiomas (25 benign, 10 atypical, and 5 anaplastic cases). RESULTS: An HGF overexpression was detected in 28%, 50%, and 80% of the benign, atypical and anaplastic meningiomas, respectively; a high expression of HGF or the coexpression of HGF/c-met was detected in the high grade meningiomas (the atypical and anaplastic cases, p=0.046, p=0.014). An HGF expression was statistically significant in the recurrent meningiomas (p=0.003), and HGF expression was significantly lower than c-met mRNA expression in benign meningiomas (p=0.034). CONCLUSIONS: There was no correlation between histologic subtypes and HGF/c-met expression. Determination of HGF expression can be used as a molecular predictor for recurrence of meningioimas. These results suggest that HGF and c-met expression in meningiomas may be associated with anaplastic progression.
Hepatocyte Growth Factor ; Hepatocytes ; Meningioma ; Neoplasm Recurrence, Local ; Oncogenes ; Polymerase Chain Reaction ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins c-met ; Recurrence ; Reverse Transcription ; RNA, Messenger

BACKGROUND: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates. METHODS: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. RESULTS: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital, 101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). CONCLUSION: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.
Death Certificates* ; Education ; Emergencies ; Mortality ; Retrospective Studies ; Seoul

BACKGROUND: Although the net atrioventricular compliance can be obtained by invasive catheterization (Ccath) in mitral stenosis (MS), feasibility of noninvasive echocardiographic calculation of the compliance (Cecho) and its hemodynamic significance were not tested. METHODS: Using valve area by 2D planimetry (A2D) and deceleration slope (dv/dt) of transmitral velocity decay in continuous wave Doppler echocardiographic tracing, Cecho was defined as -A2D/(gamma dv/dt), which was compared with Ccath obtained directly during the catheterization in 30 MS patients with sinus rhythm. Exercise Doppler echocardiography with symptom-limited treadmill was performed in 66 patients with moderate to tight MS: mean mitral gradient (MG) and peak pressure gradient of tricuspid regurgitation (PGTR) at baseline and immediately after exercise were obtained using continuous wave Doppler echocardiographic tracing. Hemodynamic variables including Cecho, MG, PGTR and mitral valve area were analyzed to determine the association with patients' exercise tolerance. RESULTS: Cecho in 30 patients with tight MS (valve area 0.9+/-0.2 cm 2) was 4+/-1 ml/mmHg (2-7 mmHg), which showed a significant correlation with Ccath (r=0.48, p=0.01). Exercise time in 66 patients with moderate to tight MS showed significant negative correlation with resting MG, resting and postexercise PGTR, and positive correlation with Cecho: exercise time in those patients did not show any significant correlation with resting valve area. In multivariate analysis, Cecho and postexercise PGTR were independent factors determining exercise time in MS. CONCLUSIONS: The net atrioventricular compliance in MS can be calculated by noninvasive echocardiography, and it is an important hemodynamic factor determining exercise tolerance in MS.
Catheterization ; Catheters ; Compliance ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Exercise Tolerance ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Multivariate Analysis ; Tricuspid Valve Insufficiency

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.
Douglas' Pouch ; Endometriosis* ; Female ; Lymph Nodes ; Metaplasia ; Neoplasm Metastasis ; Ovary ; Peritoneum ; Stem Cells ; Teratoma*

We experienced two cases of electroconvulsive therapy (ECT) through ambulatory surgery units. In case 1 patient was a 17 year old male with depressive disorder and the case 2 patient was a 64 year old male also with depressive disorder. A trial of various antidepressants had proved ineffective. They were treated with six ECTs for each case. The case 1 patient complained two times of myalgia suspected to be due to the adverse effects of succinylcholine administration and the case 2 patient showed tachycardia and hypertension due to sympathetic stimulation after application of the current, but the two cases were successfully cared for by ambulatory surgery unit and discharged without severe complications. Perioperative care for individuals who undergo outpatient ECT is similar to the care provided for scheduled ambulatory surgery. Successful performance of ambulatory ECT requires collaboration by psychiatrists, anesthesia care providers, skilled perioperative nurses, affected individuals, and family members.
Adolescent ; Ambulatory Surgical Procedures ; Anesthesia ; Antidepressive Agents ; Cooperative Behavior ; Depressive Disorder ; Electroconvulsive Therapy* ; Humans ; Hypertension ; Male ; Middle Aged ; Myalgia ; Outpatients ; Perioperative Care ; Psychiatry ; Succinylcholine ; Tachycardia

In an earlier study, a site directed mutant rFVIII (rFVIII(m), Arg(336) -> Gln(336)) expressed in baculovirus-insect cell (Sf9) system was found to sustain high level activity during incubation at 37 for 24 h while the cofactor activity of normal plasma was declined steadily. In this study, a mutant B-domain deleted rFVIII(m), Arg(336) -> Gln(336) expressed in baculovirus-insect cell (Sf9) system was characterized for its enzymatic and chemical properties. The expressed rFVIII(m) and plasma FVIII (pFVIII) were purified by immunoaffinity column chromatography and identified by Western blot analysis. The partially purified rFVIII(m) exhibited cofactor specific activity of 2.01 X 10(3)units/mg protein. The molecular weight of rFVIII(m) ranged between 40 to 150 kDa with a major band at 150 kDa. Treatment of both rFVIII(m) and pFVIII with thrombin increased their cofactor activity in a similar pattern. Treatment of both the activated rFVIII(m) and native FVIII with APC decreased their cofactor activities, however, the former exhibited a slower decrease than the latter, although no significant difference was present. rFVIII(m) formed a complex with vWF, resulting in a stabilized form, and the lag period of thrombin-mediated activating was extended by vWF association. These results implicated that rFVIII(m) expressed in baculovirus-insect cell system had a comparable capacity as FVIII cofactor activity and might be a good candidate for the FVIII replacement therapy for hemophilia A patients.
Animals ; Baculoviridae/genetics ; Cell Line ; Factor VIII/biosynthesis/*genetics/isolation & purification/*metabolism ; Insects ; Macromolecular Systems ; Mutation/*genetics ; Protein C/pharmacology ; Recombinant Proteins/biosynthesis/*genetics/isolation & purification/*metabolism ; Thrombin/pharmacology ; von Willebrand Factor/metabolism

PURPOSE: The present study aimed to investigate chromosomal microarray (CMA) and clinical data in patients with unexplained developmental delay/intellectual disability (DD/ID) accompanying dysmorphism, congenital anomalies, or epilepsy. We also aimed to evaluate phenotypic clues in patients with pathogenic copy number variants (CNVs). MATERIALS AND METHODS: We collected clinical and CMA data from patients at Konyang University Hospital between September 2013 and October 2014. We included patients who had taken the CMA test to evaluate the etiology of unexplained DD/ID. RESULTS: All of the 50 patients identified had DD/ID. Thirty-nine patients had dysmorphism, 19 patients suffered from epilepsy, and 12 patients had congenital anomalies. Twenty-nine of the 50 patients (58%) showed abnormal results. Eighteen (36%) were considered to have pathogenic CNVs. Dysmorphism (p=0.028) was significantly higher in patients with pathogenic CNVs than in those with normal CMA. Two or more clinical features were presented by 61.9% (13/21) of the patients with normal CMA and by 83.3% (15/18) of the patients with pathogenic CMA. CONCLUSION: Dysmorphism can be a phenotypic clue to pathogenic CNVs. Furthermore, pathogenic CNV might be more frequently found if patients have two or more clinical features in addition to DD/ID.
Epilepsy ; Humans ; Intellectual Disability