Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

Surgical approaches for aneurysms of the basilar artery trunk are variable and utilized depending on the location of the aneurysms and direction of the fundus of the aneurysms. We operated one patient with low lying basilar bifurcation aneurysms facing toward the brain stem by subtemporal transpetrosal approach with successful clipping of aneurysms. The advantage of this approach to low-lying basilar bifurcation or basilar trunk aneurysms over the pterional, subtemporal(transtentorial), combined supratentorial and infratentorial, transoral, and suboccipital approach are discussed.
Aneurysm* ; Basilar Artery ; Brain Stem ; Deception ; Humans

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

Argon laser trabeculoplasty(ALT) is commonly used in the treatment of uncontrolled open angle glaucoma. The authors retrospectively reviewed the efficacy of ALT in 52 patients(57 eyes) with primary open angle glaucoma. The mean follow-up was 28 months(range 2-48 months). The decrease in intraocular pressure 10P) was 10.1 +/- 3.5 mmHg at 1 month, 8.2 +/- 2.8 mmHg at 1 year, 6.2 +/- 5.1 mmHg at 2 years and 51% at 3 years. Failure was most common in the first 6 months after treatment(29%) and thereafter failure occurred at a rate of 5% to 15% per year. The sex and age of patients had no significant effect on success rate. The success rate was high in the patients with baseline IOP of 26 to 30 mmHg. A mild iritis in all cases, transient rise in IOP, peripheral anterior synechia and microscopic hyphema were noted as early complications of ALT.
Argon* ; Follow-Up Studies ; Glaucoma, Open-Angle* ; Humans ; Hyphema ; Intraocular Pressure ; Iritis ; Retrospective Studies ; Trabeculectomy*

Syphilis is an infectious and sexually transmitted chronic disease caused by Treponema pallidum. The progression of syphilis is classified into early symptomatic (primary, secondary, early latent) and late asymptomatic (late latent, tertiary) stage. Since the late 20th century, resurgence of infectious syphilis have been occuring among hetero- and homosexual males with HIV co-infection over the world, and similar trend can also be observed in Korea. In order to contain the current spread of syphilis, clinical presentation and diagnostic approach must first become available, and in particular, the peculiarity in HIV co-infection should also be considered. Serology remains the mainstay of laboratory testing for syphilis, except for during the very early stage of infection. If syphilis patients are not diagnosed properly, it may lead to a serious public health problem. Based on the review of literatures, RPR/VDRL test is not reliable as a single screening test, and a new syphilis test algorithm of treponemal antibody test needs to be established as a primary screening test.
Chronic Disease ; Coinfection ; HIV ; Homosexuality ; Humans ; Korea ; Male ; Mass Screening ; Public Health ; Syphilis ; Treponema pallidum

No abstract available.
Polyarteritis Nodosa*

No abstract available.
Krukenberg Tumor*

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

We report the imaging features of four cases with calcified intracranial aneurysm. All four patients underwentCT, CT angiography, MR, magnetic resonance angiography, and angiography. Calcification of the aneurysm wall was clearly demonstrated with CT and CTA in all cases and with conventional angiography in one case. The shape of calcification was curvilinear in two cases and punctate in two. On MR, two curvilinear calcifications were demonstrated as peripheral rim of signal void but two punctate calcifications were not shown.
Aneurysm* ; Angiography ; Cerebral Angiography ; Humans ; Intracranial Aneurysm ; Magnetic Resonance Angiography