No Abstract Available.
Keratomileusis, Laser In Situ*

OBJECTIVE: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. METHODS: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. RESULTS: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. CONCLUSIONS: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.
Addison Disease ; Adrenocorticotropic Hormone ; Amenorrhea ; Antibodies ; Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases* ; Diabetes Mellitus, Type 1 ; Electrolytes ; Endocrine System Diseases ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Mass Screening ; Primary Ovarian Insufficiency* ; Thyroid Gland ; Thyroiditis ; Thyrotropin ; Thyroxine

No Abstract Available.
Health Behavior*

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

Although many kinds of operation for rectal prolapse exist, generally they could be divided into the transabdominal and transperineal approach. The former has low recurrence rate as compared with the latter, but needs laparotomy. Unfortunately, many patients with rectal prolapse are old and debilitated. So they are not suitable candidates for a major abdominal operation. For those patient, a transperineal method may be proper, but the recurrence rate may be high and continence is not always achieved. We reviewed 12 patients who were older than 70 years of age and treated by the Thiersch operation among the 52 cases of rectal prolapse from Feb. 1992 to Mar. 1997 at Kwangju Christian Hospital. The results were summarized as follows; 1) The male to female ratio was 1 : 1.4. 2) Durations of rectal prolapse were distributed from 6 months to 30 years. Seven cases had duration of longer than 10 years. 3) The preoperative incidence of incontience was 8 (67%) of 12 cases. Among the 8 patients with incontinence, the male was 3 (37.5%) and female was 5 (62.5%). 4) Postoperative review of incontinence revealed complete disappearance in 4 cases (50%), improvement in 3 cases (37.5%), and no improvement in 1 case (12.5%). 5) After the Thiersch operation, rectal prolapse recurred in only 1 of the 12 cases (8.3%), a wound infection developed in 1 case (8.3%), defecation difficulty due to the small Thiersch ring was present in 3 cases (25%). The results of this study show that the Thiersch operation may be an effective method in treating rectal prolapse, especially in patient who are old or have poor general condition and manifested incontinence.
Defecation ; Female ; Gwangju ; Humans ; Incidence ; Laparotomy ; Male ; Rectal Prolapse* ; Recurrence ; Wound Infection

Clinical observation was performed on 23 children with Guillain-Barre syndrome which were hospitalized at the Pediatric ward of Han Yang University Hospital, from July 1975 through May 1991.@ES The results were as follows: 1) The ratio of male patient to female was 2.8:1 and 47.8% of total GBS patients were between the ages 1 to 5 years. 2) The highest seasonal incidence of GBS was seen in summer and there was no significant variation of GBS annually.3) Preceding illness of GBS was found in 60% of the total patients, and upper respiratory infection was the most common (65%). 4) Muscular paralysis or weakness in extremities was the most common chief complaints on admission, and repiratory difficulty, vomiting, diarrhea, swallowing difficulty and myalgia were followed. 5) The sites of paralysis on admission were upper and lower extremities in 14 GBS patients (60.8%), lower extremities in 7 GBS patints (34.8%) and respiratory muscle in 4 GBS patints (17.3%), respectively. 6) The protein content of cerebrospinal fluid was elevated in 18 GBS patients of total (78.3%) on admission and remnant 5 GBS patients showed increased protein later. 7) There was a tendency that recovery time in 5 GBS patients with muscular fibrillation on E.M.G. was longer than in 4 GBS patients without muscular fibrillation. We thought further studies on critical evaluation and better treatment for GBS were needed.
Cerebrospinal Fluid ; Child* ; Deglutition ; Diarrhea ; Extremities ; Female ; Guillain-Barre Syndrome* ; Humans ; Incidence ; Lower Extremity ; Male ; Myalgia ; Paralysis ; Respiratory Muscles ; Seasons ; Vomiting

PURPOSE: To analyze the characteristies of traumatic brainstem injury by CT and MR MATERIALS AND METHODS: CT and MR studies of 10 patients with traumatic brainstem lesion in MR were retrospectively reviewed, particularly attended to location, signal intensity and associated lesions. RESULTS: CT failed to depict 8 of 10 brainstem lesions. All lesions were detected in MR images with T2-weighted images showing higher detection rate (n=10) (100%) than Tl-weighted images (n=3) (30%) or CT (n=2) (20%). The brainstem lesions located in the dorsolateral aspects of the rostral brainstem(mid brain and upper pons)in 7 (70%) cases, in ventral aspects of rostral brain in 2 (20%) cases and in median portion of pons in 1 (10%) case. Corpus callosal (n=5), Iobar white matter(n=5) diffuse axonal injury, and 2 hemorrhagic lesions in basal ganglia were the associated findings. CONCLUSION: MR imaging is more helpful than CT in the detection of brainstem injury, especially T2 weighted images. Primary brainstem lesions were typically located in the dorsolateral aspect of rostral brainstem(midbrain and upper pons). Corpus callosum and white matter lesions were frequently associated.
Basal Ganglia ; Brain ; Brain Stem* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging ; Pons ; Retrospective Studies

No abstract available.
Thromboangiitis Obliterans

PURPOSE: The purpose of this study is to evaluate the findings of magnetic resonance imaging(MRI) of posterior fossa hemangioblastoma and usefulness of contrast enhancement with Gd-DTPA. MATERIALS AND METHODS: Seven patients with posterior fossa hemangioblastoma were studied with both pre- and post-enhanced MRI. The MR images were reviewed regarding the location, size, signal intensities of cysts and mural nodules, and their contrast enhancement pattern. RESULTS: Five tumors were located in cerebellar hemisphere, one in vermis, and one in posterior part of medulla. One patient with von HippeI-Lindau disease had a medullary hemangioblastoma with multiple pancreatic cysts. In 6 cases, the major portion of the tumor was cysts and had small mulkal nodules. The solid portion was relatiely lange in one case, cemprising half of the tumor Cysts were oval shaped and their sizes were 3--6.7cm in diameter. In five cases(71%), septations were noted within the cysts. Cysts were isointense or slightly hyperintense on Tl-weighted image and hyperintense on T2-weighted image compared with cerebrospinal fluid. Mural nodules were oval or rounded appearance in five cases and flattened appearance in two, and their size was 0.5--2.5cm in diameter. Mural nodules were isointense to gray matter. They were detected in five cases on Tl-weighted images and one case on T2-weighted images. In two cases, vascular signal void area was noted in mural nodules. On contrast-enhanced Tl-weighted images, all mural nodules were intensely enhanced. CONCLUSION: MRI proved to be a good diagnostic method to detect and characterize posterior fossa hemangioblastoma. The most common finding is Cystic posterior fossa lesion with enhancing mural nodule. Contrast enhancement is essential for specific diagnosis.
Cerebrospinal Fluid ; Diagnosis ; Gadolinium DTPA ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Pancreatic Cyst

Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre-and post- procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drain efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were lower than than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we though that it will be very helpful to the treatment of patients as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.
Abscess ; Catheters* ; Drainage ; Humans ; Viscosity