The clinical results and complications of 27 phacoemulsification which had been performed by ophthalmic resident during the learning curve were studied retrospectively. Mean postoperative follow-up period was 8.9 weeks and 82%(22 of 27) was followed up for 4 weeks or longer. Posterior chamber intraocular lenses were implanted in all cases. Final best corrected visual acuity of 0.5 or better was obtained in 21 eyes(95.5%) and mean value of the surgically induced astigmatism was -0.47 diopter of the 22 eyes who were followed up for 4 weeks or longer. The incidence of vitreous loss was 11.1 %(3/27). Of these, two cases occurred during nuclear emulsification, while one case during cortex aspiration. With proper patient selection, meticulous technique, and under the faculty's supervision, phacoemulsification performed by residents during the learning curve can be an effective method for cataract surgery procedure.
Astigmatism ; Cataract ; Follow-Up Studies ; Incidence ; Learning Curve ; Lenses, Intraocular ; Organization and Administration ; Patient Selection ; Phacoemulsification* ; Retrospective Studies ; Visual Acuity

We reported a case of Norwegian scabies in 14-year-old male with sepsis, pneumonia, pyopneumothorax and auto immune hemolytic anemia which subsequently became a source of ward epidemic of classical scabies, totalling 25 cases including physicians, nurses, other patients in the same ward and their families. The organisms of scabies on the KOH examination began to decrease 3-5 days after treatment, but they were detccted on the nail, elbow and fingerweb 19 days after treatment.
Adolescent ; Anemia, Hemolytic ; Elbow ; Humans ; Male ; Pneumonia ; Scabies* ; Sepsis

BACKGROUND: The nucleus tractus solitarius (NTS), the region of the brain stem in which primary baroreceptor afferents teminate, is critically important in the normal regulation of arterial pressure (AP). In the NTS, excitatory amino acids such as L-glutamate serve as the main neurotransmitter in the regulation of AP. However, the function of GABA in the NTS has not been established. To test the function of GABA, we applied GABAergic agents to the NTS. METHODS: The experiments were conducted on adult male Sprague-Dawley rats weighing 300-500g. A cannula (PE-50 tubing filled with heparinized saline) was inserted into the femoral artery for recording of AP and heart rate(HR). Another cannula was inserted into the femoral vein for administration of nitroprusside or phenylephrine. After rats were placed on a sterotaxic instrument, the dorsal surface of the medulla was exposed, and with the aid of a surgical microscope, the NTS was visualized. Drug injections were made into the NTS using single- or three-barreled grass micropipettes pulled to an outer diameter of 80-100(micro)m and connected to a 1(micro)l Hamilton syringe. RESULTS: The follwing results were obtained in this experiment. Injection into the NTS of 10 or 20 nmol nipecitic acid, a selective inhibitor of GABA untake, produced an increase in AP. The pressor responses evoked by two doses of nipecotic acid were not significantly different. Injection of GABA(A) agonist, musciml(5 pmol in 80 nl artificial CSF) and GABA(B) agonist, baclofen (20 pmol in 80 nl) into the NTS of urethane-anesthetized rats prodused an increase in AP of 16.6+/-1.3 and 27.6+/-1.5 mmHg, respectively. Thus the pressor response to GABA(B) agonist was greater than to GABA(A) agonist. On the other hand, microinjection of GABA(A) antagonist, bicuculline and GABA(B) antagonist, phaclofen into the NTS decreased AP by approximately 13.4+/-1.0 and 20.9+/- mmHg, respectively. Thus injection of nipecotic acid into the NTS was greater in control group compared with the muscimiol or baclofen groups. The AP changes caused by i.v. injection of nitroprusside or phenylephrine were smallest in control group and greatest in the baclofen group. When calculated as baroreflex sensitivity, the change was greatest in control group and smallest in the baclofen group. CONCLUSION: From these results it was concluded that GABA in the NTS plays an important role in the regulation of AP, especially through GABA(B) receptors, and have an inhibitory effect on baroreceptor reflex.
Adult ; Animals ; Arterial Pressure ; Baclofen ; Baroreflex ; Bicuculline ; Blood Pressure ; Brain Stem ; Catheters ; Excitatory Amino Acids ; Femoral Artery ; Femoral Vein ; GABA Agents ; gamma-Aminobutyric Acid* ; Glutamic Acid ; Hand ; Heart ; Heparin ; Humans ; Male ; Microinjections ; Neurotransmitter Agents ; Nitroprusside ; Phenylephrine ; Poaceae ; Pressoreceptors ; Rats ; Rats, Sprague-Dawley ; Solitary Nucleus* ; Syringes

BACKGROUND: Duchenne muscular dystrophy is an X-linked recessive disorder leading to death in the late teens or early twenties. There is no effective pharmacological therapy for now. L-carnitine (LCAR), a naturally occurring compound facilitating the transport of fatty acid into mitochondria for -oxidation, has been getting an attention for its antiapoptotic and osmoprotective effect. The aim of this study is to evaluate if LCAR administration reduces dystrophic progression and enhances exercise tolerance in dystrophin deficient (mdx) mice. METHODS: Mdx mice (n=5) and wild type mice (n=5), aged 3 weeks were treated with oral LCAR (75mg/kg/day) for 6 weeks. Five each mdx and wild type mice were recruited for their counter-control. The animals underwent a 30-minute run on a horizontal treadmill for evaluating their exercise endurance. After 6-week training, baseline and post exercise serum CK of each group were analyzed. We examined sarcolemma integrity and muscle histology after exercise. Immunofluorescent stain and Western blot analysis for dystrophin-dystroglycan complex were also performed. RESULTS: LCAR-treated mdx mice showed higher exercise tolerance and lower serum CK value compared with those of control mice. The area of Evans blue dye uptake in LCAR-treated mdx mice was much smaller than that of control mdx mice. There was no remarkable difference in dystrophin-dystroglycan complex expression between treated and control mdx mice. CONCLUSIONS: LCAR seems to enhance exercise tolerance and decrease the breakdown of sarcolemma during strenuous exercise. Our study suggests the possibility of adjunctive therapeutic use of L-carnitine to the patients with Duchenne muscular dystrophy.
Adolescent ; Animals ; Blotting, Western ; Carnitine* ; Dystrophin ; Evans Blue ; Exercise Tolerance* ; Humans ; Mice* ; Mice, Inbred mdx ; Mitochondria ; Muscular Dystrophies* ; Muscular Dystrophy, Duchenne ; Sarcolemma

PURPOSE: This study was conducted to get baseline data to establish a guideline for the infant nutrition by observing the feeding practice and nutritional intake during infancy and evaluationg the nutritional status of iron and lipids at 12-month-old infants. METHODS: This survery was cnducted from July to November, 1992. Subjects were healthy infants who were brought to Yeungnam University Hospital for vaccination. We followed up feeding methods for 6 months in 120 infants, and laboratory tests which include hemoglobin, fematocrit, MCHC, ferritin, total cholesterol, HDL-cholesterol, triglyceride and urea nitrogen/creatinine ratio were done in 36 infants at 12 months of age. RESULTS: Male to female sex ratio was 1.6:1 in total 120 study infants. Among 36 infants who took laboratory tests, five infants were breast-fed, 25 were formula-fed, and 6 were mexed-fed. Percentage of the formula-fed infants increased as their monthly age increases. Although 54.2% of the studied infants were started weaning diet at four months of age, 10.8% of infants were not given any weaning diet until 6 month of age. Breastfed infnats had lower hemoglobin(10.6+/-1.8g/dl), hematocrit(32.6+/-3.6%), serum ferritin(13.6+/-13.1ng/ml)(p<0.05), and 15.6% of them had anemia and 16.7% of them had iron deficiency. Serum lipids levels except total cholesterol in breaset-fed female infants were comparable between groups. CONCLUSIONS: We confirm that the incidence of iron deficiency anemia was increased in breast fed infants and there was no difference in lipids levels according to different feeding methods. Adequate iron supplementation through weaning diets is one of the most important problems in breast milk feeding
Anemia ; Anemia, Iron-Deficiency ; Breast ; Cholesterol ; Diet ; Feeding Methods ; Female ; Ferritins ; Humans ; Incidence ; Infant* ; Iron* ; Male ; Milk, Human ; Nutritional Status* ; Sex Ratio ; Triglycerides ; Urea ; Vaccination ; Weaning

PURPOSE: CT and MR findings of cerebral fat embolism syndrome(CFES) have been rarely reported, because its diagnosis had been made on the basis of only clinical features in the majority of the cases. The purpose of this study is to describe the clinical, CT, and MR findings in six patients of CFES. MATERIALS AND METHODS: Brain CT and MR findings were retrospectively analyzed in six patients with CFES that was diagnosed on the basis of clinical and MRI findings. All six patients had long bone fractures and showed typical delayed clinical manifestations 2-3 days later. Both CT and MRI were examined in all of six patients. Initial CT scan was performed within 48 hours after trauma in all patients, andfollow-up CT scan was done in 2-11 days in two patients. MRI was done within 2-7 days after trauma in three patients, and 13 days, 18 days, and 45 days in other three patients. Follow-up MRI studies were performed in 2-60 weeks in four patients. Clinical and laboratory findings were analyzed retrospectively with medical records. CT and MRI findings were evaluated with regard to presence or absence of diffuse brain swelling and focal abnormalities of signal intensity(density). RESULTS: CT scans obtained within 2 days after trauma showed diffuse cerebral swelling in five patients and normal findng in one patient. On Tl-weighted MRI, diffuse cerebral swelling was shown in three cases and high signal spots suggesting cerebral petechial hemorrhage were noted in both caudate nuclei and thalami in two cases. On T2-weighted images, high signal spots which were shown on Tl-weighted image were not visible. In all of six cases, multiple lesions of high signal were observed mainly in the cerebral white matters, cerebellum and brain stem, probably representing ischemia/infarct or edema. On the follow-up MRI studies performed within a period from weeks to one month after trauma, the size and the number of the lesions were significantly decreased and these findings were well corresponded with clinical course. CONCLUSION: MR findings' of CFES include diffuse cerebral swelling, petechial hemorrhage and mi- croinfarcts, which characteristically improved in short period. In cases suspected of having CFES, MRI is more useful than CT for initial and follow-up studies because of its high detection rate of lesions and correspondence with clinical course.
Brain ; Brain Edema ; Brain Stem ; Cerebellum ; Diagnosis ; Edema ; Embolism, Fat* ; Follow-Up Studies ; Fractures, Bone ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Retrospective Studies ; Tomography, X-Ray Computed

Primary hyperparathyroidism is a rare disease that can be accurately diagnosed and effectively treated in most patients. The diagnosis is established by a persistent elevation of serum calcium and parathyroid hormone and by clinical evaluation. With the introduction of a biochemical screening test for calcium and the development of radiologic techniques, the detection of hyperparathyroidism has increased slightly. However, the parathyroidectomy is still not a common operation in Korea.Twenty-eight patients with primary hyperparathyroidism comprised of 14 males and 14 females, were treated by operation from January 1986 to December 1995 at Kyunghee University Hospital and the data were analyzed retrospectively. The results are as follows: 1) The sex distribution was 14 males & 14 females, and the age distribution was from 14 to 79 years. 2) The clincal manifestations were renal symptoms (42.9%), skeletal symptoms (28.6%), a neck mass (10.7%), pancreatitis (7.1%), no symptoms (7.1%), polydipsia (3.6%) in order of frequency. 3) Most of the patients showed hypercalcemia above 11mg/dl, but five patients had calcium levels which were either slightly increased or in the upper normal range . 4) The preoperative localization methods were mainly combinations of sonography, C.T.,and Tl-Tc subtraction scans and showed high sensitivity & specificity (above 90%). 5) The main tumor locations were the Rt. lower pole in 10 cases, the Rt. upper pole in 5 cases, the Lt. upper pole in 3 cases, the Lt. lower pole in 7 cases; there were 2 cases of ectopic location and 1case of hyperplasia at the Rt. upper & the Lt. lower pole. 6) The pathologic findings revealed a solitary adenoma in 25 patients, a carcinoma in two patients, and hyperplasia associated with MEN2a in 1 patient. 7) We experienced one case of recurrence after primary excision at the Rt. lower pole. Reoperation for a missed gland, after the primary operation, was performed in one patient; the excision of the tumor was performed successsfully. 8) We performed surgical excisions and 17 patients showed hypocalcemia postoperatively. Most of the hypocalcemia was transient and disappeared after ingestion of oral calcium agents or usuage of Vit. D3.
Adenoma ; Age Distribution ; Calcium ; Diagnosis ; Eating ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Hypocalcemia ; Male ; Mass Screening ; Multiple Endocrine Neoplasia Type 2a ; Neck ; Pancreatitis ; Parathyroid Hormone ; Parathyroidectomy ; Polydipsia ; Rare Diseases ; Recurrence ; Reference Values ; Reoperation ; Retrospective Studies ; Sensitivity and Specificity ; Sex Distribution

PURPOSE: A multicenter study was performed to evaluate the clinical characteristics and the results of chemotherapy in patients with testicular tumor. MATERIALS AND METHODS: We retrospectively reviewed the records of 121 patients with testicular tumor treated at five university hospital between 1980 and 1997. We analyzed the clinical characteristics, additional treatments after orchiectomy and results of chemotherapy. RESULTS: Patients age ranged from 1 month to 74 years with a mean of 24 years. The common presenting symptoms were scrotal swelling in 63 patients, palpable mass in 50, and testicular pain in 12. The location of the tumor was on the right side in 62, left in 58, and both in 1 with lymphoma. The histologic type was germinal neoplasm in 101 patients, nongerminal neoplasm in 1, and other tumors in 19. Clinically, 76 patients(62.8%) were stage I, 16(13.2%) stage IIa, 12(9.9%) stage IIb, 3(2.5%) stage IIc, 9(7.4%) stage III and 5(4.1%) stage IV. After orchiectomy, 73 patients(60.3%) were underwent close observation, 30(24.8%) chemotherapy, 14(11.6%) radiation therapy, 3(2.5%) radiation plus chemotherapy and 1(0.8%) retroperitoneal lymph node dissection. Among the 33 chemotherapy patients, 12(36.4%) patients achieved a clinical complete remission(CR), 5(15.2%) partial remission(PR), 4(12.1%) minor response and stabilization, 5(15.2%) progression and 7(21.2%) patients were follow-up loss, and the overall clinical response rate was 65.4%. Among the 18 chemotherapy patients with nonseminomatous germ cell tumor(NSGCT), 9(50.0%) patients achieved a clinical CR, 4(22.2%) PR, 1(5.6%) minor response and stabilization, 2(11.1%) progression and 2(11.1%) patients were follow-up loss, and the overall clinical response rate was 81.3%. CONCLUSIONS: Our study group was relatively small and insufficient to evaluate the chemotherapeutic results, but NSGCT seems to have a better clinical response to chemotherapy.
Drug Therapy ; Follow-Up Studies ; Germ Cells ; Humans ; Lymph Node Excision ; Lymphoma ; Orchiectomy ; Retrospective Studies ; Testis*

BACKGROUND: Beau's lines are transverse furrows of the nail plates that can be caused by various conditions. Because the clinical manifestations of Beau's lines tend to depend on its causes, the clinical manifestations may provide diagnostic clues of causative or underlying diseases. OBJECTIVE: This study is conducted to provide a better understanding of Beau's lines and to give dermatologists diagnostic clues from assessment of its morphological patterns. METHODS: In order to investigate the clinical characteristics and patterns of Beau's lines according to its clinical manifestations, a retrospective study was being performed. A total of 150 patients with Beau's lines who visited the nails clinic of our hospital from January 1, 2006, to September 30, 2010, were included. RESULTS: The group of patients with Beau's lines consisted of 78 males (52%) and 72 females (48%). The onset age ranged from 1 to 82 years old. The most frequently involved fingernail was the right thumb nail. In this study, causes of Beau's lines were grouped into eight categories: idiopathic, traumatic, nail/skin disease, systemic illness, bone marrow transplantation, chemotherapy, nail infection, and others. Idiopathic cause was observed the most frequently. The pattern of Beau's lines was symbolized in each patient and was depicted in a row according to order of frequency. The pattern of N2B2L1D1M2 (Numerous/Multiple/Incomplete/Deep/Broad) was observed overall as the most frequently. The most common pattern in the nail/skin diseases category was N2B1L1D1M2 (Numerous/Single/Incomplete/Deep/Broad). In the traumatic group, N1B2L1D1M2 (Confined/Multiple/Incomplete/Deep/Broad) was the most frequently observed pattern. CONCLUSION: This study explored the clinical manifestations of Beau's lines. In some categories of causes, the morphological patterns showed a tendency to converge. Thus, the morphological patterns can provide certain diagnostic information.
Age of Onset ; Bone Marrow Transplantation ; Female ; Humans ; Male ; Nails ; Retrospective Studies ; Thumb

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*