No abstract available.
Hemangioma, Cavernous* ; Urinary Bladder*

PURPOSE: To verify the stability and effect of OcuLarsol(R), which was newly developed for irrigating solution, by evaluating influence on cornea. METHODS: In vivo study group, after an irrigation and aspiration instrument was put into rabbit's anterior chamber: one eye was irrigated with OcuLarsol(R) for 15 minutes, and the other eye with the balanced salt solution (BSS(R), Alcon, USA). After the operation, corneal changes were observed for a week. In vitro study group, after enucleating of rabbits' eyeballs, corneas were mounted in a dual chambered specular microscope and perfused with glutathione bicarbonate Ringer's solution (GBR) for one hour: one cornea of the pair was perfused with OcuLarsol(R) and the other cornea was perfused with BSS(R) for 2-3 hours. After perfusion, corneal swelling rates and endothelial permeability were measured. RESULTS: In vivo study group, central corneal thickness measurement and endothelial cell count showed that there was no significant difference between the two groups on the day of operation, and 1st, 3rd and 7th day after the operation (p>0.05). Corneal endothelial observation with Alizarin red S, HandE stain, and scanning electron microscope detected no difference in cell shape and density. In vitro study group, corneal swelling rates and endothelial permeability showed no significant difference between OcuLarsol(R) and BSS(R) group and transmission electron microscope showed endothelial cells with normal organelles in all groups. CONCLUSIONS: There was no significant difference between the two irrigating solutions, BSS(R) and OcuLarsol(R), in terms of effect and side effects.
Anterior Chamber* ; Cell Shape ; Cornea ; Corneal Pachymetry ; Endothelial Cells* ; Glutathione ; Hand ; Organelles ; Perfusion ; Permeability

Seizure induced transient brain CT or MRI abnormalities following status epilepticus have previously been reported. However, focal transient imaging abnormalities involving hippocampus or mesial temporal lobe as a consequence of seizure are rare findings. We report 2 patients with transient mesial temporal abnormalities on MRI associated with partial seizure of temporal lobe origin. A 59-year-old man with a 4-month history of occasional epigastric rising sensation had developed frequent olfactory hallucination 7 days prior to presentation. On brain MRI, T2 signal was increased in the right mesial temporal region, and the lesion showed mild mass effects and partial enhancement after gadolinium injection. Interictal spikes were noted from right nasopharyngeal electrode, but there was no clinical or electrical evidence of status epilepticus during prolonged scalp/sphenoidal EEG monitoring. His seizures were successfully controlled by phenytoin. T2 high signal was markedly decreased and prior enhancement was no longer seen on brain MRI done 5 weeks later. A 33-year old woman with a 6 month history of occasional vacant staring and oral automatism with amnesia complained progressive memory impairment. Right amygdala and hippocampal head was enlarged and showed T2 high signal without contrast enhancement. EEG with sphenoidal electrodes showed right sphenoidal spikes. Her seizures were controlled by carbamazepine and brain MRI became unremarkable 6 weeks later. Suggested mechanisms and significance of the transient imaging abnormalities following seizures will be briefly reviewed.
Adult ; Amnesia ; Amygdala ; Automatism ; Brain ; Carbamazepine ; Electrodes ; Electroencephalography ; Female ; Gadolinium ; Hallucinations ; Head ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Phenytoin ; Seizures* ; Sensation ; Status Epilepticus ; Temporal Lobe*

BACKGROUND: Microalbuminuria predicts cardiovascular events in diabetic and non-diabetic patients. But, few studies have addressed the relationship between microalbuminuria and cerebral infarction. We determined the incidence of microalbuminuria in non-diabetic subjects with cerebral infarction and investigated the relationship between urinary albumin excretion and risk factors of the stroke. METHODS: Urinary albumin excretion rate, 24 hours blood pressure monitoring, fasting serum lipid profiles, fibrinogen, fasting glucose, insulin and c-peptide were evaluated in 50 non-diabetic patients with acute cerebral infarction and matched 48 controls. RESULTS: Microalbuminuria was detected in 23 of 50(46%) patients with acute cerebral infarction and 4 of 48(8%) control subjects. Hypertension was present in 13 of 23(57%) microalbuminuric patients and 9 of 27(33%) non-microalbuminuric patients. In the microalbuminuric patients with cerebral infarction, diastolic blood pressure and fasting glucose were significantly greater than the control group. But, no difference in systolic blood pressure, lipid level, fibrinogen, fasting insulin and c-peptide level. CONCLUSIONS: The prevalence of microalbuminuria in patients with cerebral infarction was higher than controls and it was associated with increased diastolic blood pressure(DBP) and fasting blood glucose(FBS). Therefore, microalbuminuria is associated with thrombogenic cerebral infarction and it was partly mediated by DBP and FBS.
Blood Pressure ; Blood Pressure Monitors ; C-Peptide ; Cerebral Infarction ; Fasting ; Fibrinogen ; Glucose ; Humans ; Hypertension ; Incidence ; Insulin ; Prevalence ; Risk Factors ; Stroke

Ocular complications of HIV-related cryptococcal meningitis are reasonably common, but complete binocular blindness as the first manifestation of HIV is extremely rare. A 58-year-old man presented with binocular blindness. He experienced blurred vision for 3 days before the blindness. Mild pleocytosis was present in the cerebrospinal fluid, from which Cryptococcus neoformans was cultured. Serology revealed positivity for HIV antibody. He was treated with antifungal and antiretroviral therapy. This case indicates that HIV-related cryptococcal meningitis should be taken into consideration when determining the cause of unexpected sudden binocular blindness.
Blindness* ; Cerebrospinal Fluid ; Cryptococcus neoformans ; HIV ; Humans ; Leukocytosis ; Meningitis, Cryptococcal* ; Middle Aged ; Telescopes*

To evaluate the effect of anabolic steroid(AS) on body composition and protein metabolism in malnourished CAPD patients, 7 CAPD patients who were proved to be malnourished by subjective global assessment received 200mg of AS, nandrolone decanoate, by intramuscular route monthly for 5 months. We analyzed the body composition, biochemical nutritional markers, plasma and dialysate amino acids(AA) before and after administration of AS. The mean age was 53.6+/-11.5 years, the sex ratio was 2:5, and the duration of CAPD was 28.5+/-18.7 months. Two patients were diabetics. Five months after AS administration, %lean body mass seemed to increase from 52.6+/-11.7 to 57.3+/-11.0%(P>0.05), but there were no significant changes in body weight and body mass index. Serum insulin-like growth factor-I (172.4+/-88.5 vs. 204.1+/-85.8ng/ml, P<0.05) and transferrin(213.6+/-55.4 vs. 239.0+/-55.3mg/dl, P<0.05) were significantly increased, and serum total CO2(31.1+/-4.5 vs. 25.9+/-2.5mM/L, P<0.05) were significantly decreased. Urea nitrogen appearance(4.0+/-2.0 vs. 3.6+/-1.6g/ day) seemed to be decreased. Both plasma essential AA(EAA) level(738.3+/-206.5 vs. 492.5+/-187.2micromol/L, P<0.05) and peritoneal EAA loss(565.0+/-186.1 vs. 377.4+/-113.9micromol/day, P<0.05) decreased significantly after administration. Plasma total and non- essential amino acids(NEAA) level tended to be increased and peritoneal total and NEAA loss seemed to be decreased without statistical significance. In conclusion, AS seems to have anabolic effect and be useful in the correction of malnutrition in CAPD patients.
Amino Acids ; Anabolic Agents ; Body Composition* ; Body Mass Index ; Body Weight ; Humans ; Malnutrition ; Metabolism* ; Nandrolone ; Nitrogen ; Peritoneal Dialysis, Continuous Ambulatory* ; Plasma ; Sex Ratio ; Urea

Elevated levels of aspartate aminotrasferase(AST), alanine aminotransferase(ALT) and bilirubin were noted incidentally after laparoscopic cholecystectomy(LC). This study was attempted to investigate the elevation of AST, ALT and bilirubin after laparoscopic cholecystectomy without bile duct injury and it,s clinical significance. Bile duct injury is most feared complication of laparoscopic cholecystectomy. Increased liver enzymes and bilirubin levels may be indicative of this complication. But, these parameters have not been investigated in patients who had laparoscopic cholecystectomy and in whom no damage to the bile duct was noted. 906 patients with normal results of preoperative liver function test were entered into the study. Blood was collected at 24 hours, 48-72 hours and 6-8 days after laparoscopic cholecystectomy, and AST, ALT, Alkaline phosphatase(AlkP) and bilirubin levels were observed. In AST, a mean 2.33-fold increase was observed. In ALT, a mean 2.10-fold increase was observed. A mean 1.42-fold and a mean 1.73-fold increase were observed in total and direct bilirubun levels. But, AlkP was not increased. In many patients a significant increase in AST, ALT and bilirubin levels occured after laparoscopic cholecystectomy. But they returned to normal values within several days without any specific treatments. These elevations of AST & ALT without increasing of AlkP, and slight elevation of bilirubin without increasing of AlkP appear to have no obvious clinical significance, the exact cause of these elevations is unclear, and need further investigation.
Alanine ; Aspartic Acid ; Bile Ducts ; Bilirubin* ; Cholecystectomy, Laparoscopic* ; Humans ; Liver Function Tests ; Liver* ; Reference Values

BACKGROUND/AIMS: An ectopic opening of the common bile duct (CBD) into the duodenal bulb is known to cause biliary tract diseases or peptic ulcer. Yet such a case is extremely rare and the clinical significance of this malformation has not yet been clarified. METHODS: Ten patients with an ectopic opening in the duodenal bulb and who were treated at 4 hospitals in the Chungcheong province area were enrolled. Their clinical and radiographic features and the treatment for their combined biliary diseases were retrospectively analysed. RESULTS: The mean age of the ten patients was 73 years (range: 38~84 years, 8 men, 2 women) Eight of 10 patients had clinical signs and symptoms (RUQ abdominal pain: 5, epigastric pain: 3, fever: 3, Melena: 1). The two patients without symptoms were incidentally found to have an ectopic orifice during the evaluation for bile duct dilatation and a regular health check-up, respectively. Nine had duodenal ulcer scars or bulb deformities. Four had active duodenal ulcers and one of them had bleeding from the active duodenal ulcer, which was treated by endoscopic sclerotheraphy. Six of the 10 patients (60%) had biliary tract diseases (CBD stones: 4, cholangitis without CBD stone: 1, IHD stone: 1). Cholangiography was used for evaluation in 9 patients, and it showed dilatation of the CBD or IHD in 7 (78%), a tapered common bile duct at the distal CBD in 7 (78%) and a hook-shaped distal CBD in 8 (89%). Six patients' biliary tract diseases were treated endoscopically (ERCP: 4, PTCS: 2). Duodenal perforation occurred in 1 (10%), who was successfully managed by medical treatment. CONCLUSIONS: An ectopic opening of the CBD in the duodenal bulb is frequently associated with recurrent duodenal ulcer and biliary tract disease. Combined biliary tract disease can be successfully treated endoscopically.
Bile Ducts ; Biliary Tract Diseases ; Cholangiography ; Cholangitis ; Cicatrix ; Common Bile Duct ; Congenital Abnormalities ; Dilatation ; Duodenal Ulcer ; Hemorrhage ; Humans ; Male ; Peptic Ulcer ; Retrospective Studies

OBJECTIVE: To analyze the effects of speech therapy between children with specific language impairment (SLI) and mild intellectual disability (ID). METHOD: Fourteen children with SLI and thirteen children with mild ID who had received speech therapy for more than 1 year were enrolled. The language function and cognitive function of all subjects were assessed before and after speech therapy. RESULTS: Improvement of receptive and expressive language development were shown in 78.5% and 71.4% of children with SLI, respectively. However improvement of receptive and expressive language development was shown in only 30.7% of children with ID. Improvement of verbal intelligence which had appeared in the SLI group was not shown in the ID group. CONCLUSION: Effects of speech therapy were different in children with SLI and mild ID and more favorable outcomes were demonstrated in children with SLI.
Child ; Humans ; Intellectual Disability ; Intelligence ; Language Development ; Speech Therapy

BACKGROUND/AIMS: Focal nodular hyperplasia (FNH) is mandatory to be differentiated from other hepatic tumorous conditions such as hepatocellular carcinoma and adenoma. The purpose of this study was to explore the clinical, radiological and pathological features of FNH cases reported in Korea. METHODS: We have searched the journals from the web site "http://koreamed.org" using keywords "focal nodular hyperplasia" and "liver" - total of 38 cases of FNH, 37 cases from 17 published articles and one case from our experience confirmed histologically, were reviewed and analyzed. RESULTS: Thirty eight cases were diagnosed between gestational age of 36 weeks and 67 years. Seventeen female patients (45%) had no history of taking oral contraceptives. Twenty cases (52.6%) experienced clinical symptoms such as abdominal pain and palpable mass. Computed tomography revealed contrast-enhancement in 34 nodules (85%) and typical central stellate scar in 9 (22.5%) of 40 nodules. Magnetic resonance imaging showed T1 weighted low signal in 18 (60%) and T2 weighted high signal in 22 (73.3%) of 30 nodules. Six (60%) of 10 cases showed hypervascular staining on hepatic angiography. Among 38 cases, 32 (84.2%) cases had single nodule and their mean size was 3.9 cm (0.5-16 cm). Pathologically, fibrous septa, proliferation of bile ductules and arterial wall thickening were seen in most cases. CONCLUSIONS: Of all the FNH cases reported in Korea, there were some differences in clinical aspects of sex ratio, accompanying clinical symptoms, and relationship with oral contraceptives, compared with previous reports. Further prospective studies are needed by means of nation-wide clinical survey and analysis.
Adolescent ; Adult ; Aged ; Child ; Contraceptives, Oral ; Female ; Focal Nodular Hyperplasia/*diagnosis/pathology/radiography ; Humans ; Korea ; Male ; Middle Aged ; Sex Factors ; Tomography, X-Ray Computed