A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.
Acupuncture ; Adult ; Cardiopulmonary Bypass ; Chest Pain ; Dyspepsia ; Female ; Foreign Bodies* ; Heart Ventricles* ; Humans ; Needles* ; Radiography, Thoracic ; Substance-Related Disorders

No abstract available.
Spine*

The authors evaluated the 56 patients who received the diagnosis of myopia at the department of ophthalmology in Koryo General Hospital in Seoul from May 1975 to August 1985. In this study, we reviewed the statistics of the progression of myopia with age and with the number of visits to the hospital and also the differences between male and female and left eye and right eye. The results are as follows: 1. Myopia progresses with increase of age. 2. The mean diopter of myopia over 21 years is not so remarkable compared with below 20 years. But it is not absolutely true because the number of patients are so small. 3. On the average, males are slightly higher in the degree of myopia than female, but this seems to have no statistical meaning. 4. In terms of the degree of myopia, it is higher after the age of 12 than before 12.
Diagnosis ; Female ; Hospitals, General ; Humans ; Male ; Myopia* ; Ophthalmology ; Seoul

Gliomas of the optic nerve are relatively uncommon. We have experienced one case of glioma of the optic nerve recently. The patient was 17 year old boy who had exophthalmos and visual disturbance in his left eye for three years. The vision was CF/30cm. in his left eye and the optic nerve head was extremely atrophic. The eyeball was displaced infero-temporally. The exophthalmic value was 14mm. in right and 18mm. in left eye. On July 31, 1986, the left eyeball was exposed through Kroenlein method and the tumor mass was excised totally but the eyeball remained intact. The gross appearance of the tumor was large fusiform shape(3.5 X 2.0 X 1.8cm.) with well encapsulated grayish-white surface. The cut-section of the tumor revealed grayish-white solid area and hemorrhagic cystic area. The histopathologic slides showed that the tumor was composed of multiple pilocytic astrocytic cells in the solid area and in microcystic area. The cytoplasm of the tumor cells were bipolar spindle shape and the nucleus was uniform in general and there was no sign of mitotic figure. Numerous dense and amorphous eosinophilic materials so called "Rosenthal fibers" were also seen in the microcystic areas. Finally we have diagnosed this tumor as the Optic nerve glioma.
Adolescent ; Cytoplasm ; Eosinophils ; Exophthalmos ; Glioma ; Humans ; Male ; Optic Disk ; Optic Nerve Glioma* ; Optic Nerve*

At the present time, lidocaine is commonly used in ophthalmic surgery as a local anesthetic. Although it is safer than general anesthesia, visionthreatening and even life-threatening side effect can occur rarely. We report one case of visual loss combined with severe neurologic damage after local injection of lidocaine. Fifty-year-old male patient underwent phacoemulsification and IOL transscleral implantation with unplanned anterior vitrectomy after Nadbath-Ellis akinesia and retrobulbar anesthesia with lidocaine with 1:100,000 epinephrine. After operation, the patient had visual loss, facial palsy, total ophthalmoplegia, severe proptosis and submandibular swelling. There were no evidences of eyeball perforation, retrobulbar hemorrhage, and direct nerve injury. Although the mechanism of nerve injury is not well explainable, we suggest lidocaine toxic reaction. To our knowledge, This is the first reported case in the literature. We report this case with available literature review.
Anesthesia ; Anesthesia, General ; Blindness* ; Cataract* ; Epinephrine ; Exophthalmos ; Facial Paralysis ; Humans ; Lidocaine* ; Male ; Ophthalmoplegia ; Phacoemulsification ; Retrobulbar Hemorrhage ; Vitrectomy

PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

PURPOSE: Telomeres are specialized structures containing unique (TTAGGGG) repeats at the ends of eukaryotic chromosomes that are thought to be important in the protection and replication of chro mosomes. Lagging strand DNA synthesis at the end of linear chromosomes cannot be complieted (referred to as the end-replication problem), and this results in the progressive shortening of telomeric repeats with each cell division. This shortening of telomeres has been proposed as the mitotic clock, and when telomeres are sufficiently short, may contribute to replicative cellular senescence in cells. The enzyme telomerase permits the de novo synthesis of telomeric DNA into chromosomal ends. Apoptosis is physiologic cell death and prevent cancerous transformation of cell. METHODS: We measured the telome rase activity with the use of a PCR-based telomerase assay and apoptosis, in 10 superficial gastritis and 13 gastric cancer patients. RESULTS: Telomerase activity was present in 70% of the gastric cancer patient and in 92.7% of the superficial gastritis patients (P=0.171). Apoptosis was present in 0% of the gastric cancer patients, and in 80% of the superficial gastritis patients (P=0.001). CONCLUSION: Telomerase activity was detected in and cancer and inflammatory tissue. Although there is progressive cellular division due to telomerase activity, cancerous transformations are prevented by apoptosis.
Apoptosis* ; Cell Aging ; Cell Death ; Cell Division ; DNA ; Gastritis* ; Humans ; Stomach Neoplasms* ; Telomerase* ; Telomere

We reviewed eight solitary fibrous tumors occurring at sites other than pleura (three orbit, two retroperitoneum, one each hard palate, thyroid, and tongue) which shared the histologic and immunohistochemical features of solitary fibrous tumors of pleura. Six patients were women, and two were men, aged from 26 to 74 years. The tumors ranging from 1.5 to 19 cm in diameter presented as well-circumscribed, unencapsulated, soft to rubbery tissue masses. Histologically they were characterized by a proliferation of spindle or ovoid cells intervened by a dense bundles of collagen. A variety of growth patterns was identified but the so-called patternless pattern was the predominant one. One tumor exhibited highly cellular sarcomatous areas with extensive necrosis, which was diagnosed as malignant solitary fibrous tumor. Immunohistochemical studies showed that all of the tumors were strongly positive for both CD34 and vimentin, but negative for cytokeratin, S-100 protein, EMA, and desmin. One case examined ultrastructurally showed features of fibroblast. All but one showed no evidence of recurrence or metastasis over follow-up period of 14 to 32 months. We conclude that extrapleural solitary fibrous tumors represent a distinct mesenchymal tumor with variable histologic features and should be differentiated from other spindle cell mesenchymal tumors.
Collagen ; Desmin ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Keratins ; Male ; Necrosis ; Neoplasm Metastasis ; Orbit ; Palate, Hard ; Pleura ; Recurrence ; S100 Proteins ; Solitary Fibrous Tumors* ; Thyroid Gland ; Vimentin

PURPOSE: To describe the appearance and average thickness of the internal anal sphincter with anal endosonography in healthy Korean adults. MATERIAL AND METHODS: 184 subjects(male: 96, female: 88) with no history of anorectal disease or surgery were studied with anal endosonography. The average thickness of internal sphincter was meas ured at the mid-anal canal. For the internal sphincter, which is often asymmetric, the thickness of each 4 part(12, 3, 6 and 9 o'clock direction) were measured in left lateral decubitus position. RESULTS: The anal wall was well visualized in 5 layers(mucosa, submucosa, internal anal sphincter, intersphincteric plane, external anal sphincter) with anal endosonography. The anal endosonogram showed the internal anal sphincter as a homogenous, well-defined, hypoechoic, circular band, and slightly asymmetric. The average thickness of the internal anal sphincter in the area of mid-anal portion was 2.0 0.3 mm(range: 1~3 mm). There was no sexual difference; however, a significant positive correlation with age was found in average thickness of the internal anal sphincter. The correlation with lean body mass was not found. CONCLUSION: The internal anal sphincter is well-visualized, best defined structure by anal endosonography. Average thickeness of the sphincter in Korean appeared to be the same as in the Western.
Adult* ; Anal Canal* ; Endosonography ; Female ; Humans

Adenocarcinoma of the meibomian gland is relatively uncommon. In recent years, the authors have experienced a case of histologically proven meibomian gland adenocarcinoma. This was a 80-year-old female who had a regrowing large mass in the right upper eyelid. She was treated with surgical excision but rejected radiation therapy. A biopsy was performed and the histopathological examination revealed adenocarcinoma of the meibomian gland.
Adenocarcinoma ; Aged, 80 and over ; Anesthesia, Local ; Biopsy ; Conjunctivitis ; Eyelids* ; Female ; Humans ; Meibomian Glands* ; Molluscum Contagiosum* ; Skin