No abstract available.
Child ; Child Health* ; Child* ; Humans

Photoastigmatic refractive keratectomy (PARK) using VISX 20/20 B excimer laser with version 4.01 software was performed in 205 consecutive eyes of compound myopic astigmatism to assess the efficacy, predictability, and safety of excimer laser treatment of compound myopic astigmatism between September 1994 and June 1996. The mean preoperative manifest spherical equivalent refraction was -6.95+/-2.52D (range -1.13 to -15D) and the mean preoperative manifest cylindrical refraction was -1.25+/-0.76D (range -0.5 to -4.50D). The patients were followed from 6 months to 1 year (mean 9.19 months). At 1 year, 82(75.2%) of all 109 eyes receiving PARK were within 1D of plano refraction, and 88(80.7%) of all 109 eyes achieved uncorrected visual acuity of 20/30 or better. Postoperative refractions were stable after 3 months without significant early overcorrection. Mean postoperative astigmatism was -0.29+/-0.40D at 6 months and -0.24+/-0.42D at 12 months. Overall improvement of astigmatism was 75% at 6 months and 82% at 12 months by vector analysis using Alpins` method. In conclusion, PARK using VISX 20/20 B VisionKeyTM excimer laser with version 4.01 software appears to be effective in the treatment of compound myopic astigmatism with a relatively high degree of accuracy and safety. The predictability and stability of the postoperative refraction during the first 12 months seem to be quite reliable.
Astigmatism ; Humans ; Lasers, Excimer* ; Visual Acuity

In one case of cancer-associated Lambert-Eaton myasthenic syndrome (LEMS), treatment with cytotoxic chemotherapy and radiotherapy resulted in remission of both cancer and neuromuscular disorder. Serial repetitive nerve stimulation (RNS) findings showed that the typical RNS features of LEMS returned to normal in the orders of dramatic postexercise facilitation, an incremental response in high rate stimulation, and a decremental response in low rate stimulation with clinical improvement.
Drug Therapy* ; Lambert-Eaton Myasthenic Syndrome* ; Radiotherapy* ; Small Cell Lung Carcinoma*

PURPOSE: To study the reliability of intra- and interobserver reliability in angular measurement of hallux valgus deformity by assessing hallux valgus angle (HVA) and the 1st to 2nd intermetatarsal angle (1-2 IMA) through using computerized system. MATERIALS AND METHODS:20 cases of moderate to severe hallux valgus patients were included in this study. With the standing anteroposterior view of foot, the HVA and 1-2 IMA were calculated by computerized measurement system of Infinity cooperation, called phi-view, with its software tools. Using the statistical software program, SPSS (version 12th), we interpreted the results which were measured by two independent observers. RESULTS:In the intraobserver measurement, the HVA of observer A showed reliability (32.5 degrees +/-6.9 and 33.1 degrees +/-6.8)(p<0.05). 1-2 IMA in observer A was not regarded as reliable (16.9 degrees +/-2.8 and 17.1 degrees +/-2.8)(p>005). In the results of observer B, HVAs were measured as 35.7 degrees +/-7.6 and 36.2 degrees +/-7.7, and were not reliable (p>005). 1-2 IMA in observer B was not reliable as well (17.0 degrees +/-0.8 and 20.8 degrees +/-1.5)(p>005). In the interobservers' measurements, the first and the second results of HVA were 3.2 degrees +/-3.6 and 3.1 degrees +/-3.1, reliable within the 95% confidence interval (p<0.05). 1-2 IMAs were 0.1 degrees +/-1.9 and 3.73 degrees +/-1.3, which were not reliable (p>005). CONCLUSION: In the angular measurement of the hallux valgus by computerized system, the HVA and 1-2 IMA showed less error range in the interobserver's results, compared with the previous studies about the manual measurement. However, our results failed to show the statistical reliability of intra- and interobserver's measuring. Therefore, even the computerized angular measurements in the severity of hallux valgus require development of the measuring methods and software tools.
Congenital Abnormalities ; Foot ; Hallux ; Hallux Valgus ; Humans ; Software

PURPOSE: Pandemic influenza A (H1N1) virus has spread rapidly and prompt diagnosis is needed for successful treatment and prevention of transmission. We investigated clinical predictors, validated the use of previous criteria with laboratory tests, and evaluated the clinical criteria for H1N1 infection in the Korean population. MATERIALS AND METHODS: We analyzed clinical and laboratory evaluation data from outpatient clinics at Severance Hospital in Seoul, Korea between November 11 and December 5, 2009. RESULTS: This analysis included a total of 828 patients. Of these, 372 (44.9%) patients were confirmed with H1N1 infection by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). The most common and predictive symptom was cough (90.3%, OR 8.87, 95% CI 5.89-13.38) and about 40% of H1N1-positive patients were afebrile. The best predictive model of H1N1 infection was cough plus fever or myalgia. The sensitivities, specificities, positive predictive values, and negative predictive values of our suggested criteria were 73.9%, 69.5%, 66.4%, and 76.6%, respectively. CONCLUSION: Cough was the most common independent symptom in patients with laboratory-confirmed H1N1 infection, and while not perfect, the combination of cough plus fever or myalgia is suggested as clinical diagnostic criteria. Health care providers in Korea should suspect a cough without fever to be an early symptom of H1N1 infection.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Influenza A Virus, H1N1 Subtype/*metabolism ; Influenza, Human/*diagnosis/*epidemiology/virology ; Male ; Middle Aged ; Pandemics ; Predictive Value of Tests ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity

Pheochromocytoma during pregnancy is very rarely discovered, and this condition is life threatening to both mother and fetus. Maternal and fetal survival depend a lot on an early diagnosis, a correct medical therapy and a correct timing of delivery and surgery. We describe a case of pheochromocytoma during pregnancy. A patient was transferred to our hospital during gestational week 24 with severe hypertension, generalized edema. Pheochromocytoma caused by a left adrenal mass was diagnosed. The patient was treated with titrated dose of phenoxybenzamine, propranolol, and intravenous nicardipine, but intermittent severe hypertension was developed. At 33 weeks gestation, fetal distress was developed, and emergent cesarean section was done. Two weeks after delivery, she underwent a successful left adrenalectomy. Two months after surgery, all antihypertensive medications were discontinued and her blood pressure have remained normal range.
Adrenalectomy ; Blood Pressure ; Cesarean Section ; Early Diagnosis ; Edema ; Female ; Fetal Distress ; Fetus ; Humans ; Hypertension ; Mothers ; Nicardipine ; Phenoxybenzamine ; Pheochromocytoma* ; Pregnancy* ; Propranolol ; Reference Values

BACKGROUND: Charcot-Marie-Tooth (CMT) disease is a clinically and genetically heterogeneous disorder. Connexin32 (Cx32) gene mutations on Xq13.1 cause the X-linked form of CMT disease, and PMP22 gene duplication on 17p11.2-p12 causes CMT1A. The aim of the present study is to determine the clinical and electrophysiological characteristics between X-linked CMT patients with Cx32 missense mutations and CMT1A patients with PMP22 duplications. METHODS: We screened for 17p11.2-p12 duplication, and for point mutations in Cx32 genes of 48 Korean CMT families. Both neurological examination and nerve conduction studies were performed in all patients. RESULTS: Frequency of CMTX (6.3%) in our study was similar to Japanese, and was lower than those in European peoples. CMTX patients displayed no man-to-man transmission, and had cranial nerve involvement. CMTX patients showed more wide range of motor and sensory nerve conduction velocities than CMT1A patients. We found one family with axonal neuropathy and two families with demyelinating neuropathy in CMTX patients. CONCLUSIONS: Our findings suggest that mutations in Cx32 are probably less frequent in Asian CMT patients than European patients, and CMTX neuropathy is intermediary between CMT1 and CMT2. In addition, inheritance pattern and cranial nerve involvement are useful in differentiating CMTX from CMT1A with duplication.
Asian Continental Ancestry Group ; Axons ; Cranial Nerves ; Gene Duplication ; Humans ; Inheritance Patterns ; Mutation, Missense* ; Neural Conduction ; Neurologic Examination ; Point Mutation

No abstract available.
Aged, 80 and over ; Calcinosis/complications/*diagnosis/radiography ; Calculi/complications/*diagnosis/radiography ; Humans ; Ileum/pathology ; Intestinal Diseases/*diagnosis/etiology/radiography ; Intestinal Obstruction/*diagnosis/etiology/radiography ; Male ; Tomography, X-Ray Computed

The aim of this study was to investigate the relationships between the gadd genes expression and an apoptosis induction in two different growing cell types after treatments with cisplatin and methylmethan sulfonate (MMS). We have examined the kinetics and specificity of gadd45 and gadd153 expression following cisplatin and MMS treatments to HL-60 cells and primary cultured human kidney (HKN) cells. We have also determined an induction time of apoptosis by DNA fragmentation analysis and the presence of the cell cycle arrest by a flow cytometric measurement. The results were as follows. In non-adherent HL-60 cells, a typical ladder pattern was observed within 4 hours after treatments of 20 micrometer of cisplatin and 100 microgram/ml of MMS. At the same time while adherent HKN cells failed to exhibit a ladder pattern at even higher doses of genotoxic agents. Since HL-60 cells do not have p53 gene, these findings suggest the presence of a p53-independent apoptotic pathway. The increasing patterns of the mRNA levels of gadd45 and gadd153 varied with the type of genotoxic agents. In the case of MMS treatment, the induction was rapid and transient, regardless of the cell types. The mRNA level peaked at 4 hours after MMS treatment and markedly decreased after 12 hours. On the other hand, cisplatin-induced transcriptions of gadd45 and gadd153 continued to increase for at least 24 hours and reached a peak level at 48 hours after cisplatin treatment, regardless of the cell types. HL-60 cells revealed G2 arrest following 24 hours after cisplatin and MMS treatments. These findings suggest that the regulation mechanism of apoptosis between adherent and non-adherent cells, might be different and that gadd45 and gadd153 might have an important role in DNA repair rather than apoptosis. Also, the findings suggest that an expression pattern of gadd45 and gadd153 might be different according to the type of genotoxic agents.
Apoptosis* ; Cell Cycle Checkpoints ; Cell Cycle* ; Cisplatin ; DNA Damage ; DNA Fragmentation ; DNA Repair ; Genes, p53* ; Hand ; HL-60 Cells ; Humans ; Kidney ; Kinetics ; RNA, Messenger ; Sensitivity and Specificity

There have been few reports about extrusion of endodontic obturation materials into the maxillary sinus and inducing fungal sinusitis. Endodontic materials and fungus balls both are seen as high attenuation in a CT scan so may be overlooked. We report such a case in which the surgeon and radiologist had missed the foreign materials on preoperative CT scans, and recognized the filling defect on the alveolar bone and a foreign body in the nasal cavity postoperatively.
Foreign Bodies ; Fungi ; Gutta-Percha* ; Maxillary Sinus ; Nasal Cavity* ; Sinusitis* ; Tomography, X-Ray Computed