No abstract available.
Common Bile Duct*

Traumatic optic neuropathy is one of true ophthalmic emergencies and there is no proven form of treatment for traumatic optic neuropathy. 82 cases of traumatic optic neuropathy were investigated to evaluate the effectiveness of high dose corticosteroid for the visual improvement. Age, sex, initial visual acuity, final visual acuity, interval to treatment, the type of trauma and the affected region were studied retrospectively.250 mg of Methylprednisolone was administered intravenously every 6 hours for 3 days, and then followed by tapering using oral prednisone The vision was improved in 36 of 82 cases[43.9%]. It was difficult to interpret the relation-ships between the affected region and visual improvement, the interval for each treatment and final visual acuity. However, the vision was improved in 45 of 50 cases who had an initial visual acuity of above light perception, but in the two of 32 cases with no light perception. If indicated, fifteen cases were treated with a combination of high dose corticosteroid and optic nerve decompression. In initial treatment of traumatic optic neuropathy, high dose corticosteroid was effecive. Whether or not initial visual acuity was better than light perception was a key risk factor in the outcome.
Decompression ; Emergencies ; Methylprednisolone ; Optic Nerve ; Optic Nerve Injuries* ; Prednisone ; Risk Factors ; Visual Acuity

Animal models are useful tools to study the molecular basis of schizophrenia pathophysiology and efficacy of potential therapeutic agents. Schizophrenia animal models can be subdivided into three classes ; drug-induced models, genetic models, and environmental models and each model is designed based on specific traits corresponding to the characteristic symptoms of human schizophrenia patients. Psychomotor agitation and sensitivity to psychotomimetic drugs are often thought to reflect positive symptoms. Social interaction deficits and affective impairments are known to correspond to negative symptoms. Also, cognitive symptoms have been linked to the working memory impairments, attention deficits and related cognitive deficits in animals. To analyze such components in quantifiable manners, various behavioral paradigms have been developed and utilized. Here, we overview these animal models, focusing on underlying rationales for their use in the context of schizophrenia research.
Animals ; Behavior, Animal ; Humans ; Interpersonal Relations ; Memory, Short-Term ; Models, Animal* ; Models, Genetic ; Neurobehavioral Manifestations ; Psychomotor Agitation ; Schizophrenia*

No abstract available.
Facial Asymmetry

Synovial sarcoma is an uncommon, highly malignant soft tissue tumor usually arising from the synovial lining of a joint, bursa and tendon sheath. Occurence in muscle fascia is extremely rare. We present a case of synovial sarcoma of the left calf muscle fascia, which was confirmed by microscopically sarcomatous growth of spindle cells and irregular small multiloculation. Above knee amputation was done.
Amputation ; Fascia ; Joints ; Knee ; Sarcoma, Synovial ; Tendons

Maligant melanomas of the oral or nasal cavity, and the vulvovaginal area are relatively common among the melanomas of non-ocular mucosa. But, primary malignant melanoma arising in the mucosa of the palatine tonsil is rare. We present a case of primary malignant melanoma arising in the mucosa of the palatine tonsil. A 36-year-old male was admitted for evaluation of a recurrent sore throat. Tonsillectomy was performed on the basis of clinical suspicion of chronic tonsillitis. Grossly, the left tonsil was focally dark. Microscopically, the tonsillar mucosa was diffusely infiltrated with tumor cells. Tumor cells revealed numerous melanin pigments. Intraepithelial nests of tumor cells were noted, but pagetoid spread of tumor cells was not found. Tumor cells were positive for S-100 protein and HMB45 stain. There was no evidence of melanoma in the skin or eye.
Male ; Humans

PURPOSE: The prevalance rate of chronic hepatitis B viral infection in children is high in our contry. We performed a prospective study to evaluate the effectiveness of and the factors predictive of response to interferon-alpha therapy in children with chronic hepatitis B. METHODS: Thirty-two children with chronic hepatitis B werew admitted to the Department of Pediatrics, Yonsei University College of Medicine from Oct. 1992 to Apr. 1994, and liver biopsies were performed. They recieved interferon-alpha (Intermax-alpha: 3 million IU intramuscularly three times a week) for from 4 to 6 months and were followed for 19+/-7.5 months after treatment. The control group comprised forty children with chronic hepatitis B who had conservative or no treatment. The therapeutic effectiveness of IFN-alpha was evaluated, and factors predictive of response to treatment were analyzed. RESULTS: 1) Thirty two children in the treatment group comprised 22 males and 10 females. The mean age was 11.7+/-3.5 years at entry. The pathologic types were chronic lobular hepatitis in 4, chronic persistant hepatitis in 12 and chronic active hepatitis in 16 cases. The mean age of 40 children in the control group was 8.2+/-4.4 years. There were no differences in the clinical and laboratory data between the two group. 2) The serum ALT and AST levels normalized in 29 (91%) of 32 treated cases and 33 (88%) of 40 controls. The normalization of serum aminotransferases in control group, however, was thought to be meaningful because most controls were in healthy chronic carrier state with normal aminotransferases levels. The serum HBV-DNA was cleared in 25 (78%) of 32 treated cases and 7 (41%) of 40 controls, which showed statistically significant difference (P<0.005) between two groups. HBeAg was cleared in 24 (75%) of the treated cases and 10 (25%) of 40 controls (P<0.05). The positive seroconversion of anti-HBe was noted in 18 (56%) of 32 treated cases and 7 (18%) of 40 controls (P<0.05). 3) Normalization rate of AST and ALT levels, the clearance rate of HBV-DNA andHBeAg, and the seropositive rate to anti-HBe were 100%, 50%, 75% and 50% in CLH; 83%, 75%, 58% and 42% in CPH; 94%, 88%, 88% and 69% in CAH, respectively. 4) Children with higher pretreatment peak ALT level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 6 (55%) and 5 (45%) of 11 children with pretreatment peak ALT level of less than 100IU/L; 6 (75%) and 7 (88%) of 8 children with pretreatment peak ALT level of 100-200IU/L; 12 (92%) and 13 (100%) of 13 children with pretreatment peak ALT level of greater than 200IU/L. 5) Children with lower pretreatment HBV-DNA level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 13 (72%) and 14 (78%) of 18 children with pretreatment HBV-DNA level less than 100pg/ml; 2 (40%) and 2 (40%) of 5 children with pretreatment HBV-DNA level greater than 100pg/ml. 6) Children with higher post-treatment peak ALT level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 8 (73%) and 7 (64%) of 11 children with posttreatment peak ALT level less than 100IU/L; 9 (69%) and 10 (77%) of 13 children with post-treatment peak ALT level of 100-200IU/L; 7 (88%) and 8 (100%) of 8 children with post-treatment peak ALT level greater than 200IU/L. 7) Normalization of serum ALT and AST level took 7.1+/-6.8 months. The clearance of HBV-DNA and HBeAg took 12.9+/-8.3 and 10.1+/-7.3 months, respectively. positive seroconversion to antiHBe was obserbed at 10.6+/-6.3 months after IFN-alpha treatment. CONCLUSION: These results suggest that interferon-alpha therapy can induce an increased clearance of HBV-DNA and HBeAg with an increased positive seroconversion to anti-HBe in children with chronic type B hepatitis. Factors that may help in in identifying those children with a better chance of responding, were higher pre- and post-treatment peak ALT levels and lower pretreatment peak HBV-DNA levels.
Biopsy ; Carrier State ; Child* ; Female ; Hepatitis ; Hepatitis B e Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Liver ; Male ; Pediatrics ; Prospective Studies ; Transaminases

We studied 193 patients(200 eyes) who underwent extracapsular cataract extraction with posterior chamber lens implantation from September 1983 to May 1986. We compared the results of planned extracapsular cataract extraction(ECCE) group with those of Kelmen phacoemulsification(KPE) group. The results as follows; 1) Surgical technique is planned extracapsular cataract extraction in 98 eyes, Kelman phacoemulsification in 97 eyes, secondary implant in 2 eyes and triple procedure for glaucoma in 3 eyes. 2) Postoperative visual acuity of 0.5 or better was achieved in 190 eyes(95%) and 1.0 or better in 147 eyes(73.5%). Average of visual acuity was 0.86 +/- 0.26 in planned ECCE, 0.96 +/- 0.19 in KPE and 0.91 +/- 0.23 in toto. There was significant correlation between two(p<0.01). 3) The mean spherical equivalent of postoperative corrective spectacle lens power was -0.97 +/- 1.0 in planned ECCE, -0.95 +/- 0.95 in KPE and -0.96 +/- 0.97 in toto. Postoperative refractive state was myopic in 162 persons(84%), emmetropic in 13 persons(7%) and hyperopic in 18 persons(9%). 4) Error of predicted required spectacle lens power was -0.21D +/- 0.95 in planned ECCE, -0.12D +/- 1.0 in KPE, -0.16D +/- 0.97 in toto. With the use of the standard formula described by Hoffer, our results for the accuracy of intraocular lens calculation was 77% +/- 1.0D / 92.7% +/- 2.0D / +2.77 to -2.61D. 5) Of 200 eyes, 162 eyes required correction of astigmatism with average of -0.93D +/- 1.12 in planned ECCE, -0.57D +/- 0.76 in KPE and -0.76D +/- 0.98 in toto. There was significant correlation between two(p<0.05). 6) Mean corneal refractive power changes was -0.14D +/- 0.47 in planned ECCE, 0.05D +/- 0.49 in KPE and 0.02D +/- 0.48 in toto. There was no significant correlation between two. 7) Correlation efficiency between postoperative corneal astigmatism and actual astigmatism by skiascopy was r=0.6874(p<0.01) in planned ECCE, r=0.1833 in KPE and r=0.5747(P<0.01) in toto.
Astigmatism ; Cataract ; Cataract Extraction ; Glaucoma ; Lenses, Intraocular ; Phacoemulsification ; Retinoscopy ; Visual Acuity

BACKGROUND: This is a retrospective, descriptive study, evaluating the observed agreement between 1996 & 2002 Centers for Disease Control and Prevention (CDC) definitions of nosocomial pneumonia (NP) for medical intensive care unit (MICU) and surgical intensive care unit (SICU) patients. METHODS: A total of 476 adult patients who were over 15 years of age and had been admitted to the MICU & SICU of a university hospital between August 1, 2005 and August 1, 2007 were enrolled. Data were collected from electronic medical records according to the 1996 & 2002 CDC definitions of NP. RESULTS: According to the 1996 CDC definitions of NP, there were a total of 116 NP cases and incidence rate was 11.6 per 1,000 patient-days; when analyzed with the 2002 CDC definitions of NP, 75 cases met the criteria and the incidence rate was 7.5 per 1,000 patient-days. Kappa value measuring agreement between the two definitions was 0.67 (95% confidence interval 0.601-0.706). When 1996 CDC definitions were compared with 2002 CDC definitions, sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 88.5, 60.3, and 98.6%, respectively. CONCLUSION: Even though the aforementioned NP criteria had been applied to the same study population, the number of patients that met the definitions changed depending on which criteria had been used. Therefore, it is necessary to consider the differences when making a comparison.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity

A 19-year-old man visited out-patient department of the Ophthalmology in our hospital due to unilateral proptosis connected with excessive tearing and moderate swelling of the eyelid in the right eye, 2 years in duration. CT scan demonstrated a relatively well demarcated, single mass measuring 2.5 X 2.5cm in the posterotemporal portion of the right orbit, which had strongly enhanced, hyper dense, internal consistency. We underwent lateral orbitotomy for total removal of this mass under general anesthesia and histopathological diagnosis was made as a pleomorphic adenoma of the lacrimal gland. This patient is satisfied with good cosmetic and clinical result.
Adenoma, Pleomorphic ; Anesthesia, General ; Diagnosis ; Exophthalmos ; Eyelids ; Humans ; Lacrimal Apparatus* ; Ophthalmology ; Orbit ; Outpatients ; Tomography, X-Ray Computed ; Young Adult