No abstract availble
Adenocarcinoma/*diagnosis/radiography ; Aged ; Anus Diseases/complications ; Colon, Ascending ; Colonic Neoplasms/*diagnosis/radiography ; *Colonography, Computed Tomographic ; *Colonoscopy ; Constriction, Pathologic ; Humans ; Male ; Tomography, X-Ray Computed

The serotonin transporter (SERT) is the target site for serotonin reuptake inhibitors, which are the most widely used agents for treating various psychiatric diseases including depression. The SERT is a member of a large family of homologous integral membrane proteins. This transporter takes up 5-HT in a process that is coupled to the transmembrane movement of Na+, Cl-, and K+. The SERT may operate in at least two modes, an alternating access carrier or a channel. The function of SERT is acutely regulated by various protein kinases and phosphatases. The SERT gene is located on chromosome 17 and has several polymorphisms including 5-HTTLPR and intron 2 VNTR. Most studies involving the association between 5-HTTLPR and the response to SSRI in depression reported that l/l genotype showed better response and fewer side effects. But, it is too early to draw definite conclusion of the effects of 5-HTTLPR on anti-depressant treatment. Therefore, it is necessary to perform further studies reflecting various ethnicities and genetics of subjects as well as the environmental interactions. This review discusses recent advances in defining the structure, the action mechanism, the location, and the regulation of SERT. Furthermore, it discusses the function of SERT polymorphisms and its implications on the anti-depressant therapies.
Chromosomes, Human, Pair 17 ; Depression ; Drug Therapy* ; Genetics ; Genotype ; Humans ; Introns ; Membrane Proteins ; Phosphoric Monoester Hydrolases ; Protein Kinases ; Serotonin Plasma Membrane Transport Proteins* ; Serotonin Uptake Inhibitors ; Serotonin*

PURPOSE: To report the clinical manifestations of patients with ocular tilt reaction (OTR) and the differential point from other disorders with abnormal head posture. METHODS: The clinical manifestations of four patients who complained of abnormal head posture and diplopia and who were diagnosed to have OTR from January, 2001 to January, 2002 were investigated. The diagnoses were made with alternate cover test, duction and version test, Lancaster test, Bielschowsky head tilt test, fundus photography, and brain MRI. RESULTS: All the four patients showed ipsilateral head tilt, ocular torsion, and vertical deviation. Type of their OTR was tonic OTR. Subjective tilting of visual vertical was observed in one patient. Only with the 3-step test, OTR could be misdiagnosed as an extraocular muscle palsy. The most important sign in differentiation from other disorders of abnormal head posture was ocular torsion. Duction and version examination and tilt of subjective visual vertical were also helpful for the differentiation. CONCLUSIONS: OTR should be considered in patients with ocular torsion, vertical deviation and ipsilateral head tilt. In patients with diplopia and head tilt, examination of ocular torsion should be performed with the 3-step test in order not to make a misdiagnosis of extraocular muscle palsy.
Brain ; Diagnosis ; Diagnostic Errors ; Diplopia ; Head ; Humans ; Magnetic Resonance Imaging ; Paralysis ; Photography ; Posture

STUDY DESIGN: Authors experienced three cases of malignant schwannoma arising from multiple neurofibromatosis and invading the vertebrae. OBJECTIVE: To report treatment results and preventive idea in three cases of malignant schwannoma transformed from neurofibromatosis within the retroperifoneal area and invading the vertebrae. SUMMARY OF BACKGROUND DATA: The patients with neurofibromatosis are clearly at increased risk to develop the malignant schwannoma. A review of Korean literature revealed no such cases. RESULTS: The first case presented in the L4 body and was treated by surgical excision and chemotherapy, but she expired due to secondary metastasis in six months after diagnosis. The second case was treated by diagnostic biopsy and chemotherapy with adriamycin, ifosfamide, DTIC, mesna. He eventually lived for 14 months. After a diagnostic biopsy, the third case died due to lung metastasis before we could begin the treatment. CONCLUSION: We recommend that neurofibromatsis patients be regularly followed-up and if necessary, CT examination of spine or abdomen should be done. If a malignant schwannoma is detected, then early treatment can be started.
Abdomen ; Biopsy ; Dacarbazine ; Diagnosis ; Doxorubicin ; Drug Therapy ; Humans ; Ifosfamide ; Lung ; Mesna ; Neoplasm Metastasis ; Neurilemmoma* ; Neurofibromatoses ; Spine*

Recently there has been a progressive increase of thoracolumbar fractures with neurologic symptoms. It has been thought that laminectomy increased instability and was therefore considered a contraindication. Currently, with the development of instrument for posterior stabilization, it is possible to perform posterior fusion and instrumentation, both with and without laminectomy. To compare the effect of neurologic recovery with and without laminectomy, we analyzed the clinical records of 38 patients with neurologic symptoms who were evaluated with plain radiographs and CT before and after surgery from 1989 to 1996 in Gyeong-Sang National University Hospital. We divided our cases into two groups, one group consisted open reduction with laminectomy and instrumentation with posterior fusion. The other group consisted of open reduction without laminectomy and instrumentation with posterior fusion. Twenty three of 38 were operated with open reduction and internal fixation with laminectomy and others were operated without laminectomy. The results were that both groups had improvement of neurologic symptoms after surgery and at follow-up. There was no significant statistical difference between the two groups. Depending on the time interval between injury and surgery, patients who were underwent emergency surgery had an marked improvement of neurologic symptoms. Except cases of complete paraplegia, incomplete paraplegic patients who were operated within 24 hours with laminectomy group had greater improvement than those without laminectomy. The improvement was statistically significant(P<0.05).
Emergencies ; Follow-Up Studies ; Humans ; Laminectomy* ; Neurologic Manifestations* ; Paraplegia

Adenoid cystic carcinoma (ACC) is the second most common malignancy in sinonasal tract occurring in the minor salivary gland of paranasal sinuses. It is also an aggressive neoplasm that results in a high incidence of both local recurrence and distant metastasis by perineural invasion. A 67-year-old woman had developed progressive nasal obstruction and facial pain for over two years. The imaging study showed a huge polypoid mass in the paranasal sinuses bulging into the nasal cavity without any adjacent bony erosion and orbital extension. The pathology was reported as a cribriform type of ACC. The mass was removed by endonasal endoscopic surgery and "Mini" Caldwell-Luc operation. Considering local recurrence due to perineural lymphatic invasion, postoperative radiation therapy was performed. We discuss here how the combination of endonasal endoscopic surgery and radiotherapy could provide the best chance for disease control in the selected stages of ACC.
Adenoids ; Carcinoma, Adenoid Cystic ; Facial Pain ; Female ; Humans ; Incidence ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps ; Neoplasm Metastasis ; Orbit ; Paranasal Sinuses ; Recurrence ; Salivary Glands, Minor

No abstract available.
Bronchoscopes*

PURPOSE: To investigate the clinical characteristics of patients with acute zonal occult outer retinopathy (AZOOR). METHODS: Medical records of 13 patients who visited Seoul National University Bundang Hospital from May, 2003 to May, 2015 and diagnosed with AZOOR were retrospectively reviewed. RESULTS: Thirteen patients (11 women and 2 men), with a mean age of 28.5 ± 11.4 years were followed for 42.8 ± 30.3 months. Visual field loss, photopsia, and blurred vision were common complaints. Initially, four patients had bilateral disease and seven patients showed bilateral involvement at the last visit. Mean best corrected visual acuity of involved eyes (BCVA) was 0.75 ± 0.32 (log MAR). Among 20 eyes with AZOOR, BCVA was 20/40 or better in 17 eyes (85.0%). The mean spherical equivalent was -4.59 ± 3.23 diopters (D), and 15 eyes (75.0%) had myopia less than -2.00 D. Nine eyes of seven patients (34.6%) had abnormal fundus findings. All patients underwent full field electroretinogram (ERG) or multifocal ERG and a visual field test. Thirteen patients (100.0%) showed a decreased response in ERG and visual field defects presented in every patient. With respect to the visual field test, 10 eyes (50.0%) showed improvement, 6 eyes (30.0%) had stationary status, and the progression of the visual field defect was observed in 4 eyes (20.0%). Among 13 patients, 4 (30.8%) patients showed flu-like symptom, 4 (30.8%) patients had fatigue, 2 (15.4%) patients had nausea, and 2 (15.4%) patients showed headache. CONCLUSIONS: AZOOR should be considered as one of the differential diagnoses, especially in female patients with myopia who show photopsia or visual field defects. ERG and visual field tests are necessary to confirm a decrease in retinal function and visual field loss. Central vision is preserved in most cases and recovery of visual field defect occurs often.
Diagnosis, Differential ; Fatigue ; Female ; Fluconazole* ; Headache ; Humans ; Medical Records ; Myopia ; Nausea ; Retinaldehyde ; Retrospective Studies ; Seoul ; Visual Acuity ; Visual Field Tests ; Visual Fields

PURPOSE: In the present study we evaluated the changes of measured retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) after phakic intraocular lens (implantable collamer lens, ICL) implantation and analyzed the factors correlated with the changes of measured RNFL thickness. METHODS: Forty eyes of 40 patients (Group A: 20 patients using spectral domain OCT and Group B: 20 patients using time domain OCT) who underwent ICL implantation were included in this study. RNFL thickness was measured 1 week before surgery and 1 month postoperatively using OCT. The changes of measured RNFL thickness and the correlation between patients' data were analyzed. RESULTS: The postoperative measured RNFL thickness of the average, inferior, temporal, and superior quadrants were increased compared to preoperative measured RNFL thickness in Group A. Group B had similar results in the average, inferior, and superior quadrants (p < 0.05). However, the postoperative changes of RNFL measurements were not correlated with the preoperative spherical equivalent, the degree of spherical equivalent change and diopters of implanted lens (p > 0.05). CONCLUSIONS: The measured RNFL thickness after ICL implantation may increase compared to the preoperative value. Caution should be taken when interpreting the RNFL thickness values measured by OCT in patients with myopia who undergo ICL implantation.
Humans ; Myopia ; Nerve Fibers* ; Phakic Intraocular Lenses* ; Retinaldehyde* ; Tomography, Optical Coherence

PURPOSE: In the present study we evaluated the changes of measured retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) after phakic intraocular lens (implantable collamer lens, ICL) implantation and analyzed the factors correlated with the changes of measured RNFL thickness. METHODS: Forty eyes of 40 patients (Group A: 20 patients using spectral domain OCT and Group B: 20 patients using time domain OCT) who underwent ICL implantation were included in this study. RNFL thickness was measured 1 week before surgery and 1 month postoperatively using OCT. The changes of measured RNFL thickness and the correlation between patients' data were analyzed. RESULTS: The postoperative measured RNFL thickness of the average, inferior, temporal, and superior quadrants were increased compared to preoperative measured RNFL thickness in Group A. Group B had similar results in the average, inferior, and superior quadrants (p < 0.05). However, the postoperative changes of RNFL measurements were not correlated with the preoperative spherical equivalent, the degree of spherical equivalent change and diopters of implanted lens (p > 0.05). CONCLUSIONS: The measured RNFL thickness after ICL implantation may increase compared to the preoperative value. Caution should be taken when interpreting the RNFL thickness values measured by OCT in patients with myopia who undergo ICL implantation.
Humans ; Myopia ; Nerve Fibers* ; Phakic Intraocular Lenses* ; Retinaldehyde* ; Tomography, Optical Coherence