PURPOSE: To compare the outcomes of indocyanine green (ICG) and triamcinolone (TA) assisted internal limiting membrane (ILM) peeling during idiopathic macular hole surgery. METHODS: Fifty-four eyes of 54 patients with idiopathic macular hole underwent pars plana vitrectomy including peeling of the posterior cortical hyaloid and peeling of the internal limiting membrane. For enhanced visualization of ILM, ICG was used in 25 eyes and TA in the remaining 29 eyes. Postoperative visual acuity was measured and OCT was performed. RESULTS: Anatomical closure was achieved in 25 eyes (100%) in ICG group and 28 eyes (97%) in TA group, Best corrected visual acuity improvement by > or =2 lines was in 15 eyes (60%) in ICG group and 18 eyes (62%) in TA group. Postoperative visual improvement rates by > or =20/50 were 10 eyes (40%) in ICG group and 9 eyes (31%) in TA group. CONCLUSIONS: Peeling of the internal limiting membrane using triamcinolone and indocyanine green was safe and effective for anatomic and functional success in idiopathic macular hole surgery. Further studies of the toxicity of TA, ICG and the result of internal limiting membrane peeling is needed.
Humans ; Indocyanine Green* ; Membranes ; Retinal Perforations* ; Triamcinolone* ; Visual Acuity ; Vitrectomy

BACKGROUND AND OBJECT: Cheiro-oral syndrome (COS) is characterized by a sensory disturbance in the unilateral hand and ipsilateral mouth corner. It is usually due to a lesion in the parietal cortex, thatamocortical projections, thalamus, or rarely brain stem. However, the syndrome is relatively unknown and rarely mentioned in most neurological textbooks. We presented ten cases of COS with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible site. METHODS AND RESULTS: We studied 10 patients with stroke who showed restricted sensory disturbance on the one hand and ispilateral mouth. The study forms consisted of clinical manifestaion, neurological examination, electrophysiological, and neuroradiologic studies. Computed tomography and/or magnetic resonance imaging identified lesion in the thalamus in 5, brain stem in 3, and corona radiata in 1 patient. But, the anatomical responsible site for one case was not founded. Infarction had occurred in nine cases and hemorrhage in one. Seven of the 10 patients showed sensory disturbances restricted to the perioral area, hands, fingers when they were first examined; the remaining patients complained more diffuse sensory disturbances at first, but it had become restricted to perioral and fingers, usually within 2-3 weeks. The durations of symptom varied from 5 days to more than 15 months and these symptoms were improved within 2-3 weeks to 4 months in treated patients. CONCLUSION: When the symptoms and signs of the COS were presented, especially if a history of migraine is lacking, neuroradiological methods such as CT or MRI should be undertaken to localize and diffentiate the nature of lesion.
Brain Stem ; Fingers ; Hand ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Migraine Disorders ; Mouth ; Neurologic Examination ; Rabeprazole ; Stroke ; Thalamus

Gastrointestinal hemangiomatosis is a rare benign vascular lesion, which can produce massive or persistent blood loss. Numerous lesions, usually of the cavernous type, involve stomach, small bowel, and colon. The diagnosis of hemangiomatosis is difficult. It is diagnosed usually by endoscopic study or barium enema for bleeding or anemia evaluation in childhood. A 17-year-old female was admitted to our hospital with anemia and dizziness for several months. She was diagnosed as diffuse intestinal hemangiomatosis by gastroduodenoscopy and colonoscopy. Gastroduodenosocpic findings showed multiple, small, mound-like, reddish-purple hemangiomas on the lower body, fundus and prepyloric area of the stomach. Colonoscopic findings showed similar lesions on the ascending and descending colon. The polypoid lesion on the ascending colon was ligated by detachable snare due to bleeding. No other hemangioma was detected by ultrasonography, abdominal angiography or small bowel series. We report a case of diffuse hemangiomatosis, largely distrubuted in the stomach and colon, but without involvement of skin or other solid organ. The bleeding hemangioma on the ascending colon was treated by endoscopic ligation, and the anemia of the patient was improved.
Adolescent ; Anemia* ; Angiography ; Barium ; Colon ; Colon, Ascending ; Colon, Descending ; Colonoscopy ; Diagnosis ; Dizziness ; Endoscopy* ; Enema ; Female ; Hemangioma ; Hemorrhage ; Humans ; Ligation ; Skin ; SNARE Proteins ; Stomach ; Ultrasonography

PURPOSE: To determine the impact of interstitial laser coagulation (ILC) on the quality of life and sexual function in patients with a benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Eighty-nine patients treated with ILC were prospectively evaluated. The treatment outcome was evaluated 1, 3, 6 months and 1 year after the ILC with the international prostate symptom score (IPSS), the prostate volume, the peak urinary flow rate (Q-max), the post-void residual urine (PVR), and the quality of life assessment score. In addition, a self-reporting questionnaire including the International Index of Erectile Function (IIEF) were completed before and 3 months after treatment to determine the impact on sexual function. RESULTS: ILC showed significant improvement in the clinical and voiding parameters (IPSS, Q-max, PVR, prostate size). After ILC, 76% of patients were satisfied with the treatment and the quality of life score improved significantly after 3 months. There was no significant difference between the mean scores of the pretreatment and post-treatment erectile function, orgasmic function, sexual desire and intercourse satisfaction. However, the overall satisfaction score decreased from the pre-operative value of 3.05 to a post-operative value of 2.27 (p<0.05). An ejaculation loss or severe decrease in ejaculate volume was reported in 11 (23%) of the 46 patients followed up after ILC. Interestingly, only 5 (45%) of the 11 patients with a loss of ejaculation or severe decrease in ejaculate reported a deterioration of their sex life, while only 1 (4%) of the 23 without any change in ejaculate volume reported such deterioration. CONCLUSIONS: There were no significant changes in sexual desire, erectile function, orgasmic function, and intercourse satisfaction with ILC. However, the overall satisfaction decreased after ILC. Post-treatment sexual dysfunction appears to be mainly related to the impaired ejaculatory function.
Ejaculation ; Humans ; Laser Coagulation* ; Male ; Orgasm ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Quality of Life* ; Surveys and Questionnaires ; Treatment Outcome

BACKGROUND: We evaluated the current status of diabetes management and the predictors for poor glycemic control in an urban area. METHODS: This study included 1,138 community-dwelling adults (> or =50 years) with diabetes, of which 584 participated in the diabetes care survey. Logistic regression was used to identify the factors predicting poor glycemic control (hemoglobin A1c[HbA1c]> or =7%) in the total sample and to evaluate the relationship between the history of diabetes management checkup and poor glycemic control in the diabetes care survey sample. RESULTS: Of the 1,138 patients, 53.2% had blood pressure less than 130/80 mmHg, 41.7% had fasting glucose between 70 and 130 mg/dL, 48.6% had HbA1c below 7.0%, 60.1% had triglycerides below 150 mg/dL, 41.4% had low density lipoprotein cholesterol below 100 mg/dL, and 59.1% had normoalbuminuria (urine albumin-to-creatinine ratio <30 mg/g creatinine). Of the 584 patients completing the diabetes care survey, 63.9% had one or more lipid tests, 32.0% had one or more HbA1c tests, 43.8% had one or more microalbuminuria tests, and 42.5% had one or more fundoscopic examinations annually. Female gender (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.23-2.36), duration of diabetes (OR, 1.07; 95% CI, 1.06-1.09), and alcohol use (OR, 1.40; 95% CI, 1.06-1.85) were associated with an increased risk for poor glycemic control while age (OR, 0.97; 95% CI, 0.96-0.99) and antihypertensive medication (OR, 0.64; 95% CI, 0.50-0.83) were associated with a decreased risk. CONCLUSIONS: This study shows that glycemic control is likely to be poor in urban areas. We need to develop appropriate community-based strategies to achieve optimal glycemic control and prevent diabetes complications.
Adult ; Blood Pressure ; Cholesterol ; Cholesterol, LDL ; Diabetes Complications ; Diabetes Mellitus ; Fasting ; Female ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Lipoproteins ; Logistic Models ; Triglycerides

PURPOSE: To determine risk factors contributing to the development of an epiretinal membrane after retinal detachment surgery. METHODS: The authors retrospectively reviewed the records of 294 eyes which underwent retinal detachment surgery between 2001 and 2004. Parameters including numbers and locations of retinal breaks, operation methods and associated abnormalities were compared between the eyes from which a postoperative epiretinal membrane was removed and the eyes from which the membrane was not removed. RESULTS: Fourteen eyes (4.8%) underwent epiretinal membrane removal during the follow-up period. The mean interval between the retinal reattachment surgery and the vitrectomy for epiretinal membrane was 184 days (range: 50~546 days). Retinal breaks were located superiorly in 12 eyes and inferiorly in 2 eyes. Regarding the number of breaks, 1 break was observed in 9 eyes, 2 breaks in 2 eyes, 3 breaks in 2 eyes and no breaks in 1 eye. Vitreous hemorrhages presented in 7 eyes (50%). Twelve eyes were phakic eyes and 2 were pseudophakic. The macula was detached in 9 eyes (64.3%). Procedures for retinal detachment were vitrectomy with gas tamponade in 8 eyes (57.1%) and scleral buckling with cryoretinopexy in 6 eyes (42.9%). CONCLUSIONS: Preoperative vitreous hemorrhage, superior location of retinal breaks, old age and scleral buckling with cryotherapy were determined to be significant factors for the postoperative development of an epiretinal membrane. Postoperative visual acuity increased in all cases. This study demonstrates that vitrectomy for epiretinal membrane results in an overall favorable functional outcome.
Cryotherapy ; Epiretinal Membrane ; Eye ; Follow-Up Studies ; Membranes ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Risk Factors ; Scleral Buckling ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

Time intervals and indices of left ventricular diastolic filling were studied by M-mode and pulsed Doppler Echocardiography in 18 dilated cardiomyopathy patients. After one two hours captopril(capril(R)) 25mg medication. 1)Systolic blood pressure, Diastolic blood pressure, Heart rate were significantly decreased. 2) Dimensions of LVSD, LVDD, LA, Aorta and EF were not changed measured by M-mode echocardiography. 3) IRT measured by M-mode and Pulsed Doppler echocardiography were significantly increased(45+/-33msec VS 74+/-35msec. 84+/-32msec VS 100+/-22msec P<0.05). 4) A2-E measured by M-mode and Pulsed Doppler echocardiography were significantly increased(114+/-45msec VS 134+/-46msec, 156+/-46msec VS 194+/-48msec, P<0.05). 5) Deceleration time was significantly increased(137+/-36msec VS 205+/-40msec P<0.05). 6) Transmitral peak flow velocities were not changed significantly. In summary captopril influences early diastolic time intervals with dilated cardiomyopathy patients and we interpreted these effects be beneficial on diastolic filling pattern.
Aorta ; Blood Pressure ; Captopril ; Cardiomyopathy, Dilated* ; Deceleration ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans

Lovastatin is a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, which catalyzes the conversion of hydroxymethylglutaryl-coenzyme A to mevalonate, anearly and rate-limiting step in the synthesis of cholesterol. We studied the therapeutic effect and safety of lovastatin in 18 patients with nonfamilial primary hypercholesterolemia. Patients received 20mg/day lovastatin therapy as a single evening dose. If the total cholesterol level exceeded 200mg/dl after 2weeks of lovastatin therapy, the dosage of lovastatin was doubled. Mean percent total cholesterol level reductions from baseline were 26.4% and 31.9% after 4, and 8 weeks of lovastatin therapy respectively. Mean percent HDL-cholesterol level increase from baseline were 12% and 13% after 4, and 8 weeks of lovastatin therapy respectively. Adverse effects attributable to lovastatin were mild and temporary and no patient was withdrawn from therapy. We concluded that lovastatin was a well tolerated and effective agent for the treatment of nonfamilial primary hypercholesterolemia. Further studies are needed to establish the long-term safety and effectiveness of this drug.
Cholesterol ; Coenzyme A ; Humans ; Hypercholesterolemia* ; Lovastatin ; Mevalonic Acid ; Oxidoreductases

We have had an opportunity to study a patient with acute sensory neuronopathy. The patient was a 32-yearold housewife; the rapidly spreaded tingling sensation along both arms and legs developed, rendering her severely ataxic. There was no history of antecedent illness, familial neurological disease, or exposure to toxins and special drugs. On examinations, there was no abnormality in her mental and cranial nerve function. There was no motor weakness. She showed the profound loss of kinesthetic sense which was acutely progressive and associated with severe sensory ataxia and pseudoathetosis. All tendon reflexes were absent. However, cutaneous senses were preserved. There was no significant abnormal laboratory finding except elevated CSF protein content. On electrophysiologic findings, the decrease in the amplitude of action potentials with only mild slowing of conduction velocities of sensory nerves were found even though motor nerve conduction studies were normal. Median and tibial somatosensory evoked potentials could be elicited, although the median N19 scalp response and tibial N45 waveforms were prolonged in latency. Plasmapheresis were provided; clinical features improved. However, the electrophy-siological abnormalites remained. Thus we wish to report an additional case of woman suffering from the acute sensory neuronopathy, complementing the cases described by Stemm, Schaumburg and Asbury.
Action Potentials ; Arm ; Ataxia ; Complement System Proteins ; Cranial Nerves ; Evoked Potentials, Somatosensory ; Female ; Humans ; Kinesthesis ; Leg ; Neural Conduction ; Plasmapheresis ; Reflex, Stretch ; Scalp ; Sensation

Testosterone is required for the development and maintenance of the male accessory sex organs and their normal function. And it was reported that castration affect cells in the adult male rat accessory sex glands by induction of programmed cell death (apoptosis). So, in this study, the authors made an experiment to evaluate the effect of testosterone in the maure male rat penis and accessory sex glands following castration. Also, we utilized actinomycin D, a potent inhibitor of messenger and ribosomal RNA synthesis, in the experiment herein to assess the significance of regression process in the glands. Following are the changes in the serum testosterone level, the weight of the penis, ventral prostate and seminal vesicles and apoptosis occurrence of the control (castration, castration normal saline) and experimental (castration AD25, castration AD50) group of mature rats. 1. After castration, the control group and the experimental group showed decreased level of serum testosterone. 2. In the both groups, the weight of the penis, ventral prostate and seminal vesicles decreased gradually. 3. Compared to the control group, the castration AD25 did not show the inhibition of castration induced regression of penis and ventral prostate. However, castration AD50 showed the inhibition. 4 In the H-E staining and ApoTag in situ staining, the ventral prostate showed the most prominent apoptosis occurrence followed by the seminal vesicles and penis. These results suggest that after castration of the mature rat, due to testosterone deficiency, the weight of penis, ventral prostate and seminal vesicles decreased with the occurrence of apoptosis. Also, actinomycin D 50 micrometer seems to delay the regression process.
Adult ; Animals ; Apoptosis ; Castration* ; Cell Death ; Dactinomycin ; Genitalia ; Humans ; Male ; Penis* ; Prostate ; Rats* ; RNA, Ribosomal ; Seminal Vesicles ; Testosterone*