No abstract available.

Internuclear ophthalmoplegia (INO) is characteristic of lesions of the medial longitudinal fasciculus (MLF) between the third and sixth cranial nerve nucleus. Bilateral INO is due to bilateral lesions of MLF. We present here one case of bilateral INO in tuberculous meningitis.
Abducens Nerve ; Ocular Motility Disorders* ; Tuberculosis, Meningeal

Chromosome 18q alteration plays a key role in colorectal tumorigenesis, and loss of heterozygosity at 18q is associated with a poor prognosis in colon cancer. DCC(Deleted in Colorectal Cancer) is a putative tumor- suppressor gene at 18q21 that encodes a transmembrane protein with structural similarity to neural cell adhesion molecule that is involved in both epithelial and neuronal cell differentiation. DCC is implicated in regulation of cell growth, survival and proliferation. Thus, tumor progression in squamous cell carcinoma, stomach cancer, colorectal cancer correlates with downregulation of DCC expression. The mechanism for DCC suppression is associated with hypermethylation of the DCC gene promoter region. Hence, the goal of this study is to identify the promoter methylation responsible for the down-regulation of DCC expression in oral squamous cell carcinoma. 12 of tissue specimens for the study are excised and gathered from 12 patients who are diagnosed as SCC in department of OMS, dental hospital, dankook university. To find expression of DCC in each tissue samples, immunohistochemical staining, RT-PCR gene analysis and methylation specific PCR are processed. The results are as follows. 1. In the DCC gene RT-PCR analysis, 5(41.6%) of 12 specimens of oral squamous cell carcinoma did not expressed DCC gene. 2. In the promoter methylation specific PCR analysis, 5(41.6%) of 12 specimens showed promoter methylation of DCC gene. 3. In the immunohistochemical staining of poor differentiated and invasive oral squamous cell carcinoma, loss of DCC expression was observed. These findings suggest that methylation of the DCC gene may play a role in loss of gene expression in invasive oral squamous cell carcinoma.
Carcinoma, Squamous Cell ; Cell Differentiation ; Cell Transformation, Neoplastic ; Colonic Neoplasms ; Colorectal Neoplasms ; Down-Regulation ; Gene Expression ; Genes, DCC ; Genes, Suppressor ; Humans ; Loss of Heterozygosity ; Methylation ; Neural Cell Adhesion Molecules ; Neurons ; Polymerase Chain Reaction ; Prognosis ; Promoter Regions, Genetic ; Stomach Neoplasms

No abstract available.
Free Tissue Flaps* ; Lower Extremity* ; Soft Tissue Injuries*

Percutaneous endoscopic gastrostomy is used for long-term nutritional support and can be performed with relatively few complications. Among the major and minor complications, migration and erosion of the internal bumper into or through the abdominal wall, so called buried bumper syndrome has been described more recently. We describe a patient in whom internal bumper eroded into stomach wall and was completely covered by gastric epithelium 45 days after gastrostomy placement. The gastrostomy tube itself was patent, and the end still protruded into the lumen of the stomach. But, endoscopy was failed to remove the gastrostomy tube and surgical exploration was required in our case. We experienced a case of buried bumper syndrome after percutaneous endoscopic gastrostomy and report with a review of literatures.
Abdominal Wall ; Cytochrome P-450 CYP1A1 ; Endoscopy ; Epithelium ; Gastrostomy ; Humans ; Nutritional Support ; Stomach

PURPOSE: To compare the effect of intravitreal triamcinolone injection with and without bevacizumab for diabetic macular edema. METHODS: Of 69 patients (69 eyes) diagnosed with diabetic macular edema without any history of other intraocular disease or intraocular operation, 45 eyes (45 patients) were injected with intravitreal triamcinolone (4 mg) and the remaining eyes (24 patients) were injected with triamcinolone (2 mg) and bevacizumab (1.25 mg). The visual acuity and central macular thickness of treated eyes from both groups was measured using OCT, and these measurements were compared between the two groups. RESULTS: There were no statistical differences between the two groups with respect to baseline data. Central macular thickness (CMT) was reduced in both groups, and BCVA improved in both groups. No significant differences were detected in changes in CMT or BCVA between the two groups. CONCLUSIONS: Intravitreal injection of triamcinolone had a beneficial effect on DME in terms of CMT reduction and BCVA improvement. Addition of three consecutive intravitreal bevacizumab injections, however, did not show any significant addictive effect during the follow-up period.
Antibodies, Monoclonal, Humanized ; Eye ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema ; Triamcinolone ; Visual Acuity ; Bevacizumab

No abstract available.
Pyelonephritis*

BACKGROUND: The catheter ablation usin radiofrequency(RF) energy in patients with atrioventricular nodal reentrant tachycardia(AVNRT) and atrioventricular reentrant tachycardia(AVRT) ahs been proved as a safe and effective nonpharmacologic therapeutic modality. The purpose of our study was to evaluate the success rate and complications of the initial experience and to determine the extent of myocardial damage of RF catheter ablation. METHODS: Electrophysiologic study was performed with the standard technique. Twenty five patinents(M:F=16:9, mean age:42 years old) underwent RF catheter ablation in St. May's Hospital from April to December in 1994. The RF generator in this study was RFG-3D model and catheters were 6F or 7F steerable catheters with 4mm kistal tip. In order to evaluate the extent of myocardial damage the WBC count, LDH, CK, and CK-MB fraction were checked before and after RF catheter ablation and the Tc99m myocardial scintigraphy was performed within 72 hours of the porcedure. RESULTS: Six of twenty five patients had AVNRT, in which the success rate of selective ablation of the slow pathway was 83.8%. Nineteen patients with AVRT had one accessory pathway. The ablation success rate of 14 accessory pathways in left free wall location was 85.7%, and that of 3 in left posteroseptal location was 66.6%. Two right sided accessory pathways were not ablated successfully. The level of CK-MB fraction after ablation was within normal limit. Only one case revealed grade 2 of hot spot in Tc99m myocardial scintigraphy. CONCLUSION: The RF catheter ablation in patients with AVNRT and AVRT is a safe and effective nonpharmacologic therapeutic modality. But right sided accessory pathways are more difficult to ablate than left sided accessory pathways, requiring more experiences and better technique. The extent of myocardial damage after RF catheter ablation reveals relatively minimal by cardiac enzyme study and Tc99mmyocardial scintigraphy.
Catheter Ablation* ; Catheters ; Humans ; Myocardial Perfusion Imaging ; Radionuclide Imaging ; Tachycardia, Supraventricular*

BACKGROUNDS: The education by the family physician. is important for more practical primary care medicine education. In this study, we try to know the presnent state of education and the future and the number of education resource and how to multiply this resource. METHODS: we have got the list of family physicians who have their clinic in Seoul by the help of the Korean Academy of Family Medicine. And we performed telephone questionary. We also asked the demographic factors RESULTS: 134 persons were asked questionary by the telephone. 17persons were joining in education. Trainee by the 3rd grade hospitals was the major, the next was by 2nd grade hospital, and doctors who did not have the training. 14 persons have begun education by asking of the training hospital, 3 persons wanted it, but none thought it beneficial to them. 44 persons wanted to join education in the future, and there was no difference between the 3rd and the 2nd grade hospital trainee. CONCLUSION: There was no difference between the 3rd and 2nd grade hospital trainee but 2nd grade hospital trainee was less joining than the 3rd. This shows that the 2nd grade hospital trainee can be the good pool of the future education if there are adequate supply. So many adequate supply is necessary.
Demography ; Education* ; Humans ; Physicians, Family* ; Primary Health Care ; Seoul* ; Telephone

BACKGROUND: Aortic valve endocarditis(AVE) may produce secondary involvement of the mitral aortic-intervalvular fibrosa(MAIVF) and the anterior mitral valve leaflets(AMVL). These complications may result in the systolic regurgitation of blood from the left ventricular outflow tract into the left atrium, or formation of an aneurysm or perforation of the AMVL. Early recognition of these complications is important for optimal management and corrective surgery. The aims of the persent study were to examine the utility of transesophageal echocardiography(TEE) in the diagnosis of these subaortic complications compared to conventional transthoracic echocardiography(TTE) and to observe the prevalence and pattern of these complications. METHOD: Both TTE and TEE were performed in patients with AVE from June 1991 to June 1993. A 2.5 MHz probe was used for TTE and a 5 MHz biplane one for TEE with Hewlett Packard SONOS 1,000 All procedures were recorded in super VHS tape and reviewed by two experienced cardiologist. AVE was diagnosed clinically by the presence of continuous bacteremia or demonstration of vegetations during open heart surgery. RESULT: Ten consecutive patients with AVE underwent TTE and TEE of these patients, 6(60%) had involvement of subaortic structures, including one with an abscess in the MAIVF, two with perforation of the MAIVF into the left atrium, one with multiple vegetations in the AMVL, and two with pseudoaneurysm formation and perforation of the AMVL, TEE visualized all these lesions with high resolution images, whereas TTE detected only multiple vegetations in the AMVL in one patients and eccentric mitral regurgitation of unknown etiology in 2 patients. In 4 patients, corrective surgery was performed in which the TEE findings were confirmed. CONCLUSION: The results implicate that 1) involvement of the subaortic structures would be a common complication in patients with AVE, 2) TEE is superior to conventional TTE in the detection of these complications, and 3) routine screening with TEE would be necessary in patients with AVE to diagnose or exclude these subaortic complications.
Abscess ; Aneurysm ; Aneurysm, False ; Aortic Valve* ; Bacteremia ; Diagnosis ; Echocardiography* ; Echocardiography, Transesophageal ; Endocarditis* ; Heart Atria ; Humans ; Mass Screening ; Mitral Valve ; Mitral Valve Insufficiency ; Prevalence ; Thoracic Surgery