PURPOSE: Cerebral malaria is caused by Plasmodium falciparum. The reports about cerebral malaria are very rare because Korea is not endemic area of P. falciparum. Additionally, macular hemorrhage and decreased vision associated with cerebral malaria was not reported ever in Korea, we report one case of cerebral malaria associated with retinal hemorrhage on macular area and review of literature. METHODS: Ophthalmology was consulted with about 19-year-old woman in cerebral malaria, tropical endemic disease caused by Plasmodium falciparum, with decresed visual acuity. RESULTS: 1250 mg/day of Mefloquine was injected into patient for cerebral malaria for 18 days. After awareness, the patient complained of decreased visual acuity in left eye, then the best corrected visual acuity(BCVA) in left eye was 20/800, BCVA in right eye was 20/20, retinal hemorrhage and Roth's spot were found on fundus examination in left eye, and finding in fluorescein angiography was not specific. After 8 months, retinal hemorrhage in left eye was absorbed, but BCVA in left eye was not changed.
Endemic Diseases ; Female ; Fluorescein Angiography ; Hemorrhage ; Humans ; Korea ; Malaria, Cerebral* ; Mefloquine ; Ophthalmology ; Plasmodium falciparum ; Retinal Hemorrhage* ; Retinaldehyde* ; Visual Acuity ; Young Adult

Low back pain is common during pregnancy. However, the prevalence of symtomatic lumbar disc herniation is rare, and cauda equina syndrome due to disc herniation during pregnancy is even rarer. We report a rare case of lumbar disc herniation causing cauda equina syndrome during third trimester of pregnancy which successfully treated by endoscopic discectomy. This case shows that endoscopic discectomy can be the treatment option for the lumbar disc herniation during pregnancy.
Cauda Equina* ; Diskectomy* ; Female ; Humans ; Low Back Pain ; Polyradiculopathy* ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy* ; Prevalence

PURPOSE: To assess the effect of argon laser peripheral iridoplasty in patients with primary angle-closure glaucoma. METHODS: Eyes of 63 patients with primary angle-closure glaucoma who needed laser therapy were evaluated. We divided the patients randomly into two groups and studied prospectively. Thirty eyes (30 patients) were treated with both laser iridotomy and argon laser peripheral iridoplasty. Thirty-three eyes (33 patients) were treated with only laser iridotomy. Anti-glaucoma drugs were not used after laser therapy, and intraocualr pressure (IOP) over 21 mmHg during follow-up period were considered as failure. RESULTS: No differences were found between the two groups in age, sex, initial IOP, clinical forms of angle closure, degrees of peripheral antirior synechiae, and follow-up period. Patients treated with argon laser peripheral iridoplasty and laser iridotomy had successfully controlled IOPs (<21 mmHg) than those with only laser iridotomy through 8 months after laser therapy (p<0.05, log-rank test). However, there was no difference in the two groups at the final follow-up months (12 months) (p=0.180, log-rank test). CONCLUSIONS: Argon laser pheripheral iridoplasty decreased IOP in the early post-laser period. However, in the long term follow-up, the effect of argon laser pheripheral iridoplasty did not last when compared with laser iridotomy.
Argon* ; Follow-Up Studies ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Laser Therapy ; Prospective Studies

Purpose: This study aimed to systematically evaluate literature related to the effects of exercise intervention programs on physical or psychological variables of post-operative breast cancer patients in Korea, and identify the effectiveness of exercise intervention through meta-analysis. Methods: The review question was defined according to PICO-SD (Participants, Intervention, Comparisons, Outcomes, Study Design) to achieve a systematic literature review: “How does exercise intervention affect the physical or psychological outcome in post-operative breast cancer patients compared to the control group?” The subjects were randomized clinical trials (RCTs) studies released in Korea between 2010 and December 2020. Literature searches were conducted using four electronic databases, including Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), National Assembly Library, and DBpia. The search terms were ‘breast neoplasms’ or ‘breast cancer’ with ‘exercise’ or ‘exercise intervention’ or ‘exercise program.’ A total of 13 RCTs were finally selected. Results: The outcome variables were in the upper extremity range of motion (ROM), shoulder disability, pain and edema. The effect size of exercise intervention on ROM was 0.95(95% CI:0.58, 1.33)( p<.001); shoulder disability was -1.16(95% CI:-1.77, -0.55)(p<.001); pain was -1.24(95% CI:-1.58, -0.89) (p<.001); and edema was -0.03(95% CI:-0.39, 0.33)(p=.858). Conclusion This result suggests that oncology nurses may apply exercise intervention to improve ROM, shoulder disability, and to alleviate pain in post-op breast cancer patients.

Purpose: This study aimed to systematically evaluate literature related to the effects of exercise intervention programs on physical or psychological variables of post-operative breast cancer patients in Korea, and identify the effectiveness of exercise intervention through meta-analysis. Methods: The review question was defined according to PICO-SD (Participants, Intervention, Comparisons, Outcomes, Study Design) to achieve a systematic literature review: “How does exercise intervention affect the physical or psychological outcome in post-operative breast cancer patients compared to the control group?” The subjects were randomized clinical trials (RCTs) studies released in Korea between 2010 and December 2020. Literature searches were conducted using four electronic databases, including Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), National Assembly Library, and DBpia. The search terms were ‘breast neoplasms’ or ‘breast cancer’ with ‘exercise’ or ‘exercise intervention’ or ‘exercise program.’ A total of 13 RCTs were finally selected. Results: The outcome variables were in the upper extremity range of motion (ROM), shoulder disability, pain and edema. The effect size of exercise intervention on ROM was 0.95(95% CI:0.58, 1.33)( p<.001); shoulder disability was -1.16(95% CI:-1.77, -0.55)(p<.001); pain was -1.24(95% CI:-1.58, -0.89) (p<.001); and edema was -0.03(95% CI:-0.39, 0.33)(p=.858). Conclusion This result suggests that oncology nurses may apply exercise intervention to improve ROM, shoulder disability, and to alleviate pain in post-op breast cancer patients.

No abstract available.
Stomach Neoplasms* ; Stomach* ; Water*

GnRH stimulation test has been used to distinguish patients with hypogonadotropic hypogonadism of pituitary origin from those with hypothalamic disease. GnRH stimulation test also has been used to identify early stage of Sertoli cell insufficiency and to know the subtle abnormalities or spermatogenesis. Some investigators reported that exaggerated FSH response after GnRH stimulation means the same diagnostic meaning as basely elevated FSH level and this in turn reflects Sertoli cell insutriciency or may help to identify patients with isolated primary germ cell failure in azoospermic patients. So they suggested the possibility that GnRH stimulation test can replace testis biopsy in male infertility. To define the normal range of the gonadotropin response after GnRH stimulation and to know the indications for GnRH stimulation test if it is useful as an evaluation method for spermatogenesis, and especially to test the possibility whether GnRH stimulation test may replace testis biopsy, we performed GnRH stimulation test in 118 infertile men and 20 fertile adult male volunteers and compared the results with testicular histology. Normal basal serum levels for LH, FSH, testosterone were 1.4-18.3( mean 9.9) mIU/ml, 2.8-18.4 (mean 10.0) mIU/ml, 2.0-9.1 (mean 5.0)ng/ml respectively, and 95% confidence intervals for the peak responses to an intravenous bolus injection of 100ug GnRH were 360-1950{mean 1098)% of the basal serum LH level, and 111-318(mean 225)% of the basal FSH level in 20 rertile adult male volunteers. The results of the FSH response in GnRH stimulation test were not helpful in distinguishing patients with bad testicular histology from those with good ones in 118 infertile men. So we came to the conclusion that GnRH stimulation test can not replace testis biopsy as an evaluation method for spermatogenesis in the majority of infertile patients.
Adult ; Biopsy ; Germ Cells ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Hypogonadism ; Hypothalamic Diseases ; Infertility, Male* ; Male ; Male* ; Reference Values ; Research Personnel ; Spermatogenesis ; Testis ; Testosterone ; Volunteers

The relaxation of the corpus cavernosum smooth muscle, which is main process in penile erection, is controlled by nerves that release cholinergic and nonadrenergic-noncholinergic neurotransmitters as well as vascular endothelium derived relaxing factor(EDRF). But the adrenergically-induced tone maintains the penis in flaccid state. In order to define the physiological role of adrenergic neurotransmission in the local control of penile erection we studied the distribution of alpha adrenergic receptor subtypes and their pharmacological potency in human and rabbit corpus cavernosum tissue. In this study we used yohimbine as the alpha-2 antagonist, which is known to have beneficial therapeutic effect for organic impotence, to assess its neuropharmacological mechanism in the treatment of erectile dysfunction. The alpha-1 : alpha-2 receptor potency was approximately 7.4:1 and 2.2:1 in human and rabbit tissue respectively. These results indicate that the predominant alpha adrenergic receptor is alpha-1 type and alpha-2 receptor antagonist, yohimbine, can not play a main role on the local control of penile erection because of its low receptor potency especially in human corpus cavernosum tissue. It remains possible that yohimbine partially antagonizes the postsynaptic alpha-1 mediated effect or activation of central sympathetic pathway is necessary for the therapeutic effect of yohimbine in human.
Endothelium, Vascular ; Erectile Dysfunction ; Humans* ; Male ; Muscle, Smooth ; Neurotransmitter Agents ; Penile Erection ; Penis ; Receptors, Adrenergic ; Receptors, Adrenergic, alpha* ; Relaxation ; Synaptic Transmission ; Yohimbine

Purpose: We report a case of Purtscher-like retinopathy after aortic valve replacement surgery.Case summary: A 52-year-old male with bacteremia suspicious of infectious endocarditis was referred to our department for ophthalmic examination. Inflammatory reaction was evident in both anterior chambers. Fundus examination revealed infiltrative lesions with a Roth spot, and the patient was diagnosed with chorioretinitis. After 3 days, aortic valve replacement surgery was performed in the cardiac surgery department using cardioplegic solutions. Ophthalmologic exams were repeated after the valve surgery. The Roth spot had disappeared and infiltrated, leaving a clear margin. An anterior chamber cell was not noted. However, there were newly developed peripapillary superficial cotton-wool spots and delayed hemorrhagic lesions. Based on the medical history and specific pathognomonic fundus findings, the patient was diagnosed with Purtscher-like retinopathy. Four months later, all characteristic funduscopic features of Purtscher-like retinopathy had disappeared, leaving a remaining retinal nerve fiber defect and central visual field defect without any ophthalmologic treatment. Conclusions Although rare, doctors should be aware of the possibility of Purtscher-like retinopathy after valve replacement surgery. Further studies are needed to understand the unknown pathophysiology of Purtscher-like retinopathy.

Purpose: We report a case of Purtscher-like retinopathy after aortic valve replacement surgery.Case summary: A 52-year-old male with bacteremia suspicious of infectious endocarditis was referred to our department for ophthalmic examination. Inflammatory reaction was evident in both anterior chambers. Fundus examination revealed infiltrative lesions with a Roth spot, and the patient was diagnosed with chorioretinitis. After 3 days, aortic valve replacement surgery was performed in the cardiac surgery department using cardioplegic solutions. Ophthalmologic exams were repeated after the valve surgery. The Roth spot had disappeared and infiltrated, leaving a clear margin. An anterior chamber cell was not noted. However, there were newly developed peripapillary superficial cotton-wool spots and delayed hemorrhagic lesions. Based on the medical history and specific pathognomonic fundus findings, the patient was diagnosed with Purtscher-like retinopathy. Four months later, all characteristic funduscopic features of Purtscher-like retinopathy had disappeared, leaving a remaining retinal nerve fiber defect and central visual field defect without any ophthalmologic treatment. Conclusions Although rare, doctors should be aware of the possibility of Purtscher-like retinopathy after valve replacement surgery. Further studies are needed to understand the unknown pathophysiology of Purtscher-like retinopathy.