Acute posterior multifocal placoid pigment epitheliopathy usually occurs in young or middle-aged adults and is usually bilateral. This syndrome is characterized by the acute onset of multiple, flat, yellow-white lesion of the posterior pole at the level of the retinal pigment epithelium and by the rapid loss of vision. These lesions resolve spontaneously, leaving extensive degeneration of pigment epithelium within a few weeks and visual acuity spontaneously improves in most cases. In the acute stage, fluorescein angiographic appearance of condition is characterized by placoid lesions blocking transmission of choroidal fluorescence in the initial phase, which are gradually stained and fluorescence faintly in the late phase. Older lesions represent residual defects in the pigment epithelium and appear as transmission defect without late staining or leakage of dye. Authors experienced and treated a case of acute posterior multifocal placoid pigment epitheliopathy in 19-years old male patient, and had a good visual improvement.
Adult ; Choroid ; Epithelium ; Fluorescein ; Fluorescence ; Humans ; Male ; Retinal Pigment Epithelium ; Visual Acuity ; Young Adult

We surveyed the causes of blindness among the 6692 eye patients of 3 hospitals(Seoul, Chunan, Kumi) in 1984. Blindness is defined as visual acuity of 0.1(20/200) or less in better eye with best correction. The representation of the diagnosis of the ocular diseases is based on the examination of the ophthalmologists. The estimated number of blindness is 259(6.74%)in Seoul, 106(8.92%) in Chunan, 70(4.21%) in Kumi with total of 435(6.5%) among the 6692 eye patients. The leading causes of blindness for individual districts are cataract(28.19%), retinal and vitreous diseases(20.46%), trauma (15.06%), diseases of optic nerve(10.81%), corneal diseases(8.10%) in Seoul; cataract(35.81%), corneal diseases(18.87%), global diseases(13.21%), trauma(10.38%), retinal and vitreous diseases(6.60%) in Chunan; and cataract(34.29%), corneal diseases(14.21%), trauma (12.86%), global diseases(8.57%), retinal and vitreous diseases(8.50%) in Kumi. Rates of the blind eyes for the age groups are; 1.2%(under the age of 5), 4.1%(6~9), 10.3%(10~19), 30.8%(20~39), 23.5%(40~59), and 30.1%(above 60). Important causes of blindness in each age group are trauma(43.48%), optic nerve diseases(13.04%), and global diseases(13.04%) for below the age of 10, trauma(28.89%), retinal diseases(17.78%), and optic nerve diseases(13.33%) in 10~19 age group, corneal diseases(19.40%). cataract(18.66%), and retinal diseases(16.42%) in 20~39 age group, cataract(28.43%), retinal diseases(18.63%), and corneal diseases(10.78%) in 40~59 age group and cataract(59.54%), retinal diseases(9.92%), and glaucoma(8.40%) for above 60. There are no significant differences between male and female, right eyes and left eyes in the causes of the blind eyes, and also we make some comparisons with different statistics of domestic and foreign countries.
Blindness* ; Chungcheongnam-do ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Male ; Optic Nerve ; Retinaldehyde ; Seoul ; Visual Acuity

PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUs). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. METHOD: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. RESULT: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. CONCLUSION: Our findings give support to recent studies that suggest that frequent physical contact may increase the nosocomial acquisition of MRSA in a neurosurgical ICU.
Case-Control Studies* ; Classification ; Humans ; Intensive Care Units ; Critical Care* ; Korea ; Logistic Models ; Medical Records ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Retrospective Studies ; Risk Factors* ; Seoul ; Sputum ; Suction ; Tertiary Healthcare ; Vancomycin ; Wounds and Injuries

Introduction: Current prognostic markers have improved survival prediction, however, it has not advanced treatment strategies. Gene expression profiling may identify biological markers suitable as therapeutic targets. Leukaemia stem cell is associated with adverse outcome, however, its biological characteristics are still being investigated. We observed higher in vitro cell viability in acute myeloid leukaemia (AML) samples with poor prognosis, which may be stem cell related. Objective: The objective of this study was to profile highly expressed genes in an AML sample of poor prognosis/high viability and compare with a sample of good prognosis/low viability. Method: Subtractive hybridization was performed on two AML samples with high blast counts (>80%), a poor prognosis, PP (disease free survival, DFS<12 months) and a good prognosis, GP (DFS>12 months) sample. The PP sample had higher CD34+ counts (73% vs 46%) and higher cell viability than the GP sample. cDNA libraries were subsequently cloned and sequenced. Results: cDNA subtracted from the PP samples was identified as genes active during fetal/embryonic development (LCOR, CNOT1, ORMDL1), HOX- related genes (HOXA3, PBX3, SF3B1), hematopoiesis (SELL, IL-3RA) and aerobic glycolysis/hypoxia (PGK1, HIGD1A) -associated genes. Majority of GP clones isolated contained genes involved in oxidative phosphorylation, OXPHOS (COXs, ATPs, MTND4 and MTRNR2), protein synthesis (including ribosomal proteins, initiating and elongation factors), chromatin remodeling (H2AFZ, PTMA), cell motility (MALAT1, CALM2, TMSB4X), and mitochondria (HSPA9, MPO) genes. Conclusion: Thus, the PP sample exhibited stem cell-like features while the GP sample showed cells at a high level of cell activity. These genes are potential prognostic markers and targets for therapy.
Leukemia, Myeloid, Acute

To evaluate historical trends, anesthetic experiences of 14, 337 in the total performed at the Korea University Hospital from Jan. 1966 through Dec. 1977 were analyzed statistically according to age, sex, department, methods, physical status, duration of anesthesia, induction agents, main agents and anesthetic techniques. The results were as follows: 1) General anesthesia has been used as almost the main method of anesthesia. 2) Patients were about half in the 21~40 group of age. 3) Male patients were 2. 2 times more than females. 4) The most largest department for surgery was of patients in general surgery. 5) According to the ASA, classification of physical status, patients in class 1 were 43. 5%, and elective surgery to emergency ratio was 1. 3 to 1. 6) Patients in the 1~ 2 hour duration group were 41. 7%. 7) Thiopentone has mainly been used for intravenous induction. 8) Ether had mainly been used for a main anesthetic agent until 1970, but balanced anesthesia has been used with increasing favor since that time. 9) In almost all cases, a semiclosed circle absorption system has been employed and non- rebreathing system has recently been used with increasing favor for pediatric anesthesia.
Absorption ; Anesthesia* ; Anesthesia, General ; Balanced Anesthesia ; Classification ; Emergencies ; Ether ; Female ; Humans ; Korea ; Male ; Methods ; Thiopental

Dextran is a macromolecular polymer of dextrose. Dextran is used as a plasma expander with reduction in blood viscosity and disruption of red cell aggregates. It also inhibits platelet aggregation and prothrombin activation. It has been reported that a hemostatic defect characterized by a prolonged bleeding time in subject receiving large amount of dextran. The present study was undertaken to observe the effect of dextran on bleeding time and platelet aggregation by increasing volume. In this study, bleeding time was checked and sampling was done at before infusion, after 5 ml/kg, 10 ml/kg and 15 ml/kg infusion of dextran in 15 patients with spinal or regional anesthesia. The results were as follows: 1) There was prolonged bleeding time by increasing volume of dextran 40, but within nonnal limit. 2) There was no platelet aggregation with 15ml/kg of dextran.
Anesthesia, Conduction ; Bleeding Time ; Blood Platelets* ; Blood Viscosity ; Dextrans* ; Glucose ; Humans ; Plasma ; Platelet Aggregation ; Polymers ; Prothrombin

Aconitum is a genus of various species of flowering plants that belongs to the Family Ranunculaceae. Most Aconitum sp. have extremely toxic alkaloid substances such as aconitine, mesaconitine and hypaconitine. Among these substances, aconitine can cause fatal cardiotoxicity by activating sodium channels followed by calcium channels in myocardial cells. Even though there have been various therapeutic plans suggested comprising antidotes based on diverse case reports and studies, there is no confirmatory treatment protocol for aconite poisoning. Here, we report an aconite poisoning patient who had refractory ventricular tachyarrhythmia that did not respond to intravenous amiodarone therapies even though they were sustained for over 2 hours, but showed successful recovery following intravenous fat emulsions (IFE) therapy.
Aconitine ; Aconitum* ; Amiodarone ; Antidotes ; Calcium Channels ; Cardiotoxicity ; Clinical Protocols ; Fat Emulsions, Intravenous ; Flowers ; Humans ; Poisoning* ; Ranunculaceae ; Sodium Channels ; Tachycardia

Aconitum is a genus of various species of flowering plants that belongs to the Family Ranunculaceae. Most Aconitum sp. have extremely toxic alkaloid substances such as aconitine, mesaconitine and hypaconitine. Among these substances, aconitine can cause fatal cardiotoxicity by activating sodium channels followed by calcium channels in myocardial cells. Even though there have been various therapeutic plans suggested comprising antidotes based on diverse case reports and studies, there is no confirmatory treatment protocol for aconite poisoning. Here, we report an aconite poisoning patient who had refractory ventricular tachyarrhythmia that did not respond to intravenous amiodarone therapies even though they were sustained for over 2 hours, but showed successful recovery following intravenous fat emulsions (IFE) therapy.
Aconitine ; Aconitum* ; Amiodarone ; Antidotes ; Calcium Channels ; Cardiotoxicity ; Clinical Protocols ; Fat Emulsions, Intravenous ; Flowers ; Humans ; Poisoning* ; Ranunculaceae ; Sodium Channels ; Tachycardia

The anesthesiologist is sometime presented with the problem of coagulation defects through the perioperative period. The possible causes of inappropriate hemostasis in this situation are numerous, and multiple mechanism may be simultaneously involved. Coagulation and fibrinolysis variables were measured in 15 patients who had undergone prolonged major surgery or received massive transfusion before and until 10 days after operation. Hemostactic surveys included platelet count, fibrinogen, prothrombin time, activated partial thromboplastin time, antithrombin lll, and fibrin degraduation products. No patients had major hemorrhage, thrombosis, or disseminated intravascular coagulation, but laboratory findings suggest that a hypercoagulable state existed even 10 days postoperatively. The results were as follows: 1) Platelet counts decreased just after operation, but significantly increased to 154% of the control value 7 days after operation and 204% 10 days postoperatively. 2) Prothrombin time was significantly prolonged just after operation compared to the control value, but returned to normal in 4 days postoperatively. 3) Fibrinogen decreased just after operation, but significantly increased to 165% of the control value 4 days after operation, 178% 7days after operation and 191% 10 days postoperatively. 4) Activated partial thromboplastin time was not changed through the entire period. 5) Antithrombin lll was not changed through the entire period. 6) Fibrin degradation product was within normal ranges before operation, but in 11 cases it exceeded normal range from 1 to 10 days postoperatively.
Disseminated Intravascular Coagulation ; Fibrin ; Fibrinogen ; Fibrinolysis* ; Hemorrhage ; Hemostasis ; Humans ; Partial Thromboplastin Time ; Perioperative Period ; Platelet Count ; Prothrombin Time ; Reference Values ; Thrombosis

Clinical findings, electrocardiographic voltage and left ventricular function were evaluated in 104 patients with percardial effusion. Patients were classified into three groups by the amounts of pericardial effusion measured by two-dimensional echocardiography. 49 patients had small pericardial effusion, 31 moderate effusion and 24 large effusion. In 47 patients the effusions were clinically unsuspected prior to echocardiographic examination. Pericardial friction rub was noted in 14 patients, two-thirds of whom had moderate to large effusions. There was no relationship between the size of effusion and the presence of friction rub. Total QRS amplitudes were lower in patients with moderate to large effusions than those in control group. Maximum diastolic endocardial velocity(DEVM) and E-F slope of the anterior mitral leaflet were decreased significantly in patients with moderate to large effusions as compared with those with small effusions. As a result, authors concluded that reduction in the QRS voltages in serial ECGs may suggest the presence and the amount of pericardial effusion and also DEVM and E-F slope of the anterior mitral leaflet can be sensitive measures of left ventricular relaxation in patients with pericardial effusion.
Echocardiography* ; Electrocardiography* ; Friction ; Humans ; Pericardial Effusion* ; Relaxation ; Ventricular Function, Left*