No abstract available.
Transcutaneous Electric Nerve Stimulation*

Ascorbic acid in aqueous humor, the concentration is 15-69 times higher than in plasma, protects ocular tissues from free radicals as an antioxidant and absorbs ultraviolet rays. It is regarded that the concentration of ascorbic acid in the vitreous body is greater than in the plasma, but there is no knowledge about it's role and relationships to retinal disease. We measured the concentrations of ascorbic acid in plasma, aqueous humor, vitreous and subretinal fluid in 10 patients with rhegmatogenous retinal detachment who were treated with scleral encircling by high performance liquid chromatography. The average concentrations of ascorbic acid in plasma, anterior chamber aqueous humor, vitreous, and subretinal fluid were 30.8 +/- 7.5 micro gram/ml, 157.4 +/- 2.5 micro gram/ml, 195.3 +/- 7.5 micro gram/ml, and 178.5 +/- 2.5 micro gram/ml respectively. The ascorbic acid concentrations in intraocular fluids were 5-6 times higher than in plasma.
Anterior Chamber ; Aqueous Humor ; Ascorbic Acid* ; Chromatography, Liquid ; Free Radicals ; Humans ; Plasma ; Retinal Detachment* ; Retinal Diseases ; Retinaldehyde* ; Subretinal Fluid* ; Ultraviolet Rays ; Vitreous Body

The Duodenal diverticulum is the rare cause of the common bile duct obstruction. We experienced a case of the diverticulum of the second portion of duodenum in a 59-year-old male, who complained recurrent attacks of right upper abdominal pain and fever since 16 months prior to admission. Duodenoscopic finding and UGI study revealed a typical duodenal diverticulum just side to the papilla of Vater. Diverticulectomy and cholecystectomy was performed and after than, he has been free front above mentioned symptoms. We reported a case of duodenal diverticulum which caused recurrent common bile duct obstruction.
Abdominal Pain ; Cholecystectomy ; Common Bile Duct* ; Diverticulum* ; Duodenum ; Fever ; Humans ; Male ; Middle Aged

OBJECTIVE: To find out the incidence of reduced median conduction velocity of forearm (MNCV-F) in carpal tunnel syndrome (CTS) and to compare clinical and electrophysiologic characteristics of CTS with reduced MNCV-F and to observe the changes of reduced MNCV-F after carpal tunnel release. METHOD: One hundred and fifty nine hands with CTS are divided into two groups; MNCV-F of 50 m/sec and above as group I and that of below 50 m/sec as group II. For the electrophysiologic comparison, median sensorimotor distal latency, peak-to-peak amplitudes and abnormal spontaneous activity of abductor pollicis brevis were observed and for clinical comparison, sensorimotor symptoms, Phalen and Tinel sign were observed. Twenty four hands which had successful carpal tunnel release were examined for the changes of MNCV-F. RESULTS: The hands with reduced MNCV-F were 29 among 159 hands. Sensorimotor distal latency were significantly prolonged and sensorimotor amplitudes also significantly reduced in group II. Sensory change and Phalen signs were more frequently observed in group II. MNCV-F in group I had not changed after carpal tunnel release, but MNCV-F in group II was improved significantly. The changes MNCV-F in group II were much delayed than the improvement of parameters of distal conduction studies. CONCLUSION: The incidence of reduced MNCV-F in CTS was 18.24%. Patients with reduced MNCV-F had more severe CTS both electrophysiologically and clinically. Reduced MNCV-F had improved significantly, but there was significant time gap between the electrophysiologic improvements of distal and proximal portions of nerve. This findings may suggest that retrograde degeneration may play a partial role in reduced forearm motor nerve conduction velocity of the median nerve in CTS.
Carpal Tunnel Syndrome* ; Forearm* ; Hand ; Humans ; Incidence ; Median Nerve* ; Neural Conduction ; Retrograde Degeneration

BACKGROUND: The circadian rhythm of circulating melatonin is regulated by the endogenous oscillators, the suprachi-asmatic nuclei, and entrained by the light-dark cycle of the environment, but it seems that the rhythm can be affected by variable lesions outside the retina-pineal pathway. We intended to know how acute cerebral infarction affects on the cir-cadian rhythm of plasma melatonin secretion. METHODS: Plasma melatonin level was measured from 64 patients with acute cerebral infarction. On admission, blood samples were collected by venipuncture at 2AM, 4AM, 10AM, and 2PM and melatonin level was measured by radioimmunoassay. The state of consciousness of each patient was assessed clini-cally and the infarction site and size were evaluated clinically and radiographically. RESULTS: Among 64 patients with acute cerebral infarction, dramatic blunting or obliteration of nocturnal melatonin surge in the blood was found in 29 patients. The circadian rhythm of melatonin secretion was absent in 12 of 35 alert patients, in 10 of 20 drowsy patients, and in 5 of 7 stuporous patients. Melatonin secretion into plasma was markedly decreased in all 2 comatose patients. Of 14 patients with brainstem lesions, 8 patients showed decreased melatonin levels with the absence of a nocturnal rise, although most of them were alert. CONCLUSIONS: This study suggests that brainstem and the initial mental state might contribute to the regulation of the circadian rhythm of plasma melatonin even though the lesion does not involve the retina-pineal pathway, but further extensive study is required to elucidate it. (J Korean Neurol Assoc 19(4):359~363, 2001)
Biological Clocks ; Brain Stem ; Cerebral Infarction* ; Circadian Rhythm* ; Coma ; Consciousness ; Humans ; Infarction ; Melatonin* ; Phlebotomy ; Photoperiod ; Pineal Gland ; Plasma ; Radioimmunoassay ; Stupor

Moyamoya disease is characterized by a bilateral progressive narrowing of the distal internal carotid and proximal portions of the anterior and middle cerebral arteries. The cerebral vessels of the 11 to 14 mm embryonic period are extremely similar to these moyamoya vessels. The vertebral arteries unite with a contralateral homologue to form the basilar artery during embryonic development and rarely, the failure of complete fusion results in duplication of these arteries. It is well known that moyamoya disease sometimes is accompanied by persistent primitive arteries, cerebral aneurysm, or rarely arteriovenous malformation. However, no case of the moyamoya disease with complete duplication of basilar artery has been previously reported. These two types of vascular abnormality are probably associated in certain developmental period, and moyamoya disease causes hemodynamic load in the basilar artery system as a collateral pathway and these effects are also involved in duplication of basilar artery. The relationship between these two varieties of vascular abnormality and possible pathogenesis of the moyamoya disease are discussed.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery* ; Cerebral Arteries ; Embryonic Development ; Female ; Hemodynamics ; Middle Cerebral Artery ; Moyamoya Disease* ; Pregnancy ; Vertebral Artery

The Neurosensory retinal detachment contributes to the visual loss in the idiopathaic macular holes. Vitrectomy can be performed to reattach the retina by removing anterior-posterior and tangential traction between cortical vitreous and macular surface. Also bioadhesives, like autologous serum or platelets aggregates are used to flatten of surrounding rim detachment of macular holes. Among 22 eyes that underwent vitrectomy for the treatment of macular holes, anatomic success was achieved in 12 eyes (59.1%), and visual improvement in 10 eyes (45.5%). The time interval between diagnosis and operation was well-correlated to the functional success rate, while the type of surgical procedures was not. Postoperative complications included 2 cases of cataract, and 1 case of retinal detachment.
Cataract ; Diagnosis ; Postoperative Complications ; Retina ; Retinal Detachment ; Retinal Perforations* ; Traction ; Vitrectomy*

No abstract available.
Cross Infection ; Foot* ; Pseudomonas aeruginosa

BACKGROUND: When used to reverse the anticoagulant effect of heparin, protamine administration after cardiovascular bypass often can lead to systemic hypotension. During the reversal of heparin-induced anticoagulation, the effects of protamine on both a heparin-protamine complex and free protamine on the cardiovascular system should be considered. METHOD: To determine whether the hypotensive effect of heparin-protamine and/or protamine could be caused by endothelium-dependent and-independent component, we studied rings of the arotic arteries in rats suspended in organ chambers containing Tris Tyrode solution at 37oC and 100% O2. Arterial rings with or without endothelium were contracted with 40 mM KCl or 3 +/- 10-6M phenylephrine and then exposed to increasing concentrations of protamine (final organ bath concentration, 40~400 g/ml) both in the absence and presence of heparin (200 U/ml). RESULTS: Protamine induced concentration-dependent relaxation in arterial rings with endothelium, which were significantly greater than in rings without endothelium. The endothelium-dependent relaxation induced by protamine was inhibited by NG-monomethyl-L-arginine (L-NMMA) (10-5M) pretreatment, but was not inhibited by indomethacin (3x10-6M) pretreatment on rings with endothelium. Furthermore, the contractile inhibition was enhanced by superoxide dismutase (100 U/ml). Also, such vasodilating actions were not influenced in the presence of heparin (200 U/ml). In endothelium-denuded strips, protamine (400ug/ml) inhibited Ca++ induced contraction, which was evoked in Ca++-free solution containing 40 mM K+, and also inhibited the norepinephrine (NE)-induced contraction. Protamine inhibited on the NE-induced contraction, but not the caffein-induced contration in Ca++ free, 2 mM EGTA solution. Also, such inhibition of contracions were not inluenced in the presence of heparin (40 U/ml). CONCLUSION: This study demonstrates that protamine (in the presence or absence of heparin) acts on endothelial cell receptors to stimulate the production of nitric oxide and inhibits both Ca++-influx and the NE-induced Ca++ release from intracellular stores.
Animals ; Arteries* ; Baths ; Cardiovascular System ; Egtazic Acid ; Endothelial Cells ; Endothelium ; Heparin* ; Hypotension ; Indomethacin ; Nitric Oxide ; Norepinephrine ; omega-N-Methylarginine ; Phenylephrine ; Rats* ; Relaxation ; Superoxide Dismutase ; Vasodilation*

PURPOSE: Previously reported ocular complications of interferon alfa administration are extremely rare. We experienced a 15-year-old boy with chronic hepatitis B who developed glaucoma after interferon alfa therapy. The purpose of this prospective study was to evaluate the possible development of glaucoma after interferon alfa therapy for chronic hepatitis B. METHODS: Nine patients with chronic hepatitis B who visited Inha university hospital between February 1998 and July 1999 received interferon alfa therapy. We measured visual acuity, intraocular pressure, C/D ratio, and visual field examination at pre-interferon therapy, three and six months after therapy, respectively. RESULTS: The total number of patients was 9 (4 boys and 5 girls). Mean age was 11.7±4.1 years. The duration of therapy was 6 months and mean dosage of interferon was 5 million units. Compared with visual acuity, intraocular pressure, and C/D ratio at pre-therapy, those parameters at 3 months and 6 months after therapy showed no significant differences and none showed visual field defect after therapy. CONCLUSION: Our prospective study showed no evidence of development of glaucoma after interferon therapy. However, it is necessary to be concerned about the possibility of developing glaucoma or other ophthalmologic diseases after interferon therapy in chronic hepatitis B.
Adolescent ; Glaucoma ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Interferons ; Intraocular Pressure ; Male ; Prospective Studies ; Visual Acuity ; Visual Fields