In the early stages of glaucoma the disc changes prior to the visual field loss, so assessment of the optic disc is very important for the evalutation of the glaucoma patient. The most senstitive techniques for detecting changes of the optic disc require highly sophisticated instruments, such as computerized image analyzer, which are expensive and not generally available in clinical practice. Less expensive, but reliable, is color stereoscopic photography. The aim of this topic is to assess glaucomatous discs and look for the features of the optic disc that are commonly associated with early visual field defect. Forty-three eyes of 28 patients were included in this investigation. The criteria for inclusion were a cup/disc(C/D) ratio more than 0.4 by direct ophthalmoscopy, no visual field defect with Goldmann perimetry, and open anterior chamber angle. Each optic disc was photographed with a Canon fundus camera with Polaroid 600 Plus. Each photographic set was then examined stereoscopically for morphologic parameters: 1) comparison of vertical versus horizontal C/D ratio; 2) presence of nasal cupping; 3) presence of overpassing vessels; 4) presence of baring of circumlinear vessles; 5) presence of peripapillary atrophy; 6) ratio of the thinnest neuroretinal rim(NRR) width in the vertical sectors to the NRR width of the temporal sector. All subjects were examined for central visual field with the automated static perimeter, Humphrey program C 30-2 with STATPAC. The C/D ratio estimated by direct ophthalmoscopy consistently showed smaller C/D ratio than that by the stereophotographic method. Parameter with highest probability value to differentiate between the optic disc of early visual filed loss and the optic disc of normal subjects was "Ratio of the thinnest NRR width in the vertical sectors to the NRR width of the temporal sector Anterior Chamber ; Atrophy ; Glaucoma ; Humans ; Ophthalmoscopy ; Photography ; Visual Field Tests ; Visual Fields*

Congenital branchial anomalies are developmental defects resulting from incomplete obliteration of branchial clefts, arches and pouches, and usually found as cysts, fistulas and sinuses. The sinus or fistula is usually noted during infancy and young childhood due to recurrent infection. We have experienced a case of branchial cleft fistula in a 12-year-old male. It was a skin colored, nontender nodule which had mucus secreting from a small opening pore. We performed complete surgical removal and histopathologically the lumen was lined by pseudostratified columnar cells and the stroma was composed of aggregates of lymphocytes with many germinal centers. So we finally diagnosed it as branchial cleft fistula of second type branchial anomaly.
Branchial Region* ; Child ; Fistula* ; Germinal Center ; Humans ; Lymphocytes ; Male ; Mucus ; Skin

Chrionic exposure of the skin UVB radiation causes erythema and dermal connective tissue damage including wrinkling, neoplastic skin lesions, and delayed wound healing. The topical application of epidermal growth factor(EGF) has been reported to be effective in the treatment of partial and full thickness skin wounds, second degree burns, incision wound, and chronic ulcers. However, its effect thickness UVB damaged skin has not yet been defined. Fifty Sprague-Dawley rats were divided into four groups: UV irradiated-EGF treated group; UV irradiated-EGF untreated group; UV nonirradiated-EGF treated group; UV nonirradiated-EGF untreated Group peroperatively, the UV exposure groups were irradiated with UVB (40 mJ/cm2, 2 MEDs) on the dorsal skin every other day for 12 weeks. Following cessation of UNB exposure, a standard 6 cm midline dorsal linear incision was made in each animal. The animals in EGF treated group were topically applicated with EGF ointment (10 microgramg/g) twice a day. Wounds were excised and wound burst strength was applicated using tensiometer on the 7th and 10th postwounding days. The wound burst strength of the UV irradiated-EGF treated group (662+/-49.7 g/cm) was significantly increased compared to that of the UV irradiated-EGF untreated group (352 +/-40.3 g/cm) (p < 0.01) and even stronger than that of the UV nonirradiated-EGF untreated group (570+/-44.7 g/cm) (p < 0.05). On the 10th day, there was no significant difference in the wound burst strength between the UV irradiated-EGF treated group (1248 +/-101.3 g/ cm) and UV nonirradiated-EGF treated group (1270+/-98.5 g/cm) (p = 0.595). Histological examination revealed epidermal hyperplasia, degeneration of collagen fibers, and inflammatory cell infiltration in the UV irradiated groups. Thick epidermis, prominent skin appendages, increased capillaries and fibroblasts, and linear organization of collagen fibers were observed in EGF treated groups. These results indicate that repeated exposure to UVB irradiation alters normal skin structure and adversely affects subsequent wound healing and the topical application of epidermal growth factor facilitates wound healing of UVB damaged skin.
Animals ; Burns ; Capillaries ; Collagen ; Connective Tissue ; Epidermal Growth Factor* ; Epidermis ; Erythema ; Fibroblasts ; Hyperplasia ; Rats* ; Rats, Sprague-Dawley ; Skin ; Ulcer ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: Several kinds of adverse reactions can occur during blood donation such as vasovagal reaction (VVR), hematoma, citrate toxicity, etc. These adverse reactions are not common, but they are important because they cause a decrease in re-donation. The cost for maintaining a repeat donation is very low compared to that for securing first-time donors. Whole blood donation differs from apheresis in some aspects, and this could have an influence on blood donor reactions. We compared whole blood donation with apheresis for blood donor reactions. METHODS: From January to December in 2007 at Busan Red Cross Blood Center, 109,004 donations were investigated for blood donor reactions. 76,098 (69.8%) donations were from male donors and 32,906 (30.2%) were from females. 77,813 (71.3%) donations were for whole blood, 25,224 (23.2%) were for plasmapheresis and 5,967 (5.5%) were for plateletpheresis. RESULTS: The frequencies of VVR were 0.10% (75/77,813) for the whole blood donations, 0.15% (37/25,224) for plasmapheresis and 0.03% (2/5,967) for plateletpheresis (P<0.05). The frequency of hematoma was 0.05% (37/77,813) for whole blood donation, 0.25% (62/25,224) for plasmapheresis and 0.27% (16/5,967) for plateletpheresis (P<0.05). Citrate toxicity was extremely rare. VVR was most common in plasmapheresis, and it was rare in plateletpheresis. CONCLUSION: The kinds of donated blood components had an influence on blood donor reactions. Understanding these characteristics helps to prevent adverse reaction. Having people re-donate is essential for keeping a large sized donor pool. So, appropriate management to prevent donor reactions is very important.
Blood Component Removal ; Blood Donors ; Citric Acid ; Female ; Hematoma ; Humans ; Male ; Plasmapheresis ; Plateletpheresis ; Red Cross ; Tissue Donors

We report the case of 60-yr-old female in which therapeutic hypothermia (TH) was successfully induced maintaining the target temperature of 34degrees C for 12 hr despite a risk of hypothermia-induced coagulation abnormalities following an emergent coronary artery bypass grafting (CABG) due to failed percutaneous coronary intervention, who suffered a cardiac arrest. Emergent CABG may be a relative contraindication for TH in post-cardiac arrest patients because hypothermia may increase the risk of infection and bleeding. However, the possibility of an improved neurologic outcome outweighs the risk of bleeding, although major surgery may be a relative contraindication for TH.
Body Temperature ; Coma/complications ; *Coronary Artery Bypass ; Electrocardiography ; Female ; Heart Arrest/complications/*diagnosis/therapy ; Humans ; *Hypothermia, Induced ; Intensive Care Units ; Middle Aged ; Percutaneous Coronary Intervention ; Treatment Outcome

BACKGROUND: The etiologies of ischemic cerebrovascular diseases are various-thrombosis or artery to artery embolism, cardiogenic embolism and lipohyalinosis. In the past embolic cerebral infarct was thought to occur uncommonly. But these days substantial portion of patients have been found to have potential embolic sources by transesophageal echo cardiography and carotid duplex doppler. As transesophageal echocardiography has a high yield for identification of potential sources of cardiac embolism in patients with ischemic cerbrovascular diseases, its use has been increasing. In Korea an increasing number of patients with ischemic cerebrovascular diseases have been examined by transesophageal echocardiography since 1990. But in all the previous studies transesophageal echocardiographic evaluation has been confined to the patients with high probability of embolic cerebral infarct. All kinds of ischemic cerebrovascular diseases patients have never been examined by transesophageal echocardiography and carotid duplex doppler and the prevalence of potential embolic sources in Korean ischemic cerebrovascular disease patients is not known. The aim of this study was to evaluate the prevalence of potential cardiovascular embolic sources by transesophageal echocardiography and carotid duplex doppler in unselected patients with ischemic cerebrovascular diseases. METHODS: We evaluated all kinds of ischemic cerebrovascular diseases patients admitted from 1994. 9. 1. until 1995 9. 31. to the Departments of Neurology and Internal Medicine of Kangnam General Hospital. We evaluated them by transesophageal echocardiography, carotid doppler, brain CT(or brain MRI). A significant carotid stenosis was defined as a duplex scandetected lesion producing at least 50% vessel narrowing. The following echocardiographic findings were defined prospectively as potential cardiac sources of embolism : atrial appendage or left atrial cavity thrombus, spontaneous echocardiographic contrast, atrial septal aneurysm, interatrial shunt, ventricular aneurysm, ventricular thrombus, myxomatous mitral valve and protruding atherosclerotic plaque in the ascending aorta or transverse aortic arch. RESULTS: Of 64 patients admitted during the study period, 30 were excluded(Three patients were critically ill, and twenty seven patients refused diagnostic work-up.). Thorough diagnostic work-up was performed in 34 patients. Transesophageal echocardiographic positive findings were present in six patients(17.6%). Of them four(4/34, 11.7%) had spontaneous echo contrast, two(2/34, 5.8%) had left atrial thrombi, one(1/34, 2.9%) had ascending aorta atheroma. Eleven patients(11/34, 32.3%) had abnormalities in carotid doppler study. Five patients(5/34, 14.7%) had abnormalities both in transesophageal echocardiography and carotid doppler study. CONCLUSIONS: The results suggest that among ischemic cerebrovascular diseases patients substantial portion of patients have potential embolic sources. The prevalence of potential embolic sources in Korea may be higher than previously expected. Because the relative small number of the patients studied make it difficult to generalize the results, further studies with a large number of patients are needed.
Aneurysm ; Aorta ; Aorta, Thoracic ; Arteries ; Atrial Appendage ; Brain ; Carotid Stenosis ; Critical Illness ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Hospitals, General ; Humans ; Internal Medicine ; Korea ; Mitral Valve ; Neurology ; Plaque, Atherosclerotic ; Prevalence ; Prospective Studies ; Thrombosis

Aneurysmal fibrous histiocytoma(AFH) is a histologic variant of dermatofibroma. The importance of the recognition of AFH as a variant of dermatofibroma lies in the differential diagnosis because the histologic appearance of AFH is very similar to dermatofibrosarcoma protuberans and other vascular malignancies, such as Kaposi's sarcoma and angiosarcoma. A 32-year-old man was seen for a nodular mass on the right popliteal fossa of 4 years' duration. The excisional biopsy specimen showed a relatively well circumscribed tumor mass in the dermis. In addition to compact storiform proliferation of spindle cells, there were multiple, irregular, blood-filled, aneurysmal tissue spaces that were devoid of lining of endothelial cells. Also, deposition of hemosiderin was prominent, particularly in the periphery of the aneurysmal spaces. Immunohistochemical stain for CD34 were negative to most tumor cells. After excisional therapy, there was no evidence of recurrence during the period of ten months' follow-up.
Adult ; Aneurysm* ; Biopsy ; Dermatofibrosarcoma ; Dermis ; Diagnosis, Differential ; Endothelial Cells ; Follow-Up Studies ; Hemangiosarcoma ; Hemosiderin ; Histiocytoma, Benign Fibrous* ; Humans ; Recurrence ; Sarcoma, Kaposi

We report a case of primary cutaneous adenoid cystic carcinoma in a 39-year-old male patient. It was a slightly erythematous hard nodule on left chin and composed of cribriform and tubular masses of basaloid cells. Lumina formed by neoplastic cells contained mucin and hyalin, and similar constituents were located between neoplastic cell masses and adjacent dermis. Immunohistochemically, the neoplastic cells stained only focally with S-100 protein and negative with carcinoembryonic antigen(CEA). Therapy should employ wide surgical excision that extends well beyond the clinical confines of the neoplasm.
Adenoids* ; Adult ; Carcinoma, Adenoid Cystic* ; Chin ; Dermis ; Humans ; Hyalin ; Male ; Mucins ; S100 Proteins

We evaluated the clinical results of 43 patients (47 eyes) who underwent cataract extraction and implantation of domestic posterior chamber intraocular lens manufactured by Universal Optics Co. (UNI(R) IOL) and could be followed up over 6 months. The mean follow-up period was 10.2 months with a range of 6 to 15 months. The results were as follows: 1. The final corrected visual acuity of 0.5 or better was noted in 41 eyes (87.2%). 2. The difference between the calculated postoperative refraction and the actual postoperative refraction was less than +/-1.00 D in 33 eyes (70.2%). 3. The corneal thickness increased 8.2% at postoperative period of 3 days and returned to preoperative level at postoperative period of 4 weeks. 4. The corneal endothelial cell density decreased 11.2% at postoperative period of 4 weeks and 12.8% at postoperative period of 6 months. 5. The early postoperative inflammatory reaction in anterior chamber and deposits on the surface of intraocular lens decreased gradually in the course of postoperative period. 6. The postoperative complications included posterior capsular opacification (7 eyes), fibrinous membrane (3 eyes), and hyphema (2 eyes). The above results showed that the visual outcome and the safety of UNI(R) IOL were favorable.
Anterior Chamber ; Cataract Extraction ; Endothelial Cells ; Fibrin ; Follow-Up Studies ; Humans ; Hyphema ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Membranes ; Postoperative Complications ; Postoperative Period ; Visual Acuity

Seminal vesicle cyst (SVC) with ipsilateral renal agenesis is a rare congenital anomaly. When the patient is symptomatic, surgical treatment may be necessary. The open surgical approach, traditionally considered the definite form of treatment, has been associated with a high rate of morbidity. The laparoscopic approach for the management of SVCs has recently been described. A 18-year-old man presented with a 2-year history of dysuria and perineal pain. The diagnostic evaluation revealed a 45x35x48 mm sized left seminal vesicle cyst. In addition, he had a solitary, right, functioning kidney, with left renal agenesis. Transperitoneal laparoscopic excision of the cyst was performed successfully. The patient was discharged from the hospital on the fourth postoperative day and did not present with any complaints or complications.
Adolescent ; Congenital Abnormalities ; Dysuria ; Humans ; Kidney ; Kidney Diseases ; Seminal Vesicles