Choroideremia is a rare hereditary disease with characteristic fundus that causes night blindness and peripheral visual field loss. The authors encounter choroideremia accompanied by recurrent uveitis. This paper is designed to give a description of the condition, along with an investigation of the literature. Ophthalmological tests and treatments were performed. Characteristic fundus, night blindness, peripheral visual field loss, electroretinography and other manifestations led us to a diagnosis of choroideremia. The anterior uveitis was managed with medication.
Adult ; Choroideremia/*complications/diagnosis ; Electroretinography ; Fluorescein Angiography ; Fundus Oculi ; Human ; Male ; Night Blindness/etiology ; Recurrence ; Uveitis, Anterior/*complications ; Vision Disorders/etiology ; Visual Fields

PURPOSE: To determine whether the use of prophylactic vancomycin in the irrigating solutions during cataract surgery is associated with increased incidence of cystoid macular edema METHODS: We underwent a study from November 1, 1999 to May 31, 2000 by inserting hydrophilic acryl-IOL after phacoemulsification to patients diagnosed with senile cataract over 60 years of age, without systemic and ocular disease. The patients were divided into two groups, one is the use of prophylactic vancomycin in the irrigating solutions and the other is no use of prophylactic vancomycin. A randomized prospective study on the respective 50 subjects who did not have complications such as intraoperative posterior capsular rupture or other postoperative complications was conducted. We checked ophthalmologic examinations and fluorescene angiography for cystoid macular edema of the two gruops in 1 month and 4 months after surgery. RESULTS: The incidences of clinical or angiogenic cystoid macular edema in postoperative 4 months are 2 (4%), 7 (14%) in vancomycin group and 0 (0%), 2 (4%) in control group respectedly. (p=0.4095), (p=0.0999) There was no statically significant difference between two groups but slightly higher in the vancomycin group than that in control group. Visual recovery had no significant difference between two groups. CONCLUSIONS: There was no statically significant relationship between the use of preventive intracameral vancomycin during cataract surgery and the incidence of cystoid macular edema, but need further study to clear up the relationship of them.
Angiography ; Cataract ; Endophthalmitis ; Humans ; Incidence ; Macular Edema* ; Phacoemulsification ; Postoperative Complications ; Prospective Studies ; Rupture ; Vancomycin*

OBJECTIVE: Bronchopulmonary dysplasia (BPD) is one of the most frequent and clinically significant complications of prematurity and it has been widely accepted that immaturity, barotrauma, and oxygen toxicity are major factors in the etiology of BPD. However, recent studies showed that infection may also play a role in the pathogenesis of BPD and exposure to a prenatal inflammatory process may lead to lung injury and predispose to the subsequent development of BPD. The purpose of this study was to test the hypothesis that neonates with BPD had higher incidence of histologic chorioamnionitis than those in whom BPD does not develop. METHODS: A retrospective study was conducted to examine the relationship between histologic chorioamnionitis and the occurrence of BPD in neonate. We reviewed the hospital charts of 363 women and their neonates whose gestational age at birth were between 24 weeks and 35 weeks and recorded their pregnancy outcomes, the results of placental Biopsy, perinatal outcomes including the occurrence of BPD. RESULTS: 1. Neonates who developed BPD showed higher incidence of acute histologic chorioamnionitis. The relationship remained significant even after the adjustment for gestational age (odds ratio, 3.2: 95% confidence interval, 1.6-11.3: P<0.05). 2. Higher maternal serum CRP was also associated with increased incidence of histologic chorioamnionitis and BPD (P<0.05). 3. Neonates who developed BPD also had higher incidence of infectious morbidity such as early neonatal pneumonia and sepsis (P<0.05). CONCLUSION: These results suggest that histologic chorioamnionitis is closely related to the occurrence of BPD. This support the hypothesis that intrauterine infection may cause fetal lung injury and subsequent development of BPD.
Barotrauma ; Biopsy ; Bronchopulmonary Dysplasia* ; Chorioamnionitis* ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Lung Injury ; Oxygen ; Parturition ; Pneumonia ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Sepsis

The hysteroscope has become a standard part of gynecologists' armamentarium, and hysteroscopy is taught routinely in residency curriculums. In recent years, its use in gynecology has changed from a diagnostic tool only to an instrument for gynecologic operations. An electrolyte-free irrigation fluid is used for hysteroscopic surgery, and it has a possibility of substantial absorption of irrigation fluid. The absorption depends on the rate, volume and nature of the irrigation fluid. Fortunately, large-scale fluid absorption is rare but leads to symptoms severe enough to require intensive care. Several methods have been proposed to reduce the risk but none of them is capable of preventing the complication from fluid absorption. In this case, the patient had pulmonary interstitial edema with hyponatremia after hysteroscopic uterine septectomy but that had resolved without sequelae.
Absorption ; Curriculum ; Edema ; Gynecology ; Humans ; Hyponatremia ; Hysteroscopes ; Hysteroscopy ; Intensive Care ; Internship and Residency ; Pulmonary Edema

PURPOSE: When pneumothorax occurs during a percutaneous needle biopsy, the radiologist usually stops the biopsy. We evaluated the usefulness of computed tomographic (CT) fluoroscopy-guided percutaneous needle biopsy in the presence of pneumothorax during biopsy. MATERIALS AND METHODS: We performed 288 CT fluoroscopy guided percutaneous needle biopsies to diagnose the pulmonary nodules. Twenty two of these patients had pneumothorax that occurred during the biopsy without obtaining an adequate specimen. After pneumothoax occurred, we performed immediate CT fluoroscopy guided percutaneous needle biopsies using an 18-gauge cutting needle. We evaluated the success rate of the biopsies and also whether or not the pneumothorax progressed. We classified these patients into two groups according to whether the pneumothorax progressed (Group 2) or not (Group 1) by measuring the longest distance between the parietal pleura and the visceral pleura both in the early and late pneumothorax. Additionally, we analyzed the relationship between the progression of pneumothorax after biopsy and 1) the depth of the pulmonary nodule; 2) the number of biopsies; 3) the presence or absence of emphysema at the biopsy site; and 4) the size of the pulmonary nodule. RESULTS: Biopsy was successful in 19 of 22 nodules (86.3%). Of the 19 nodules, 12 (63.2%) were malignant and 7 (36.8%) were benign. Twelve patients (54.5%) were classified as group 1 and 10 patients (45.4%) as group 2. The distance between the lung lesion and pleura showed a statistically significant difference between these two groups: < or = 1 cm in distance for group 1 (81.8%) and group 2 (18.2%), and > 1 cm in distance for group 1 (30%) and group 2 (70%), p < 0.03. Yet the number of biopsies, the presence or absence of emphysema at the biopsy site and the size of the pulmonary nodules were not related to the progression of pneumothorax (p > 0.05). CONCLUSION: When early pneumothorax occurs during a biopsy, CT fluoroscopy guided percutaneous needle biopsy is an effective and safe procedure. Aggravation of pneumothorax after biopsy is affected by the depth of the pulmonary nodule.
Biopsy* ; Biopsy, Needle* ; Emphysema ; Fluoroscopy ; Humans ; Lung ; Needles* ; Pleura ; Pneumothorax*

Erythema nodosum is considered to be a hypersensitivity reaction to various conditions. Vaccination-related erythema nodosum is uncommon but cases associated with hepatitis B virus, human papillomavirus, tetanus, diphtheria and pertussis, rabies, smallpox, typhoid and cholera, and Bacille-Calmette-Guerin vaccinations have beenreported. A 33-year-old Korean woman presented with a 3-day history of painful erythematous plaques on both lower legs and knees. Prior to the development of the skin rash, she had received the pneumococcal polysaccharide conjugate vaccine Prevenar13(R). Histological examination of the left lower leg lesion revealed septal panniculitis without vasculitis. To the best of our knowledge, erythema nodosum caused by pneumococcal vaccination has not previously been reported. It is important for clinicians to be aware of this rare, yet potential, adverse effect to the pneumococcal vaccine.
Adult ; Cholera ; Diphtheria ; Erythema Nodosum* ; Erythema* ; Exanthema ; Female ; Hepatitis B virus ; Humans ; Hypersensitivity ; Knee ; Leg ; Panniculitis ; Rabies ; Smallpox ; Tetanus ; Typhoid Fever ; Vaccination ; Vasculitis ; Whooping Cough

PURPOSE: The purpose of this study was to evaluate the long term results of performing femoral varus osteotomy (FVO) for the treatment of Legg-Calve-Perthes disease (LCPD). MATERIALS AND METHODS: We selected 35 LCPD patients who received FVO and they were followed up to the time their skeletons' matured. The inclusion criteria were patients in a fragmentation stage, the patients were in Catterall group III or IV, and the patients underwent a teleoroentgenographic examination at the time of full skeletal maturity. RESULTS: The radiological outcome at the time of skeletal maturity was assessed using Stulberg's classification. The final results were 4 hips in class I, 17 hips in class II, 13 hips in class III, one hip in class IV and none in class V. The satisfactory results (good+fair hips) were 34 hips (97%). Significant shortening (>10 mm) was observed in 12 hips (34%). In 35 patients, 5 (14%) had same leg length (less than 2 mm difference), 27 (77%) had shortening of 2 mm or more, and 3 had lengthening of 2 mm or more in the operated limb. Of these 12 patients with significant shortening, only 3 patients (9%) showed shortening of 21 mm or more. CONCLUSION: FVO is a reliable method for managing LCPD in patients who are in Catterall group III or IV and who are in the fragmentation stage of disease.
Extremities ; Hip ; Humans ; Leg ; Legg-Calve-Perthes Disease ; Osteotomy

In general, a 2-yr disease-free duration is recommended before kidney transplantation (KT) in end-stage renal disease (ESRD) patients who also have acute leukemia. However, the optimal disease-free interval has not been specified for all subtypes of acute leukemia. Among these subtypes, acute promyelocytic leukemia (APL) shows a favorable prognosis and low relapse rate compared to other types of leukemia. We here report KT after complete remission (CR) of APL in an ESRD patient. Irreversible kidney injury developed in a 23-yr-old man with APL. First, we induced CR and subsequently performed KT 7 months after the achievement of CR. The patient's clinical course after KT was favorable, without allograft rejection or relapse of APL up to1 yr after KT. On the basis of our clinical experience, it is suggested that a long wait may not be necessary before KT in patients with ESRD and APL.
Adult ; Antineoplastic Agents/therapeutic use ; Arsenicals/therapeutic use ; Bone Marrow Cells/pathology ; Humans ; Kidney Failure, Chronic/*therapy/ultrasonography ; *Kidney Transplantation ; Leukemia, Promyelocytic, Acute/*diagnosis/drug therapy ; Male ; Oxides/therapeutic use ; Receptors, Retinoic Acid/genetics/metabolism ; Remission Induction

BACKGROUND: Early oral intake (EOI) associated with early recovery of normal bowel function has been shown to be an important determinant for improving patients' satisfaction. We investigated the tolerability of EOI and its effects on the recovery of bowel function after epidural anesthesia. METHODS: A prospective randomized trial of patients undergoing lower extremities surgery under epidural anesthesia was performed. A liquid drink was given to 150 patients in the EOI group 1 hours after surgery, and to 150 patients in the delayed oral intake (DOI) group 8 hours after surgery. We recorded presence of bowel sounds immediately after operation, symptoms of ileus, time to the first flatus, time to the first defecation, degree of appetite before the first meal, and patients' satisfaction. RESULTS: There was no significant difference in the presence of immediate postoperative bowel sounds, the degree of appetite before the first meal, mild ileus, and severe ileus between groups. Time to the first flatus and time to the first defecation in the EOI group were shorter than those of the DOI group. The patients' satisfaction in the EOI group was higher than that of the DOI group. CONCLUSIONS: For uncomplicated patients undergoing lower extremities under epidural anesthesia, beginning oral hydration as early as 1 hour after the operation is safe and well tolerated and resulting in faster recovery of bowel function and higher patients' satisfaction.
Anesthesia, Epidural ; Appetite ; Defecation ; Flatulence ; Humans ; Ileus ; Lower Extremity ; Meals ; Prospective Studies

Lack of hygiene and puerperal mastitis are common causes of bacterial diseases in nursing neonates. The aim of this study was to isolate microorganisms from milk samples of healthy female Jindo dogs with suckling puppies and to investigate antimicrobial susceptibility against the isolated bacteria. Milk samples were collected from 120 udders of 12 lactating Jindo dogs that were 2~4 years old without any clinical diseases including mastitis. Bacteria were isolated from 64 milk samples (53.3%), either singly (76.6%) or in combination (23.4%). Staphylococcus (S.) spp. was the most common microorganisms (74.7%) isolated from canine milk, followed by Haemophillus spp. (10.9%), Streptococcus spp. (9.6%), Gardnerella spp. (2.4%) and Moraxella spp. (2.4%). The most frequently isolated organism was S. warneri (31.3%). Antimicrobial susceptibility of these bacteria was tested with 17 antimicrobial agents by Kirbyand Bauer standardized disc diffusion method. Results indicated that bacteria isolated from healthy canine milk were mostly susceptible to amoxicillin-clavulanic acid, cephalothin and ceftiofur, but were resistant to erythromycin, neomycin and tetracycline.
Amoxicillin-Potassium Clavulanate Combination ; Animals ; Anti-Infective Agents ; Bacteria ; Cephalosporins ; Cephalothin ; Diffusion ; Dogs ; Erythromycin ; Female ; Gardnerella ; Humans ; Hygiene ; Infant, Newborn ; Mammary Glands, Animal ; Mastitis ; Milk ; Moraxella ; Neomycin ; Staphylococcus ; Streptococcus ; Tetracycline