PURPOSE: Racemose hemangiomas of the retina are rare developmental vascular anomalies with abnormal arteriovenous anastomoses. We report our observations of a retinal racemose hemangioma with marked dilation and tortuosity of the retinal vessels in the entire left retina. METHODS: In a 9-year-old boy with loss of vision and mild esotropia who presented with hugely dilated and tortuous retinal vessels in left retina, we examined fundus, fluorescein angiography, cerebral angiography, brain CT and MRI. RESULTS: Fundus and fluorescein angiography of the left eye showed marked dilation and tortuosity of the retinal vessels. Angiographic finding showed rapid filling of all vessels and no dye leakage. MRI finding revealed small tortuous vessels around left optic nerve, optic chiasm and tract. Brain CT and cerebral angiography showed nothing abnormal.
Arteriovenous Anastomosis ; Brain ; Cerebral Angiography ; Child ; Esotropia ; Fluorescein Angiography ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Male ; Optic Chiasm ; Optic Nerve ; Retina ; Retinal Vessels ; Retinaldehyde*

PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections

There are several methods for diagnosis of leprosy, including AFB stain, the measurement of PGL-1 (phenolic glycolipid - 1) antigen titer, and DNA-PCR. In this study, we have used the DNA-PCR amplifying the RLEP repetitive sequence. Our result showed that the RLEP primer offered the more sensitive detection and identification of M. leprae DNA in clinical specimens, compared with the other primer, for example, 18-kDa antigen gene. To screen the resistant M. leprae strain of MDT (Multi-Drug Therapy), we have used the TD (Touch-Down) PCR. We arranged and amplified sequences of the genes, folP, rpoB, gyr, 23S rRNA, in M. leprae involved in MDT-resistance, and could obtain the PCR product each gene, simultaneously. This method, based on annealing temperature, was useful to the detection for diagnosis and the screen of MDT-resistant strain of M. leprae, rapidly. Thus, we suggest that the RLEP primer and TD-PCR method are effective in assessing the diagnosis of leprosy and the identification of drug-resistant M. leprae.
Diagnosis* ; DNA ; Leprosy* ; Polymerase Chain Reaction* ; Repetitive Sequences, Nucleic Acid

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

No abstract available.
Fetal Growth Retardation* ; Rheology* ; Umbilical Arteries*

Canavan disease(CD) is a rare autosomal recessive leukodystrophy caused by the deficiency of aspartoacylase and the accumulation in brain of N-acetylaspartate(NAA). CD has been reported mainly Ashkenazi Jews but also occurs in other ethnic groups. Usually it presents as early as the third month of life with megalencephaly, hypotonia later progressing to hypertonia, psychomotor and mental retardation, blindness, occasionally deafness and seizure. Diagnosis is based on the clinical feature, N-acetylaspartic aciduria, radiologic and pathologic findings. Histologically, the affected white matter shows extensive vacuolation and demyelination. There is no treatment for CD and the only prevention is through genetic counselling and prenatal diagnosis. We experienced a case of Canavan disease that was presented with hypotonia and developmental delay. Diagnosis was confirmed histologically. Radiologic findings are extensive high signal throughout the white matter on T2-weighted MRI and increased NAA peak and decreased choline peak of the white matter on MR spectroscopy.
Blindness ; Brain ; Canavan Disease* ; Choline ; Deafness ; Demyelinating Diseases ; Diagnosis ; Ethnic Groups ; Humans ; Intellectual Disability ; Jews ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Muscle Hypotonia ; Prenatal Diagnosis ; Seizures

The stricture of the calyx, pelvis or ureter due to renal tuberculosis had been managed like nephrectomy, partial nephrectomy, ureteroileoneocystoplasty or even pancaliceal-ileoneocystoplasty. To salvage the renal parenchyme and to treat the tuberculous renal caliceal strictures, percutaneous endocalicotomy with or without endopyelotomy was performed in 10 cases from Aug. `90 to Jan. `92. The sites of stricture were mainly upper calyx in 6 cases and lower in 4. A cold knife was used to incise the stricture and a stenting 2-sectioned(14 Fr.) endopyelotomy catheter was retained for 6 to 8 weeks. Postoperative intravenous pyelography revealed marked shrinkage of the dilated calyx in 7 cases. moderate in 1 and no change in 2(success rate, 80%). In failed 2 cases, 1 cases was performed partial nephrectomy and the other was following. There was no significant complications except 1 case of upward migration of D-J catheter. In conclusion, endocalicotomy is safe, less invasive, successful (in cases that guide wire could pass) and parenchyme preserving procedure. The retregrade pyelography is mandatory just before the surgery because stricture can be progressed during Anti-Tbc chemotherapy.
Catheters ; Constriction, Pathologic* ; Drug Therapy ; Nephrectomy ; Pelvis ; Stents ; Tuberculosis, Renal ; Ureter ; Urography

Branch retinal vein occlusion(BRVO), along with central retinal vein occlusion, is second only to diabetic retinopathy as a cause of retinal vascular disease. It has been suggested that eyes with shorter axial length have smaller lamina cribrosa and a narrower scleral canal through which the central retinal vein and artery could pass, causing physical blockage in the vein which predisposes to thrombus formation. The subsequent narrowing of the venous lumen will lead to trubulence. reduced flow, venous stasis and thrombus formation at the level of the arteriovenous crossing. This study was conducted to determine whether there was any difference between the axial lengths of eyes with BRVO and those of control eyes. The axial lengths of the eyes in the group of 37 patients with a unilateral BRVO was compared with those of eyes in the control group. The BRVO group consisted of 23 male and 14 female patients and their mean ages were 61.5+/-7.0 years(51~75years) in male and 63.7+/-7.0 years(52~76years) in female. The control group consisted of 46 male and 28 female patients and their mean ages were 62.5+/-6.5 years(50~73years) in male and 63.9+/-6.1 years(52~75years) in female. The mean axial length of eyes of the BRVO group was 23.08+/-0.57mm(21.92~24.19mm) in male and 22.71+/-0.65mm(21.08~24.00mm) in female. The mean axial length of control eyes was 23.74+/-0.73mm(22.46~25.24mm) in male and 23.18+/-0.81mm(21.62~24.76mm) in female. The difference between the mean axial length of eyes of the BRVO group and that of control eyes was statistically significant(p<0.05). In conclusion, the short axial length may play as a risk factor in the occurrence of a BRVO.
Arteries ; Diabetic Retinopathy ; Female ; Humans ; Male ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Risk Factors* ; Thrombosis ; Vascular Diseases ; Veins

No abstract available.
Animals ; Rats* ; Urinary Bladder*

No abstract available.
Intercellular Signaling Peptides and Proteins*