PURPOSE: We report a case of bilateral optic neuritis without encephalomyelitis, following measles that has recently spread in our country. METHODS: Nine-year-old male patient diagnosed as measles based on the typical symptoms and serum IgM positivity complained of sudden decrease in visual acuity of both eyes (FC/50 Cm in both eyes). Bilateral afferent pupillary defect were detected and visual evoked potentials show the delayed P100 latency and the decreased amplitude in both eyes. We diagnosed his case as the bilateral optic neuritis and treated with the high dose steroid therapy. RESULTS: At 2 months after visual loss, the afferent pupillary defect disappeared and the visual evoked potentials returned to normal. At 6 month, the visual acuity of the right and left eyes improved to 0.9 and 1.0, respectively. CONCLUSION: Optic neuritis following measles is a rare entity, and it is the first time such a case has been reported in Korea. This is a rare case where optic neuritis occurred without the symptoms or signs of encephalitis. In this study, we diagnosed and treated the first case of optic neuritis following measles in korea, with satisfactory results.
Encephalitis ; Encephalomyelitis ; Evoked Potentials, Visual ; Humans ; Immunoglobulin M ; Korea ; Male ; Measles* ; Optic Neuritis* ; Pupil Disorders ; Visual Acuity

To define indications of primary treatment in ureteroscopic stone manipulation with comparing the success rates and complications of A(11.5F rigid ureteroscopy from March 1989 to April 1993) and B(7.5F rigid ureteroscopy from May 1993 to February 1995) groups, 216 ureteroscopies were performed for ureteral stone removal between March 1989 and February 1995 in our urologic department. The overall success rates of ureteroscopic stone manipulation were obtained and compared according to stone locations, sizes and anesthesia or not. The overall success rate was 85.6%(80% in group A and 94.2% in group B respectively). The success rates in each group A and B were 60% and 77.8% in the upper ureter, 100% and 66.7% in the middle ureter, 80.0% and 95.9% in the lower ureter. There were the more success rates and the less complication rates in group B than group A. The success rates of stone removal are increased and the complications are decreased remarkably in group B(especially in the lower ureter stone). The rapid relief of ureteral obstruction and colic is possible immediately after ureteroscopic stone manipulation. So, we conclude that ureteroscopic stone manipulation is primarily indicated in the treatment of lower ureteral stones.
Anesthesia ; Colic ; Ureter ; Ureteral Obstruction ; Ureteroscopes ; Ureteroscopy

Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three group and aspirates were categorized into three cytologic groups. The cytologic result was reported benign masses (cytologic group 1) in 71 cases (52%), malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 cases (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benigh masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.
Biopsy ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: PET developed on the basis of biochemical characteristics of malignant tissues where the increase in glucose metabolism. Therefore, early and accurate detection of primary or metastatic lesion can be expected. This study is to compare PET and other traditional methods in detection of primary breast carcinoma and metastatic lesion, and to find the advantage of PET. MATERIALS AND METHODS: We compared and analysed the results of PET, US, mammogr aphy, bone scan, CT and biopsy reports of the 46 patients who were examined in our hospital from September 1, 19094 to July 31, 1995. PET Trace 200 cyclotron and PET Advanced Scenner were used for FDG synthesis and imaging respectively. RESULTS: 10 of the 12 cases who had preoperative PET were consistent with the results of mammography and ultrasound and 9 of the 10 cases were consistent with the pathologic results. In one case, which did mammography and PET after excis ional biopsy, PET gaves a false positive result. In the detection of axilliary node metastasis, PeT after excisional biopsy, PET gaves a false positive result. In the detection of axilliary node metastasis, PET shows 100% sensitivity and specificity but bone scan shows 100%, 72.2% respectively. CONCLUSION: PET is useful for diagnosis of primary breast cancer and is superior to bone scan in specificity for diagnosis of bone metastasis and in early detection of response to treatment. Because PET cannot exclude false (+) in inflamm atory lesion, continuous investigation is needed for establishment of indication and reduction of false (+), false (-).In spite of high cost, PET may become a new and useful diagnostic tool.
Biopsy ; Breast Neoplasms* ; Breast* ; Cyclotrons ; Diagnosis* ; Electrons* ; Glucose ; Humans ; Mammography ; Metabolism ; Neoplasm Metastasis ; Positron-Emission Tomography* ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: The purpose of this study is to compare the effect of topical nonsteroidal anti-inflammatory drugs (NSAID) with topical steroid in conjunctival inflammation, wound healing, and intraocular pressure when used after strabismus surgery. METHODS: Twenty five patients who received bilateral horizontal rectus muscle recession were selected. 0.1% prednisolone acetate (Optilon(R), Chongkundang Pharma Corporation) was applied to the right eye of each patient and 0.1% pranoprofen (Pranopulon(R), Choongwae Pharmacology Corporation) was applied to the left eye four times a day after surgery. Both eyes were compared at one day, 1 week, 2 weeks and 4 weeks after surgery to measure the extent of inflammation (injection, chemosis, discharge), pain and conjunctival incisional healing. The intraocular pressure was compared at the day before surgery and 1 week, 2 weeks and 4 weeks after surgery. RESULTS: The steroid group showed earlier improvement of inflammation and pain and faster conjunctival incisional healing than the NSAID group (p>0.1). The steroid group showed a significantly higher IOP than the NSAIDs group throughout the periods (p<0.001), and showed a progressive increasement in IOP during the study periods (p<0.001). CONCLUSIONS: Topical NSAIDs were proved to be as effective as topical steroids in controlling inflammation and pain, and in the healing of conjunctival wounds. In addition, topical NSAIDs showed no side effect of increasing IOP. Therefore, topical NSAIDs may be a safe alternative to topical steroids after strabismus surgery in children who have difficulty in measuring IOP.
Anti-Inflammatory Agents, Non-Steroidal ; Child ; Humans ; Inflammation ; Intraocular Pressure ; Pharmacology ; Prednisolone ; Steroids* ; Strabismus* ; Wound Healing ; Wounds and Injuries

We report a case of cutaneous metastatic carcinoma from an esophageal carcinoma in a 54-year-old male who complained of several pinhead-sized erythematous tender papules on the up-per chest. He had been admitted to the department of internal medicine for esophageal carcinoma. Radiological examinations revealed a luminal narrowing below the level of carina on esophagography, and a mass on the mid esophagus, left atrium and pulmonary vein on the chest CT scan. On endoscopy, about 30cm from the central incisor, a huge polypoid mass with a central ulceration and dirty surface margin was noted. Histopathological examination of the skin and esophageal biopsies showed the same atypical squamous cells with distinctive nucleoli, nuclear membrane and intercellular bridge, which were consistent with the squamous cell carcinoma of nonkeratinizing large cell type, suggesting these cutaneous lesions were metastasized from the esophageal carcinoma.
Atypical Squamous Cells of the Cervix ; Biopsy ; Carcinoma, Squamous Cell ; Endoscopy ; Esophagus ; Heart Atria ; Humans ; Incisor ; Internal Medicine ; Male ; Middle Aged ; Neoplasm Metastasis* ; Nuclear Envelope ; Phenobarbital ; Pulmonary Veins ; Skin ; Thorax ; Tomography, X-Ray Computed ; Ulcer

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

Bilateral adrenal tuberculosis is a rare disease and often occurs bilaterally. We report a case of bilateral adrenal masses due to tuberculosis with adrenal insufficiency. The patient was a 39- year-old man who had complained of intermittent pain of right upper quadrant and general weakness. The plasma levels of cortisol and catecholamine were normal. The levels of 24-hour urinary catecholamine and VMA were also normal. But the levels of 24-hour urinary 17- hydroxycorticosteroids and 17-ketosteroids were reduced. Abdominal CT showed about 6.5 x4.8 x 5.4cm sized left adrenal mass and 4.0 x 2.8 x 3.6cm sized right adrenal mass with calcification. The result of sono-guided percutaneous needle biopsy was adrenal tuberculosis. The patient was treated with antituberculous chemotherapy and hormonal replacement. But the masses are unchanged during 5-months follow-up.
17-Ketosteroids ; Adrenal Glands ; Adrenal Insufficiency ; Biopsy, Needle ; Drug Therapy ; Follow-Up Studies ; Humans ; Hydrocortisone ; Hydroxycorticosteroids ; Plasma ; Rare Diseases ; Tomography, X-Ray Computed ; Tuberculosis*

Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.
Anxiety Disorders ; Behavior Therapy ; Comorbidity ; Drug Therapy ; Humans ; Obsessive-Compulsive Disorder ; Tics ; Tourette Syndrome

A discoid medial meniscus is a relatively rare pathology of the knee joint, and bilateral cases are extremely rare. We present one case of bilateral symptomatic discoid medial menisci. Arthroscopy revealed a complete type of discoid medial meniscus in one knee and an incomplete type in the other knee. Ours is a very rare case of bilateral discoid medial menisci with associated osseous changes in the tibia, and it is perhaps the first such reported case in the world. The patient was successfully treated by partial meniscectomy using routine arthroscopic procedures.
Arthroscopy ; Humans ; Knee ; Knee Joint ; Menisci, Tibial ; Tibia