Grave's disease is an autoimmune disorder and affects thyroid gland and orbit. Ocular manifestations of this disease, referred to as Grave's ophthalmopathy are caused by deposition of antithyroglobulin immune complexes into extraocular muscles and orbital fats. Consequent increase in volume of orbital contents results in exopthalmos. Severe exopthalmos results in several significant visual consequences as follows: exposure keratitis, diplopia and optic neuropathy. Orbital decompression for Grave's ophthalmopathy has traditionally been performed through either an external or a transantral approach. The advent of intranasal endoscopes allowed for the development of a transnasal approach for medial and inferior orbital wall decompression. Recently, the authors experienced a case of Grave's ophthalmopathy complicated with exposure keratitis and performed endoscopic transnasal orbital decompression, so report this case with a review of literature.
Antigen-Antibody Complex ; Decompression* ; Diplopia ; Endoscopes ; Fats ; Keratitis ; Muscles ; Optic Nerve Diseases ; Orbit* ; Thyroid Gland

One case of unilaterally developed acute retinal necrosis syndrome was studied with retina and vitreous from biopsy during operation through electronmicroscope pathologically and virolo gically. In photoreceptor cells, generalized necrosis was found: loss of outer segments, fragmentation of inner segments, and decrease of mitochondria in ellipsoids. Bipolar cells and axons were well preserved. Internal limiting membrane was intact, and covered by an unidentified cell. Degenerated retinal proper had various sized vacuoles. Around the intraretinal vessels, neutrophils and lymphocytes were infiltrated considering vasculitis. In ganglion cells, swelling of mitochondrias were seen, and their cell organelles were decreased, No virus particle was detected in all layers of the retina with electronmicroscope.
Axons ; Biopsy ; Ganglion Cysts ; Lymphocytes ; Membranes ; Mitochondria ; Necrosis ; Neutrophils ; Organelles ; Photoreceptor Cells ; Retina ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde ; Vacuoles ; Vasculitis ; Virion

OBJECTIVE: The purpose of this study was to determine the frequency and distribution of cytogenetically abnormal miscarriages in couples with spontaneous abortions (SA) or recurrent miscarriages (RM). METHODS: Karyotyping of specimens from 164 abortuses with SA and 86 abortuses with RM was successfully performed according to the standard cytogenetic methods using G-banding technique. RESULTS: Among the total 164 cases of SA group, 81 (49.4%) were euploid and the rest (83, 50.6%) showed chromosomal abnormalities. In RM(> or =2) and RM(> or =3) group, 31 (36.0%)/27 (34.6%) cases were euploid and 55 (64.0%)/51(65.4%) cases were abnormal, respectively. A statistically significant difference was found in the rate of cytogenetic abnormality between SA and RM groups (P<0.05). In all groups, women with advanced maternal age (> or =35 years) had a higher rate of chromosome anomalies compared with women younger than age 35 (normal:abnormal = 32.4%:67.6% for > or =35 years and 53.8%:46.2% for <35 years in SA; 19.2%:80.8%/21.7%:78.3% for > or =35 years and 43.3%:56.7%/40.0%:60.0% for <35 years in RM(> or =2) and RM(> or =3), respectively; P<0.05). In SA group, an increase of normal karyotypes was noted with increased gestational age (<10 week, 38.0%; 10-15 week, 53.5%; 16-20 week, 65.7%). In RM group, most of cases were in <10 week and the frequency of trisomies with chromosomes 1 to 10 were increased compared with that of SA. CONCLUSION: There was a statistically significant difference in the frequency and distribution of chromosomal abnormalities between SA and RM groups. Our results will provide useful information for diagnosis and genetic counseling of patients with SA or RM.
Abortion, Habitual* ; Abortion, Spontaneous* ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics* ; Diagnosis* ; Family Characteristics ; Female ; Genetic Counseling ; Gestational Age ; Humans ; Karyotype ; Karyotyping ; Maternal Age ; Pregnancy ; Trisomy

47,XYY males are found in approximately 1 per 1,000 men. There is no significant difference in intelligence compared with a normal karyotype group. 47,XYY males are fertile and are considered to be relatively tall in stature owing to the increased growth velocity during the earliest childhood. It has been known that 47,XYY males are usually quite normally developed at birth with normal birth weight and length without any physical abnormalities. We have experienced a case of 47,XYY male with increased nuchal fold thickness, choroid plexus cyst and limb anomaly and we report the case with brief review of the literature. A 31-year-old woman, who had terminated her first pregnancy due to limb anomaly at 24 weeks gestation, received ultrasonography at about 16 weeks gestation and was found having a fetus with increased nuchal fold, choroid plexus cyst and limb anomaly. Through the genetic counselling, her pregnancy was terminated and the chromosome karyotyping was performed with the fetal tissue and parent's peripheral blood. The results revealed that the parents had normal karyotypes, but the karyotype of the fetus showed 47,XYY.
Adult ; Birth Weight ; Choroid Plexus* ; Choroid* ; Extremities* ; Female ; Fetus ; Humans ; Intelligence ; Karyotype ; Karyotyping ; Male* ; Nuchal Translucency Measurement* ; Parents ; Parturition ; Pregnancy ; Ultrasonography

The antiarrhythmic efficacy if low dose amiodarone treatment was studied in 30 cases of ventricular premature beats(VPBs). Amiodarone was administered 600mg daily in three divided doses for for initial 7-10 days as loadihg dosage,then 100-200mg once daily as maintenance. The results obtained were as follow : 1) The complete control of VPBs was achieved by amiodarone treatment in 90%, 27cases of 30 cases(all 11 cases with simple VPBs and 16 cases of the remainders with complex VPBs). 2) The QT interval and QTc were significantly prolonged, whereas heart rate was reduced significantly after amiodarone treatment. 3) In 27 cases of responder, the frequency of VPBs began to decrease overtly 2-3 days after amiodarone administration, then relatively stablized in 6 days, and complete cnotrol of VPBs was achieved in all cases about 10 days after treatment. 4) No significant side-reaction was observed except the decrease of serm T3 level after treatment.
Amiodarone* ; Arrhythmias, Cardiac* ; Heart Rate ; Selective Estrogen Receptor Modulators

No abstract available.
Glomerular Basement Membrane*

The purpose of this study was to analyze the minimum two year clinical and radiological results of revision total hip arthroplasties using allogenic chip bone graft and cement in acetabular bone deficiencies. Thirty six revision total hip arthroplasties that had been performed in thirty four patients between Sep. 1992 and May. 1994 at Seoul Paik Hospital and had followed more than two years were included in this study. The clinical result was evaluated by Harris hip score. The mean Harris hip score was 48 points preoperatively, 88 points at final follow-up, a mean of 3 years after revision. In radiological evaluation, osseous union between grafted bone and host bone was seen within 4 months in thirty two hips (89%), a complete grafted bone-cement radiolucent line of two millimeter or more in at least one zone was seen in seven hips (19%) and acetabular component migration was seen in six hips (17%) at postoperative 3 year follow-up radiograph. At the time of follow-up, five hips (14%) had been revised a second time: three for aseptic acetabular loosening, two for infection. In conclusion, we recommend the technique using allogenic chip bone graft and cement to reconstruct the acetabular bone deficiencies in revision total hip arthroplasties, though other technique will be recommend in severe segmental acetabular deficiencies or previous infection.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Hip ; Humans ; Seoul ; Transplants*

Aged ; Caregivers ; Dementia ; Depression ; Empathy ; Epidemiologic Studies ; Humans ; Korea ; Pilot Projects

A 78-year-old male presented with an asymptomatic pinkish multi-nodular mass on his frontal scalp. The lesion had recurred twice after incomplete surgical excision. Initial punch biopsy was diagnosed with cylindroma. He revisited after one year with exophytic enlargement of the mass, and two staged Mohs micrographic surgery identified well-differentiated malignant cylindroma. Histopathology in the lower dermis and periosteal layer showed atypical cells with mitosis and hyperchromatic nucleoli with increased Ki-67 index of 10% to 30%. The postoperative wound was successfully treated with negative wound pressure therapy (NPWT) and secondary intentional healing. We report this case showing malignant transformation of solitary cylindroma, and good result for secondary intention healing using NPWT for postoperative defect.

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis