Dengue fever is a viral disease that is transmitted by mosquitoes and affects humans. In rare cases, dengue fever can cause visual impairment, which usually occurs within 1 month after contracting dengue fever and ranges from mild blurring of vision to severe blindness. Visual impairment due to dengue fever can be detected through angiography, retinography, optical coherence tomography (OCT) imaging, electroretinography, event electroencephalography (visually evoked potentials), and visual field analysis. The purpose of this study is to report changes in the eye captured using fluorescein angiography, indocyanine green, and OCT in 3 cases of dengue fever visual impairment associated with consistent visual symptoms and similar retinochoroidopathic changes. The OCT results of the three patients with dengue fever showed thinning of the outer retinal layer and disruption of the inner segment/outer segment (IS/OS) junction. While thinning of the retina outer layer is an irreversible process, disruption of IS/OS junction is reported to be reversible. Follow-up examination of individuals with dengue fever and associated visual impairment should involve the use of OCT to evaluate visual acuity and visual field changes in patients with acute choroidal ischemia.
Adult ; Dengue/*complications/diagnosis/physiopathology ; Electroretinography ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Tomography, Optical Coherence/*methods ; Vision Disorders/*diagnosis/etiology/physiopathology ; *Visual Acuity ; *Visual Fields

Dengue fever is a viral disease that is transmitted by mosquitoes and affects humans. In rare cases, dengue fever can cause visual impairment, which usually occurs within 1 month after contracting dengue fever and ranges from mild blurring of vision to severe blindness. Visual impairment due to dengue fever can be detected through angiography, retinography, optical coherence tomography (OCT) imaging, electroretinography, event electroencephalography (visually evoked potentials), and visual field analysis. The purpose of this study is to report changes in the eye captured using fluorescein angiography, indocyanine green, and OCT in 3 cases of dengue fever visual impairment associated with consistent visual symptoms and similar retinochoroidopathic changes. The OCT results of the three patients with dengue fever showed thinning of the outer retinal layer and disruption of the inner segment/outer segment (IS/OS) junction. While thinning of the retina outer layer is an irreversible process, disruption of IS/OS junction is reported to be reversible. Follow-up examination of individuals with dengue fever and associated visual impairment should involve the use of OCT to evaluate visual acuity and visual field changes in patients with acute choroidal ischemia.
Adult ; Dengue/*complications/diagnosis/physiopathology ; Electroretinography ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Tomography, Optical Coherence/*methods ; Vision Disorders/*diagnosis/etiology/physiopathology ; *Visual Acuity ; *Visual Fields

No abstract available.
Nasopharyngeal Neoplasms*

OBJECTIVES: The pathogenesis of nonalcoholic fatty liver in non-obese persons is poorly understood. We aimed to elucidate whether hyperinsulinemia and glucose intolerance are associated with development of fatty liver in patients with normal body weight. METHODS: Forty-seven patients with fatty liver were divided into non-obese (n = 25) and obese groups (n = 22) according to age adjusted body mass index. Inclusion criteria were as follows: (1) elevated transaminase levels during more than 3 months of follow up period, (2) no detectable HBsAg or anti-HCV in the serum, (3) alcohol consumption less than 40 gm/week, (4) no use of potential hepatotoxic drugs within 3 months and (4) sonographic evidence of fatty liver(moderate to severe degree). Baseline insulin levels and oral glucose tolerance test using 75gm of glucose were performed and the results were compared in each group of patients. RESULTS: Mean baseline insulin levels were elevated in both groups above the reference value, 9.3 +/- 3.5 microU/L in non-obese group and 9.9 +/- 3.5 microU/L in obese group (p = 0.26). Seventeen of non-obese patients (68%) had elevated basal insulin level and 16 of obese patients (73%) had elevated basal insulin level (p = 0.39). In oral glucose tolerance test, there was no difference in glucose level between non-obese and obese groups from O minute to 180 minutes (p > 0.05). Eleven patients from the non-obese group (44%) and 8 patients from the obese group (36%) had either impaired glucose tolerance or diabetes (p = 0.29). CONCLUSION: Our data suggest that hyperinsulinemia and glucose intolerance may play a role in the pathogenesis of fatty liver in patients with normal body weight as well as in patients with obesity.
Adult ; Body Weight ; Fatty Liver/pathology ; Fatty Liver/etiology* ; Fatty Liver/blood ; Female ; Glucose Intolerance/complications* ; Human ; Insulin/blood* ; Insulin Resistance ; Male ; Middle Age ; Obesity/complications

PURPOSE: To compare the results of anterior segment biometry including white-to-white (WTW) between scanning-slit topography (ORBscan IIz(R), Bausch & Lomb), optical low-coherence reflectometry (OLCR) biometry (Lenstar(R), Haag-Streit), and Castroviejo calipers. METHODS: Measurements on 72 eyes of 36 patients that underwent refractive surgery were measured using ORBscan(R), Lenstar(R), and calipers and compared. Ocular biometry parameters used in this study included the WTW, central corneal thickness, anterior chamber depth (ACD), keratometry, and pupil size. RESULTS: The WTW measurements using ORBscan(R) and calipers (11.57 +/- 0.35 mm and 11.58 +/- 0.34 mm, respectively) were statistically similar. However, the measurement using Lenstar(R) (12.05 +/- 0.40 mm) was significantly greater than with the other methods (p < 0.001). Central corneal thickness and keratometry measurements using ORBscan(R) were greater than when using Lenstar(R) (p = 0.01 for both). ACD and pupil size measurement using Lenstar(R) were greater than when using ORBscan(R) (p < 0.001 for both). CONCLUSIONS: Because WTW and ACD measurements using Lenstar(R) were greater than when using ORBscan(R) and calipers, unexpected high-vaulting may be observed due to the selection of a larger-sized posterior chamber phakic intraocular lens. Therefore, the differences in measurements obtained when using these methods should be considered.
Anterior Chamber ; Biometry* ; Humans ; Phakic Intraocular Lenses ; Pupil ; Refractive Surgical Procedures

PURPOSE: To compare the results of anterior segment biometry including white-to-white (WTW) between scanning-slit topography (ORBscan IIz(R), Bausch & Lomb), optical low-coherence reflectometry (OLCR) biometry (Lenstar(R), Haag-Streit), and Castroviejo calipers. METHODS: Measurements on 72 eyes of 36 patients that underwent refractive surgery were measured using ORBscan(R), Lenstar(R), and calipers and compared. Ocular biometry parameters used in this study included the WTW, central corneal thickness, anterior chamber depth (ACD), keratometry, and pupil size. RESULTS: The WTW measurements using ORBscan(R) and calipers (11.57 +/- 0.35 mm and 11.58 +/- 0.34 mm, respectively) were statistically similar. However, the measurement using Lenstar(R) (12.05 +/- 0.40 mm) was significantly greater than with the other methods (p < 0.001). Central corneal thickness and keratometry measurements using ORBscan(R) were greater than when using Lenstar(R) (p = 0.01 for both). ACD and pupil size measurement using Lenstar(R) were greater than when using ORBscan(R) (p < 0.001 for both). CONCLUSIONS: Because WTW and ACD measurements using Lenstar(R) were greater than when using ORBscan(R) and calipers, unexpected high-vaulting may be observed due to the selection of a larger-sized posterior chamber phakic intraocular lens. Therefore, the differences in measurements obtained when using these methods should be considered.
Anterior Chamber ; Biometry* ; Humans ; Phakic Intraocular Lenses ; Pupil ; Refractive Surgical Procedures

BACKGROUND: Difficult-to-treat asthma afflicts a small percentage of the asthma population. However, these patients remain refractory to treat, and account for 40% to 50% of the health costs of asthma treatment, incurring significant morbidity. We conducted a multi-center cross-sectional study to characterize difficult-to-treat asthma in Korea. METHODS: Subjects with difficult-to-treat asthma and subjects with controlled asthma were recruited from 5 outpatient clinics of referral hospitals. We reviewed medical records of previous 6 months and obtained patient-reported questionnaires composed of treatment compliance, asthma control, and instruments for stress, anxiety, and depression. RESULTS: We recruited 21 subjects with difficult-to-treat asthma and 110 subjects with controlled asthma into the study. The subjects with difficult-to-treat asthma were associated with longer treatment periods, more increased health care utilization, more medication (oral corticosteroids, number of medication), and more anxiety disorder compared to those of well-controlled asthmatics. There was no difference in age, gender, history of allergy, serum IgE, blood eosinophil count, or body mass index between the 2 groups. CONCLUSION: Difficult-to-treat asthma is characterized by increased health care utilization and more co-morbidity of anxiety.
Adrenal Cortex Hormones ; Ambulatory Care Facilities ; Anxiety ; Anxiety Disorders ; Asthma ; Body Mass Index ; Comorbidity ; Compliance ; Cross-Sectional Studies ; Delivery of Health Care ; Eosinophils ; Health Care Costs ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea ; Medical Records ; Surveys and Questionnaires ; Referral and Consultation

Amyloidosis is characterized by deposition of amyloid, which is resistant to proteolysis & phagocytosis, in intercellular spaces & vascular walls. The amyloid deposition provokes dysfunction of an accumulated organ & displays variable clinical symptoms depending upon the involved organ. A diagnosis is rendered through a biopsy of the affected organ, followed by staining using congo red which reveals an apple greenish refractile birefringence via polarizing microscopy. Using an electro-microscopy specific filaments can be found. Amyloidosis is classified into primary amyloidosis, composed of light chain filaments (AL) and secondary amyloidosis, comprised of A protain (AA). The AL type of amyloidosis shows deposition of amyloid in muscularis mucosa & muscularis externa. Priunary amyloidosis on the other hand, is relatively rare. We experienced primary stornach amyloidosis (AL), which was mistaken for stomch cancer.
Amyloid ; Amyloidosis* ; Biopsy ; Birefringence ; Congo Red ; Diagnosis ; Endoscopy* ; Extracellular Space ; Hand ; Microscopy ; Mucous Membrane ; Phagocytosis ; Plaque, Amyloid ; Proteolysis ; Stomach

Hereditary hemorrhagic telangiectasia, also knawn as Rendu-Osler-Weber disease, is a rare autosomal dominant condition characterized by telangiectases, arteriovenous fistulas, and aneurysms involving the skin and mucosa, as well as blood vessels of the lung, liver, and central nervous system. The most common clinical manifestations are epistaxis and gastrointestinal bleeding. Arteriovenous shunting leads to hepatic congestion, and congestive heart failure may occur. We report a casie of Rendu-Osler-Weber disease which revealed typical clinical symptoms and radiologic findings with a review of relevant literatures.
Aneurysm ; Arteriovenous Fistula ; Blood Vessels ; Central Nervous System ; Epistaxis ; Estrogens, Conjugated (USP) ; Heart Failure ; Hemorrhage ; Liver ; Lung ; Mucous Membrane ; Skin ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis

Mesenteric vein thrombosis (MVT) is an infrequent but old form of acute mesenteric ischemia, various forms of which have been recognized through imaging techniques. Pre- viously, diagnosis was made only by a laparotomy or autopsy. MVT is an abdominal emergency that is rarely diagnosed early. Review of the literature has shown that most cases have been treated by intestinal resection, and a few by thrombectomy with or with- out resection. Most are primary thromboses, but some are related to thromboembolic dise- ases, sepsis, cirrhosis, coagulopathy, abdominal neoplasms, traurna, or use of oral contra- ceptives. We report a case of superior mesenteric vein thrombosis with acute ischemic bowel disease, diagnosed early through a duodenoscopy and definitively assessed by superior mesenteric angiography and computed tomography. The predisposing factor for this case was a pelvic abscess post placenta previa operation. The first symptoms were hematemesis and abdominal pain. An intestinal mucosal lesion and clinical symptoms were improved by only heparinization and symptomatic treatment without resection.
Abdominal Neoplasms ; Abdominal Pain ; Abscess ; Angiography ; Autopsy ; Causality ; Diagnosis ; Duodenoscopy ; Emergencies ; Enteritis* ; Fibrosis ; Hematemesis ; Heparin ; Ischemia ; Laparotomy ; Mesenteric Veins ; Placenta Previa ; Sepsis ; Thrombectomy ; Thrombosis ; Venous Thrombosis*