We injected tissue plasminogen activator(TPA) and expansile gas into the vitreous of 17-year-old patient who presented with traumatic macular hole and subretinal hemorrhage. Most of the subretinal hemorrhage drained into the vitreous cavity through the macular hole. Two weeks after intravitreal injection, closure of macular hole accompanied by complete posterior vitreous detachment was observed. This case suggests that the tangential vitreous traction may play an important role in the development of traumatic macular hole as in the development of idiopathic macular hole. It is speculated that the induction of posterior vitreous detachment without vitrectomy can result in removal of this traction and closure of traumatic macular hole.
Adolescent ; Hemorrhage ; Humans ; Intravitreal Injections ; Plasminogen ; Retinal Perforations* ; Traction ; Vitrectomy ; Vitreous Detachment

The intraocular pressure (IOP) in 115 cases of extracapsular cataract extraction (ECCE) and ciliary sulcus fixation of posterior chamber lens implantation was measured more than 2 months postoperatively. These results were compared to the unoperated fellow eyes, as well as to a group of 14 patients who had ECCE and implantation of an anterior chamber lens. The posterior chamber lens implanted eyes demonstrated a significant IOP reduction after surgery compared to the unoperated fellow eyes and the anterior chamber lens implanted eyes. In the posterior chamber lens implanted eyes, there was a significant IOP reduction after surgery in all age groups and there was a significant IOP reduction in the eyes with a 2 to 6 months and a 7 to 12 months follow-up after surgery, but no IOP change in the eyes with more than 1 year follow-up after surgery. We concluded that in the case of ECCE and ciliary sulcus fixation of posterior chamber lens implantation, IOP was initially reduced after surgery, but approarhed the preoperative level over a period of time.
Adult ; Aged ; *Cataract Extraction ; Female ; Humans ; *Intraocular Pressure ; *Lenses, Intraocular ; Male ; Middle Aged

BACKGROUND: Testicular rupture is a surgical emergency which command immediate repair. If surgery is delayed, a hematoma causes severe pain and loss of spermatogenesis as well as hormonal functions. Scrotal ultrasonography has been helpful in early diagnosis of testicular rupture. But disadvantage of ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Also the diagnostic accuracy, sensitivity or specificity of scrotal ultrasonography was variable in regard to authors. And so, a diagnostic accuracy of scrotal ultrasonography was evaluated in scrotal trauma. METHODS: We reviewed 38 patients of scrotal trauma from May, 1994 to March, 1998. 6 patients were treated conservatively following scrotal sonography and 10 patients treated only surgical exploration without ultrasonography. Surgical exploration was performed in 22 case, which were evaluated by ultrasound before surgical treatment. In a such 22 cases, diagnostic accuracy of scrotal ultrasonography was evaluated. RESULTS: We compared ultrasound before treatment with surgical exploration finding in a such 22 cases. The ultrasonographic features in 7(31.8%) out of 22 cases, which showed testicular ruptured, but surgical exploration revealed testicular rupture in 5 and epididymal rupture in 1, simple hematocele in 1. In 15(68.2%) out of 22 cases the simple hematocele was diagnosed by ultrasonography, but surgical finding feature in of the 7 cases revealed testicular rupture, epididymal rupture in 1, simple hematocele in 7. The sensitivity and specificity for the ultrasonography are 42.9% and 87.5%, and the positive and negative predictive values are 86.5% and 46.7%, respectively. Ultrasonography is low sensitive in identifying testicular rupture. CONCLUSION: Ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Therefore, early surgical exploration for saving the testis should be performed that sonographically by seeing hypoehoic peripheral lesions and disappearance of normal ovoid form of testis, hematocele in scrotal sac.
Contrast Media ; Early Diagnosis ; Emergencies ; Hematocele ; Hematoma ; Humans ; Male ; Rupture ; Sensitivity and Specificity ; Spermatogenesis ; Testis ; Ultrasonography*

No abstract available.
Animals ; Brain* ; Corpus Striatum* ; Neurons* ; Neuropeptides* ; Rats*

These studies document species differences in the distribution of the catecholamine-synthesizing enzyme tyrosine hydroxylase (TH) within the main olfactory bulb (MOB) of a number of rodents and insectivore species including the rat, wild mouse, mongolian gerbil, stripped field mouse (apodemus agrarius), hedgehog, mole, laboratory shrew (suncus murinus). TH-containing neuronal perikarya were observed in the MOB of the both species of the rodents and insectivore except the hedgehog and laboratory shrew (suncus murinus). None of these cell groups displayed either dopamine beta hydroxylase (DBH) or phenylethanolamine-N-methyltransferase (PNMT). The number of stained somata and their intensity varied such that label was most prominent in the stripped field mouse followed in decreasing order by the rat, mongolian gerbil, wild mouse and mole. The vast majority of such cells occurred in the glomerular layer as periglomerular cells surrounging the glomeruli of the stripped field mouse, rat, mongolian gerbil, wild mouse and moles. Numerous additional cells were present in the external plexiform layer (EPL) and mitral cell layer (MCL). These often displayed long ascending immunoreactive processes and appeared to correspond to tufted cells. Also a few smaller, multipolar cells were present in the internal granular layer scattered among the granule cells. However, the hedgehog and laboratory shrew displayed no perikaryal staining in the MOB. In conclusion, these data suggest that TH is present in the MOB of stripped field mouse, rat, mongolian gerbil, wild mouse and moles but is not found in the MOB of the hedgehog and laboratory shrew, or that species differences exist in the level of TH.
Animals ; Dopamine beta-Hydroxylase ; Dopaminergic Neurons* ; Gerbillinae ; Hedgehogs ; Mice ; Neurons ; Olfactory Bulb* ; Rats ; Rodentia* ; Shrews ; Tyrosine 3-Monooxygenase

BACKGROUND: Through a genome-wide search using the genetic markers(RFLP genetic markers), the familial hypertrophic cardiomyopathy(FHCM) with an autosomal dominant mode of inheritance has been firstly detected to be genetically linked to chromosome 14q1. The subsequent studies have shown that the point mutations at the exons encoding for the head and head /rod junction of the cardiac beta myosin heavy chain(beta-MHC) are the most frequent type of mutation in the FHCM families genetically implicated with a linkage to beta-MHC, whereas the alpha/beta-MHC hybrid gene and a large deletion at the 3' region of beta-MHC gene were also rarely detected. With the other families genetically implicated with the chromosomes 1,11,15,16 and 18, FHCM also manifests locus heterogeneity, a phenomenon in which abnormalities at different genes are involved in different families. In addition, a korean FHCM family with 403Arg-->Gln mutation of beta-MHC gene has been previously found by an american research group. METHODS: For clinical diagnosis, echocardiography and electrocardiography were performed on the individual members of a korean FHCM family. The microsatellite markers(MYO-I,MYO-II) located in the beta-MHC gene region were amplified by PCR(polymerase chain reaction) and the polymorphism was analyzed for the possible linkage to the phenotypic expression of FHCM. Independently, the same PCR products of the exons 13 and 23 were digested with the specific restriction enzymes for the presence of the most frequently reported point mutations of beta-MHC gene (403 and 908 amino acid mutations). Single strand conformation polymorphism(SSCP) of the exon 13 and 23 of the beta-MHC gene was also analyzed of the mobility shift expected if any point mutation is present at these two exons. RESULTS: The inheritance pattern of HCM(hypertrophic cardiomyopathy) in the family is considered as autosomal dominant. In this family(KU 101), one of the microsatellite markers(MYO-II) indicated the possible cosegregation between the allele was also present in the 32-year-old brother of the proband, who reveals no clinical signs of the disease. The other microsatellite genetic marker(MYO-I) was uninformative, without giving the discriminating power to verify the linkage to beta-MHC gene. In the analysis for two common mutations of beta-MHC gene by PCR-RFLP and PCR-SSCP, no evidence was found for 403 and 908 amino acid mutations and any point mutation in the exons 13 and 23. CONCLUSIONS: Based on the linkage analysis using microsatellite genetic markers, there was a possibility that the disease could be linked to an abnormality in the beta-MHC gene of the chromosome 14q1.
Adult ; Alleles ; Cardiomyopathy, Hypertrophic, Familial* ; Diagnosis ; Echocardiography ; Electrocardiography ; Exons ; Genetic Markers ; Head ; Humans ; Inheritance Patterns ; Mass Screening* ; Microsatellite Repeats ; Point Mutation ; Polymerase Chain Reaction ; Population Characteristics ; Siblings ; Ventricular Myosins* ; Wills

BACKGROUND: Through a genome-wide search using the genetic markers(RFLP genetic markers), the familial hypertrophic cardiomyopathy(FHCM) with an autosomal dominant mode of inheritance has been firstly detected to be genetically linked to chromosome 14q1. The subsequent studies have shown that the point mutations at the exons encoding for the head and head /rod junction of the cardiac beta myosin heavy chain(beta-MHC) are the most frequent type of mutation in the FHCM families genetically implicated with a linkage to beta-MHC, whereas the alpha/beta-MHC hybrid gene and a large deletion at the 3' region of beta-MHC gene were also rarely detected. With the other families genetically implicated with the chromosomes 1,11,15,16 and 18, FHCM also manifests locus heterogeneity, a phenomenon in which abnormalities at different genes are involved in different families. In addition, a korean FHCM family with 403Arg-->Gln mutation of beta-MHC gene has been previously found by an american research group. METHODS: For clinical diagnosis, echocardiography and electrocardiography were performed on the individual members of a korean FHCM family. The microsatellite markers(MYO-I,MYO-II) located in the beta-MHC gene region were amplified by PCR(polymerase chain reaction) and the polymorphism was analyzed for the possible linkage to the phenotypic expression of FHCM. Independently, the same PCR products of the exons 13 and 23 were digested with the specific restriction enzymes for the presence of the most frequently reported point mutations of beta-MHC gene (403 and 908 amino acid mutations). Single strand conformation polymorphism(SSCP) of the exon 13 and 23 of the beta-MHC gene was also analyzed of the mobility shift expected if any point mutation is present at these two exons. RESULTS: The inheritance pattern of HCM(hypertrophic cardiomyopathy) in the family is considered as autosomal dominant. In this family(KU 101), one of the microsatellite markers(MYO-II) indicated the possible cosegregation between the allele was also present in the 32-year-old brother of the proband, who reveals no clinical signs of the disease. The other microsatellite genetic marker(MYO-I) was uninformative, without giving the discriminating power to verify the linkage to beta-MHC gene. In the analysis for two common mutations of beta-MHC gene by PCR-RFLP and PCR-SSCP, no evidence was found for 403 and 908 amino acid mutations and any point mutation in the exons 13 and 23. CONCLUSIONS: Based on the linkage analysis using microsatellite genetic markers, there was a possibility that the disease could be linked to an abnormality in the beta-MHC gene of the chromosome 14q1.
Adult ; Alleles ; Cardiomyopathy, Hypertrophic, Familial* ; Diagnosis ; Echocardiography ; Electrocardiography ; Exons ; Genetic Markers ; Head ; Humans ; Inheritance Patterns ; Mass Screening* ; Microsatellite Repeats ; Point Mutation ; Polymerase Chain Reaction ; Population Characteristics ; Siblings ; Ventricular Myosins* ; Wills

PURPOSE: This study was designed to evaluate the clinical charateristics, surgical treatment and outcome of carcinoid tumors of the rectum. METHODS: A retrospective review of the charts of all patients treated for rectal carcinoid tumors at Kangbuk Samsung Medical Center between Jan 1989 and April 1998. Thirteen patients with rectal carcinoids tumors were treated. Follow-up data, histopathological information and surgical procedures were obtained from case notes. RESULTS: There were 10 men and 3 women. The ages ranged from 28 to 60 years (mean 41.1 years for all, 43.8 years for men and 32 years for women). Eight patients (61.5%) had no symptoms. Of the five patients, four complained of rectal bleeding (30.8%), and one complained of defecational difficulty (7.7%). Size of rectal carcinoid tumor was less than 1 cm in 7 patients (53.8%), between 1 cm and 2 cm in 2 patients (15.4%), in four patients (30.8%) larger than 2 cm. Three patients were treated in Abdominoperineal resection. Two patients underwent stapled low anterior resection. The remaining 8 patients underwent conservative resection (3 colonoscopic polypectomy and electrocauterization, 2 colonoscopic snaring biopsy, 2 transanal resection and one Mason's operation). The depth of invasion was contained within sutmucosa in 3 patients. Liver metastasis was found in 2 patients. Average follow-up time was 35.6 months. Two patients died of mutiple mestastasis (liver, bone, peritoneum) 9 and 30months later. CONCLUSION: We concluded that tumors smaller than 1 cm could be managed by local treatment whereas larger than 2 cm should be managed by radical treatment.
Biopsy ; Carcinoid Tumor* ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Male ; Neoplasm Metastasis ; Rectum ; Retrospective Studies ; SNARE Proteins

PURPOSE: Acute scrotum is a clinical syndrome that is defined as an acute painful swelling of the scrotum. It is well known that early surgical exploration is needed to prevent the testicular loss when testicu lar torsion breakouts. But most of reports were only focused on testicular torsion of prepubertal age group. This fact let us examine the acute scrotum with all age group and the significance of surgical exploration. MATERIALS AND METHODS: We retrospectively reviewed the results collected from 112 patients (131 cases) with acute scrotum who had been admitted to our hospital between June 1994 and November 1999 with the exception of scrotal trauma. RESULTS: The incidence of acute scrotum over 20 years old was 72.4% of total acute scrotum patients. The most common disease was acute epididymitis giving the rate of 71.8% (94 cases). In adult the incidence of testicular torsion was low (3 cases). Surgical torsion was 12 cases and acute epididymitis was 12 cases as the cause of acute scrotum. CONCLUSIONS: Most cases of testicular torsion have been below 20 years old and only 3 cases have been over 20 years old. Although the incidence of testicular torsion over 20 years old has been low. There were severe infectious diseases needing surgical approach in the cases of aged patient. this research shows that the treatment of acute scrotum goes with the need of surgical therapy.
Acute Pain ; Adult ; Communicable Diseases ; Epididymitis ; Humans ; Incidence ; Linear Energy Transfer ; Male ; Retrospective Studies ; Scrotum* ; Spermatic Cord Torsion ; Young Adult

Migration of roundworms, Ascaris lumbricoies, into the biliary tract is a relatively common cause of biliary symptoms in endemic areas, but the number of reported gallbladder ascariasis was scanty even in these areas. Some diagnostic methods might provide suggestive informations, but there are no pathognomonic clinical features for biliary ascariasis, so it is discovered usually after surgical exploration, which is especially the case of gallbladder ascariasis. A young female patient with 4 months' history of right upper quadrant pain which did not respond to medical control and was aggravated recently, presented normal level of peripheral blood leukocyte count with no eosinophilia, normal liver function test, normal serum amylase level and subjectively no febrile sense. Abdominal ultrasonogram disclosed a long, thick, linear, non-motile echogenic structure, not accompanied by acoustic shadowing, within the gallbladder. The intra-and extra-hepatic bile ducts were not dilated and the pancreas was revealed as normal echogenecity and contoru. Endoscopic retrograde cholangiopancreatography was performed immediately thereafter, and it showed a thin linear filling defect in the gallbladder. Cholecystectomy was performed under the impression of gallbladder ascariasis. A mummified Ascaris lumbricoides was found in the lumen of the gallbladder. There was no stones and the histologic examination of the gallbladder revealed chronic cholecystitis.
Acoustics ; Amylases ; Ascariasis* ; Ascaris ; Ascaris lumbricoides ; Bile Ducts ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis ; Eosinophilia ; Female ; Gallbladder* ; Humans ; Leukocyte Count ; Liver Function Tests ; Pancreas ; Shadowing (Histology) ; Ultrasonography