This study aimed to assess the potential usefulness of optical coherence tomography[OCT]for the diagnosis of central serous chorioretinopathy. OCT was used to examine 50 patients[50 eyes]whose initial examination disclosed the clinical diagnosis of central serous chorioretinopathy. Optical coherence tomographic section acquired directly through the fovea showed an increase of the neurosensory retina above an optically clear space corresponding to a fluid-filled cavity. Serial OCT were able to demonstrate a decrease in the sensory retina elevation from[900~120]micrometer t o [130~0]micrometer for 3 months of period. This resolution correlated with an improvement in the patient's visual acuity. OCT is potentially useful as a new, noninvasive diagnostic technique for quantitative examination by objectively monitoring the degree of serous retinal detachment in patients with central serous chorioretinopathy.
Central Serous Chorioretinopathy ; Diagnosis* ; Humans ; Retina ; Retinal Detachment ; Tomography, Optical Coherence ; Visual Acuity

No abstract available.
Cardiomyopathy, Hypertrophic*

BACKGROUND: Hepatocyte growth factor (HGF) is a potent mitogenic cytokine. C-met protein, which is known to be the HGF receptor has transmembrane tyrosine kinase activity and is encoded by the c-met oncogene. The HGF/c-met signaling pathway may play various roles in the carcinogenesis of various organs. METHODS: We examined HGF and c-met mRNA expression by utilizing reverse transcription polymerase chain reaction on 40 surgically resected intracranial meningiomas (25 benign, 10 atypical, and 5 anaplastic cases). RESULTS: An HGF overexpression was detected in 28%, 50%, and 80% of the benign, atypical and anaplastic meningiomas, respectively; a high expression of HGF or the coexpression of HGF/c-met was detected in the high grade meningiomas (the atypical and anaplastic cases, p=0.046, p=0.014). An HGF expression was statistically significant in the recurrent meningiomas (p=0.003), and HGF expression was significantly lower than c-met mRNA expression in benign meningiomas (p=0.034). CONCLUSIONS: There was no correlation between histologic subtypes and HGF/c-met expression. Determination of HGF expression can be used as a molecular predictor for recurrence of meningioimas. These results suggest that HGF and c-met expression in meningiomas may be associated with anaplastic progression.
Hepatocyte Growth Factor ; Hepatocytes ; Meningioma ; Neoplasm Recurrence, Local ; Oncogenes ; Polymerase Chain Reaction ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins c-met ; Recurrence ; Reverse Transcription ; RNA, Messenger

PURPOSE: Cerebral contusion is often associated with delayed edema, ischemia, demyelination, and secondary impairment in the neurological function. Early prediction of the outcome for patients with diverse critical illnesses has long been a concern of intensive care unit physicians. Recently, the systemic release of host-derived inflammatory mediators has been used for prognosis assessment in patients with multiple infections, burn injury, and systemic infection. Experimental investigations have revealed the importance of free radicals and calcium currents in cellular damage. Also experimental injuries have caused an early production of cytokines. This study was undertaken to analyze the production of interleukin-6 in the brain and in plasma following a brain contusion. METHODS: Sixty male Sprague-Dawley (SD) rats, each weighing 300-350 g were used in an experimental group following brain contusion, and 18 SD rats were used as a control group following a sham operation. Intracerebral IL-6 and plasma IL-6 were measured by using the ELISA method with a rat IL-6 kit at 3, 6, 24, 48, and 72 hours after the brain contusion. After contusion, the brains were fixed by perfusion via the carotid artery with 40% formaldehyde, glacial acetic acid, and 100% ethanol (1:1:8) at a flow rate of 25 ml/min and stained with hematoxylin and eosin for histologic examination. RESULTS: Brain IL-6 levels increased to reach a maximum of 160.23 pg/ml, at 6 hour after brain trauma. Plasma IL-6 levels increased to 70.02 pg/ml at 3 hour following brain contusion. CONCLUSION: The elevated brain IL-6 level in the injured rat does not seem to reflect a systemic inflammation. Although plasma IL-6 is detected in the sham-operated and the traumatized rats, the levels are too low to account for the increase observed in the brain cortex. This finding shows that the increase in brain IL-6 is related to the dynamics of brain contusion.
Acetic Acid ; Animals ; Brain Injuries* ; Brain* ; Burns ; Calcium ; Carotid Arteries ; Contusions ; Critical Illness ; Cytokines ; Demyelinating Diseases ; Edema ; Enzyme-Linked Immunosorbent Assay ; Eosine Yellowish-(YS) ; Ethanol ; Formaldehyde ; Free Radicals ; Hematoxylin ; Humans ; Inflammation ; Intensive Care Units ; Interleukin-6* ; Ischemia ; Male ; Perfusion ; Plasma ; Prognosis ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: Recently, Doppler echocardiography has been widely used to evaluate left ventricular(LV) diastolic filling. However, There are only limited date about the influence of LV systolic function on the pattern of left ventricular diastolic filling. METHODS: To evaluate the changes of Doppler echocardiographic parameters of left ventricular filling induced by variations in left ventricular systolic function in dilated cardiomyopathy(DC) with heart failure(HF), 25 patients(M : F=14 : 11) with DC and HF, and 21 age-matched normal subjects(M : F=13 : 8) were examined by ECG, phonocardiography and echocardiography. From the Doppler recording, A2D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity(E/A) and flow velocity integral(FVI) were measured. RESULTS: In 22 patients with DC and HF without mitral regurgitation(MR), A2D was significantly prolonged(119.5+/-12.7 vs 92.4+/-14.1msec, p<0.01), and early diastolic peak velocity and E/A velocity ratio were decreased as compared with the normal subjects(E=0.39+/-0.08 vs 0.57+/-0.12m/sec, p<0.01, E/A : 0.87+/-0.19 vs 1.33+/-0.19 vs 1.33+/-0.18, p<0.05). There were significant correlations between A2D and FVI(r=+0.73, p<0.01), and between E/A velocity ratio and FVI(r=-0.78, p<0.01). However, in 3 patients with MR, A2D(88.7+/-12.1msec), E(0.56+/-0.05m/sec), and E/A(1.32+/-0.12) were similar to those in normal subjects, despite of decreased FVI(12.0+/-0.9cm). CONCLUSIONS: These data show that a change of left ventricular systolic function in patients without MR may influence a diastolic filling pattern of left ventricle but not in patient with MR, and suggest that MR masks left ventricular distolic filling abnormalities.
Cardiomyopathy, Dilated* ; Echocardiography ; Echocardiography, Doppler* ; Electrocardiography ; Heart ; Heart Sounds ; Heart Ventricles ; Humans ; Masks ; Phonocardiography ; Ventricular Function, Left*

In so-called primary osteoarthritic knees, there may be secondary osteoarthritis due to the instability from chronic cruciate ligament and/or meniscal tear. The purpose of this study is to compare the findings of bone single-photon emission computed tomography(SPECT) and those of simple radiography in osteoarthritic knees which we consider as primary on the status of anterior cruciate ligament(ACL). We reviewed the preoperative bone SPECT and simple radiography of forty-three osteoarthritic knees in 23 patients who underwent total knee arthroplasty between 1995 and l996. We divided the cases into two groups on the status of ACL: thirty intact ACLs(Group I), thirteen insufficient ACLs(Group II). Meniscal tear and/or ACL insufficiency were found in 38 of 43 knees, As regards with presence of osteophytes and sclerotic changes on simple radiograph, there was no significant differences between group I and II. Joint space narrowing was more prominent and diffuse in group I(medial 29, lateral 24) than group II(medial 7, lateral 6). Bone SPECT showed diffuse uptake in group I(medial 30, lateral 23), but less uptake on the lateral compartment(medial 13, lateral 3) in group II. In ACL-intact osteoarthritic knees, joint space narrowing on simple radiograph and hot uptake on bone SPECT were more prominent and diffuse than in ACL-insufficient knees. Clinical relevance is still uncertain and further investigation is needed.
Anterior Cruciate Ligament* ; Arthroplasty ; Humans ; Joints ; Knee* ; Ligaments ; Osteoarthritis ; Osteophyte ; Radiography* ; Tomography, Emission-Computed, Single-Photon*

Background/Aims: Esophageal cancer is not an uncommon cancer in Korea, however, the prognosis still remains very poor with a 5 year survival rate bemg less than l0% mainly becauae of the delayed diagnosis. Although chromoscopy with lugol solution has been received to diagnose the esophageal cancer in an early stage without difficulty, its clinical use has not been popular yet in Korea. This study was performed prospectively to evaluate the usefulness of the chromoscopy for the detection of superficial esophageal cancer in risk patients for esophageal cancer. Methods: Ninety-five patients were selected among persons who received gasiroscopy at Asan Medical Center between Jan. 1996 and May 1996 and were prospectively included for chromoscopy. Inclusion criteria for the chromoscopy were patients older than 60 years of age with smoking history of more than 30 packyears, and/or past or family history of cancers. After conventional endoscopic examination, lugol solution was sprayed to stain the glycogen granules in the epithelial cells. The size of unstained lesion was measured and stainability was classified into 5 grades. All lesions unstained were biopsied for histological diagnosis.(continue...)
Chungcheongnam-do ; Delayed Diagnosis ; Epithelial Cells ; Esophageal Neoplasms* ; Glycogen ; Humans ; Korea ; Prognosis ; Prospective Studies ; Smoke ; Smoking ; Survival Rate

BACKGROUND: Facial laceration is a common clinical problem in the emergency room that is frequently associated with other craniofacial injuries. It elicits an emotional response from the patient because of the underlying concern of permanent scar and secondary facial disfigurement, so they demand prompt and adequate treatment. The aim of this study is to analyze the incidence, etiology, depth, and site of facial lacerations to provide basic data for further understanding. METHOD: This study reviewed 1,043 facial-laceration patients treated in the emergency room at Pusan Paik Hospital between March 1999 and February 2000. This retrospective study was done by reviewing and analyzing the sex and age distributions, the monthly and daily distributions, the causes of injury, the types of injury, the sites of injury, the lengths of the lacerations, and associated injuries. RESULTS: The sex ratio of men to wemen was 2.4:1, and the 0~10 age group was at the top of the age distribution. The number of patients was the highest on sundays and during March. About 9.2% of the patients visited the emergency room between 10:00 P.M. and 11:00 P.M. Falls(38.1%) were the most common cause of facial laceration, and deep laceration(51.8%) was the most common type of facial laceration. The most common laceration site was the forehead, followed by the chin and the nose. The most common associated craniofacial injury was facial bone fracture(39%). Facial-lacerations were sutured by plastic surgeons(80%), emergency physicians(10%), and oromaxillofacial surgeons(10%). We found statistical significance in the types and lengths of lacerations between men and wemen, among age groups(p<0.05). CONCLUSION: Facial laceration is one of the most common craniofacial injuries in the emergency room. By now, most lacerations have been repaired by plastic surgeons. But, the causes of lacerations are diverse and many patients are admitted due to the associated injuries. Therefore, emergency physicians should participate more aggressively in the care of facial-laceration patients to improve the outcome of the patients.
Age Distribution ; Busan ; Chin ; Cicatrix ; Emergencies* ; Emergency Service, Hospital ; Facial Bones ; Forehead ; Humans ; Incidence ; Lacerations* ; Male ; Nose ; Retrospective Studies ; Sex Ratio

PURPOSE: Ethical problems are common in the emergency department (ED)- much more common than is usually recognized. However, the difficult ethical dilemmas and unique aspects of ethics in emergency medicine have not been thoroughly discussed in the context of Korean emergency medicine. The purpose of this study is to evaluate the degree of general recognition of emergency medical ethics, as well as attitude toward several difficult ethical dilemmas among emergency physicians. METHODS: This is a qualitative study by survey. By using a questionnaire, we surveyed on emergency physicians working in teaching- hospitals in Korea in August 2007. RESULTS: The survey response rate was 30%, and there were 192 total respondents to the questionnaire. The results are as follows. Eighty-one percent of respondents said that they had trouble with difficult ethical dilemmas, 74% of respondents said that they need to be educated or trained to improve ethical decision-making capacity, and 58% of respondents said that they will use emergency ethical guideline actively if they are established. The ethical values that emergency physicians must possess, according to the survey responses, are agility, a sense of vocation, and prudence. With respect to questions about ending a patient's life, we found that emergency physicians have a tendency to ignore a patient's desires not to start CPR. Finally, in relation to colleagues and other professionals, many respondents said that they will take action to correct their medical errors. CONCLUSION: Study and development of emergency medical ethics will be greatly helpful to many emergency physicians. Further study and discussion must be pursued in order to establish ethical guideline.
Cardiopulmonary Resuscitation ; Surveys and Questionnaires ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital ; Ethics ; Ethics, Medical* ; Korea* ; Medical Errors ; Medical Futility ; Occupations

PURPOSE: Urethral catheterization is a commonly done, painful procedure, but few studies have evaluated the use of topical anesthesia prior to catheterization. This study was designed to assess the effect of topical anesthetics (2% lidocaine gel) prior to uretheral catheterization. METHODS: This study was a prospective, randomized, case-controlled trial conducted in an emergency department of a university teaching hospital. The 54 subjects were alert, cooperative male adults. Patients in the experimental group were catheterized after injection of topical lidocaine gel in their urethras, and a wait of 3 minutes. Patients in the control group were catheterized with a urethral catheter that was coated by plain lubricant. After each procedure, the patients indicated their subjective assessment of pain on a 100 mm visual analog scale (VAS). We assessed VAS at 4 times: during the procedure, at the end of the procedure, and at 3 and 6 hours after the procedure. SPSS 17.0 was used for statistical analysis. RESULTS: The 54 patients were evenly distributed between the 2 study groups. Mean age was 50 years (range 28-71) in the control group, and 54 years (range 27-70) in the experimental group. The mean reduction in VAS values in the experimental group was 27 mm during the procedure, and 23 mm at 6 hours after the procedure. CONCLUSION: Use of a topical lidocaine gel during urethral catheterization results in significant reduction in pain compared to topical lubricants. This benefit is provided both during the procedure as well as up to 6 hours after the procedure.
Adult ; Anesthesia ; Anesthesia, Local ; Anesthetics ; Case-Control Studies ; Catheterization ; Catheters ; Emergencies ; Hospitals, Teaching ; Humans ; Lidocaine ; Lubricants ; Male ; Prospective Studies ; Urethra ; Urinary Catheterization ; Urinary Catheters