PURPOSE: The purpose of this study was to compare the radiation adaptive response (RAR) in peripheral lymphocytes (PL) of patients induced by Tc.-99m MDP and Tc-99m DTPA scintigraphies. MATERIALS AND METHODS: Lymphocytes from 45 patients (25 males, 20 females, mean age 44+/-18 years) were collected before and after scintigraphies using 740 MBq Tc-99m MDP (n=22) or Tc-99m L)TPA (n=23). Lympho-cytes from 20 controls (12 males, 8 females, mean age 43+/-7 years) were also callected. They were exposed to challenge dose of 2 Gy gamma-rays using a Cs-137 cell irradiator, Number of ring-form (R) and dicentric (D) chromosomes was counted under the light microscope. From them a representative score, Ydr, was calculated as Ydr=(D+R)/cells. Adaptation index (AI) was defined as difference of Ydr between unconditioned and conditioned lymphocytes. Ydr was also measured after an administration of cyclohexi-mide (CHM), a protein synthesis inhibitor, before challenge dose. RESULTS: RAR was induced in both groups of patients. CHM abolished the adaptive response in both groups. AI of Tc-99m MDP group was significantly higher than that of Tc-99m DTPA group. CONCLUSION: Tc-99m MDP induced RAR was more prominent than those induced by Tc-99m DTPA.
Chromosome Aberrations ; Female ; Humans ; Lymphocytes* ; Male ; Pentetic Acid* ; Technetium Tc 99m Medronate*

Fractures of the capitellum humeri are rare and the recommendations for treatment vary. It can involve a significant portion of the articular surface, rendering the elbow joint unstable. In this situation, it is desirable to reduce and internally fix the capitellar fragment, because this restores the articular surface and augments joint stability. We experienced two cases of capitellar fractures which one case was spontaneously anatomical reduced and the other case was treated by open reduction. In one case the capitellar fragment was spontaneous reduced to a stable position although it was noticed radiographically as an unstable displaced fracture preoperatively. The other case was treated by open reduction and internal fixation with 3.5mm, small, AO, cannulated screw and K-wire. Both cases are reported here with references.
Elbow Joint ; Joints

PURPOSE: To report a case of a full-thickness macular hole caused by Terson syndrome. CASE SUMMARY: A 49-year-old man presented to our clinic with decreased visual acuity in the right eye after a subarachnoid hemorrhage due to spontaneous rupture a middle cerebral artery aneurysm. On the first examination, the corrected visual acuity was hand movement in the right eye and 1.0 in the left eye. There was massive vitreous hemorrhage in the right eye. In the left eye, there was no abnormal ocular finding. He was diagnosed with vitreous hemorrhage due to Terson syndrome and waited for the spontaneous absorption of the vitreous hemorrhage. Six months later, the vitreous hemorrhage was considerably absorbed, but a macular hole was observed. OCT scans showed a full-thickness macular hole with an epiretinal membrane.
Absorption ; Epiretinal Membrane ; Eye ; Hand ; Humans ; Intracranial Aneurysm ; Middle Aged ; Retinal Perforations ; Rupture, Spontaneous ; Subarachnoid Hemorrhage ; Visual Acuity ; Vitreous Hemorrhage

Small cell carcinoma does originate from APUD cells of any parts of the body. Usually the cases discovered in the lung and have poor prognosis. In esophagus only about 100 cases are reported world widely after McKneown reports in 1952 and only 2 cases were reported in Korea. There was a cese of small cell carcinoma developed multiple lesions in esophagus but no reports said that small cell carcinoma developed syncronously in esophagus and other organs. We are to report a case that showed a multiple lesions in esophagus and cardia. The patient 60 yeata old man, has suffered from the substernal discomfort and significant weight loss for one month.
APUD Cells ; Carcinoma, Small Cell* ; Cardia* ; Esophagus* ; Humans ; Korea ; Lung ; Prognosis ; Stomach ; Weight Loss

We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.
Aged ; Brain ; Decision Making* ; Drainage ; Emergencies ; Female ; Heart Ventricles ; Humans ; Hydrocephalus ; Lymphangioma, Cystic ; Neurosurgery ; Pentetic Acid ; Subarachnoid Hemorrhage ; Subarachnoid Space ; Subdural Effusion* ; Ventriculoperitoneal Shunt

PURPOSE: To report a case of a drug-resistant Penicillium endophthalmitis that was treated with intravitreal voriconazole injection. CASE SUMMARY: A 73-year-old male who developed endophthalmitis after cataract surgery was treated with intravitreal vancomycin and ceftazidime injection after aqueous and vitreous cultures were done. The condition were not improve after intravitreal injection, and the culture showed Penicillium species. Fungal endophthalmitis was diagnosed and pars plana vitrectomy, intraocular lens removal, and intravitreal amphotericin B injection were performed. However, a progressive worsening of the ocular condition was observed, and the patient was transferred to our hospital. At initial visit, the best corrected visual activity was hand movement. The hypopyon and thick exudative membrane filled the anterior chamber. Pars plana vitrectomy and intravitreal voriconazole injection were performed under the diagnosis of drug-resistant Penicillium endophthalmitis. The condition improved after the operation, and there was no recurrence of endophthalmitis until four months after vitrectomy. CONCLUSIONS: Voriconazole is useful in the treatment of drug-resistant fungal endophthalmitis.
Aged ; Amphotericin B ; Anterior Chamber ; Cataract ; Ceftazidime ; Diagnosis ; Endophthalmitis* ; Hand ; Humans ; Intravitreal Injections ; Lenses, Intraocular ; Male ; Membranes ; Penicillium* ; Recurrence ; Vancomycin ; Vitrectomy

PURPOSE: To report a case of central retinal artery obstruction (CRAO) caused by protein S deficiency. CASE SUMMARY: A 36-year-old man presented with acutely reduced visual acuity in the right eye. The patient had no other diseases such as diabetes mellitus or hypertension. The visual acuity was 20/20 in the right eye and light perception in the left eye. Afferent pupillary defect was observed in theleft eye. Fundus examination showed diffuse retinal opacification and a cherry-red spot at the macula. Thus the patient was diagnosed with CRAO in the left eye. There were no abnormal findings on routine hematologic tests including blood coagulation test. Protein C activity, antithrombin III activation, anticardiolipin antibody were within normal limits but protein S activity was decreased. Thus, the patient was diagnosed with CRAO with protein S deficiency. CONCLUSIONS: Coagulation factors such as protein S need to be measuredin cases of CRAO in young patients without medical problems.
Adult ; Antibodies, Anticardiolipin ; Antithrombin III ; Blood Coagulation Factors ; Blood Coagulation Tests ; Diabetes Mellitus ; Eye ; Hematologic Tests ; Humans ; Hypertension ; Light ; Protein C ; Protein S ; Protein S Deficiency ; Pupil Disorders ; Retinal Artery ; Retinaldehyde ; Visual Acuity

PURPOSE: To report a case of central retinal artery obstruction (CRAO) caused by protein S deficiency. CASE SUMMARY: A 36-year-old man presented with acutely reduced visual acuity in the right eye. The patient had no other diseases such as diabetes mellitus or hypertension. The visual acuity was 20/20 in the right eye and light perception in the left eye. Afferent pupillary defect was observed in theleft eye. Fundus examination showed diffuse retinal opacification and a cherry-red spot at the macula. Thus the patient was diagnosed with CRAO in the left eye. There were no abnormal findings on routine hematologic tests including blood coagulation test. Protein C activity, antithrombin III activation, anticardiolipin antibody were within normal limits but protein S activity was decreased. Thus, the patient was diagnosed with CRAO with protein S deficiency. CONCLUSIONS: Coagulation factors such as protein S need to be measuredin cases of CRAO in young patients without medical problems.
Adult ; Antibodies, Anticardiolipin ; Antithrombin III ; Blood Coagulation Factors ; Blood Coagulation Tests ; Diabetes Mellitus ; Eye ; Hematologic Tests ; Humans ; Hypertension ; Light ; Protein C ; Protein S ; Protein S Deficiency ; Pupil Disorders ; Retinal Artery ; Retinaldehyde ; Visual Acuity

This study was undertaken to investigate the effect of subparalytic doses of pancuronium on the its onset time of action during induction before endotracheal intubation. The patients were composed of 20 healthy female and 20 male adults which were ASA class l and ll. At the time of intubation, the control group received a pancuronium 0.08mg/kg as a single bolus after a 2.5% thiopental sodium 5mg/kg injection, and the pretreatment group received subparalytic dose of pancuronium 0.015mg/kg before the thiopental sodium injection and then followed by pancuronium 0.08mg/kg 3 minutes later. The degree of neuromuscular transmission was measured using the train of four stimulation of the ulnar nerve repeated every 20 seconds, and the time was measured when the 1st twitch height(T1) was changed to 85%, 75%, 50% and 25%. The results were as follows; the onset time of neuromuscular blocking action was quicker in female patients than in male patients, and was significantly more rapid in both sexes in the pretreated group by 23.3 to 63.8% compared to the control group.
Adult ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Male ; Neuromuscular Blockade* ; Pancuronium ; Thiopental ; Ulnar Nerve

PURPOSE: We report a case of Parry-Romberg syndrome associated with right enophthalmos, hypotropia, up-gaze limitation, en coup the sabre, morphea, and hypothyroidism. CASE SUMMARY: A 41-year-old woman presented with slowly progressive right enophthalmos that started 5 years previous. With a Hertel exophthalmometer, the right eye measured 10 mm, and the left eye 13 mm. Right enophthalmos and atrophy of subcutaneous tissues of right side orbit were observed. Axial scan of computerized tomography shows atrophy of right side orbital subcutaneous tissues without bony abnormality. At primary gaze, 4 prism diopter hypotropia was observed in the right eye. Up-gaze was limited in both eyes. Visual acuity was 1.0 in both eyes. No specific sign was found in her anterior segment. The patient had experienced right side alopecia 20 years prior and had undergone biopsy, which proved morphea. Linear en coup de sabre morphea was found on the right forehead and scalp. Hypothyroidism due to Hashimoto's thyroiditis was diagnosed based on a blood test, which also showed positive antinuclear antibody. Thus, the patient was diagnosed with Parry-Romberg syndrome associated with hypothyroidism. CONCLUSIONS: Clinicians need to consider the rare disease Parry-Romberg syndrome when a patient with ophthalmologic symptoms such as enopthlamos or eye movement disorders is accompanied by dermatologic symptoms such as linear en coup de sabre morphea or alopecia.
Adult ; Alopecia ; Antibodies, Antinuclear ; Atrophy ; Biopsy ; Enophthalmos ; Facial Hemiatrophy* ; Female ; Forehead ; Hematologic Tests ; Humans ; Hypothyroidism* ; Ocular Motility Disorders ; Orbit ; Rare Diseases ; Scalp ; Scleroderma, Localized ; Subcutaneous Tissue ; Thyroid Gland ; Thyroiditis ; Visual Acuity