Cryptococcosis is an acute, subacute or chronic infectian caused by the encap sulated yeast Cryptococcus neoformans. The case of Cryptococcosis is a 2 5/12 year-old boy with involvement of the skin, lungs, liver, spleen, lymph node and central nervous system is reported. He has suffered from fever, nausea., vomiting and multiple skin lesions for a month. Thcre were various cutaneous lesions consisting of papules, pustules, nodules, crusts and ulcers on the scalp, face, back, buttocks and both extremities. Diagnosis was confirmed by the clinical characteristics, histopathologic findings and culture of the C. neoformans from cerebrospinal fluid and marcerated skin tissue. He was successfully treated with combination of Amphotericin B and 5-fluorocytosine.
Amphotericin B ; Buttocks ; Central Nervous System ; Cerebrospinal Fluid ; Cryptococcosis* ; Cryptococcus neoformans ; Diagnosis ; Extremities ; Fever ; Flucytosine ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Nausea ; Scalp ; Skin ; Spleen ; Ulcer ; Vomiting ; Yeasts

Histiocytic medullary reticulosis is a rare, uniformly fatal, acute disease of the reticuloendothelial system. The disease is associated with fever, malaise, weakness, weight loss, lymphadenopathy, hepatosplenomegaly, jaundice, and purpura. Common laboratory findings are severe anemia, leukopenia, and thrombocytopenia. A 49-year-old male patient is described who had multiple purple nodules and tumors in the skin. A biopsy taken from a skin lesion showed a diffuse proliferation of atypical histiocytes in the dermis and subcutaneous tissue.However, erythrophagocytosis of these atypical histiocytes was not seen.
Acute Disease ; Anemia ; Biopsy ; Dermis ; Fever ; Histiocytes ; Humans ; Jaundice ; Leukopenia ; Lymphatic Diseases ; Male ; Middle Aged ; Mononuclear Phagocyte System ; Purpura ; Skin ; Thrombocytopenia ; Weight Loss

More intraoperative and postoperative complications of diabetic vitrectomy may result in poor visual prognosis. Sixty eye (49 patients) underwent vitrectomy for complications of proliferative diabetic retinopathy. Iatrogenic retinal breaks occurred in 6 (10%) of 60 eyes. Postoperative vitreous emorrhage was complicated in 13 (21%) of 60 eyes. Postoperative vitreous hemorrhage cleared spontaneously in one eye. Fluid-air exchange alone was successful in clearing the vitreous cavity in 4 eyes. Two eyes in which clearing does not occur in the postexchange period underwent repeated vitrectomy. Remaining 6 eyes required repeated vitrectomy. Choroidal effusion occurred in 4 eyes (7%) and resolved spontaneously within one week. Neovascular glaucoma occurred in 4 eyes (7%) and was treated with glaucoma implant surgery in 2 eyes, trabeculectomy with Mitomycin C in 1 ye, and cyclophotocoagulation in 1 eye. Retinal detachment developed postoperatively in 3 eyes (5%) and was treated successfully. Corneal epithelial defect persisting more than one week was present in 2 eyes (3%). Accidental mechanical lens damage occurred in one eye. The anatomical success rate was 98% (59 eyes). Visual acuity of 0.025 or better was obtained in 49 eyes (82%). Minimizing intraoperative complications as well as properly managing postoperative complications produced better surgical results.
Choroid ; Diabetic Retinopathy* ; Glaucoma ; Glaucoma, Neovascular ; Incidence* ; Intraoperative Complications ; Mitomycin ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Trabeculectomy ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Sensory Heterotropia is defined as a secondary deviation following loss or severe reduction in visual function in one eye. We have analyzed the records of 68 patients with sensory heterotropia in order to find the incidence, etiologic causes, the factors influencing the direction of the deviation, and the amount of deviation. The incidence of sensory heterotropia was 1.1% of total out patients, and 10.5% of strabismic patients. The major causative factors of sensory heterotropia was anisometropia(33.8%) followed in frequency by uncorrected aphakia(25.0%), cataract(16.2%), retina and vitreous diseases(16.2%), optic nerve atrophy(8.8%) and corneal opacity(2.9%). Esotropia and exotropia were encountered with almost equal frequency when the onset of visual impairment occured between birth and 5 years of age, but exotropia predominated in older children and adult. Those was statistically significant(p<0.01). The direction of a sensory heterotropia was determined by the refractive error of the sound eye, i.e., if the sound eye was emmetropic or myopic, thd blind eye was predominantly exotropic, and if it is hyperopic, it was predominantly esotropic. Also, duration of visual impairment was related to the amount of deviation in exotropic patients. If the duration was under 5 years, the amounts of deviation was 16.3 prism, and over 5 years, it was 25.5 prism, and difference was statistically significant.
Adult ; Child ; Esotropia ; Exotropia ; Humans ; Incidence ; Optic Nerve ; Outpatients ; Parturition ; Refractive Errors ; Retina ; Vision Disorders

Tissue plasminogen activator(tPA) is a fibrin-specific fibrinolytic agent that has recently been shown to be effective in accelerating the clearance of hyphema. Intravitreal injection of tPA can promote rapid lysis of experimental intravitreal fibrin clots. The purpose of this study was to investigate the efficacy of intravitreal tPA injection for the treatment of vitreous hemorrhage in normal phakic non-vitrectomized rabbit eyes. Vitreous hemorrhages were produced by intravitreal injections of 0.05 ml of autologous whole blood in 25 rabbit eyes with intact vitreous. The injection of 25 or 100 micrograms of tPA in 15 eyes resulted in the clearance of vitreous hemorrhage in 99 +/- 19 or 34 +/- 6.5 days, respectively. This was significantly faster than in the control eyes in which the clearance was not seen until 131 +/- 17 days later. No tractional retinal detachment was observed.
Animals ; Rabbits ; Retina/drug effects ; Tissue Plasminogen Activator/*therapeutic use ; Vitreous Body/drug effects ; Vitreous Hemorrhage/*drug therapy

Allele designation for HumACTBP2 is not yet established while many authors introduced different kinds of designation methods. Here, we are introducing a new allele designation method. We used allelic ladder as an internal size standard on behalf of GS-500ROX and designation of each allele was followed recommendation of DNA commission of International Society of Forensic Hematogenetics(ISFH). This method is considered more reasonable for complex repeat loci like HumACTBP2 than other methods that published before.
Alleles* ; DNA

The hypervariable short tandem repeat (STR) locus D12S391 was investigated in a Korean population. A total of 14 alleles were detected by size under denaturing conditions in 517 unrelated individuals. To confirm all of the alleles detected in a Korean population, a total of 34 fragments were sequenced. Prior to allele designation, we constructed the allelic ladders containing 11 alleles sequenced in this study. Allele 18 is the most common with a frequency of 0.281 in Koreans, and one variant allele 19.3 which have been confirmed by sequencing, was detected. The observed heterozygosity, the power of discrimination (PD), and the mean exclusion chance (MEC) for the locus D12S391 is 0.781, 0.946 and 0.652, respectively. No deviation from Hardy-Weinberg equilibrium was observed in a Korean population (p=0.557). In the 424 meioses in 105 Korean families confirmed using other 17 STR loci, no mutation was detected in locus D12S391. The STR locus D12S391system is useful both for the analysis identification and parternity.
Alleles ; Discrimination (Psychology) ; Gene Frequency ; Genetics, Population* ; Humans ; Meiosis ; Microsatellite Repeats ; Sequence Analysis

Many operative procedures for osteonecrosis of the femoral head(ONFH) have been proposed, but their clinical results remain controversial to many clinicians. Recently, a new surgical procedure that incorporates cementation with polymethylmethacrylate(PMMA) after core drilling has been tried clinically. In this study, a finite element method (FEM) was employed to analyze and compare various surgical procedures of ONFH to provide a biomechanical insight by varying physiological loading conditions. Our finite element models were constructed for this purpose they included normal, necrotic, core decompressed, fibular bone grafted, and cementation models. The extent of necrotic region was determined based upon the average CT-scan data from 10 patients. The physiological load directions and magnitudes during the gait cycle were selected at the stage of heel-strike, toe-off, and average stance. The von Mises stresses were calculated and volumetric percentages of the necrotic region under different levels of stresses were analyzed for each model. Our results indicated that there were substantial increase of the necrotic region subjected to the high stress level (beyond 11 MPa) and decrease in the low stress level (below 5 MPa) with the core decompression model, an indication of a malignant stress transfer pattern. On the other hand, the exact opposite pattern of stress transfer was noted with the fibular bone graft and cementation methods suggesting that they could provide structural integrity within the necrotic region.
Cementation ; Decompression ; Gait ; Hand ; Head* ; Humans ; Osteonecrosis* ; Surgical Procedures, Operative ; Transplants

BACKGROUND: The causes of hepatic dysfunction after exposures to the halogenated inhaled anesthetics may be free radical, metabolites of inhaled anesthetics, immune reaction and hypoxic damage by decreasing total hepatic blood flow. The present study was performed to comparison of estimated hepatic blood flow and systemic hemodynamic changes between the general anesthesia with enflurane and thoracic epidural anesthesia in rabbits. METHODS: In general anesthesia group with enflurane, anesthesia was performed with enflurane 2vol% and 100% oxygen for 60 minutes. In thoracic epidural anesthesia group, epidural block was done at T5 level with 0.4 ml/kg of 1% lidocaine. Hepatic blood flow was estimated by clearance of indocyanine green according to the constant infusion method before and 30, 60 minutes after anesthesia. Heart rate, mean arterial pressure, central venous pressure and splanchnic vascular resistance were measured at the same time in both groups. RESULTS: Heart rate was decreased significantly in thoracic epidural anesthesia group and mean arterial pressure and central venous pressure were decreased significantly in both groups at 30, 60 minutes. Hepatic blood flow was decreased at 30, 60 minutes in both groups. Splanchnic vascular resistance was increased significantly 30, 60 minutes in thoracic epidural anesthesia group. There were significant differences in mean arterial pressure and splanchnic vascular resistance between two groups. There was no difference in hepatic blood flow between two groups. CONCLUSIONS: The decreased hepatic blood flow was caused by decreased mean arterial pressure in general anesthesia group with enflurane and by increased splanchnic vascular resistance in thoracic epidural anesthesia group.
Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics ; Arterial Pressure ; Central Venous Pressure ; Enflurane ; Heart Rate ; Hemodynamics* ; Indocyanine Green ; Lidocaine ; Oxygen ; Rabbits ; Vascular Resistance

PURPOSE: In our previous study, the authors developed high heat-treated mineralized porcine cancellous bone(TS-GBB, TaeSan Green Bone Block) as bone-substitute. So we projected that this experiments about TSGBB would prove its safety about problems after transplants, and its stability in mechanical strength as the human bone-substitute. MATERIALS AND METHODS: Highly heat-treated mineralized porcine cancellous bone was made. The chemical, mechanical, and morphological properties were evaluated through various tests. Animal study Total 31 New Zealand White rabbits were randomly selected. Bony defect on medial side of the proximal tibia was made. TS-GBB was implanted into the defect area in experimental group, while it was not inserted in control group. For stable fixation self-designed plate of stainless steel was used in both groups. At 2, 8, and 24 weeks, radiological evaluation was performed to measure new bone formation. At 4 and 16 weeks, clinical laboratory tests were performed. Mechanical shear tests were performed for control and experimental groups at 2, 8, and 16 weeks after operation. Also, histological observations were performed by H & E staining at 2 and 16 weeks after operation. Clinical experiments With the approval of IRB in Pusan Paik Hospital of Inje University and Hwasoon Hospital of Chunnam National University, the clinical trials were processed. After harvesting iliac bone for auto grafts from the 40 patients, 20 for each hospital, the TS-GBB were inserted to the donor site. ESR, CRP, WBC count were performed at postoperative time immediately, 1 week, 4 weeks, and 12 weeks to examine possible infection. At 12 weeks after operation, additional X-ray and CT observation were performed. RESULTS: Animal study At all laboratory finding, two group did not indicate a significant difference. At radiologic evaluation, we could comfirm that bone defect size was small gradually by new bone formation in the control group but new bone formation degree was more smaller and slower compared to the TS-GBB group. And at result of biological dynamic stiffness experiments, at postoperative 16 weeks, maximum load at breakage of control group showed to approximately 70% in normal tibia's that. But, maximum load at breakage or yield of TS-GBB group showed to more than 95% in normal tibia's that. In histologic examination, at postoperative 16 weeks, we comfirmed that in control group atypical bony tissue existed in defect site. On the other side, in TS-GBB group new bone formation formed in uniform. Clinical experiments In 20 cases of Inje University, absorption rate was slow a little at 1 case, but the others absorbed normally. In 17 cases of Hwasun Hospital of Chunnam National University, we comfirmed in grade 3 about TS-GBB's absorption and new bone formation at 16 case. At only 1 case, degree of TS-GBB's absorption and new bone formation was poor. In clinical chemistry tests to evaluate the safety, 19 of 20 patients who participated in the experiment in Pusan Paik hospital showed no specific abnormality and showed similar result to preoperative laboratory. In 1 case at postoperative 12 weeks, CRP was elevated, at 16 weeks this patient showed in normal value in ESR, CRP, and WBC count. In 20 patients of Hwasun Hospital all showed similar results to preoperative laboratory in clinical chemistry tests. CONCLUSION: We think that TS-GBB is the suitable material for regeneration of bone defect site as xenograft of clinical bone substitute.
Absorption ; Animals ; Bone Substitutes ; Chemistry, Clinical ; Clinical Chemistry Tests ; Ethics Committees, Research ; Humans ; Osteogenesis ; Rabbits ; Reference Values ; Regeneration ; Stainless Steel ; Tibia ; Tissue Donors ; Transplantation, Heterologous ; Transplants