Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying* ; Diagnosis ; Humans ; Nervous System Diseases

No abstract available.
Acanthoma*

Argon laser trabeculoplasty(ALT) is commonly used in the treatment of uncontrolled open angle glaucoma. The authors retrospectively reviewed the efficacy of ALT in 52 patients(57 eyes) with primary open angle glaucoma. The mean follow-up was 28 months(range 2-48 months). The decrease in intraocular pressure 10P) was 10.1 +/- 3.5 mmHg at 1 month, 8.2 +/- 2.8 mmHg at 1 year, 6.2 +/- 5.1 mmHg at 2 years and 51% at 3 years. Failure was most common in the first 6 months after treatment(29%) and thereafter failure occurred at a rate of 5% to 15% per year. The sex and age of patients had no significant effect on success rate. The success rate was high in the patients with baseline IOP of 26 to 30 mmHg. A mild iritis in all cases, transient rise in IOP, peripheral anterior synechia and microscopic hyphema were noted as early complications of ALT.
Argon* ; Follow-Up Studies ; Glaucoma, Open-Angle* ; Humans ; Hyphema ; Intraocular Pressure ; Iritis ; Retrospective Studies ; Trabeculectomy*

BACKGROUND: Total intravenous anesthesia(TIVA) with various kinds of sedatives and synthetic analgesics has many advantages such as no air pollution, no hepatic or renal toxicity and good postoperative pain relief compared with inhalation anesthesia. METHODS: TIVA with fentanyl and propofol was applied to the 25 patients in ASA class I and II. The changes of hemodynamics, arterial blood gas, blood sugar level, hepatorenal function and complications were evaluated perioperatively. RESULTS: Systolic blood pressure and mean arterial pressure decreased after induction, but intraoperatively systolic blood pressure became preoperative value while mean arterial pressure increased compared with preoperative value. Heart rate increased after induction and intraoperatively. At recovery room there were no clinically significant changes in the data of arterial blood gas. The blood sugar level slightly increased during postoperative period. There were no clinically significant changes in hepatic or renal function test of postoperative 3rd day compared with preoperative one. The chief complications of TIVA during anesthesia were pain on injection site and slight movement, while nausea or vomiting, dizziness and urinary retention were the major complications at postoperative period. CONCLUSIONS: TIVA with fentanyl and propofol is considered to have good controllability and it can be applied as one of the general anesthesia methods in the case of contraindications to N2O and volatile anesthetics, but further study will be required to quantify the appropriate dosage of propofol or fentanyl to minimize perioperative hemodynamic change and respiratory depression.
Air Pollution ; Analgesics ; Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation ; Anesthesia, Intravenous* ; Anesthetics ; Arterial Pressure ; Blood Glucose ; Blood Pressure ; Dizziness ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Nausea ; Pain, Postoperative ; Postoperative Period ; Propofol* ; Recovery Room ; Respiratory Insufficiency ; Urinary Retention ; Vomiting

The author analyzed 514 patients with ocular injuries among 2676 inpatients who were admitted to Chosun University Hospital from January 1986 to December 1991. The results were as follows: 1. The incidence of ocular injuries was 19.2% of all inpatients. 2. The incidence was more common in male (82.6%) and in the order of 3rd decade (26.7%), 4th decade (20.7%) and teenage (16.4%). 3. The ocular injuries were more common in the spring (31.9%), and in March. 4. The most common cause of ocular injuries was industrial accident (25.5%), followed by individual accident, traffic accident and violence. Trauma inflicated while staging demonstration was 6.6%. 5. The most common ocular injury was traumatic hyphema (21.0%), followed by corneal laceration, canalicular disruption, and lid laceration. 6. The most common surgical procedure was corneoscleral suture (34.6%), followed by primary lid suture and canalicular reconstruction. 7. The final visual acuity was improved to 0.5 or more in 41.4%. 8. The most common complication of ocular injuries after treatment was corneal opacity (41.2%), followed by vitreous opacity and traumatic cataract.
Accidents, Occupational ; Accidents, Traffic ; Cataract ; Corneal Opacity ; Humans ; Hyphema ; Incidence ; Inpatients* ; Lacerations ; Male ; Sutures ; Violence ; Visual Acuity

No abstract available.
Ovarian Neoplasms*

BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

BACKGROUND: Laparoscopic and pelviscopic techniques have rapidly increased in recent years. Laparoscopy or pelviscopy require carbon dioxide (CO2) insufflation and Trendelenburg or reverse-Trendelenburg position for operational convenience. Many studies were done about the effects of laparoscopic procedures. But simultaneous comparisons of end-tidal CO2 tension (PETCO2), peak airway pressure (Ppeak), plateau pressure (Pplat) and respiratory compliance (Cdyn), between Trendelenburg and reverse-Trendelenburg position are rare. We compared the airway pressure and compliance between the two positions during laparoscopic surgery. METHOD: Eighty patients were divided into 2 groups: for 10o reverse-Trendelenburg position (n=40, Group R) and 10o Trendelenburg position (n=40, Group T). Abdominal pressure was maintained at 10 mmHg by a CO2 insufflator, and minute ventilation was controlled with a constant tidal volume and fixed respiratory rate. We observed the change of PETCO2, Ppeak, Pplat, and Cdyn at 1 minutes before CO2 insufflation (control value), 2 min after position change, 5, 20, 30, 60 minutes after CO2 insufflation, 2 min after CO2 removal, and 2 min after operation. RESULT: PETCO2, Ppeak, and Pplat were increased and Cdyn was decreased significantly after pneumoperitoneum compared with the control in group R. PETCO2, Ppeak, and Pplat were increased significantly under the Trendelenburg compared with the reverse-Trendelenburg, and Cdyn was decreased significantly in Trendelenburg compared with reverse-Trendelenburg. CONCLUSION: PETCO2, Ppeak, Pplat, and Cdyn impedances increased more under the Trendelenburg after pneumoperitoneum compared with reverse-Trendelenburg. We should pay more attention to patient with pulmonary disease, obesity, and old age under the Trendelenburg than reverse-Trendelenburg position.
Carbon Dioxide ; Compliance* ; Head-Down Tilt ; Humans ; Insufflation* ; Laparoscopy* ; Lung Diseases ; Obesity ; Pneumoperitoneum ; Respiratory Rate ; Tidal Volume ; Ventilation

PURPOSE: We investigate the effect of osteoprotegerin (OPG) on activation of osteoclastogenesis and NF-kappaB activation by PMMA (Polymethyl methacrylate) particles in osteoclast precursor cells. MATERIALS AND METHODS: Osteoclast precursor cells (CSF-1 dependent) were obtained from whole bone marrow of C57BL mouse. Four experiments included 1) different dose of RANKL (Receptor Activator of NF-kappaB ligand) treatment (0, 1, 10, 40 ng/ml) 2) PMMA treatment +/- RANKL 3) PMMA treatment with different dose of RANKL 4) PMMA treatment +/- OPG. After treatments, cultured cells were stained with TRAP (Tartrate resistant alkaline phosphatase). The activity of NF-kappaB DNA nuclear translocation was detected by EMSA (electrophoretic mobility shift assay). RESULTS: The experiments with RANKL on osteoclast precursors differentiation demonstrated a dose-dependent stimulation of osteoclastogenesis (p<0.05). Control cultures without RANKL had no osteoclasts, while maintenance in 1 ng/ml of RANKL results in low level osteoclast formation. PMMA particles activated osteoclastogenesis in RANKL-primed osteoclast precursor cells. And the effect of particles on osteoclastogenesis were dependent on RANKL concentration (p<0.03). OPG treatment significantly decreased osteoclast formation and NF-kappaB DNA binding activity by PMMA particles in osteoclast precursor cells. CONCLUSION: OPG inhibits activation of osteoclast formation and NF-kappaB DNA binding activity by PMMA particles through RANK-RANKL pathway.
Animals ; Bone Marrow ; Cells, Cultured ; DNA ; Electrophoretic Mobility Shift Assay ; Mice ; Mice, Inbred C57BL ; NF-kappa B* ; Osteoclasts* ; Osteoprotegerin ; Polymethyl Methacrylate*

It is recognized that rebleeding of traumatic hyphema may predispose patients to several complications including decreased visual acuity. We reviewed the medical records of 92 patients(92 eyes) with the diagnosis of nonperforating traumatic hyphema. The relative efficiencies of Aminocaproic acid and systemic Predisolone for reducing rate of rebleeding and their side effects were evaluated under the statistical analysis. Fourty-seven patients received an oral dosage of 50 mg/kg of Aminocaproic acid every 4 hours for 5 days(up to a maximum 30 gm/day), and fourty-five patients took an oral dosage of 0.6 mg/kg of Prednisolone daily in two devided doses. The frequency of rebleeding was not statistically significantly different between the aminocaproic acid treated group(4.3%, 2/47 patients) and the prednisolone treated group(6.7%, 3/45 patients). The developing rates of their acute adverse reaction were statistically different between the aminocaproic acid treated group(44.7%, 21/47 patients) and the prednisolone treated group(20%, 9/45 patients).
Aminocaproic Acid* ; Diagnosis ; Humans ; Hyphema* ; Medical Records ; Prednisolone* ; Visual Acuity