No abstract available.
Cholesterol*

No abstract available.
Family Practice* ; Follow-Up Studies* ; Humans ; Internship and Residency*

In an effort to evaluate the effectiveness of teaching behaviors and to compare the qualitative and quantitative methods of evaluating clinical preceptors, we performed a study with questionnaires to survey students and preceptors who participated in preceptorship in our department of Family Medicine over 6 months from May, 1991 to September, 1991. Students reported humanistic orientation behaviors to be most contributing to their clinical medical education. However, preceptors favored student centered instructional strategies. An analysis and comparison of the qualitative and quantitative evaluation of preceptors suggest that qualitative approach identifies individual preceptor strengths and weaknesses more clearly than quantitative approach and may be more useful for providing feedback to stimulate and guide change.
Education, Medical ; Evaluation Studies as Topic ; Hospitals, Teaching* ; Humans ; Preceptorship ; Surveys and Questionnaires

PURPOSE: To evaluate photodynamic therapy (PDT) with verteporfin for iris and angle neovascularization in eyes with neovascular glaucoma. METHODS: We treat a patient who had neovascular glaucoma with iris and angle neovacularization and showed reduction of intraocular pressure (IOP) and the obliteration of neovascularization after PDT. PDT was performed following the treatment parameters used in age-related macular degeneration. The laser was directed at the anterior chamber angle and iris surface using a Goldmann three-mirror contact lens. Follow-up examination was performed 1, 2, 3, 5, 7, and 8 weeks after PDT, and included visual acuity, IOP, and iris fluorescein angiography (7 weeks after PDT). RESULTS: Two months after PDT, we observed a reduction of IOP and the improvement of iris fluorescein leakage. IOP diminished considerably after 1 week, and showed subsequent tendency toward stabilization without additional antiglaucoma medicine. CONCLUSIONS: Photodynamic therapy can be used safely and effectively in the early phase of neovascular glaucoma to achieve the obliteration of iris and angle neovascularization and induce IOP reduction.
Anterior Chamber ; Fluorescein ; Fluorescein Angiography ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Iris ; Macular Degeneration ; Photochemotherapy* ; Visual Acuity

We present an ultrastructure of an incidentally found renomedullary interstitial tumor also called as medullary fibroma in a 77 year-old female who had a metastatic adenocarcinoma of colon to the ureter. This tumor was a small and grayish white nodule in renal medulla, measuring 0.4 x 0.4 cm. Microscopically the tumor composed of spindle cells, with some vacuolation and intercellular collagen fibers. The electron microscopic observation of the spindle cells reveal that nuclei are spindle to oval shape and cytoplasm contain abundant rough endoplasmic reticulum, polyribosome without microfilaments and cisterna like structures supporting that the renomedullary interstitial cell tumor is renal interstitial cell origin than fibroblasts.
Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

BACKGROUND: For gastric cancer, primary prevention by risk factor modification might have some important roles. However, previous studies having investigated the factors associated with stomach cancer reported various results. In addition, there were only a few studies based on Korean population. METHODS: A case control study was carried out on 106 cases matched for age and sex with 106 controls in a tertiary care hospital. In patients who were aged 75 years or less and had been newly diagnosed as adenocarcinoma of stomach between July 1996 and January 1997 were included into the case group. Information on baseline characteristics, health habits, dietary habits of study subjects was obtained through an interview using structured questionnaire. Conditional logistic regression analysis was used to evaluate the factors associated with stomach cancer. RESULTS: Salt preference was associated with significantly increased risk of stomach cancer (odds ratio[OR]=9.81, 95% confidence interval[CI]=2.28 42.2). Eating broiled food more than three times a week significantly increased the risk of stomach cancer (OR=3.33, 95% CI=1.16 9.55) compared to eating it less than once a week. Blood type, family history of stomach cancer, smoking, and alcohol consumption were not associated with stomach cancer. CONCLUSION: Salt preference and frequent eating of broiled food are the risk factors significantly associated with stomach cancer in this study subjects.
Adenocarcinoma ; Alcohol Drinking ; Case-Control Studies* ; Diet ; Eating ; Food Habits ; Humans ; Logistic Models ; Primary Prevention ; Risk Factors* ; Smoke ; Smoking ; Stomach Neoplasms* ; Stomach* ; Tertiary Healthcare ; Surveys and Questionnaires

PURPOSE: To evaluate the diagnostic ability of Stratus optical coherence tomography (OCT) parameters to distinguish normal eyes from those with early glaucomatous visual field defects. METHODS: One eye each of 52 normal-tension glaucoma patients with early visual field defects (mean deviation, -3.98+/-1.30dB; range, -0.01 to -5.86dB) and 88 age-matched normal subjects were enrolled. The Peripapillary retinal nerve fiber layer (RNFL) and optic nerve head regions were scanned using the Stratus OCT. Areas under the receiver operating characteristic curve (AROC) and the sensitivity and specificity for various OCT parameters were used to assess the performance of OCT. RESULTS: The AROC for the C/D area ratio was 0.865. Other high AROC values included the vertical C/D ratio (0.848), the average RNFL thickness (0.813), and the RNFL thickness in the inferior quadrant (0.791). A stepwise discriminant analysis found that a combination of the C/D area ratio and RNFL thickness in the inferior quadrant could correctly identify 86.4% of the normals and 80.8% of the glaucoma patients (AROC=0.893). CONCLUSIONS: In our sample of patients with early visual field defects, Stratus OCT parameters showed moderate discriminating abilities. Combining the C/D area ratio and RNFL thickness in the inferior quadrant by discriminant analysis improved the diagnostic ability to detect glaucoma.
Discriminant Analysis ; Discrimination (Psychology)* ; Glaucoma ; Humans ; Nerve Fibers ; Optic Disk ; Optic Nerve ; Retinaldehyde ; ROC Curve ; Sensitivity and Specificity ; Tomography, Optical Coherence* ; Visual Fields

Thymic cyst is relatively rare tumor which usually occurs in the neck or mediastinum. Cervical thymic cyst is usually situated laterally and deep to the anterior border of the sternocleidomastoid muscle, simulating a branchial cyst. Thymic cyst of the mediastinum is usually detected incidentally and differential diagnoses include cystic degeneration of thymoma, and cystic teratoma. Two case of a cervical and a mediastinal thymic cysts were reported. The one was a cervical thymic cyst developed slowly growing mass in a 53-year-old male a for 10 years. The cyst was unilocular and measures 5.4x2.9x2.8 cm with columnar or squamous cell linings. The other is a mediastinal thymic cyst developed in a 37-year-old female with chest discomfort for 7 months. The cyst was uniocular and measures 2.8x2.2x2.0 cm. The epithelial lining of the cyst was largely desquamated and covered by macrophages with cholesterol granuloma. Involutional thymic stissue in their walls were noted in both cysts. In both cases presence of thymic tissue in the wall of the cyst thought to be the most important diagnostic feature.
Female ; Male ; Humans ; Diagnosis, Differential ; Cysts

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology