No abstract available.
Genes, myc* ; Neuroblastoma* ; Polymerase Chain Reaction*

No abstract available.
Humans ; Spinal Cord*

The HELLP syndrome, which is characterized by hemolysis, elevated liver enzymes and low platelets, complicates 4 to 14% of preeclamptic or eclamptic pregnancy. Its course is usually benign except when spontaneous hepatic rupture, a rare catastrophic event, threatens life. The authors have experienced one case of spontaneous hepatic rupture in HELLP syndrome during immediate postpartum period, which was treated with surgical intervention on the first postpartum day. We report this case with a brief review of the literatures.
Female ; HELLP Syndrome* ; Hemolysis ; Hemorrhage* ; Liver ; Postpartum Period* ; Pregnancy ; Rupture*

PURPOSE: To analyze the correlation between microperimetric parameters and optical coherent tomographic findings in the eyes of patients with macular diseases. METHODS: A total of 64 eyes were included in this retrospective cross-sectional study. Differences in the macular integrity index and microperimetric parameters were analyzed according to types of outer retinal band defects. Correlations between average threshold values and retinal thickness in the corresponding areas were analyzed. Finally, microperimetric parameters were compared between inner and outer retinal lesions. RESULTS: Measures of best-corrected visual acuity, macular integrity index, and average threshold values were significantly worse in eyes with defects in the ellipsoid portion of the photoreceptor inner segment (ISe), the cone outer segment tip (COST), and the external limiting membrane (ELM) than in eyes without ISe, COST, and ELM defects. Also, visual functionality is more significantly impacted by ELM defects than by other hyper-reflective band defects. There was a significant negative correlation between retinal thickness and the average threshold of the corresponding area in the Early Treatment Diabetic Retinopathy Study grid. Microperimetric parameters in the eyes of patients with inner retinal lesions were better than in the eyes of patients with outer retinal lesions. CONCLUSIONS: The macular integrity index may be a useful factor for reflecting the functional aspects of macular diseases. Specifically, ELM, ISe, and COST defects are significantly associated with poor retinal sensitivity and macular integrity index values that suggest abnormalities. Among eyes with these particular defects, the visual functionality of patients is most sensitively impacted by ELM defects. This finding suggests that microperimetric parameters are sensitive and useful for evaluating functional abnormalities in the eyes of patients with macular disease, particularly in patients with outer retinal pathology.
Cross-Sectional Studies ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Macula Lutea/*pathology ; Macular Edema/*diagnosis ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Optical Coherence/*methods ; Visual Field Tests/*methods

BACKGROUND: This study was performed to examine the relationship between alcohol consumption and obesity according to facial flushing in Korean males. METHODS: The 1,198 men in this study were divided into four groups according to the amount of alcohol they consumed: non-drinkers (ND), lower moderate drinkers (LM, < or =7 standard drinks per week), higher moderate drinkers (HM, 7 to 14 drinks per week), and heavy drinkers (HD, >14 drinks per week). They were also separated into two groups according to facial flushing: non-flushers and flushers. Obesity and abdominal obesity were defined as body mass index of 25 kg/m2 or higher and waist circumference of 90 cm or higher, respectively. RESULTS: In LM and HM groups without flushing, the risks of obesity and abdominal obesity were not significantly increased compared to those of non-drinkers. However, in the HD group without flushing, those risks were significantly increased [OR, 1.55; confidence interval (CI), 1.01 to 2.40, and OR 1.63; CI 1.02 to 2.58, respectively]. In the LM group with flushing, those risks were not significantly increased. However, in HM and HD groups with flushing, the risks of obesity and abdominal obesity were significantly increased (OR, 2.10; CI, 1.07 to 4.16, and OR, 2.06; CI, 1.05 to 4.06, respectively, in HM; and OR, 2.16; CI, 1.08 to 4.34, and OR, 2.50; CI, 1.26 to 4.98, respectively, in HD). CONCLUSION: This study suggests that the risk of obesity is increased in moderate flushing drinkers compared to non-drinkers and in heavy non-flushing drinkers.
Alcohol Drinking ; Body Mass Index ; Flushing ; Humans ; Male ; Obesity ; Obesity, Abdominal ; Waist Circumference

PURPOSE: Paradoxical embolism due to the presence of patent foramen ovale(PFO) is a well-established possible mechanism of ischemic stroke of unknown origin, and the closure of PFO seems to be a kind of most effective method of the prevention of stroke recurrence. We report the initial and intermediate-term result of transcatheter closure of PFO associated with paradoxical embolism leading to cryptogenic transient ischemic attack or cerebrovascular accident using the Amplatzer(R) PFO Occluder. METHODS: From January 2003 through May 2005, 10 patients with PFO(4 male, 6 female) with history of at least 1 cryptogenic transient ischemic attack or cerebrovascular accident underwent percutaneous transcatheter closure of PFO using Amplatzer(R) occluder assisted by transesophageal echocardiography(TEE). All procedure were performed under general anesthesia and assisted by TEE. RESULTS: In all patients, the implantation procedure was successful and no significant complication was observed(in one case, peri-interventional ST-segment elevation observed). During the follow-up period of mean 13.1 months(range, 1-28 months), no recurrence of neurologic episode were observed and there was no residual shunt through PFO. CONCLUSION: We were able to implant the device without significant complication in all our patients and close PFO effectively. No recurrence of neurologic episode were observed. We conclude that in this initial and intermediate-term follow up, the transcatheter closure of PFO associated with paradoxical embolism using the Amplatzer(R) PFO Occluder is a safe and effective method in prevention of stroke recurrence and there is no significant adverse effect until now. And this procedure may be the treatment choice in patients with the high risk of recurrence ischemic attack. However, in this study, the number of patients included[5 patients(50%) had multiple thromboembolic events] is small and follow-up period is not long. So, we need more clinical cases and long-term clinical follow-up.
Anesthesia, General ; Embolism, Paradoxical* ; Follow-Up Studies ; Foramen Ovale, Patent* ; Humans ; Ischemic Attack, Transient ; Male ; Recurrence ; Stroke

BACKGROUND: Nowadays, as public awareness of t,he Acquired immunedeficiency syndrome(AIDS) epidemic was increasing, athletes have become more concerned about their risk of infection with human immunedeficiency virus(HIV) since it, was announced that Magic Johnson, hero of basketball in the United States, was infected. Because there are no exact cure method about AIDS, the only treatment is prevention through the education and awareness of AIDS. Therefore, we researched the athletes knowledge of AIDS to provide the b#asis of preventive methods. METHODS: A questionnaire was given directly to the 110 wrestling and taekwondo athletes attending a sports college. RESULT: Athletes are all men and their mean age is 24.6 years old. Concerning the question of latent period, 54.5% had correct answer that AIDS development took more than several years after HIV infection. The person who had educated about the preventive methods of infection during the sports was 4.6%. The person who answered AIDS athletes should be excluded from the sports was 64.5% and the reason of exclusion was the risk of infection through the small bleeding(49.8%), sweating(38.0%), and simple skin cont,acts(19. 7%) during the sports. The correct recognition rate of preventive method of infection during the sports was 51.8 to 62%. Concerning the risk routes and behaviors of infection during daily life, most of them recognized correctly(from 76,3% to 99.0% by each item), but some have also misconception about transfusion(61.0%), skin contact(33%) and mosquitos bite(30%) etc. CONCLUSION: Almost all of athletes recognized correctly the risky behavior of sex and blood in transmission of infection, but some have also misconception in daily activities, e.g. transfusion and mosquitos. Many persons answered AIDS infected athletes should be excluded from the sports and they didnt receive any education about preventive methods of AIDS infection during the sports. The knowledge of preventive methods of infection recommended during the sports was relatively high.
Athletes* ; Basketball ; Culicidae ; Education ; HIV Infections ; Humans ; Korea* ; Magic ; Male ; Skin ; Sports ; United States ; Wrestling ; Surveys and Questionnaires

Multiple biliary papillomatosis involves an epithelial field change of the intrahepatic and extrahepatic portions of the biliary tree. Pathologically it is benign, occasionally with dysplasia, but the clinical behavior is regarded as having a low-grade malignant potential. Such malignancy is rare but the prognosis is poor if it is impossible to remove the tumor completely. Here, we report one case of multiple biliary papillomatosis in the biliary tree.
Biliary Tract ; Papilloma* ; Prognosis

PURPOSE: Periampullary malignant tumors become symptomatic at an early stage because of their particular location. For this reason, radical resection is possible in the majority of cases. Periampullary tumors can be removed either by a local resection, as performed by Halsted in 1899, or by a radical pancreaticoduodenectomy, as performed by Whipple et al. in 1935. Both techniques have been used, and their respective places in the treatment of benign or malignant periampullary tumors has been the subject of constant debate. Therefore, we reviewed the cases of four patients who had undergone a transduodenal ampullectomy for an ampullary tumor which was confined to the ampulla of Vater. METHODS: The clinical records of 4 patients who undergone a transduodenal ampullectomy were reviewed. All patients were diagnosed as having an ampullary mass based on gastroduodenoscopy, endoscopic retrograde cholangiopancreatography, or both. Clinical presentation, comparison of pathologic findings of preoperative endoscopic biopsy, operative frozen section, final pathologic examination, complications, follow-up period, and recurrence were reviewed. RESULTS: The two men and the two women studied had a median age of 59.3 (range, 49 to 64 years). Among the four patients who underwent a transduodenal ampullectomy, an adenocarcinoma was found at final pathologic examination in two patients with preoperative diagnoses of a villotubular adenoma and a villous adenoma, respectively. The other two cases were diagnosed as tubular adenomas at final pathologic examination as they had been at the preoperative diagnosis. No evidence of disease was observed in any of the four patients on follow-up at 29 months, 30 months36 months, and 4 months. None of these patients had major complications in the immediate postoperative period, transient hyperamylasemia without clinical significance developed in two patients. CONCLUSION: The transduodenal ampullectomy is a valuable tool in the treatment of ampullary lesions. The result of local excision of the Vater for ampullary tumors appears satisfactory, and this procedure may be particularly indicated for benign tumors, as well as for older or high-risk patients whose malignant lesions are confined to the ampulla of Vater. However, the selection of this procedure required judicious decision making and precise technique and should involve an experienced team of pathologists and surgeons. As a result, for patients in whom it is indicated, a transduodenal ampullectomy is an alternative to the pancreaticoduodenectomy and has good long-term results.
Adenocarcinoma ; Adenoma ; Adenoma, Villous ; Ampulla of Vater ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Decision Making ; Diagnosis ; Female ; Follow-Up Studies ; Frozen Sections ; Humans ; Hyperamylasemia ; Male ; Pancreaticoduodenectomy ; Postoperative Period ; Recurrence

Confirmation of patency of the portal vein by either ultrasound or angiography is important for evaluating patients considered for living-related liver transplant(LRLT) and liver resection(LR). Portal vein thrombosis(PVT) in LRLT necessitates planning for a technically difficult operation because consideration must be given to obtaining an alternative for splanchnic inflow. When performing LR for hepatocellular carcinoma(HCC), portal vein tumor thrombus was usually thought of as a poor prognositic factor for tumor recurrence. Recently, we experienced two cases of pseudo-obstruction of the portal vein, one in LRLT and the other in LR. In the case of LRLT, a 16-month-old female patient was diagnosed as congenital biliary atresia. PVT had been preoperatively suggested, but the vein was actually open. The patient was successfully transplanted using the left lateral segment of the donor with ordinary portal vein anastomosis and the postoperative course was uneventful except for mild acute rejection episodes. In the case of LR, a 60-year-old male patient presented with incidental symptoms. Preoperative ultrasonography, computed tomography, and angiography showed a 9x8cm-sized mass in the right lobe of the liver with obstruction of the right portal vein, which suggested tumor thrombus. However, the operation disclosed the patency of the portal vein and a right lobectomy was subsequently done. Because of the scanty blood flow of the portal vein due to arterio-portal shunt, PVT was preoperatively suggested. Our experience indicates that more sophisticated image studies are needed for evaluating portal vein patency in the patient who needs hepatic transplant as well as liver resection, and that the surgeon should not hesitate to procede to operative procedures even though conventional studies suggest PVT.
Angiography ; Biliary Atresia ; Female ; Humans ; Infant ; Liver Transplantation* ; Liver* ; Male ; Middle Aged ; Portal Vein* ; Recurrence ; Surgical Procedures, Operative ; Thrombosis ; Tissue Donors ; Ultrasonography ; Veins