Vitelliform macular dystrophy, adult type, is a type of pattern dystrophies of the pigment epithelium characterized by autosomal daminant inheritance, mid-life onset and small, round or oval, yellow deposits located at the level of the pigment epithelium. The authors report a case of this dystrophy which showed small yellow round lesion measuring 1/4-1/3 D.D. within the macula, normal electroretinogram, subnormal electrooculogram light-peak/dark-traugh ratio. typical irregular ring-like transmitted fluorescence surrounding the central non-fluorescent Iesion and leakage from perifoveal capillaries on fluorescent angiogram.
Adult* ; Capillaries ; Electrooculography ; Epithelium ; Fluorescence ; Humans ; Vitelliform Macular Dystrophy* ; Wills

Central serous chorioretinopathy was defined as an isolated serous elevation of macular retina unassociated with subretinal blood, optic nerve head pathology, or evidence of other retinochoroidal or systemic disease. A review of 259 consecutive cases of patients under the age of 40 years with central serous chorioretinopathy seen between 1976 and 1985 was performed in order to define temporal patterns of occurrence. Although an increased number of cases were seen in June and July, a statistical trend analysis failed to confirm a defini te seasonal variation(p>0.1).
Central Serous Chorioretinopathy* ; Humans ; Optic Disk ; Pathology ; Retina ; Seasons*

The predictive accuracy of the SRK and SRKII formulas were compared in 113 pseudophakic eyes who had extracapsular cataract extraction with implantation of same type of posterior chamber IOL from Feburary 1990 to March 1991. These patients were folio we red up for at least 2 months postoperatively. Their best corrected visual acuities were above 0.5 and their astigmatisms were below 3 diopters by spectacles correction at the time of the last refraction. The results were as follows. 1. Overall, there were no significant differences in predictive accuracy between SRK and SRKII formulas. 2. The revised constant A for same type of implatnts, which constant A was 118.8. was 117.4 The SRK and SRKII formulas with revised constant A were more accurate than conventional formulas(p<0.001). 3. Our results suggested the constant A was to be revised appropriately according to the surgeon's individual regression analysis when using SRK or SRKII formulas for the calculation of intraocular lens power in Koreans.
Cataract Extraction ; Eyeglasses ; Humans ; Lenses, Intraocular* ; Visual Acuity

Abdominal ultrasonography was performed in 25,622 adults during the period from July 1992 to June 1995 at the Helth Care Examination Center. The renal masses detected and identified by abdominal sonography were investigated to estimate the incidence of each identification. Renal masses were found in 562 cases(2.19%). Of five hundred and sixty two cases, 555(98.75%) were cystic masses and seven(1.25%) were solid masses. Of five hundred and fifty five cystic masses, 550 were simple cyst(97.86%), four polycystic kindney(0.71%) and one cystic renal cell carcinoma(0.18%). Of seven solid masses, two were angiomyolipoma(0.36%) and another four were renal cell carcinoma(0.71%). The rest one case revealed equivocal finding on an ultrasonography, but the patient refused further study. Although the study population was not a random sampling, the incidence of simple cyst was 2,146 per 100,000 in adult and that of renal cell carcinoma was 19 per 100,000 in adult. Furthermore, ultrasonography is a useful tool for screening the renal carcinoma at the low cost.
Adult ; Carcinoma, Renal Cell ; Humans ; Incidence* ; Mass Screening ; Ultrasonography*

BACKGROUND: Upregulation of one type of the pro-inflammatory chemokine (CCL2) and its receptor (CCR2) following peripheral nerve injury contributes to the induction of neuropathic pain. Here, we examined whether another type of chemokine (CCL3) is involved in neuropathic pain. METHODS: We measured changes in mechanical and thermal sensitivity in the hind paws of naive rats or rats with an L5 spinal nerve ligation (SNL) after intra-plantar injection of CCL3 or met-RANTES, an antagonist of the CCL3 receptor, CCR1. We also measured CCL3 levels in the sciatic nerve and the hind paw skin as well as CCR1 expression in dorsal root ganglion (DRG) cells from the lumbar spinal segments. RESULTS: Intra-plantar injection of CCL3 into the hind paw of naive rats mimicked L5 SNL-produced hyperalgesia. Intra-plantar injection of met-RANTES into the hind paw of rats with L5 SNL attenuated hyperalgesia. L5 SNL increased CCL3 levels in the sciatic nerve and the hind paw skin on the affected side. The number of CCR1-positive DRG cells in the lumbar segments was not changed following L5 SNL. CONCLUSIONS: Partial peripheral nerve injury increases local CCL3 levels along the degenerating axons during Wallerian degeneration. This CCL3 binds to its receptor, CCR1, located on adjacent uninjured afferents, presumably nociceptors, to induce hyperalgesia in the neuropathic pain state.
Animals ; Axons ; Chemokine CCL3 ; Chemokine CCL5 ; Diagnosis-Related Groups ; Ganglia, Spinal ; Hyperalgesia ; Ligation ; Neuralgia ; Nociceptors ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rats ; Receptors, CCR1 ; Sciatic Nerve ; Skin ; Spinal Nerves ; Up-Regulation ; Wallerian Degeneration

Cerebrospinal fluid from 27 patients with tuberculous meningitis and from appropriate control individuals were assayed for immunoglobulin G activity to tuberculin purified protein derivative (PPD) and Lipoarabinomannan-B (LAM-B) antigens by a'n enzyme-linked immunosorbent assay (ELISA), and polymerase chain reaction (PCR). A significant difference was found between the tuberculous meningitis group and control. The sensitivity and specificity of these tests in cerebrospinal fluid was 59.2% and 93.9% for PPD, 85.2% and 95.9% for LAM-B antigen, and 70.3% and 89.7% for PCR method. The ELISA method measuring IgG antibody to LAM-B in cerebrospinal fluid and PCR method were both reliable and complementary each other for early diagnosis of patient with tuberculous meningitis.
Cerebrospinal Fluid ; Diagnosis* ; Early Diagnosis ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Immunoglobulin G ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Tuberculin ; Tuberculosis, Meningeal*

We report a patient with a previously undiagnosed spine metastasis that developed into paraplegia following a continuous epidural block. This is an uncommon and quite rare complication. A 52-year-old male hepatoma case with upper abdominal cancer pain was indicated for a celiac plexus block. A continuous epidural block was performed prior to the celiac plexus block. A Tuohy needle was introduced at the Tll-12 interspace and an epidural catheter was inserted about 15cm in length cephalad through the needle. During the procedure, a saline solution was infused through the Tuohy needle and epidural catheter. The tip of the catheter was expected to be near the T, level. The upper abdominal pain was subsided after the injection of 3 ml of 1% lidocaine and 3 ml of 0.5% bupivacaine via the epidural catheter around noon time. When we made ward rounds that evening, the patient complained of motor weakness and sensory change below T; however, the local anesthetics were injected continuously through the epidural catheter every 4 hours. Next morning, because the patient complained of paraplegia, the epidural injection was discontinued. Under the suspicion of spinal cord compression, a computed tomogram of the thoracic spine was taken. It showed an osteolytic destruction of the right pedicle of T, due to a metastatic tumor. This suggested subclinical tumor invasion to the epidural space. The infusion of saline and local anesthetics through the Tuohy needle and the epidural catheter may increase the epidural pressure and compress the spinal cord. A laminectomy was refused by the family and the patient was discharged from the hospital after 6 treatments of radiotherapy without any improvement. It is advisable to take a spine CT or bone acan in terminal cancer patients before an epidural block, and when paraplegia develops after an epidural block.
Abdominal Pain ; Anesthetics, Local ; Bupivacaine ; Carcinoma, Hepatocellular* ; Catheters ; Celiac Plexus ; Epidural Space ; Humans ; Injections, Epidural ; Laminectomy ; Lidocaine ; Male ; Middle Aged ; Needles ; Neoplasm Metastasis* ; Paraplegia* ; Radiotherapy ; Sodium Chloride ; Spinal Cord ; Spinal Cord Compression ; Spine*

With the aim of gaining more insight into the catecholaminergic system in the nervous system of the rat, we have studied the precise distribution pattern of the tyrosine hydroxylase immunoreactive[TH-IR] fibers and soma in the spinal cord and dorsal root ganglion. In the dorsal root ganglion[DRG], TH-IR fibers were observed to run along the vessel wall, spirally and not found in the neural tissue itself. A few TH-IR fibers were found in the spinal nerve, not in the ventral root. Many TH-IR neurons were distributed in the L3, 4, 5, and 6 DRG but none of them were found in the other DRG segments. In the spinal cord, TH-IR fibers have shown sparse distribution all over spinal cord but relatively dense distribution in the ventral horn, intermediolateral column, lamina I of the dorsal horn of the cervical, lumbar, sacral, and coccygeal segment. TH-IR neurons were found in the intermediolateral column, dorsal gray commissure, dorsal horn of the C1 and C2 segments and S1-4 segments. TH-IR neurons in the cervical segments were polygonal and spindle shaped with well developed processes. In contrast to this, TH-IR neurons in the sacral segments were oval or spindle shaped with no processes. In conclusion, neurons in the DRG were not influenced by catecholaminergic nervous input. Intrinsic catecholaminergic nervous systems were found in both of spinal cord and DRG.
Animals ; Carisoprodol ; Diagnosis-Related Groups ; Ganglia, Spinal* ; Horns ; Immunohistochemistry ; Nervous System ; Neurons ; Rats* ; Spinal Cord* ; Spinal Nerve Roots* ; Spinal Nerves ; Tyrosine 3-Monooxygenase ; Tyrosine*

We present a case of Aspergillus septic hip arthritis in an immunocompetent patient with undiagnosed recurrent pulmonary aspergillosis who underwent arthroscopic surgery. Biopsy specimens of synovium revealed fungal hyphae, confirming Aspergillus infection. Aspergillus septic hip arthritis can occur in immunocompetent patients, and arthroscopy can be a noninvasive surgical option in these cases.
Arthritis ; Arthritis, Infectious* ; Arthroscopy ; Aspergillus* ; Biopsy ; Female* ; Hip* ; Humans ; Hyphae ; Pulmonary Aspergillosis* ; Synovial Membrane

Primary fixation is one of the most important factor in establishing adequate osseointegration between implant and bone. To evaluate the initial healing response of bone around implants without primary bone contact, this study was designed to create considerable space between implant and bone in 5 mongrel dogs, about l-year old. After 3 holes of 6 . h in diameter were prepared at the femur neck of the dogs, commercially pure titanium thread type implants(STERI-OSS^(R)), 8mm in length and 3.8mm, 5.0mm and 6 .0mm in diameter, were inserted. Implants were supported by only nonresorbable membrane(Teflon^(R)), and the penetration of upper soft tissue into the gap was inhibited by it. The each implant was positioned in the center of the drilled hole. 9 implants with different diameters were inserted in 3 dogs for histologic observation, and 12 were inserted in 2 dogs for mobility test and removal torque test. Fluorescent dyes were injected in order of Doxycycline, Arizarin Red S, and Calcein at intervals of 2 weeks. At 4-,8-, and 12-week after placement, 3 dogs were sacrificed for histologic observation, and at 8- and 12-week after placement, 2 dogs were sacrificed for mobility test using Periotest^(R) (Simens AG, Bensheim, Germany) and torque test using Autograph AGS-1000D series^(R)(Japan). The result were as follows: 1. The wider the gap between bone and implant was, the less bone maturity was, and the later osseointegration was occurred. Trabecular direction of new bone around implant was changed from parallel to perpendicular to the implant, and the gap was filled with new bone, over time. 2. There was a decreasing tendency over time in the mobility of all implants, but the wider gap between bone and implant was, the smaller decrease of the mobility was. 3. There was a increasing tendency over time in the removal torque gauge of all implants, and the wider gap was, the smaller increase of the removal torque gauge was. The results suggest that osseointegration in case of implant without primary bone contact may be obtained by guided bone regeneration technique with prolonged healing period, but the time of second surgery should be considered carefully.
Animals ; Bone Regeneration ; Dogs ; Doxycycline ; Femur Neck ; Fluorescent Dyes ; Osseointegration ; Titanium* ; Torque