Thelazia callipaeda was first described by Railliet and Henry in 1910. The first human case was reported by Stuckey in 1917, who extracted four worms in the eye of a coolie in Peiping. In Korea, seven cases of human thelaziasis have been already reported and all of the worms were identified to be thelazia callipaeda. The present paper is to report the 8th human infested case of Thelazia callipaeda in Korea. The patient was 25 years old virgin who had lived in Seoul since birth. She experienced lacrimation and moving foreign body sensation of the left eye, and extracted 1 living worm from the left eye by herself on one day prior to examination. Microscopic measurements of an extracted worm are as follows; A worm(male) is 13.0 mm B worm(male) is 13.1 mm and C worm(female) is 19.0 mm in length. It was confirmed as Thelazia callipaeda Railliet et Henry 1910.
Adult ; Foreign Bodies ; Humans* ; Korea* ; Parturition ; Sensation ; Seoul ; Thelazioidea

No abstract available.
Krukenberg Tumor*

OBJECTIVE: The use of decompressive craniectomy for treating massive cerebral infarction is attracting much attention because conventional medical treatment is associated with high mortality. The aim of this retrospective study was to evaluate the surgical treatment results and prognostic factors for patients suffering with malignant cerebral infarction. METHODS: We analyzed 9 consecutive patients who underwent decompressive craniectomy with or without temporal lobectomy after malignant cerebral infarction from 2000 to 2008. We reviewed the medical records, the radiological finding and the pre-operative clinical assessment using the Glasgow Coma scale (GCS). The postoperative functional outcome was assessed as the Barthel-Index (BI) and the modified Rankin scale (mRS). RESULTS: The male to female ratio was 3.5:1. The mean age was 50 years (range: 36-68). Eight patients (89%) showed involvement of the entire middle cerebral artery (MCA) territory and the concomitant anterior cerebral artery (ACA) or posterior cerebral artery (PCA) territory. The preoperative mean GCS was 8.3 (range: 5-12) and the mean time to surgery after the onset of symptoms was 47.7 hours (range: 4-168 hours). All the patients underwent decompressive craniectomy and duroplasty. Among them, four patients (45%) underwent temporal lobectomy. The mean followup period was 7.3 months (range: 1-26 months) and five patients died within this period. CONCLUSION: Decompressive craniectomy with or without lobectomy for patients with malignant cerebral infarction decreases the mortality rate and it improves the functional outcome. In the survived group, comparison of the two surgical modalities didn't show any statistically significant difference. However, the decompressive craniectomy with lobectomy group demonstrated a high survival rate (75%). Future studies are needed to investigate the proper treatment modalities for malignant cerebral infarction.
Anterior Cerebral Artery ; Cerebral Infarction ; Decompressive Craniectomy ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Humans ; Male ; Medical Records ; Middle Cerebral Artery ; Posterior Cerebral Artery ; Retrospective Studies ; Stress, Psychological ; Survival Rate

Human papillomavirus(HPV) has been implicated in the development of uterine cervical cancer. Detectioe of the small amounts of HPV DNA in cervical cells has been very difficult. The polymerase chain reaction(PCR) is a new technique that can specifically amplify target DNA to facilitate its detectiion. PCR technique wes used to detect HPV types 16 and 18 in cervical specimeas obtained from nnormal cervix(20 cases), dysplasia(25 cses), carcinoma in situ(21 cases), microinvasive cancer(ll cases), and invasive cancer(46 cases). And then, case of invasive carcinoma of the uterine cervix were analyzed to determine that the presence of specific human papillomavirus DNA in the neoplasm was a contributing factor to their outcome. The detection rate of HPV 16 DNA in normnal cervix, dysplasia, ClS, microinvasive cancer, and invasive squamous cell carcinoma were 50.0%, 36.0%, 81.0%, 45.5%, and 58.7%, respectively. The detection rate of HPV 18 DNA in normal cervix, dysplasia, CIS, microinvasive cancer, and invasive squamous cell carcinoma were 0.0%, 8,0%, 4.8%, 0.0%, and 19.6%, respectively. of the factors evaluated in invasive cervical cancer, adenocarcinomatous component(p= 0.004) and tumor grade(p=0.015) were found to be correlated with HPV l8 infection. 5 of 8 women whose tumors contained glandular elements had HPV 18 DNA, whereas only 4 of 38 women whose tumors contained only squamous elements showed this infection. 6 of 9 women of HPV l8 infected tumors were grade 3 tumors as compared to only 7 of 28 of HPV 16 infected tumors. Age at diagnosis and nodal status in relation to HPV type 18 exhibited a trend but were not statisitically significant. These observations suggest that HPV type 18 may be associated with a more aggressive form of cervical cancer than HPV type 16.
Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; DNA ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Polymerase Chain Reaction* ; Uterine Cervical Neoplasms*

PURPOSE: To determine the incidence of and the systemic risk factors for postoperative vitreous hemor-rhage(PVH). METHOD: The records of 503 consecutive diabetic vitrectomy cases were reviewed. RESULT: Eighty-seven eyes(17.3%) had at least one episode of PVH. Sixty-five eyes(12.9%) had PVH within 3 months after vitrectomy, and the mean onset time of the first episode of PVH was about 13 weeks after vitrectomy. The mean follow-up period was 17.2 months in non-hemorrhage group, and 21.9 months in hemorrhage group. While 34 eyes(29.6%) had spontaneous absorption of blood, 42 eyes(36.5%) required air(or gas)-fluid exchange and 39 eyes(33.9%) vitreous cavity lavage. Using univariate analysis, the factors associated with increased incidence of PVH include type 1 diabetes mellitus(p=0.01), method of glycemia control(p=0.02), anemia(p=0.04), and hypercholesterolemia(p=0.005). Multivariate analysis revealed diabetic nephropathy(p=0.02) and hypercholesterolemia(p=0.01) were the risk factors. Five eyes(1.0%) lost light perception, 7 eyes(1.4%) had rhegmatogenous retinal detachment, and 11 eyes(2.2%) had neovascular glaucoma. CONCLUSION: Vitreous hemorrhage after diabetic vitrectomy occurred in the 17.3%, three quarters of them within 3 months. About one third had spontaneous clearing, and two-thirds required reoperation. Diabetic nephropathy and hypercholesterolemia were the systemic risk factors of vitreous hemorrhage after diabetic vitrectomy.
Absorption ; Diabetic Nephropathies ; Follow-Up Studies ; Glaucoma, Neovascular ; Hemorrhage ; Hypercholesterolemia ; Incidence ; Multivariate Analysis ; Reoperation ; Retinal Detachment ; Risk Factors* ; Therapeutic Irrigation ; Vitrectomy* ; Vitreous Hemorrhage*

BACKGROUND: GreenMono (R) is a plasma-derived factor VIII concentrate produced by Greencross PD based on a license of Baxters monoclonal antibody technology. The purpose of this prospective study was to document the pharmacokinetics and the acute safety of the drug. METHODS: Pharmacokinetic analysis was performed in 13 previously treated patients with hemophilia A after administration of GreenMono (R) with dose of 50units/kg. The adverse effects were observed, and changes of laboratory tests, including complete blood counts, liver and kidney function tests, urinalysis, were assessed 48 hours after the drug administration. Bethesda assay for inhibitors to factor VIII were performed on 3-7 days. RESULTS: The recovery rate of GreenMono (R) was 99+-22% (range, 71~136%), and plasma beta half life analysed by 2-compartment model was 15.7+-6.6 hours (range, 9.7~35.9 hours). No clinically significant immediate adverse effects were observed after administration of GreenMono (R). No significant change in laboratory tests were observed after administration of GreenMono (R). Inhibitors to factor VIII were maintained below 0.6 BU. CONCLUSION: GreenMono (R) is effective in pharmacokinetic analysis, and is safe without any immediate adverse effect.
Blood Cell Count ; Factor VIII* ; Half-Life ; Hemophilia A* ; Humans ; Kidney Function Tests ; Licensure ; Liver ; Pharmacokinetics* ; Plasma ; Prospective Studies* ; Urinalysis

Hepatic portal venous gas (HPVG) is a rare radiographic finding associated with severe intra-abdominal disease and fatal outcome. Most cases of HPVG are historically related to mesenteric ischemia accompanied by bowel necrosis. The current spread of computed tomography scan promotes not only the early detection of related severe diseases but also the identification of other causes of HPVG. It has been reported in many non-fatal conditions, such as inflammatory bowel disease, intra-abdominal abscess, bowel obstruction, paralytic ileus, endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, and gastric dilatation. Among these, paralytic ileus is a very rare condition, with no case yet reported in South Korea. Reported herein is a case of HPVG in paralytic ileus, which was treated well internally and was promptly resolved.
Abdominal Abscess ; Cholangiopancreatography, Endoscopic Retrograde ; Fatal Outcome ; Gastric Dilatation ; Ileus ; Inflammatory Bowel Diseases ; Intestinal Pseudo-Obstruction* ; Ischemia ; Korea ; Mesenteric Veins ; Necrosis ; Portal Vein ; Sphincterotomy, Endoscopic

Background :The incidence of gastroesophageal reflux disease(GERD)is increasing recently, but medical management for GERD has many limitations.Therefore,variable surgical treatments have been introduced. MATERIAL AND METHOD: A retrospective study was done in 10 patients who underwent the Belsey Mark IV operation at Korea university Guro hospital between 1996 and 2001.Preoperative diagnoses were hiatal hernia with gasroesophageal reflux in 8 patients and achalasia in 2 patients. RESULT: Mean age of the patients was 54.3 +/- 19.0 years.Belsey Mark IV operation was performed on patients where preoperative medical failed and mean hospital days were 13.1 +/- 2.6 days.We routinely practiced follow-up endoscopy on postoperative 3rd,6th,9th,and 12th months.After remission for reflux and esophagitis,they were transferred to internal medicine department.Six patients of hiatal hernia with reflux (one patient who lost follow-up and the other patient who didn't practice the follow-up endoscopy due to short postoperative follow-up period were excluded)had lowered endoscopic gradings and two patients of achalasia did not complained of reflux symptoms,postoperatively.We experienced 10%operation failure rate. CONCLUSION: We experienced satisfactory operation results with Belsey Mark IV in hiatal hernia with GERD and achalasia patients.
Diagnosis ; Endoscopy ; Esophageal Achalasia* ; Follow-Up Studies ; Gastroesophageal Reflux* ; Hernia, Hiatal* ; Humans ; Incidence ; Internal Medicine ; Korea ; Retrospective Studies

PURPOSE: Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. This study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. MATERIALS AND METHODS: A total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The point A dose from the HDR brachytherapy was 28 Gy to 30 Gy (4 Gyx7, or 5 Gyx6). The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months (12~86 months). RESULTS: The incidence of rectal bleeding was 12.7% (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was 8.5%. Most complications (92.6%) developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding : an icruCRBED greater than 100 Gy (19.7% vs. 4.2%), an EBRT dose to the parametrium over 55 Gy (22.1% vs. 5.1%) and higher stages of III and IV (31.8% vs. 10.5%). In the multivariate analysis, the icruCRBED was the only significant factor (p>0.0432). The total parametrial dose from the EBRT had borderline significance (p=0.0546). Grade 1 bleeding was controlled without further management (3 patients), or with sucralfate enema 1 to 2 months after treatment. For grade 2 bleeding, sucralfate enema for 1 to 2 months reduced the frequency or amount of bleeding but for residual bleeding, additional coagulation was performed, where immediate cessation of bleeding was achieved (symptom duration of 3 to 10 months). Grade 3 bleeding lasted for 1 year even with multiple transfusions and coagulations. CONCLUSION: Moderate and severe rectal bleeding occurred in 8.5% of patients, which is comparable with other reports. The most significant risk factor for rectal bleeding was the accumulated dose to the rectum (icruCRBED), which corrected with consideration to biological equivalence. Prompt management of rectal bleeding, with a combination of sucralfate enema and coagulation, reduced the duration of the symptom, and minimized the anxiety/discomfort of patients.
Appointments and Schedules ; Barium ; Brachytherapy ; Cervix Uteri* ; Enema ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Multivariate Analysis ; Radiotherapy ; Rectal Fistula ; Rectum ; Risk Factors ; Sucralfate ; Uterine Cervical Neoplasms*

STUDY DESIGN: Experimental animal study OBJECTIVES: To examine the ability of human umbilical cord blood (hUCB) stem cells to target a zone of injury and to determine the efficacy of hUCB cells to ameliorate the behavioral deficits after a hUCB cell infusion in paralyzed rats. SUMMARY OF LITERTURE: Many groups have investigated the use of stem cells as potential treatments for a CNS injury. hUCB cells have recently been reported to alleviate the behavioral consequences of a stroke injury. MATERIALS AND METHODS: Thirty Sprague Dawley rats were divided into 6 groups (Gr) (Gr 1. SCI (spinal cord injury) + hUCB delivered at one day postinjury, Gr 2. SCI + hUCB delivered at 3 days postinjury, Gr 3. SCI + hUCB delivered at 5 days postinjury, Gr 4. laminectomy + hUCB, Gr 5. SCI only, Gr 6. Laminectomy only). SCI was produced by compressing the spinal cord to the level of the 8-9th thoracic spine for 1 minute with an aneurysm clip that was calibrated to a closing pressure of 50 gms. The hUCB cells (0.5 ml, 1.5x106) were administered intravenously to the rats. The rat was assessed behaviorally at one, two and three weeks using the BBB behavioral scale. Four weeks after the injury, the animals were sacrificed and the hUCB positiveresponse neural cells (mouse anti-human mitochondria monoclonal antibody=MAB 1273) at the injury level observed using optical and fluorescent microscopy. RESULTS: MAB 1273 positive cells were observed in groups 1, 2 and 3 but not in groups 4, 5 and 6. In particular, there were 870 cells distributed over an area of 1.2 mm(2) in group 3. Group 3 showed the most significant recovery over time in the open field exam, and the most improvement in another tests of incline, leg extension, and toe spread compared with group 1 (p<0.01). CONCLUSION: After infusing the hUCB stem cells to SCI rats, it was confirmed that hUCB cells migrate to an injured area and ameliorate the behavioral deficits. A hUCB infusion 5 days after the injury produced best results in terms of the number of cells and motor recovery.
Aneurysm ; Animals ; Fetal Blood* ; Humans* ; Laminectomy ; Leg ; Microscopy ; Mitochondria ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Spinal Cord Injuries ; Spine ; Stem Cells ; Stroke ; Toes ; Umbilical Cord*