Conjunctivo-dacryocystorhinostomy with the Jones tube has been commonly performed for the management of common canaliculi obstruction. However this procedure necessitates a long-term follow-up because of numerous potential complications. So the authors attempted common canaliculo-dacryocystorhinostomy with silicone tube intubation and the surgical outcomes were evaluated. Common canaliculo- dacryocystorhinostomy with silicone tube intubation was performed in 15 patients, 18 eyes. The patients presented with lacrimal sac mucocele, previous dacryocystectomy or unknown etiology. In 9 eyes 0.04% mitomycin C drops were applied for 1 week postoperatively. After a follow-up period of 6 months to 29 months, 16 eyes (88.9%) of 18 eyes were patent on lacrimal irrigation and 15 eyes (83.3%) showed relief of epiphora. In all of the 9 eyes who had applied mitomycin C showed patency and 7 of the remaining 9 eyes who had not applied mitomycin C showed patency on lacrimal irrigation. As the above results show common canaliculo- dacryocystorhinostomy is an effective method in the management of common canaliculi obstruction and the application of mitomycin C can improve surgical success.
Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Intubation ; Lacrimal Apparatus Diseases ; Mitomycin ; Mucocele ; Silicones

We analyzed the results of 5.0mm and 6.0mm ablation diameter in excimer laser photorefractive keratectomy using the same excimer laser (Aesculap-Meditec, MEL 60, Germany) In 5.0mm ablation diameter group, forty one eyes of thirty five patients were operated from March 1994 to February 1995 and in 6.0mm ablation diameter group, thirty eyes of twenty three patients were operated from July 1995 to December 1995. All were followed for at least 6 months and analyzed by retrospective method. Refractive change, naked visual acuity, corneal haze and night vision difficulties were measured at 1, 3, and 6 months postoperatively. In eyes treated with 6.0mm ablation diameter, the initial hyperopic shift was reduced with significant differences at 1 and 3 months (p<.01). In measurements of naked visual acuity and corneal haze, the results of 6.0mm zone were better than 5.0mm zone but the differences did not reach the statistical significance (p>.05). The subjective symptoms of night vision difficulty were significantly lower in the 6.0mm treatment group at 1 and 3 months (p=0. 0067, p=0.02). In conclusion, treatment with 6.0mm ablation diameter made less initial hyperopic shift and reduction of side effects in comparison with 5.0mm ablation diameter.
Humans ; Lasers, Excimer* ; Myopia ; Night Vision ; Photorefractive Keratectomy* ; Retrospective Studies ; Visual Acuity

BACKGROUND: Advising lifestyle modification to patients suffering from hypertension is important. However, how strictly hypertensive patients in korea are adherent to non-pharmacologic recommendation has not been well known. This study was performed to determine the compliance of hypertensive patients to the recommendation for life style modification and to find out on factors related to compliance. METHODS: Ninety-six patients, diagnosed as hypertensives between November 1997 and April 1998 in the Department of Family Medicine, Samsung Medical Center were educated on lifestyle modifications by their physicians during routine outpatient consult questionnaires inquiring of demographic and clinical characteristics, and health habits were Self administered done before and after the education. Blood pressure, height, and weight were measured repeatedly. The relationships between various characteristics and the compliance with lifestyle modification and follow-up visits were evaluated using Chi-square test and multiple logistic regression analysis. RESULTS: Among 96 patients, 47 patients (49.0%) attended for regular check-up two months after being diagnosed as hypertension. Being prescribed with antihypertensive agent, non-smoking, and doing regular exercise were the significant factors related to higher compliance with regular check-up. A total of 19 patients (40.4%) among 47 patients who have attended for regular check-up were adherent to the recommendation for modification of one or more health habits. The proportion of patients doing regular exercise increased significantly after education. Although 15 patients(53.6%) among 28 patients whose body mass indices were over 25 kg/m2 reported that they had made efforts to reduce body weight, no significant differences were observed in the change of body mass index between patients who reported their efforts for reducing body weight and those who did not. There was no association between various characteristics and compliance with lifestyle modification. CONCLUSIONS: Low compliance with recommendation for lifestyle modification during routine outpatient consultation and no association between various clinical and demographic characteristics and patient compliance suggests the necessity of developing special program and its active application to all hypertensive patients.
Blood Pressure ; Body Mass Index ; Body Weight ; Compliance* ; Education ; Follow-Up Studies ; Humans ; Hypertension* ; Korea ; Life Style* ; Logistic Models ; Outpatients ; Patient Compliance ; Surveys and Questionnaires

PURPOSE: The supply of donor organs does not meet the demand of transplantation. To find a possible way of expanding the donor pool, we have evaluated the risk factors of cadaveric donors that influence the graft survival. METHODS: Between Feb. 1995 and Dec. 1999, we performed 200 cases of cadaveric kidney transplantation. The graft survival rates in 1 yr, 2 yr, & 3 yr are 93.0%, 91.1%, & 89.9%, respectively. We defined the marginal donor as a donor who possesses one of the risk factors of donor age > or = 50, or < or =5 year old (n=18), ICU stay > or =10 days (n=46), history of hypertension (n=30), CPR > or =20 min (n=7), prolonged hypotension (SBP < or =80 mmHg, over 6 hr) (n=40), high dose inotropic support (dopamine > or =20microgram/kg/min, or dobutamine > or =15microgram/kg/min) (n=78), serum creatinine level > or =2.5 mg/dl (n=16), or cold ischemic time > or =12 hr (n=34). We compared graft survival rates between the marginal donor group and the non-marginal donor group, and analyzed risk factors affecting graft survival by univariate and multivariate methods. RESULTS: CPR > or =20 min (71.5%, 71.5%, - vs 93.8%, 91.8%, 90.6%, p=0.027), prolonged hypotension (85.0%, 85.0%, 80.3% vs 95.0%, 92.6%, 92.6%, p=0.028) and serum creatinine > or =2.5 mg/dl (75.0%, 75.0%, 75.0% vs 94.6%, 92.4%, 91.0%, p=0.001) affect graft survival in univariate analysis. There is, However, no risk factor that affects graft survival in multivariate analysis. CONCLUSION: We can increase the supply of donor organs for kidney transplantation by the selective use of high-risk cadaver donor. However, a prospective randomized study including recipient factors is needed to define the acceptable conditions better.
Risk Factors

The hyperosmotic stimulus is regarded as a mechanical factor for bone remodeling. However, whether the hyperosmotic stimulus affects 1alpha, 25-dihydroxyvitamin D3 (1alpha,25(OH)2D3)-induced osteoclastogenesis is not clear. In the present study, the effect of the hyperosmotic stimulus on 1alpha,25(OH)2D3-induced osteoclastogenesis was investigated in an osteoblast-preosteoclast co-culture system. Serial doses of sucrose were applied as a mechanical force. These hyperosmotic stimuli significantly evoked a reduced number of 1alpha,25(OH)2D3-induced tartrate-resistant acid phosphatase-positive multinucleated cells and 1alpha,25(OH)2D3-induced bone-resorbing pit area in a co-culture system. In osteoblastic cells, receptor activator of nuclear factor kappaB ligand (RANKL) and Runx2 expressions were down-regulated in response to 1alpha,25(OH)2D3. Knockdown of Runx2 inhibited 1alpha,25(OH)2D3-induced RANKL expression in osteoblastic cells. Finally, the hyperosmotic stimulus induced the overexpression of TonEBP in osteoblastic cells. These results suggest that hyperosmolarity leads to the down-regulation of 1alpha,25(OH)2D3-induced osteoclastogenesis, suppressing Runx2 and RANKL expression due to the TonEBP overexpression in osteoblastic cells.
Bone Remodeling ; Coculture Techniques ; Down-Regulation ; Osteoblasts ; RANK Ligand ; Sucrose