Primary success rate of endonasal dacryocystorhinostomy has been reported lower than that of conventional cedure. Gradual stenosis of mucosal ostium would progress until 6 to 10 months following operation and a longterm follow-up should be necessary. Endonasal dacryocystorhinostomy was performed in 100 patients[118 eyes]between July 1993 and March 1998 at the Department of Ophthalmology, Yeungnam University College of Medicine. After the follow-up period of 1 to 4 years[average 16.2 months], longterm success rate, postoperative omplications, and factors to affect success rate were studied. The success rate of primary operation was 89.83%, and the success rate after secondary revision of the ostium was up to 99.15%. Granulation tissue formation was the most common postoperative complication, and other complications included protrusion of silicone tube, membranous obstruction, partial obstruction of common canaliculus, canaliculitis and prolapse of orbital fat. Factors to obtain good success rate were careful and acurate surgical technique to achieve large mucosal ostium, postoperative management, antibiotics and steroid medication, etc. Long-term surgical efficacy of endonasal dacryocystorhinostomy was similar to skin approach and secondary success rate following revision was very satisfactory.
Anti-Bacterial Agents ; Bezafibrate ; Constriction, Pathologic ; Dacryocystorhinostomy ; Follow-Up Studies ; Granulation Tissue ; Ophthalmology ; Orbit ; Postoperative Complications ; Prolapse ; Silicones ; Skin ; Canaliculitis

Expression of the cDNA of the VP1 gene on the genome RNA B segment of infectious pancreatic necrosis virus (IPNV) DRT strain in E. coli and a recombinant baculovirus were carried out. The VP1 gene in the peal-pol clone (Lee et al 1995) was cleaved with XbaI and transferred into baculovirus transfer vector, pBacPAK9 and it was named pBacVP1 clone. The VP1 gene in the pBacVP1 clone was double-digested with SacI and PstI and then inserted just behind 75 phage promoter and the 6x His region of the pQE-30 expression vector, and it was called pQEVP1. Again, the 6xHis-tagged VP1 DNA fragment in the pOEVPl was cleaved with EcoRl and transferred into the VP1 site of the pBacVPl, resulting pBacHis-VPl recombinant. The pBacHis-VP1 DNA was cotransfected with LacZ-Hyphantria cunea nuclear polyhedrosis virus (Lacz-HcNPV) DNA digested with Bsu361 onto S. frugiperda cells to make a recombinant virus. One VP1-gene inserted recombinant virus was selected by plaque assay, The recombinant virus was named VP1-HcNPV-1. The 6xHis-tagged VP1 protein produced by the pQEVPl was purified with Ni-NTA resin chromatography and analyzed by SDS-PAGE and Western blot analysis. The molecular weight of the VP1 protein was 94 kDa. The recombinant virus, VP1-HcNPV-1 did not form polyhedral inclusion bodies and expressed VP1 protein with 95 kDa in the infected S. frugiperda cells, which was detected by Western blot. The titer of the VP1-HcNPV-1 in the first infected cells was 2.0x10(5) pfu/ml at 7 days postinfection.
Bacteriophages ; Baculoviridae ; Blotting, Western ; Chromatography ; Clone Cells ; DNA ; DNA, Complementary ; Electrophoresis, Polyacrylamide Gel ; Genome ; Inclusion Bodies ; Infectious pancreatic necrosis virus* ; Molecular Weight ; Nucleopolyhedrovirus* ; Recombination, Genetic* ; RNA

The short term beneficial effect of arthroscopic excision of synovial tissue in knees with rheumatoid arthritis have been well documented. The purpose of this study to report the results of synovectomy in patients with rheumatoid arthritis who have been observed at least 3 years. We analysed the clinical result with modified Laurin criteria, radiologic change and patients own satisfaction degree with survey. The results were as follows; 1. The preoperative symptoms were pain (100%), swelling (100%), decreased range of motion (83%) and joint tenderness (74%), and those were improved postoperatively to 43%, 60%, 11%, 43% each other. 2. Among the laboratory parameters, C-reactive protein (CRP) was improved most significantly (pvalue =0.026). 3. On simple supine A-P X-rays, the width of medial joint space and lateral joint space were compared to preoperatively and postoperatively. The width of medial joint space was 4.33mm preoperatively, and it was changed to 3.22mm at last follow up (p=0.032). Those of lateral joint space was changed from 4.24mm preoperatively to 3.27mm at last tollow up (p=0.106). 4. The grade of articular cartilage damage was related with severity of preoperative symptoms and the patients with low grade of articular cartilage damage showed more postoperative improvement. The result of operation was related to symptom duration, degree of X-ray change and degree of cartilage damage. 5. 58% ot patients were satisfied to results of synovectomy, 28% were answered neither satisfied nor ansatisfied and 14% were unsatisf'ied to operation. We concluded the arthroscopic synovectomy of the knee joints was effective procedure to improve the clinical symptoms, range of knee motion and to alleviate the inflammatory reaction at mid-term period al'ter the operation. So we consider this procedure is a palliative treatment that modified and alleviate the progression of rheumatoid arthritis of knee joints.
Arthritis, Rheumatoid* ; C-Reactive Protein ; Cartilage ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Joints ; Knee Joint* ; Knee* ; Palliative Care ; Range of Motion, Articular

Background & Objectives: Frontal executive dysfunction, which is hypothesized to reflect dorsolateral prefrontal function, predominates in Parkinson’s disease (PD). Visuospatial dysfunction and episodic memory deficit, which are associated with the posterior cortical area, are critical symptoms of mild cognitive impairment in PD (PD-MCI). The first aim of this study is to investigate whether dominant cognitive deficits are caused by posterior cortical dysfunction in drug naïve, de novo PD-MCI patients. The second aim is to analyze the relationship between parkinsonian motor symptoms and the cognitive domain in these patients. Methods: Newly diagnosed PD patients who had not received treatment were divided into two subgroups as follows: PD-MCI (n=39) and PD patients with normal cognition (PD-NC) (n=39). Various neuropsychological tests were performed in all of the patients. The parkinsonian motor subscores were divided into tremor, rigidity, axial impairment, bulbar dysfunction and bradykinesia by the UPDRS motor scores. Results: Verbal episodic memory (immediate recall; p = 0.0001, delayed recall; p = 0.0001, recognition; p = 0.003), visual episodic memory (immediate recall; p = 0.0001, delayed recall; p = 0.002) and visuospatial function (p = 0.046) were lower in the PD-MCI group than in the PD-NC group. In the analysis of the correlation of the motor components to the cognitive tests, impairment in visual episodic memory correlated with axial symptoms (immediate recall; r = -0.441, p = 0.021, delayed recall; r = -0.393, p = 0.042). The contrast program test correlated with bradykinesia (r = -0.479, p = 0.013) Conclusion: Episodic memory and visuospatial dysfunction, which reflect impairment of the posterior cortical area, are critical cognitive deficits, and memory impairment is correlated with the axial symptoms that are associated with non-dopaminergic pathways in newly diagnosed PD-MCI patients.

Localized pigmented villonodular synovitis is a monoarticular proliferative condition that may affect any joint but is frequently found in the knee. The locaiized form was less frequent than the diffuse one. The estimated frequency of localized pigmented villonodular synovitis among patients performed an arthroscopic procedure was known one case lor each 2,500 cases. Previous reports pointed that the lower recurrence rate after the arthroscopic excision for localized form. We also experienced a case of localized pigmented viilonodular synovitis located at the posterior compartment of the knee, so we report this case with review of literatures.
Humans ; Joints ; Knee* ; Recurrence ; Synovitis ; Synovitis, Pigmented Villonodular*

The total knee arthroplasty (TKA) is now an established treatment of severe arthritis of the knee joint. The results of TKA estimate good result in mid-90% of patient. But most of assessing method was based on the evaluation methods, made by surgeons, so the patients own evaluation of success may different from the assessment of the surgeons. Especially the Korean life style is different from western style because Korean need more flexed knees for sitting position on the floor. But there no paper about patient subjective satisfactory result of Korean in the authors knowledge. So we studied the satisfactory degree about the outcome of TKA in Korean by the survey. A total 90 patients (103 cases), had undergone TKA were asked to complete a questionnaire-the questionnaire composed of question; ""are you satisfactory with operation?""and the answer; ""very satifactory, generally satisfactory, improved, no change or aggravated-about their satisfaction with the outcome of surgery. The results were as follows; 1.Of 90 patients, 90.3% were satisfied with the outcome of TKA. 2. The patints were satisfied 100% in avascular necrosis of femoral condyle, 83.8% in degenerative osteoarthritis, and 93.6% in rheumatoid arthritis. 3. The satisfactory degree had no relations with age, prevalent period, bilaterality and the evaluation period after the TKA (P>0.05). 4. There was a significant difference in knee scores between the patients who satisfied or not (P<0.05) and the satisfactory degree had a correlation with the points of knee score and amelioration rate of knee and function scores.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Humans ; Knee Joint ; Knee* ; Life Style ; Necrosis ; Osteoarthritis ; Surveys and Questionnaires

The authors describe a technique consisting of subfascial temporalis dissection and performing a pedicled bone flap in pterional craniotomy. This technique provides reliable preservation of the frontalis nerve, does not necessitate the reconstruction of the temporalis muscle at the end of the surgery, and does not compromise the operative exposure.
Craniotomy

The authors present a case of cervical syringomyelia associated with cerebellar mixed oligoastrocytoma in an 18-month-old boy who was normally delivered at full-term. The child presented with an increasing incidence of vomiting and irritability, and a poor truncal control. Preoperative magnetic resonance imaging of the brain revealed cerebellar vermian tumor with an obstructive hydrocephalus and a small-sized syringomyelia at the 6th cervical vertebral level. The tumor was completely removed via suboccipital craniectomy. Histologically, the tumor consisted of mixed oligo-astrocytoma. The cervical syringomyelia was conservatively managed with no specific operative treatment. At two months postoperatively, magnetic resonance imaging of the cervical spine showed a remarkable reduction in size of the syringomyelic cavity.
Astrocytoma ; Brain ; Cerebellar Neoplasms ; Child ; Humans ; Hydrocephalus ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Spine ; Syringomyelia* ; Vomiting

We investigated the fibrovascular ingrowth and fibrovascular tissue maturation of hydroxyapatite-coated, porous alumina sphere (Alumina sphere) in comparison with the hydroxyapatite sphere (HAp sphere) in rabbits. Alumina spheres and HAp spheres were implanted in the left orbits of 42 New Zealand white rabbits after enucleation. Fibrovascular ingrowth and maturation were graded from 1 to 5 at postoperative 1, 2, 3, 4, 8, 12 and 24 weeks. We defined 4 phases: postoperative 1-2 weeks as phase I, 3-4 weeks as phase II, 8-12 weeks as phase III, and 24 weeks as phase IV. The grade was analyzed at each phases. There was no significant difference in fibrovascular ingrowth and maturation between the two groups at all 4 phases, except phase II at which the Alumina sphere showed significantly lower maturation grade (p< 0.05). We concluded that the Alumina sphere is an ideal orbital implant material and an ideal substitute for the HAp sphere in clinical practice.
*Aluminum Oxide ; Animals ; *Coated Materials, Biocompatible ; *Durapatite ; Eye Enucleation ; Female ; Fibroblasts/cytology/physiology ; Microscopy, Electron, Scanning ; Neovascularization, Physiologic/*physiology ; *Orbital Implants ; Prosthesis Implantation ; Rabbits ; Research Support, Non-U.S. Gov't

PURPOSE: To report three cases of orbitofrontal cholesterol granuloma. METHODS: The study subjects were three patients with chief complaints of proptosis and upgaze limitation of ocular movement. Exophthalmometric values were 4~8 mm by Hertel exophthalmometer. Orbital CT and MRI scans were taken in all patients, and regarded as orbitofrontal cholesterol granuloma. In all cases, excisional biopsy was done through the lateral approach. RESULTS: Orbital CT scan showed an isodense to hypodense, well-defined, homogeneous mass and osteolytic lesion in the adjacent superolateral bony orbit. Orbital MRI scan showed a mass with high signal intensity in both T1- and T2-weighted images. Histopathologically, the specimen showed numerous slits like cholesterol clefts surrounded by multinucleated, foreign body type, giant cells with hemosiderin pigments. CONCLUSIONS: Orbitofrontal cholesterol granuloma, although rare, has typical clinical and radiologic features. Surgical excision has a high success rate without recurrence.
Biopsy