Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.
Rotator Cuff* ; Superficial Back Muscles* ; Tears* ; Tendon Transfer* ; Tendons*

This study was performed to know effectiveness and safety of cadaveric lyophilized dura mater grafts(Lyodura, B.Braun Melsungen, Germany) to cover glaucoma implant tube. Tewnty-seven eyes of 25 patients who underwent glaucoma implant surgery between April 1996 and September 1997 received a lyophilized dura mater patch graft to cover the subconjunctival portion of the tube and then followed up for clinical signs. The mean follow up visit was 10.3 months (range: 5-18 months). All eyes tolerated the lyophilized dura mater grafts well without clinical signs of graft related conjunctival, scleral, of intraocular inflammation. And no conjunctival erosion or melting of the graft was observed. The result of this study suggests that preserved dura mater is maybe a reasonable alternative to eye bank sclera for use in glaucoma implant surgery.
Cadaver ; Dura Mater* ; Eye Banks ; Follow-Up Studies ; Freezing ; Glaucoma* ; Humans ; Inflammation ; Sclera ; Transplants*

PURPOSE: Primary cutaneous adenoid cystic carcinoma(PCACC) is a very rare malignant tumor originating from the eccrine glands of skin and 39 cases have been reported in the world literature. We report PCACC on the lower lid with metastasis to the lung and brain. METHOD: 56 years old man visited because of hard mass on left lower lid which developed 18 months ago. On punch biopsy the mass showed malignant nature and it was removed by wedge resection method with clear margin. RESULT: Adenoid cystic carcinoma was diagnosed by histologic exam of removed mass and it was diagnosed PCACC because salivary gland region is normal and systemic exam shows no abnormality. After 2 years 10 months recurrent tumor developed on medial lower lid and zygomatic area. We tried to remove mass totally but it failed. Metastases to lung and brain developed.
Adenoids* ; Biopsy ; Brain ; Carcinoma, Adenoid Cystic* ; Eccrine Glands ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Salivary Glands ; Skin

To study the relationship between the corneal erosion by inverted eyelash and the degree of astigmatism and visual acuity, we reviewed the surgical recorders of epiblepharon children. We classified 106 eyes of 53 children as 3 groups according to the area of corneal erosion(grade I:confined below pupil, grade II:involving pupil partially, grade III:involving pupil totally). We examined uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and noncycloplegic auto-refraction test before and 1 month after surgery. Mean UCVA was increased from 0.61 before surgery to 0.71 after surgery and mean BCVA was increased from 0.82 to 0.89 and the differences were stastically significant(p<0.05). Mean astigmatism was decreased from 1.28 diopter(D)to 1.19 D 1 month after surgery(p>0.05). The degree of visual improvement and astigmatic decrease was similar in 3 groups. In conclusion in epiblepharon children the visual acuity was poor more likely due to corneal erosion itself than due to refractive error like astigmatism. In epiblepharon children with-the-rule astigmatism was more prevalent than in normal children before and after the surgery.
Astigmatism* ; Child* ; Humans ; Pupil ; Refractive Errors ; Visual Acuity*

The most serious problem of ruptured hepatocellular carcinoma (HCC) is the difficulty to achieve curative resection due to unplanned emergency operations, the hemodynamic instability, the frequent intrahepatic recurrence and the peritoneal seeding after resection for primary ruptured hepatocelluar carcinoma. Recent articles have suggested that well planned elective hepatic resection after hemodynamic stabilization of a ruptured HCC patient has a good prognosis, and repeat hepatic resection of recurred HCC has good prognosis when the liver function is good. We report here on patient who survived a long time with recurred HCC after 3 bouts of repeated hepatic resection for intrahepatic recurrences and 1 bout of right hemicolectomy for an omental recurrence. (ED note: now it shows good.)
Carcinoma, Hepatocellular ; Emergencies ; Hemodynamics ; Humans ; Liver ; Prognosis ; Recurrence*

OBJECTIVES: Protein-calorie malnutrition has been shown to be prevalent among patients on chronic dialysis, And assessment of nutritional status of continuous ambulatory peritoneal dialysis(CAPD) patients has assumed greater importance because of the association of protein-calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling and cretinine clearance in CAPD patients. METHODS: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 82CAPD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling and creatinine clearance with the other parameters of nutritional status. RESULTS: The malnutrition index classified 47(57%) patients as normal, 30(37%) intermediately malnourished, and 5(6%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle area (MAMA), duration of CAPD, subjective symptoms, serum albumin, transferrin, cholesterol, and triglyceride. The malnutrition index also showed a significant correlation with residual renal function(RRF), and standardized creatinine clearance(SCCr). The TWR-Kt/V(total Kt/Vurea per week with consideration of residual renal urea clearance) was significantly lower in the severely malnourished group than in the normal group. Serum alkaline phosphatase and BUN levels were higher in the severely malnourished group than in the normal and inter-mediate groups. CONCLUSION: In assessing the nutrition status of CAPD patients, body weight, TSF, MAC, MAMA, subjective symptoms, serum albumin, transferrin, cholesterol, triglyceride, urea nitrogen, and alkaline phosphatase were considered useful parameters. There was a trend of increased BUN and decreased TWR-Kt/V in severely malnourished patients, and the value of SCCr was significantly lower in malnourished patients. However, no meaningful relationships between TW-Kt/V and malnutrition index or between NPCR(normalized protein catabolic rate) and malnutrition index were found m this cross-sectional study. As the number of patients with longer duration of CAPD or negligible RRF has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and SCCr, may be helpful to assess dialysis adequacy to keep good nutritional status of each CAPD patient.
Alkaline Phosphatase ; Anthropometry ; Body Weight ; Chemistry ; Cholesterol ; Creatinine* ; Cross-Sectional Studies ; Dialysis ; Humans ; Incidence ; Malnutrition ; Mortality ; Nitrogen ; Nutritional Status ; Peritoneal Dialysis, Continuous Ambulatory* ; Protein-Energy Malnutrition ; Serum Albumin ; Transferrin ; Triglycerides ; Urea*

A double gallbladder is a condition that arises during the fetal period due to the abnormal differentiation of presumptive gallbladder cells, which causes two separate gallbladders, each with their own cystic duct. Most cases are diagnosed incidentally during surgery. Detailed preoperative investigations (ultrasound, oral cholecystography, intravenous cholangiography, CT, ERCP and MRCP) are required for an accurate preoperative diagnosis before considering a cholecystectomy to avoid inadvertent damage to the biliary ductal system and to overlook the second gallbladder during surgery. A total cholecystectomy, with removal of both gallbladders, should be the appropriate treatment for a double gallbladder to avoid complications and a reoperation. We report a patient with an accessory gallbladder, originating from right hepatic duct, and also discuss the characeristics of this rare anomaly.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystography ; Cystic Duct ; Diagnosis ; Gallbladder* ; Hepatic Duct, Common* ; Humans ; Reoperation

PURPOSE: Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric DNA onto the ends of chromosomes, thereby preventing the replication-dependent shortening of those ends. This enzyme is essential for stability of eukaryotic chromosomes and may be necessary for cell immortalization. Telomerase activity is detected in a wide range of cancers of various tissues, and its expression may be a critical step in tumor progression. METHODS: The telomerase activity was measured using a telomeric repeat amplification protocol (TRAP) assay in 65 cases of breast cancers, 9 cases of fibroadenomas, and 7 cases of normal breast tissues. To compare the telomerase activity with cell cycle regulators, we measured the expression of the cyclin D1 and the p53 proteins by using immunohistochemical analysis. To compare the telomerase activity with traditional prognostic indicators, we measured the ER, PR, c-erbB-2 and ki-67 expression by using immunohistochemical analysis. Disease-free survival and overall survival in relation to telomerase activity were studied by using the Kaplan-Meier method. RESULTS: Telomerase activity was detected in 42 (64.6%) of the 65 breast cancers, 4 (44.4%) of the 9 fibroadenomas, and in none of the 7 normal breast tissues. There was no significant relationship between telomerase activity and cell cycle regulators such as cyclin D1 or p53. There was no statistical correlation between telomerase activity and tumor size, lymph nodal status, or histopathological prognostic parameters, such as ER, PR, p53, c-erbB-2 and ki-67, but a significant correlation was found (p=0.006) between telomerase activity and histologic grade. The telomerase activity was not significantly correlated with either the overall survival or the disease-free survival. CONCLUSION: These results suggest that telomerasemay play a role in the malignant transformation of breast tissue and that this enzyme was more activated in cancers of a poor histologic grade. However, the telomerase activity was not related to cell cycle regulators and traditional prognostic parameters. The possible significance of telomerase activity in breast cancer remains open to further investigation.
Breast Neoplasms* ; Breast* ; Cell Cycle* ; Cyclin D1 ; Disease-Free Survival ; DNA ; Fibroadenoma ; Ribonucleoproteins ; Telomerase*

Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.
Rotator Cuff ; Superficial Back Muscles ; Tears ; Tendon Transfer ; Tendons

This study examined the anti-diabetic effects of aqueous extracts of Dendropanax morbifera leaves (DMWEs) in streptozotocin-induced diabetic Sprague-Dawley (SD) rats. Thirty male SD rats (body weight [BW], 250.4 ± 19.7 g) were divided into the following six groups: normal control rats (NC), diabetic control rats (DC), diabetic rats treated with metformin HCl 100 mg/kg BW (DT), diabetic rats treated with DMWEs 50 mg/kg BW (DM-50), diabetic rats treated with DMWEs 100 mg/kg BW (DM-100), and diabetic rats treated with DMWEs 200 mg/kg BW (DM-200). From two weeks of administration of DMWEs, the BW of all groups treated with DMWEs increased significantly compared to DC (p < 0.05). At four weeks after treatment, the blood glucose levels in DT, DM-100, and DM-200 decreased below 200 mg/dL, while the glycated hemoglobin concentrations in all groups administered DMWEs were similar to those of NC and DT. Regarding the blood biochemical parameters, the levels of aspartate transaminase, alanine transaminase, blood urea nitrogen, and creatinine in DM-100 and DM-200 were similar to those in NC and DT. Overall, these results highlight the effectiveness of DM-100 in the treatment of diabetes.