PURPOSE: To evaluate clinical results of combined phacotrabeculectomy (PHACO-TRAB) and trabeculectomy (TRAB) for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: Forty-two eyes of 42 patients with POAG and 60 eyes of 60 patients with PACG were studied retrospectively. Fifty-two patients underwent PHACO-TRAB and 50 patients underwent TRAB. The IOP, number of anti-glaucoma medications, and duration of filtering bleb survival for 3 years after surgery were compared. RESULTS: For 12 months after surgery, the TRAB group maintained significantly lower IOP than the PHACO-TRAB group (p < 0.05, t-test), and there was no significant difference thereafter. The filtering bleb survival rate was significantly higher in the TRAB group during the study period. In patients with POAG, the TRAB group showed higher filtering bleb survival rate for 3 years (p = 0.016, log-rank test). However, in patients with PACG, there was no significant difference in filtering bleb survival between the 2 groups. In patients with POAG, the TRAB group maintained significantly lower IOP for 12 months after surgery, and there was no significant difference afterwards. In patients with PACG, the TRAB group maintained lower IOP only at 1, 3, and 6 months after surgery. However, the PHACO-TRAB group showed significantly lower IOP at 18 months and 36 months after surgery. CONCLUSIONS: In patients with POAG, TRAB was more effective in lowering IOP and maintaining filtering bleb. However in patients with PACG, there was no difference in filtering bleb survival between the 2 groups. TRAB was more effective in maintaining IOP during the early period after surgery, but PHACO-TRAB was superior to TRAB beyond 1 year after surgery in patients with PACG.
Blister ; Eye ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Retrospective Studies ; Survival Rate ; Trabeculectomy

PURPOSE: To evaluate clinical results of combined phacotrabeculectomy (PHACO-TRAB) and trabeculectomy (TRAB) for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: Forty-two eyes of 42 patients with POAG and 60 eyes of 60 patients with PACG were studied retrospectively. Fifty-two patients underwent PHACO-TRAB and 50 patients underwent TRAB. The IOP, number of anti-glaucoma medications, and duration of filtering bleb survival for 3 years after surgery were compared. RESULTS: For 12 months after surgery, the TRAB group maintained significantly lower IOP than the PHACO-TRAB group (p < 0.05, t-test), and there was no significant difference thereafter. The filtering bleb survival rate was significantly higher in the TRAB group during the study period. In patients with POAG, the TRAB group showed higher filtering bleb survival rate for 3 years (p = 0.016, log-rank test). However, in patients with PACG, there was no significant difference in filtering bleb survival between the 2 groups. In patients with POAG, the TRAB group maintained significantly lower IOP for 12 months after surgery, and there was no significant difference afterwards. In patients with PACG, the TRAB group maintained lower IOP only at 1, 3, and 6 months after surgery. However, the PHACO-TRAB group showed significantly lower IOP at 18 months and 36 months after surgery. CONCLUSIONS: In patients with POAG, TRAB was more effective in lowering IOP and maintaining filtering bleb. However in patients with PACG, there was no difference in filtering bleb survival between the 2 groups. TRAB was more effective in maintaining IOP during the early period after surgery, but PHACO-TRAB was superior to TRAB beyond 1 year after surgery in patients with PACG.
Blister ; Eye ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Retrospective Studies ; Survival Rate ; Trabeculectomy

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease. Pathologic changes occurred in patients with AS result in a weakened vertebral column with increased susceptibility to fractures, even though a trivial injury. Fractures usually tends to involve the lower cervical spine, but rarely, they are also occurred in thoracolumbar spine. We present our experiences of three cases of spinal fracture in patients with AS, cervical, thoracic, and lumbar spine, with a review of literatures.
Humans ; Rheumatic Diseases ; Spinal Fractures ; Spine ; Spondylitis ; Spondylitis, Ankylosing

PURPOSE: To analyze and compare the clinical and radiologic results of treatments in unstable intertrochanteric fractures of the femur with proximal femoral nail antirotation (PFNA) and compression hip screw with trochanter stabilizing plate (CHS with TSP). MATERIALS AND METHODS: We retrospectively reviewed the results of 66 cases of unstable intertrochanteric fractures of the femur treated with PFNA (Group I) and CHS with TSP (Group II) which could be followed up for minimum a year. We evaluated several comparative factors such as operation time, blood loss, time to bone union, changes in neck-shaft angle, sliding of screw (or blade), complications, postoperative pain, social-function score of Jensen, and mobility score of Parker and Palmer. RESULTS: Group I showed shorter operation time and less blood loss with significance than group II (p<0.05), but there were no differences between the groups in the mean time to bone union, changes in neck-shaft angle, sliding of screw (or blade), complications, postoperative pain, and social-function score of Jensen (p>0.05). Two cases of cutting out of the blade through the femoral head were found in group I. One case of cutting out of the screw, one case of the breakage of the plate, and loosening of the plate were found in group II as complications. CONCLUSION: We think that there were no significant differences between PFNA and CHS with TSP in view point of radiologic and clinical outcomes in unstable intertrochanteric fractures of the femur, but PFNA is less invasive device than CHS with TSP, therefore it may be useful device in elderly patients.
Aged ; Femur ; Head ; Hip ; Hip Fractures ; Humans ; Nails ; Postoperative Complications ; Retrospective Studies

BACKGROUND: The aim of this in vitro study was to determine the effect of zoledronate, which is frequently used to treat osteoporosis, on osteoarthritis by analyzing zoledronate-induced expression of vascular endothelial growth factor-A (VEGF-A) in chondrocytes and synovial cells. METHODS: After chondrocytes and synovial cells were separated and cultured, zoledronate was added, and VEGF-A and pigment epithelium-derived factor (PEDF) expression were quantified by real-time polymerase chain reaction and Western blotting. RESULTS: There was no significant difference in the expression of VEGF-A mRNA in chondrocytes between the zoledronate group and the control group on the 8th day of culture. The expression of both VEGF-A and PEDF mRNA in synovial cells was significantly decreased in the zoledronate group (P<0.05). CONCLUSIONS: Zoledronate decreases the expression of VEGF-A in synovial cells and may affect the development and progression of osteoarthritis.
Blotting, Western ; Chondrocytes* ; Osteoarthritis ; Osteoporosis ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Vascular Endothelial Growth Factor A*

Purpose: The purpose of this study is to analyze the clinical results of patients with basicervical fractureundergoing cephalomedullary nailing (CMN) with an additional cannulated screw fixation compared to only performing CMN. We hypothesized that a difference may exist in the clinical outcomes if an ad-ditional screw is fixed with CMN compared to only performing CMN in basicervical fracture. Materials and Methods: A total of 28 consecutive patients who underwent CMN for basicervical fracture were included. In 9 cases, only CMN was conducted, and in 19 cases, an additional cannulated screw fixation was performed with CMN. Bone union, sliding distance, reduction status, and fixation failure were evaluated by postoperative radiography, and ambulatory ability was evaluated by functional results. These findings were compared between a group of CMN and a group of CMN with an additional cannulated screw. Results: There were 4 males and 24 females with a mean age of 84 years (range, 69–100 years). No significant difference was found in postoperative reduction, tip-apex distance, bone union, and walking function recovery after surgery between the two groups, but in the sliding distance of the lag screw, the CMN group demonstrated more sliding (6.2 mm [range, 2.5–13.4 mm] vs 3.5 mm [range, 0.1– 9.2 mm]; p=0.045). Among the two groups, only one case of fixation failure at the postoperative four months was observed in the CMN group (p=0.321), and hemiarthroplasty with nail construct removal was performed. Conclusion CMN with additional cannulated screw fixation is a safe and reliable surgical option in basicervical fracture. It provided favorable clinical outcomes and may be a good alternative for treating basicervical fracture.

No abstract available.
Echocardiography* ; Humans ; Mitral Valve*

A humanized monoclonal antibody against HER2 has been using in a clinical setting and has been shown to possess therapeutic properties. A mimetic peptide against HER2 was also reported to bind to the HER2 receptor with some therapeutic potential. Based on a previous report and the sequence of Herceptin, we designed oligonucleotides of anti-HER2 mimetic peptides, named V2 and V3 peptides, in order to develop a peptide- producing vector system for biologic therapy against HER2- overexpressing cancers. We also adopted the sequence of a previously reported mimetic peptide, V1 (Park BW et al. Nat. Biotechnol, 2000, 18: 194-198), as a reference peptide. We examined the effects of the V2 and V3 peptides against the HER2-overexpressing cell lines, SK-BR-3 and T6-17. Transient transfection of the construct expressing V1 and V2 inhibited cell proliferation in HER2-overexpressing cell lines by 20 - 30%, but had no effect on the HER2-negative NIH3T3 cells. The proliferation inhibition shown by V2 was slightly better than that shown by V1. Recombinant peptides V2 and V3 were produced on a large scale in an E. coli system, and the V2 peptide showed anti-HER2-specific tumor cell proliferation inhibition of 10% to 30%. Current results suggest that anti-HER2 mimetic peptides, overexpressed by a constitutive promoter or produced in an E. coli system, could specifically inhibit the proliferation of HER2-expressing cancer cells. Further efforts to augment the biologic specificity and efficacy and to develop new technologies for the purification of the peptide from the E coli system are needed.
Amino Acid Sequence ; Animals ; Cell Division/drug effects ; Cell Line ; Mice ; Oligopeptides/chemical synthesis/pharmacology ; Peptide Fragments/*chemical synthesis/*pharmacology ; Receptor, erbB-2/*chemistry ; Recombinant Proteins/chemical synthesis/pharmacology ; Support, Non-U.S. Gov't ; *Technology, Pharmaceutical ; Transfection

PURPOSE: The diagnosis of Graves' disease can be clinically made by the findings of hyperthyroidism combined with eye signs or a diffusely enlarged goiter. The pathological findings of Graves' disease are hypertrophy and hyperplasia of the thyroid follicles. Surgical treatment for Graves' disease is indicated for patients with a suspicion of cancer, a large goiter, medical failure, patient preference or severe ophthalmopathy. The aim of this study is to determine the diagnostic accuracy of clinically diagnosed Graves' disease on the basis of the postoperative pathologic findings. METHODS: We performed a retrospective analysis of the medical records of the patients who were diagnosed as having Graves' disease since Jan 2000 at St. Mary's Hospital, The Catholic University of Korea. To confirm the pathological findings in this study, the patients who underwent surgical treatment were enrolled, and their preoperative diagnostic tests were also reviewed. RESULTS: A total of 57 patients with Graves' disease underwent surgery due to medical failure in 45 (78.9%), ophthalmopathy in 25 (43.8%), huge goiter in 4 (7%), suspicion of cancer in 4 (7%), and others in 4 (7%). Thirty nine (68.4%) patients were female and total thyroidectomies were performed in 52 (91.2%) patients. The pathological reports of the thyroid specimens showed diffuse hyperplasia in 53 (92.9%), nodular hyperplasia in 2 (3.5%), Lymphocytic thyroiditis in 1 (1.8%) and Hashimoto's thyroiditis in 1 (1.8%). The diagnostic accuracy of preoperative antimicrosomal Ab, anti-TSHR Ab and a technetium 99m thyroid scan was 73.8%, 86.0% and 69.7%, respectively. Papillary carcinoma was identified in 6 patients (10.5%). CONCLUSION: The microscopic findings of 5 patients (7.0%) who were diagnosed clinically as having Graves' disease were not compatible with the criteria for a pathological diagnosis. Surgical treatment and confirmation of the exact pathology should be performed for the appropriate treatment.
Carcinoma, Papillary ; Diagnosis ; Diagnostic Tests, Routine ; Female ; Goiter ; Graves Disease* ; Humans ; Hyperplasia ; Hyperthyroidism ; Hypertrophy ; Korea ; Medical Records ; Pathology ; Patient Preference ; Retrospective Studies ; Technetium ; Thyroid Gland ; Thyroidectomy ; Thyroiditis ; Thyroiditis, Autoimmune

In immunocompromised renal transplant patients, aspergillosis can be a life-threatening opportunistic infection. Aspergillus is a ubiquitous organism in our environment, so pulmonary aspergillosis usually results from the ingrowths of the colonized Aspergillus in bronchial trees, pulmonary cysts or cavities. We have experienced a case of endobronchial aspergillosis developed in a renal transplant patient with neutropenia. Bronchoscopic biopsy revealed a necrotizing Aspergillus bronchitis in the orifice of the lateral segmental bronchus of left upper lobe. The patient received total 2,760 mg intravenous liposomal amphotericin B. There was no endobronchial lesion on follow up bronchoscopy and biopsy was also negative. This case serves as a reminder to clinicians that Aspergillus should be kept in mind as a possible infectious organism in renal transplant patients.
Amphotericin B ; Aspergillosis* ; Aspergillus ; Biopsy ; Bronchi ; Bronchitis ; Bronchoscopy ; Colon ; Follow-Up Studies ; Humans ; Kidney Transplantation ; Neutropenia ; Opportunistic Infections ; Pulmonary Aspergillosis