Authors have experienced a case (aged 24, female) of epithelial downgrowth following partial penetrating keratoplasty. Clinically, this patient was received 7mm penetrating keratoplasty due to herpetic corneal Scar of right eye. After keratoplasty, iris prolapse through the wound dehiscence was occurred and then it was closed immediately with resection of prolapsed iris tissue. But, thereafter, the graft showed haziness which is suspected as a immune reaction and eventually the graft became irreversible opaque. A cosmetic epikeratoprosthesis waS attached on the opaque eye. But intractable secondary glaucoma was not controlled by medications. Finally the illed eye was enucleated and was confirmed histopathologically the main cause of graft failure which was presumed due to epithelial downgrowth into the anterior chamber.
Anterior Chamber ; Cicatrix ; Corneal Transplantation ; Glaucoma ; Humans ; Iris ; Keratoplasty, Penetrating* ; Prolapse ; Transplants ; Wounds and Injuries

PURPOSE: The objective of this study was to evaluate the Caspase 3 and p21 expression level and to understand the correlation between Caspase 3 expression and the clinical factors in renal cell carcinoma. MATERIALS AND METHODS: Forty-two patients with renal cell carcinoma were enrolled in this study. Immunohistochemical staining of Caspase 3 and p21 was performed in formalin-fixed and paraffin-embedded tissue sections using rabbit polyclonal antibody (Caspase 3) and mouse antibody (p21). The Caspase 3 and p21 expression levels were compared with the TNM stage, Fuhrman grade, pathological type and survival rates. RESULTS: The Caspase 3 expression level correlated only with the Fuhrman grade (p=0.017). There was no significant correlation between the Caspase 3 and p21 expression level. The prognostic values did not correlate with the Caspase 3 and p21 expression level. CONCLUSIONS: The prognostic value of the Caspase 3 expression level in renal cell carcinoma was insufficient. The relationship between Caspase 3 and p21 was not proven in renal cell carcinoma, and new factors may be implicated with Caspase 3.
Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Caspase 3* ; Humans ; Mice ; Prognosis ; Survival Rate

There are many theonies regarding the etiology of idiopathic facial paralysis(Bell's palsy), but none will bear close examination at the present time. Quite possibly a proportion of causes should be classified as due to the herpes virtus. Herpes zoster is commonly known as a benign viral disease affecting the sensory nerves, but less well known is that this viral infection also caused muscle paralysis, in a not significant number of patients. There is increasing evidence that sympathetic blocks performed during the acute stage of herpes zoster infection shorten the eruptive phase of the disease and decreases the incidence of post herpetic neuralgia. Early treatment is particularly important in elderly patients in whom the incidence of long standing postherpetic pain is extremely high. The aim of treatment of Bell's palsy is to reduce edema and improve circulation to be facial nerve. Stellate ganglion block resulted in abolishing cerebral vascular spasm and in increasing cerebral blood flow. Thus stellate ganglion block is effective in treatment of Bell's palsy. This patient with herpes zoster associated with idopathic complete Bell's palsy was treated by repeat stellate ganglion block with 1% lidocaine and excellent result were noted.
Aged ; Bell Palsy ; Edema ; Facial Nerve ; Facial Paralysis* ; Herpes Zoster* ; Humans ; Incidence ; Lidocaine ; Neuralgia ; Paralysis ; Spasm ; Stellate Ganglion* ; Virus Diseases

To evaluate the risk and factors associated with seizure recurrence in children with epilepsy while receiving the adequate anticonvulsant treament, we studied 58 patients with newly diagnosed epilepsy who were followed prospectively for a median of 26 months (range 7 to 54). The results were as follows: 1) Forty-four of the 58 patients (75.9%) had recurrence of seizure. 2) The rate of recurrence according to type of seizure was observed to be 22 patients (68.8%) in generalized tonic-clonic seizure, 6 patients (85.7%) in simple partial seizure, 5 patients (83.3%) in complex partial seizure, 3 patients (100%) in mixed seizure, 2 patients (100%) in absence, 3 patients (100%) in infantile spasm, 1 patient (100%) in atonic seizure, 2 patients (50%) in secondary generalized seizure. There was no significant difference in the risk of recurrence observed among these seizure types. 3) The risk of recurrence varied according to the history of seizure, seizure recurrence was observed in 100% of the cases with history of neonatal seizure, 72.7% of the cases with febrile convulsion, and 73.3% of the cases with non-specific history. No significant difference was observed among these past history of seizure. 4) The rate of seizure recurrence according to electroencephalographic abnormalities did not differ significantly. Seizure recurrence was noted in 13 of the 18 patients with mildly disordered tracings (72.2%), 15 of the 20 patients with moderate abnormality (75.0%), and 12 of the 16 patients with severe abnormality (75.0%). 5) Recurrence rate according to cause of seizure was more significantly frequent in those with symptomatic epilepsy than in those with idiopathic type (100% vs 70.2%, p<0.05). 6) The frequency percentage of seizure recurrence by age groups of below 1 year, 1 to 3 years, 4 to 6 years, and above 6 years at onset of seizure were 100, 66.7, 57.1, and 72.7, respectively. The rate of seizure recurrence was significantly highest in patients aged below 1 year at onset of seizure. 7) There was significant difference in seizure recurrence between those with and without abnormalities as shown by neurologic examination (100% vs 70.8%, p<0.05). 8) There was no consistent difference in valproic acid serum levels between those who had a recurrence and those who did not. The patients receiving phenobarbital had significantly high serum levels of the phenobarbital in recurrent groups than those who had no recurrence. In conclusion, factors associated with an increased risk of seizure recurrence were early age at onset of epilepsy, symptomatic epilepsy, and neurologic abnormalities. We found no associations between risks of recurrence and types of epilepsy, or electroencephalographic abnormalities.
Anticonvulsants* ; Child ; Epilepsy ; Humans ; Infant ; Infant, Newborn ; Neurologic Examination ; Phenobarbital ; Prospective Studies ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile ; Spasms, Infantile ; Valproic Acid

In order to know the change of internal ostium after dacryocystorhinostomy, we examined the nasal cavity with nasal endoscope. We analyzed 106 patients, 112 cases of minimum follow-up for 4 months who had undergone dacryocystorhinostomy from April 1994 to December 1996. Functionally successful results were obtained in 96 cases (86%) and anatomically successful results in 102 cases (91%). The size of internal ostium seen one month after operation did not show statistically significant change through the follow-up period. Movements of the internal punctum and lateral wall of the lacrimal sac with blinking were seen in 61 cases (54%). After instilling fluorescein dye in inferior conjunctival sac, we could find the dye in the internal ostium in 93 cases, 97% of functioning dacryocystorhinostomy. Granulomas located around the ostium were found in 27 cases (24%), however, the granuloma disappeared or decreased in size in 19 cases (70%) and there were 5 cases of operation failure owing to granuloma. It is useful to examine the nasal cavity with nasal endoscope after dacryocystorhinostomy to confirm the internal ostium and to increase surgical success rate through proper managenient postoperatively.
Blinking ; Dacryocystorhinostomy* ; Endoscopes ; Fluorescein ; Follow-Up Studies ; Granuloma ; Humans ; Nasal Cavity

PURPOSE: This study evaluated the prognostic differences in invasive cancer that progressed from a superficial transitional cell carcinoma (TCC) compared to an already invasive TCC at the time of the initial presentation. MATERIALS AND METHODS: Seventy-one patients who had a radical cystectomy performed for an invasive TCC were enrolled in this study. They were divided into two groups. In the first group, the patients were diagnosed as a superficial TCC at initially, which progressed to an invasive tumor. The second group consisted of patients who were diagnosed with invasive TCC at the time of the initial diagnosis. Two groups were compared with regard to the TNM stage, Ash grade, presence of accompanying carcinoma in-situ and survival rate. RESULTS: The group with invasive cancer at the time of the initial presentation had a significantly higher grade than the progressed group. The five-year survival rate was lower in the progressed group. Moreover, Kaplan-Meier analysis showed it was statistically significant (p=0.04). CONCLUSIONS: The grade was higher and the five-year survival rate was lower in the group with invasive cancer at the time of the initial presentation. Therefore, the invasive TCC at the initial diagnosis might take a more aggressive nature than the progressed group.
Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis* ; Humans ; Kaplan-Meier Estimate ; Prognosis ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Cor triatriatum is a rare cardiac malformation in which the left atrium is subdivided into two chambers by a fibromuscular septum, one locates posterosuperiorly, which is connects with the pulmonary veins, and the other locates anteroinferiorly connecting with the mitral valves and left ventricie. It is often lethal in children with cor triatriatum due to congestive heart faliure which develops abruptly and rapidly. So, the most important thing is early detection of the disease. We experienced a case of cor triatriatum in 20 month-old female. She had severe symptoms related to congestive heart faliure, and the conditions showed dangerous. Echocardiography was used for correct diagnosis. The patients was improved dramatically after proper surgery. So, We reported this case and review literatures briefly.
Child ; Cor Triatriatum* ; Diagnosis ; Echocardiography ; Estrogens, Conjugated (USP) ; Female ; Heart ; Heart Atria ; Heart Septal Defects, Atrial* ; Humans ; Infant ; Mitral Valve ; Pulmonary Veins

No abstract available.
Choanal Atresia*

PURPOSE: To investigate the safety and the efficacy of intravesical gemcitabine therapy, we prospectively studied intravesical gemcitabine instillation followed by Bacillus Calmette-Guerin(BCG) instillation for treating the patients who suffer from superficial bladder cancer, and the above method was then compared with conventional BCG instillation. MATERIALS AND METHODS: Between May 2005 and April 2007, a total of 84 patients were divided into Group I: the patients were treated with a 2-week course of gemcitabine(1,000mg/50ml, 2,000mg/50ml) followed by a conventional 6-week course of BCG, and Group II: the patients were treated by BCG instillation only. Gemcitabine was instilled immediately within 6 hours after complete trans-urethral resection of the bladder tumor (TURBT) and then this was repeated one week later. BCG instillation was started 2 weeks after TURBT. The complications, recurrence rates, progression rates and recurrence-free period(RFP) were analyzed in both groups. RESULTS: The treatment was well tolerated in all the patients. Most of the complications were self-limiting, and there was no significant difference between the two groups(p=0.379). The recurrence rates of the two groups were 25.6% and 26.7%, respectively(p=0.899). Yet the recurrence-free period(RFP) was significantly longer in Group I(p=0.021). The progression rates of the two groups were 2.6% and 6.7%, respectively(p=0.620). CONCLUSIONS: Intravesical gemcitabine instillation showed the effect to prolong the recurrence-free period for patients with superficial bladder cancer. Further long-term study will be needed.
Administration, Intravesical ; Bacillus ; Deoxycytidine ; Humans ; Mycobacterium bovis ; Prospective Studies ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms

A retrospective review of 36 patients with infective endocarditis by strict case definition was performed from 1972 through April of 1984. Male to female ratio was 1:1.25, with mean age of 19.1. Thirty of the 36 patients(83.3%) had the history of predisposing heart diseases: congenital heart disease was most frequent one below the age of 20, rheumatic heart disease between the age of 20-39 and degenerative heart disease above the age of 40. The commonest presenting symptoms were fever, dyspnea, and malaise, and the commonest signs were fever, murmur, and hepatomegaly. Average hemoglobinand hematocrit were 10.1g/dl and 30.8% respectively, showing moderate degree of anemia. White cell count was 11,600+/-5400/mm3 and erythrocyte sedimentation rate was 46+/-18mm/hr. Over four fifths of the patients demonstrated proteinuria and elevated C-reactive protein. Two thirds of the patients showed microscopic hematuria and one third showed positive rheumatoid factor. Eight patients(22.2%) showed arrhythmia and 4(11.1%) showed conduction abnormalities on electrocardiography. The commonest etiologic microorganisms were alpha-hemolytic streptococcus(30.6%) and staphylococcus aureus(22.2%). Abacteremic cases were found in 38.9% of the patients. To compared with alpha-hemolytic streptoccus endocarditis the cases caused by staphylococcus aureus showed the shorter duration of symptoms before admission, the less frequent complication, the higher fever, and the more elevated white cell counts. To penicillin, alpha-hemolytic streptococcus was sensitive in most cultures and staphylococcus arueus was resistant in half of them, and to aminoglycosides vice versa. To cefazolin, both microorganisms were sensitive in most cultures. In 18 of 24(75%) patients vegetation was visualized by echocardiography. The most frequent site of involvement was the mitral valve. And in vegetation detected group complication rate by embolism was found to be higher. The common complications were congestive heart gailure in 24(66.75%), embolism in 8(22.2%), and metastatic infection in 6(16.7%). The mortality rate of infective endocarditis was 25%, and the causes of death were cerebral embolism in 3(8.3%), septic septic shock in 3(8.3%), congestive heart failure in 2(5.6%), and mycotic aneurysmal rupture in 1(2.8%). Conclusively in infective endocarditis the author observed the increasing prevalence of degenerative heart disease as a prdisposing heart disease and increasing incidence of staphylococcus aureus as a causative microorganism. Adn the differences of clinical characteristics between staphylococcus ureus and alpha-hemolytic streptococcus endocarditis would be helpful in diagnosis and treatment of infective endocarditis as well as recognition of prognosis.
Aminoglycosides ; Anemia ; Aneurysm, Infected ; Arrhythmias, Cardiac ; Blood Sedimentation ; C-Reactive Protein ; Cause of Death ; Cefazolin ; Cell Count ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Embolism ; Endocarditis* ; Estrogens, Conjugated (USP) ; Female ; Fever ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Heart Failure ; Hematocrit ; Hematuria ; Hepatomegaly ; Humans ; Incidence ; Intracranial Embolism ; Male ; Mitral Valve ; Mortality ; Penicillins ; Prevalence ; Prognosis ; Proteinuria ; Retrospective Studies ; Rheumatic Heart Disease ; Rheumatoid Factor ; Rupture ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Streptococcus