PURPOSE: To investigate the surgical results of repeated trabeculectomy in primary congenital glaucoma. METHODS: The authors retrospectively reviewed the data of 16 patients (23 eyes) who underwent two or more trabeculectomies with or without mitomycin C for primary congenital glaucoma between 1990 and 2004. Surgical success rate and postoperative complications were assessed. The relationship between the use of mitomycin C and the surgical outcomes was also studied. RESULTS: Among the 23 eyes, 10 had a history of previously failed goniotomy or trabeculotomy and 6 eyes had undergone trabeculectomy more than 3 times. The overall success rate of repeated trabeculectomy was 63.9% and the success rate of the 14 eyes operated on with mitomycin C was not higher than that of the 9 eyes that did not receive mitomycin C (p=0.166). Two eyes were reported to have postoperative hypotony and there was one case of endophthalmitis after trabeculectomy; however, the use of mitomycin C did not increase the overall rate of surgical complication (p=1.00). CONCLUSIONS: Repeated trabeculectomy can be considered as a procedure to treat primary congenital glaucoma, particularly in severe cases of congenital glaucoma.
Endophthalmitis ; Glaucoma* ; Humans ; Mitomycin ; Postoperative Complications ; Retrospective Studies ; Trabeculectomy*

PURPOSE: The purpose of this research is to elucidate the trend of incidence of childhood cancers for the recent 5 years and to use this study as a database of childhood cancers research by comparing to the existing data. METHODS: Childhood cancer patients registered in the cancer registry program of the Ministry of Health and Welfare in Korea during January 1, 1995 to December 31, 1999 were included as study samples. Our current data was obtained to be compared with the previous results 1st report during 1982~1987 and 2nd report during 1988~1992). Analysis of our study was obtained from the data of the patients of childhood cancers under 15 years old registered in the 128 hospitals, except for the patients who are registered repeatedly. RESULTS: Accumulated number of cases of the childhood cancers was 5, 433 (1.5% of the total cases of all ages). A male to female incidence ratio was 1.3 to 1. The most common malignant tumor was leukemia (33.1%). Out of 1, 800 cases of leukemia, 1, 142 cases (63.4%) were lymphoid leukemia, 468 cases (26.0%) were acute non-lymphocytic leukemia and 97 cases (5.4%) were chronic myeloid leukemia. The second most common malignancy was central nervous system tumor (16.0%), followed by lymphoma (8.0%), gonadal and germ cell tumors (7.9%), sympathetic nervous system tumor (6.7%), bone tumor (5.1%), soft tissue sarcoma (4.8%), renal tumor (4.0%), retinoblastoma (3.3%) and hepatic tumor (2.6%). The most common malignant tumor in the 0~4 year-old age was leukemia (32.6%), followed by central nervous system tumor (12.7%) and sympathetic nervous system tumor (11.5%). In the 5~9 year-old age group, the most common malignant tumor was leukemia (38.0%), as well, followed by central nervous system tumor (21.7%) and lymphoma (11.6%). In the 10~14 year-old age group, the most common cancers were leukemia (29.8%), central nervous system tumor (16.5%) and bone tumor (11.7%). CONCLUSION: We were unable to note any differences in the incidence of childhood cancers when comparing the current data and the previous ones.
Adolescent ; Central Nervous System ; Female ; Gonads ; Humans ; Incidence ; Korea* ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Lymphoma ; Male ; Neoplasms, Germ Cell and Embryonal ; Retinoblastoma ; Sarcoma ; Sympathetic Nervous System

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in Korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectomy was performed under the impression of thyroid carcinoma. The resected thyroid gland showed a poorly circumscribed hard mass. Histologically, the tumor consisted of solid nests of large atypical cells with dense fibrous stroma. The tumor cells showed squamoid appearance with abundant eosinophilic cytoplasm. There were also rare mucin-containing cells within the nests. Within the hyalinized stroma, numerous eosinophils were found. The surrounding thyroid parenchyma displayed Hashimoto's thyroiditis. There was metastasis in a regional lymph node. Two years after initial surgery, she underwent a modified radical neck dissection due to recurrent neck mass. After the radiation therapy for eight weeks, laryngectomy and esophagectomy were performed due to a recurrent carcinoma in the esophageal wall. We report an additional case of SMECE, with metastasis to regional lymph nodes and esophagus. The tumor appears to be more aggressive than previously reported and a correct diagnosis can be rendered by just examining the metastatic lesions.
Carcinoma, Mucoepidermoid/surgery ; Carcinoma, Mucoepidermoid/secondary* ; Carcinoma, Mucoepidermoid/pathology* ; Carcinoma, Mucoepidermoid/complications ; Case Report ; Eosinophilia/pathology ; Eosinophilia/complications* ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/secondary* ; Female ; Human ; Laryngectomy ; Lymph Nodes ; Middle Age ; Recurrence ; Sclerosis ; Thyroid Gland/pathology* ; Thyroid Neoplasms/surgery ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/complications ; Thyroiditis, Autoimmune/complications

We report two cases of mucinous ductal ectasia of the pancreas which showed characteristic pancreatoscopic findings. They also showed characteristic duodenoscopic findings such as patulous ampullary orifice and mucus leakage from the papilla, and underlying pathology was hyperplasia in one case and adenoma in the other case, The insertions of pancreatoscope into the main pancreatic duct were easy without previous sphincterotomy and whitish frog egg-like mucosa was noted in one case and finger-like papillary projection was noted in the other case.
Adenoma ; Dilatation, Pathologic* ; Hyperplasia ; Mucins* ; Mucous Membrane ; Mucus ; Pancreas* ; Pancreatic Ducts ; Pathology

PURPOSE: To determine the normal reference range of pulsatile ocular blood flow (POBF) values in healthy Korean subjects and to find out the factors that may affect them. METHODS: A total of 280 eyes of 280 normal subjects were included in this study. Best corrected visual acuity (BCVA), intraocular pressure (IOP), axial length, POBF, systemic blood pressure, and pulse rate were measured. The mean, standard deviation, range, and the 5th and 95th percentiles of POBF were calculated, and the influences of various parameters to POBF were determined by multiple regression analyses. RESULTS: The mean POBF value was 766.0+/-221.6 microliter/min in men and 1021.1+/-249.5 microliter/min in women. The 5th and 95th percentiles for POBF values were 486.0 microliter/min and 1140.0 microliter/min in men and 672.0 microliter/min and 1458.0 microliter/min in women. The POBF values were significantly influenced by gender, mean blood pressure, pulse rate, and axial length. CONCLUSIONS: Even though the POBF values were influenced by gender, BP, and axial length, we could define the normal reference range of POBF in healthy Koreans.
Adult ; *Asian Continental Ancestry Group ; Blood Pressure/physiology ; Eye/*blood supply ; Female ; Heart Rate/physiology ; Humans ; Intraocular Pressure/physiology ; Korea ; Male ; Pulsatile Flow/*physiology ; Reference Values ; Tonometry, Ocular/methods

We report a case of somatostatinoma, which manifested as insulinoma after liver metastasis. A 74-year-old man suffered from diabetes mellitus and jaundice. The abdominal CT scan of this patient showed a mass in the pancreas head, which obstructed biliary duct. He underwent Whipples procedure. Immunohistochemical staining of postoperative specimen disclosed that this tumor was strongly positive for somatostatin. After 4 months, follow up CT scan showed multiple metastatic lesions in the liver. We performed transarterial chemoinfusion two times, but the response was disappointing. After 2 months, he suffered from altered mentality, which was relieved by intake of sugar. Biochemical laboratory findings and immunohistochemical staining of liver biopsy disclosed that the metastatic lesion in this patient was insulinoma. We performed embolization of hepatic artery with gelform. The biochemical response was dramatic, but he died of septic shock, which was caused by gas forming liver abscess. In summary, we report a case of somatostatinoma which manifested as insulinoma after metastasis to the liver.
Aged ; Biopsy ; Diabetes Mellitus ; Follow-Up Studies ; Head ; Hepatic Artery ; Humans ; Insulinoma* ; Jaundice ; Liver Abscess ; Liver* ; Neoplasm Metastasis ; Pancreas ; Shock, Septic ; Somatostatin ; Somatostatinoma* ; Tomography, X-Ray Computed

Depression is well-known to comorbid with several psychiatric disorders. Many schizophrenics also suffer from depression in the course of their illness. Combined therapy of SSRI and tricyclic antidepressants were reported to have benefits in some depressed patients. Paroxetine, a potent CYP2D6 inhibitor, increases the blood levels of tricyclic antidepressant markedly, Using paroxetine, we tried this combined therapy in the treatment of depressive symptoms in 10 chronic schizophrenic inpatients and evaluated its efficacy and drug interactions between paroxetine and tricyclic antidepressants. The following results were obtained: 1) The mean score of Hamilton's Depression Rating Scale(HDRS) was reduced significantly after 6 weeks-trials of this combined therapy for the mild depressive symptoms in 10 chronic schizophrenics. In four patients, 50% or more reductions in the scores of HDRS were noticed at final evaluation. 2) Two among our 10 subjects experienced severe toxic behavioral problems. Anticholinergic crisis with toxic confusion due to high blood levels of tricyclics was fecund in one patient and the other showed rapid clinical deterioration in his psychotic symptoms such as delusion and hallucination without any consciousness alternation. 3) Baseline plasma levels of tricyclics before adding paroxetine were higher or than expected in our chronic schizophrenic subjects maintained with their antipsychotic medications. Several antipsychotics were also known as a potent CYF2D6 inhibitors and to increase the blood levels of tricyclics. Because the blood levels of tricyclics had already increased significantly by the use of antipsychotics, adding paroxetine to antipsychotics and tricyclic antidepressant In our subjects could increase the blood levels of tricyclics not so much as previously reported in the literatures.
Antidepressive Agents, Tricyclic ; Antipsychotic Agents ; Consciousness ; Cytochrome P-450 CYP2D6 ; Delusions ; Depression* ; Drug Interactions ; Hallucinations ; Humans ; Inpatients ; Paroxetine* ; Plasma ; Schizophrenia

BACKGROUND/AIMS: We studied the prevalence of chronic hepatitis B, C and abnormality on liver function among the population in northwest area of Chungnam. METHODS: We have reviewed 40,112 adults who had received medical examination at health promotion center in Dankook university hospital. We studied them retrospectively about HBsAg, HBsAb, anti-HCV, and liver function test (LFT). RESULTS: Among the study subjects, 22,936 men and 17,176 women were involved. The overall seroprevalence of HBsAg was 4.2%. The prevalence in men (4.5%) was higher than that of women (3.7%) (p<0.001). The seroprevalence of HBsAg in their age was 5.1% in the 5th decade, 4.2% in the 2nd decade, 4.1% in the 4th decade, and 4.1% in the 6th decade. The overall seroprevalence of HBsAb was 65.1%. The overall seroprevalence of anti-HCV was 0.7%. After we reexamined them with HCV RNA or RIBA (Recombinant Immunoblot Assay), the prevalence of chronic hepatitis C was 0.09%. The LFT abnormality in total subjects was 11.4%. The LFT abnormality of chronic hepatitis B and C subjects was 21.72% and 63.2%. CONCLUSIONS: The prevalence of chronic hepatitis B and C was lower than that of previous studies. The prevalence of chronic hepatitis B in the 2nd decade was still high.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Hepatitis B Antibodies/blood ; Hepatitis B Surface Antigens/blood ; Hepatitis B, Chronic/*epidemiology/immunology/physiopathology ; Hepatitis C Antibodies/blood ; Hepatitis C, Chronic/*epidemiology/immunology/physiopathology ; Humans ; Korea ; Liver Function Tests ; Male ; Middle Aged ; Prevalence ; RNA, Viral/blood ; Retrospective Studies

The expression of p-glycoprotein (p-gp) was evaluated in pre- and post-chemotherapy states after the administration of adriamycin-based chemotherapy in 24 gastric cancer patients. Among them, group A was composed of twelve patients who relapsed after surgery plus adjuvant chemotherapy and group B was composed of another twelve patients who received neoadjuvant chemotherapy plus surgery. Pre-chemotherapy p-gp was evaluated in 18 out of 24 patients (6 patients had no pre-chemotherapy paraffin blocks) and post-chemotherapy p-gp was evaluated from all 24 patients. Pre- and post-chemotherapy p-gp was expressed in 5 of 18 patients (27.8%), and 9 of 24 patients (37.5%), respectively, with immunohistochemical stain using monoclonal antibody JSB-1. No differences of disease-free survivals were observed in Group A based on post-chemotherapy p-gp expression from relapsed lesions. In Group B, there was a higher relapse rate (p = 0.04) and a lower one-year disease-free survival rate (p = 0.04) in post-chemotherapy p-gp positive patients when adjuvant treatment was done with the same regimen as neoadjuvant chemotherapy. In all patients studied, post-chemotherapy p-gp expression correlated with a higher systemic recurrence (p = 0.04). These data suggest that p-gp can be induced by an adriamycin-based chemotherapy in gastric cancer. Thus, we suggest that the prognosis of gastric cancer may be poor if a multidrug resistance (MDR)-related regimen is used in the presence of p-gp after neoadjuvant chemotherapy with an adriamycin-based regimen, even if the initial response is good.
Adult ; Aged ; Combined Modality Therapy ; Dose-Response Relationship, Drug ; Doxorubicin/administration & dosage/*therapeutic use ; Drug Resistance ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Neoplasm Recurrence, Local ; P-Glycoprotein/*metabolism ; Stomach Neoplasms/*drug therapy/*metabolism/surgery ; Survival Analysis

PURPOSE: The purpose of this study was to investigate the prevalence and characteristics of glaucoma in the population of the rural Korean town, Sangju. METHODS: Residents of Sangju aged greater than 50 years old were included in this study. Participants completed an interview examining their medical and ophthalmic history Information was collected on the participants' uncorrected and best corrected vision scores, slit lamp examination results, angle width measurements using the Van Herick technique, gonioscopy if the angle width was less than 1 / 4 angle, intraocular pressure (IOP) assessed with the Goldmann applanation tonometry, optic disc examination results, and a visual field test results using frequency-doubling perimetry in cases in which glaucoma was suspected. Glaucoma was diagnosed according to the criteria described by the International Society for Geographic and Epidemiological Ophthalmology. RESULTS: 1,118 residents aged greater than 50 years were examined initially from a population of 2,984 people. Of these, 671 subjects (60%) participated in this study. The prevalence of glaucoma was determined to be 3.4% (95% confidence interval [CI], 2.1-4.8). Open-angle glaucoma with low IOP was determined to be the most common form with a prevalence rate as high as 2.5% (95% CI, 1.8-3.7). Additionally, primary angle closure glaucoma was determined to have a prevalence rate of 0.3% (95% CI, 0.1-0.9). Open-angle glaucoma with low IOP accounted for 94.4% of the open-angle glaucoma cases. CONCLUSIONS: The prevalence of glaucoma among the population of rural Sangju was 3.4%, and open-angle glaucoma with low IOP was the most common form accounting for 94.4% of the total number of cases.
Age Distribution ; Aged ; Aged, 80 and over ; Female ; Glaucoma/*epidemiology/physiopathology ; Humans ; *Intraocular Pressure ; Male ; Middle Aged ; Prevalence ; Republic of Korea ; Risk Factors ; *Rural Population ; *Urban Population