PURPOSE: We report a patient with intraocular silicone oil leakage into the subconjunctival space and orbit through an Ahmed glaucoma valve implant. METHODS: A 47-year-old male with high myopia and traumatic retinal detachment underwent in the left eye, pars plana vitrectomy, lensectomy and ultimately intraocular silicone oil placement for traumatic retinal detachment. Subsequently, he developed intractable glaucoma and underwent a superotemporal Ahmed glaucoma tube implant, left eye. RESULTS: Intraocular silicone oil migrated through the Ahmed valve into the subconjunctivalspace and orbit. The Ahmed glaucoma valve was removed with excisional biopsy. CONCLUSIONS: Silicone oil migration through an Ahmed valve may be observed after retinal detachment repair with intraocular silicone oil. An Ahmed valve implantation should be done with great care.
Biopsy ; Glaucoma* ; Humans ; Male ; Middle Aged ; Myopia ; Orbit* ; Retinal Detachment ; Silicone Oils* ; Vitrectomy

No abstract available.
Head* ; Hypopharynx* ; Mouth* ; Neck* ; Oropharynx*

BACKGROUND/AIMS: Increased incidence of coronary artery disease has led to the increased use of dual antiplatelet therapy composed of aspirin and clopidogrel. We investigated the incidence of gastrointestinal complications in patients who received single or dual antiplatelet therapy and analyzed their clinical characteristics in order to predict the prognostic factors. METHODS: Between January 2009 and December 2011, we retrospectively reviewed the medical records of patients who underwent coronary angiography at Chung-Ang University Hospital (Seoul, Korea). One hundred and ninety-four patients were classified into two groups: aspirin alone group and dual antiplatelet group. Clinical characteristics, past medical history, and presence of peptic ulcer were analyzed. RESULTS: During the follow-up period, 11 patients had duodenal ulcer; the event rate was 2.02% in the aspirin alone group and 9.47% in the dual antiplatelet group (hazard ratio [HR] 5.24, 95% CI 1.03-26.55, p<0.05). There was no significant difference in the rate of significant upper gastrointestinal bleeding: 0% vs. 4.2% (p=0.78). In patients who received proton pump inhibitor (PPI), 24 patients had gastric ulcer; the event rate was significantly different between the two groups: 4.87% vs. 22.98% (HR 3.40, 95% CI 1.02-11.27, p<0.05). CONCLUSIONS: Dual antiplatelet groups had a higher incidence of duodenal ulcers without significant bleeding compared with the aspirin alone group. In patients who received PPI, the dual antiplatelet therapy group had a higher incidence of gastric ulcers without significant bleeding compared with the aspirin alone group. Therefore, physicians must pay attention to high risk groups who receive dual antiplatelet therapy and aggressive diagnostic endoscopy should also be considered.
Aged ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use/toxicity ; Aspirin/*therapeutic use/toxicity ; Coronary Angiography ; Coronary Artery Disease/*prevention & control ; Drug Therapy, Combination ; Female ; Gastrointestinal Hemorrhage/chemically induced/prevention & control ; Humans ; Incidence ; Male ; Middle Aged ; Peptic Ulcer/*diagnosis/epidemiology/etiology ; Platelet Aggregation Inhibitors/*therapeutic use/toxicity ; Proportional Hazards Models ; Proton Pump Inhibitors/therapeutic use ; Retrospective Studies ; Risk Factors ; Ticlopidine/*analogs & derivatives/therapeutic use/toxicity

Carnobacterium is a genus of gram-positive bacilli belonging to the family Lactobacillaceae.Generally, Carnobacterium species are considered nonpathogenic to humans and are mostly found in the natural environment, food, and food packaging. Furthermore, some Carnobacterium species play a bioprotective role in the food industry. Isolation of Carnobacterium from human blood or other sites, such as skin or abscess, has rarely been reported—there are only four published case reports worldwide, and none of them is from Korea. In all the reported cases, the patients reported contact with an aqueous environment or were administered nutrition via a parenteral route. Herein, we report the detection of Carnobacterium divergens bacteremia in an immunocompromised patient by using mass spectrometry in Korea.

Spinal schwannoma is a slow growing symptomatic tumor which is derived from Schwann cells of peripheral nerves. Most reported cases have been single lesion, while multiple schwannomas have invariably documented one manifestation of von Recklinghausen's disease. Nevertheless, we observed a case of independent, multiple, spinal schwannomas for 6 years before excision. We report the growing velocity and progression of neurologic symptoms and neurologic changes before excision and present a literature review.
Neurilemmoma* ; Neurofibromatosis 1 ; Neurologic Manifestations ; Peripheral Nerves ; Schwann Cells

STUDY DESIGN: Retrospective and controlled study OBJECTIVES: To verify the risk factors, distinction of symptomatic and prognosis of the postoperative neurologically symptomatic epidural hematoma at the lumbar region. SUMMERY OF LITERATURE REVIEW: Even though an epidural hematoma is one of the well known causes of postoperative neuro-logical complications, the rarity makes it difficult to account for the causes of this phenomenon. MATERIAL AND METHODS: Eight patients who had a proven neurologically symptomatic epidural hematoma were reviewed. We analyzed the degrees of neurologic recovery according to the initial degree of the neurological deficit and the time to the hematoma evacuation. Two hundred four patients who underwent a lumbar operation during the months contemporary with the occurrence of each cases (ed note: I do not know what this means.) by the same surgeon, were selected as the control group. RESULTS: Among the 2,951 patients, 8 patients (0.027%) developed such complication. Using a simple logistic regression test, an increased amount of bleeding, a prolonged operation time, a decreased platelet count before and after surgery, hypertension and previous cardiovascular disease were recognized as significant risk factors, but the statistical significance was lost in all factors by multiple logistic regression test. There was no significant correlation between the neurological recovery and initial neurolog-ical deficit or retardation before the hematoma evacuation. CONCLUSIONS: Compressive epidural hematoma following lumbar spine surgery can cause serious neurological symptom. Significant risk factors were not demonstrated. Therefore, it can be developed in ordinary patients. All cases developed neurological symptom within the first 8 hours after surgery. Accordingly, cautious observation of the neurological changes at early period is important for detecting and treating such complication. The neurologically symptomatic epidural hematoma should be evacuated even in delayed cases, because neurological recovery can be expected.
Cardiovascular Diseases ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Logistic Models ; Lumbosacral Region ; Neurologic Manifestations ; Platelet Count ; Prognosis ; Retrospective Studies ; Risk Factors* ; Spine*

PURPOSE: X-ray film over responds to low-energy photons in relative photon beam dosimetry because its sensor is based on silver bromide crystals, which are high-Z molecules. This over-response becomes a significant problem in clinical photon beam dosimetry particularly in regions outside the penumbra. In intensity modulated radiation therapy (IMRT), the radiation field is characterized by multiple small fields and their outside-penumbra regions. Therefore, in order to use film dosimetry for IMRT, the nature the source of the over-response in its radiation field need to be known. This study is aimed to verify and possibly improve film dosimetry for IMRT. MATERIALS AND METHODS: Modulated beams were constructed by a combination of five or seven different static radiation fields using 6 MeV X-rays. In order to verify film dosimetry, we used X-ray film and an ion chamber were used to measure the dose profiles at various depths in a phantom. In addition, in order to reduce the over-response, 0.01 inch thick lead filters were placed on both sides of the film. RESULTS: The measured dose profiles showed a film over-response at the outside-penumbra and low dose regions. The error increased with depths and approached 15% at a maximum for the field size of 15X15 cm(2) at 10 cm depth. The use of filters reduced the error to 3%, but caused an under-response of the dose in a perpendicular set-up. CONCLUSIONS: This study demonstrated that film dosimetry for IMRT involves sources of error due to its over-response to low-energy photons. The use of filers can enhance the accuracy in film dosimetry for IMRT. In this regard, the use of optimal filter conditions is recommended.
Film Dosimetry* ; Photons ; Silver ; X-Ray Film

BACKGROUND/AIMS: Thymidylate synthase (TS) is a target enzyme of 5-fluorouracil (5-FU) and has a polymorphic 28 bp tandem repeated sequence. TS enhancer region (TSER) polymorphism has been associated with the efficacy of 5-FU-based chemotherapy in colon cancer. Methylenetetrahydrofolate reductase (MTHFR) plays a central role in converting folate to methyl donor for DNA methylation. The aim of this study was to determine the clinical value of TSER and MTHFR polymorphism in gastric cancer. METHODS: From October, 1995 to February, 2002, 40 gastric cancer patients underwent operation and 25 patients among those patients have received postoperative 5-FU-based chemotherapy (5-FU (+) group). Peripherial blood were sampled for TSER and MTHFR genotype analysis by PCR amplification of genomic DNA. The survival of patients according to TSER and MTHFR polymorphism were compared. RESULTS: We observed a longer survival in stage II than stage III of the patients (p=0.0037). However, the TSER and MTHFR C677T polymorphisms were not associated with better survival of gastric cancer patients as well as combined TSER and MTHFR genotypes with 5-FU chemotherapy. CONCLUSIONS: The TSER and MTHFR genotypes are not effective markers for tumor sensitivity to 5-FU-based chemotherapy in Korean gastric cancer patients after curative resection. These results may suggest further large-scale study about TSER and MTHFR polymorphism for the prediction of efficacy of 5-FU-based chemotherapy in gastric cancer in Korea.
Aged ; Antimetabolites, Antineoplastic/*therapeutic use ; Drug Screening Assays, Antitumor ; Female ; Fluorouracil/*therapeutic use ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2)/*genetics ; Middle Aged ; *Polymorphism, Genetic ; Stomach Neoplasms/*drug therapy/genetics/mortality ; Survival Rate ; Thymidylate Synthase/*genetics

BACKGROUND AND OBJECTIVES: Because the mechanisms of the biological effects of statin and antiotensin converting enzyme inhibitor therapies differ, the vascular responses to these therapies were studied in hypercholesterolemic patients. MATERIALS AND METHODS: Simvastatin, 20 mg, placebo or ramipril, 10 mg, were administered daily for 2 months, with a 2 month washout, to 32 hypercholesterolemic patients. This was a randomized, double-blind, placebo-controlled, crossover in design study. RESULTS: Simvastatin alone, or in combination with ramipril, significantly changed the lipoproteins, and improved the percentage of the flow-mediated dilator response to hyperemia by 46+/-48% and by 59+/-66%, respectively, relative to the baseline measurements (both p<0.001). The plasma malondialdehyde levels were reduced, relative to baseline measurements, by 6+/-57% (p=0.045) and 13+/-47% (p=0.045 and p<0.001, respectively) and plasma levels of monocyte chemoattractant protein-1 by 3+/-27% and by 9+/-16%, respectively (p=0.113 and p=0.001, respectively). The C-reactive protein were also reduced, relative to baseline measurements, by 17+/-75% and by 17+/-37%, respectively (p=0.003 and p=0.001, respectively). However, simvastatin combined with ramipril changed, to a greater extent, but was statistically insignificant, the percentage of the flow-mediated dilator response to hyperemia, and the plasma monocyte chemoattractant protein-1 levels, than simvastatin alone. CONCLUSION: Compared with simvastatin alone, the addition of ramipril improved the endothelial function to greater extent, but was statistically insignificant, in hypercholes-terolemic patients.
C-Reactive Protein ; Chemokine CCL2 ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperemia ; Inflammation* ; Lipoproteins ; Malondialdehyde ; Nitric Oxide* ; Plasma ; Ramipril* ; Simvastatin*

PURPOSE: Angiogenesis plays an important role in the growth, progression, and metastasis of tumors. Vascular endothelial growth factor (VEGF) overexpression has been associated with advanced stage and poor survival in several cancers. We investigated the present case-control study to determine whether there is an association between the VEGF 936C>T polymorphism and stomach cancer. PATIENTS AND METHODS: The association of functional single nucleotide polymorphisms (SNPs) of the VEGF gene with stomach cancer development was evaluated in a case-control study of 154 Korean stomach cancer patients. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. RESULTS: Our results revealed significant association of T allele-bearing genotypes with increased risk for stomach cancer development. Genotype frequencies of the VEGF 936C>T polymorphisms were significantly different between patient and control groups (CT, AOR: 2.007, 95% CI: 1.277-3.156, TT, AOR: 4.790, 95% CI: 1.174-19.539, CT+TT, AOR: 2.147, 95% CI: 1.382-3.337). When stratified by gender and age, genotype frequencies were significantly different for stomach cancer in women and in patients younger than 55 years (in women, CT, OR: 3.049, 95% CI: 1.568-5.930, CT+TT, OR: 3.132, 95% CI: 1.638-5.990; in < 55 years, CT, OR: 3.306, 95% CI: 1.413-7.732, CT+TT, OR: 3.967, 95% CI: 1.729-9.104). In addition, this association partially remained in cases with intestinal and diffuse-type stomach cancer. CONCLUSION: Our present study suggests that the VEGF 936C>T polymorphism is a susceptibility factor for stomach cancer, at least in Korean. These observations, however, require further confirmation by a larger multi-ethnic study.
Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Genotype ; Humans ; Male ; Middle Aged ; *Polymorphism, Genetic ; Sex Factors ; Stomach Neoplasms/*genetics ; Vascular Endothelial Growth Factor A/*genetics