PURPOSE: To investigate postoperative outcomes of endonasal dacryocystorhinostomy (DCR) using lacrimal sac flap and silastic sheet in patients with acquired nasolacrimal duct obstruction. METHODS: From November 2009 until December 2010, endonasal DCR with lacrimal sac flap was performed in 26 eyes (group 1) and conventional DCR without flap in 28 eyes (group 2). The anatomic and functional success rates and complications were analyzed and compared between the 2 groups. RESULTS: The anatomical success rate was 96.2% in group 1 and 85.7% in group 2. The functional success rate was 100% in group 1 and 92.9% in group 2. The success rate was higher in group 1 than in group 2, although not being statistically significant. Granuloma was found in 15.4% of patients in group 1 and 32.1% of patients in group 2. Synechia or membranous obstruction was not found in group 1, whereas synechia developed in 14.3% of patients in group 2. CONCLUSIONS: Endonasal DCR with lacrimal sac flap showed a greater success rate and lower formation of granuloma than conventional endonasal DCR without flap because of reduced inflammation and granulation tissue formation around retained bony spicles.
Dacryocystorhinostomy ; Dimethylpolysiloxanes ; Eye ; Granulation Tissue ; Granuloma ; Humans ; Inflammation ; Nasolacrimal Duct

PURPOSE: To report a case of isolated anterior capsule rupture with cataract after blunt ocular trauma. CASE SUMMARY: A 38-year-old male complained of decreased visual acuity in the right eye after blunt ocular trauma 5 days earlier. The visual acuity was counting fingers at 30 cm in the right eye, and intraocular pressure, measured using an applanation tonometer, was 25 mm Hg. Slit lamp examination showed a white intumescent cataract with anterior lens capsule rupture and cortical lens material extruding into the anterior chamber. Under local anesthesia, removal of the cataract was approached via a clear corneal incision. After removal of the cataract using irrigation and aspiration, the intact posterior capsule was observed. IOL haptic was implanted in the sulcus, and IOL optic was implanted in the bag. Postoperatively, the BCVA improved in the right eye to 0.8 at 1 month, and the intraocular pressure, by the Goldmann applanation tonometer was 13 mm Hg at that time.
Adult ; Anesthesia, Local ; Anterior Chamber ; Cataract ; European Continental Ancestry Group ; Eye ; Fingers ; Humans ; Intraocular Pressure ; Male ; Rupture ; Visual Acuity

No abstract available.
Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells*

PURPOSE: To evaluate the findings of carotid ultrasonography performed on patients with retinal vascular disease and to determine the risk of cardiovascular disease and association of retinal vascular disease and cardiovascular disease. METHODS: From December 2009 to May 2012, patients diagnosed with central retinal artery occlusion (CRAO, n = 18), central retinal vein occlusion (CRVO, n = 23), and branch retinal vein occlusion (BRVO, n = 68) underwent carotid ultrasonography. We evaluated the intima-media thickness (IMT) of the common carotid artery (CCA) and the internal carotid artery (ICA), stenosis and the number of plaques, and then compared these results with those of a healthy control group (n = 221). RESULTS: The mean CCA-IMT and ICA-IMT were significantly higher in the CRAO and BRVO groups compared with the control group. On the contralateral side, CCA-IMT was increased in the CRAO, BRVO, and CRVO groups and ICA-IMT was increased in the CRAO and BRVO groups compared with the control group. Contralateral CCA stenosis was higher in the CRVO group (9.1%) and ipsilateral ICA stenosis in CRAO group (21.7%) was significantly higher than that of the control group. Plaque was observed better in all groups compared with the control group. The proportion of patients risk for cardiovascular disease, i.e. those who had IMT thickenesses more than 1.0 mm, was higher in the CRAO and BRVO groups compared with the control group. CONCLUSIONS: The carotid ultrasound findings of patients with retinal vascular diseases showed increased IMT and plaque. The group of patient at risk for cardiovascular disease, which was defined with carotid artery IMT, was higher in patients with retinal vascular disease. Therefore, in patients with retinal vascular disease, carotid artery ultrasonography and the overall management and treatment of cardiovascular disease are necessary.
Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Constriction, Pathologic ; Ultrasonography ; Humans ; Retinal Artery Occlusion ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde* ; Ultrasonography* ; Vascular Diseases*

BACKGROUND: This study was designed to investigate the relationship between psychiatric disease and systemic Internal Medical disease in psychiatric inpatients who were consulted to department of Internal Medicine and was directed to assess the physical problems and possible ways to resolve them in a closed psychiatric unit. METHOD: Through evaluation of medical records of 1549 inpatients who had consulted in department of internal medicine in Seoul National(mental) Hospital from January 1, 2002 to December 31, 2002. We classified the Physical illness according to ICD-9-CM and psychiatric disease according to DSM-IV RESULTS: The results were as follows: 1) In age and sex distribution, male was 64.4% and 45.9% of the subject was 4th and 5th decades. 2) The most systemic diagnosis were disease of respiratory system, disease of digestive system and endocrine system. 3) schizophrenia showed the highest rate in respiratory disease. Rate of digestive disease was the highest in alcohol use disorder. Disease of respiratory system and disease of digestive system were the most frequent in mood disorder 4) In 1st decade, Digestive system digease was the most frequent, others were respiratory system disease. 5) onset age of psychiatric disease was the oldest in circulatory disease. In genitourinary system disease, duration of psychiatric disease was the longest CONCLUSION: The clinical characteristics of psychiatric disease influenced to get systemic disease in psychiatric patients.
Age of Onset ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Digestive System ; Endocrine System ; Humans ; Inpatients* ; Internal Medicine ; International Classification of Diseases ; Male ; Medical Records ; Mood Disorders ; Respiratory System ; Schizophrenia ; Seoul ; Sex Distribution ; Urogenital System

From January 1988 to December 1994, endoscopic sphincterotomy with stone extraction was attempted in 395 patients with common duct stones at Yeungnam University Hospital. Endoscopic sphincterotomy was successful in 389 patients(98.5 %), and clearance of the duct was achieved in 364 patients with an overall success rate of 92.2%. After sphincterotomy, stone extraction by basket or balloon was undertaken in 298 patients without lithotripsy, and stones could be extracted after fragmentation of stones in 19 patients. In 47 patients, stones were passed into duo denum spontaneously. There were 6 cases of sphincterotomy failure due to large periampullary diverticulum or previous gastrojejunostomy. In patients with success ful sphincterotomy, endoscopic stone extraction was failed in 25 cases due to 14 large stones, 5 bile duct strictures, 4 impacted stones, and 2 cases of technical fail ure. Complications were developed in 13 patients(3.3%); 8 pancreatitis and 5 bleedings. All of them were improved with medical therapy only. Despite relatively high success rate and low complications of the endoscopic management of choledocholithiasis, there were significant difficulties in removing large stones. Developement of more effective and inexpensive methods of lithotripsy, and the search for rapidly effective solvent dissolving stones were needed.
Bile Ducts* ; Bile* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Constriction, Pathologic ; Diverticulum ; Gastric Bypass ; Humans ; Lithotripsy ; Pancreatitis ; Sphincterotomy, Endoscopic

BACKGROUND: Epidermolytic palmoplantar keratoderma (EPPK) is an autosomal dominant disease of cornification which presents as severe thickening of the palms and soles with prominent epidermolytic hyperkeratosis pathologically. Recent studies have shown that EPPK is caused by mutations in the keratin 9 (K9) gene which is expressed essentially only in the palms and soles. Previously, We have reported that patients in one large pedigree of EPPK have an R162W substitution in the K9 protein. In this pedigree, two women whose husbands are both EPPK patients had become pregnant. OBJECTIVE: Since both women were concerned about this genetic disorder, we have performed prenatal diagnosis by biopsy analysis of chorionic villi tissue. METHODS: Chorionic villi biopsies were performed at 12 weeks gestation. Since the skin lesions are strictly confined to the palms and soles of the babies, the prenatal diagnosis of EPPK by ultrastructural analysis of fetal skin biopsy or amniotic fluid cells is highly problematic. Polymerase chain reaction amplification of specific allele (PASA) assay and direct DNA sequencing analyses were performed whether the fetuses carried mutant allele of K9 gene. RESULTS: PASA assay and direct DNA sequencing analyses showed that one fetus was normal, but the other fetus carried the abnormal allele. Subsequently, the mother of the unaffected fetus delivered a normal child, but the mother of the affected fetus terminated the pregnancy. CONCLUSION: We describe the analysis of the K9 mutation in the two fetuses at risk for EPPK. We believe that this is the first report of prenatal diagnosis for EPPK. But, we have to think about the ethical problems before we decide to perform the prenatal diagnosis of any kind of skin diseases.
Alleles ; Amniotic Fluid ; Biopsy ; Child ; Chorionic Villi ; Chorionic Villi Sampling ; Female ; Fetus ; Humans ; Hyperkeratosis, Epidermolytic ; Keratin-9 ; Keratoderma, Palmoplantar, Epidermolytic* ; Mothers ; Pedigree* ; Polymerase Chain Reaction ; Pregnancy* ; Prenatal Diagnosis* ; Sequence Analysis, DNA ; Skin ; Skin Diseases ; Spouses

PURPOSE: Lymphatic invasion (LI) is regarded as a predictor of the aggressiveness of ovarian cancer (OC). However, LI is not always the major determinant of long-term patient survival. To establish proper diagnosis and treatment for OC, we analyzed differentially expressed genes (DEGs) for patients with serous epithelial OC, with or without LI, who did or did not survive for 5 years. MATERIALS AND METHODS: Gene expression data from 63 patients with OC and LI, and 35 patients with OC but without LI, were investigated using an Affymetrix Human Genome U133 Array and analyzed using The Cancer Genome Atlas (TCGA) database. Among these 98 patients, 16 survived for 5 years or more. DEGs were identified using the Bioconductor R package, and their functions were analyzed using the DAVID web tool. RESULTS: We found 55 significant DEGs (p<0.01) from the patients with LI and 20 highly significant DEGs (p<0.001) from those without it. Pathway analysis showed that DEGs associated with carbohydrate metabolism or with renal cell carcinoma pathways were enriched in the patients with and without LI, respectively. Using the top five prognostic marker genes, we generated survival scores that could be used to predict the 5-year survival of patients with OC without LI. CONCLUSION: The DEGs identified in this study could be used to elucidate the mechanism of tumor progression and to guide the prognosis and treatment of patients with serous OC but without LI.
Cystadenocarcinoma, Serous/*genetics/*mortality/pathology ; Databases, Genetic ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Microarray Analysis ; Middle Aged ; Ovarian Neoplasms/*genetics/*mortality/pathology ; Prognosis ; Regression Analysis ; Retrospective Studies ; Survival Rate

A 52-year-old male had presented with painful swelling on the left shoulder. The lesion had progressed to involve the left chest, neck, and arm, and 3 months later, evolved into brown to light purplish hard plaque mimicking the feature of scleroderma. A skin biopsy findings were consistent with metastatic carcinoma, and neck MRI and thyroid sonogram revealed primary thyroid cancer of left lobe. The patient's condition was carcinoma en cuirasse, an uncommon clinical feature of metastatic skin cancer. Skin metastasis of thyroid cancer is rare, and to our knowledge, there is not any documented case of carcinoma en cuirasse from thyroid cancer. We present a case of carcinoma en cuirasse from thyroid cancer.
Arm ; Biopsy ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Shoulder ; Skin ; Skin Neoplasms ; Thorax ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND: Glycogen synthase kinase 3beta (GSK3beta) is a ubiquitous serine/threonine kinase that is regulated by serine phosphorylation at 9. Recent studies have reported the beneficial effects of a number of the pharmacological GSK3beta inhibitors in rodent models of septic shock. Since most of the GSK3beta inhibitors are targeted at the ATP-binding site, which is highly conserved among diverse protein kinases, the development of novel non-ATP competitive GSK3beta inhibitors is needed. METHODS: Based on the unique phosphorylation motif of GSK3beta, we designed and generated a novel class of GSK3beta inhibitor (GSK3i) peptides. In addition, we investigated the effects of a GSK3i peptide on lipopolysaccharide (LPS)-stimulated cytokine production and septic shock. Mice were intraperitoneally injected with GSK3i peptide and monitored over a 7-day period for survival. RESULTS: We first demonstrate its effects on LPS-stimulated pro-inflammatory cytokine production including interleukin (IL)-6 and IL-12p40. LPS-induced IL-6 and IL-12p40 production in macrophages was suppressed when macrophages were treated with the GSKi peptide. Administration of the GSK3i peptide potently suppressed LPS-mediated endotoxin shock. CONCLUSION: Collectively, we present a rational strategy for the development of a therapeutic GSK3i peptide. This peptide may serve as a novel template for the design of non-ATP competitive GSK3 inhibitors.
Animals ; Cytokines ; Glycogen Synthase Kinase 3 ; Glycogen Synthase Kinases ; Interleukin-12 Subunit p40 ; Interleukin-6 ; Interleukins ; Macrophages ; Mice ; Peptides ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; Rodentia ; Serine ; Shock ; Shock, Septic