No abstract available.
Dyskeratosis Congenita*

PURPOSE: To report three cases of severe endothelial cell density loss after iris claw phakic intraocular lens (Artisan® lens) implantation. CASE SUMMARY: A 32-year-old woman underwent iris claw intraocular lens implantation in both eyes. Preoperative corneal endothelial cell count was 2,556 cells/mm² in the right eye and 2,674 cells/mm² in the left eye. After 4 years, the corneal endothelial cell count was 1,968 cells/mm² in the right eye and 1,997 cells/mm² in the left eye. A 27-year-old woman underwent iris claw intraocular lens implantation in both eyes. Preoperative corneal endothelial cell count was 3,222 cells/mm² in the right eye and 3,122 cells/mm² in the left eye. After 4 years 8 months, the corneal endothelial cell count was 2,729 cells/mm² in the right eye and 2,488 cells/mm² in the left eye. A 39-year-old woman underwent phakic intraocular lens implantation in other clinic, and the lens of left eye was removed the same day because of elevated intraocular pressure. She underwent iris claw intraocular lens implantation in the left eye. Preoperative corneal endothelial cell count was 2,500 cells/mm² in the left eye, which decreased to 1,873 cells/mm² after 8 years. Six months after intraocular lens removal and cataract surgery, her cornea endothelial cell count was 1,412 cells/mm². CONCLUSIONS: Although iris-fixed intraocular lens implantation is safe and effective for correcting myopia, at least 4 years of long-term observation for evaluating corneal endothelial cell density maybe necessary.
Adult ; Animals ; Cataract ; Cornea ; Endothelial Cells* ; Female ; Hoof and Claw ; Humans ; Intraocular Pressure ; Iris ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Myopia ; Phakic Intraocular Lenses*

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Hemorrhage ; Intestine, Small ; Leiomyosarcoma*

The successful closure of a fistula clearly involves application of spectrum of techniques depending variable factors. There was variety of opinions regarding the timing and optimum surgical technique for repair of fistula. Several muscles and myocutaneous flaps are applicable to a variety of tissue defects. The gracilis muscle is especially useful as adjuncts for wound coverage, vaginal or penile reconstruction and as interpositional tissue for the closure of various fistulas. We experienced two cases of female urinary tract fistula treated with gracilis muscle flap successfully.
Female* ; Fistula* ; Humans ; Muscles ; Myocutaneous Flap ; Urinary Tract* ; Wounds and Injuries

Raeder's syndrome, or Raeder's paratrigeminal syndrome, is a painful Horner's syndrome characterized by unilateral head pain, oculosympathetic paralysis (miosis, ptosis) and anhydrosis over the forehead with otherwise normal facial sweating. We report two cases of Raeder's syndrome whose cause had not been found despite of intensive investigation and one case associated with nasopharyngeal tumor. The first case had a headache, miosis, ptosis but had not cranial nerve palsy. The second case had a unilateral facial headache, oculosympathetic paralysis, aoydrosis of forehead and sensory change in the ipsilateral ophthalmic division of the trigeminal nerve. The third case had a headache, miosis, ptosis, anhydrosis of forehead and sensory change in the whole territory of the trigeminal nerve.
Cranial Nerve Diseases ; Forehead ; Headache ; Horner Syndrome ; Miosis ; Paralysis ; Sweat ; Sweating ; Trigeminal Nerve

OBJECTIVE: The purpose of this study is to evaluate the effects of a self-stretching exercise on the pressure threshold of myofascial trigger point. METHOD: We examined the changes of pressure threshold in 66 patients with myofascial trigger points before and after a self-stretching exercise of shoulder girdle and also tested the visual analogue scale (VAS) of the subjective pain intensity. The self-stretching exercise of shoulder girdle includes a stretching exercise of four muscles in shoulder girdle simultaneously, including upper trapezius, levator scapulae, infraspinatus, rhomboideus major and minor, which is followed by 1) a sitting position, relaxed, 2) lateral bending of neck to contralateral side, 3) forward and downward stretching of ipsilateral arm with protrusion of scapula and internal rotation of arm maximally to the contralateral foot. Each stretching motion is maintained for 30 seconds. RESULTS: The results of the patients experiencing unilateral or bilateral myofascial neck and shoulder pain showed that the pressure threshold of trigger point increased in response to the self-stretching exercise as assessed by a pressure algometer. Also visual analogue scale (VAS) decreased in response to the self-stretching exercise. CONCLUSION: We conclude that the self-stretching exercise of shoulder girdle is an effective method for the simultaneous stretching of upper trapezius, levator scapulae, infraspinatus, rhomboideus major and minor.
Arm ; Foot ; Humans ; Muscles* ; Neck ; Scapula ; Shoulder Pain ; Shoulder* ; Superficial Back Muscles ; Trigger Points*

The empty sella syndrome is defined as the intrasella herniation of the chiasmal cistern resulting from a congenitally incompetent diaphragma sellae. In idiopathic or primary empty sella syndrome, sella remodelling occurs as a result of an anatomical variation in the diaphragma sella. The secondary empty sella syndrome occurs following surgery or irradiation of an intrasellar lesion. Empty sella syndrome is known to be rarely associated with Cerebrospinal fluid (CSF) rhinorrhea. We experienced a case of secondary empty sella symdrome with CSF rhinorrhea in a 56-year old female who complained of persistent rhinorrhea through the roof of the sphenoid sinus after brain surgery due to meningioma. The CSF rhinorrhea was treated successfully with transseptal trans-sphenoidal approach.
Brain ; Cerebrospinal Fluid Rhinorrhea* ; Cerebrospinal Fluid* ; Empty Sella Syndrome* ; Female ; Humans ; Meningioma ; Middle Aged ; Sphenoid Sinus

BACKGROUND AND OBJECTIVES: Metastatic process of carcinoma cells involves dissolution of tumor matrix and penetration of the basement membrane (BM) which involves the active proteolysis of type IV collagen, proteoglycan, laminin, and fibronectin. The hallmark of invasion is the penetration of epithelial BM by serine protease and matrix metalloproteinase. Matrix metalloproteinases (MMP) include type IV collagenase, interstitial collagenase, and stromelysin, where MMP-2 and MMP-9 are considered to be the most important in tumor invasion. Urokinase-type plasminogen activator (u-PA) promotes conversion of plasminogen to active plasminogen causing degradation of fibrin, fibronectin, proteoglycan, and laminin. Plasminogen activator inhibitor (PAI-1) is a specific inhibitor of u-PA, and it is involved in defense from tumor invasion through metastasis. In this thesis, the expression patterns of MMP-2, u-PA and PAI-1 were investigated in laryngeal squamous cell carcinoma in tumor invasion and lymph node metastasis. MATERIALS AND METHODS: Tumor tissue from 50 cases of laryngeal cancer paraffin block specimens were used from the archives of Department of Pathology in Korea University hospital to study the expression pattern of MMP-2, u-PA, and PAI-1. RESULTS: The results have shown that in laryngeal cancer, the positive expression rate for MMP-2 was 54%, u-PA 72%, and PAI-1 46%. The expression of MMP-2 was related with lymph node metastasis, and u-PA expression increased according to the increase of primary tumor staging. There were no significant relationship between the expression rates of MMP-2, u-PA, and PAI-1 with histopathologic grading and invasion mode. These results suggest that u-PA could be used as a biological marker for tumor size and MMP-2 for lymph node metastasis, whereas PAI-1 is not a significant marker for tumor invasion or lymph node metastasis.
Basement Membrane ; Biomarkers ; Carcinoma, Squamous Cell* ; Collagen Type IV ; Collagenases ; Fibrin ; Fibronectins ; Korea ; Laminin ; Laryngeal Neoplasms ; Lymph Nodes* ; Matrix Metalloproteinase 1 ; Matrix Metalloproteinase 3 ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Neoplasm Staging ; Paraffin ; Pathology ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Proteoglycans ; Proteolysis ; Serine Proteases ; Urokinase-Type Plasminogen Activator*

BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.
Acute Kidney Injury ; Chungcheongnam-do ; Doxycycline ; Female ; Fever ; Gangwon-do* ; Humans ; Hypoalbuminemia ; Incidence ; Korea ; Leukocytosis ; Male ; Medical Records ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Scrub Typhus* ; Shock ; Thrombocytopenia ; Ventilators, Mechanical

BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.
Acute Kidney Injury ; Chungcheongnam-do ; Doxycycline ; Female ; Fever ; Gangwon-do* ; Humans ; Hypoalbuminemia ; Incidence ; Korea ; Leukocytosis ; Male ; Medical Records ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Scrub Typhus* ; Shock ; Thrombocytopenia ; Ventilators, Mechanical