PURPOSE: The objective of this case report was to present tube erosion of Ahmed valve implantation using a synthetic dura substitute (Neuro-Patch®, B. Braun, Boulogne, France). CASE SUMMARY: Tube erosion was caused by dissolution of the conjunctiva and partial-thickness scleral tunnel in 5 patients who received Ahmed valve implantation using a synthetic dura substitute for glaucoma treatment 2 to 4 months after the operation. Furthermore, the patients required re-operation for preventing secondary complications such as endophthalmitis. CONCLUSIONS: This case series using a synthetic dura substitute in Ahmed valve implantation demonstrated the risk of tube erosion with scleral tunnel melting and following secondary complications even with a partial-thickness scleral tunnel method.
Conjunctiva ; Endophthalmitis ; Freezing* ; Glaucoma ; Humans ; Methods

The routine screening of patients for hypercalcemia has increased the incidence of hyperpa-rathyroidism, But, Primary hyperparathyroidism is relatively rare disease in korea. Especially, primary hyperparathyroidism caused by parathyroid chief cell hyperplasia has not been reported. The numbers of patients with bone disease, renal stones, other severe complication has declined, but the numbers of patients with psychiatric and neuromuscular disturbance or with asymptomatic disease has increased. We experienced a case with severe bone diseases due to primary hyperparathyroidism caused by parathyroid chief cell hyprepiasia which was confirmed through the mearsurement of serum calcium and parathyroid hormone, neck CT scanning and surgical exploration and which was managed by total parathyroidectomy with autotransplantation.
Asymptomatic Diseases ; Autografts ; Bone Diseases* ; Calcium ; Humans ; Hypercalcemia ; Hyperparathyroidism, Primary* ; Hyperplasia* ; Incidence ; Korea ; Mass Screening ; Neck ; Parathyroid Hormone ; Parathyroidectomy ; Rare Diseases ; Tomography, X-Ray Computed

Idiopathic myelofibrosis (IMF), which is characterized by marrow fibrosis, leukoerythroblastic anemia, teardrop poikilocytosis and splenomegaly due to extrumedullary hematopoiesis, has known to have no form of therapy. On the ground of the possibility of reversing collagen deposion in IMF using 1, 25dihydroxycholecalciferol [1, 25(OH)2D3], we report here our observations of 5 patients (M:F=1:4) with IMF before and after treatment with 0.5 microgram/day of alfacalcidol, precursor of 1, 25(OH)2D3. In 3 fo 5 patients the hemoglobin rose and in 4 of 5 the platelet count increased. Follow-up marrow examination revealed that marrow trephine reticulin fibrosis decreased according as the amelioration of clinical and laboratory findings. But these did not persist except one patient in spite of the sustained use of alfacalcidol. Our results suggest that alfacalcidol may have a therapeutic role in some patients with IMF. More extensive studies will be clarify the action of alfacalcidol in IMF.
Anemia, Myelophthisic ; Bone Marrow ; Child* ; Collagen ; Fibrosis ; Follow-Up Studies ; Hematopoiesis ; Humans ; Platelet Count ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

No abstract available.
Diagnosis* ; Hirschsprung Disease* ; Manometry*

We report a case of pure red cell aplasia due to parvovirus B19 infection in a renal transplant recipient. The patient was a 32-year-old male with end stage renal disease due to chronic glomerulonephritis, who had been undergoing regular hemodialysis. He received a living nonrelated renal transplant and immumosuppressive therapy including prednisolone, tacrolimus, and mycophenolate mofetil. One week after kidney transplantation, severe anemia was persisted despite recombinant human erythropoietin administration and packed red blood cell transfusion. His bone marrow aspiration smear demonstrated erythroid hypoplasia and giant pronormoblasts with prominent intranuclear inclusions. Both serum and bone marrow were positive for parvovirus B19 DNA polymerase chain reaction and anti-parvovirus B19 IgM. He was treated with intravenous immunoglobulin and conversion of tacrolimus to cyclosporine. His hemoglobin level was completely recovered three months later.
Adult ; Anemia ; Bone Marrow ; Cyclosporine ; DNA ; Erythroblasts ; Erythrocyte Transfusion ; Erythropoietin ; Glomerulonephritis ; Humans ; Immunoglobulin M ; Immunoglobulins ; Intranuclear Inclusion Bodies ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Parvovirus* ; Polymerase Chain Reaction ; Prednisolone ; Red-Cell Aplasia, Pure* ; Renal Dialysis ; Tacrolimus ; Transplantation*

Carthamus tinctorius L.is known to improve fracture healing, and bone morphogenetic proteins (BMPs) are associated with the formation and healing process of bone. BMP-2 and BMP-7 are two of the most important BMPs during the bone healing process. Human osteosarcoma MG63 cells and rats were used to determine the effects of Carthamus tinctorius L. extract (CTE) on BMP-2 gene expression. BMP-2 gene expression by CTE treatment in human osteosarcoma MG63 cells was not different from the control group until 8 hours of incubation, but was significantly higher, by 31%, than that of the control group at 16 hr of incubation. Microscopic findings of the 9th rib 3 weeks after fracture showed typical rimming of the osteoblast and immature bone formation in control and CTE groups. BMP-2 gene expression by in situ hybridization was remarkably increased by a CTE-supplemented diet in the fracture group compared to the control group. In conclusion, Carthamus tinctorius L. increased BMP-2 gene expression in human osteosarcoma cells and fractured bone. But further studies would be needed to elucidate the effect of CTE on fracture healing in vivo because our results did not show any evidence of healing improvement histologically 3rd week after fracture.
Animals ; Bone Morphogenetic Protein 7 ; Bone Morphogenetic Proteins ; Carthamus tinctorius* ; Carthamus* ; Diet ; Fracture Healing ; Fractures, Bone* ; Gene Expression* ; Humans ; In Situ Hybridization ; Osteoblasts ; Osteogenesis ; Osteosarcoma ; Rats* ; Ribs

Pacemaker Runaway is a rare, but potentially lethal complication after pacemaker implantation. Pacemaker runaway was one of the common manifestations of malfunctioning pacemaker at the time of fixed rate pacemaker, but has been less common after the demand type pacemaker had replaced the fixed rate model. The early recognition of runaway pacemaker is very important because runaway pacemaker can cause bradyarrhythmia, ventricular tachycardia-fibrillation and asystole resulting in syncope or death. We report a clinical experience of runaway pacemaker in 68 year-old woman, who received permanent pacemaker implantation(fixed rate 72/min, VVI, Micropulse 22U, Edwards system) due to sick sinus syndrome eight years ago. She complained of sudden chest tightness and dyspnea 10 days prior to admission. On physical examination, increased jugular venous pressure, rapid heart beats, basal rales on both lung fields and three finger-breath tender hepatomegaly. Electrocardiogram showed a rapid pacemaker rhythm of 140 beats per minute. So, the malfunctioning pacemaker was removed and replaced with a new programmable demand type pacemaker(VVI, OPTIMA-MP, Telectronics) in the same pocket under the diagnosis of pacemaker runaway. Her subject symptoms were relieved and electrocardiogram showed a regular pacemaker rhythm of 71 BPM. She was discharged ten days after pacemaker replacement.
Aged ; Bradycardia ; Child ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Heart ; Heart Arrest ; Hepatomegaly ; Homeless Youth* ; Humans ; Lung ; Physical Examination ; Respiratory Sounds ; Sick Sinus Syndrome ; Syncope ; Thorax ; Venous Pressure

BACKGROUND: Welders tend to be exposed to a variety of hazards including metal fumes, toxic gases, electricity, heat, noise, and radiation such as ultraviolet and infrared light. Noxious gases generated during welding include carbon monoxide, ozone, and nitrogen oxide. Although the effects of metal fumes have been well studied, few reports have investigated the influence of noxious gas exposure in welders. CASE REPORT: We encountered a patient who developed non-cardiogenic pulmonary edema within a day after fairing up a steel plate with an oxygen/LPG torch. The patient was a 43-year-old female who complained of dyspnea which became exacerbated the following morning. Her chest X-ray and chest CT scan showed an extensive ground glass opacity which was more prominent in the both upper lungs. Both her symptoms and chest X-ray findings improved. We attributed the patient's symptoms to non-cardiogenic pulmonary edema caused by nitrogen dioxide exposure, by reasoning that: 1) the patient's clinical course and radiologic findings suggested pulmonary edema 2) the event happened following fairing work with oxygen/LPG torch that usually induces a high concentration of nitrogen dioxide, and 3) the other possible causes of pulmonary edema could be excluded. CONCLUSION: Nitrogen dioxide-induced pulmonary edema should be considered in oxygen torch contrary to arc welding.
Adult ; Carbon Monoxide ; Dyspnea ; Electricity ; Female ; Gases ; Glass ; Hot Temperature ; Humans ; Lung ; Nitrogen Dioxide ; Nitrogen* ; Noise ; Oxygen* ; Ozone ; Pulmonary Edema* ; Steel ; Thorax ; Tomography, X-Ray Computed ; Welding

It has been thought for many years that gastric adenocarcinoma almost never crosses the pylorus. Rokitanski in 1861 made the classic statement that the pyloric served as a barrier to duodenal dissemination of gastric cancer. Although this theory was generally accepted, but direct spread of gastric carcinoma into the duodenum has been reported, most recently in 1965. We report two recent cases of gastric cancer spreading into the duodenum and review the literature.
Adenocarcinoma ; Duodenum* ; Pylorus ; Stomach Neoplasms

To evaluate the incidence and clinical course of AV conduction disturbances associated with acute myocardial infarction(MI) and coronary angiographic characteristics in acute inferior MI with AV blocks. We reviewed the medical records and serial ECG's in 89 patients with acute MI treated in CCU of Chonnam National University Hospital from january, 1987 through August, 1990. The subjects were 44 anterior MI's, 43 inferior MI's, and 2 anterior and inferior MI's. AV conduction disturbances were observed in 25.8% of all the patients with acute MI's, 48.8% of 43 inferior MI's and 4.5% of 44 anterior MI's. High degree AV block was observed in 20.0% of all the subjects, 39.3% of inferior MI patients, and none of anterior MI patients. The most severe AV blocks observed in each patients were 7(30.4%) first-degree, 5(21.7%) second-degree, and 11(47.8%) third-degree AV block. The initial AV conduction disturbances developed within 6 hours after onset of symptoms in 9(47.4%) and after 24-hours in 9(47.4%). Seven(30.4%) of 23 patients with AV block showed a transient progression in the degree of AV block, 5(29.4%) of 17 patients with first-or second-degree AV block progressed to third-degree AV block thereby constituting 45.5% of 11 third-degree AV blocks. Nine patients with early AV block less tended to progress in the degree of AV block than the patients with late AV block (1/9 vs 4.9). In early AV block the duration of high-degree AV block was shorter than late AV block(2.5 days vs 6.1 days). The duration of third-degree AV block was less than 2-hurs in 36.4~24 hours in 27.3%, and more than 24 hours in 36.4%. All third-degree AV blocks(90.9%) but one with the longest duration of 13 days returned to 1 : 1 AV conduction within 7 days. There was no significant difference in coronary angiographic findings including the incidence of stenotic lesion in proximal LAD and first septal perforator, number of involved vessel(s), and severity of RCA lesion between the patients with AV block and the patients without AV block in inferior MI.
Atrioventricular Block ; Humans ; Incidence ; Jeollanam-do ; Medical Records ; Myocardial Infarction*