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

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

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

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

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

Endobronchial leiomyoma is extremely rare and accounts for less than 2% of benign tumors of the lower respiratory tract. Leiomyomas are predominantly found in the young and the middle aged : of the average age being 35 years for bronchial and lung parenchymal lesions and 40.6 years for tracheal lesions. The symptom depends on the location of the tumor, its size, and changes in the lung distal to the lesion. A 37-year-old woman was admitted to our hospital complaining of coughing. Bronchoscopy revealed complete obstruction of the right main bonchus at the carina by an oval-shaped, nonulcerative, smooth, and pinkish-tan tumor with a broad margin and extended to the left main bronchus. A biopsy was performed and showed a benign spindle cell tumor. A right pneumonectomy was performed because of chronic infection, and the lung could not expanded during aeration. The histological diagnosis of the resected specimen was leiomyoma. The postoperative course was uneventful.
Adult ; Biopsy ; Bronchi ; Bronchoscopy ; Cough ; Diagnosis ; Female ; Humans ; Leiomyoma* ; Lung ; Mediastinitis ; Middle Aged ; Pneumonectomy ; Respiratory System

BACKGROUND: This study was designed to figure out how anesthesiologists think about their job values and expected tendencies through questionnaires. METHODS: The directions for completing internet questionnaires were sent to all members and semi-members of the Korean Society of Anesthesiologists by email. Paper version of the same questionnaires was sent to residents of some university hospitals, who did not answer the internet questionnaires. The questionnaires consisted of items of basic, 14 job values and 80 expected tendencies. The answerers were asked to choose 4 items among job values and 10 items among 80 tendencies. The answers were analyzed according to the groups of job positions, subspecialties, ages and gender. RESULTS: Among items of job values, 'decision making', 'taking care of people', 'working with my hands' and 'working with my mind' were chosen by more than 40% of answerers, and answer rates were similar between each comparative groups. Among items of expected tendencies, 'be calm in crisis', 'make decisions rapidly', 'be perfectionistic', 'be good coordinators', 'be self-confident', 'think logically', 'be tolerant of others', 'be able to do more than one thing at a time', and 'be persevering' showed high answer rate, but the answer rate of individual items showed some differences between groups. CONCLUSIONS: Although there were some items that showed different answer rates between groups, there was little difference in job values and expected tendencies between groups on the whole.
Electronic Mail ; Hospitals, University ; Internet ; Surveys and Questionnaires

Blunt chest trauma can cause various types of cardiac injuries such as myocardial contusion,cardiac ruptrue, valvular or papillary muscle injuries, and pericardial or coronary artery injuries. Complete rupture of both papillary muscles accompanied by left ventricular(LV) rupture following blunt chest trauma to our knowledge has not been previously reported. A 40-year-old female was referred because of severe dyspnea and anterior chest pain which occured immedicately after blunt chest trauma. Echocardiography demonstrated a moderate pericardial effusion as well as rupture of both papillary muscle with severe mitral regurgitation. Hemopericardium and a complets tear of the anterolateral papillary muscle at the mid portion were observed. The posteromedial papillary muscle was totally transected at the attachment site of LV wall and accompanied by external rupture of left ventricle at that site. Mitral valve replacement and primary repair of LV ruptrue was performed successfully. In the case we report, complete rupture of both papillary muscles developed after blunt chest trauma and LV rupture occurred as the papillary muscle was torn from the LV wall.
Adult ; Chest Pain ; Coronary Vessels ; Dyspnea ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Papillary Muscles* ; Pericardial Effusion ; Rupture* ; Thorax*

The surgical treatment of diseases of thoracic aorta has had much better success rate in recent years compaired to the past. Aortic aneurysms or dissections that extend along the entire thoracic aorta are usually approached in two or three stages. Recently we successfully performed one-stage aortic replacement from the aortic root to the abdominal aorta in chronic DeBakey type I dissection. A 25 year-old man who had dyspnea on exertion (NYHA Fc II) and a Marfanoid feature was operated under the diagnosis of chronic type I dissection with severe aortic regurgitation. At operation, a huge ascending aorta with two intimal tearings was seen and the blood supply of intercostal arteries and right renal artery was done from the false lumen. Modified Bentall operation with total aortic replacement was done successfully, and the patient is being followed-up without major complications.
Adult ; Aorta* ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Valve Insufficiency ; Arteries ; Diagnosis ; Dyspnea ; Humans ; Renal Artery