The success rate of endonasal lacrimal surgery have been reported inferior to that of external lacrimal surgery. But nowadays, owing to developement of surgical instrument, such as endoscope, and improvement of surgical skill, better success rates have been reported. We have performed endonasal lacrimal surgery in 36 eyes of 34 patients and external lacrimal surgery in 41 eyes of 36 patients who have had lacriaml pathway obstruction confirmed by dacryocystography. Endonasal lacrimal surgery has been performed with endoscope, fiberoptic light pipe, and conventional lacrimal surgery instruments. Primary success rates are 84.0% in endonasal dacryocystorhinostomy (DCR), 89.5% in external DCR, 81.8% in endonasal conjunctivodacryocystorhinostomy(CDCR), and 90.9% in external CDCR. The rate of postoperative complications are 32.0% in endonasal DCR, 47.4%, in external DCR, 27.3% in endonasal CDCR, and 40.9% in external CDCR. Therefore, in order to increase the success rate of endonasal lacrimal surgery, improvement of surgical technique, use of adequate surgical instrument and careful followup examination for proper management of postoperative complicaitons are considered essential.
Dacryocystorhinostomy ; Endoscopes ; Follow-Up Studies ; Humans ; Postoperative Complications ; Surgical Instruments

Progressive iris atrophy is a disease characterized by marked iris atrophy, iris hole, corneal endotherial abnormality, perripheral anterior synechia, and glaucoma. It is considered as a variant of iridocorneal endotherial syndrome with Chandler's syndrome and Cogan-Reese syndrome. We have experianced a 34 year old male patient complaning visual blurring in his left eye. At examination, we found characteristics of progressive iris atrophy. After filerring surgery, associated glaucoma was well controlled. Then we report a case with review of the literatures.
Adult ; Atrophy* ; Glaucoma ; Humans ; Iridocorneal Endothelial Syndrome ; Iris* ; Male

Between 1984 and 1996, 8 patients who were suffered from stage g Kienbock's disease underwent interpositional arthroplasty using pronator quadratus pedicled bone. Patients comprised 2 males and 6 females, with an average age of 33 years(range 19-47). Range of motion of the wrist, residual pain, grip strength, and carpal height ratio of the patients were analyzed. The follow-up period was between 1.5 years and 12.5 years(average 5.5 years). The arc of flexion-extension of the wrist was increased from average 74 degrees preoperatively to 96 degrees postoperatively. Among eight patients, five were free of pain and three had intermittent pain during heavy work. None of eight patients had any discomfort in daily work and changed his or her occupation. The grip strength was average 83% of the normal side. Carpal height ratio was average 0.48 preoperatively and was not changed postoperatively. Clinical results, assessed by Lichtman-Evans criteria, showed 4 good and 4 fair. The interpositional arthroplasty using pronator quadratus pedicled bone was considered as a very effective method for the treatment of stage III Kienbock's disease.
Arthroplasty* ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Occupations ; Osteonecrosis* ; Range of Motion, Articular ; Wrist

It was known that the regenerating liver cytosol accelerated liver regeneration, whereas normal liver cytosol inhibited it during first 28 hours, but promoted it later by the thymidine incorporation test. In experiments, Sprague-Dawley male rats were divided into 3 experimental groups (A, B and C) which had 10 rats in each. Also, each group was equally subdivided into 2 subgroups such as A-8 and A-28 in the A group, B-8 and B-28 in the B group and C-8 and C-28 in the C group. All groups were partially hepatectomized equally. The remnant livers were procured at 8 hours in the 3 subgroups A-8, B-8 and C-8 and at 28 hours in the other 3 subgroups A-28, B-28 and C-28. Another experiment was performed in 10 rats under the same partial hepatectomy to get the average weight of the remnant liver. These data could be taken as the initial weight of the remnant liver in the above experimental animals. The normal saline, normal liver cytosol extract and regenerating liver cytosol extract were injected intraperitoneally after the partial hepatectomies, 4 ml of in the A, B, and C groups, respectively. Since specific structural changes might precede demonstrable functional alterations, morphometric measurements were done in the histological specimens of the 3 subgroups A-8, B-8, and C-8. The remnant livers, obtained in all six subgroups, were weighed to calculate the regeneration rates. The overall results are as follows : 1) The liver regeneration rates in the six subgroups were 4.1% in A-8, 3.8% in B-8, 4.3% in C-8, 28.4% in A-28, 16.7% in B-28, and 32.8% in C-28. 2) The morphometric study showed that the nucleus/cytoplasm ratios in the three subgroups were 0.1389 in A-8, 0.2048 in B-8, and 0.3705 in C-8. These results mean that regenerating liver cytosol extract promotes liver regeneration and that normal liver cytosol extract inhibits it during first 28 hours after a partial hepatectomy, but promotes cell division for subsequent regeneration.
Animals ; Cell Division ; Cytosol* ; Hepatectomy* ; Humans ; Liver Regeneration* ; Liver* ; Male ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Thymidine

The Diabetes Educator Training Module (DETM), which was developed in 2011, contained more than 900 slides. The purpose of the DETM is to help Korean diabetes educators develop programs for diabetic patients and health professionals. In this paper, we present information regarding the history, the principles of development, the contents, and the use of the DETM program. We hope that the DETM will be a useful tool for helping diabetic patients to understand their disease and to improve their glycemic control and treatment adherence.
Health Occupations ; Humans ; Patient Education as Topic ; Teaching Materials

Acute mesenteric ischemia can result from emboli, arterial and venous thrombi or vasoconstriction secondary to low-flow states. Isolated spontaneous dissection of the superior mesenteric artery is a rare cause of acute mesenteric ischemia. The mortality rates of acute mesenteric ischemia averages 71% with a range of 59-93%. Diagnosis before the occurrence of intestinal infarction is the most important factor in improving survival rate for patients with acute mesenteric ischemia. A 68-year-old female presented with postprandial epigastric pain, and a dissection of the superior mesenteric artery and a gallbladder polyp were shown in abdominal computed tomographic scan. After the percutaneous metalic stent placement and laparoscopic cholecystectomy, her symptoms improved. We report a case of spontaneous dissection of main trunk of the superior mesenteric artery which was successfully treated by percutaneous stent placement with a review of literature.
Acute Disease ; Aged ; Aneurysm, Dissecting/complications/*therapy ; *Angioplasty, Balloon ; Female ; Humans ; Ischemia/etiology ; *Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion/etiology ; *Stents

Variceal bleeding from enterostomy site is an unusual complication of portal hypertension. The bleeding, however, is often recurrent and may be fatal. The hemorrhage can be managed with local measures in most patients, but when these fail, surgical interventions or portosystemic shunt may be required. Herein, we report a case in which recurrent bleeding from stomal varices, developed after a colectomy for rectal cancer, was successfully treated by placement of transjugular intrahepatic portosystemic shunt (TIPS) with coil embolization. Although several treatment options are available for this entity, we consider that TIPS with coil embolization offers minimally invasive and definitive treatment.
Colectomy/adverse effects ; Contrast Media/pharmacology ; Embolization, Therapeutic/*methods ; Esophageal and Gastric Varices/surgery ; Gastrointestinal Hemorrhage/*therapy ; Humans ; Male ; Middle Aged ; *Portasystemic Shunt, Transjugular Intrahepatic ; Rectal Neoplasms/surgery ; Tomography, X-Ray Computed/methods ; Treatment Outcome

PURPOSE: This study was designed to assess the clinical manifestations and the effect on prognosis of seizures in children with acute lymphoblastic leukemia(ALL). METHODS: The study group consisted of 20 patients(10 males and 10 females) who experienced seizures out of the 198 pediatric ALL patients(117 males and 81 females) who were diagnosed and treated at the Department of Pediatrics, St. Mary's Hospital, the Catholic University of Korea. RESULTS: The overall incidence of seizure developing after the diagnosis of ALL was 10.1% and in 11 patients(5.6%), seizure recurred one or more times. An average of 6.5+/-3.6 months(range 0-42 months) elapsed between the beginning of treatment and the new onset of seizures. In 13 patients(65%), the first seizure occurred during the induction or re-induction chemotherapy phase. Seizure type was partial seizure in 11 patients(55%), and generalized seizure in 9 patients(45%). In 15 patients(88.2%), brain imaging study showed abnormal findings and in 18 patients(90%), EEG revealed abnormal findings. 11 patients were diagnosed with epilepsy and were treated with long-term anticonvulsants. In these patients, 4 patients(36.4%) had no seizure recurrence, but 2 patients(18.2%) showed no response to anticonvulsants. The 5-year survival rate of the patients experiencing seizures was 47%, while the rate was 78% for those did not experience seizures (P<0.001). CONCLUSION: Seizures in pediatric patients with ALL was closely related to the 5-year survival rate. Therefore, these patients require early careful observation, evaluation and intensive care. Also, further studies such as ways to diminish the side effects of antileukemic agents are necessary to reduce the risk of seizure.
Anticonvulsants ; Child ; Electroencephalography ; Epilepsy ; Humans ; Incidence ; Critical Care ; Leukemia ; Male ; Neuroimaging ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Recurrence ; Seizures ; Survival Rate

PURPOSE: Preaxial polydactyly is the most common congenital anomaly of upper extremities. In this study, we classified 112 patients of preaxial polydactyly for investigation of recent incidences of each types. METHODS: We reviewed 120 cases of preaxial polydactyly diagnosed at university hospitals of Incheon and Bucheon from 2000 to 2008. All cases were grouped using simple radiographs and all cases were classified according to the Upton modified Iowa system. RESULTS: Among the 120 cases of preaxial polydactyly, 7 cases(6%) were in type I polydactyly, 35 cases(29%) type II, 1 case(1%) type III, 48 cases(40%) type IV, 12 cases(10%) type V, 5 cases(4%) type VI, 12 cases(10%) type VII, respectively. All cases in type VII polydactyly were triphalangism. CONCLUSION: Comparing with Wassel's study and Upton's study, our study showed similar distribution of each types of preaxial polydactyly.
Hospitals, University ; Humans ; Incidence ; Iowa ; Polydactyly ; Thumb ; Upper Extremity

Acute idiopathic pulmonary hemorrhage in infants (AIPHI) is characterized by a sudden onset of pulmonary hemorrhage in previous healthy infants. Evidence of pulmonary hemorrhage may present as hemoptysis or a finding of blood in the nose or airway with no evidence of upper respiratory or gastrointestinal bleeding. Patients presenting with acute, severe respiratory distress or failure, and those requiring mechanical ventilation and often demonstrate bilateral infiltrates by chest radiography. We report a case of AIPHI which developed during the induction of anesthesia. A 3-month-old male infant received right herniorraphy under general endotracheal anesthesia. After intubation, blood tinged fluid was aspirated using an endotracheal tube during operation. Chest radiography showed bilateral ground glass opacity. We transferred the patient to the ICU and applied conventional mechanical ventilation. However hypoxemia and respiratory acidosis were persisted. We then switched to a high frequency ventilator (HFV), the hypoxemia and respiratory acidosis were corrected. The patient was transferred to the general ward on the 7th postoperative day.
Acidosis, Respiratory ; Anesthesia ; Anoxia ; Glass ; Hemoptysis ; Hemorrhage* ; High-Frequency Ventilation* ; Humans ; Infant* ; Intubation ; Male ; Nose ; Patients' Rooms ; Radiography ; Respiration, Artificial ; Thorax ; Tolnaftate ; Ventilators, Mechanical