Pneumatic retinopexy was introduced by Hilton in 1986, and this methed is a recently described procedure used for the treatment of primary rhegmatogenous retinal detachment. A gas bubble is injected into the vitreous cavity so that the bubble closes the retinal break, permitting resorption of subretinal fluid. A chorioretinal adhesion formed around the break by cryotherapy or laser photocoagulation secures the retina in place. Indication of pneumatic retinopexy in A Two-step Outpatient Operation Without Conjuntival Incision described by Hilton in 1986 is retinal detachments secondary to one break or group of breaks no larger than 1 o'clock hour located within the superior 8 o'clock hours of the fundus. The ocular conditions of the 26 cases included in this study were proliferative vitreoretinopathy C1, C2, aphakia, multiple breaks in multiple quadrants, extensive retinal detachment more than 3 quadrants in size, pseudophakia. The overall success rate for primary pneumatic retinopexy was 73.1%(19 eyes). The greatest number of failure were due to delayed absorption of subretinal fluid (5 eyes). With subsequent procedure, 7 eyes that failed with primary pneumatic retinopexy were reattached.
Absorption ; Aphakia ; Cryotherapy ; Humans ; Light Coagulation ; Outpatients ; Pseudophakia ; Retina ; Retinal Detachment ; Retinal Perforations ; Subretinal Fluid ; Vitreoretinopathy, Proliferative

Verrucous carcinoma as a well differentiated squamous cell carcinoma appeared in skin and mucosa, so called Ackerman's tumor, is a slow-growing tumor with local infiltration rather than the tendency of metastasis. Though this tumor has been reported by many authors since named by Ackerman, despite the relatively small number of skin cancers, the difficulty in diagnosis due to benignity and pathologic finding and the high recurrence rate has aroused the interest in the disease. In addition, the premalignant region or pathogenesis has not been discovered clearly yet, besides the assosiation with chewing tabacco, but such as the correlation with hereditary carcinogenic factor(gene) in etiology with recent molecular biological approach has been clarified steadly. In the 51-year-old male patient with 1.5 x 1.5cm verrucous carcinoma originating from lower lip, it was possible to achieve a good result in terms of both aethetics and function with the use of surgical excision. Since 1980 when one case originating from postauricular area was reported in 1980, there has been no reports on the case from oral cavity in Korea. Therefore, we report one case of verrucous carcinoma from lower lip, experienced for the first time, on this literature.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Diagnosis ; Humans ; Korea ; Lip* ; Male ; Mastication ; Middle Aged ; Mouth ; Mucous Membrane ; Neoplasm Metastasis ; Recurrence ; Skin ; Skin Neoplasms

BACKGROUND: The use of leeches can effectively increase the salvage rate of flap congestion. However, the first reaction from patients and carers in using leeches in clinical fields is strong aversion. This can be due to the fact that development of our culture from agriculture to industrial society, coming across leeches became fairly rare. Also because of the biological traits that leeches carry; staying attached to a leg or other body parts of the host, sucking blood, and leaving wounds. METHODS: This study was conducted through questionnaires, divided into many subgroups. We scaled the compliance of the two therapies, with or without leech. Maximum scale of 10 showing no rejective response to the therapy and minimum scale of 0 showing the greatest rejective response. RESULTS: Overall subjects' compliance was improved after explaining the benefits of hirudotherapy. Irrelevant to the explanation, there was no significant difference in general compliance between male and female. Young-aged group and medical personnel or people studying medicine showed higher compliance over older-aged group and the general public. CONCLUSION: In the terms of general social cognition, recognizing leech as a therapeutic material may not be welcomed at first, but provided with proper information and explanations, overall compliance of patients and carers can be improved and consequently result in superior outcomes in flap salvage.
Agriculture ; Bloodletting ; Caregivers ; Cognition ; Compliance ; Estrogens, Conjugated (USP) ; Female ; Human Body ; Humans ; Leeches ; Leg ; Male ; Patient Compliance* ; Surgical Flaps ; Surveys and Questionnaires ; Wounds and Injuries

BACKGROUND: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap. Thus, the study aims to demonstrate its versatility with clinical practices. METHODS: This is retrospective case study on 38 patients who removed facial masses and reconstructed by the cheek rotation flap from 2008 to 2015. It consists of defects on cheek (16), lower eyelid (12), nose (3), medial canthus (3), lateral canthus (2), and preauricle (2). Buccal mucosa was used for the reconstruction of eyelid conjunctiva, and skin graft was processed for nasal mucosa reconstruction. RESULTS: The average defect size was 6.4 cm², and the average flap size was 47.3 cm². Every flap recovered without complications such as abnormal slant, entropion or ectropion in lower eyelid, but revision surgery required in three cases of nasal side wall reconstruction due to the occurrence of dog ear on nasolabial sulcus. CONCLUSION: The cheek rotation flap can be applicable instead of paramedian forehead flap for the large nasal sidewall defect reconstruction as well as former medial and lateral canthal defect reconstruction.
Animals ; Cheek* ; Cicatrix ; Conjunctiva ; Dogs ; Ear ; Ectropion ; Entropion ; Eyelids ; Forehead ; Humans ; Lacrimal Apparatus ; Mouth Mucosa ; Nasal Mucosa ; Nose ; Retrospective Studies ; Skin ; Skin Pigmentation ; Transplants

PURPOSE: To evaluate the therapeutic effect of gamma knife radiosurgery in cerebral vascular malformationusing a radiologic imaging method such as MRI or angiography. MATERIALS AND METHODS: We retrospectively reviewedMRIs, Ct scans and angiograms of 29 cases of arteriovenous malformation and 15 of cavernous malformation beforeand after gamma knife radiosurgery. The patients underwent follow-up radiologic studies for between 6 and 35months after radiosurgery. No patient underwent ofter surgery of embolization. Radiological imaging analysisfocused on changes in the volume of the nidus or central core. Other findings of edema, cystic change, hemorrhage,signal intensity, enhancement and distributional vascular markings were also studied. The volume of the AVM niduswas measured and assigned ot one of four groups : <1cc, 1-4cc,> 4-10cc and> 10cc. RESULTS: In arteriovenousmalformation cases, the volume of the nidus decreased by mean 60.2%; reduction was greatest(68.1%) in the 1-4ccgroup. Three cases showed complete loss of the nidus at 9, 12 and 25 months after radiosurgery, respectively. Innine cases, dereased caliber or loss of draining vein was noted. High signal intensity on T2-weighted MR images,suggesting either edema or demyelination, was observed in four cases. In cavernous angioma cases, core volume wasreduced by 36.8%. Transient cerebral edema and presumed radiation necrosis were observed in two cases and one,respectively. CONCLUSION: Gamma knife suregery was effective in nearly all cases of arteriovenous malformationand some cases of cavernous malformation. More than two years follow-up involving radiologic imaging such as MRIis needed for the evaluation of therapeutic effect and diagnosis of complications.
Angiography ; Arteriovenous Malformations ; Brain Edema ; Demyelinating Diseases ; Diagnosis ; Edema ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Intracranial Arteriovenous Malformations ; Magnetic Resonance Imaging ; Necrosis ; Radiosurgery* ; Retrospective Studies ; Tomography, X-Ray Computed ; Veins

It has been demonstrated that inhibitors of advanced glycation end products (AGE), such as aminoguanidine, can suppress peritoneal AGE in rats on peritoneal dialysis (PD). However, it is unknown whether late administration of a putative crosslink breaker, alagebrium, could reverse peritoneal AGE. We therefore compared alagebrium with aminoguanidine in their ability to reverse peritoneal AGE in rats on PD. Male Sprague-Dawley rats were randomly divided into 3 groups: group I dialyzed with 4.25% glucose solution for all exchanges; group II dialyzed with 4.25% glucose solution containing aminoguanidine, and group III dialyzed with 4.25% glucose solution containing alagebrium for last 8 weeks of 12-week dialysis period. Dialysis exchanges were performed 2 times a day for 12 weeks. Immunohistochemistry was performed using a monoclonal anti-AGE antibody. One-hour PET was performed for comparison of transport characteristics. The immunolabelling of AGE in peritoneal membrane was markedly decreased in the alagebrium group. Consistent with this, the alagebrium group exhibited significantly higher D/Do glucose and lower D/P urea, suggesting low peritoneal membrane transport. But there were no significant differences between the control and the aminoguanidine group. These results suggest that the alagebrium may be the optimal therapeutic approach, compared with treatment with inhibitors of AGE formation, in rats on PD.
Animals ; Biological Transport ; Body Weight ; Cell Membrane/metabolism ; Glycosylation End Products, Advanced/*metabolism ; Guanidines/metabolism ; Immunohistochemistry/methods ; Male ; Peritoneal Dialysis/*methods ; Peritoneum/metabolism/*pathology ; *Permeability ; Rats ; Rats, Sprague-Dawley

BACKGROUND: The number of patients suffering from acute myocardial infarction is on the increase in Korea due to the westernization of life style. Recent improvement of therapeutic stratigies have shown early mortality benefits in acute myocardial infarction. But we don't have data how many patients died and what's the cause of death in these patients. This study aimed to find out the mortality rate, cause of death and it's relevant prognostic factors of myocardial infarction (MI) patients who admitted alive, and to construct a database which will be used to develop a risk stratification strategy for the implementation of new preventive therapeutic modalities, such as implantable cardioverter-defibrillator (ICD). METHODS: Seven hundred and forty two MI patients admitted to our hospital from March, 1999 to August, 2002 were included in this study. The risk factors and survivals were evaluated by medical record searching and telephone survey in these patients. RESULTS: The average age was 64 years-old and 67% was male. During the mean follow up 20.7+/-15.4 months, total 105 cardiac death (14.2%) was occurred and cumulative mortality rate at 1 year and 2 year was 5.69% and 10.80%, respectively. Of the total 129 death, in-hospital death was 68 (cardiac death 48, non-cardiac death 20) and out of hospital death was 60 (cardiac death 57, non-cardiac death 4). When it comes to cause of death, most common cause of cardiac death was malignant arrhythmia. The proportion of malignant arrhythmia in cardiac death was 81.3% and 72% of in-hospital and out of hospital death, respectively. Multivariate analysis showed that old age, low LV ejection fraction and no percutaneous coronary intervention (PCI) treatment were independent risk factors for cardiac mortality. CONCLUSIONS: Myocardial infarction shows still high mortality rate despite the recent development of therapeutic strategy. As post-MI patients with low LVEF or no PCI shows high mortality, the early reperfusion therapy should be encouraged. Additionally, because malignant arrhythmia was one of the most in cause of cardiac death, ICD therapy to prevent sudden cardiac death should be considered in an active manner.
Arrhythmias, Cardiac ; Cause of Death* ; Death ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Follow-Up Studies ; Humans ; Korea ; Life Style ; Male ; Medical Records ; Middle Aged ; Mortality* ; Multivariate Analysis ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Reperfusion ; Risk Factors ; Telephone

A few cases of gastrointestinal stromal tumor (GIST) synchronous cancers with other malignancies have been reported, such as gastric cancer, pancreatic cancer, renal cell carcinoma, colon cancer, and carcinoid tumor. However, little is known about their coincidence with other tumors with a different histogenesis. A 62-year-old man visited our hospital with generalized weakness and intermittent hematochezia. A colonoscopic examination showed an ulcerating mass in the ascending colon, and a biopsy specimen revealed adenocarcinoma. A lobulated submucosal mass in the gastric fundus was found incidentally during the preoperative staging procedures, including computed tomography (CT) and positron emission tomography-CT. The colon cancer and gastric tumor were removed simultaneously (laparoscopy assisted right hemicolectomy and total gastrectomy). Immunohistochemical studies on the gastric tumor surgical specimen showed that it was CD117 (+) and CD34 (+), and the final diagnosis was a GIST of the stomach. Herein, we report a case of the synchronous occurrence of colon adenocarcinoma and gastric GIST.
Adenocarcinoma ; Biopsy ; Carcinoid Tumor ; Carcinoma, Renal Cell ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Electrons ; Gastric Fundus ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Humans ; Middle Aged ; Pancreatic Neoplasms ; Stomach ; Stomach Neoplasms ; Ulcer

PURPOSE: Recent experimental evidence shows that extracellular vesicles (EVs) in indoor dust induce neurtrophilic pulmonary inflammation, which is a characteristic pathology in patients with severe asthma and chronic obstructive pulmonary disease (COPD). In addition, COPD is known to be an important risk factor for lung cancer, irrespective of cigarette smoking. Here, we evaluated whether sensitization to indoor dust EVs is a risk for the development of asthma, COPD, or lung cancer. METHODS: Serum IgG antibodies against dust EVs were measured in 90 healthy control subjects, 294 asthmatics, 242 COPD patients, and 325 lung cancer patients. Serum anti-dust EV IgG titers were considered high if they exceeded a 95 percentile value of the control subjects. Age-, gender-, and cigarette smoke-adjusted multiple logistic regression analyses were performed to determine odds ratios (ORs) for asthma, COPD, and lung cancer patients vs the control subjects. RESULTS: In total, 4.4%, 13.6%, 29.3%, and 54.9% of the control, asthma, COPD, and lung cancer groups, respectively, had high serum anti-dust EV IgG titers. Adjusted multiple logistic regression revealed that sensitization to dust EVs (high serum anti-dust EV IgG titer) was an independent risk factor for asthma (adjusted OR, 3.3; 95% confidence interval [CI], 1.1-10.0), COPD (adjusted OR, 8.0; 95% CI, 2.0-32.5) and lung cancer (adjusted OR, 38.7; 95% CI, 10.4-144.3). CONCLUSIONS: IgG sensitization to indoor dust EVs appears to be a major risk for the development of asthma, COPD, and lung cancer.
Antibodies ; Asthma* ; Dust* ; Humans ; Immunoglobulin G* ; Logistic Models ; Lung Neoplasms* ; Lung* ; Odds Ratio ; Pathology ; Pneumonia ; Prevalence* ; Pulmonary Disease, Chronic Obstructive* ; Risk Factors ; Smoking ; Tobacco Products

BACKGROUND/AIMS: Type 2 autoimmune pancreatitis (AIP) has been considered extremely rare in East Asia. This study aimed to clarify the prevalence, clinical characteristics and radiological findings of type 2 AIP highlighting patients presenting as acute pancreatitis in a single center. METHODS: Type 2 AIP patients were classified according to International Consensus Diagnostic Criteria. Radiological findings were compared between type 2 AIP presenting as acute pancreatitis and gallstone pancreatitis. RESULTS: Among 244 patients with AIP, 27 (11.1%) had type 2 AIP (definite, 15 [55.5%] and probable 12 [44.5%]). The median age of patients with type 2 AIP was 29 years (interquartile range, 20 to 39 years). Acute pancreatitis was the most common initial presentation (n=17, 63%) while obstructive jaundice was present in only one patient. Ulcerative colitis (UC) was associated with type 2 AIP in 44.4% (12/27) of patients. Radiological pancreatic imaging such as delayed enhancement of diffusely enlarged pancreas, homogeneous enhancement of focal enlargement/mass, absent/minimal peripancreatic fat infiltration or fluid collection, and multifocal main pancreatic duct narrowings were helpful for differentiating type 2 AIP from gallstone pancreatitis. During follow-up (median, 32.3 months), two patients (2/25, 8%) experienced relapse. CONCLUSIONS: In South Korea, type 2 AIP is not as rare as previously thought. Overall, the clinical profile of type 2 AIP was similar to that of Western countries. Type 2 AIP should be considered in young UC patients with acute pancreatitis of uncertain etiology.
Colitis, Ulcerative ; Consensus ; Far East ; Follow-Up Studies ; Gallstones ; Humans ; Jaundice, Obstructive ; Korea ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Prevalence ; Recurrence