PURPOSE: To evaluate the success rate of conventional skin dacryocystorhinostomy(DCR), the success rate and postoperative complications were evaluated after the follow-up period of 6~72 months(average 16.7 months), and compared with those of our previous reports on endonasal DCR, at postoperative 6 months(PO6M) and 12 months(PO12M). METHODS: skin DCR was performed in 76 patients, 89 eyes between July 1993 and June 2000 at the Department of Ophthalmology, Yeungnam University College of Medicine. RESULTS: Primary success rate of skin DCR was 93.3%, and the final success rate after revision of mucosal ostium revealed 96.6%. Postoperative complications included 7 cases of silicone tube protrusion and 4 cases of mucosal ostium obstruction. CONCLUSIONS: Primary success rate of skin DCR was 93.3%, and those of endonasal DCR were 92.3%(PO6M) and 89.8%(PO12M). The final success rate of skin DCR was 96.6%, and those of endonasal DCR were 98.4%(PO6M) and 99.2%(PO12M).
Follow-Up Studies ; Humans ; Ophthalmology ; Postoperative Complications ; Silicones ; Skin

We reviewed 887 cases of esohagogram, 8863 cases of UGI series, 174 cases of small bowel series and 1926 casesof double contrast barium enema performed at the department of Radiology, Wonju College of Medicine from Jan. 1982 to Dec. 1984 to analyzed diverticula disease pattern of the GI tract in Korean. The results were as follows: 1.Esophageal diverticula The incidence was 3.27% and the sex ratio of male to female was 2.22:1 Age distribution wasrelatively even and most common in 5th decade. Most of them showed single in number, above 6mm sized and common inmiddle one third of both lateral side of esophagus. 2. Stomach diverticula The incidence was 0.07% and the sexratio of male to female was equal. Multiplicity was single in all cases. Most of them were above 11mm sized andcommon in gastric fundic area of greater curvature site of stomach. 3. Duodenal diverticula The incidence was1.51% and relatively even distribution in sex and age and common in after 5th decade. Most of them showed singlein number, 11-30mm sized and common in medial margin of 2nd portion of duodenum. 4. Colonic diverticula Theincidence was 2.34% and predominant in male and common in 5th. and 6th. decade. Most of them showed single innumber, below 5mm sized and common in right sided colon.
Age Distribution ; Barium ; Colon ; Diverticulum ; Diverticulum, Colon ; Diverticulum, Stomach ; Duodenum ; Enema ; Esophagus ; Female ; Gangwon-do ; Gastrointestinal Tract ; Humans ; Incidence ; Male ; Sex Ratio ; Stomach

A 30 years old female patient was diagnosed valvular heart disease and double valve replacement was ndertaken. After operation, mediastinitis developed and we had done continuous mediastinal irrigation and had used IV antibiotics for 3 weeks. During outpatient follow-up, infection signs developed, so she readmitted and was reoperated because CT revealed mediastinal abscess. No infected material was observed at the operation. Infection signs continued for 3 weeks. Chest CT revealed giant pseudoaneurysm of ascending aorta. We resected the pseudoaneurysm and performed an aortoplasty with bovine pericardium under deep hypothermia and total circulatroy arrest. She recovered well and was discharged without any complication.
Abscess ; Adult ; Aneurysm, False ; Anti-Bacterial Agents ; Aorta* ; Female ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Hypothermia ; Mediastinitis* ; Outpatients ; Pericardium ; Thoracic Surgery* ; Tomography, X-Ray Computed

We experienced a rare case of sacral meningeal cyst so called sacral perineurial cyst(Tarlov cyst). A 15 years old girl was admitted to the hospital because of sudden severe low back pain and Lt. sciatica for about one week. We performed delayed myelography and spinal computeized tomographic myelography(C.T.M) for differential diagnosis. Delayed filling of contrast media in the cyst was significant in diagnosis of sacral meningeal cyst type II. Laminectomy of sacrum(S1) was performed for partial excision of cystic wall and plastic suture. Operative finding was typical sacral perineurial cyst(Tarlov cyst) which was recently clssified as sacral meningeal cyst type II. The classification of spinal meningeal cysts in the literature was indistinct and confused. We also agree with Nabors et. al, in current classificcation of spinal meningeal cysts, in which the spinal meningeal cysts, in which the spinal meningeal cysts were divided into 3 groups as extradural spinal Mcs Type I(Diverticulum), Type II(perineurial cyst), intradural spinal Mcs(arachnoid cyst).
Adolescent ; Classification ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Laminectomy ; Low Back Pain ; Myelography ; Plastics ; Sciatica ; Sutures

Choledochal cyst is a relatively rare disease entity considered to be a congenital cyatic dilatation of the common bile duct. Since occurrence of malignant tumor in choledochal cyet was first reported by Irwin and Morrison in 1944, approximately 100 more cases of malignant tumors arising in congenital choledocal cyst have been reported in the world, and the risk of malignant tumor related to choledochal cyst have been reported 2.4-14%. Recently, we experienced a case of adenocarcinoma arising in choledochal cyst in 39 year-old woman who was diagnosed by ERCP and cholangioscopy with forceps biopsy, and was treated with en bloc resection of the choledochal cyst along with the pancreatic head and duodenum.
Adenocarcinoma ; Adult ; Bile Duct Neoplasms ; Biopsy ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Head ; Humans ; Rare Diseases ; Surgical Instruments

Choledochal cyst is a relatively rare disease entity considered to be a congenital cyatic dilatation of the common bile duct. Since occurrence of malignant tumor in choledochal cyet was first reported by Irwin and Morrison in 1944, approximately 100 more cases of malignant tumors arising in congenital choledocal cyst have been reported in the world, and the risk of malignant tumor related to choledochal cyst have been reported 2.4-14%. Recently, we experienced a case of adenocarcinoma arising in choledochal cyst in 39 year-old woman who was diagnosed by ERCP and cholangioscopy with forceps biopsy, and was treated with en bloc resection of the choledochal cyst along with the pancreatic head and duodenum.
Adenocarcinoma ; Adult ; Bile Duct Neoplasms ; Biopsy ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Head ; Humans ; Rare Diseases ; Surgical Instruments

Background and Objectives: Vascular smooth muscle cell (SMC) proliferation and migration play a critical role in neointimal formation. Focal adhesion is involved in cell proliferation and migration, and talin is known to be a key regulator of these processes. We synthesized a new talin modulator that binds to the talin protein, and investigated its effects on SMCs and neointimal formation after vascular injury. Methods: Human aortic SMCs (HAoSMCs) were treated with a newly synthesized talin modulator. Apolipoprotein E knockout (ApoE KO) mice were subjected to left femoral arterial injury and orally administered with the talin modulator daily. Laser Doppler imager was used to compare the blood flow, and injured femoral arteries and blood serum were analyzed after 28 days. Results: The talin modulator significantly inhibited cell proliferation in a concentration-dependent manner and suppressed the migration of HAoSMCs. Treatment with a talin modulator resulted in a significant reduction in the phosphorylation of focal adhesion molecules and downstream signaling molecules related to cell proliferation and migration. The effects of the talin modulator in HAoSMCs were found to be reversible, as evidenced by the reactivation of signaling pathways upon its removal. After 28 days of administration of the talin modulator, an improvement in the blood flow and reduction in neointimal formation in the injured femoral arteries were observed. Conclusions We demonstrated the inhibitory effects of a talin modulator on SMC proliferation and migration, and that were associated with downregulation of signaling pathways, resulting in the attenuation of neointimal formation in ApoE KO mice.

PURPOSE: To evaluate the relative adhesion and migration rate of cultured human aortic endothelial cells onto modified stent material in vitro. MATERIALS AND METHODS: Flat 1 x 1cm square, stainless steel 316 L pieces(600 micrometer thick) were initially glow dis-charged to increase the polarity of the metal and were coated with 1 %polyhydroxyethylmethacrylate to which two different amino acid peptide sequences (GRGDY, GREDVY) were covalentlylinked via an amide to an amino-terminus, thus providing a known orientation of these covalently bound peptides.To stimulate implantation of a stent onto the intact arterial wall, human aortic endothelial cells were seeded andgrown to confluence on thick, firm collagen gel. The peptide coated steel pieces were then implanted on thisendothe-lialized surface and migration of HAEC to the surface was monitored and measured for ten days. The contactangle of steel was measured before and after glow-discharge treatment. RESULTS: Our results indicate that themigration and adhesion rate of HAEC to surfaces bearing either GRGDY or GREDVY adhesive peptide sequences wassignificantly higher than that of uncoated stainless steel. The contact angles of glow-discharged steel (eitherpositive or negative charge) were significantly lower, and this in-dicates the increased wettability of steel. Furthermore, migration to a GREDVY-coated surface was greater than to one coated with GRGDY. CONCLUSION: Theseresults indicate that a specific peptide sequence (GREDVY), together with positive glow-discharge treatment ofsteel can selectively enhance endothelial cell migration to metallic stent material.
Adhesives ; Collagen ; Endothelial Cells ; Humans* ; Stainless Steel ; Steel ; Stents* ; Wettability

OBJECTIVE: To make decision of the dialysis or transplantation in the patient with renal failure should be demanded the precise measurement serving the critical level of the renal function. 99mTc- DMSA is a new renal scanning agent that provides a good quality of renal image as a result of preferential cortical accumulation and also makes feasible a quantitative assessment of renal function. We want to know the critical level of the renal function with 99mTc-DMSA scanning in the experimental rabbits with pathologic solitary kidney. MATERIALS AND METHODS: We made artificial left hydronephrosis having left ureter ligation at 2 weeks after performing right functional nephrectomy with vessels ligation in 20 experimental rabbits. At 24, 48, and 72 hours after then, 99mTc-DMSA renal uptake rates, serum urea nitrogen, and creatinine were checked to evaluate the critical levels of renal function impairment. RESULTS: Before left ureteral ligation 99mTc- DMSA renal uptake rates, serum urea nitrogen, and creatinine were 9.59+/-1.14%(mean+/-SD), 28.0+/-5.2 mg/dl, and 1.3+/-0.2 mg/dl respectively. Those of the fifteen pathologic solitary kidney at 24 hours after ureter ligation were 4.37+/-1.68%, 74.2+/-20.2mg/dl, and 7.6+/-2.4mg/dl respectively. Those of the thirteen at 48 hours were 4.25+/-1.09%, 126.0+/-33.5mg/dl, and 9.8+/-3.5mg/dl respectively. And serum urea nitrogen and creatinine of the twelve at 72 hours were 183.9+/-51.0mg/dl, and 14.4+/-2.3mg/dl respectively. 99mTc- DMSA renal uptake rates appeared indiscriminate values with approaching to death while the levels of serum urea nitrogen and creatinine revealed increasing values. CONCLUSION: 99mTc-DMSA renal scan was one of the appropriate tests to evaluate the critical level of renal function impairment.
Creatinine ; Dialysis ; Humans ; Hydronephrosis ; Kidney Function Tests ; Kidney* ; Ligation ; Nephrectomy ; Nitrogen ; Rabbits ; Radionuclide Imaging ; Renal Insufficiency ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Urea ; Ureter

BACKGROUND: We describe herein the application of whole exome sequencing (WES) for the molecular genetic diagnosis of a large Korean family with dominantly inherited myopathy. CASE REPORT: The affected individuals presented with slowly progressive proximal weakness and ankle contracture. They were initially diagnosed with limb-girdle muscular dystrophy (LGMD) based on clinical and pathologic features. However, WES and subsequent capillary sequencing identified a pathogenic splicing-site mutation (c.1056+1G>A) in COL6A1, which was previously reported to be an underlying cause of Bethlem myopathy. After identification of the genetic cause of the disease, careful neurologic examination revealed subtle contracture of the interphalangeal joint in the affected members, which is a characteristic sign of Bethlem myopathy. Therefore, we revised the original diagnosis from LGMD to Bethlem myopathy. CONCLUSIONS: This is the first report of identification of COL6A1-mediated Bethlem myopathy in Korea, and indicates the utility of WES for the diagnosis of muscular dystrophy.
Ankle ; Capillaries ; Contracture ; Diagnosis* ; Exome* ; Humans ; Joints ; Korea ; Molecular Biology* ; Muscular Diseases* ; Muscular Dystrophies ; Muscular Dystrophies, Limb-Girdle ; Neurologic Examination