PURPOSE: Achieving good eyelid position and symmetric palpebral fissure for asymmetric bialteral congenital ptosis would require skillful technique and a lot of experiences of surgeon. Patients were divided into two groups, A and B, in terms of preoperative MRD and the possible relationship between preoperative MRD difference. The outcome of the surgery was studied. METHODS: External levator resection with apponeurotic approach was performed for 19 patients with asymmetric bilateral congenital ptosis from October 1994 to June 2000. According to differences of MRD between the both eyes, patients were divided into two groups. Group A included 8 patients with 1.0~2.0 mm of MRD differences, and group B included 11 patients with more than 2.0 mm of MRD differences. RESULTS: Age of patients ranged from 3 to 20 years (mean 6.1 years) and follow-up period was 9 to 60 months (mean 20 months). Six patients of group A and seven patients of group B showed almost excellent symmetric palpebral fissure. Only one patient of group B had postoperative MRD difference more than 2.0 mm, and none in group A. CONCLUSIONS: Success rate was 100% in group A and 91% in group B, but no statistical difference was found between group A and group B (p>0.05).
Eyelids ; Follow-Up Studies ; Humans

BACKGROUND: Standard solution-phase PCR cannot localize the amplified DNA products in cells or tissue sections. Recently, in situ PCR technique which combines PCR with in situ hybridization was developed and applied to detect target DNA or gene expression in the tissue sections. OBJECTIVE: The purpose of this study was to detect the presence of HSV type-1 DNA in herpes simplex lesions by using hot start PCR in situ hybridization and hot start in situ PCR and to compare the sensitivity and specificity of the two methods. The sensitivity and specificity of multiple overlapping primers and a single primer pair in hot start in situ PCR were also compared. METHODS: We performed hot start PCR in situ hybridization and in situ PCR with multiple overlapping primers, and hot start in situ PCR with a single primer pair in paraffin-embedded, formalin-fixed tissues. RESULTS: HSV type-1 DNA was detected in 4 (80%) of.5 cases of herpes simplex and negative in all cases of herpes zoster, verruca vulgaris, and normal skins. One negative case of herpes simplex could not be detected by HSV type-1 specific primers because it might be caused by HSV type-2. There was no difference in the sensitivity, specificity, and intensity of signals between the three methods. CONCLUSION: Hot start in situ PCR with a single primer pair is a simpler, easier, and more rapid technique for detecting the HSV type-1 DNA in lesional tissue sections with similar sensitivity and specificity than hot start PCR in situ hybridization and hot start in situ PCR using multiple overlapping primers.
DNA* ; Gene Expression ; Herpes Simplex* ; Herpes Zoster ; In Situ Hybridization ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Simplexvirus* ; Skin ; Warts

BACKGROUND: Angioleiomyoma of the skin is a rare smooth muscle tumor and may develop anywhere in the body. Comprehensive clinicopathological analysis of angioleiomyomas developed in Korean has not been reported in domestic dermatological journals. OBJECTIVE: The purpose of this study was to evaluate the clinical and pathological characteristics of angioleiomyoma and the relationship between the tumor and the nerve with immunohistochemical stains. METHODS: Fifty nine cases of angioleiomyoma were reappraised from the files of the pathology of Seoul National University, Green Cross Reference Laboratory Center and Korea Veterans Hospital. Brief clinical histories of all cases were examined and microscopic findings in 35 cases were classified according to subtypes. Paraffin blocks were recut and stained in 16 cases for desmin, smooth muscle actin and S-100 protein. RESULTS AND CONCLUSION: 1. Male to female ratio was 1:1.27. 2. The age of the patients was mostly over 20 years and the mean age was 51 years in men and 40 years in women. 3. Tumors occurred most frequently in the lower extremity(38 cases), and followed by upper extremity(18 cases), head(2 cases), and trunk(1 case). Women had predominance of the legs in location site and men showed equal distribution in the lower and upper extremities.
Actins ; Angiomyoma* ; Coloring Agents ; Desmin ; Female ; Hospitals, Veterans ; Humans ; Korea ; Leg ; Male ; Muscle, Smooth ; Paraffin ; Pathology ; S100 Proteins ; Seoul ; Skin ; Smooth Muscle Tumor ; Upper Extremity

Idiopathic renal hypouricemia (iRHUC) is a rare hereditary disease caused by a defect in urate handling of renal tubules. Type 1 renal hypouricemia (RHUC1) is diagnosed with confirmation of a mutation in SLC22A12 gene which encodes a renal urate-anion exchanger (URAT1). The majority of iRHUC patients are asymptomatic, especially during childhood, and thus many cases go undiagnosed or they are diagnosed late in older age with complications of hematuria, renal stones, or acute kidney injury (AKI). We report a case of a 7-year-old boy with subtle symptoms such as general weakness and dizziness and revealed hypouricemia and incidental nephrolithiasis. Homozygous mutations were detected in the SLC22A12(c.774G>A) by molecular analysis. The present case suggests that fractional excretion of uric acid (FEUA) screening could be better followed by the coincidental discovery of hypouricemia, to prevent conflicting complications of iRHUC, even with normal urine uric acid to creatinine ratio (UUA/UCr), and sequential genetic analysis if needed.

Idiopathic renal hypouricemia (iRHUC) is a rare hereditary disease caused by a defect in urate handling of renal tubules. Type 1 renal hypouricemia (RHUC1) is diagnosed with confirmation of a mutation in SLC22A12 gene which encodes a renal urate-anion exchanger (URAT1). The majority of iRHUC patients are asymptomatic, especially during childhood, and thus many cases go undiagnosed or they are diagnosed late in older age with complications of hematuria, renal stones, or acute kidney injury (AKI). We report a case of a 7-year-old boy with subtle symptoms such as general weakness and dizziness and revealed hypouricemia and incidental nephrolithiasis. Homozygous mutations were detected in the SLC22A12(c.774G>A) by molecular analysis. The present case suggests that fractional excretion of uric acid (FEUA) screening could be better followed by the coincidental discovery of hypouricemia, to prevent conflicting complications of iRHUC, even with normal urine uric acid to creatinine ratio (UUA/UCr), and sequential genetic analysis if needed.

In an attempt to clarify the relationshop between left ventricular function and chronic obstructive pulmonary disease(COPD), systolic time intervals were measured in 79 control subjects and 60 patients with COPD who had no evidence of organic heart disease. The patients with COPD were divided into three groups based on the percent predicted forced expired volume in one second. Significant differences in pre-ejection period index(PEPI) and left ventricular ejection time index(LVETI) existed between the control subjects and the patients with the most severe lung disease(Group III). A highly significant difference in PEP/LVET existed between these two groups. The abnormalities of systolic time intervals demonstrated in these patients are characteristic of left ventricular dysfunction and indicate that left ventricular dysfunction is frequently present in patients with moderate obstructive lung disease.
Heart Diseases ; Humans ; Lung ; Lung Diseases, Obstructive ; Pulmonary Disease, Chronic Obstructive* ; Systole* ; Ventricular Dysfunction, Left ; Ventricular Function, Left

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors that arise in the wall of the gastrointestinal tract. We report a case of obscure gastrointestinal bleeding due to a GIST of the jejunum successfully documented by videocapsule endoscopy (VCE) and single-balloon enteroscopy (SBE). A 36-year-old man with hematochezia was referred for further evaluation of no evidence of bleeding focus on esophagogastroduodenoscopy and colonoscopy. A VCE showed a suspicious ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion. SBE revealed a nonbleeding 4x2 cm mass with an ulcer at the proximal jejunum. The patient underwent laparoscopic resection without complication. Histological examination revealed a well circumscribed, dumbbell-shaped firm mass comprised of spindle cells. Immunohistochemical staining for CD 117 was diffusely positive, whereas staining for S-100, CD 34 and MIB-1 was all negative. It was confirmed to be a low-grade GIST at the proximal jejunum.
Capsule Endoscopy ; Colonoscopy ; Endoscopy ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Jejunum ; Ulcer

BACKGROUND: We previously reported that ginsan, a polysaccharide extracted from Panax ginseng had an immunostimulatory activity such as mitogenic activity, activation of macrophages and killer cells, and production of a variety of cytokines which resulted in antitumor and antiseptic effects. We further purified alpha-(1-->6)-glucan and beta-(2-->6)-fructan from the ginsan with size exclusion and ion-exchange column chromatography successively. In this study, we performed the structure-based activity of ginsan by comparison with known polysacchrides such as beta-glucan, curdlan, laminarin, levan, dextran, lentinan and OK-432. METHODS: To investigate the immunostimulatory activity of several polysaccharide compounds, we investigated the stimulation of lymphocytes proliferation, the generation of activated killer cells and the secretion of nitrites from activated macrophages. RESULTS: Of polysaccharides tested, curdlan and ginsan stimulated lymphocyte proliferation, suggesting that the molecular weight and composition of polysaccharide are dependent on the mitogenic activity. The production of nitric oxide was significantly increased in curdlan, levan, ginsan and its fraction, indicating that fructan has also capacity to activate macrophages and may devote to kill pathogens. In addition, the activation of macrophages was seemed to be independent of molecular weight of polysaccharide. The generation of AK cells was exhibited in order of curdlan, OK-432> F1, ginsan, F3>levan>etc. The AK activity may be dependent on molecular weight and composition of polysaccharides. CONCLUSION: Unfortunately, purified polysaccharide from ginsan were less active on immunostimulatory activity than mixed compounds of polysaccharides. From the viewpoint of structure and activity relationships, we found several characteristic features.
Chromatography ; Cytokines ; Dextrans ; Lentinan ; Lymphocytes ; Macrophages ; Molecular Structure* ; Molecular Weight ; Nitric Oxide ; Nitrites ; Panax ; Picibanil ; Polysaccharides*

We investigated the fibrovascular ingrowth and fibrovascular tissue maturation of hydroxyapatite-coated, porous alumina sphere (Alumina sphere) in comparison with the hydroxyapatite sphere (HAp sphere) in rabbits. Alumina spheres and HAp spheres were implanted in the left orbits of 42 New Zealand white rabbits after enucleation. Fibrovascular ingrowth and maturation were graded from 1 to 5 at postoperative 1, 2, 3, 4, 8, 12 and 24 weeks. We defined 4 phases: postoperative 1-2 weeks as phase I, 3-4 weeks as phase II, 8-12 weeks as phase III, and 24 weeks as phase IV. The grade was analyzed at each phases. There was no significant difference in fibrovascular ingrowth and maturation between the two groups at all 4 phases, except phase II at which the Alumina sphere showed significantly lower maturation grade (p< 0.05). We concluded that the Alumina sphere is an ideal orbital implant material and an ideal substitute for the HAp sphere in clinical practice.
*Aluminum Oxide ; Animals ; *Coated Materials, Biocompatible ; *Durapatite ; Eye Enucleation ; Female ; Fibroblasts/cytology/physiology ; Microscopy, Electron, Scanning ; Neovascularization, Physiologic/*physiology ; *Orbital Implants ; Prosthesis Implantation ; Rabbits ; Research Support, Non-U.S. Gov't

BACKGROUND: Reciprocal ST-segment depression in precordial leads is a common finding in acute inferior myocardial infarction. The responsible mechanism and the significance of this finding, however, are still controversial. METHODS: From January 1991 to December 1994, 38 patients with acute inferior myocardial infarction were treated at the Department of Internal Medicine in Kyung Hee University Hospital. Clinical characteristics, serial electrocardiograms, and angiographic findings of coronary artery and left ventriculography, echocardiography were reviewed. Reciprocal ST-segment depression was defined as ST-segment depression>or=1.0mm in two or more adjacent precordial leads(V1-V3) in patients with acute inferior myocardial infarction showing ST-segment elevation in II, III, aVF. Coronary angiography and echocardiography were performed within 24 hours from admission. In this study, angiographic distribution score was used to define the perfusion territory causing inferior ischemia. RESULTS: 1) The summation of ST-segment elevation in II, III, aVF leads was significantly more higher in group H than group A (P<0.05). 2) However, the angiographic distribution score, peak CK levels, in-hospital complications and ejection fraction showed no difference between two groups (P>0.05). 3) There were no evidence of anterior wall motion abnormality in two groups. CONCLUSIONS: Our results suggest that the S'I'- segment depression on the precordial leads in acute myocardial infarction can be explained mainly by benign reciprocal electrical change.
Coronary Angiography ; Coronary Vessels ; Depression* ; Echocardiography ; Electrocardiography ; Humans ; Inferior Wall Myocardial Infarction* ; Internal Medicine ; Ischemia ; Myocardial Infarction ; Perfusion