PURPOSE: To evaluate the surgical outcome of deep anterior lamellar keratoplasty (DALKP) in patients with corneal opacity with an intact corneal endothelium. METHODS: We transplanted partial thickness donor cornea, devoid of endothelium and Descemet's membrane, on to a recipient bed of which the deep stromal area had been dissected to expose the smooth surface of Descemet's membrane. We evaluated the visual acuity, refractive error, endothelial cell density, intraocular pressure, complication and graft rejection after a follow-up period of at least 6 months. RESULTS: Twelve eyes of 11 patients (M: F=7: 4) were enrolled in this study, with a mean age of 39 years (17~60). The mean follow-up period was 9.8 months. The underlying diseases were keratoconus in 6 eyes, corneal dystrophy in 4 and herpetic corneal lesion in 2. The mean postoperative visual improvement was 5 lines of Snellen chart. Microperforations occurred during operation in 4 eyes, and were treated with intracameral gas injection. One of them underwent penetrating keratoplasty due to persistent double anterior chamber. Transient elevation of intraocular pressure was noted in 7 eyes, but no case of graft rejection was observed during the follow-up period. CONCLUSIONS: Even though intraoperative microperforation may require an additional procedure such as gas injection which increases the possibility of intraocular pressure elevation, deep anterior lamellar keratoplasty is thought to be a good option for the primary surgery in patients with corneal opacity with an intact corneal endothelium due to its relatively fast recovery, reduced risk of rejection and preservation of endothelium without ongoing loss.
Anterior Chamber ; Cornea ; Corneal Opacity ; Corneal Transplantation* ; Descemet Membrane ; Endothelial Cells ; Endothelium ; Endothelium, Corneal ; Follow-Up Studies ; Graft Rejection ; Humans ; Intraocular Pressure ; Keratoconus ; Keratoplasty, Penetrating ; Refractive Errors ; Tissue Donors ; Visual Acuity

PURPOSE: Serum level of the aminotransferase is the most common test in use to assess hepatocellular injury and are sensitive test of hepatocyte necrosis, but both AST and ALT level in serum rise in a variety of hepatic disorders. Some clinical study reports that AST/ALT ratio was possible to predict prognostic outcome of infants with liver disease. We have tried to assess whether AST/ALT ratio is valuable or not for predict prognosis of hepatitis and differentiate cause of it. METHODS: Serum AST, ALT, and AST/ALT ratio were evaluated in the infants with acute hepatitis. They were grouped into 12 patients with Hepatitis B surface antigen positive only(group I), 23 patients with Hepatitis B surface antibody positive only(group II), and 12 patients with not-known cause of hepatitis(group III). The 24 patients were able to follow-up of AST and ALT for 2 months. They are grouped into 12 patients with normalized AST and ALT within 2 months(group A) and 12 patients not normalized within 2 months(group B). RESULTS: 1)There were no statistical difference of mean serum level of AST and ALT that were tested on admission day, one week and 2 week of admission respectively among the group I, II, and III. 2)The value of AST/ALT ratio were increased from 0.6 on admission day to 0.9 after 2 week of admission in group I(p<0.05), decreased from 1.1 to 0.8 in group II. It were not changed in group III. 3)The mean values of AST/ALT ratio were not statistically different in group A and B. 4)The mean values of serum alkaline phosphatase, total bilirubin, and prothrombin time were not statistically different among these groups, if we exclude two cases of cholestatic jaudice, one case of acute fulminant hepatitis, and one case of hepatitis C from these groups. CONCLUSIONS: On the basis of this study, we concluded that progression of hepatitis and damage of hepatic cell was different according to the cause of hepatitis. AST/ALT ratio of the acute phase hepatitis were not able to reflect the time duration of normalization of AST and ALT and it was not related to etiology of hepatitis. For predict prognosis of infant with acute hepatitis, long term follow up is needed in many more cases of infants with acute hepatitis.
Alkaline Phosphatase ; Bilirubin ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C ; Hepatitis* ; Hepatocytes ; Humans ; Infant ; Liver Diseases ; Necrosis ; Prognosis ; Prothrombin Time

C-type natriuretic peptide (CNP), a member of natriuretic peptide family, is mainly synthesized in the endothelium and central nervous system. But CNP is also involved in the growth and differentiation of other peripheral organs. Although we have reported the local synthesis and localization of CNP in the adult submandibular glands (SMG), it is not known that the expression and biological activity of CNP following the morphogenesis, differentiation and aging. This study aimed to examine the expression of CNP and its receptors in the developing and differentiating stages of mouse SMG, and the changes of biological activity of its receptors with aging. The SMG, obtained from 14, 16, 18 days-old embryos (E) and 1 day, 2 weeks, 1, 2, 12, and 24 month-old C57BL/6N mouse, were processed for RT-PCR, in situ hybridization, immunohistochemistry and cGMP assay. CNP was strongly expressed in the epithelial clusters of primitive SMG, which was maintained before birth but was markedly decreased after birth. CNP was localized in the intercalated duct and granular convoluted tubules of adult SMG, where NPRC was specifically expressed but NPRB was not. CNP mRNA was gradually decreased from E16 to 2 M but ANP mRNA was opposed. NPRB and NPRC were the same pattern of the expression of CNP but NPRA was weakly expressed. In addition, CNP mRNA was also expressed in the craniofacial tissues such as tooth germs, tongue, premaxilla and bone forming area in which NPRC was specifically expressed but NPRB was not. In the SMG of 2 M, the membrane of duct cells markedly produced cGMP by CNP whereas acini produced cGMP by ANP and BNP rather than CNP. The biological activity of cGMP production of SMG gradually decreased with age. cGMP production was dominant by CNP in SMG of 1M but was by ANP after 2M. These results shows that CNP may play roles both in the morphogenesis and differentiation via NPRC and in the maintenance of duct system via NPRB in the mouse SMG and that the biological activity of its receptors may decreased with aging.
Adult ; Aging* ; Animals ; Atrial Natriuretic Factor ; Central Nervous System ; Child, Preschool ; Embryonic Development* ; Embryonic Structures ; Endothelium ; Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Membranes ; Mice* ; Morphogenesis ; Natriuretic Peptide, C-Type* ; Parturition ; Pregnancy ; Receptors, Peptide* ; RNA, Messenger ; Submandibular Gland* ; Tongue ; Tooth Germ

This study was conducted to reveal nutrient intakes and factors affecting the nutritional status of elderly women in a rural area. The data of dietary intakes were obtained using 24hour recall data which were collected from 244 women subjects older than fifty years old. The data from the questionnaire regarding eating habits were obtained through interview. The education level and economic status of the subjects in this study were very low and education level(p<0.001), occupation(p<0.001), marital status(p<0.001), family size(p<0.05) and smoking habit(p<0.05) were significantly different among different age groups. The nutrient intakes of all age groups were not adequate to RDA level-specially, micronutrient intakes were lower in those in their sixties compared to those in their fifties. Important factors associated with variation in nutrient intakes of subjects were beef preference, regular eating habits, and education level. Therefore it is necessary to focus on subjects with low education levels and low income in order to improve the health and nutritional atatus of the elderly in rural areas. It is necessary to prepare a nutritional education program to establish and maintain good eating habits of the elderly in rural areas.
Aged ; Eating ; Education ; Female ; Humans ; Micronutrients ; Nutritional Status ; Smoke ; Smoking ; Surveys and Questionnaires

PURPOSE: Primary cutaneous anaplastic large cell lymphoma is rarely encountered in the lower eyelids. We report a patient with primary cutaneous anaplastic large cell lymphoma arising from the lower eyelid. METHODS: A 39-year-old man presented with a relatively fast growing mass on the center of his left lower eyelid for one month. The mass did not respond to local injection of triamcinolone at a local clinic. The lesion appeared as a solitary reddish nodule with ulceration, was non-tender, round, crusted, and measured 13 mm x 11 mm x 5 mm. Well- developed superficial vessels were found on the surface of the nodule. An incisional biopsy was performed. RESULTS: Histologic examination revealed that the bulk of the infiltrate was in the papillary and reticular dermis. Tumor cells had abundant, well-defined cytoplasm and pleomorphic nuclei with multiple nucleoli. The majority of the neoplastic cells showed immunoreactivity for CD 30 (Ki-1) along the cell membrane. A histopathological diagnosis of primary cutaneous anaplastic large cell lymphoma was made. CONCLUSIONS: Most cases of primary cutaneous anaplastic large cell lymphoma arise from the body and extremities. However, since primary cutaneous anaplastic large cell lymphoma may occur in the eyelid, it should be differentiated from nodular and relatively fast growing inflammatory tumors despite local steroid treatment.
Adult ; Biopsy ; Cell Membrane ; Cytoplasm ; Dermis ; Diagnosis ; Extremities ; Eyelids ; Humans ; Lymphoma, Primary Cutaneous Anaplastic Large Cell* ; Triamcinolone ; Ulcer

PURPOSE: The incidence of food allergy associated with atopic dermatitis is approximately 40-60%. We evaluated serum specific IgE to cow's milk (CM), egg white (EW) and soybean in atopic dermatitis and then compared the sensitization rates of patients in 2002 to those in 2007. METHODS: Two hundred fifty-eight patients with atopic dermatitis who visited Dong-A University Medical Center in 2002 (n=121) and 2007 (n=137) were enrolled in this study. Medical records were retrospectively reviewed to determine serum total eosinophil count (TEC), and total IgE and specific IgE to CM, EW, and soybean. RESULTS: The TEC was significantly higher in 2002 than in 2007. The sensitization rates to CM, EW and soy bean were significantly different in 2002 and 2007.(P=0.001 and P=0.03 for each) The sensitization rates to CM were significantly different according to age in 2007.(P= 0.04) The sensitization rates to EW were significantly different according to age in 2002 and 2007.(P=0.02 and P=0.00 for each) The sensitization rates to CM were significantly different according to combined allergic diseases in 2002 and 2007.(P=0.04, P=0.01 for each) The sensitization rates to EW were significantly different according to combined allergic diseases in 2002 and 2007.(P=0.00, P=0.002 for each) CONCLUSION: Among atopic dermatitis patients who visited a single university hospital in Busan, there were no significant differences in the overall sensitization rates in 2002 and 2007.
Academic Medical Centers ; Dermatitis, Atopic ; Egg White ; Eosinophils ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Incidence ; Medical Records ; Milk ; Ovum ; Retrospective Studies ; Soybeans

Bowel obstruction is a rare complication of pregnancy. The usual causes include previous abdominal surgery, volvulus, intussusception, colonic neoplasm, or the enlarging uterus. Bowel obstruction secondary to uncorrected Hirschsprung's disease as a complication of pregnancy is difficult to diagnosis, its occurrence can have grave implications for both mother and fetus, and anticipation of dystocia. Hirschsprung's disease is diagnosed and treated in the neonatal period. Persistence of Hirschsprung's disease into adulthood is very rare and confirmed by rectal biopsy providing the absence of the ganglion cell in Auerbach and Meissner's plexus. We experienced vaginal Delivery in Hirschsprung's disease complicating pregnancy and report our own case study with a brief literature review.
Biopsy ; Colonic Neoplasms ; Diagnosis ; Dystocia ; Female ; Fetus ; Ganglion Cysts ; Hirschsprung Disease* ; Humans ; Intestinal Volvulus ; Intussusception ; Mothers ; Pregnancy* ; Submucous Plexus ; Uterus

Prolactin-secreting adenomas are the most common pituitary tumors resulting in hyperprolactinemia which is one of the most important causes of female infertility with amenorrhea or galactorrhea. Although it is reported that spontaneous pregnancy occured in these patients using bromocriptine treatment or ovulation induction, it is very rare to find a pituitary tumor during a pregnancy by having neurological symptoms of headache, diplopia or visual disturbance. We experienced a case of normal delivery after symptom improvement and maintenance of pregnancy by administration of bromocriptine in a 27 year-old primigravida with diplopia and visual disturbance due to prolactin-secreting pituitary macroadenoma, which is diagnosed by brain MRI scan and serum prolactin level. A brief review of related literature was done.
Adenoma ; Adult ; Amenorrhea ; Brain ; Bromocriptine ; Diplopia ; Female ; Galactorrhea ; Headache ; Humans ; Hyperprolactinemia* ; Infertility, Female ; Magnetic Resonance Imaging ; Ovulation Induction ; Pituitary Neoplasms ; Pregnancy ; Prolactin

Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.
Child ; Male ; Female ; Humans

Vesicouterine fistula, a fistula between bladder and uterus, is one of the rarest urogenital fistula. Most cases are associated with repeat Cesarean section and with vaginal birth after Cesarean section (VBAC). During Cesarean section, it is important to dissect and move the bladder away from uterus carefully, especially in case of adherent bladder to the anterior vaginal wall or lower segment wall and it is necessary to explain the possibility of vesicouterine fistula development in case of VBAC. Patients usually present with urinary incontinence in the early postoperative period or present months or years later with cyclic hematuria, amenorrhea, vaginal leakage of urine, urinary tract infection and secondary infertility. The diagnosis is made by cystoscopic visualization of the fistula orifice in the bladder and outlining the fistula tract on cystogram, hysterosalpingogram or transvaginal ultrasonogram. There have been varied approaches to the treatment of vesicouterine fistula with conservative therapy or surgical therapy. We experienced two cases of vesicouterine fistulas in women with previous Cesarean section, the one is delivered with repeat Cesarean section after trying VBAC, the other is delivered with vacuum assisted VBAC, and treated with surgical repair.
Amenorrhea ; Cesarean Section* ; Cesarean Section, Repeat ; Diagnosis ; Female ; Fistula* ; Hematuria ; Humans ; Infertility ; Postoperative Period ; Pregnancy ; Ultrasonography ; Urinary Bladder ; Urinary Incontinence ; Urinary Tract Infections ; Uterus ; Vacuum ; Vaginal Birth after Cesarean