Commonly, the lateral canthus is located higher than medial canthus and many people are often shown short lateral palpebral fissure. This seemed to be shown as wild, anxious, and pierced eye. Many surgeons have made desperate efforts to improve this by anchoring lateral canthus to lower part of orbital bone. But, authors would like to show the two-third portion of the lateral lower eyelid by anchoring to capsulopalpebral fascia via transconjunctival approach. Authors performed this operation since 2009 and first named it by "Nun-Mit-Teuim" in Korean. Key of this operation is that anchoring of the lower tarsus and capsulopalpebral fascia via transconjunctival approach without resection of skin. It is not necessary to remove a redundant conjunctiva. Commonly, the lateral canthoplasty is performed simultaneously to descend a lower eyelid easily. After the operation, it can be observed that the lower eyelid lift up a little bit for 1~2 weeks and redundant conjunctiva will be constricted in several months. The operation is defined as anchoring the lower tarsus to capsulopalpebral fascia. The limit of the operation is it cannot change the position of the lateral canthus. Over-lowering the lower eyelid to increase palpebral fissure, results in scleral show and unfavorable line. Thus, it is important that surgeons should remind the purpose and limitation of this operation.
Animals ; Ankle ; Conjunctiva ; Eye ; Eyelids ; Fascia ; Isothiocyanates ; Orbit ; Skin

OBJECTIVE: Reduced tumor cell adhesion is associated with invasive growth and unfavorable prognosis. In endometrial carcinoma, the prognostic impact of adhesion marker such as E-cadherin is partly known. The purpose of this study is to investigate the correlation of the expression and the mutation of E-cadherin in endometrioid endometrial adenocarcinomas and endometrial hyperplasias and to correlate their results with various clinicopathological factors. METHODS: The expression of E-cadherin by using immunohistochemical staining (IHC) and the mutation of E-cadherin gene by using polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and sequencing were performed in tissues of 20 endometrial adenocarcinomas and 30 endometrial hyperplasias. The results were compared with previously known prognostic factors such as the stage, tumor grade and lymph node metastasis. RESULTS: Decreased expression of E-cadherin was detected in 13 of 30 (43.3%) endometrial carcinomas and in 1 of 20 (5%) endometrial hyperplasias (P=0.009). There was no statistical significance of the mutation of E-cadherin gene in between the endometrial carcinomas and endometrial hyperplasias (6.7%: 0%) (P=0.06). The incidence of the expression loss of E-cadherin in endometrial carcinomas also showed significantly higher with tumor grade 3, tumor stage above Ic or lymph nodal metastasis (P=0.01, P=0.02, P=0.03). CONCLUSION: Decreased expression of E-cadherin was detected significantly higher in endometrial carcinomas than endometrial hyperplasias. And the incidence of decreased expression of E-cadherin was more frequent in advanced stage, high histopathologic grade, and lymph nodal metasis. The mutation of E-cadherin gene was detected in only 2 cases. These results suggests that the expression of E-cadherin seems to be important in endometrial carcinomas and associated with aggressive subgroups. But the mutation of E-cadherin gene would not be related to endometrial carcinomas.
Adenocarcinoma ; Cadherins ; Cell Adhesion ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Female ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.
Adenomyosis ; Endometrium ; Female ; Humans ; Hysterectomy* ; Leiomyoma ; Uterus

Intracranial lipomas are uncommon and rarely symptomatic benign tumors comprising 0.1% of intracranial tumors. Although they can be found in other sites of the brain, the corpus callosum is generally believed to be the most common location of these tumors. And lipomas within the cerebellopontine (C-P) angle and internal auditory canal are extremely rare. In the C-P angle region, lipomas are the most symptomatic compared in other intracranial regions, although symptoms depend on the origin site and involve neural and vascular tissues adjacent to lipomas. And hearing loss, dizziness and tinnitus are the commonly presenting symptoms. Among these symptoms, hearing loss is the most common, but sudden hearing loss, as in this case, has not been reported. Because of the potential for significant morbidity with surgical resection of these lesions, conservative follow-up is the best treatment option for patients with these rare lesion. But surgery is indicated only when significant progressive or disabling symptoms are present. We experienced a case of right side C-P angle lipoma with sudden hearing loss in a 49-year old female who showed complete recovery of hearing by conservative therapy. With a review of literature, authors report a case of right C-P angle lipoma presented as sudden hearing loss.
Brain ; Cerebellopontine Angle* ; Corpus Callosum ; Deafness ; Dizziness ; Female ; Hearing ; Hearing Loss ; Hearing Loss, Sudden* ; Humans ; Lipoma* ; Middle Aged ; Tinnitus

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has become a one of the most important causes of nosocomial infections, and use of vancomycin for the treatment of MRSA infection has increased. Unfortunately, vancomycin-resistant enterococcus have been reported, as well as vancomycin-resistant S. aureus. Arbekacin is an antibacterial agent and belongs to the aminoglycoside family of antibiotics. It was introduced to treat MRSA infection. We studied the clinical and bacteriological efficacy and safety of arbekacin compared to vancomycin in the treatment of infections caused by MRSA. MATERIALS AND METHODS: This was a retrospective case-control study of patients who were admitted to tertiary Hospital from January 1st, 2009 to December 31st, 2010, and received the antibiotics arbekacin or vancomycin. All the skin and soft tissue MRSA infected patients who received arbekacin or vancomycin were enrolled during the study period. The bacteriological efficacy response (BER) was classified with improved and failure. The improved BER was defined as no growth of MRSA, where failure was defined as growth of MRSA, culture at the end of therapy or during treatment. Clinical efficacy response (CER) was classified as improved and failure. Improved CER was defined as resolution or reduction of the majority of signs and symptoms related to the original infection. Failure was defined as no resolution and no reduction of majority of the signs and symptoms, or worsening of one or more signs and symptoms, or new symptoms or signs associated with the original infection or a new infection. RESULTS: Totally, 122 patients (63/99 in arbekacin, 59/168 in vancomycin group) with skin and soft tissue infection who recieved arbekacin or vancomcyin at least 4 days were enrolled and analysed. The bacteriological efficacy response [improved, arbekacin vs vancomycin; 73.0% (46/63), 95% confidence interval (CI) 60.3 to 83.4% vs 83.1% (49/59), 95% CI 71.0 to 91.6%] and clinical efficacy response [improved, arbekacin vs vancomycin; 67.2% (41/61), 95% CI 52.0 to 76.7% vs 78.0% (46/59), 95% CI 65.3 to 87.7%] were similar between the two groups (P=0.264, 0.265). The complication rate was significantly higher in the vancomycin group [29/59(49.2%), 95% CI 35.9 to 62.5%] than arbekacin [10/63(15.9%), 95% CI 8.4 to 29.0%] (P<0.001). CONCLUSIONS: Arbekacin could be considered as an alternative antibiotics for vancomycin in skin and soft tissue infection with MRSA. However, further prospective randomized trials are needed to confirm this finding.
Anti-Bacterial Agents ; Case-Control Studies ; Cross Infection ; Dibekacin ; Enterococcus ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Tertiary Care Centers ; Vancomycin

Teratoma is a congenital tumor which occurs rarely in the head and neck. Head and neck teratomas have been described infrequently in the literature as a result of their low incidence, occuring in only 1 in 20, 000 to 40, 000 live births. And the heterotopic gastrointestinal cyst, a type of choristoma, is uncommon in head and neck also. Patients with these tumors have symptoms related to difficulties with swallowing and respiration that could result in high degree of morbidity and mortality by virtue of size and location of tumor. The purpose of this paper is to report a case of neonate who had mature teratoma of nasopharynx and a heterotopic gastrointestinal cyst of left submandibular gland. We review the literature pertaining to teratoma and heterotopic gastrointestinal cyst in head and neck.
Choristoma ; Deglutition ; Head* ; Humans ; Incidence ; Infant, Newborn ; Live Birth ; Mortality ; Nasopharynx ; Neck* ; Respiration ; Submandibular Gland ; Teratoma* ; Virtues

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of ear infections. We attempted to evaluate the clinical usefulness of arbekacin in treating chronic suppurative otitis media (CSOM) by comparing its clinical efficacy and toxicity with those of vancomycin. Efficacy was classified according to bacterial elimination or bacteriologic failure and improved or failed clinical efficacy response. Ninety-five subjects were diagnosed with CSOM caused by MRSA. Twenty of these subjects were treated with arbekacin, and 36 with vancomycin. The bacteriological efficacy (bacterial elimination, arbekacin vs. vancomycin: 85.0% vs. 97.2%) and improved clinical efficacy (arbekacin vs. vancomycin; 90.0% vs. 97.2%) were not different between the two groups. However, the rate of complications was higher in the vancomycin group (33.3%) than in the arbekacin group (5.0%) (P=0.020). In addition, a total of 12 adverse reactions were observed in the vancomycin group; two for hepatotoxicity, one for nephrotoxicity, eight for leukopenia, two for skin rash, and one for drug fever. It is suggested that arbekacin be a good alternative drug to vancomycin in treatment of CSOM caused by MRSA.
Adult ; Aged ; Anti-Bacterial Agents/administration & dosage ; Chronic Disease ; Dibekacin/administration & dosage/*analogs & derivatives ; Female ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus/*drug effects ; Middle Aged ; Otitis Media, Suppurative/diagnosis/*drug therapy/microbiology ; Staphylococcal Infections/diagnosis/*drug therapy/microbiology ; Treatment Outcome ; Vancomycin/*administration & dosage ; Young Adult

BACKGROUND: Recently, liquid-based cytology (LBC) has been introduced as an alternative to the conventional smear (CS) technique in thyroid fine needle aspiration, due to its diagnostic convenience. METHODS: We assessed 77 cases of thyroid fine needle aspiration using the SurePath(TM) method (SP) as LBC and CS via split-sample techniques. BRAF mutation tests were carried out via polymerase chain reaction and pyrosequencing immediately after diagnosis or a delay of more than one year. RESULTS: In a comparison between SP and CS, the rate of concordance between SP and CS was as high as 84.4% (kappa value, 0.754). In comparison with histologic diagnosis, the overall sensitivity was 100% for both. The specificity was 62.5% for SP and 56.3% for CS. Relative to CS, papillary carcinomas on SP slides revealed more accentuated nuclear irregularities, nucleoli, and reduced nuclear size. In contrast to CS, the delayed BRAFV600E mutation test using SP slides after 1-2 years failed. The use of new primers amplifying shorter product size could help the delayed test achieve success. CONCLUSIONS: Differences in the diagnostic efficacy of SP and CS were negligible. The failure of the delayed BRAF mutation test on the SP slides might be associated with DNA degradation.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; DNA ; Needles ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Thyroid Gland

OBJECTIVE: To know whether HPV Oligonucleotide Microarray (HPVDNAChip) can detect the HPV DNA in the urine and, if it can, to compare the results with Pap smear, biopsy, and cervix HPVDNAChip. METHODS: The authors had done Pap smear, cervix HPVDNAChip and colposcopy-guided punch biopsy as well as detailed information to those who visited Dept. of Ob. And Gyn. during 1st of April to 31st of May in 2003 for their uterine cervical problems related to the neoplasia. When they were determined to admit for treatment, urine had been collected to be tested by HPVDNAChip. RESULTS: Among 25 patients enrolled in this study, there were 10 whose urine HPVDNAChip test turned out positive (40%). Among 10 positive results, 9 patients had HPV 16 subtypes. Among 10 urine HPVDNAChip positive patients, there were 5 HSIL, 4 squamous cell cancer (SCC), and 1 ASCUS cell types on the Pap smears. Among 15 urine HPVDNAChip negative patients, there were 7 HSIL, 5 SCC, 1 ASCUS, 1 LSIL, and 1 AGUS. Among 10 urine HPVDNAChip there are 5 CIN3, and 4 invasive SCC, and 1 adenocarcinoma at the biopsy. Among 15 urine HPVDNAChip negative patients, there are 7 CIN3, 6 invasive SCC, 1 adenocarcinoma in situ, and 1 CIN1 patient. Whenever there were a urine HPVDNAChip 16 subtype positive, there were always cervix HPVDNAChip 16 subtype positive, but among the 12 urine HPVDNAChip negative patients, 5 had HPV 16 subtype positive and 4 had another subtypes and 3 had negative on cervix HPVDNAChip tests. CONCLUSION: Using HPVDNAChip, we verified that 40% of patients had the HPV DNA in their urine who had admitted for the treatment of their cervical neoplasm. And HPV 16 subtype was the most common type in the urine. If we can extend this data more widely, we might use it as an auxiliary tool for cervical HPV infection.
Adenocarcinoma ; Biopsy ; Cervix Uteri* ; DNA ; Female ; Human papillomavirus 16 ; Humans ; Neoplasms, Squamous Cell ; Oligonucleotide Array Sequence Analysis* ; Uterine Cervical Neoplasms*

OBJECTIVE: This study was performed to evaluate the clinical efficacy of high risk HPV DNA test using PCR for the detection of high-grade CIN or invasive cancer from patients with ASCUS or LSIL on Papanicolaou smear. METHODS: Sixty one patients with a Papanicolaou smear report of atypical squamous cells of undetermined significance or a low-grade squamous intraepithelial lesion underwent Cervical colposcopy and directed cervical biopsy and human papillomavirus test by PCR. We compared the detection rate of the high grade CIN and invasive cancer by Papanicolaou smear method only with that of both Papanicolaou smear and HPV PCR method. and we decided to be significant when P value was below 0.05 by SAS (v 6.02) program. RESULTS: The detection rate of high risk HPV DNA was 50.8% (31/61). The detection rate of high risk HPV DNA in high grade CIN and invasive cancer was 84.2% (16/19). Higher the grade of biopsy, more the detection rate of high risk HPV DNA. False negative rate which appeared high grade CIN or invasive cancer by biopsy was 31.2% (19/61) in Papanicolaou smear method only and 4.9% (3/61) in both Papanicolaou smear and HPV DNA method. CONCLUSION: We thought that additional HPV DNA test was useful to dectect behind high grade CIN or invasive cancer when the Papanicolaou smear result was ASCUS or LSIL.
Biopsy ; Colposcopy ; Diagnosis* ; DNA ; Human Papillomavirus DNA Tests* ; Humans ; Papanicolaou Test ; Polymerase Chain Reaction