PURPOSE: Through a study of 3 diabetic patients who experienced decreased visual acuity due to deposit on the surface of hydrophilic acrylic IOLs which were inserted after cataract extraction, the authors attempted to examine pathological and histochemical characteristics of such undesirable deposit on the IOL surface and also evaluate whether a correlation exists between that and diabetes mellitus. METHODS: A 42 year old male patient with bilateral proliferative diabetic retinopathy who has had diabetes for 10 years, a 43 year old male with identical clinical history, and a 46 year old male with bilateral proliferative diabetic retinopathy and clinically significant macular edema who has had diabetes for 13 years were selected for the study. Cataract was extracted by phacoemulsification and after hydrophilic acrylic IOL was inserted into the bag, deposit appeared on IOL surface which caused decreased visual acuity. IOL exchange was conducted thereafter, and by studying the pathological and histochemical characteristics of deposit found on the surface of the retrieved IOL, and by examining the deposit's fine details with electron microscope, the authors attempted to identify the causative material and also evaluate whether diabetes plays a significant role in giving rise to such undesirable deposit. RESULTS: All three IOL that have been retrieved from the patients were covered with multiple deposits which took on a structure with fine circular granules, and all these deposits tested positive when 1% alizarin red staining and von Kossa staining (designed to identify calcium in a given material) were conducted. Electron microscopic study of the deposit also showed needlelike calcium crystals.
Adult ; Calcium* ; Cataract ; Cataract Extraction ; Diabetes Mellitus ; Diabetic Retinopathy ; Humans ; Macular Edema ; Male ; Middle Aged ; Phacoemulsification ; Visual Acuity

Supraaortic stenosis is a localized or diffuse congenital narrowing of the ascending aorta at the levels of superior margin of the sinus of Valsalva, just above coronary arteries. Hemodynamically, it is a usually manifestated as aortic stenosis especially when it combined with subaortic membrane. And there is no case report of supraaortic stenosis combined with subaortic membrane which has aortic valvular reurgitation due to secondary change of dilated sinus of Valsalva by supraaortic ridge. We have experienced a case of aortic regurgitation associated with supraaortic ridge combined with subvalvular aortic membrane.
Aorta ; Aortic Valve Insufficiency* ; Aortic Valve Stenosis ; Constriction, Pathologic ; Coronary Vessels ; Membranes* ; Sinus of Valsalva

Ten cases with esophageal foreign body were treated surgically from July 1980 to October 1995 at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The mean age was 45.3 years, with a range from 25 to 71. Out of ten cases, 6 were female and four were male. Common symptoms were dysphagia, fever, foreign body sensation and neck pain. Three cases of foreign bodies were of fish bones, two of bubble package of drugs, one case of a beer bottle cap, one of a piece glass, one of a bathtub plug, one of chicken and one of a bean. The diagnosis was established by esophagography using a water soluble contrast material and esophagoscopy. Among of ten cases, two had esophageal stricture due to the ingestion of lye at a young age. One case had experienced psychological problems. All foreign bodies were removed by surgical procedures. Five cases were treated by cervical esophagostomy, one case by right thoracotomy, one case by retrograde bougienation through gastrostomy and two cases by cervical incision and drainage for cervical abscess. Three cases developed post operative esophageal leaks which healed spontaneously and transient hoarseness developed in one case. One case developed traumatic pneumothorax and subcutaneous emphysema which was treated by closed thoracostomy. There were no operative deaths.
Abscess ; Beer ; Chickens ; Chungcheongnam-do ; Deglutition Disorders ; Diagnosis ; Drainage ; Eating ; Esophageal Stenosis ; Esophagoscopy ; Esophagostomy ; Esophagus ; Female ; Fever ; Foreign Bodies* ; Gastrostomy ; Glass ; Hoarseness ; Humans ; Lye ; Male ; Neck Pain ; Pneumothorax ; Sensation ; Subcutaneous Emphysema ; Thoracostomy ; Thoracotomy

A 24 year old man visited our hospital, because an intrapulmonary foreign body had been found incidentally. Simple chest X-ray showed a 5 cm sized foreign body of metallic density, and chest CT confirmed the foreign body, which was like a sewing needle, in the left upper lobe. We performed a simple extraction of the foreign body using VATS (Video Assisted Thoracic Surgery). After the operation, the patient was discharged without any complications.
Foreign Bodies ; Humans ; Needles* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Young Adult

A 24 year old man visited our hospital, because an intrapulmonary foreign body had been found incidentally. Simple chest X-ray showed a 5 cm sized foreign body of metallic density, and chest CT confirmed the foreign body, which was like a sewing needle, in the left upper lobe. We performed a simple extraction of the foreign body using VATS (Video Assisted Thoracic Surgery). After the operation, the patient was discharged without any complications.
Foreign Bodies ; Humans ; Needles* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Young Adult

Malignant schwannoma is rare tumor which is derived from schwan cells or nerve sheath cells, and it is frequently associated with Von Rechlinghausen's disease. We experienced one case of malignant schwannoma on the right chest wall without Von Rechlinghausen's disease. Patient was 64-year-old man who presented painless palpable mass on the right lower chest wall for about 2 months. On chest computed tomography, the mass which was 6 X 6 cm in size and had central necrosis, involved 11th rib with destruction, invaded the diaphragm and displaced the kidney anteriorlly. He underwent en-bloc resection of the tumor and discharged without any problem after 20 days.
Diaphragm ; Humans ; Kidney ; Middle Aged ; Necrosis ; Neurilemmoma* ; Ribs ; Thoracic Wall* ; Thorax*

Alport syndrome is a hereditary, progressive disease characterized by progressive nephritis, sensorineural deafness, and ocular abnormalities, including anterior lenticonus. The ultrastructure of the lens capsule abnormalities in Alport syndrome is reported. Four anterior lens capsules from 31-year-old patient and 26-year-old patient with lenticonus who were affected by the Alport syndrome were obtained at capsulectomy. And all four anterior lens capsules were examined by transmission electron microscopy. The histopathologic findings showed that the thickness of the anterior lens capsules was decreased (4~13 micrometer) and that there were many vascular dehiscences localized at the inner part of the lens capsule. There were large numbers of capsular dehiscences containing fibrillar materials and vacuoles. The anterior capsules were clearly fragile in this disease, forming the basis for the progressive lenticonus and anterior polar cataract.
Adult ; Epithelial Cells/ultrastructure ; Humans ; Lens Capsule, Crystalline/*ultrastructure ; Lens Diseases/genetics/*pathology ; Lens Implantation, Intraocular ; Male ; Nephritis, Hereditary/genetics/*pathology ; Phacoemulsification

Fusobacteria are anaerobic gram-negative, non-spore forming bacilli found in normal flora of the oral cavity, urogenital tract, and gastrointestinal tract. Fusobacterium nucleatum has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. A 55-year-old man with frequent periodontal disease visited our hospital with intermittent fever and headache for 2 months. Abdominal CT scan revealed an 8.2x6 cm mass in the right hepatic lobe with central low density. Abscess culture revealed F. nucleatum as the causative organism. Percutaneous abscess drainage and intravenous administration of antibiotics for 4 weeks improved symptoms and decreased the abscess size. We report a rare case of liver abscess due to F. nucleatum in an immunocompetent man with periodontal disease.
Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Fusobacterium Infections/complications/*diagnosis/drug therapy ; Fusobacterium nucleatum/*isolation & purification ; Humans ; Injections, Intravenous ; Liver Abscess/*diagnosis/etiology/microbiology ; Male ; Middle Aged ; Periodontal Diseases/*diagnosis ; Sulbactam/therapeutic use

BACKGROUND: Adequate exposure of the mitral valve is a prerequisite for mitral procedures including the repair. An extended transseptal approach in mitral valvular operations is known to have certain technical advantages in recent years because of the anatomic posterior location of the mitral valve, especially in reoperations and in the presence of the small atrium in spite of the possibility of arrhythmia due to injury of sinus nodal artery. MATERIAL AND METHOD: We compared the preoperative status, operative, and postoperative factors among patients in two study groups, transseptal only (Group I, n=10) and extended transseptal approach (Group II, n=25). RESULT: There were no differences in age, sex, NYHA functional class, left atrial size, and left ventricular function. The incidence of the redo-operation was high and early postoperative arrhythmia, which was improved later, appeared in 3 patients in Group II, but not in Group I. CONCLUSION: We believe that atrial septal incision could be extended up to the atrial roof whenever exposure of the mitral valve during a transseptal approach is inadequate because the late results were similar.
Arrhythmias, Cardiac ; Arteries ; Humans ; Incidence ; Mitral Valve ; Ventricular Function, Left

We report our experience with 2 cases of perforation of intrathoracic stomach after Ivor Lewis operation for esophageal cancer. There was no problem in the anastomotic site, but the drainage from pleural cavity increased after oral intake. The stomach perforation was proved by rethoracotomy. The perforation site was repaired by sutures with pedicled intercostal muscle.
Drainage ; Esophageal Neoplasms* ; Intercostal Muscles ; Pleural Cavity ; Postoperative Complications ; Stomach* ; Sutures