Conventional hemorrhoidectomy is still the main stairway to the treatment of the third or the fourth degree hemorrhoids. Among the various methods of hemorrhoidectomy, open hemonhoidectomy is claimed to decrease postoperative pain and wound infection, but to have disadvantage of long period of wound healing. Semi-closed hemorrhoidectomy has the advantage of rapid wound healing without increased risk of wound infection, but more painful postoperative course than open hemorrhoidectomy is suggested. To assess this conventional concept, two hundreds of patients were randomly allocated to either an open hemorrhoidectomy(Group 4, Operated by modified Goligher method, n=100) or a semi-closed hemorrhoidectomy(Group B, Operated by modified Nesselrod method, n=100), and postoperative results were analyzed. In group 4, the average time for disappearance of wound edema was 4.9days, average time for disappearance of wound pain was 9.0days, average time for painless defecation was 14.1 days, average time for complete wound healing was 28.4days. The main complications were overgranulation, skin tag, anal discharge and pruritus. The overgranulation requires curettage, the skin tags were resected under local anesthesia. Anal discharge and pruritus were spontaneously disappeared after the healing of the wound. In group B, the average time for disappearance of wound edema was 6.1 days, average time for disappearance of wound pain was 6.3days, average time for painless defecation was 9.2days, average time for complete wound healing was 20.7days. The main complications were skin tags, more prevalent than group 4, requiring resection under local anesthesia. No infectious complications were noted in both groups. Consequently, the old concept that open hemorrhoidectomy has advantage of less painful postoperative course than semiclosed hemorrhoidectomy cannot be accepted. Semi-closed hemorrhoidectomy offers more rapid loss of pain and more rapid healing of the wound than open hemorrhoidectomy, without increased risk of infectious complications. In conclusion, semi-closed hemorrhoidectomy is superior method to open hemorrhoidectomy in third or fourth degree hemorrhoids.
Anesthesia, Local ; Curettage ; Defecation ; Edema ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Pain, Postoperative ; Pruritus ; Skin ; Wound Healing ; Wound Infection ; Wounds and Injuries

Gorham's syndrome is a rare disorder involing a proliferation of vascular channels associated with extensive loss of bony matrix. It starts in bone, but it may secondarily involve soft tissue and adjacent bones. Although the osteolysis usuakky arrests spontaneously, its biologic behavior is difficult to predict. The mechanism of steolysis is unkown, and the role of osteoclasts is controverwial We have experienced one case of Gorham's syndrome affecting the scapula and clavicle, which is reported in this paper with brief review of literature.
Clavicle ; Osteoclasts ; Osteolysis ; Scapula

The role of GABA or glycine as an inhibitory neurotransmitter is well established, and GABAergic or glycinergic neurons appear to play an important role in the mammalian retinas. It has been reported that certain amacrine, bipolar, displaced amacrine and ganglion cells are consistently labeled with anti-GABA or anti-glycine antisera in the mammalian retinae so far, and it has been suggested that colocalization of GABA and glycine within the retinal neurons could be common in the mammalian retina by recent immunecytochemical and electrophysiological studies. This study was conducted to localize GABAergic and glycinergic neurons and to define whether GABA and glycine are colocalized within same retinal neurons of the rat retina by immunocytochemical method using anti-GABA and anti-glycine antisera. The results were as follows : 1. GABAergic neurons of the rat retina were amacrine, interplexiform, bipolar, displaced amacrine and ganglion cells, and processes of GABAergic neurons formed dense networks with distinct two bands in the inner plexiform layer. 2. Glycinergic neurons were amacrine, bipolar, displaced amacrine and ganglion cells,and their processes were evenly distributed as dense networks through whole inner plexiform layer. 3. 28.5% of GABA immunoreactive amacrine cells and 9.8% of GABA immunoreactive bipolar cells located in the inner nuclear layer,and 11.9% of labeled neurons located in the ganglion cell layer showed glycine immunoreactivity in the rat retina. These results demonstrate that GABA and glycine, major inhibitory neurotransmitters, are colocalized within certain amacrine and displaced amacrine cells, and a few bipolar cells, and that neurons synthesizing and utilizing both GABA and glycine as their neurotransmitters may play an unique role in the visual processing in the rat retina.
Amacrine Cells ; Animals ; GABAergic Neurons ; gamma-Aminobutyric Acid* ; Ganglion Cysts ; Glycine* ; Immune Sera ; Neurons* ; Neurotransmitter Agents ; Rats* ; Retina* ; Retinal Neurons

This study was conducted to examine the effect of chronic low dose organic solvent exposures in the industries towards then neurobehavioral functions of workers subjective symptoms on neurobehavioral function as well as a visual reaction time test (Flicker test) were administered to 94 exposed and 162 unexposed workers in a oil refinery and some other auto-repair shops. The results obtained were as follows: 1. Symptom complaints were higher and Flicker test values were lower in exposed workers than in unexposed workers. 2. Flicker values were inversely correlated with urinary Hippuric acid concentration in exposed workers (r=-0.26, p<0.05). 3. Flicker values were inversely correlated with subjective symptom score (r=-0.15, p<0.05). Low Flicker value were also related with some subjective symptoms such as "Dimmed vision", "Nightmare", "weakness on extremity" in workers as a whole. While symptoms of "Dimmed vision", "Nightmare" only observed among exposed workers.
Reaction Time

Behcet's disease is a multisystematic inflammatory disorder affecting eyes. Visual loss is the most serious effect of Behcet's disease with posterior segment involvement.Because of the disorder's devastating visual consequences, its treatment has received considerable attention.Since the treatment of Behcet's disease has often been unsatisfactory, many different types of treatment have been attempted. We retrospectively reviewed the charts of 28 patients with severe ocular Behcet's disease involving posterior segment.The patients with posterior segment involvement were initially treated with triple regimen (corticosteroid, colchicines, and azathioprine).If intraocular inflammation does not resolve or the inflammatory process recurs, combination with low doses of cyclosporine should be considered (quadruple therapy).Over the course of therapy, visual acuity improved in 25 of 51 eyes (49.01%), remained stable in 14 of 51 eyes (27.45%), and declined in 12 of 51 eyes (23.52%).It improved or maintained the visual acuity in 39 of 51 eyes.There were no serious side effects attributable to triple or quadruple therapy that required withdrawal. The use of corticosteroids, colchicines, azathioprine, and cyclosporine may improve therapeutic efficacy and limit the adverse drug effects, and this combination method appears to be an effective treatment for the ocular complications of Behcet's disease.
Adrenal Cortex Hormones ; Azathioprine ; Cyclosporine ; Humans ; Inflammation ; Retrospective Studies ; Visual Acuity

Livedo vasculitis is thought to be a thrombogenic disorder that is related to the autoimmune disease. It clinically shows purplish mottling and recurrent painful ulcers in the lower extremities, leaving atrophie blanche after healing of the ulcers. Histopathologic finding are thrombotic occlusion in the mid-dermal vessels without necrotizing vasculitis. The therapeutic approach has largely been made by the use of drugs that stimulate endogenous fibrinolytic activitiy, that inhibit thrombus formation, or that cause vasodilation, but surgical intervention by excision and skin graftion has rarely been reported as a primary treatment.In our experience, two patients with livedo vasculitis, who had been unresponsive to various medications, were treated with wide excision and several times of skin grafting. And they experienced complete healing without recurrence.
Autoimmune Diseases ; Humans ; Lower Extremity ; Recurrence ; Skin ; Skin Transplantation ; Thrombosis ; Ulcer ; Vasculitis* ; Vasodilation

Thirty patients who coincided with CVA and MI, from january 1980 to August 1984, at Department of Internal Medicine, Kyung Hee University Hospital, were studied. And the following results were obtained; 1) The ratio of male to female was 2:1. The average age was 61.6 years. The in-hospital mortality rate was higher than cerebrovascular accident or myocardial infarction alone. 2) The most common risk factor was hypertension(83%), smoking(64%), hyperlipidemia(57%) and diabetes mellitus(33%) in order of frequency. 3) Fifteen cases of 30 patients had acute episode of MI and CVA during hospitalization and showed highest in -hospital mortality rate(66.7%). 4) There was no difference in mortality rate between cereral infarction and cerebral hemorrhage.
Cerebral Hemorrhage ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Infarction ; Internal Medicine ; Male ; Mortality ; Myocardial Infarction* ; Risk Factors ; Stroke*

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

The purpose of this study was to evaluate the remineralization effect of experimental fluoride varnish mixed with nano-tricalcium phosphate (TCP) and nano-hydroxyapatite (HA) on bovine teeth under demineralization and remineralization cycling by Vickers hardness. After fabrication of rosin-based experimental fluoride varnish with 5 wt% of NaF (EX) in the laboratory, 10 wt% of nano-hydroxyapatite (HA+EX) and nano-TCP (TC+EX) were mixed, respectively. Casein phosphopeptide-amorphous calcium phosphate (Tooth mousse) (CP) was used for comparison. Bovine incisors were impregnated by acrylic resin and exposed to caries inducing solution for 72 hours. EX, HA+EX, TC+EX, and CP were applied on the surface of bovine teeth. The specimens were immersed in a demineralization solution for 1 hour and in a re-mineralization solution for 23 hours and the cycle was repeated for 20 days. Vickers hardness was measured at baseline and after each treatment. CP group showed the highest hardness value at 24 hours after application of each material (p<0.05) and the other groups were not significantly different (p>0.05).On the 10th day of de-/re-mineralization cycling, the TC+EX group showed the highest hardness value (p<0.05), but not significantly different from the HA+EX group (p>0.05). On the 20th day, the TC+EX group kept the highest hardness value, followed by HA+EX and EX groups (p<0.05). In conclusion, experimental fluoride varnish with 10 wt% of nano-TCP showed higher remineralization effect on the enamel of bovine teeth during the de/re-mineralization cycling.