Waardenburg syndrome is a very rare auditory-pigment syndrome with autosomal dominant inheritance. In his first report in 1951, Waardenburg characterized this syndrome as dystopia canthorum, a high broad nasal bridge, synophrys[confluent eyebrows], heterochromia iridid, a white forelock or early graying, and sensory neural deafness. We observed a case of Type 2 Waardenburg syndrome with openangle glaucoma and, therefore report with literature review.
Deafness ; Glaucoma ; Glaucoma, Open-Angle* ; Waardenburg Syndrome* ; Wills

No abstract available.
Immunologic Tests* ; Tuberculosis, Meningeal*

We reviewed retrospectively 51 cases of patients with canalicular laceration from March 1994 to April 1999 about the patient characteristics, associated ocular injuries and other clinical informations through medical records. The injuries were most commonly occurred between the age of 20 to 39(27cases, 52.9%). The most common cause of injury was due to violence by kick or fist blow(26 cases, 51%), and accidental injuries by sharp-pointed objects in all cases under the age of 10(5 cases, 9.8%). Most cases have occurred to the lower eyelid(41, 80.4%), 6 cases(11.8%)to upper lid, and 4 cases(7, 8%)to both upper and lower lids. The right side was involved in 34 patient(66.7%), whereas the left side was involved in 17 patients(33.3%). While reviewing the used materials in canalicular repair, canaliculoplasty was not performed in 11 patients(21.6%)due to various reasons, Mini-Monoka was used in 34 patients(66.7%)and bicanalicular stent in 7 patients(13.7%). The increased incidence of epiphora was noted in those cases with notrepaired canalicular laceration, early protrusion of stent, and incomplete anatomical repair of lid margin and medial canthal angle due to extensive injury.
Humans ; Incidence ; Lacerations* ; Lacrimal Apparatus Diseases ; Medical Records ; Retrospective Studies ; Stents ; Violence

PURPOSE: The author performed this experimental study to investigate the changes in the tensile strength of a new insertion following a superior rectus recession in a rabbit's eye. METHODS: Conventional superior rectus muscle recession procedures with the hang-back suture technique were performed on New Zealand white rabbits (body weight 2~3kg), after which the disinsertional force was measured using a digital tension gauge on the 3rd, 5th, and 7th days, and then weekly for up to 8 weeks postoperatively. RESULTS: The postoperative disinsertional forces were as follows: 38.25 +/- 2.75, 165 +/- 31.27, and 167.25 +/- 26.99 g at the 3rd , 5th and 7th days, and 211.00 +/- 25.66, 222.75 +/- 26.66, 255.25 +/- 24.51, 271.50 +/- 38.25, 429.50 +/- 21.14 g at the 2nd, 3rd, 4th, 6th and 8th weeks respectively. The disinsertional forces linearly increased with the postoperative time period and there was a strong correlation with correlation coefficient being 0.903. CONCLUSIONS: We concluded that musculoscleral adhesion with hang-back suture maintained enough strength in early postoperative time period.
Rabbits ; Suture Techniques ; Sutures ; Tensile Strength*

Transrectal ultrasound (TRUS)-guided biopsy of the prostate is a common outpatient procedure for diagnosing prostatic cancer. It is a relatively noninvasive, safe, and effective method, as the majority of post-biopsy complications are mild and self-limiting. Fatal complications including infection or massive hemorrhage are rare, but can be life threatening. We herein present an autopsy case of fatal rectal bleeding after prostate biopsy and an analysis of similar cases.
Autopsy ; Biopsy ; Hemorrhage ; Humans ; Outpatients ; Prostate ; Prostatic Neoplasms

OBJECTIVE: The purpose of this study is to verify the correlation between gestational sac volume (GSV) from automatic tracing mode the VOCAL-imaging program and gestational age and to construct the nomogram of gestational sac volume as the new biometric parameter in early pregnancy. METHODS: The cross-sectional study has been conducted in 242 uncomplicated singleton pregnancies. 47 cases were excluded due to early pregnancy failure, fetal malformations, elective abortion, age discrepancy, etc. In 195 uncomplicated singleton pregnancies from 5 to 12 weeks' menstrual age, gestational sac volume, mean sac diameter and crown-lump length were measured for the assessment of gestational age. Gestational sac volumetry was carried out with automatic method and manual method of the VOCALTM (Virtual Organ Computer- aided AnaLysis) for the comparison between two methods. The collected data were analyzed for mean, standard deviation, 90% reference interval, 5th, 50th and 95th percentiles of gestational sac volume, mean sac diameter and CRL, and the nomogram were constructed. RESULTS: Polynomial regression analysis demonstrated the statistically significant positive correlation between gestational age and gestational sac volume by automatic tracing mode (R2 0.826, p<0.001), gestational sac volume by manual tracing mode (R2 0.844, p<0.0001), mean sac diameter (R2 0.763, p<0.0001) and crown-lump length (R2 0.950, p<0.0001). The 5th, 50th and 95th percentiles of the gestational sac volume were calculated and the nomogram was tabulated. In determining gestational age, the standard deviation (SD) of gestational sac volume by automatic tracing mode is 5.6 days, the SD of gestational sac volume by manual tracing mode is 5.2 days and the SD of MSD is 6.6 days. CONCLUSION: we can conclude that three-dimensional GSV with automatic tracing mode of the VOCAL-imaging program can be used as the new biometric measurement in determining gestational age. Gestational sac volumetry with automatic tracing mode of the VOCAL-imaging program have been proven available and convenient method and it can be recommended in 5-7 weeks' of gestation, when CRL is not clearly visualized.
Cross-Sectional Studies ; Gestational Age* ; Gestational Sac* ; Nomograms ; Pregnancy

Carcinoma of the gallbladder is relatively rare malignancy usually found in an elderly, predominantly female population. Histologically, adenocarcinoma predominate, with only 10% to 15% being of other varieties(small cell carcinoma and others). Small cell carcinoma of the gallbladder is a rare lesion and predominantly a disease of older women with clinical history of stones. These tumors show an aggressive clinical course and death usually occurs with in a few months of the diagnosis. The diagnosis of small cell carcinoma should be based on cell morphology, histologic pattern and immunohistochemical study. Correct diagnosis is important not only because these tumors give rise to endocrine syndromes, but also because the chemotherapeutic approach to small cell carcinoma differs from that for adenocarcinoma.
Adenocarcinoma ; Aged ; Carcinoma, Small Cell* ; Diagnosis ; Female ; Gallbladder* ; Humans

OBJECTIVE: This study was undertaken to compare the diagnostic performances of magnetic resonance imaging (MRI), MR myelography (MRM) and myelography in young soldiers with a herniated lumbar disc (HLD). METHODS: Sixty-five male soldiers with HLD comprised the study cohort. A visual analogue scale for low back pain (VAS-LBP), VAS for leg radiating pain (VAS-LP), and Oswestry disability index (ODI) were applied. Lumbar MR, MRM, and myelographic findings were checked and evaluated by four independent radiologists, respectively. Each radiologist was asked to score (1 to 5) the degree of disc protrusion and nerve root compression using modified grading systems devised by the North American Spine Society and Pfirrmann and the physical examination rules for conscription in the Republic of Korea. Correlated coefficients between clinical and radiological factors were calculated. Interpretational reproducibility between MRI and myelography by four bases were calculated and compared. RESULTS: Mean patient age was 20.5 +/- 1.1. Mean VAS-LBP and VAS-LP were 6.7 +/- 1.6 and 7.4 +/- 1.7, respectively. Mean ODI was 48.0 +/- 16.2%. Mean MRI, MRM, and myelography scores were 3.3 +/- 0.9, 3.5 +/- 1.0, and 3.9 +/- 1.1, respectively. All scores of diagnostic performances were significantly correlated (p < 0.05). However, none of these scores reflected the severity of patients' symptoms. There was no statistical difference of interpretational reproducibility between MRI and myelography. CONCLUSION: Although MRI and myelography are based on different principles, they produce similar interpretational reproducibility in young soldiers with a HLD. However, these modalities do not reflect the severity of symptoms.
Cohort Studies ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Male ; Military Personnel ; Myelography ; Physical Examination ; Radiculopathy ; Republic of Korea ; Spine

BACKGROUND: The stones in the biliary tree situated proximal to the origin of the common hepatic duct are considered intrahepatic duct stone. This conditon causes the serious problems including cholangitis, obstructive jaundice and liver abscess. AIM AND METHOD: This study is a clinical review for the results of surgical treatment in 178 cases of patients with intrahepatic stones in the Department of Surgery, Gyeongsang National University Hospital from January 1991 to December 1997. RESULTS: Sex ratio of male to female was 1 : 2.1 and most prevalent age group was 6th decade. Common symptom and sign was RUQ pain(83.2%) and tenderness(64.7%). Common laboratory finding were elevated alkaline phosphatase(56.6%), elevated serum GOT(47.4%), leukocytosis (44.5%) and hyperbilirubinemia(36.4%). C. Sinensis was identified in 22 cases(12.4%) of operation cases. Intrahepatic stones were located in the left hepatic duct in 87 cases(48.9%), the right duct in 27 cases(15.2%) and both intrahepatic duct in 64 cases (35.9%). Partial hepatectomy was performed in 94 cases(52.8%), non-hepatectomy was performed in 84 cases(47.2%). The remained stone was noted in 57 cases(32%) of operation cases. Among them, 39 cases(68%) were non-hepatic group, 18 cases(32%) were hepatic group. Postoperative complication rate in hepatic resection group(29.8%) was higher than that in non-resection group(15.5%). Most common complication was wound infection and operative mortality was 2.2%. The follow-up study showed that 146 cases(82%) were graded as good, 7 cases(3.9%) as fair and 25 cases(14%) as poor result and relative incidence of good result in hepatic resection group(88.3%) was higher than that in non-hepatic group(75%). CONCLUSIONS: We conclude that hepatic resection rather than biliary bypass procedure alone as an initial treatment for hepatolithiasis is satisfactory treatment.
Biliary Tract ; Cholangitis ; Female ; Follow-Up Studies ; Hepatectomy ; Hepatic Duct, Common ; Humans ; Incidence ; Jaundice, Obstructive ; Leukocytosis ; Liver Abscess ; Male ; Mortality ; Postoperative Complications ; Sex Ratio ; Wound Infection

BACKGROUND: Resolution of postoperative ileus has traditionally been the moment at which bowel function returns. The re-start of postoperative oral feeding usually occurs after that. Recently, many reports have been published on early postoperative feeding in patients operated on laparoscopically and even in patients receiving a laparotomy. The aim of this study was to scrutinize the validity of early postoperative feeding. METHODS: Fiftyfour colorectal cancer patients who had undergone radical resective surgery for cure were included in this study and were divided into two group. Group 1 included 32 patients who were fed in a traditional manner. Group 2 consisted of 22 patients who received a regular diet on the first postoperative day. The mean age was 62, the male-to-female ratio was 1.2:1. Thirteen tumor were located on the right side colon, 4 on the left side colon, 10 on the rectosigmoid, 27 on the rectum. Operative methods were 13 right hemicolectomies, 4 left hemicolectomies, 19 low anterior resections, and 18 abdominoperineal resections. The possible problems associated with early oral feeding were well understood by the patients and consents were obtained. Immediately after the operation, the nasogastric tube was removed in the operation room, and The time of complete recovery from anesthesia was 3 to 5 hours later. At that time, liquid drink was given; then, liquid food or blended food was allowed. RESULT: Early oral intake was tolerable in 14 patients out of 21 (67%); in 8 patients a nasogastric tube was reinserted due to severe nausea, vomiting, and/or abdominal distension. All those minor problems were resolved after reinsertion of the nasogastric tube and returning to the traditional method. In one patient, who had a received a low anterior resection, a serious complication, anastomatic leakage, developed. Early oral intake was not thought to be the exact cause of the leakage, but it made the problem more complicated. A huge amount of feces soiled the peritoneal cavity and the already dissected retroperitoneum. CONCLUSIONS: The tolerability of early postoperative oral intake was 67%. In the remainder of patients, all the minor problems except one, were relieved by simply returning to the traditional method. However, early postoperative oral intake should be used with caution for patients who experience difficulty with anastomosis or have an intraoperative technical breakdown and in whom the possibility of leakage exists.
Anesthesia ; Colon ; Colorectal Neoplasms* ; Diet ; Feces ; Humans ; Ileus ; Laparotomy ; Nausea ; Peritoneal Cavity ; Rectum ; Soil ; Vomiting