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

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

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

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

PURPOSE: To determine whether differences in arterial and end-tidal carbon dioxide [P(a-et)CO2], shock index, and serum lactate levels are helpful for predicting the outcome of resuscitation in hypovolemic shock patients in the emergency department. METHODS: A prospective study of end-tidal carbon dioxide (EtCO2)-derived variables and patient outcomes in hypovolemic shock was conducted in the emergency department of a university hospital from January 2005 to February 2006. A total of fifty-eight hypovolemic shock patients over 20 years old were included. During resuscitation, patients received volume replacement including blood transfusions, as well as vasopressor or inotropic therapy if needed. RESULTS: Twenty-one patients died in the hospital. At the time of admission (hour 0) and after resuscitation (hour 4), there were no differences related to age, respiration and heart rate, CVP, arterial blood gases, or EtCO2 between survivors and non-survivors. Non-survivors had significantly higher shock index scores, serum lactate levels, and P(a-et) CO2 than the survivors. The Receiver operator characteristic (ROC) curves at hour 4 hour for P(a-et)CO2 were as effective for predicting mortality as were the shock index and serum lactate levels. Shock index > 1.0, P(a-et)CO2 > 4 mmHg, and serum lactate > 5.0 mmol/L after resuscitation were all associated with a high early mortality rate (p=0.074, 0.001, 0.000, respectively). CONCLUSION: P(a-et)CO2, shock index, and serum lactate levels are predictive of in-hospital mortality and may be useful as guidelines in the resuscitation of hypovolemic shock patients in the emergency department.
Blood Gas Analysis ; Blood Transfusion ; Capnography ; Carbon Dioxide* ; Carbon* ; Emergency Service, Hospital ; Gases ; Heart Rate ; Hospital Mortality* ; Humans ; Hypovolemia* ; Lactic Acid* ; Mortality ; Prospective Studies ; Respiration ; Resuscitation* ; Shock* ; Survivors ; Young Adult

OBJECTIVE: Although some sporadic reports reveal the link between the homeobox (HOX) genes and ovarian carcinoma, there is no comprehensive analysis of the expression pattern of the class I homeobox genes in ovarian carcinoma that determines the candidate genes involved in ovarian carcinogenesis. METHODS: The different patterns of expression of 36 HOX genes were analyzed, including 4 ovarian cancer cell lines and 4 normal ovarian tissues. Using a reverse transcription-polymerase chain reaction (RT-PCR) and quantification analysis, the specific gene that showed a significantly higher expression in ovarian cancer cell lines than in normal ovaries was selected, and western blot analysis was performed adding 7 ovarian cancer tissue specimens. Finally, immunohistochemical and immunocytochemical analyses were performed to compare the pattern of expression of the specific HOX gene between ovarian cancer tissue and normal ovaries. RESULTS: Among 36 genes, 11 genes had a different level of mRNA expression between the cancer cell lines and the normal ovarian tissues. Of the 11 genes, only HOXB4 had a significantly higher level of expression in ovarian cancer cell lines than in normal ovaries (p=0.029). Based on western blot, immunohistochemical, and immunocytochemical analyses, HOXB4 was expressed exclusively in the ovarian cancer cell lines or cancer tissue specimens, but not in the normal ovaries. CONCLUSION: We suggest HOXB4 may be a novel candidate gene involved in ovarian carcinogenesis.
Aluminum Hydroxide ; Blotting, Western ; Carbonates ; Cell Line ; Female ; Genes, Homeobox ; Ovarian Neoplasms ; Ovary ; RNA, Messenger

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

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