PURPOSE: To evaluate the surgical results of tarsal fracture and anterior lamellar reposition in patients with cicatricial entropion. METHODS: The authors retrospectively analyzed the medical records of 9 patients (11 eyes) who had undergone tarsal fracture and anterior lamellar reposition for cicatricial entropion from October 2003 to September 2008. RESULTS: 6 eyes of 5 patients were male and 5 eyes of 4 patients were female. The patients' mean age was 63.4 (43.5~75.9) years. The mean follow-up period was 29.9 (7~67.6) months. After surgery, the ocular irritation disappeared in all patients. There were no recurrences or complications. CONCLUSIONS: Tarsal fracture and anterior lamellar reposition in patients with cicatricial entropion is a simple and cosmetically effective procedure without complications.
Entropion ; Eye ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Recurrence ; Retrospective Studies

PURPOSE: To evaluate the efficacy and safety of the inferior conjunctival transposition flap for primary pterygium surgery. METHODS: This study reviewed 59 eyes in 59 patients with primary pterygium who were treated with pterygium excision and an inferior conjunctival transposition flap. The inferior conjunctival flap was obtained from lower bulbar conjunctiva and was secured with 8-0 vicryl. Patients were followed-up on the third day after surgery and then at 1, 2, 4 and 12 weeks postoperatively. RESULTS: The mean patient age was 55.6 (ranging from 34 to 74) years. The mean follow-up period was 24.9 (ranging from 12 to 46) months. During the follow-up period, the pterygium recurred in one (1.7%) of the 59 eyes. There were no severe complications except for mild congestion and hemorrhage of the conjunctival flap. CONCLUSIONS: Inferior conjunctival transposition flap technique may be considered as a safe and effective method that reduces complications and recurrences after primary pterygium excision.
Conjunctiva ; Estrogens, Conjugated (USP) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Polyglactin 910 ; Pterygium ; Recurrence

MEN type 1 is characterized primarily by the presence of functioning and nonfunctioning tumors or hyperplasia of the pituitary gland, parathyroid glands, and pancreatic islet cells. Pancreatic islet tumors in MEN type 1 produce different kinds of hormone which were pancreatic polypeptide, gastrin, glucagon, insulin and so on. To date, ten cases had been reported in Korea. We report another case with MEN type 1 having prolatin-secreating pituitary adenoma, parathyroid hyperplasia and insulinoma. A 36-year-old woman was admitted because of long-standing amenorrhea and recently diagnosed osteoporosis. Otherwise, she had been in good health except experiencing one episode of loss of consciousness after skipped meal. The blood chemistries were normal except hypercalcemia and hypophosphatemia. Hormonal studies revealed elevated levels of intact PTH and prolactin and decreased value of estradiol with low LH and FSH. The neck CT revealed 1 cm-sized nodule at posterior portion of right thyroid gland and 99mTc-sestamibi sintigraphy showed a increased uptake in left lower and right lower parathyroid glands. The sella MRI showed 0.7 cm-sized enhanced lesion in the left pituitary gland. The ratio of immunoreactive insulin to glucose was elevated and 3-4 pancreatic masses of variable size were identified by endoscopic ultrasonography and angiography. Subtotal parathyroidectomy and pyrolus-preserving pancreaticoduodenectomy with spleen-preserving distal pancreatectomy was done. Postoperative she had been doing well with normocalcemia and normoglycemia. Transsphenoidal adenonectomy was done 5 months later. Histologic examination of removed tissues revealed a single insulinoma, prathyroid hyperplasia and prolactin-secreating pituitary adenoma.
Adult ; Amenorrhea* ; Angiography ; Endosonography ; Estradiol ; Female ; Gastrins ; Glucagon ; Glucose ; Humans ; Hypercalcemia ; Hyperplasia ; Hypophosphatemia ; Insulin ; Insulinoma ; Islets of Langerhans ; Korea ; Magnetic Resonance Imaging ; Male ; Meals ; Multiple Endocrine Neoplasia Type 1* ; Multiple Endocrine Neoplasia* ; Neck ; Osteoporosis* ; Pancreatectomy ; Pancreatic Polypeptide ; Pancreaticoduodenectomy ; Parathyroid Glands ; Parathyroidectomy ; Pituitary Gland ; Pituitary Neoplasms ; Prolactin ; Technetium Tc 99m Sestamibi ; Thyroid Gland ; Unconsciousness

Spontaneous retroperitoneal hemorrhage due to liver cirhosis associated with impaired coagulopathy is very rare disease. Spontaneous retroperitoneal hemorrhage has been recorded as having originated from many retroperitoneal organs and blood vessels, and it may be due to local disease and/or systemic factors. In the majority of patients the bleeding arose from the kidney or adrenal gland. Among the systemic causes of spontaneous retroperitoneal hemorrhage are anticoagulation therapy and chronic hemodialysis during the course of which hemorrhagic complications may occur at many site, including the retroperitoneal space. Blood dyscrasias have been a rare cause of spontaneous retroperitoneal hemorrhage. Conditions reported have been included hemophilia, leukemia, polycythemia and sickle cell trait. Virtually every hemostatic function may be impaired in patients with severe hepatic disease as the result of failure of both the biosynthetic and clearence function of the liver, thrombocytopenia, platelet dysfunction, intravascular coagulation and fibrinogenolysis, and the effects of products of fibrinogen catabolism on the coagulation mechanism. We are reporting a case of spontaneous retroperitoneal hematoma in a patient with alcoholic liver cirrhosis with brief review of literature.
Adrenal Glands ; Blood Platelets ; Blood Vessels ; Fibrinogen ; Hematoma* ; Hemophilia A ; Hemorrhage ; Humans ; Kidney ; Leukemia ; Liver Cirrhosis* ; Liver Cirrhosis, Alcoholic ; Liver* ; Metabolism ; Polycythemia ; Rare Diseases ; Renal Dialysis ; Retroperitoneal Space ; Sickle Cell Trait ; Thrombocytopenia

OBJECTIVES: To determine the relationship between exercise and the incidence of type 2 diabetes in an impaired fasting glucose group. METHODS: This prospective cohort study was conducted in 19,440 men and 4,297 women, aged 30-69 years, with impaired fasting glucose at baseline who had undergone biennial medical evaluation through the National Health Insurance Corporation from 2000 to 2004. Impaired fasting glucose was defined as fasting glucose of 100 to 125 mg/dl and the subjects were divided into 3 groups depending on weekly exercise frequency. Multivariate logistic regression analysis was used to evaluate the association between the baseline exercise status and incidence of type 2 diabetes. RESULTS: During the 4-year follow-up, a total of 3,239 men and 283 women developed type 2 diabetes, a cumulative incidence of 16.6% for men, and 6.5% for women. Also, 1,688 men (21.2%) and 127 women (15.2%) developed type 2 diabetes in the obese group. The adjusted relative risk (RR) of developing type 2 diabetes in non-exercising men was significantly higher than exercising men regularly (RR= 1.375, 95% CI=1.236-1.529)(p<0.0001), and the RR for non-exercising women was higher than exercising women regularly (RR=1.124, 95% CI=0.711-1.778). The RR for non-exercise men/women in the obese group was 1.571 (95% CI=1.351-1.827)(p<0.0001)/1.869(95% CI=0.846-4.130). CONCLSIONS: Regular exercise is effective in preventing type 2 diabetes in people with impaired fasting glucose, and particularly in obese people. People with risk factors for diabetes should participate in a regular exercise program.
Adult ; Aged ; *Blood Glucose ; Diabetes Mellitus, Type 2/*epidemiology/prevention & control ; *Exercise ; Female ; Glucose Tolerance Test ; Humans ; Incidence ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Sex Factors

Cytomegalovirus(CMV) rarely causes cutaneous rnanifestations. But since the recent development of organ transplants and the increased prevalence of AIDS, various skin manifestations of CMV infection such as varicelliform eruptions, perineal hulcerations, papular, purpurc and vesiculobllous lesions are increasing in immunocompromised subjects, Perineal ulceration is a typical cytomegalovirus-induced skin manifestation which exhibits similar morphology to herpes simplex viral infection. We describe a case of CMV-induced ulcer on labia majora in an AIDS patient, proven by histologic findings and immunohistochemistry. The patient was treated with ganciclovir and the lesion improved two months later.
Cytomegalovirus* ; Ganciclovir ; Herpes Simplex ; Humans ; Immunohistochemistry ; Prevalence ; Skin Manifestations ; Transplants ; Ulcer*

Xanthogranulomatous cholecystitis is an uncommon inflammatory disease of the gall baldder characterised by a focal or diffuse destructive inflammatory process. The pathogenesis is uncertain, but an inflammatory response to extravasated bile due to acute inflammation and obstruction is likely. Macroscopically, the gall bladder wall is invariably thickened, and extensive adhesions to adjacent organs are frequent. Clinically, xanthogranulomatous cholecystitis can mimic gall bladder carcinoma and radiologic differential diagnosis is extremely difficult. Fistula to skin and duodenum was reported. We report the first case of cholecysto-colonic fistula due to xanthogranulomatous cholecystitis.
Bile ; Cholecystitis* ; Diagnosis, Differential ; Duodenum ; Fistula* ; Inflammation ; Skin ; Urinary Bladder

BACKGROUND/AIMS: Gallstone pancreatitis has showed higher mortality and morbidity rate as compared to other causes of pancreatitis, and the proper timing of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) is still controversial. But recent several trials reveals early ERCP/EST is safe procedure and can reduce mortality and complication rate in gallstone pancreatitis. METHODS: To assess the safety and effectiveness of early ERCP/EST, we perfomed ERCP and EST, if necessary, in 40 cases of acute gallstone pancreatitis. RESULTS: 1) Early ERCP group (in 72 hours) were 27 cases, delayed group were 13 cases, and 11 early EST group, 16 delayed EST group. No statistically significant difference was found between two groups in blood chemistry and the severity of pancreatitis according to Ranson's criteria, respectively. No remarkable complication due to ERCP or EST was noted, and the hospital days were shorter in early ERCP/EST group with statistical significance, 2) Duodenoscopic findings show 14 normal papillae, 20 papillary edema, hemorrhagic and lacerated papillae in 6 cases. CONCLUSION: In cases of gallstone pancreatitis, early ERCP and EST is considered as a safe and effective treatment modality.
Chemistry ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Edema ; Gallstones* ; Mortality ; Pancreatitis* ; Sphincterotomy, Endoscopic

Arotinolol, a new alpha and beta receptor antagonist, was administered in 27 essential hypertensive patients for 8 weeks in order to evaluate the antihypertensive effect and side effects. The dose were 10mg to 15mg given twice a day. The results are as follows : 1) Before medication, systolic and diastolic blood pressure in sitting, supine and erect position were 173.1+/-3.2/105.8+/-1.8, 171.1+/-3.6/86.7+/-2.0 and 169.3+/-2.6/97.2+/-2.1mmHg. 2) After 8 weeks treatment moderated to marked antihypertensive effect was observed in 74.0%(in systolic blood pressure) and 81.4%(in diastolic blood pressure) respectively in sitting position. 3) There was a significant reduction of pulse rate from 73.0+/-2.5 beats per minute on the beginning of the treatment to 63.4+/-5.2 beats per minute after 8 weeks of medication. 4) There was no significant change in hematocrit, WBC, serum lipid, GOT, GPT, BUN and creatinine. But fasting blood sugar was reduced from 95.3mg% to 81.5mg% with treatment. 5) The side effects of arotinolol were gastrointestinal symptoms(15%), fatigue(11%), dizziness(7%) and insomnia(3%). But these side effects were not severe enough to discontinue medication. In summary, arotinolol seemed to be an effective antihypertensive drug in treating mild to moderate hypertension without significant side effects.
Blood Glucose ; Blood Pressure ; Creatinine ; Fasting ; Heart Rate ; Hematocrit ; Humans ; Hypertension

BACKGROUND/AIMS: Pancreas divisum is a congenital anomaly caused by failure of fusion of the ventral and dorsal pancreatic anlagen during the sixth and seventh week of gestation. With widespread use of endoscopic retrograde cholangiopancreatography(ERCP), pancreas divisum is being detected with increasing frequency. Pancreas divisum is the most common congenital pancreatic anatomic variant, occuring in approximately 4.7~14% of necropsy series and has been demonstrated 1.3~6.7% of patients undergoing ERCP, The condition is seen least frequently in Asian(1~2%). It has been postulated that this anomaly may be a cause of obstructive pancreatic pain and pancreatitis on the basis of impaired drainage through the minor papilla. But there is a controversy as to whether pancreas divisum is associated with an increased incidence of pancreatitis. This study is performed to evaluate the clinical presentation and significance of pancreas divisum. METHODS: 27 cases of pancreas divisum detected among 1,718 ERCP examinations performed from June, 1993 to December, 1996 at our institution were critically analyzed. RESULTS: Overall incidence of pancreas divisum was 1.6%. Among them, 13 cases(48.1%) were classified as complete type, 14 cases(51.9%) were classified as incomplete type. There was a significantly high incidence of pancreatitis, 22.2% in pancreas divisum compared with 5.6% in fused pancreas. Pancreas divisum was misdiagnosed as pancreatic head mass on radiological imaging study in 4 cases(25%). CONCLUSIONS: Pancreas divisum may be predispose to development of pancreatitis, and that its presence may lead to misinterpretation of ultrasonographic and CT scan findings.
Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Head ; Humans ; Incidence ; Pancreas* ; Pancreatitis ; Pregnancy ; Tomography, X-Ray Computed