Recently, intubation of silicone tubes have become popular for canalicular laceration. The surgery can be done with monocanalicular or bicanalicular methods. Fifteen cases of lacerated canaliculi were repaired using the silicone tube stents (seven monocanalicular stents, eight bicanalicular stents). An endoscope was used to reduce inferior meatal injury during surgery. The follow-up period was from six to eighteen months(mean, thirteen months). Four cases using the monocanalicular method and eight cases using the bicanalicular method were successful. Three cases of monocanalicular method had epiphora with canalicular obstruction due to early loss of the silicone tube. In monocanalicular method, postoperative complications were as the foUowing two cases of punctal granulomas, two cases of punctal slits and three cases of early loss of the silicone tube. All cases showed nasal bleeding. In bicanalicular method, postoperative complications occurred in one case each of conjunctival irritation sign and loop retraction. In our conclusion, the success rate of bicanaJicular stents in higher than that of monocanalicular stents for canalicular laceration. Also, use of an endoscope will help to reduce pain and nasal bleeding during the surgery.
Endoscopes ; Epistaxis ; Follow-Up Studies ; Granuloma ; Intubation* ; Lacerations* ; Lacrimal Apparatus Diseases ; Postoperative Complications ; Silicones* ; Stents

The results of corrective surgery in strabismus patients are not always predictable. To lower the chance of reoperation, intraoperative or postoperative adjustment is performed. The authors performed intraoperative adjustment surgery in 24 patients with topical Anesthesia with 0.5% tetracaine. We evaluated the severity of pain and the strabismus angel postoperatively. Follow-up showed success rate of 95.8% immediately after surgery. 79.2% on 6 weeks after surgery and 70.8% after 1 year. Among 24 patients, 17 patients felt no pain and 7 patients had on slight pain on muscle traction. The above results suggest that we can not prevent long-term recurrence after adjustment operation using topical anesthetics, this method causes no intolerable pain and making this a useful treatment for strabismus angle.
Anesthesia* ; Anesthetics ; Follow-Up Studies ; Humans ; Recurrence ; Reoperation ; Strabismus* ; Tetracaine ; Traction

Centric Relation ; Dental Arch ; Jaw ; Osteotomy ; Splints

Dental Occlusion ; Female ; Humans ; Incisor ; Jaw ; Lip ; Male ; Mandible ; Orthodontics ; Orthognathic Surgery ; Reference Values

The contemporary two-jaw surgical approach usually involves a Le Fort osteotomy of the maxilla and a ramal osteotomy of the mandible with 3-dimensional repositioning of the jaws as well as the occlusal planes. After making the surgical treatment plan, the surgical movements are duplicated in the model surgery. During this procedure, reference points and lines are drawn on the base of the models over the dental arch, and sawcuts are made according to these marked osteotomy lines. This technique, however, has been found to be inexact, especially when the jaws are moved in several dimensions simultaneously. To overcome this, different methods have been developed for an accurate repositioning of the jaws as planned. A new appliance, Surgical Jaw Relator, has been devised by the author for the simple 3-dimensional relocation of the upper and lower models, resulting in the easy construction of the splints such as centric relation splint, intermediate and final splint. This article describes an introduction and a clinical application of this appliance. Through the application of this system to the orthognathic cases including two-jaw surgery, it is proved that the new device is very clinically useful.
Centric Relation ; Dental Arch ; Dental Occlusion ; Jaw* ; Mandible ; Maxilla ; Osteotomy ; Osteotomy, Le Fort ; Splints

PURPOSE: Diabetic retinopathy (DR) has influence on peripheral retina, and progression of DR is thought to make prolongation of peripheral retinal circulation. However, there has been no study on circulation of peripheral retina. This study is to make a comparision of peripheral retinal microcirculation between control, non-proliferative diabetic retin-opathy (NPDR), and pre-and post-panretinal photocoagulation (PRP) of proliferative diabetic retinopathy (PDR). METHODS: The authors performed the study on 19 control eyes and 68 DR eyes (NPDR 31, PDR 37) and PDR group was subdivided into before and after PRP. The authors measured arm to retinal circulation time (ART), arteriovenous passage time (AVP), venous filling time (VFT) by scanning laser ophthalmoscope in upper temporal retinal vessel in order to evaluate peripheral retinal microcirculation. RESULTS: VFT was 9.4+/-0.3 sec in pre-PRP of PDR, 7.5+/-0.6 sec (p<0.05) in post-PRP of PDR and 6.4+/-2.2 sec in control, 8.17+/-1.90 sec (p<0.05) in NPDR. However, there is no significant difference in ART, AVP. CONCLUSIONS: Patients with NPDR showed prolongation of VFT compared to normal indivisuals. There was shortening of VFT in post-PRP of PDR similar to NPDR. Peripheral retinal circulation time after PRP can be utilized as an indicator of PRP effect.
Arm ; Diabetic Retinopathy* ; Humans ; Light Coagulation* ; Microcirculation ; Ophthalmoscopes ; Retina ; Retinal Vessels ; Retinaldehyde

The signal intensity of paranasal sinus mucocele is highly variable, ranging from high to low on both T1 weighted and T2 weighted sequence, This variation is likely due to the combined effects of decreased free water concentration, cross-linking and polymerization of the macromolecular mucus glycoprotein, and increased viscosity. We have experienced three cases of the paranasal sinus mucocele with different signal intensity on Magnetic Resonance Imaging. We describe MR characteristics of the paranasal sinus mucocele and compare with MR characteristics for other paranasal sinus disease.
Glycoproteins ; Magnetic Resonance Imaging ; Mucocele* ; Mucus ; Paranasal Sinus Diseases ; Polymerization ; Polymers ; Viscosity ; Water

p27Kip1 protein, a negative cell cycle regulator in G1 progression, has been reported to be related with human cancers including colon, breast and non-small cell lung carcinomas. To elucidate a possible prognostic indicator, we studied 49 cases of human breast carcinoma for expression of p27Kip1 protein using an immunohistochemical method, and compared these results with known prognostic parameters of the breast cancer. p27Kip1 protein was intensely stained in nuclei of carcinoma cells in 26 cases (53.1%). The expression rate of p27Kip1 protein was significantly higher in higher nuclear grade (p<0.05), lower histologic grade (p<0.01), lower N classification (p<0.001) and lower clinical stage (p<0.05) than in lower nuclear grade, higher histologic grade, higher N classification and higher clinical stage, respectively. p27Kip1 protein expression was significantly correlated with progesterone receptor status (p<0.05) or cyclin D expression (p<0.05). No statistical correlations were found between expression of p27Kip1 protein and other parameters including tumor size, estrogen receptor status, p53 overexpression and c-erbB-2 expression. The results suggest that reduced expression of p27Kip1 protein plays a role in biologically aggressive behavior of breast carcinoma and might contribute in predicting breast cancer patient's survival.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Classification ; Colon ; Cyclin D ; Cyclin-Dependent Kinase Inhibitor p27 ; Estrogens ; Humans* ; Lung ; Phosphotransferases* ; Prognosis ; Receptors, Progesterone

BACKGROUND: Kidney transplantation from cadaveric donor is increasing in KOREA. Knowledge of donor factors that can influence early graft function should be an important guideline in determining the suitability of a donor kidney for transplantation. METHOD: From June 1989 to August 1995, sixty patients with end-stage renal disease underwent kidney transplantation from thirty-two cadaver donors in Asan Medical Center. In this study, we reviewed the clinical characteristics of the cadaver donors including vital sign, urine output, serum creatinine, amounts of vasopressor needed, as well as the cause of brain death and evaluated the effect of these parameters on the early post-transplantation graft function (up to 6 months). RESULTS: The data are given as median (range). The donors had been admitted for 40 hours (12-177) before nephrectomy. During admission, the lowest systolic blood pressure was 85mmHg (60-130). Platelet count was 112 X 10(3)/L (11-270 X 10(3)). Hour urine output was 447ml/h (212-937). These parameters did not have significant effects on the early post-transplantation graft function of our patients. Fifteen of thirty two donors had peak serum creatinine higher than 1.4mg/dl (mean 1.9mg/dl, range 1.5-3.6mg/dl) with serum creatinine 1.5mg/dl (1.5-2.0) at the time of nephrectomy. The declining tendency and lowest level of serum creatinine after renal transplantation in patients who received kidneys from donor with peak serum creatinine higher than 1.4mg/dl was not different from those in patients who received kidney with normal function. CONCLUSION: The transient hypotension or acute reversible mild to moderate deterioration of renal function in cadaver donor does not seem to have significant effect on the early post-transplantation graft function if underlying organic renal disease could be ruled out by careful history taking and clinical evaluation.
Blood Pressure ; Brain Death ; Cadaver* ; Chungcheongnam-do ; Creatinine ; Humans ; Hypotension ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Korea ; Nephrectomy ; Platelet Count ; Tissue Donors* ; Transplants* ; Vital Signs

PURPOSE: This study investigated the present conditions of clinical clerkship management in Korea to make recommendations for it. METHODS: The data were collected between April 15 and May 30 in 2009 using questionnaires that were sent to the clerkship directors of 41 colleges of medicine and medical graduate schools. RESULTS: The elective course system was established in 78% of the institutions; the 6 core specialties were found in all medical schools. The duration of clerkship was longest in internal medicine, followed by surgery, pediatrics, obstetrics and gynecology, psychiatry, and emergency medicine. There were differences between the planning and monitoring agencies. Preclinical courses existed in 92.7% of the institutions. However, much more remains to be done ie, with regard to the issues of student assessment in clinical clerkship, faculty development programs for the faculty and residents, incentive systems for educational involvement, provisions for yearly systematic clerkships, integration of basic-clinical science-medical humanities, and community-based education. CONCLUSION: Because clinical clerkship education is very important as a core curriculum, curriculum planning and its management must be given adequate attention. The following measures are suggested: elective systems that allow students to choose by career planning; concerns over faculty development programs for residents as a teacher; consensus on the concept, objectives, duration, content, evaluation tools of pre-clinical clerkship and clinical clerkship, and student well-being; and emphasis on community-based education.
Clinical Clerkship ; Clinical Competence ; Consensus ; Curriculum ; Education, Medical ; Emergency Medicine ; Gynecology ; Humanities ; Humans ; Internal Medicine ; Korea ; Motivation ; Obstetrics ; Pediatrics ; Schools, Medical ; Surveys and Questionnaires