PURPOSE: To report a case of isolated posterior pole-penetrating ocular injury treated by nonsurgical methods such as argon laser photocoagulation and administration of antibiotics. CASE SUMMARY: A 46-year-old male visited the hospital complaining of floaters in his left eye which had occurred when his cheek was penetrated by scissors from the inferior posterior part to the superior anterior part while working earlier that day. Upon initial examination, his best corrected visual acuity (BCVA) in the left eye was 0.8, and his intraocular pressure (IOP) was 10 mmHg. No cells or aqueous flares were observed in the anterior chamber. Fundus examination was performed, and three disc diameter-large breaks of the retina and choroid, scleral rupture and vitreous hemorrhage were observed at the posterior pole three disc diameters away from the fovea. It was difficult to make a surgical approach as the lesion was situated on the posterior pole, and there was the risk of prolapse of the eye contents. Therefore, we first performed argon laser photocoagulation around the lesion and administered topical as well as and systemic antibiotics. After admission the patient was observed carefully as the tractional retinal fold was located at the posterior pole. Additional argon laser photocoagulation was performed. After six months of treatment, BCVA in the left eye was 1.0, IOP was 16 mmHg, and no pathologic change was observed on fundus examination.
Anterior Chamber ; Anti-Bacterial Agents ; Aqueous Humor ; Argon ; Cheek ; Choroid ; Eye ; Humans ; Intraocular Pressure ; Light Coagulation ; Male ; Middle Aged ; Prolapse ; Retina ; Retinaldehyde ; Rupture ; Traction ; Visual Acuity ; Vitreous Hemorrhage

PURPOSE: To report a case of conjunctival autotransplantation using the conjunctival flap of the pterygium for thetreatment corneal ulcer perforation. CASE SUMMARY: A 72-year-old woman was referred to our hospital because her left eye had a corneal ulcer due topine needle trauma, and she did not respond to the initial therapy in a private clinic for 1 week. We first applied topical and systemic antibiotics. However, the lesion did not subside, and necrosis progressed in the stroma at the center of the cornea. On day 6 of admission, perforation was found at the center of the cornea, and we excised the necrotic tissue and performed bilateral pedicle conjunctival flap transposition. After the operation, an ischemic change was observed, and in the fourth week perforation occured at the center of the transplanted conjunctival flap. Because we considered it difficult to perform the transplantation of a conjunctival flap in the left eye, we performed autotransplantation on the corneal perforation in the left eye using conjunctival flap obtained through a pterygium excision in the right eye. After the operation, vascular ingrowth started from the edge of the flap, and there were no symptoms of inflammation, shrinkage, or necrosis of the flap. During the follow-up observation, the flap survived well without necrosis.
Aged ; Anti-Bacterial Agents ; Cornea ; Corneal Perforation ; Corneal Ulcer ; Eye ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Necrosis ; Needles ; Pterygium ; Transplants

PURPOSE: To report a case of conjunctival autotransplantation using the conjunctival flap of the pterygium for thetreatment corneal ulcer perforation. CASE SUMMARY: A 72-year-old woman was referred to our hospital because her left eye had a corneal ulcer due topine needle trauma, and she did not respond to the initial therapy in a private clinic for 1 week. We first applied topical and systemic antibiotics. However, the lesion did not subside, and necrosis progressed in the stroma at the center of the cornea. On day 6 of admission, perforation was found at the center of the cornea, and we excised the necrotic tissue and performed bilateral pedicle conjunctival flap transposition. After the operation, an ischemic change was observed, and in the fourth week perforation occured at the center of the transplanted conjunctival flap. Because we considered it difficult to perform the transplantation of a conjunctival flap in the left eye, we performed autotransplantation on the corneal perforation in the left eye using conjunctival flap obtained through a pterygium excision in the right eye. After the operation, vascular ingrowth started from the edge of the flap, and there were no symptoms of inflammation, shrinkage, or necrosis of the flap. During the follow-up observation, the flap survived well without necrosis.
Aged ; Anti-Bacterial Agents ; Cornea ; Corneal Perforation ; Corneal Ulcer ; Eye ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Necrosis ; Needles ; Pterygium ; Transplants

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

No abstract available.
*Diagnostic Errors ; Eosinophilia/*diagnosis/pathology/radiography ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver Abscess/*diagnosis/pathology/radiography ; Liver Neoplasms/diagnosis/secondary ; Male ; Middle Aged ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed

Mucosa-associated lymphoid tissue (MALT) lymphoma has several characters different from those of nodal lymphoma. Histologically, MALT lymphoma is mainly composed of centrocyte-like cells and other heterogeneous cells, and is classified as high grade and low grade by the proportion of blasts. Most of MALT lymphoma is initially diagnosed as localized disease, and has slow progression and relatively longer disease-free survival time. The rate of bone marrow permeation of MALT lymphoma is reported variable from 8% to 45% by previous other country reports. We report 2 cases of bone marrow permeated MALT lymphoma, for MALT lymphoma has lower incidence than that of nodal lymphoma and no marrow permeated cases have been reported in Korea. Fifty six-year-old male who complained dyspepsia is diagnosed as MALT lymphoma by biopsy of gastric angle. His bone marrow biopsy showed well demarcated paratrabecular neoplastic lymphoid cell infiltration. The other case is 78-year-old female who had epigastric pain. She was diagnosed as MALT lymphoma of gastric angle, and her bone marrow biopsy showed poorly demarcated nodal infiltration of neoplastic lymphoid cells.
Aged ; Biopsy ; Bone Marrow* ; Disease-Free Survival ; Dyspepsia ; Female ; Humans ; Incidence ; Korea ; Lymphocytes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Male

BACKGROUND: As surgical techniques and postoperative care are improving, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other types of pulmonary resection. However, a postpneumonectomy complication is a serious life-threatening problem if it occurrs. The purpose of this study is to evaluate determinants for postoperative mortality after pneumonectomy. METHODS: Patients were divided for study as follows: the Dead group versus the Alive group. To determine whether age, operation site, operation time, intraoperative fiuid intake, urine output, blood loss, complications, preoperative and intraoperative arterial blood gas analyses, and preoperative pulmonary function tests influence the determinants for postoperative mortality after pneumonectomy, a rettospecive analysis was performed on 71 patients who had undergone pneumonectomy from 1990to 1994 in Kosin Medical COLLEGE hOSPITAL. RESULTS: Operation time and blood loss were longer and greater respectively in the Dead group. The intraoperative PaO2 was lower and incidence of complications was more frequent in the Dead group.Otherwise there were no significant differences between two groups. CONCLUSION: We concluded that operation time, blood loss, incidence of complications and intra-operative PaO2 were closely related with postoperative mortality.
Blood Gas Analysis ; Humans ; Incidence ; Mortality* ; Pneumonectomy* ; Postoperative Care ; Respiratory Function Tests

Holoprosencephaly is a developmental malformation complex of forebrain and midface which arises from incomplete cleavage of the embryonic forebrain. It is subdivided into alobar, semilobar and lobar types based on the degree of growth disturbance within the anterior wall of the telencephalon, particularly in the midline. Cyclopia is the most severe form of alobar holoprosencephaly presenting a single median eye and a blind-ending proboscis usually located above the eye. We report a case of alobar holoprosencephaly with cyclopia and proboscis in premature infant.
Holoprosencephaly* ; Humans ; Infant, Newborn ; Infant, Premature ; Prosencephalon ; Telencephalon

PURPOSE: The subareolar area is often difficult to evaluate ultrasonographically due to tissue shadowing, which obscures visualization of ducts and parenchymal tissue. The purpose of this study is to determine if real-time compound imaging improves evaluation of normal subareolar tissue and solid nodules in subareolar area compared to conventional ultrasonography. METHODS: 190 images of the subareolar area were obtained from 135 patients from March 2001 to July 2002. Thirty-three of 190 images showed solid nodules, extraductal nodules in 30 and intraductal nodules in three. We scanned both conventional and compound imaging with a stationary probe, to maintain an identical projection and tissue pressure. We used two compound techniques; survey mode (S) is made by 3 coplanar images and target mode (T) by 9 coplanar images. The evaluating points were 1) reduction in the density of shadowing, 2) resolution of duct wall, 3) resolution of duct lumen, 4) margin of nodule, and 5) internal echoes of nodule. In a blinded fashion, three radiologists graded the quality of images on a 5-point scale. RESULTS: For reviewer 1/2/3, S showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.1 0.6/0.5+/-0.5), 2) resolution of duct wall (0.9+/-0.2/1.5+/-0.6/1.0+/-0.5), 3) resolution of duct lumen (0.9+/-0.2/1.6 +/-0.6/0.7+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.5/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/- 0.5/1.2+/-0.4) and T showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.2+/-0.6/0.7+/-0.7), 2) resolution of duct wall (1.0+/-0.3/1.5+/-0.6/1.1+/-0.5), 3) resolution of duct lumen (0.9+/-0.3/1.6+/-0.6/0.8+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.6/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/-0.6/1.3+/-0.4). In all evaluating points, two modes of real-time compound imaging were superior to conventional imaging (P<0.05). There was no significant difference between two modes of compound imaging. CONCLUSION: Real-time compound imaging improves evaluation of normal subareolar tissue and subareolar solid nodules compared to conventional ultrasonography by reducing shadowing and increasing anatomic resolution of ducts.
Breast ; Humans ; Shadowing (Histology) ; Ultrasonography*

Intrahepatic arterioportal fistulae are rare, but can induce serious complications such as portal hypertension. We present a patient who developed portal hypertension secondary to an intrahepatic arterioportal fistula which was successfully embolized with occlusive balloon and microcoils. A 47-year-old previously healthy male was admitted to our hospital following an episode of melena and abdominal distension. The noteworthy feature in his previous medical history was a hepatic injury caused by a traffic accident when he was aged 9. He didn't drink liquor at all. General appearance was pale and acutely ill. The abdomen was markedly distended and a very noisy bruit over the liver area was continously heard. Laboratory findings, including liver function tests were completely normal except for anemia (Hb 5.7g/dL) and hepatitis viral markers were all negative. Endoscopy demonstrated gastroesophageal varices as the source of bleeding which was treated with variceal ligation. Computed tomography showed a dilated vascular structure in the periphery of the liver at the arterial phase, which suggested a intrahepaic arterioportal fistula. The fistula was also subsequently identified with duplex ultrasound and angiography. Occlusion of the right hepatic artery was performed with occlusive balloon and microcoils. Ascites was rapidly corrected in accordance with a large amount of diuresis and gastroesophageal varices were also completely disappeared whithin a month. On follow-up examination 18 months after hepatic embolization, duplex ultrasound and selective angiography revealed a minute flow of blood through this fistula, but the patient remains well with no recurrence of signs of portal hypertension.
Abdomen ; Accidents, Traffic ; Anemia ; Angiography ; Ascites ; Biomarkers ; Diuresis ; Endoscopy ; Fistula* ; Follow-Up Studies ; Hemorrhage ; Hepatic Artery ; Hepatitis ; Humans ; Hypertension ; Hypertension, Portal* ; Ligation ; Liver ; Liver Function Tests ; Male ; Melena ; Middle Aged ; Recurrence ; Ultrasonography ; Varicose Veins