We report a two-generation Korean family in which 2 siblings have congenital cataract and phenotype i. This report is a first case in Korean people and shows the evidence suggesting the linkage of Ii blood group with a recessive form of congenital cataracts.
Cataract* ; Humans ; Phenotype* ; Siblings*

The authors present a series of 35 patients who underwent operation for metastatic spinal tumor. Patients were operated via anterior, posterior or posterolateral and combined anterior-posterior approach. The anterior approach was used in cases where there was no involvement of the posterior column, tolerable of a thoracotomy and involvement of three or less adjacent vertebral bodies. The posterior or posterolateral approach was used in cases with involvement of the posterior column, disease at two seperated locations, intolerable of a thoracotomy and involvement of three columns. The combined anterior-posterior approach was used when it was not enough to obtain stabilization with anterior or posterior approach alone and expected greater than 1 year life expectancy. Twenty-five(89%) of the 28 patients improved neurologically following surgery. Average neurologic improvement was 1.3 Frankel grade. Pain relief was obtained in twenty-six(93%) of the 28 patients. Recovery of spincter change was obtained twelve(80%) of the 15 patients. Two patients died postoperatively due to DIC and pneumonia. Prior to operation, selective spinal angiography and embolization were performed in nine patients with metastases from renal carcinoma, thyroid cancer and hepatoma to reduce intraoperative bleeding. The authors believe that the choice of surgical approach has to be individualized for each patient depending on extent and location of the tumor, general condition of patient, goal of therapy and life expectancy.
Angiography ; Carcinoma, Hepatocellular ; Dacarbazine ; Hemorrhage ; Humans ; Life Expectancy ; Neoplasm Metastasis ; Pneumonia ; Thoracotomy ; Thyroid Neoplasms

The authors present a series of 12 patients who underwent one-stage spondylectomy, vertebral reconstruction, posterior segmental stabilization for malignant metastatic disease. Major indication for this approach includes three column involvement or untolerable thoracotomy. This operative method involved the spondylectomy via a bilateral transpedicular or unilateral extracavitary approach, vertebral body reconstruction with methlymethacrylate (MMA), and posterior stabilization with sublaminar wiring in one stage. Postoperatively, all patients improved neurologically. Average neurologic improvement was 1.5 Frankel grade. Pain relief was obtained in all patients. Recovery of sphincter change was obtained 7(88%) of the 8 patients. One patient died postoperatively due to pneumonia. Spinal alignment was maintained in all. The major advantage of this approach is that circumferential decompression of the spine and stabilization can be obtained safely by one stage.
Decompression ; Humans ; Neoplasm Metastasis* ; Pneumonia ; Spine ; Thoracotomy

Patients with pain syndromes resulting from recurrent or metastatic cancer should be evaluated carefully to determine the cause of their pain and the need for appropriate antitumor treatment. The most effective ablative pain control procedure at the current time is cordotomy, which is indicated in patients with unilateral pain. The authors results of 12 antero-lateral thoracic cordotomies performed for intractable cancer pain between 1996-1998. The follow-up of these patients was continued for at least 12 months or until death to determine the late success of this procedure. Excellent surgical results were obtained in 100% after one week and in 50% in 6 months after operation. The operation was considered to be successful for patients with malignant disease of short life expectancy.
Cordotomy* ; Follow-Up Studies ; Humans ; Life Expectancy

BACKGROUND AND OBJECTIVES: With the increasing use of high resolution sonography and fine needle aspiration biopsy, the proportion of newly diagnosed thyroid papillary carcinomas have increased. However, it is not entirely clear whether microcarcinomas detectable by the above technology the should be considered a threshold for risk evaluation. The purpose of this study is to evaluate the clinical behavior of papillary carcinomas smaller than 1.5 cm. SUBJECTS AND METHOD: A retrospective chart review was conducted for 181 patients who underwent surgery for thyroid cancer and was proven to have papillary carcinoma smaller than 1.5 cm in size from 1997 to 2006. The patients were divided into 3 groups according to cancer size. The patient's gender, age, surgical method, pathology, initial neck node and neck recurrence was analyzed by chi-square test, analysis of variance (ANOVA) test and multinomial logistic regression analysis. RESULTS: Progressively increasing frequency of signs of tumor aggressiveness (multifocal, bilateral, extracapsular spread) was observed with increasing size. The rate of lymph node metastasis increased also, but it did not reach a significant value. Despite the increasing rate of aggressiveness and lymph node metastasis, there was no significant difference in recurrence between these groups. CONCLUSION: Although the long term outcome does not seem to directly depend on tumor size in these small thyroid cancers, a progressing frequency of aggressiveness with increasing cancer size at presentation is evident.
Biopsy ; Biopsy, Fine-Needle ; Carcinoma ; Carcinoma, Papillary ; Humans ; Logistic Models ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms

Malignant lymphoma of salivary gland is rare and takes 2-5% of all neoplasm of salivary glands. Mucosa-associated lymphoid tissue (MALT) lymphoma is known as a unique subtype of Non-Hodgkin's lymphoma. Since MALT lymphoma tends to be an indolent and localized disease, complete surgical resection is able to be performed as a single treatment. In this article, we present a case of MALT lymphoma in both parotid glands of the patient with systemic lupus erythematosus, who underwent both superficial parotidectomy
Autoimmune Diseases ; Humans ; Lupus Erythematosus, Systemic ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Parotid Gland ; Salivary Glands

Pneumoperitoneum usually indicates rupture of a hollow viscus and considered a surgical emergency. But air may also enter the peritoneum from the lung or the genital organs in female without visceral perforation. While scuba diving, the rapid ascent is usually controlled by placing in a decompression chamber and the excess gas volume is exhaled. Failure to allow this excess gas to escape will result in overdistension of air passage, which may rupture resulting in pulmonary interstitial emphysema or, if air enters the circulation, air embolus can occur. Pneumo-peritoneum is a rare complication of diving accidents. While the majority of cases are not related to an intraabdominal catastrophy, more than 20% have been the result of gastric rupture. We report a 42-yr-old male patient with massive pneumoperitoneum after scuba diving, who presented himself with dyspnea and abdominal distension. Knowledge of this rare condition and its benign course may allow the emergency physician and surgeon to order appropriate studies to help avoid unnecessary surgical treatment. It is important to determine promptly whether the air emanated from a ruptured viscus or was introduced from an extraperitoneal source. Free air in the abdomen does not always indicate a ruptured intra-abdominal viscus.
Adult ; Diving/adverse effects* ; Female ; Human ; Male ; Pneumoperitoneum/diagnosis* ; Pneumoperitoneum/etiology* ; Radiography, Abdominal ; Radiography, Thoracic

OBJECTIVE: A retrospective clinical analysis for metastatic brain tumors was undertaken to understand demographic feature, to determine the survival rate, prognostic factors and to decide the role of surgery. PATIENTS AND METHODS: From 1987 to 1994, 178 patients with brain metastases were treated at our hospital. Data regarding the primary disease and characteristics of brain metastases were retrospectively collected. We used Kaplan-Meier method to assess survival rate, and log-rank test to compare survival rates between subgroups. RESULTS: The most common age at the time of diagnosis was sixth and seventh decade(62%). The male to female ratio was 97:81. The supratentorial lesions were in 128(77%, n=67) and multiple lesions were in 84(55%, n=52). The most common primary cancer was lung cancer(80, 45%), and metastases of unknown origin(28, 16%), breast(27, 15%), head and neck(11, 6%), colorectal cancer(7, 4%), and stomach cancer(6, 3%). The time to metastasis was shortest in lung cancer(15 months), and longest in head and neck cancer(61 months). The overall 1 year survival rate(1YSR) was 25.4% and median survival time(MST) was 5.6 months. There was no statistically significant difference in MST and 1YSR between single and multiple metastases. The 1YSR of metastatic brain tumor from head and neck cancer was 62.5% and that from breast, lung, and GI tract was 37.7%, 25.7%, and 8.3% respectively. The overall 1YSR and MST of resected group in single metastasis(n=0, resection plus whole brain radiation therapy; WBRT) were 33.3% and 6.6 months, and those of non-resected group(n=5, WBRT) were 31.5% and 5.6 months. The 1YSR and MST of resected group in single metastasis from lung cancer(n=) were 37.5% and 8.4 months, and those of non-resected group(n=6) were 25% and 4.8 months. But there were no statistically significant differences. Karnofsky performance scale score was improved in 37% of resected group, compared with 24% of non-resected group. CONCLUSION: Surgical removal of metastatic brain tumor in selected patients results in increased survival time and better quality of life. For the statistical significance, multi-institutional well-designed prospective randomized study is needed.
Brain Neoplasms* ; Brain* ; Breast ; Diagnosis ; Female ; Gastrointestinal Tract ; Head ; Head and Neck Neoplasms ; Humans ; Lung ; Male ; Neck ; Neoplasm Metastasis ; Quality of Life ; Retrospective Studies ; Stomach ; Survival Rate

Allopurinol hypersensitivity syndrome is a rare but life-threatening complication. We here report a case of allopurinol hypersensitivity syndrome manifested with irreVersible change of renal function and severe toxic epidermal necrolysis in a patient with chronic renal faiure. A 29-year-old male patient with chronic renal failure due to chronic glomerulonephritis presented with high fever and skin rash. He had been taking allopurinol for 6 weeks due to asymptomatic hyperuricemia. Blood chemistry showed severe hepatic dysfunction and aggrevated renal function. Skin biopsy revealed consistent findings with allopurinol hypersenstivity syndorme. Allopurinol was discontinued and steroid was instituted. His cutaneous lesion and high fever, and hepatic dysfunction improved but renal function irreversibly progressed in end stage renal failure requiring maintenance hemodialysis treatment.
Adult ; Allopurinol* ; Biopsy ; Chemistry ; Exanthema ; Fever ; Glomerulonephritis ; Humans ; Hypersensitivity* ; Hyperuricemia ; Kidney Failure, Chronic* ; Male ; Renal Dialysis ; Renal Insufficiency ; Skin ; Stevens-Johnson Syndrome

BACKGROUND: Despite proposing clonal depletion, anergy, and alternation of cytokines in peripheral tolerance, the precise mechanism for the immunosuppressive effect of blood transfusion remains unknown. Here, we evaluated the effect of transfusion on the immune system indirectly via quantitation of leukocyte cytokine mRNA expression before and after allogeneic transfusion. METHODS: Samples were obtained from eight patients, being ordered one to four units of leukocytefree erythrocytes, before, 1, and 7 days after transfusion, from November to December, 2002 at Inha University Hospital. We explored the changes in mRNA expression of interleukin-2 (IL-2), IL-4, IL-10, tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma). RESULTS: In four patients who received blood transfusions among eight, significant changes were observed in the blood mRNA levels of INF-gamma and IL-10. The amounts of IFN-gamma mRNA were significantly decreased a day after transfusion to 78.5% and then recovered to 110.9% 7 days later (P=0.032), whereas, that of IL-10 was increased to 151.5% a day after and recovered to 119.1% 7 days later (P=0.034). mRNA expressions of IL-2, IL-4, and TNF-alpha were not detected in all patients. CONCLUSIONS: We observed a significant decrease in leukocyte IFN-gamma mRNA expression and an increase in IL-10 mRNA after transfusion. These findings indirectly represent that down-regulation of the Th1 cells and the up-regulation of the Th2 cells could be caused by allogeneic transfusion.
Blood Transfusion ; Cytokines ; Down-Regulation ; Erythrocytes ; Humans ; Immune System ; Interferons ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Leukocytes ; Peripheral Tolerance ; RNA, Messenger* ; Th1 Cells ; Th2 Cells ; Tumor Necrosis Factor-alpha ; Up-Regulation