No abstract available.
Pre-Eclampsia* ; Proteinuria*

The secondary implantation has gradually increased year by year. The authors conducted a study on eighty-two patients(92 eyes) recieving secondary intraocular lens implantation from Jan 1989 to Jan 1993. Sulcus fixation of posterior chamber IOL implantation was done in cases of intact or small posterior capsule rupture(56 cases). Anterior chamber intraocular lens(8 cases) and posterior chamber intraocular lens implantation by scleral fixation(28 cases) was done in eyes with large posterior capsule rupture or no zonular support. Final postoperative visual acuity of 0.5 or better was acquired in 77 eyes(83.7%) and didn't show statistically significant difference in three groups. The postoperative complications induced IOL decent ration(9.8%), uveitis(6.7%), cystoid macular edema(3.3%), vitreous hemorrhage(3.3%), and retinal detachment(3.3%). The causes of postoperative decreased visual acuity were cystoid macular edema(2.2%), fibrous membrane on IOL(2.2%), IOL decentration(1.1%) and IOL dislocation(1.1%), No statistically significant difference was noted in postoperative central corneal endothelial cell loss in three groups.
Anterior Chamber ; Aphakia* ; Corneal Endothelial Cell Loss ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Membranes ; Postoperative Complications ; Retinaldehyde ; Rupture ; Visual Acuity

Atherosclerotic cardiovascular disease(AVD) is a major cause of the mortality and morbidity in end-stage renal disease(ESRD) patients undergoing chronic dialysis therapy. The factors such as lipopretein metabolism abnormality, diabetes, hypertension, hyperhomocysteinemia and oxidative stress have been implicated as underlying causes related AVD. Malnutrition, chronic inflammation, increased oxidative stress, hyperparathyroidism and its related lipoprotein abnormalities are suggested to accelerate AVD in ESRD patients. High-resolution B-mode ultrasono-graphy has been used to evaluate atherosclerotic change in carotid artery in a number of epidemiologic or clinical studies because of its non-invasive advantage and proven effects in predicting AVD or cardiovascular mortality. Using high-resolution B-mode sonography, we evaluated the presence of plaque and carotid intima-media area(cIM area), which is known to be a good predictor of athero-sclerosis. We compared and analyzed those sonographic findings according to a number of selected clinical and laboratory factors. Study subjects were 27 stable ESRD patient receiving hemodialysis(HD) or chronic ambulatory peritoneal dialysis(CAPD) at least over 24 months. The patients with present or past coronary, cerebral or peripheral vascular disease, history of anti-platelet agents or age over 70 years were excluded. Nine HD and 18 CAPD patients were included and mean age was 52.1+/-2.6 years and number of male and female patients were sixteen and eleven. Among many factors, sex, age, dialysis duration, diabetes, smoking history, blood pressure, body mass index, albumin, creatinine, high-density lipoprotein, triglyceride, C-reactive protein, total calcium, phosphorus, intact-parathyroidid hormone were selected and analyzed for their correlation with carotid sonograpic findings. 1) Mean cIM area of all patients was 15.4+/-0.7 mm2. cIM area was significantly increased in CAPD patients compared to HD patients(16.5+/-1.2 vs 14.9+/- 0.9mm2, p<0.05). Atherosclerotic plaques were found in 48.1% and bilateral lesion was found in 18.5% of all patients. The incidence of the plaque was 42.1% in HD and 55.6% in CAPD patients. 2) cIM area was more significantly increased in male than female(16.7+/-0.8 vs 13.6+/-1.2mm2, in diabetes than non-diabetes(16.4+/-0.8 vs 14.7+/-l.lmm2) and in smoker than non-smoker(18.8+/-0.7 vs 12.8+/-0.7mm2, p<0.05). It was also significantly inereased in patients with body mass index more than 2.3kg/ m(18.3+/-1.1 vs 14.6+/-0.8mm), systolic blood pres-sure more than 14mmHg(16.6+/-0.7 vs 13.0+/-1.2mm) and C-reactive pretein more than 0.5 mg/dL(18.9+/-1.5 vs 14.2+/-0.77mm2p<0.05). Among those factors, age, systolic blood pressure, body mass index and C-reactive protein were proven to positively correlate to cIM area with statistical significance(p<0.05). Even though cIM area was increased in patients with high serum parathyroid hormone, high total cholesterol and triglyceride and low high-density lipoprotein level, no statistical significances were found in these factors. 3) In comparison of each factor according to the presence of the plaque, age and the presence of diabetes were proven to be significantly different between patients without the plaque and with the plaque(45.7+/-2.7 vs 59.5+/-3.8 year, 33.3% vs 53.8%, respectively, p<0.05). Systolic blood pressure and C-reactive protein were increased in patients with the plaque but no statistical significance was shown. In conclusions, we found that old age, male sex, presence of diabetes, smoking history, high systolic blood pressure, increased body mass index and increased C-reactive protein were significantly related to increased cIM area and the plaque was more frequent in old age and diabetes patients using high resolution B-mode ultrasonography. It can be assumed that inflammatory state as reflected by C-reactive protein would be more related with atherosclerosis in ESRD patients than such as nutritional state, parathyroid hormone or lipoprotein metabolism based on these results. Fusing prospective analysis demonstrating causeeffect relationship or analyzing inflammatory index such as TNF-a or interleukin would be necessary to prove this assumption.
Age Factors ; Atherosclerosis* ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Calcium ; Carotid Arteries* ; Cholesterol ; Creatinine ; Dialysis ; Female ; Humans ; Hyperhomocysteinemia ; Hyperparathyroidism ; Hypertension ; Incidence ; Inflammation ; Interleukins ; Kidney Failure, Chronic* ; Lipoproteins ; Male ; Malnutrition ; Metabolism ; Mortality ; Oxidative Stress ; Parathyroid Hormone ; Peripheral Vascular Diseases ; Peritoneal Dialysis, Continuous Ambulatory ; Phosphorus ; Plaque, Atherosclerotic ; Sex Factors ; Smoke ; Smoking ; Triglycerides ; Ultrasonography*

Community-based centres were surveyed to determine the frequency of and risk factors for falls among elderly Koreans. We examined fall-related risk factors, including physiological and physical health, psychosocial functions, self-reported physical capacity and activity, vision, and the use of medication, among 351 elderly people aged 65 years or older, with ambulatory. Forty-two per cent of elderly Korean subjects reported at least one episode of falling in the previous 12 months, 38% of whom had consequences that required either the attention of a physician or hospitalization. Factors significantly associated with an increased risk of falling were a restricted activity during the previous five years (adjusted OR 1.3), use of alternative therapy (adjusted OR 2.7), low knee flexor and extensor-muscle strength (adjusted OR 1.21 and 1.20), and poor balance with closed eyes (adjusted OR 8.32). We conclude that falls among older persons living in the community are common in Korea and that indicator of bad health and frailty or variables directly related to neuromuscular impairment are significant predictors of the risk of falling.
Accidental Falls/prevention & control/*statistics & numerical data ; Accidents, Home/prevention & control/*statistics & numerical data ; Activities of Daily Living ; Aged/physiology/psychology/*statistics & numerical data ; Aged, 80 and over ; Drug Utilization ; Female ; Gait ; Geriatric Assessment ; Health Status ; Housing/statistics & numerical data ; Humans ; Incidence ; Korea/epidemiology ; Male ; Mental Health ; Population Surveillance ; Prevalence ; Questionnaires ; Residence Characteristics/statistics & numerical data ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Socioeconomic Factors ; Vision Disorders/complications/epidemiology

No abstract available.
Administration, Oral ; Aged ; Anti-Bacterial Agents/*administration & dosage ; Bone Diseases, Infectious/diagnosis/*drug therapy/microbiology ; Drug Therapy, Combination ; Female ; Hospitals, University ; Humans ; Joint Diseases/diagnosis/*drug therapy/microbiology ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Republic of Korea ; Staphylococcal Infections/diagnosis/*drug therapy/microbiology ; Staphylococcus aureus/*drug effects/isolation & purification ; Treatment Outcome

PURPOSE: The goal of this article was to characterize and explain the etiology of a left-sided gallbladders with intrahepatic portal vein anomalies, and these cases of this unusual anatomy were all encountered at a single center. METHODS: We reviewed the movies recorded during surgery, the database information and the preoperative radiologic examinations of 1,141 patients who underwent cholecystectomies at our institution between August 2007 and July 2010 to assess the presence of left-sided gallbladder and its combined anomalies. RESULTS: Four of 1141 patients (0.35%) were diagnosed with left-sided gallbladder. In all the cases, the gallbladder was located on the left side of the falciform ligament, under the left lobe of the liver with typical abnormal intrahepatic portal venous branching. The right posterior portal vein came directly from the main portal vein, and the right anterior portal vein originated from the left portal vein, but the ligamentum teres joined to the left branch of the portal vein in the liver. CONCLUSION: Left-sided gallbladder with intrahepatic portal venous branching anomaly resulted from the defective development of the central portion of the liver rather than from abnormal regression of the left umbilical vein with persistence of the right umbilical vein.
Cholecystectomy ; Gallbladder ; Gallbladder Diseases ; Humans ; Ligaments ; Liver ; Porphyrins ; Portal Vein ; Umbilical Veins

PURPOSE: Mutations in the Bruton's tyrosine kinase(Btk) gene are responsible for X-linked agammaglobulinemia(XLA), an immunodeficiency caused by a block in B cell differentiation. In this report we characterize the protein expression and genetic mutations of Btk in four Korean patients with three unrelated XLA families. METHODS: The resulting Btk proteins were characterized by a flow cytometry and the mutations were analyzed using single strand conformation polymorphism(SSCP) and direct sequencing. RESULTS: Two deletions, including one novel genetic alteration, and one splicing error, were found in these three XLA families. Along with the identification of mutations, Btk protein analysis using flow cytometry clearly showed cellular mosaicism in monocytes from five obligate carriers, findings consistent with those by SSCP. We attempted to determine the origin of mutation in an XLA family with a novel 4-bp deletion of exon eight, suggesting a germline mutation in this family. In addition, we found some clinical heterogeneities in the affected brothers with the same gene mutation. CONCLUSION: These identified genetic alterations provided valuable clues to the pathogenesis of XLA in Korea. The flow cytometric analysis is suggested as a useful tool for rapid detection of XLA patients and carriers.
Cell Differentiation ; Exons ; Flow Cytometry ; Germ-Line Mutation ; Humans ; Korea ; Monocytes ; Mosaicism ; Polymorphism, Single-Stranded Conformational ; Siblings ; Tyrosine*

A randomized comparison of pre-and post-experimental design was used to examine the effects of a fall prevention exercise program (FPEP) on muscle strength, ankle flexibility, balance, instrumental activities of daily living (IADLs), and depression for the community-dwelling elderly in Korea. Twenty-two subjects were assigned to an experimental group and twenty-three to a control group. The experimental group participated in a 4-day-per week FPEP of 8 weeks duration, twice a week by direct instruction and twice a week with videotaped instruction by the program instructor at each senior center. The eight-week FPEP turned out to be significantly effective in enhancing muscle strength, ankle flexibility and balance, and in reducing depression, after intervention among community-dwelling elderly in Korea. IADLs, however, was not changed by the intervention. Further research with a larger sample and longer follow up period is needed to expand our understanding about the effects of FPEP. Future study is also recommended to differentiate between the effects of FPEP by direct instruction and by videotaped.
Accidental Falls/*prevention & control ; Activities of Daily Living ; Aged ; Aged, 80 and over ; Ankle/physiology ; *Exercise ; Female ; Human ; Male ; Muscle, Skeletal/physiology ; Musculoskeletal Equilibrium ; Pliability ; Risk Reduction Behavior ; Support, Non-U.S. Gov't

Sodium concentration in the hemodialysis solution has been increased to prevent intradialytic hypotension after highly effective and shortened time hemodialysis(HD) was introduced in the late 70's. Many authors have pointed out that the high concentration in the dialysate sodium HD may be one of causes of increasing difficulty in the management of hypertension in HD patients. Sodium profiling hemodialysis (SPHD) is a modified form of high sodium dialysate HD. Even though sodium concentration is decreased progressively to the conventional level during the HD session, the time-averaged sodium concentration is usually higher compared to that of conventional HD. To evaluate the effect of dialysate sodium concentration on interdialytic blood pressure(BP) control, we conducted a cross over study. Eleven patients showing more than four episodes of intradialytic hypertension per month were studied(5 male, 6 female; 52+-13 years). All subjects underwent 8-week conventional HD(CHD)(dialysate Na+ 138mEq/L X 4 hour) and 8-week step-down SPHD(Na+ 150mEq/L X 2 hours> OR =140 X 1> OR =138 X 1) on the order of random assignment. At the end of each peiords, interdialytic 24-hour BP were measured by 24-hour Ambulatory BP monitor(ABPM : 90207, Space Labs, USA). 1) Time-averaged sodium concentration in dialy sate were 138mEq/L during SPHD and 144.5mEq/L during CHD. Pre HD serum sodium were not significantly different between two periods but post HD serum sodium and intradialytic increase of serum sodium significantly higher during SPHD period 138.1+/-0.5 v 141.1+/-0.6mEq/L, 0.5+/-0.6 v 2.6+/-0.4mEq/L, p<0.05). Dry weight was determined before the start of study and not changed throughout the study periods. Interdialytic weight gain and the amount of ulfrafiltration required to maintain the determined dry weight were significantly higher during SPHD period compared to those during CHD period(2.5+/-0.5 v 3.6+/-0.6 kg, 2.6+/-0.8 v 3.6+/-0.8kg, p<0.01). 2) The frequency of interdialytic hypotension was significantly reduced during SPHD period(23.9 v 15 %, p<0.01). But the frequency of symptoms requiring intervetion such as ultrafiltration adjustment or saline infusion was not different between two periods. Thirst during interdialytic period was significantly frequent during SPHD(37.8 vs 30% 138.1+/-0.5 v 141.1+/-0.6mEq/L, 0.5+/-0.6 v 2.6+/-0.4mEq/L, p<0.05). 3) Day-time, night-time and 24 hour mean systolic BP measured by 24 hour ABPM were significantly higher during SPHD period(149.2+/-4.8, 144.3+/-3.6, 146.6+/-4.1mmHg) than during CHD period(140.1+/-4.8, 133.0+/-4.1, 136.4+/-4.6mmHg, p<0.01). Day-time, night-time and 24 hour mean diastolic BP were also significantly higher during SPHD period(82.6+/-1.5, 84.1+/-1.4, 86.1+/-1.4mmHg) than during CHD period (78.7+/-2.2, 79.6+/-2.3, 81.8+/-2.2mmHg, p<0.05). 4) Systolic load and diastolic load by the criteria of higher than 150/90mmHg throughout the day increased significantly from 21.1+/-7.0 and 18.2+/-6.3% during CHD period to 41.7+/-9.9 and 28.4+/-4.7% during SPHD period. Diurnal difference was not different between the two periods but a significant number of dippers(36.4%) converted to nondipper during SPHD period. Our results shows SPHD increases interdialytic BP and its load. It also adversely alter diurnal variation and dipping status. The additional sodium load and an consequent excessive interdialytic weight gain aassociates with SPHD might contribute to this findings.
Blood Pressure* ; Female ; Humans ; Hypertension ; Hypotension ; Male ; Renal Dialysis* ; Sodium* ; Thirst ; Ultrafiltration ; Weight Gain

PURPOSE: To evaluate implant survivorship and clinical outcomes after acetabular revision using cementless acetabular cups. MATERIALS AND METHODS: We evaluated 27 cementless acetabular revision cases performed between January 1998 and October 2005. All patients were followed up for more than 2 years, and the mean follow-up period was 54.1 months (range: 24~120 months). In all cases, morselized allografting was performed. Five cases needed structural allografting to achieve stability of the acetabular cup. The clinical results were analyzed using the Harris hip score, and radiological analysis was performed for evaluation of radiolucent lines, osteolysis, loosening, and changes in the hip center. RESULTS: At the time of latest follow-up, no cups showed failure requiring re-revision. The average Harris hip score improved from 67.1 points preoperatively to 91.4 points postoperatively. Radiologically, 7 cases (25.9%) showed radiolucent lines around the acetabular cup, but there was no loosening or osteolysis. CONCLUSION: Cementless acetabular revision showed satisfactory radiological and clinical results on short-term follow-up analysis. Even in cases with considerable amounts of acetabular bone loss, stable fixation could be obtained with structural bone grafting.
Bone Transplantation ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Survival Rate ; Transplantation, Homologous