Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

PURPOSE: The purpose of this study is to determine whether partially neovascularized Medpor(R) by preplacement of implant to buttock area for one month before secondary orbital insertion demonstrates earlier refibrovascular ingrowth into implant than that in primary orbital placement. METHODS: Thirty-five rabbits were divided into two groups: Group A (15 rabbits) ; primary orbital implantation of Medpor(R)(nonvascularized) after enucleation, Group B (15 rabbits) ; secondary orbital implantation of implant (vascularized) after enucleation after harvesting implants from buttock area, inserted for one month prior to orbital implantation. Five neovascularized implants by preplacement of implant to buttock area for one month were sectioned and investigated for the fibrovascular ingrowth, expression of bFGF, and CD-31 to evaluate the influence of pretreatment. Implants from group A and B were harvested from the orbit at 1, 2, 4, 6, and 8 weeks postoperatively. The implants were sectioned and studied grossly and histopathologically. Immunohistochemical study on bFGF and CD-31 were conducted to detect the angiogenetic factor and degree of angiogenesis in both group A and B. RESULTS: The fibrovascular ingrowth and expression of bFGF and degree of angiogenesis in group B were higher than those in group A. The degrees of angiogenesis were well correlated with bFGF expression. CONCLUSIONS: This animal model may provide the basis for the future investigation of agents and structural modifications directed towards optimization of fibrovascular ingrowth into porous anophthalmic socket implants and clinically apply to enucleation for the vascular compromised patients such as in the settings of postirradiation, diabetes.
Buttocks ; Humans ; Models, Animal ; Orbit* ; Orbital Implants ; Polyethylene* ; Rabbits*

From January 1982 to December 1991, we experienced 96 hands of 66 patients with Dupuytren's disease in Seoul National University Hospital. We performed retrospective analysis of these 96 hands of 66 patients and the results were as follows. Among 66 patients, 60 patients (91%) were male and 51 patients (77%) were in sixth or seventh decade, the average age 58.1 years. Occupations of 66 patients were manual laborer(18 patients, 28%), farmer(15 patients, 22%), sportsman(4 patients, 6%) and deskworker(29 patients, 44%). Among the diseases such as diabetes mellitus, alcoholics, epilepsy known as associated with Dupuytren's disease, diabetes mellitus was more common in our cases, whereas alcoholics and epilepsy were relatively rare. There was no case in which family history was present. Both hands were involved in 30 patients, right hand only in 30 patients, and left hand only in 6 patients. Right hand was involved in 60 patients(91%), whereas left hand was involved in 36 patients(55%). The case in which only the 4th finger was involved was most common(42 hands, 44%). The 4th finger was affected most frequently(81 hands, 84%). In diabetic patients, the middle finger was involved more frequently than in non-diabetic patients(p < 0.05). Most of patients(83 hands, 86%) had symptoms of flexion contracture, nodule or contracted cord simultaneously. Surgical treatment was per- formed in 32 hands of 22 patients, with the results of excellent in 24 hands(75%), good in 6 hands(19%) and no recurrence, in average follow-up 3.6 years(2.6 years to 5.0 years). In conclusion, it might be thought that Dupuytren's disease in which surgical treatment was required was relatively rare in Korean and even if necessary, partial fasciectomy resulted in rather good result.
Alcoholics ; Contracture ; Diabetes Mellitus ; Dupuytren Contracture ; Epilepsy ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Male ; Occupations ; Recurrence ; Retrospective Studies ; Seoul

Backgrounds: Thyroid hormones play a fundamental role in the initiation and maintenance of somatic growth in mammalian species, and the insulin-like growth factors(IGFs) occupy a position of central importance in the growth of all tissues. To evaluate the changes in serum insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding proteins in hyperthyroid and hypothyroid patients, sera was obtained from 19 hyperthyroid patients, 9 hypothyroid patients, and 10 healthy volunteers. Methods: IGF-I concentration was determined by radioimmunoassay, and changes in IGFBPs were assesed by Western Ligand Blotting. To evaluate the binding pattern of IGF-I & IGFBPs, autoradiographs were obtained. Results & Conclusion: IGF-I levels were increased significantly in hyperthyroid patients(mean ±SE, 267.88±9.80 ng/ml, p<0.05) and decreased significantly in hypothyroid patients(154.81±1.43 ng/ml, p<0.01) compaired to healthy control group(209.45±.60 ng/ml). Autoradiograph of serum IGFBPs from patients with hyperthyroidism and hypothyroidism did not show any change in the intensity of IGFBP-3 bands(40-45 KD) and IGFBP-1 bands, but in hyperthyroid patients, it showed increased intensity of IGFBP-2 band compared to healthy control group and hypothyroid patients.
Equidae ; Healthy Volunteers ; Humans ; Hyperthyroidism ; Hypothyroidism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Radioimmunoassay ; Thyroid Hormones

Purpose: Circulating cell-free single-stranded DNA (ccf-ssDNA) is extracellular DNA and it is a useful biomarker for the diagnosis of tumors and predicting the prognosis of tumors. However, the clinical usefulness of ccf-ssDNA in colorectal cancer (CRC) is not well known. Thus, the purpose of this study was to investigate the clinical usefulness of ccf-ssDNA in CRC. Methods: The study was conducted on 44 patients who had undergone surgery for CRC, and ccf-ssDNA level was measured before surgery and statistical analysis was performed on clinical factors. Results: The association between ccf-ssDNA level and clinicopathological factors was analyzed and compared, and these factors included age, sex, body mass index, diabetes mellitus, hypertension, tumor markers (carcinoembryonic antigen and carbohydrate antigen 19-9), tumor location, size, stage (TNM), recurrence, and death. The group with a ccf-ssDNA level of ≥ 7.5 ng/μL had a lower age (P = 0.010), and was associated with diabetes mellitus (P = 0.037) and lymph node metastasis (P = 0.049). Multivariate analysis of disease-free survival showed that lymph node metastasis and ccf-ssDNA level (hazard ratio, 10.011; 95% confidence interval, 2.269–44.175; P = 0.002) were independent prognostic factors for recurrence. In terms of overall survival, there were no statistically significant results except for vascular invasion. Conclusion This study showed that ccf-ssDNA level in plasma in CRC patients was an independent prognostic factor that could predict recurrence non-invasively. In this regard, further evaluation with a prospective, large sample size study will be needed to obtain additional results.

Acute gastric dilatation without obstructive or organic disease is rare, but is possible after a gastric or an abdominal operation in cases of trauma, retroperitoneal hematoma, diabetic gastroparesis, hypoxemia, electrolyte imbalance, etc. However ischemic necrosis due to acute gastric dilatation is very rare and has been reported only in patients who has anorexia nervosa or overeat suddenly. If the distended stomach is not decompressed successfully by using a conservative method or if the process proceeds to ischemic necrosis, operative treatment is necessary. We experienced a case in which the stomach was acutely distended, and mutiple ischemic necroses had developed. The patient was a 27-year-old woman and had no specific underlying disease in her medical history. After overeating, the stomach was distended acutely. During the operation, mutiple ischemic necroses were found in the stomach. A total gastrectomy and Roux-en-Y esophagojejunostomy were performed.
Adult ; Anorexia Nervosa ; Anoxia ; Female ; Gastrectomy ; Gastric Dilatation* ; Gastroparesis ; Hematoma ; Humans ; Hyperphagia ; Necrosis* ; Stomach

PURPOSE: This study evaluated the success and complication rates of endonasal dacryocystorhinostomy (DCR) in children and adults. METHODS: Fifty-six children (57 eyes) and 843 adults (870 eyes) who underwent endonasal DCR to treat nasolacrimal duct obstruction (NLDO) at the Department of Ophthalmology between April 1994 and March 2004 were included in this retrospective study. RESULTS: The mean age of patients was 7.7+/-2.83 years (2~15 years) in children and 51.8+/-14.10 years (16~81 years) in adults, with mean follow-up periods of 28.4+/-23.62 months (10~91 months) and 14.7+/-11.08 months (9~120 months), respectively. The primary success rate in children (94.7%) was significantly higher than that in adults (86.0%). Significantly more synechia formation was found in children (26.3%) than in adults (10.4%). However, granuloma and membranous obstruction in children (respectively 21% and 7.1%) were significantly less than in adults (respectively 37.9% and 15%). CONCLUSIONS: Although endonasal DCR in children has problems such as technical difficulty due to a narrower nasal cavity, postoperative care difficulties and higher rates of synechia formation, endonasal DCR is a safe and effective means of treating NLDO in children, with higher success rates than those in adults.
Adult* ; Child ; Dacryocystorhinostomy* ; Follow-Up Studies ; Granuloma ; Humans ; Nasal Cavity ; Nasolacrimal Duct ; Ophthalmology ; Postoperative Care ; Retrospective Studies

PURPOSE: This study was to evaluate the effectiveness of autogenous dermis graft in managing the exposed porous orbital implants. METHOD: Nine cases with exposed orbital implants(hydroxyapatite or Medpor(R)) were included in this study: six cases with hydroxyapatite and the remaining three cases with Medpor(R). Each of the cases was repaired with autogenous dermis graft. RESULTS: The mean follow-up was 13.3 months. Of nine cases, seven implants remained covered at the last visit. During the follow-up period, three of them received a second dermis patch graft surgery for re-exposure. The final success rate was 77.7%. CONCLUSION: These results suggested that autogenous dermis graft served as an excellent material for repair of the exposed porous orbital implants.
Dermis* ; Durapatite ; Follow-Up Studies ; Orbit* ; Orbital Implants* ; Transplants*

Because the 'Tsunami of type 2 diabetes' is presently rolling on a global scale, owing to the ever-increasing prevalence of obesity, increasing physical inactivity, and aging populations worldwide, the economic burden of diabetes caused by increased health resource use and lost productivity increase rapidly. So prevention in general population and good glycemic controls become even more important with earlier diagnosis and more aggressive cardiovascular prevention and treatment. Diabetes requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is very complex and requires that many issues, beyond glycemic control, be solved by the active governmental policy. Lifestyle modifications are the cornerstones of management of type 2 diabetes. The progressive nature of type 2 diabetes requires use of one or more oral agents and eventually insulin, along with lifestyle modification and intensification. Rapid achievement of the target goals often prompts providers to consider combination therapy to target different pathogenic mechanisms and manage both fasting and postprandial blood glucose levels. Maintenance of glycemic control over the lifespan of a patient with diabetes is overwhelmingly likely to require combination therapy with oral diabetes medications. Ultimately, because of the progressive nature of the disease and the progressive decline in pancreatic beta-cell function, insulin therapy is almost always obligatory to achieve optimal glycemic goals.
Achievement ; Aging ; Blood Glucose ; Diabetes Mellitus ; Efficiency ; Fasting ; Health Resources ; Humans ; Insulin ; Life Style ; Obesity ; Prevalence ; Self Care

PURPOSE: To introduce and assess the results of punctoplasty using a radiofrequency surgical unit for punctal stenosis. METHODS: Patients who complained of epiphora, had an intact lacrimal pathway below puncti, and underwent punctoplasty with the Ellman Surgitron F.F.P.F were evaluated in the present study. RESULTS: A total of 19 patients (31 eyes) were included in the study. The average age was 55 years (+/-15.7 years). At the last follow-up visit, 27 eyes (87%) had patent puncti, 1 eye became stenotic again, and 3 eyes were completely obstructed. Twenty-two eyes (71%) showed almost complete disappearance of dye on the fluorescein dye-disappearance test (FDDT). Twenty-five eyes (81%) had symptomatic improvement. No significant complication was reported postoperatively. CONCLUSIONS: Punctoplasty with a radiofrequency surgical unit is a simple and effective method for punctal stenosis.
Constriction, Pathologic ; Eye ; Fluorescein ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases