The clinical and statistical evaluations of the 280 corneal grafted eyes which were operated at St. Mary's and Kangnam St. Mary's hospital from January 1980 to December 1985 were done. The follow-up period ranged from 1 month to 5 and 3/4 years(mean: 3 and 1/2 years). The results are as follows: 1. There were three major causes requiring corneal graft. The highest percentage was occupied by trauma(80 eyes, 28.57%) followed by keratoconus(46 eyes, 16.43%) and herpes simplex keratitis(40 eyes, 14.29%). At the time of keratoplasty the condition of the majority of the cornea was either leucoma cornea(125 eyes, 44.65%) or leucoma cornea adherens(26 eyes, 9.29%). 2. 215 eyes(76.79%) had penetrating keratoplasty and 65 eyes(23.21%) lamellar keratoplasty. 3. 221 eyes(78.92%) maintained the clarity of grafted cornea. 4. Postoperative corrected visual acuity of 0.5 or more was achieved in 111 eyes(40.36%), between 0.4 and 0.1 in 93 eyes(33.82%) and below 0.1 in 71 eyes(25.82%). There were 5 eyes excluded because of poor cooperation. 5. The causes of 59 opaque grafts were graft rejection(42 eyes, 71.19%), corneal edema(6 eyes, 10.17%), herpes simplex reinvasion(4 eyes, 6.78%), glaucoma(3 eyes, 5.08%) and others(4 eyes, 6.78%). 6. There were no statistically significant differences in the graft clarity and corrected visual acuity of both the Healon(R)-used group and the control group.
Cornea ; Corneal Transplantation ; Follow-Up Studies ; Herpes Simplex ; Keratoplasty, Penetrating ; Transplants* ; Visual Acuity

PURPOSE: Angiogeneisis is essential process for tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is major regulator of angiogenesis. Recently, the incidence of papillary thyroid microcarcinoma (PTMC) increased because of development in diagnostic modality. Several recent reports have documented relationship of VEGF and papillary thyroid cancer. The aims of this study were to determine whether angiogenetic phenotype was changed or not changed and to evaluate the relationship between clinicopathologic features and VEGF, vascular endothelial growth factor receptor-1 (VEGFR-1), hypoxic induced factor-1alpha (HIF-1α) mRNA expression in PTMC. METHODS: VEGF, VEGFR-1, HIF-1α mRNA expression was examined by RT-PCR in 14 patients who had undergone thyroidectomy due to PTMC. The thyroid tumor tissue and adjacent normal thyroid tissue were collected in operation and preserved at -70℃ in RNA later solution. We evaluate the expression of VEGF, VEGFR-1, HIF-1α mRNA by RTPCR. The expression of mRNA was quantititated by densitometer and analyzed the relationship between clinicopathologic features and mRNA expression. RESULTS: Compared to normal tissues, in PTMC we observed higher expression of HIF-1α mRNA (P=0.024) and lower expression of VEGF mRNA (P=0.002). There was no difference in expression of VEGFR-1.The patients with nodal metastasis had higher expression of the VEGF mRNA in tumor tissues than those without nodal metastasis but not significantly. The VEGF mRNA of tumor tissues in patients with thyroid capsule invasion or not were expressed similarly. The lower expression of VEGF mRNA were observed more frequently in younger patients (<40). CONCLUSION: The expression of VEGF mRNA was lower in tumor tissue in spite of higher expression of HIF-1α mRNA. These results suggest that the reason for good prognosis and no progression to clinical cancer in PTMC was related to the unchanged angiogenic phenotype.
Humans ; Incidence ; Neoplasm Metastasis ; Phenotype ; Prognosis ; RNA ; RNA, Messenger* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Vascular Endothelial Growth Factor A* ; Vascular Endothelial Growth Factor Receptor-1*

PURPOSE: Although the measles-mumps-rubella vaccination covers most children against mumps in Korea, the development of mumps has been reported. However, the clinical manifestations of mumps orchitis in postpubertal vaccinated patients have never been investigated. Herein we report the clinical features of mumps orchitis in postpubertal vaccinated patients. MATERIALS AND METHODS: This study included a total of 62 postpubertal males who developed acute mumps orchitis from 2005 to 2010. The clinical manifestations such as the incubation period, febrile duration, and the mean duration of orchitis were retrospectively investigated. The laboratory and sonographic findings were also reviewed and compared with the features of previously reported cases of unvaccinated postpubertal mumps orchitis. RESULTS: The mean age of the 62 patients was 17.56 years (range, 15 to 29 years). All patients were serologically confirmed with acute mumps infection (positive immunoglobulin [Ig] M and negative or positive IgG). The mean incubation period was 5.39 days (range, 0 to 23 days), with a febrile duration of 1.8 days (range, 0.5 to 3 days), and a mean duration of orchitis of 4.96 days (range, 0 to 17 days). Sonography revealed unilateral orchitis in 58 patients (93.6%) and bilateral orchitis in only 6 (6.4%). CONCLUSIONS: In our study, mumps orchitis in postpubertal vaccinated patients showed a relatively shorter febrile duration. In addition, less scrotal swelling and a lower incidence of bilaterality were found upon physical examination and ultrasonography. In the future, additional long-term follow-up is needed to determine the features of mumps orchitis in postpubertal vaccinated males, and an additional booster vaccination should be considered.
Child ; Follow-Up Studies ; Humans ; Immunoglobulins ; Incidence ; Korea ; Male ; Mumps ; Orchitis ; Physical Examination ; Retrospective Studies ; Vaccination ; Young Adult

PURPOSE: We evaluated the clinical significance of simultaneous transurethral resection of bladder tumor(TURB) and the prostate(TURP) in patients who have superficial bladder cancer with bladder outlet obstruction. MATERIALS AND METHODS: Between April 1997 to April 2006, 213 patients with superficial bladder cancer were included in this study. The patients were treated with TURB only(n=107, Group I) or TURB with TURP (n=106, Group II). Bladder cancer recurrence was observed by performing cystoscopy and urine cytology. Uroflowmetry was performed three months after surgery. RESULTS: There were no significant differences in age, the tumor size or the number of tumors between groups I and II. There was no evidence of cancer implantation where TURP was applied. The recurrence rate of group II was significantly lower than that of group I(p=0.044), and the time to recurrence was longer for group II than for group I(p=0.026). There was no significant difference in the progression rate between the two groups(p=0.788). Three months after surgery, the mean residual urine volume was lower for group II(7.9ml) than that for group I(21.7ml). CONCLUSIONS: For superficial bladder cancer patients with bladder outlet obstruction, simultaneous TURB and TURP may help reduce the bladder cancer recurrence rate and delay the time to recurrence without the risk of cancer implantation at the site where TURP is applied.
Cystoscopy ; Humans ; Prostate ; Recurrence ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder Neoplasms

Premature ejaculation(PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin(5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors(SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine(hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neurotransmission, it has been suggested that on-demand selective serotonin reuptake inhibitor(SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.
Animals ; Antidepressive Agents ; Brain ; Clomipramine ; Ejaculation ; Fluoxetine ; Humans ; Male ; Neurophysiology ; Paroxetine ; Phosphodiesterase 5 Inhibitors ; Premature Ejaculation ; Rats ; Serotonin ; Sertraline ; Spinal Cord ; Synaptic Transmission

OBJECTIVES: In this study, we evaluated early surgical results including 30 days early stroke and death rate and complications in 168 cases carotid endarterectomy (CEA). METHODS: A retrospective review of patients who underwent CEA at our institute between September 1999 and August 2010 was done. Preoperative symptoms were stroke in 72 cases, transient ischemic stroke or reversible ischemic neurologic deficit in 56 cases and asymptomatic in 40 cases. Most of the patients had conventional cerebral angiography or neck computed tomography angiography (CTA) for preoperative evaluation. Immediate radiological follow up was performed by neck CTA 1 week postoperatively. RESULTS: The overall postoperative stroke rate including transient ischemic attack within 30 days of the treatment was 1.7%. Major stroke rate with morbidity and death rate within 30 days was 0.6% (1 : major stroke, 1 : death). The cause of death was airway occlusion due to wound hematoma. Cranial nerve palsy developed in two patients (1.1%) and neck hematoma in six patients (3.5%). Neck CTA revealed total occlusion of internal carotid artery in one patient with acute cerebral infarction and then recovered fully. Intracranial hemorrhage relating to the hyperperfusion syndrome developed in one patient. Radiological patency rate was 98.7%. The comparison of 30 days morbidity and mortality rate between CEA and carotid angioplasty and stenting were each 0.6% and 1.5%, but there was no statistical significance. CONCLUSIONS: Carotid endarterectomy provides considerable future risk prevention against stroke in patients with symptomatic and asymptomatic carotid stenosis.
Angiography ; Angioplasty ; Carotid Artery, Internal ; Carotid Stenosis ; Cause of Death ; Cerebral Angiography ; Cerebral Infarction ; Cranial Nerve Diseases ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies ; Hematoma ; Humans ; Intracranial Hemorrhages ; Ischemic Attack, Transient ; Neck ; Neurologic Manifestations ; Retrospective Studies ; Stents ; Stroke

OBJECTIVES: In this study, we evaluated early surgical results including 30 days early stroke and death rate and complications in 168 cases carotid endarterectomy (CEA). METHODS: A retrospective review of patients who underwent CEA at our institute between September 1999 and August 2010 was done. Preoperative symptoms were stroke in 72 cases, transient ischemic stroke or reversible ischemic neurologic deficit in 56 cases and asymptomatic in 40 cases. Most of the patients had conventional cerebral angiography or neck computed tomography angiography (CTA) for preoperative evaluation. Immediate radiological follow up was performed by neck CTA 1 week postoperatively. RESULTS: The overall postoperative stroke rate including transient ischemic attack within 30 days of the treatment was 1.7%. Major stroke rate with morbidity and death rate within 30 days was 0.6% (1 : major stroke, 1 : death). The cause of death was airway occlusion due to wound hematoma. Cranial nerve palsy developed in two patients (1.1%) and neck hematoma in six patients (3.5%). Neck CTA revealed total occlusion of internal carotid artery in one patient with acute cerebral infarction and then recovered fully. Intracranial hemorrhage relating to the hyperperfusion syndrome developed in one patient. Radiological patency rate was 98.7%. The comparison of 30 days morbidity and mortality rate between CEA and carotid angioplasty and stenting were each 0.6% and 1.5%, but there was no statistical significance. CONCLUSIONS: Carotid endarterectomy provides considerable future risk prevention against stroke in patients with symptomatic and asymptomatic carotid stenosis.
Angiography ; Angioplasty ; Carotid Artery, Internal ; Carotid Stenosis ; Cause of Death ; Cerebral Angiography ; Cerebral Infarction ; Cranial Nerve Diseases ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies ; Hematoma ; Humans ; Intracranial Hemorrhages ; Ischemic Attack, Transient ; Neck ; Neurologic Manifestations ; Retrospective Studies ; Stents ; Stroke

PURPOSE: We investigated the safety and efficacy of transurethral resection of the prostate(TURP) in benign prostatic hyperplasia(BPH) more than 60cc by single surgeon for the relief of infravesical obstruction. MATERIALS AND METHODS: We evaluated 211 patients treated with TURP in BPH with large prostate by single surgeon. Each group was divided by prostate volume(group 1; 60-69.9, group 2; 70-79.9, group 3; 80-89.9, group 4; 90-99.9, group 5; >100cc of prostate volume). Various parameters such as International Prostate Symptom Score(IPSS), maximal flow rate(Qmax.), postvoid residual volume(PVR), prostate volume, adenoma volume, resection time, resection prostate volume, irrigation fluid volume and complications were evaluated and compared. RESULTS: Age of each group was not significantly different. Prostate volume, adenoma volume, resection time, Resection volume, irrigation volume of each groups were different significantly. But, resection volume/resection time and irrigation volume/resection time were not different significantly. Mean resection volume/resection time was 1.34g/min, and mean irrigation volume/resection time was 315.8ml/min. And intraoperative and postoperative complications of each group were not different. Mean postoperative change of Hb was 2.0+/-1.1g/dl. Postoperative parameters(IPSS, Qmax, PVR) were improved significantly. Only 2 patients needed transfusion in group 5. No urinary incontinence and TUR syndrome in each group was observed. CONCLUSIONS: TURP by experienced surgeon is a safe and effective treatment in BPH patients with large prostates for relief of infravesical obstruction.
Adenoma

PURPOSE: The purpose of this study is to set guidelines for the management of renal angiomyolipoma (AML), clinical prognosis according to tumor size, in association with tuberous sclerosis complex (TSC), multiplicity, radiographic finding, and treatment modality. MATERIALS AND METHODS: Between March 1998 and October 2008, 129 out of 254 patients with AML who underwent surgical intervention or angioembolization were enrolled. Diagnosis of AML was determined by the presence of a low attenuated component on CT imaging or by pathological confirmation. Indications of treatment were intractable pain, hematuria, suspicion of malignancy, large tumor size, spontaneous rupture, and radiographically equivocal tumors in which a differential diagnosis was needed to rule out malignancy. Parameters including age, sex, tumor size, multiplicity, radiographic characteristics, association with TSC, and treatment modality were reviewed. RESULTS: Age at presentation was 50.6 years and mean tumor size was 3.5 cm. Presentation symptoms were flank pain, hematuria, spontaneous rupture, and fatigue. 97 (75.2%) patients were incidentally discovered. 100 (77.5%) were females. 68 (52.7%) underwent nephron-sparing surgery (NSS), 35 (27.1%) radical nephrectomy, and 26 (20.2%) angioembolization. TSC was accompanied in 12 (9.3%) patients. No patient developed renal function impairment during the mean follow-up period of 64.8 months. Patients with TSC presented at a younger age, along with larger, bilateral, and multiple lesions. CONCLUSION: Significant differences in clinical manifestations and treatment outcomes were noted in respect to tumor characteristics, association with TSC, and treatment modality. Considering the benign nature of AML, these parameters ought to be considered when deciding upon active surveillance or prophylactic intervention.
Adult ; Angiomyolipoma/*pathology/*surgery/therapy ; Female ; Humans ; Kidney Neoplasms/*pathology/*surgery/therapy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

PURPOSE: We compared the efficacy of urine cytology, nuclear matrix protein 22 (NMP22), and fluorescence in situ hybridization (FISH) for the detection of bladder cancer. MATERIALS AND METHODS: Washing urine samples from 156 patients were evaluated for the detection of bladder cancer. Patients were divided into 3 groups. Group 1 was 106 patients with bladder cancer, group 2 was 30 patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate without bladder cancer, and group 3 had gross hematuria without bladder cancer. The sensitivity and specificity of cytology, NMP22, and FISH were compared. NMP22 positivity was defined as > or =10U/ml. FISH was done with the UroVysion(R) system and FISH positivity was defined as > or =2 abnormal urothelial cells with an abnormal signal from any out of 4 probes. RESULTS: The overall sensitivity of urine cytology, NMP22, and FISH was 60.4%, 75.5%, and 84.9%, respectively (p<0.001). The overall specificity of cytology, NMP22, and FISH was 96.7%, 83.3%, and 93.3%, respectively (p=0.168). In group 3, the false-positive rates of cytology, NMP22, and FISH were 20.0%, 55.0%, and 10.0%, respectively. In these patients with gross hematuria, the false-positive rate with NMP22 was significantly higher than with cytology or FISH (p=0.004). The sensitivity of cytology, NMP22, and FISH in low-grade bladder cancer patients was 25.9%, 51.9%, and 77.8%, respectively, and that in pTa-1 bladder cancer patients was 40.6%, 65.6%, and 78.1%, respectively. In low-grade or in pTa-1 patients, the sensitivity of the three diagnostic tools was significantly different (low grade; p<0.001, pTa-1; p<0.001). CONCLUSIONS: FISH is more sensitive in low-grade bladder cancer than is urine cytology and can be used as a diagnostic tool for the detection of primary and recurrent bladder cancer. NMP22 was affected by gross hematuria and thus has limitations for screening of bladder cancer. However, it can be used to follow-up bladder cancer.
Carcinoma, Transitional Cell ; Fluorescence ; Hematuria ; Humans ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Mass Screening ; Nuclear Matrix ; Nuclear Proteins ; Prostate ; Prostatic Hyperplasia ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder Neoplasms