PURPOSE: Superior sulcus deformity is the main cosmetic problem in anophthalmic patients. Many methods of correcting enophthalmos have been reported, especially in patients with orbital wall fracture. The purpose of this study is to review the long term results of effectiveness in superior sulcus deformity correction by subperiosteal Medpor (R) sheet implantation in anophthalmic patients. METHODS: Subperiosteal Medpor (R) sheets were used in 11 eyes of 11 anophthalmic patients. To estimate the effectiveness, photographs were taken and exophthalmometric value with their own prosthesis using Hertel exophthalmometer was measured in all patients before and after surgery. RESULTS: The overall cosmetic results in superior sulcus deformity were 'excellent' in 3 (27.3%), 'good' in 6 (54.5%), 'fair' in 2 (18.2%). The overall results in enophthalmos were 'excellent' in 3 (27.2%), 'markedly improved' in 4 (36.4%), 'slightly improved' in 4 (36.4%). Most patients had a marked increase in orbital volume, except two patients. They received irradiation treatment in early childhood so showed unsatisfactory results in both superior sulcus deformity and enophthalmos. CONCLUSIONS: Subperiosteal Medpor (R) sheet implantation is considered to be a reliable and safe procedure without serious complication and with an excellent cosmetic results.
*Surgical Mesh ; Surgery, Plastic ; Retrospective Studies ; *Polyethylene ; Middle Aged ; Male ; Humans ; Female ; Eyelid Diseases/*etiology/*surgery ; Enophthalmos/*etiology/*surgery ; Child ; Anophthalmos/*complications ; Adult ; Adolescent

PURPOSE: To investigate the preoperative characteristics and postoperative change of the higher-order wavefront aberrations (HOAs) in myopic photorefractive keratectomy (PRK). METHODS: Standard PRK was performed in 39 eyes (spherical equivalent -4.71+/-1.56D) using the VISX(R) STAR S4(TM) excimer laser system. Wavefront analysis was performed preoperatively and 6 months postoperatively using the VISX(R) WaveScan(TM) aberrometer. Statistical analysis was performed to assess the preoperative characteristics of the HOAs and the PRK-induced aberrations. RESULTS: The preoperative root mean square (RMS) value of the total HOAs was 0.291 micrometer: coma 0.159 micrometer, trefoil 0.157 micrometer, spherical aberration 0.093 micrometer. Among the 3 HOAs, only the spherical aberration showed moderate magnitude negative correlation with the spherical equivalent (p=0.012) and sphere (p=0.005). The magnitude of all of the HOAs, except trefoil, were significantly increased at postoperative 6 months: total HOAs 183% (0.533 micrometer, p<0.001), spherical aberration 341% (0.317 micrometer, p<0.001), coma 185% (0.294 micrometer, p<0.001), trefoil 104% (0.163 micrometer, p=0.681). In the postoperative correlation analysis, only the PRK-induced spherical aberration showed the increase of magnitude with increasing preoperative spherical equivalent (p=0.036) and sphere (p=0.019). CONCLUSIONS: The HOAs, especially spherical aberration and coma, were increased after PRK. Among the 3 HOAs, the spherical aberration showed the greatest increase of magnitude and percent change; it also showed a positive correlation with increasing preoperative spherical equivalent and sphere. Further software improvements in the wavefront-guided surface ablations need to have a diminution of PRK-induced spherical aberration.
Coma ; Lasers, Excimer ; Lotus ; Photorefractive Keratectomy

Peritonitis is a frequent and serious complication in continuous ambulatory peritoneal dialysis (CAPD) patients. Recently, due to educational promotion in general hygiene and development of laboratory technique for bacterial cultures and sensitivity test, proper use of antibiotics, the incidence of CAPD peritonitis has gradually decreased. However, CAPD peritonitis is still one of the most common causes of peritoneal dialysis failure and of removal peritoneal catheter. It has been suggested that the formation of biofilm on the inner surface of peritoneal catheter leads to relapsing peritonitis and removal of the peritoneal catheter in CAPD patients. The biofilm is a kind of protecting coat which consists of fibrin inhibiting the penetration of antibiotics. It surrounds and covers the bacteria, making them to survive from the attack of antibiotics. Therefore thrombolytic therapy, urokinase modifies the structure of biofilm, and helps the antibiotics penetrating the fibrin coat, eventually amplify the bacteriocidal effect. We experienced two cases of successful treatment with urokinase and antibiotics in CAPD peritonitis patients. The combination of thrombolytic agents and antibiotics might be one of the strategies for the treatment of CAPD patients who experienced it frequently.
Anti-Bacterial Agents ; Bacteria ; Biofilms ; Catheters ; Fibrin ; Fibrinolytic Agents ; Humans ; Hygiene ; Incidence ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator*

Pyogenic granuloma (PG) and port-wine stain (PWS) are vascular lesions that rarely occur in association. While PWSs are congenital capillary vascular malformations, PGs are acquired benign vascular proliferations. Although the pathogenesis of PG is unknown, many authors feel that they represent reactive hyperplasias, especially as they are often seen in response to trauma. We report the multiple pyogenic granulomas developed in a port-wine stain following Nd-YAG laser therapy.
Capillaries ; Granuloma, Pyogenic* ; Hyperplasia ; Laser Therapy* ; Lasers, Solid-State ; Port-Wine Stain* ; Vascular Malformations

The present study was done to validate the two-site Semmes-Weinstein (SW) monofilament test in identifying patients at risk of lower-extremity complications in clinical setting. The SW monofilament test and nerve conduction study were conducted on type 2 diabetic patients (n=37) at Pusan National University Hospital in Korea. As the duration of diabetes mellitus was longer, neuropathy identified by nerve conduction study and complications of diabetes were more severe (p<0.01). The number of sites unable to perceive SW monofilament (p<0.001) was larger in patients with lower-extremity neuropathy symptoms than those without symptoms. Sensitivity and specificity at two sites (the third and fifth metatarsal head sites) were 93% and 100%, respectively. In conclusion, the two-site SW monofilament test was a sensitive, specific, simple, and inexpensive screening tool for identifying diabetic peripheral neuropathy in clinical setting.
Aged ; Comparative Study ; Diabetes Mellitus, Type II/complications* ; Diabetic Neuropathies/diagnosis* ; Female ; Human ; Male ; Middle Aged ; Neural Conduction ; Neurologic Examination/instrumentation* ; Neurologic Examination/methods ; Pressure ; Sensation Disorders/diagnosis* ; Sensation Disorders/etiology ; Sensitivity and Specificity ; Touch

STATEMETN OF PROBLEM: In-Ceram system is one of the all-ceramic crowns that can be used in anterior 3 unit fixed partial dentures and posterior single crowns. The alumina core used in In-Ceram system is manufactured using slip-casting technique. The slip-casting technique is difficult and technique sensitive. To improve this problem, tape-casting method was introduced into dentistry. There were no studies to examine the effect of margin design on the margin fit-ness of all-ceramic crowns fabricated from alumina tape. PURPOSE: The purpose of this study was to compare the marginal fitness of glass infiltrated alu-mina core fabricated from aqueous-based alumina tape according to different margin types (90 .,110 ., 135 .shoulder margin). MATERIAL AND METHOD: Three upper central resin incisors were prepared with 90 ., 110 .and 135 .shoulder margins for all-ceramic crowns, respectively. The resin teeth were duplicated and master die and special plaster die were made as usual. After alumina cores were fabri-cated from aqueous-based alumina tape, cores were cemented to each 15 epoxy dies replicated from three resin teeth with resin cement. These cemented cores were embedded in epoxy resin. Specimens were cut mesiodistally and buccolingually. Marginal gap and discrepancy were measured under microscope. RESULTS: The marginal gap and discrepancy of 90.marginal angle was 75.1 mu m, 86.6 mu m, 110 .marginal angle was 41.5 mu m, 50.7 mu m and 135 .marginal angle was 51.7 mu m, 54.2 mu m, respectively. The smallest value was seen in 110 (angle, which was statistically significant com-pared to that of 90 .angle (p<0.05). CONCLUSION: Marginal fitness of alumina cores made of alumina tape with 110 .shoulder mar-gin was best and others were clinically acceptable.
Aluminum Oxide* ; Crowns ; Dentistry ; Denture, Partial, Fixed ; Glass* ; Incisor ; Resin Cements ; Shoulder ; Tooth

BACKGROUND: The purpose of our study was to assess the efficacy of influenza vaccination against influenza-like illness and the common cold in the elderly. METHODS: A total of 62 subjects, aged 60 years or older, were evaluated, who visited the Un-bong Welfare center, Bansong, Pusan. Attack rate of influenza-like illness and the common cold during winter, before and after influenza vaccination, was assessed by means of interview. RESULTS: After influenza vaccination, the attack frequency of influenza-like illness during winter was 0.07 0.31. This differed with 0.81 1.17 before vaccination (P<0.000). After influenza vaccination, the attack frequency of the common cold during winter was 1.22 1.61. This differed with 2.71 2.35 before vaccination (P<0.000). After influenza vaccination, the attack rate of influenza-like illness during winter was 45.2%. This differed with 4.8% before vaccination (P<0.000). After influenza vaccination, the attack frequency of common cold during winter was 87.1%. This differed with 48.4% before vaccination (P<0.000). The only side effect of influenza vaccination was pain (1.6%). CONCLUSION: In the elderly, influenza vaccination may reduce the incidence of influenza-like illness and the common cold during winter.
Aged* ; Busan ; Common Cold ; Humans ; Incidence* ; Influenza, Human* ; Vaccination*

Multiple myeloma is lethal plasma cell proliferation that produces monoclonal M-protein and presents bone pain, pathologic fractures, anemia, hypercalcemia, renal failure, abnormalities of the coagulation system, and dysfunctions of the nervous system. About 1% of the multiple myeloma have more than one such protein (monoclonal M-protein). We experienced a case of mutiple myeloma presented as biclonal gammopathy. Protein electrophoresis and immunoelectrophoresis showed biclonal band that consisted of IgG-landa and IgA-k.
Anemia ; Electrophoresis ; Fractures, Spontaneous ; Hypercalcemia ; Immunoelectrophoresis ; Multiple Myeloma* ; Nervous System ; Plasma Cells ; Renal Insufficiency

PURPOSE: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. MATERIALS AND METHODS: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. RESULTS: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). Follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. CONCLUSION: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our RESULTS suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.
3-Iodobenzylguanidine ; Female ; Follow-Up Studies ; Gamma Cameras ; Humans ; Kidney ; Lymph Nodes ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Nuclear Medicine ; Pheochromocytoma

PURPOSE: The prognosis of stage IV stomach cancer patients is very poor and the effectiveness of radical surgery including extended lymphadenectomy and combined resection in these patients is still controversial. The purposes of this retrospective study were to identify the prognostic factors and to evaluate the effectiveness of extended lymphadenectomy and combined resection in stage IV stomach cancer paients. MATERIALS AND METHODS: Of 585 patients who were operated for stomach cancer at the NMC from Jan. 1987 to Oct. 1993, 154 patients of stage IV stomach cancer (121 patients who had distant metastasis and 33 patients who had not) were identified. We analyzed data of these 154 patients to find the characteristic clinicopathological features, the prognostic factors and the proper extent of surgical treatment. RESULTS: Comparing with stage I, II and III groups, larger tumor size, higher proportions of Borrmann type IV and undifferentiated carcinoma and higher rates of lymph node metastasis and combined resection were noticed in stage IV stomach cancer group. In combined resection, pancreas tail was mainly resected due to tumor invasion but spleen was mainly resected for the completeness of lymph node dissection. In multivariate analyses, peritoneal metastasis and postoperative residual tumor were independent prognostic factors. The overall 5-year survival rate was 14.6%. Stage IV stomach cancer patients without distant metastasis had better 5-year survival rate than that of those who had distant metastasis (34.3% vs 7.9%, p=0.00001). CONCLUSIONS: Radical procedures including extended lymphadenectomy and combined resection of the invaded organs should be considered in the stage IV stomach cancer patients without distant metastasis.
Carcinoma ; Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm, Residual ; Pancreas ; Prognosis ; Retrospective Studies ; Spleen ; Stomach Neoplasms* ; Stomach* ; Survival Rate