PURPOSE: To evaluate the efficacy of anterior-side rectangular 4-snip punctoplasty, a modification of posterior ampullectomy that is currently used in patients with punctal stenosis. METHODS: We performed a retrospective chart review of patients with punctal stenosis who underwent anterior-side rectangular 4-snip punctoplasty at our hospital. Fluorescein dye disappearance test (FDT) and questionnaire on tearing symptoms and tear meniscus height (TMH) based on spectral-domain optical coherence tomography (SD-OCT) were evaluated in preoperative and postoperative follow-up examinations of the patients. Anatomical success was defined as punctum without re-stenosis at last visit; functional success was defined as FDT grade of 0 or 1, or tearing symptom score of 2 or less. RESULTS: A total of 44 anterior-side 4-snip punctoplasty procedures were performed in 27 patients. The average age of all subjects was 56.0 +/- 11.0 years (range, 39 to 82 years). The mean follow-up period was 9.4 months (range, 6 to 20 months). FDT, tearing symptom score (p < 0.01, Wilcoxon signed-rank test), and TMH (p < 0.01, paired t-test) were significantly decreased after surgery. Anatomical success was 40/44 cases (90.9%) and functional success was 38/44 cases (86.4%). There were no complications such as skin defect or cosmetic problems. CONCLUSIONS: Anterior-side rectangular 4-snip punctoplasty is an effective surgical procedure for patients with punctal stenosis, maintaining functions of the lacrimal drainage system without re-stenosis of punctum.
Constriction, Pathologic* ; Drainage ; Fluorescein ; Follow-Up Studies ; Humans ; Surveys and Questionnaires ; Retrospective Studies ; Skin ; Tomography, Optical Coherence

PURPOSE: To compare the efficacy of an intralesional steroid injection in the treatment of chalazion according to triamcinolone acetonide (TA) concentrations. METHODS: A total of 108 patients with 120 chalazia received an intralesional injection of TA. Patients were divided into 3 groups according to the concentrations of TA: 5 mg/ml, 10 mg/ml, and 40 mg/ml. A regular follow-up was performed and the size of lesion and recurrence were evaluated. RESULTS: Success was defined as a minimum of 80% decrease in size with no recurrence. The success rate was 78.1% in the 5 mg/ml group, 76.2% in the 10 mg/ml group, and 78.4% in the 40 mg/ml group. These results were not statistically significant (p = 0.999, Fisher's exact test). Yellow deposits developed in 4 out of 37 lesions in the 40mg/ml group, and in 1 out of 42 lesions in the 10 mg/ml group. Skin depigmentation was observed in 1 case in the 5 mg/ml group. CONCLUSIONS: Intralesional TA injection is an effective treatment for chalazion. There is no significant difference in success rates according to the concentrations of TA. However, caution is advised in cases of high injection concentrations of TA to prevent yellow deposits.
Chalazion ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Recurrence ; Skin ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To evaluate the efficacy and safety of fibrin bioadhesive in conjunctivolimbal autograft surgery for primary pterygium. METHODS: Thirty-six eyes in 34 patients were reviewed with nasal primary pterygium who were treated with pterygium excision with superior conjunctivolimbal transplantation with fibrin bioadhesive. Surgical durations were recorded and the patients were followed up on the first day after surgery and then at 1, 2, 4, 8 and 12 weeks postoperatively. The graft-recipient site attachments were examined and subjective symptoms of patients were recorded at every follow-up examinations. RESULTS: The mean patient age was 57.9+/-10.1 (ranging from 33 to 83) years. The mean follow-up period was 22.05+/-5.78 weeks. The mean surgery time was 18.04+/-5.65 minutes. The subjective symptoms (pain, foreign body sensation, tearing and discomfort) disappeared in 23 of 36 eyes (64%) in one week after surgery, and all discomforts subsided within two weeks after surgery in all patients. The conjunctivolimbal autograft was correctly positioned and fixed in 34 of 36 eyes (94.4%) throughout the follow-up period. Graft dehiscence was seen in two eyes (5.6%), one eye was treated with remedial sutures, and the other eye showed a spontaneous healing without remedial sutures. Transient graft edema occurred in four eyes (11.2%) but subsided spontaneously within a month. There were no cases of pterygium regrowth or complications due to the fibrin bioadhesive. CONCLUSIONS: The use of fibrin bioadhesive in conjunctivolimbal autograft surgery in primary pterygium simplifies surgical techniques, shorten surgical duration, and produce less postoperative subjective symptoms . Therefore, the fibrin bioadhesive is a safe and effective tool to attach conjunctivolimbal autograft in primary pterygium surgery.
Adult ; Aged ; Aged, 80 and over ; Conjunctiva/*transplantation ; Female ; Fibrin Tissue Adhesive/*therapeutic use ; Follow-Up Studies ; Humans ; *Limbus Corneae ; Male ; Middle Aged ; Postoperative Complications ; Pterygium/*surgery ; Tissue Adhesives/*therapeutic use ; Transplantation, Autologous

PURPOSE: To study the effect of recombinant human epidermal growth factor (rhEGF) on oral mucositis induced by cisplatin and radiotherapy in a mouse model. MATERIALS AND METHODS: Twenty-four ICR mice were divided into three groups? the normal control group, the no rhEGF group (treatment with cisplatin and radiation) and the rhEGF group (treatment with cisplatin, radiation and rhEGF). A model of mucositis induced by cisplatin and radiotherapy was established by injecting mice with cisplatin (10 mg/kg) on day 1 and with radiation exposure (5 Gy/day) to the head and neck on days 1~5. rhEGF was administered subcutaneously on days -1 to 0 (1 mg/kg/day) and on days 3 to 5 (1 mg/kg/day). Evaluation included body weight, oral intake, and histology. RESULTS: For the comparison of the change of body weight between the rhEGF group and the no rhEGF group, a statistically significant difference was observed in the rhEGF group for the 5 days after day 3 of the experiment. The rhEGF group and no rhEGF group had reduced food intake until day 5 of the experiment, and then the mice demonstrated increased food intake after day 13 of the of experiment. When the histological examination was conducted on day 7 after treatment with cisplatin and radiation, the rhEGF group showed a focal cellular reaction in the epidermal layer of the mucosa, while the no rhEGF group did not show inflammation of the oral mucosa. CONCLUSION: These findings suggest that rhEGF has a potential to reduce the oral mucositis burden in mice after treatment with cisplatin and radiation. The optimal dose, number and timing of the administration of rhEGF require further investigation.
Animals ; Body Weight ; Cisplatin* ; Eating ; Epidermal Growth Factor* ; Head ; Humans* ; Inflammation ; Mice* ; Mice, Inbred ICR ; Mouth Mucosa ; Mucositis ; Mucous Membrane ; Neck ; Radiotherapy* ; Stomatitis*

The purpose of this study was to evaluate cumulative survival rate (CSR, %) of mandibular posterior single tooth implants replaced with ITI SLA (sand-blasted, large-grit, acid-etched) implant system and compare the CSR between first and second molar. The findings from the results were as follows; 1. Total of 158 implants were inserted into 147 patients. 68 patients were males, 79 patients were females and their mean age was 47.8 years. 98 implants were placed in first molar area and 60 implants were placed in second molar area. In terms of diameter, implants with wide diameter over 4.8mm dominated (91.1%). Implants with length over 10mm were used (96.2%). 2. In the two cases, there was a slight transient numbness which recovered within 1-2 months. Nine SynOcta screw type abutments demonstrated screw loosening. There were ten cases of crown fallen-out from decementation. 3. Only one failed out of 158 implants. The CSR was 99.4%. The CSRs for first molar and second molar were 99% and 100%, respectively. From the results, it was concluded that single tooth replacement implant in the mandibular posterior area, might be considered as the effective treatment modality comparable to the conventional crown and bridge.
Crowns ; Dental Implants, Single-Tooth ; Female ; Humans ; Hypesthesia ; Male ; Molar ; Retrospective Studies* ; Survival Rate ; Tooth*

PURPOSE: To investigate the effects of mutated cartilage oligomeric matrix protein (COMP) on the synthesis of cartilage-specific major matrix proteins of Swarm rat chondrosarcoma chondrocytes. MATERIALS AND METHODS: The Swarm rat chondrosarcoma chondrocytes transfected with chimeric construct consisting of a mutant gene of human COMP and an amino acid FLAG tag sequence were cultured in agarose gel. Formation of extracellular proteoglycan and type-II collagen of the cells were evaluated by immunohistochemical staining and measuring 35S-sulfate incorporation. RESULTS: No difference was observed in type-II collagen detection among the cell line expressing mutant COMP and control cell lines. Histochemical staining of sulfated proteoglycans with safranin-O showed lower amounts of proteoglycans were incorporated into the extracellular matrix of chondrocytes transfected with mutant gene. 35S-sulfate incorporation into the cell/matrix fractions demonstrates marked lower radiolabel incorporation compared to control cells. CONCLUSION: Mutation of COMP impacts the processing of proteoglycans rather than type-II collagen in three-dimensional culture of Swarm rat chondrosarcoma chondrocytes.
Animals ; Cartilage Oligomeric Matrix Protein* ; Cartilage* ; Cell Line* ; Chondrocytes ; Chondrosarcoma* ; Collagen ; Extracellular Matrix* ; Humans ; Proteoglycans ; Rats* ; Sepharose

Ultraviolet (UV) radiation is the main physiological stimulus for human skin pigmentation. Recently, nitric oxide (NO) have been involved in mediation of skin pigmentation induced by UVB. Rutin, a flavonoid of vegetables and fruits, has antiviral and antioxidant properties. Therefore, we investigated the effect of rutin on UVB-induced melano-genesis and NO production in HM3KO cells. In this study, we demonstrated that UVB-irradiation stimulated melanin content and tyrosinase activity in HM3KO cells. Rutin suppressed UVB-stimulated total melanin content and tyrosinase activity in a dose-dependent manner. Additionally, we showed that UVB-irradiation stimulated NO production in HM3KO cells. Rutin also suppressed UVB-induced NO production and repaired reduction of cell proliferation by UVB. UVB stimulation of melanogenesis was mimicked by exogenous NO donor (sodium nitroprusside, SNP), and rutin effectively suppressed it. Therefore, we concluded that rutin suppressed UVB-stimulated melanogenesis and that it is involved in melanogenesis regulation partially through the suppression of UVB-induced NO production.
Cell Proliferation ; Fruit ; Humans* ; Melanins ; Melanoma* ; Monophenol Monooxygenase ; Negotiating ; Nitric Oxide* ; Nitroprusside ; Rutin* ; Skin Pigmentation ; Tissue Donors ; Vegetables

BACKGROUND/AIMS: Apolipoprotein E polymorphism plays an important role in the metabolism of cholesterol and bile acids, which may be related to the development of colorectal adenomas. An association between apolipoprotein E genotype and colonic adenomas has been reported in a western country. This study was designed to determine whether the apolipoprotein E was genotype would be associated with proximal or distal colonic adenomas in Koreans. METHODS: On the colonoscopy, colonic adenomas were found in 132 patients. Proximal colonic adenoma was found in 35 patients and distal colonic adenoma was found in 97 patients. Serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride were measured. Apolipoprotein E genotype was determined by PCR and allele specific oligonucleotide hybridization. 279 control subjects without an adenoma on the screening sigmoidoscopy were selected randomly. RESULTS: The serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride did not significantly differ between each adenoma group and control group. The individual frequencies of epsilon2, epsilon3 and epsilon4 alleles in patients with colonic adenomas did not differ from those in control subjects. The frequency of either heterozygote or homozygote for epsilon4 allele in patients with proximal adenoma was lower than that in control subjects (0.029 vs 0.168, p<0.05). CONCLUSIONS: The data suggest that epsilon4 allele may be associated with a lower risk for the development of proximal colonic adenoma in Korean men.
Adenoma* ; Alleles ; Apolipoproteins* ; Bile Acids and Salts ; Cholesterol ; Colon* ; Colonoscopy ; Genotype* ; Heterozygote ; Homozygote ; Humans ; Male ; Mass Screening ; Metabolism ; Polymerase Chain Reaction ; Sigmoidoscopy ; Triglycerides

BACKGROUND: Cystic tumors of the pancreas are uncommon, and frequently mistaken for pancreatic pseudocysts. Recently if the patient is a good surgical candidate and is symptomatic, resection is the treatment of the choice without the cytological and chemical analysis by the fine needle aspiration. But, we have no data in Korean population. The aim of this study was to evaluate the subclassification of the cystic tumors of the pancreas and the differential points between pancreatic pseudocysts and cystic tumors of the pancreas which had to be operated. METHODS: fifty-nine patients with cystic lesions of the pancreas have been operated at the Samsung Seoul Hospital from 1994 to 1999 and evaluated about the subclassification, frequency and the difference between pseudocysts and cystic tumors retrogradely. RESULTS: There were 14 mucinous cystic neoplasms (mucinous cystadenomas : 11 cases, mucinous cyst-adenocarcinomas : 3 cases), 10 serous cystadenomas, 9 solid and papillary epithelial neoplasms, 8 intra-ductal papillary mucinous neoplasms, 5 pseudocysts, 4 retention cysts, 3 endocrine tumors, 1 pancreatic ductal adenocarcinoma with cystic change, 1 solid pseudopapillary tumor, 1 pancreatic ductal adenocarci-noma with pseudocyst, 1 cavernous lymphangioma, 1 lymphoepithelial cyst and 1 simple cyst. 57.6% of the patients were females and the mean age was 50.0 years (16 years-77 years). The characteristics between pseudocysts and cystic tumors of the pancreas (sex differentiation, mean age, previous history of alcohol drinking and pancreatitis, communication with the main duct on the pancreatogram and the sign of the pancreatitis on the radiologic study) had no differences. CONCLUSION: We conclude there were no other methods to differentiate accurately the pseudocyst from the cystic tumor of the pancreas other than the operation.
Adenocarcinoma ; Alcohol Drinking ; Biopsy, Fine-Needle ; Cystadenoma ; Cystadenoma, Serous ; Female ; Humans ; Lymphangioma ; Mucins ; Neoplasms, Glandular and Epithelial ; Pancreas* ; Pancreatic Ducts ; Pancreatic Pseudocyst ; Pancreatitis ; Seoul

Tubo-ovarian abscess is an end-stage disease of acute pelvic inflammatory disease (PID). Since most cases of PID are caused by sexually transmitted microorganisms, this is very rare in children. Here, we report an 1 1/2-year-old girl with bilateral tubo-ovarian abscesses. She was admitted to our Department with chief complaints of fever, vomiting and diarrhea. Abdominal ultrasonography and CT scanning of the patient showed solid and cystic masses in pelvic cavity. It was very difficult to differentiate the lesions from abscess and tumor. In addition, intravenous pyelography (IVP) and abdominal CT scanning of the patient showed both hydronephrosis and ureteral dilatation. Because of severe visceral adhesions, we could not perform laparoscopic examination of the pelvic masses. By exploratory operation and frozen biopsy, the masses were confirmed as tubo-ovarian abscesses and they were drained. In the bacterial culture, K. pneumoniae and E. coli were grown. The patient was treated with sensitive antibiotics and recovered from her disease. After 4 weeks of operation, IVP showed no abnormal findings and voiding cystourethrography (VCUG) showed grade I vesicoureteral reflux of the left side. It was suggested the hydronephroses were developed by the ureteral obstruction of tubo-ovarian abscesses.
Abscess* ; Anti-Bacterial Agents ; Biopsy ; Child ; Diarrhea ; Dilatation ; Female* ; Fever ; Glycogen Storage Disease Type VI ; Humans ; Hydronephrosis ; Pelvic Inflammatory Disease ; Pneumonia ; Tomography, X-Ray Computed ; Ultrasonography ; Ureter ; Ureteral Obstruction ; Urography ; Vesico-Ureteral Reflux ; Vomiting