PURPOSE: To compare the levels of calcium and phosphorus in the aqueous humor and serum of diabetics and non-diabetics. METHODS: We divided patients into two groups: seventy-six non-diabetic cataract patients and fifty-two diabetic cataract patients. The diabetic group was divided again into three subgroups: twenty-six patients with no diabetic retinopathy, thirteen patients with non-proliferative diabetic retinopathy, and thirteen patients with proliferative diabetic retinopathy. The authors compared the levels of calcium and phosphorus in the serum and aqueous humor of cataract patients. Statistic analysis was performed to form two comparisons: 1) a comparison between non-diabetics and diabetics and 2) a comparison among non-diabetics and the three subgroups of diabetics. RESULTS: In serum, calcium levels did not statistically differ between non-diabetics and diabetics. The phosphorus level was also not significantly different. In the aqueous humor, however, while calcium levels did not differ significantly, the phosphorus levels in diabetics were considerably higher than those in non-diabetics. When non-diabetics were compared to the three diabetic subgroups, calcium levels did not differ in serum or aqueous humor, but the phosphorus levels in diabetics with proliferative diabetic retinopathy were significantly higher than those in non-diabetics, diabetics without diabetic retinopathy, and diabetics with non-proliferative diabetic retinopathy. CONCLUSIONS: The level of phosphorus in the aqueous humor and serum of diabetics was significantly increased, especially in diabetics with proliferative diabetic retinopathy. This result may be related to hydrophilic acrylic IOL opacification. Future studies regarding the pathogenic role of a high concentration of aqueous humor and serum phosphorus are required.
Aged ; Aged, 80 and over ; Aqueous Humor/*chemistry ; Biological Markers/analysis ; Calcium/*analysis ; Cataract/complications/*metabolism ; Diabetic Retinopathy/complications/*metabolism ; Female ; Humans ; Male ; Middle Aged ; Phosphorus/*analysis ; Regression Analysis ; Retrospective Studies

PURPOSE: To compare the levels of calcium and phosphorus in the aqueous humor and serum of diabetics and non-diabetics. METHODS: We divided patients into two groups: seventy-six non-diabetic cataract patients and fifty-two diabetic cataract patients. The diabetic group was divided again into three subgroups: twenty-six patients with no diabetic retinopathy, thirteen patients with non-proliferative diabetic retinopathy, and thirteen patients with proliferative diabetic retinopathy. The authors compared the levels of calcium and phosphorus in the serum and aqueous humor of cataract patients. Statistic analysis was performed to form two comparisons: 1) a comparison between non-diabetics and diabetics and 2) a comparison among non-diabetics and the three subgroups of diabetics. RESULTS: In serum, calcium levels did not statistically differ between non-diabetics and diabetics. The phosphorus level was also not significantly different. In the aqueous humor, however, while calcium levels did not differ significantly, the phosphorus levels in diabetics were considerably higher than those in non-diabetics. When non-diabetics were compared to the three diabetic subgroups, calcium levels did not differ in serum or aqueous humor, but the phosphorus levels in diabetics with proliferative diabetic retinopathy were significantly higher than those in non-diabetics, diabetics without diabetic retinopathy, and diabetics with non-proliferative diabetic retinopathy. CONCLUSIONS: The level of phosphorus in the aqueous humor and serum of diabetics was significantly increased, especially in diabetics with proliferative diabetic retinopathy. This result may be related to hydrophilic acrylic IOL opacification. Future studies regarding the pathogenic role of a high concentration of aqueous humor and serum phosphorus are required.
Aged ; Aged, 80 and over ; Aqueous Humor/*chemistry ; Biological Markers/analysis ; Calcium/*analysis ; Cataract/complications/*metabolism ; Diabetic Retinopathy/complications/*metabolism ; Female ; Humans ; Male ; Middle Aged ; Phosphorus/*analysis ; Regression Analysis ; Retrospective Studies

PURPOSE: To investigate the difference in corneal endothelial cell loss between diabetic and non-diabetic patients who were divided by the degree of phacoemulsification time after phacoemulsification with intraocular lens implantation. METHODS: Forty eyes of 30 patients with diabetes and 47 eyes of 36 patients without diabetes were divided by phacoemulsification time into 3 groups: less than 40 seconds, from 40 to 80 seconds and over 80 seconds. The corneal endothelial cell density was compared before and 1, 4 and 16 weeks after phacoemulsification by one-way ANOVA. Bivariate correlation analysis was used to identify the correlation between phacoemulsification time and the endothelial density before and 1, 4 and 16 weeks after phcoemulsification. RESULTS: The endothelial cell densities in diabetic and non-diabetic patients with different phacoemulsification time were not significantly different when compared before and 1, 4 and 16 weeks after phacoemulsification (P>0.05). Phacoemulsificaiton time and endothelial cell loss at 1, 4 and 16 weeks also showed no significant correlation. CONCLUSIONS: Diabetes and differences in phacoemulsification time had no significant influence on corneal endothelial cell loss. This result suggests uncomplicated phacoemulsificaion is a safe method for cataract extraction in patients with or without diabetes.
Cataract ; Cataract Extraction ; Cornea ; Corneal Endothelial Cell Loss ; Endothelial Cells* ; Endothelium ; Humans ; Lens Implantation, Intraocular ; Phacoemulsification*

Tubular apocrine adenoma and papillary eccrine adenoma are rare sweat gland neoplasms that appear as a small solitary lesion on the scalp or extremities, respectively. Although these lesions are thought to be distinct entities, there are enough similarities between them to group them under the term tubulopapillary hidradenoma or papillary tubular adenoma. We describe a case showing many tubular structures with papillary projection, syringocystadenoma-like structures, and eccrine hirocystoma-like structures in the axillary area. The term of papillary tubular adenoma or tubulopapillary hidradenoma may be prefered in this case.
Acrospiroma ; Adenoma* ; Extremities ; Scalp ; Sweat Gland Neoplasms

PURPOSE: The aim of this study was to compare three types of hernioplasty using a mesh: Lichtenstein, Mesh-plug and Prolene Hernia System. METHODS: From February 2002 to April 2007, we retrospectively studied the clinical outcome of 138 cases of adult inguinal hernia patients who had operations performed with the use of mesh. Three types of mesh operations were composed of Lichtenstein repair group (LR group; N=18), Mesh plug repair group (MR group; N=38) and Prolene hernia system group (PHS group; N=82). The Clinical features and outcomes of the three groups were compared by age, sex, operation time, lengths of hospital stay, numbers of post-operative intravenous analgesics, complications, and recurrence. RESULTS: Mean age of three groups was 50.2+/-20.7, 51.0+/-18.4 and 61.5+/-15.9 years for LR. MR, PHS groups, respectively. The PHS group was significantly older than other two groups (P=0.002). The sex, operation time and lengths of hospital stay were not significantly different among the three groups. Numbers of intravenous analgesics used after the operations were 1.7+/-1.2, 2.7+/-2.2, 3.3+/-2.0 in the LR, MR, PHS groups, respectively. A lesser amount of IV analgesics was injected into the LR group than the PHS group. Although some complications occurred such as wound infection, hematoma, dehiscence, testicular edema in the three groups, there were no significant differences among the three groups. There were no recurrences in all three groups. CONCLUSION: We could not find any better outcome among the LR, MR and PHS groups.
Adult ; Analgesics ; Edema ; Hematoma ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Polypropylenes ; Recurrence ; Retrospective Studies ; Wound Infection

No abstract available.
Cesarean Section* ; Female ; Pregnancy ; Pulmonary Embolism*

BACKGROUND: Baseline prostate volume (PV) is related with the progression of benign prostatic hyperplasia (BPH). Although recent studies have reported the relationship between BPH and metabolic syndrome, the findings are inconsistent. Thus, this study was performed to investigate the association of PV with metabolic factors and prostate-specific antigen (PSA) in individuals with normal PV and clarify the factors associated with benign prostate enlargement (BPE), including PSA. METHODS: We selected 3,915 health examinees aged >40 yr with a PSA level <4 ng/mL who underwent ultrasonography of the prostate as part of a routine health check-up. These individuals were classified into two groups according to PV: normal PV (PV <30 mL) and BPE (PV > or =30 mL). We investigated the association of PV with metabolic factors and PSA using multiple linear regression analysis, and clarified the factors associated with BPE using logistic regression analysis. RESULTS: The factors associated with PV were PSA, age, and waist circumference in individuals with normal PV. The factors associated with BPE were age, body mass index (BMI), and PSA. The logistic regression analysis adjusted for age and confounding factors showed that individuals with a BMI of 23-24.9 kg/m2, 25-29.9 kg/m2, and > or =30 kg/m2 had higher odds ratios of 1.580 (95% confidence interval, 1.171-2.131; P=0.003), 1.767 (1.332-2.344; P<0.001), and 2.024 (1.042-3.933; P=0.038), respectively, for BPE than individual with a BMI <23 kg/m2. CONCLUSIONS: Abdominal obesity was significantly associated with PV in individuals with normal PV, whereas obesity was an associated metabolic factor of BPE. PSA level was positively associated with PV.
Body Mass Index ; Linear Models ; Logistic Models ; Obesity ; Obesity, Abdominal ; Odds Ratio ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Ultrasonography ; Waist Circumference

The effect of hyperbaric tetracaine spinal anesthesia was studied in 40 patients having genitourinary surgery in the horizontal lithotomy position. Patients were randomly assigned to one of two groups, after spinal injection, patients in one group were placed immediately in the supine and horizontal lithotomy position, and patients in the second group were placed immediatley in the supine and horizontal position for 10 minutes and then placed into the horizontal 1thotomy position. There were no statistically significant differences in anesthesia sensory level and heart rate of patients placed immediately in the horizontal lithotomy position compared to the patients kept in the supine position for the first 10 minutes after receiving the spinal anesthetic. The ranges of systolic blood pressure were all within normal limits, although systolic blood pressure showed a difference at 5,10 and 60 minute intervals after anesthesia. We conclude that immediate application of the horizontal lithotomy position can be safely practiced in the anesthesia of genitourinary surgery.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Heart Rate ; Humans ; Injections, Spinal ; Supine Position ; Tetracaine*

PURPOSE: The Sentinel lymph node (SLN) is the first draining node from the primary lesions, and is the first site of lymph node metastasis in malignancies. The aim of this study was to determine the feasibility of a SLN biopsy in patients with gastric cancer to assess the regional lymph node status. METHODS: A SLN biopsy was performed in 46 consecutive gastric cancer patients, with preoperative imaging stages of T1/T2, N0 and M0. Three hours prior to each operation, a (99m)Tc tin-colloid (2.0 ml, 1.0 mCi) was endoscopically injected into the gastric submucosa around the primary tumor. Subsequently, serial lymphoscintigraphy was performed using a dual head gamma camera. After the SLN biopsy had been performed using a gamma probe, the patients underwent a radical gastrectomy (D2 or D2+ alpha). The SLNs were cut and immediately frozen-sectioned. A paraffin block was then produced for permanent hematoxylin-eosin staining and immunohistochemistry (IHC). RESULTS: SLNs were successfully identified in 43 of the 46 patients (success rate, 93.5%), at an average of 2 (range, 1~8) per patient. The positive and negative predictive values, sensitivity and specificity of the SLN biopsy were 100 (11/11), 93.8 (30/32), 84.6% (11/13) and 100% (30/30), respectively. SLNs were located at the level I, I+II and II lymph nodes in 38 (88.4%), 2 (4.7%) and 3 (7.0%), respectively. No micrometastases of the SLNs was found on the IHC for cytokeratin. CONCLUSION: A sentinel lymph node (SLN) biopsy, using a radioisotope, in patients with gastric cancer is a technically feasible and accurate technique, and is a minimally invasive approach for assessing the nodal status in patients.
Biopsy* ; Gamma Cameras ; Gastrectomy ; Head ; Humans ; Immunohistochemistry ; Keratins ; Lymph Nodes ; Lymphatic Metastasis ; Lymphoscintigraphy ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Paraffin ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Stomach Neoplasms*

BACKGROUND: The effect of spinal nitric oxide (NO) on mechanical allodynia brought about by Freund's complete adjuvant (FCA)-induced inflammation is not known. From our previous experiment nitric oxide synthase (NOS) inhibitor nitroG-L-arginine methyl ester (L-NAME) given intraplantarly during the induction period decreased a mechanical hyperalgesia occurring because of FCA-induced inflammation. Therefore, we investigated the spinal effect of NO on mechanical allodynia after the development of allodynia produced by FCA-induced inflammation in rats. METHODS: Male Sprague Dawley rats were prepared with lumbar intrathecal catheter implantation. Inflammation was induced in the rats by injecting 0.1 ml of FCA under halothane anesthesia. Behavioral tests were done 1, 3, 6, 24, and 48 hours after injection of FCA. In the other group, intrathecal L-NAME (10 microgram) was given prior to FCA injection to examine the effect of pretreatment. On postinjection day 2, either L-NAME (10 microgram) or methylene blue (10 and 30 microgram) was administered intrathecally after the baseline measurement. The withdrawal response on mechanical allodynia was assessed by applying von Frey filaments to the right lesioned hindpaw and contralateral paw (as control) at 15, 30, 45, 60, 90, and 120 minutes. Sodium nitroprusside was administered intrathecally to determine the reversal effect of increased threshold in the L-NAME group. RESULTS: Injection of FCA produced a significant mechanical allodynia over time. Pretreatment with L-NAME did not prevent such a mechanical allodynia. Intrathecal L-NAME, but not methylene blue, reduced the mechanical allodynia, which was reversed by sodium nitroprusside. CONCLUSIONS: Spinal NO is likely invloved in the mechanism of the development and maintenance of mechanical allodynia in a state of FCA-induced inflammation.
Anesthesia ; Animals ; Catheters ; Halothane ; Humans ; Hyperalgesia* ; Inflammation* ; Male ; Methylene Blue ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroprusside ; Rats ; Rats, Sprague-Dawley