PURPOSE: The purpose of this study is to evaluate the difference of tear EGF(epidermal growth factor) concentration between in dry eyes and normal ones, and the relationship between the tear EGF concentration and the severity of corneal epithelial lesion in dry eyes. METHODS: In 43 normal eyes and 52 dry eyes, tear samples were collected with polyester rod(Transob) from the lower fornix after topical anesthesia. EGF concentration was determined by ELISA(enzyme linked immunosorbent assay). Other methods of dry eye examination were also used which include Schir-mer I test, measurement of tear film break up time and fluorescein scoring of corneal epithelial lesion. RESULTS: Tear EGF concentration was significantly lower in dry eyes with corneal epithelial lesion than in normal eyes or dry eyes without corneal epithelial lesion(P<0.05). There was a significant correlation between tear EGF concentration and the severity of corneal epithelial lesion in dry eyes(r=-0.65, P<0.05). In dry eyes with corneal epithelial lesion, tear EGF concentration decreased, which was correlated with the severity of corneal epithelial lesion. CONCLUSIONS: These findings suggest that EGF may be included in the therapeutic armamentarium of dry eyes with corneal erosion.
Anesthesia ; Dry Eye Syndromes ; Epidermal Growth Factor* ; Fluorescein ; Polyesters ; Tears*

BACKGROUND: Lowe and Ernst's square root of time model employs direct injection of liquid agent into breathing circuit for low flow anesthesia. Intermittent injections of the agent by Lowe's method change rapidly arterial partial pressure of the agent and fail to maintain hemodynamic stability to surgical stimuli. We designed to investigate the possibility and safety of low flow anesthesia with continuous infusion of liquid enflurane into breathing circuit. METHODS: Twenty patients, ASA physical status I or II, undergoing gastrectomy under inhalational general anesthesia were randomly divided into two groups. Anesthesia was maintained with a fresh gas flow of O2 500 ml/min and continuous infusion of liquid enflurane. An identical semiclosed Dr ger circle anesthesia system was used to all patients. Liquid enflurane calculated by the Lowe's method (group I) or simplified by patient's weight (group II) was continuously infused directly into inspiratory limb of breathing circuit using syringe pump. Inspiratory and expiratory concentrations of enflurane, enflurane consumptions, hemodynamic parameters, carboxyheomoglobin were checked intraoperatively. Hepatic and renal functions were evaluted postoperatively. RESULTS: Liquid enfurane was initially infused at a rate in ml/hr of 16.1 0.8 weight in kg in group I and 1.0 weight in kg in group II. After 5 minutes the infusion rate was reduced to 20% of this value and then well adjusted to maintain blood pressure within 20% of the reference preoperative value. Enflurane consumptions and recovery time were similar between the two groups. There were no clinical significant changes in arterial blood gas, carboxyheomoglobin, and hepatic and renal functions. CONCLUSIONS: These data show that low flow anesthesia with continuous infusion of liquid enflurane into breathing circuit is safe and effective, and that the infusion method simplified by patient's weight may easily be applied to clinical practice for low flow anesthesia.
Anesthesia* ; Anesthesia, General ; Blood Pressure ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Partial Pressure ; Respiration* ; Syringes

PURPOSE: The purpose of this study was to analyze the relationship between apoptotic index and clinicopathological findings in laryngeal squamous cell carcinomas. MATERIALS AND METHODS: Fourty-one cases of laryngeal squamous cell carcinomas were analyzed for the detection of apoptotic bodies by in situ hybridization. RESULTS: The average apoptotic index was 9.38+/-2.89. The apoptotic indices were 11.26+/-1.86, 8.17+/-2.55, and 4.32+/-2.41 in well differentiated, moderately differentiated and poorly differentiated carcinoma, respectively. The histopathological differences and apoptotic index were statistically significant(p<0.05). But there was no relationship between apoptotic index and T stage, nodal status, recurrence and treatment results. CONCLUSION: The apoptotic index was only related to cellular differentiation. Also these results suggest that the numbers of apoptotic bodies in the tumor tissues can make it possible to presume indirectly the malignant potentiality of the tumor and will help us to understand the biologic behavior of head and neck cancer.
Apoptosis ; Carcinoma, Squamous Cell* ; Head and Neck Neoplasms ; In Situ Hybridization ; Recurrence

In a placebo-controlled trial, we have studied the vasodilator properties of bolus dose of nitroglycerin, isosorbide dinitrate and chlorpromazine in 38 patients during cardiopulmonary bypass with a constant pump flow. Mean arterial pressure and blood volume of the venous reservoir were recorded for 10 min after drug administration to detect changes in arteriolar resistance and venous capacitance, respectively. Nitroglycerin, 2.5 ug/kg, decreased arterial pressure, but the effect lasted for 3 minutes. Chlorpromazine, 0.1 mg/kg, decreased arterial pressure for 9 minutes. Isosorbide dinitrate, 20 ug/kg, had no significant change on arterial pressure. The venous capacitance-increasing effects of nitroglycerin and chlorpromazine were significant for 4 minutes after the bolus. Thereafter the effect of nitroglycerin began to decline, while that of chlorpromazine significantly continued. Isosorbide dinitrate had no significant change on venous reservoir level. The SVR reduction effects of nitroglycerin was significant for 3 minutes, chlorpromazine decreased SVR for over 10 minutes. In conclusion chlorpromazine effect on arterial pressure and venous capacitance was more potent and longer than nitroglycerin and isosorbide dinitrate. Nitroglycerin and chlorpromazine effect on preload and afterload were significant after bolus dose.
Arterial Pressure ; Blood Volume ; Cardiopulmonary Bypass ; Chlorpromazine* ; Humans ; Isosorbide Dinitrate* ; Isosorbide* ; Nitroglycerin* ; Vascular Access Devices

For anesthesia of sixty children undergoing elective tonsillectomy, we randomly assigned the patients as 2 groups, intravenous propofol for induction and 6-12 mg/kg/hr propofol infusion with 66% nitrous oxide for maintenance(propofol group) or intravenous 4 mg/kg thiopental for induction and inhalation of enflurane with 66% nitrous oxide for maintenance(enflurane group). We compared the effects of two groups for induction time, hemodynamic change, recovery time, and side effects. The results were as follows. 1) Time for loss of eyelid reflex was significantly shorter in enflurane group than in propofol group(P <0.05). 2) Heart rate was increased significantly in both groups at 1 min after intubation, 1 min after operation, 5min after end of operation(P< 0.05). But there were no significant differences between groups. 3) Systolic and diastolic arterial pressure were increased significantly in both groups at 1 min after intubation(P<0.05). But there were no siginificant differences between groups. 4) The recovery time was shorter siginificantly in propofol group than in enflurane group(P< 0.05), and recovery scores according to modified Steward coma scale were higher in propofol group than in enflurane group until 25 min after end of anesthesia(P< 0.05). 5) Pain on injection at induction was siginificantly more frequent in propofol group than in enflurane group(P< 0.05), and excitatory effect during emergence was significantly more frequent in enflurane group than in propofol group(P< 0.05).
Anesthesia ; Arterial Pressure ; Child* ; Coma ; Enflurane* ; Eyelids ; Heart Rate ; Hemodynamics ; Humans ; Inhalation ; Intubation ; Nitrous Oxide ; Propofol* ; Reflex ; Thiopental ; Tonsillectomy*

BACKGROUND: Lidocaine has been used for spinal anesthesia in short surgical procedure. However, transient neurologic symptoms (TNS) frequently occur after spinal anesthesia with lidocaine. Mepivacaine which has a silimar duration of action and rare incidence of TNS may be an alternative to lidocaine for spinal anesthesia. This study was designed to compare the efficacy of hyperbaric 1.5% lidocaine and 1.5% mepivacaine for spinal anesthesia. METHODS: Sixty patients, ASA physical status I or II, scheduled for lower abdominal or lower extremity procedures under spinal anesthesia were randomly allocated into two groups. Lidocaine group received 2% lidocaine 75 mg with 10% dextrose 1.25 ml. Mepivacaine group received 2% mepivacaine 75 mg with 10% dextrose 1.25 ml. After intrathecal injection of the anesthetics, sensorimotor block and recovery, cardiovascular effect and quality of surgical anesthesia were evaluated. TNS was evaluated 1 day after the operation. RESULTS: Both groups were similar with regard to demographic data and surgical procedures. The onset of sensory and motor blocks was similar in both groups. Time to regression to L5 sensory level and complete resolution of motor blockade were significantly prolonged in mepivacaine group than in lidocaine group (p<0.05). The effect of cardiovascular system was similar in both groups. Fentanyl was required for 4 cases only in the lidocaine group. None of both groups developed TNS. CONCLUSIONS: Hyperbaric 1.5% mepivacaine produced longer duration of action than hyperbaric 1.5% lidocaine in spinal anesthesia. This study didn't prove what drug develops a higher incidence of TNS.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Cardiovascular System ; Fentanyl ; Glucose ; Humans ; Incidence ; Injections, Spinal ; Lidocaine* ; Lower Extremity ; Mepivacaine* ; Neurologic Manifestations

Frontal sinus osteoma is one of the rare diseases and is diagnosed incidentally by skull X-ray. After the disease is confirmed, long term follow-up is necessary. The etiology of the disease is usually unknown and almost all of the patients has any kind of symptoms or signs. The most of the symptoms of this disease are pain, headache, swelling and lagophthalmos. Frontal sinus osteoma has characteristic features such as radiopaque, mass like lesion in the frontal sinus. Operation of the frontal sinus osteoma is not necessary unless it has symptoms or infection sign. We experienced one case and operated the osteoma and reconstructed frontal sinus by cranialization and bihalving calvarial bone graft. The result is satisfactory without complication.
Follow-Up Studies ; Frontal Sinus* ; Headache ; Humans ; Osteoma* ; Rare Diseases ; Skull ; Transplants

Frontal sinus osteoma is one of the rare diseases and is diagnosed incidentally by skull X-ray. After the disease is confirmed, long term follow-up is necessary. The etiology of the disease is usually unknown and almost all of the patients has any kind of symptoms or signs. The most of the symptoms of this disease are pain, headache, swelling and lagophthalmos. Frontal sinus osteoma has characteristic features such as radiopaque, mass like lesion in the frontal sinus. Operation of the frontal sinus osteoma is not necessary unless it has symptoms or infection sign. We experienced one case and operated the osteoma and reconstructed frontal sinus by cranialization and bihalving calvarial bone graft. The result is satisfactory without complication.
Follow-Up Studies ; Frontal Sinus* ; Headache ; Humans ; Osteoma* ; Rare Diseases ; Skull ; Transplants

The cyto-histologic correlation and cytologic accuracy are reported in thirty cases of consecutive aspirated cells and their biopsied tissues of patients with clinical and neuroradiologic evidences of central nervous system tumors and other lesions investigated at the Pathology and Neurosurgery Department, Korea University Hospital, from Apr. 1987 to Apr. 1988. The series comprised of 17 benign and 12 malignant histopathologically verified brain neoplasms and 1 infectious lesion. In 78% of the cases, the cytologic diagnosis was concordant with the histologic diagnosis provided adequate sample was obtained. In 17 benign tumors, the diagnostic rate was 87% ; the diagnostic accuracy for 12 malignant CNS tumors was 63% cytologically. In almost all cases, differentiation of non-neoplastic lesion from neoplastic one and that of benign tumors from malignant ones were possible. Most discordance stemmed from failure to distinguish different types of malignant tumors. In meningioma, neurilemmoma, pituitary adenoma, and medulloblastoma, cytologic diagnostic accuracy was high, but germinoma, malignant ependymoma, and hemangioblastoma were difficult to diagnose by cytology alone.

PURPOSE: We evaluated the HPV type 16, 18 infection and p53 expression and MHC class Iantigen expression, and analyzed he relationship between HPV infection and p53 expression and MHC class I expression in laryngeal squamous cell carcinomas. MATERIALS AND METHODS: Thirty-nine cases of laryngeal squamous cell carcinomas and ten cases of laryngeal nodules were analyzed for detection of HPV DNA by in situ hybridization and the detection of p53 and MHC class I antigen by immunohistochemical technique. RESULTS: HPV DNA was detected in 10(26%), and p53 expression was detected in 19(49%) out of 39 cases in laryngeal squamous cell carcinomas. HPV positive cases showed 50% of p53 expression whereas HPV negative cases showed 48% expression. MHC class I down-regulation (heterogenous and negative expression) in HPV positive lesions was higher than HPV negative lesions, but there was no statistically significance. The expression of MHC class I was related to cellular differentiation regardless of T-stage and nodal involvement. CONCLUSION: There was no reiationship between HPV infection and p53 expression and MHC class I expression in laryngeal squamous cell carcinomas. Also these results suggest that MHC class I expression can make it possible to presume indirectly the malignant potentiality of the tumor.
Carcinoma, Squamous Cell* ; DNA ; Down-Regulation ; In Situ Hybridization