PURPOSE: To evaluate the efficacy of two excimer laser systems with eye-tracker in the term of decentration amount. METHODS: We performed LASIK with LaserScan LSX(TM) (group 1, 39 eyes) and Allegretto Wave(TM) (group 2, 94 eyes), both of which were equipped with eye-tracker. The amount of decentration was measured on a difference map that was obtained from preoperative and postoperative corneal topography, and was compared between the two groups. RESULTS: The amount of decentration was significantly higher in group 1 (0.39 +/- 0.22 mm) than in group 2 (0.29 +/- 0.18 mm) (p=0.018). When these groups were subdivided by preoperative spherical equivalent, in case of under -6.0 D, the amount of decentration between the two groups (0.31 +/- 0.16 mm in group 1, 0.28 +/- 0.15 mm in group 2, p=0.380), whereas in case of over -6.0 D, the amount of decentration was significantly higher in group 1 (0.48 +/- 0.26 mm) than in group 2 (0.30 +/- 0.21 mm) (p=0.020). CONCLUSIONS: Allegretto Wave(TM) showed better centration ability than LaserScan LSX(TM) and this superiority was more profound in highly myopic eyes.
Corneal Topography ; Keratomileusis, Laser In Situ* ; Lasers, Excimer

PURPOSE: To compare the influences on the cornea between the WhiteStar mode and the continuous mode in the Sovereign(R) phacoemulsification unit after cataract surgery using temporal clear corneal incisions. METHODS: This study comprised 46 eyes of 23 patients who had cataracts in both eyes with similar grades of nucleosclerosis. The WhiteStar mode was used in one eye, and the continuous mode was used in the other eye. Pachymetry at the corneal center and 2 mm from the temporal limbus was performed. Topography and specular microscopy were performed, and surgically induced astigmatism was calculated using the Holladay-Cravy-Koch formula by simulated keratometric readings of Humphrey topography. Effective phaco time and average phaco power were recorded. RESULTS: Changes of corneal thickness at the center of the eye and at the incision site were significantly lower in the WhiteStar mode than in the continuous mode at 1 month postoperatively. However, there was no significant difference in corneal thickness at either site and in other parameters measured at 2 months postoperatively. The effective phaco time in the WhiteStar mode was significantly lower than in the continuous mode for cataracts with a high grade of nucleosclerosis. CONCLUSIONS: The early postoperative corneal edema in the WhiteStar mode was less than in the continuous mode. However, there was no remarkable difference in corneal endothelial damage. The effectiveness of phacoemulsification in the WhiteStar mode was superior to that in the continuous mode, especially for dense cataracts.
Astigmatism ; Cataract ; Cornea* ; Corneal Edema ; Endothelium, Corneal ; Humans ; Microscopy ; Phacoemulsification ; Reading

PURPOSE: The aim of this study is to evaluate the T2 value of the articular cartilage of the glenohumeral joint in rotator cuff disease displayed on 3.0T MRI and to apply it in clinical practice. MATERIALS AND METHODS: This study involved sixty-two patients who underwent shoulder MRI containing T2 mapping. The mean T2 value was measured by placing a free hand ROI over the glenoid or humeral cartilage from the bone-cartilage interface to the articular surface on three consecutive, oblique coronal images. The drawn ROI was subsequently divided into superior and inferior segments. The assessed mean T2 values of the articular cartilage of the glenohumeral joint were compared and evaluated based on the degree of rotator cuff tear, the degree of fatty atrophy of the rotator cuff, and the acromiohumeral distance. RESULTS: ICC values between two readers indicated moderate or good reproducibility. The mean T2 value for the articular cartilage of the glenoid and humeral head cartilage failed to show any significant difference based on the degree of rotator cuff tear. However, the mean T2 values of articular cartilage, based on fatty atrophy, tended to be higher in fatty atrophy 3 or fatty atrophy 4 groups while some sub-regions displayed significantly higher mean T2 values. There was no correlation between the acromiohumeral distance and the mean T2 values of the articular cartilage of the glenoid and humeral head. CONCLUSION: T2 mapping of the glenohumeral joint failed to show any significant difference in quantitative analysis of the degenerative change of the articular cartilage based on the degree of rotator cuff tear. However, it also offers quantitative information on the degenerative change of cartilage of the glenohumeral joint in patients with rotator cuff tear and severe fatty atrophy of the rotator cuff.
Atrophy ; Cartilage ; Cartilage, Articular ; Hand ; Humans ; Humeral Head ; Magnetic Resonance Imaging ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Tears

BACKGROUND: Carcinoembryonic antigen (CEA), a serological marker of malignant tumors, demonstrates a modest increase under nonmalignant conditions such as aging and smoking. Also, recent study results suggested that serum CEA levels may be related to insulin resistance or low-grade inflammation. The aim of this study was to investigate the factors associated with serum CEA levels in healthy non-smokers. METHODS: Data was gathered from 21,501 adults aged 20 and over. We excluded 19,081 subjects who had omissions in anthropometric measurements or laboratory tests, or who had previous or current smoking history. RESULTS: The mean CEA level was 1.18 +/- 0.85 ng/dL in males and 0.93 +/- 0.73 ng/dL in females. After adjustment for age, CEA level was positively correlated with fasting glucose, glycosylated hemoglobin (HbA1C), high density lipoprotein (HDL) cholesterol, estimated glomerular filtration rate in males. In females, CEA level was positively correlated with fasting glucose, HbA1C, HDL cholesterol, aspartate aminotransferase, and high-sensitivity C-reactive protein. In both gender groups, HbA1C had a strong influence on CEA levels when all other variables were included in the regression model (P < 0.05). CONCLUSION: Within normal range, serum CEA levels were significantly associated with HbA1C levels but not with homeostasis model assessment of insulin resistance in the non-smoking population. These findings suggest that serum CEA levels are influenced by the glucose level itself instead of insulin resistance.
Adult ; Aging ; Aspartate Aminotransferases ; C-Reactive Protein ; Carcinoembryonic Antigen* ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Fasting ; Female ; Glomerular Filtration Rate ; Glucose ; Hemoglobin A, Glycosylated ; Homeostasis ; Humans ; Inflammation ; Insulin Resistance ; Lipoproteins ; Male ; Reference Values ; Smoke ; Smoking

PURPOSE: To determine the significance of nerve root contrast enhancement in patients with residual or recurrent symptomatic postoperative lumbar spine. MATERIALS AND METHODS: Eighty-eight patients with 116 postoperative lumbar disc lesions causing radiating back pain underwent enhanced MR imaging. Intradural nerve root enhancement was quantified by pixel measurement, and affected nerve roots were compared before and after contrast administration. Extradural nerve root enhancement was assessed visually, and nerve root enhancement and clinical symptoms were correlated. Associated lesions such as recurrent disc herniation, scar tissue, nerve root thickening and nerve root displacement were also evaluated. RESULTS: Of 26 cases(22.4%) involving intradural nerve root enhancement, 22 (84.6%) showed significant clinical symptoms (p=0.002). and of 59 (50.9%) demonstrating extradural enhancement, clinical symptoms showed significant correlation in 47 (79.7%) (p=0.001). Nerve root enhancement, including eleven cases where this was both intra-and extradural, showed highly significant association with clinical symptoms in 74 of the 116 cases (63.8%) (p=0.000). Among 33 cases (28.4%) of recurrent disc herniation, nerve root enhancement was observed in 28 (84.8%) and in 24 of these 28 (85.7%), significant correlation with clinical symptoms was observed (p=0.000). Where epidural fibrosis was present, correlation between nerve root enhancement and clinical symptoms was not significant (p>0.05). Nerve root thickening and displaced nerve root were, however, significantly associated with symptoms(87.2% and 88.6%, respectively). CONCLUSION: In patients with postoperative lumbar spine, the association between nerve root enhancement revealed by MRI and clinical symptoms was highly significant.
Back Pain ; Cicatrix ; Fibrosis ; Humans ; Magnetic Resonance Imaging* ; Nerve Tissue ; Spine*

PURPOSE: To provide fundamental data for screening for prior refractive surgery in donor cornea. METHODS: The corneal curvature map and pachymetric measurements were analyzed in 68 eyes that had undergone corneal refractive surgery. Differences in the corneal curvature of the center and periphery, differences in the corneal thickness of the center and periphery, and the shape factor on the curvature map in postoperative eyes were compared with preoperative measurements. RESULTS: Measurement of the central corneal curvature subtracted from the peripheral corneal curvature was -1.64 +/- 0.71D in the preoperative eyes and 3.10 +/- 1.68D in the postoperative eyes. With a criterion of -0.23D, the sensitivity and specificity were 100% and 98.5%, respectively. The shape factor was 0.24 +/- 0.09 in the preoperative eyes and -0.82 +/- 0.45 in the postoperative eyes. With a criterion of 0.058, the sensitivity and specificity were both 100%. Measurement of the central corneal thickness subtracted from the peripheral corneal thickness was 97.60 +/- 25.42 micrometer in the preoperative eyes and 163.47 +/- 38.5 micrometer in the postoperative eyes. With a criterion of 123.0 micrometer, the sensitivity and specificity were 89.7% and 88.4%, respectively. CONCLUSIONS: Regional differences in corneal curvature and shape factor may be very useful parameters in screening for prior refractive surgery in donor cornea. The difference in corneal thickness may also be a useful parameter.
Cornea ; Humans ; Mass Screening* ; Refractive Surgical Procedures* ; Sensitivity and Specificity ; Tissue Donors

Sebaceous neoplasms are rare adnexal tumors that can present a challenge to clinicians. Only four cases of sebaceous carcinoma with sebaceoma have been reported in the literature. Herein, we describe the case of a sebaceous carcinoma originating from a sebaceoma in a solitary nodule of the posterior neck. Immunohistochemically, the tumor cells were strongly positive for epithelial membrane antigen and p53. It is possible that adnexal carcinomas may arise from malignant transformation of their benign counterparts as well as de novo. Malignant transformation was likely in this case because the lesion was composed of distinct benign and malignant components, and the benign component showed the typical histopathological features of sebaceoma. This case underscores the fact that partial and superficial biopsies sometimes may not provide the correct diagnosis. If a surgeon suspects malignancy based on a clinical examination, then it is mandatory to perform a deep biopsy.

When planning oral rehabilitation for maxillary edentulous patients, fixed prosthetic restoration using implants, complete denture restoration or overdentures using implants can be considered as treatment methods. In the case of complete denture restoration, it does not require additional surgery and is relatively economical. In the case of implant-supported fixed prostheses, the functional part is generally superior to that of complete denture restoration, but there are cases in which implant placement is clinically difficult. Recently in consideration of the patient’s needs and the condition of the remaining alveolar bone, after partial implant placement, a method of restoring with a removable partial denture using implant-supported surveyed crown is also being attempted. This case is a case of performing a removable partial denture restoration using implant-supported surveyed crown in the anterior maxilla, and showing satisfactory esthetic and functional results.

Sebaceous neoplasms are rare adnexal tumors that can present a challenge to clinicians. Only four cases of sebaceous carcinoma with sebaceoma have been reported in the literature. Herein, we describe the case of a sebaceous carcinoma originating from a sebaceoma in a solitary nodule of the posterior neck. Immunohistochemically, the tumor cells were strongly positive for epithelial membrane antigen and p53. It is possible that adnexal carcinomas may arise from malignant transformation of their benign counterparts as well as de novo. Malignant transformation was likely in this case because the lesion was composed of distinct benign and malignant components, and the benign component showed the typical histopathological features of sebaceoma. This case underscores the fact that partial and superficial biopsies sometimes may not provide the correct diagnosis. If a surgeon suspects malignancy based on a clinical examination, then it is mandatory to perform a deep biopsy.

A lung hernia, defined as the protrusion of pulmonary tissue and pleural membranes through a defect in the thoracic wall, is a rare event. It can be congenital or acquired, and cervical, thoracic, or diaphragmatic in location. We report the rare occurrence of a congenital atraumatic lung herniation through the azygoesophageal recess. An 8 -month-old male infant, who was born at 3 5 weeks gestation, had a chronic cough. Chest radiography showed haziness at the right lower lobe of the lung (RLL). Chest computed tomography (CT) revealed herniation of the RLL through the azygoesophageal recess. If persistent unilateral haziness is observed on chest radiography, the possibility of lung herniation should be considered.
Child ; Cough ; Hernia ; Humans ; Infant ; Lung ; Male ; Membranes ; Pregnancy ; Thoracic Wall ; Thorax