LASIK is an effective and exact procedure to correct myopic refractive error but fatal complication may be happened during making corneal flap using microkeratome. We report a patient who developed acute central stomal melting following LASIK on postoperative day 4. This complication was treated by lifting the flap and scraping the interface of corneal flap & central stroma with a metal blade. After 4 months, overcorrected hyperopic refractive error was retreated with excimer laser ablation and patient recovered successful visual acuity. The pathogenesis of this case is not completely understood. Corneal endothelium and central cornea stroma may be mechanically damaged due to excessive suction ring application during LASIK procedure. Interface epithelial ingrowth may be associated with early postoperative inflammation and infection of corneal flap may produce proteinase which melts corneal flap. If corneal flap melting happens after LASIK procedure, early surgical debridement of melting stroma and proper reattachment of the flap may be needed.
Cornea ; Debridement ; Endothelium, Corneal ; Freezing* ; Humans ; Inflammation ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Lifting ; Refractive Errors ; Suction ; Visual Acuity

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*

Aneurysmal bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with blood. This case, a eighteen years old female, complained of pain and swelling in the right lateral aspect of thigh. Roentgenograms showed a ballooned-out distension of the shaft of the femur, eccentric buldging of the cortex and soap-bubble appearance of interior of the lesion. The case was treated with radical curettage and autogenous bone graft with bone chips which were taken from the iliac wing. Pathological examination grossly and microscopically revealed an aneurysmal bone cyst. Patient made an uneventful recovery, and 11 months later she had no complaints and no evidence of recurrence.
Aneurysm ; Bone Cysts ; Curettage ; Female ; Femur ; Humans ; Recurrence ; Thigh ; Transplants

BACKGROUND: Three age-depedent clinical phases(infantile, childhood and adult phase) of atopic dermatitis(AD) were recognized. We think that for t he diagnosis of AD there seems to be some differences in minor clinical features of diagnosic significance according to each phase, yet only a few studies about them. OBJECTIVES: The purprrse of the present study was to evalute the diagnostic significance of total 39 minor clinical features of AD in Korean adolescenc and adult popluation, all but only skin were proposed by our previous study for Korean children. METHODS: The frequeney of 39 minor clinical features wistudied in 82 patients with typical AD compared to that in 109 control subjects. The age all studied individuals ranged from 13 to 42 years. Furthermore, some characteristic micro features of AD in them were compared with those from our previous study for Korean children. RESULTS: Twenty-seven minor features including xerosis, peifolhcular accentuation, frontal lichenification, anterior neck folds, eyelid eczema, Dennie-Mogan folds, auricular fissure/eczema, pityriasis alba, ventiral wrist eczema, infragluteal eczcm, sandpaper-like skin lesions on elbow/knee/lateral malleblus, white dermographism, scalaling, Hertoghes sign, orbital darkening, cheilitis, facial erythema/pallor, hyperlinear paln, ichthyosiform skin lesions, nipple eczema, nummular eczema, pompholyx, itchy hyperker totic lesions of dorsal hands, knuckle dermatitis of hands, hangnail, non-specific hand/foot dermatitis, chronic dermatophytosis were shown to be of much diagnostic signiic, nce(P<0.001). CONCLUSION: We think tiat 13 minor features such as Hert piges sign, cheilitis, facial erythe- mapallor, hyperlinear ichthyosiform skin lesions, ripile eczema, nummular eczema, pompholyx, itchy hyperkpratotic lesions of dorsal hands, kzukle dermatitis of hands, hangnail, non-specific hand/foot dermatitis, chronic dermato h tosis are specific for Korean adolescence and adult population with AD. Taken together, to propose that these 13 minor features be added to a gardeline for the large scale field sirvy on the incidence and prevalence of AD in the Korea adolescence and adult population.
Adolescent* ; Adult* ; Cheilitis ; Child ; Dermatitis ; Dermatitis, Atopic* ; Diagnosis ; Eczema ; Eczema, Dyshidrotic ; Eyelids ; Hand ; Humans ; Incidence ; Korea* ; Neck ; Nipples ; Orbit ; Pityriasis ; Prevalence ; Skin ; Tinea ; Wrist

No abstract available.
Stomach Neoplasms*

BACKGROUND: For the diagnoais of atopic dermatitis(AD) an array of basic and minor clinical features proposed by Hanifin and Rajka were in common use. However, there have been some disputes in the diagnostic significance of minor clinical features of AD due to ethni. differences, variance in definitions, materisls and methods, OBJECTIVES: The purpose of the present study was to evaluate the dignostic significance of total 38 minor clinical features of AD in Korean children. Most of them wefe roposed by some authors in the literature and the remainder by ourselves based on our clinical experienes. METHODS: The frequency of these features was studied in 48 patieni s with typical AD compared to that in 89 control subjects. The age of all studied individuals ranged from 2 to 12 years. RESULTS: Thirteen of these was including xerosis, perifollicular acccntuation, frontal lichenification, anterior neck folds, eyelid eczema, Dennie-Morgan folds, auricular fiss are/eczema, pityriasis alba, vertral wrist eczema, infragluteal eczema, sandpaper-like skin lesion of yelbow/knee/lateral malleolus, white dermographism, and scalp scaling were shown to be of mueh diag nostic significance(P<0,001). CONCLUSION: We propose that above-mentioned 13 monor features may be a valuable guideline for the large scale field survey on the incidence and prevalence of AD in Korea children.
Child ; Dermatitis, Atopic* ; Dissent and Disputes ; Eczema ; Eyelids ; Humans ; Incidence ; Korea* ; Neck ; Pityriasis ; Prevalence ; Scalp ; Skin ; Wrist

No abstract available.
Ligaments* ; Magnetic Resonance Imaging* ; Tendons* ; Transplants*

No abstract available.
DNA* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction*

BACKGROUND: Patients receiving an elective total knee replacement (TKR) are frequently older and immobilized. The related decline in respiratory function and structural changes may place these patients at an increased risk of perioperative pulmonary complications. METHODS: This study reviewed the data of 239 consecutive procedures performed by a single surgeon. The data examined included the patient's characteristics (age, gender, height, weight and body mass index [BMI]); concurrent pulmonary comorbidity (presence vs. absence); anesthetic techniques (general vs. spinal); types of operation (unilateral vs. bilateral); duration of operation (< 4 vs. > or = 4 hr); duration of tourniquet inflation (< 2 vs. > or = 2 hr); number of perioperative transfusions (< or = 4 vs. > or = 5 units); and American society of anesthesiologists (ASA) physical status. Pulmonary complications were grouped together as a single outcome. A Chi-square test and multiple logistic regression analysis were used to identify the risk factors. A P value < 0.05 was considered significant. RESULTS: Pneumonia, pulmonary edema, pulmonary congestion, atelectasis and pulmonary embolism were the pulmonary complications (n = 28; 11.7%) examined. Age, gender, BMI, pulmonary comorbidity, type and duration of surgery, duration of tourniquet inflation, anesthetic technique and ASA physical status were not associated with pulmonary complications. Only the number of packed cells transfused (> or = 5 units) was found to be associated with the pulmonary complications (odds ratio 5.21; P = 0.015). In particular, transfusions were related to pneumonia, pulmonary edema, pulmonary congestion and pulmonary embolism (P < 0.01). However, atelectasis was not related to any of the potential risk factors including the anesthetic technique. CONCLUSIONS: Transfusion requirements may be an important risk factor of the early postoperative pulmonary complications in patients receiving a TKR.
Arthroplasty, Replacement, Knee* ; Body Mass Index ; Comorbidity ; Estrogens, Conjugated (USP) ; Humans ; Inflation, Economic ; Logistic Models ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Edema ; Pulmonary Embolism ; Risk Factors* ; Tourniquets

BACKGROUND AND PURPOSE: Valproic acid (2-propylpentanoic acid) which enhances GABA synthesis and blocks it's degradation has been useful treatment of migraine and may activate GABA receptors to modulate trigeminal nociceptive neurons innervating the meninges. But the mechanism and action of sodium valproate in headache is not clear. To investigate the mechanism of valproic acid action in headache model, we compared the change of dural plasma protein extravasation in both substance-P neurogenic inflammation rats with valproic acid pretreatment and without valproic acid pretreatment. METHOD: Sprague-Dawely rats were pretreated with valproate 30 minutes prior to substance-P administration in order to test the effects of sodium valproate on dural plasma protein extravasation by detecting the amount of extravasated Evans blue in the dura matter. To examine the abilities of either bicuculine (GABAA antagonist) and phaclofen (GABAB antagonist) to reverse the effect of valproate, they were administered 5 min before valproate administration. After then we also test the effect of muscimol (GABAA agonist) and bicuculine (GABAA antagonist) in substance-P induced neurogenic inflammation rats. RESULTS: Intraperitoneal injection of sodium valproate and muscimol reduced dural plasma protein extravasation after intravenous substance-P administration. The GABAA antagonist bicuculine completely reversed the effect of valproate and muscimol on plasma extravasation following substance-P administration, whereas the GABAB receptor antagonist, phaclofen, did not. CONCLUSION: We concluded that the attenuation of dural plasma protein extravasation by valproate and muscimol is mediated by via GABAA receptors within the meninges. Agonists and modulators at the GABAA receptor may become useful for the development of selective therapeutic agents for migraine headache.
Animals ; Evans Blue ; gamma-Aminobutyric Acid ; Headache* ; Injections, Intraperitoneal ; Meninges ; Migraine Disorders ; Muscimol ; Neurogenic Inflammation ; Nociceptors ; Plasma ; Rats* ; Receptors, GABA ; Sodium* ; Valproic Acid*