PURPOSE: To evaluate the association with corneal thickness and corneal thinnest point using Orbscan topography. METHODS: One hundred and four eyes of the 52 normal subjects who were investigated using an Orbscan topography, were devided into following two groups ; one was inferonasal group which has the thinnest point in inferonasal quadrant(23 eyes, 22.1%), and the other was inferotemporal group which has the thinnest point in inferotemporal quadrant. (79 eyes, 76%) Among them, age-matched 30 eyes were randomly selected. The corneal thickness of two groups were measured at eight meridian of each point distant 1.0, 1.5, 2.0, 2.5, 3.0mm from corneal center. The thickest point and the thinnest point of cornea in two groups were compared and analysed. RESULTS: The thickest point of cornea in two groups was located in the superior portion. The thinnest quadrant was located in the inferonasal portion for inferonasal group and in the inferotemporal portion for inferotemporal group. CONCLUSIONS: The quadrant where the thinnest quadrant existed had the thinnest corneal thickness in comparing with any other quadrant.
Cornea

PURPOSE: We explored the prognostic significance of obesity for the surgical and hormonal treatment of prostate cancer in correlation with the other prognostic factors such as Gleason's sum, the clinicopathologic stage, and the pre- and post treatment prostate specific antigen (PSA) changes. MATERIALS AND METHODS: A retrospective review was performed on 132 consecutive patients who had received androgen deprivation therapy (ADT) (108 patients) or radical prostatectomy (24 patients) under the diagnosis of prostate cancer via transrectal prostatic biopsy from July 1993 to May 2003 in our hospital. Obesity was evaluated in terms of the body mass index (BMI), and the patients were categorized into four groups according to the National Institute of Health (NIH) classification. The relationship between the BMI and the other prognostic factors were statistically analyzed by One-way ANOVA test and the Spearman correlation coefficient. RESULTS: There were no significant associations between the BMI and any of the measured clinical and pathological parameters except for the time to hormone failure and biochemical recurrence. In the ADI group, the mean time to hormone failure was significantly longer in case of the low BMI group compared to the normal and overweight groups (p<0.006). Sperman's correlation analysis showed a significant inverse correlation between the BMI and the PSA free survival after radical prostatectomy. CONCLUSIONS: These findings showed that the BMI is closely related to the failure to hormone treatment after ADI and the BMI was also related to the biological failures after radical prostatectomy.
Biopsy ; Body Mass Index ; Classification ; Diagnosis ; Humans ; Obesity* ; Overweight ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms* ; Recurrence ; Retrospective Studies

This study was conducted to examine the species differences in the urinary excretion of trichloroethanol(TCE-OH) and trichloroacetic acid(TCA) of trichloroethylene(TCE) metabolites and the effect of ethanol on these metabolites in mice and rats. TCE administered to Male Sprague Dawley rats and ICR mice as a single oral dose(100, 200, 500, 1,000 or 2,000 mg/kg body weight) and ethanol(3.0 g/kg body weight) was taken orally 12 hours before TCE administration. The metabolites in urine were measured 0, 12, 24, 36 and 48 hours after TCE administration. The results of metabolite excretion were as follows; Total trichlorocompounds(TTC) in urine increased with TCE dose in mice while increased only below dose of 1,000 mg/kg TCE in rats. The net excretion of TCE metabolites was significantly greater in mice than rats, although the proportion of TCE-OH to TCA was not different between mice and rats. These findings indicate that mice were internally exposed to significantly higher concentration of TCE metabolites than rats and this trend appeared to be more prominent with the increase of TCE dose. Ethanol increased significantly TCE-OH in urine of rats while the increase of TCE-OH induced by ethanol was not significant in mice, and didn't increase TCA of urine in both of rats and mice. This result suggests that the effect of ethanol on TCE metabolism may be due to the increase of TCE-OH.
Animals ; Ethanol* ; Humans ; Male ; Metabolism ; Mice* ; Mice, Inbred ICR ; Rats* ; Rats, Sprague-Dawley ; Trichloroethylene*

OBJECTIVES AND METHODS: To directly examine the function of the endothelial cell(EC) and smooth muscle cell in umbilical arteries acquired from preeclampsia patients between June 1998 to November 1999, using a conventional tension measurement and bioassay experiment. RESULTS: Relaxation responses to EC-dependent relaxing agents including bradykinin and A23187 in human umbilical artery rings were significantly decreased in preeclampsia(p<0.01). Relaxation responses to EC-independent agents(SNP and SNAP) were also inhibited in umbilical artery rings acquired from preeclampsia patients(p<0.01). To test the change of endothelial cell function in preeclampsia without involvement of smooth muscle dysfunction, we used human umbilical artery and rabbit femoral artery as a donor and detector, respectively, in bioassay experiment. Relaxation responses to EC-dependent agents(A23187 and bradykinin) showed similar results to conventional tension measurement (p<0.01). Relaxation responses to 8-bromo-cGMP in human umbilical artery rings were also significantly decreased in preeclampsia(p<0.01). CONCLUSIONS: It can be concluded that increased vascular resistance in preeclampsia is not only due to the disturbance of endothelial function, but also to smooth muscle dysfunction.
Biological Assay ; Bradykinin ; Calcimycin ; Endothelial Cells ; Femoral Artery ; Humans ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Pre-Eclampsia* ; Relaxation* ; Tissue Donors ; Umbilical Arteries* ; Vascular Resistance

On video fluorescein angiogram, it is known that arm-to-retinal circulation(ART)influences retinal macrocirculation and arterio-venous passage time(AVP)influences microcirculation.In diabetic retinopathy(DR), midperiphery involved earlier than posterior pole.However, there has been no study on the circulation of the entire retinal circulation including the peripheral retina. The authors conducted a prospective study by performing fluorescein angiography on 19 controls and 19 DR patients in order to measure the ART, AVP and venous filling time(VFT). The VFT correspond to the circulation of the peripheral retina. In the DR group, the retina circulation time was compared with the existence of proliferative diabetic retinopathy(PDR), distribution of nonperfusion area and beading vessels. There was no significant difference between diabetic group and the control group in the ART.AVP was 1.8+/-0.7sec in the control group and 2.5+/0.7sec(p=0.04)in the DR group and venous filling time was 6.4+/-2.4sec and 8.9+/-1.5sec(p=0.006)respectively. Patients with PDR showed prolongation only in VFT compared to patients with non-proliferative diabetic retinopathy(NPDR). In addition, patients presenting with nonperfusion areas and beading of vessels showed longer prolongation of VFT than of AVP. In conclusion, the VFT is delayed in DR compared to control group and in PDR compared to NPDR. The VFT can be utilized as an indicator of DR to measure the retinal circulation including the peripheral retina.
Diabetic Retinopathy* ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Microcirculation* ; Prospective Studies ; Retina ; Retinaldehyde*

The large conductance Ca2+ activated K+ channel (BK channel) has been considered to play an important role in the excitability and contractility of vascular smooth muscle cells. Activation of the BK channel causes the hyperpolarization and relaxation of vascular smooth muscle cells. It has been reported that fatty acids can affect the BK channel activity and its concentration is increased significantly during myocardial ischemia. These reports suggest that fatty acids may contribute to the ischemic coronary vasodilation by increasing the BK channel activity. However, the underlying mechanism of fatty acid-induced activation of the BK channel is still uncertain. In the present study, we measured the effect of fatty acids on the BK channel activity in rabbit coronary smooth muscle cells by using patch clamp method and also examined its underlying mechanism. Arachidonic acid (AA) dissolved in DMSO activated the BK channel in a dose-dependent manner (from 0.5 to 10 microM), and DMSO (0.1%) alone had no effect on the activity of the BK channel. Arachidonic acid activated BK channels in both cell-attached and inside-out patches, but the onset and recovery of this effect were slower in the cell-attached patch configuration. The BK channel activity was also increased by other fatty acids, including myristic acid, linoleic acid, palmitoleic acid and palmitic acid. Long chain fatty acids were more effective than short chain fatty acids (myristic acid), and there was no statistical difference between the effect of saturated (palmitic acid) and unsaturated fatty acids (palmitoleic acid) on the BK channel activity. The concentration of Ca2+ and Mg2+ in the bathing solution had no appreciable effects on the AA-induced increase of BK channel activity. From the above results, it may be concluded that fatty acids directly increase the BK channel activity and may contribute to the ischemic coronary vasodilatation in rabbit coronary smooth muscle cells.
Animal ; Calcium/physiology ; Cells, Cultured ; Coronary Vessels/cytology/drug effects/*physiology ; Fatty Acids/*pharmacology/physiology ; Female ; Male ; Membrane Potentials/drug effects ; Muscle, Smooth, Vascular/cytology/drug effects/*physiology ; Potassium Channels/*drug effects ; Rabbits ; Support, Non-U.S. Gov't

BACKGROUND: Periampullary cancer is a relatively common malignancy, and its incidence is increasing. A pancreaticoduodenectomy is the procedure of choice in patients with periampullary cancer. However, leakage of the pancreaticojejunal anastomosis has been a major complication after a pancreaticoduodenectomy, with a frequently reported incidence of 5 percent to 25 percent. The ideal management of the pancreatic stump has not yet been determined. Thus we tried to find a safe and effective pancreatic stump management technique and to monitor the security of the pancreatic stump anastomosis by using the body fluid amylase level. PATIENTS AND METHODS: Forty six (46) consecutive patients who had undergone a pancreaticoduodenectomy, between January 1990 and January 1998, were evaluated retrospectively. Before June 1997, we did 36 pancreaticojejunostomies without long stent insertion into the pancreatic duct (group 2). After that, we did 10 P-Jstomies with long stent insertion (group 1). A long silicone stent was used for intubation of the anastomosis. Also the amount of pancreatic juice drainage from the long pancreatic duct tube was checked daily. We placed two Penrose drains and one Jackson-Pratt drain near the anastomosis. Patients were monitored for clinical evidence of a pancreatic fistula by evaluation of the amylase concentration in serum and the peritoneal drainage at postoperative day 7. The normal range of body fluid amylase was defined to be within five times of the normal serum amylase level. Cholangiography, which was obtained through a T-tube or a percutaneous transhepatic catheter, was performed on postoperative day 7 and was used to assess to leakage from or the obstruction at any of the three reconstructive anastomoses. RESULTS: In group 1, there was no leakage from the P-Jstomy site. The daily mean pancreatic juice amount and body fluid amylase level were 76.6 ml/day (range, 0.4-137.4 ml/day) and 147.4 U/L (range,44-323 U/L). In group 2, there were 4 cases of leakage at the P-Jstomy site (11.1%). CONCLUSION: An external long pancreatic duct stent insertion is an effective and safe method for management of a pancreatic remnant. We could check the amount of the daily pancreatic juice precisely. Effective decompression of the P-Jstomy was achieved by long stent insertion. We could monitor the security of the pancreatic stump anastomosis by the body fluid amylase level. We suggest that our method, which monitors the body fluid amylase level, is effective in early detection and treatment of P-Jstomy site leakage. The effort to find the best method for management of the pancreatic remnant should be continued.
Amylases ; Body Fluids ; Catheters ; Cholangiography ; Decompression ; Drainage ; Humans ; Incidence ; Intubation ; Pancreatic Ducts* ; Pancreatic Fistula ; Pancreatic Juice ; Pancreaticoduodenectomy ; Pancreaticojejunostomy* ; Reference Values ; Retrospective Studies ; Silicones ; Stents*

PURPOSE: To evaluate the accuracy and safety of ultrasound-guided biopsy of the thickened peritoneal reflections and to determine the efficacy and diagnostic role of this procedure in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis. MATERIALS AND METHODS: Twenty-seven patients with only mildly thickened (25 mm or less) peritoneal reflections without apparent mass formations, and in whom imaging findings were not diagnostic, underwent ultra-sound-guided biopsy. Five-MHz linear or convex linear array transducers were used for ultrasound guidance,and an automated gun with 18-gauge (n = 23) or 20-gauge (n = 4) needles for tissue sampling. Biopsies were performed on the thickened parietal peritoneum (n = 9), greater omentum (n = 11), and small bowel mesentery (n = 7), and the results were compared with the final diagnosis determined by adiologic/clinical follow-up (n = 17) or laparoscopic biopsy (n = 10). Complications and changes in hemoglobin and hematocrit levels after the procedure were evaluated. RESULTS: Specimens adequate for pathologic examination were obtained in all 27 patients. The histopathologic results were metastatic carcinomatosis (n = 15), peritoneal tuberculosis (n = 8), and chronic granulomatous inflammation (n = 4). Specific pathologic diagnosis was obtained in all patients except the four with chronic granulomatous inflammation. Differentiation between benignancy and malignancy was possible in all patients and the histopathologic specific accuracy rate was 100%. No clinically significant complications were observed. In 24 patients with ascites at the site of the biopsy, transient bleeding was observed immediately after the procedure, but this stopped spontaneously within a few minutes. Post-procedural hemoglobin and hematocrit levels were only minimally lower (mean values of 0.9g/dL and 3.0%, respectively) than pre-procedurally. CONCLUSION: Ultrasound-guided biopsy of thickened peritoneal reflections is a safe and effective diagnostic procedure and is useful in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis.
Ascites ; Biopsy* ; Carcinoma* ; Diagnosis ; Diagnosis, Differential* ; Follow-Up Studies ; Hematocrit ; Hemorrhage ; Humans ; Inflammation ; Mesentery ; Needles ; Omentum ; Peritoneum ; Peritonitis, Tuberculous* ; Transducers ; Tuberculosis ; Ultrasonography

Isolated rabbit aortic ring with intact endothelial cell preparations precontracted with NE (10(-7) M) were relaxed by vanadate in a dose dependent manner (from 0.2 to 2 mM). Application of vanadate and ACh during the tonic phase of high K+(100 mM)-induced contraction showed a slight relaxation in contrast to that in NE-induced contraction, but sodium nitroprusside (10 microM) more effectively relaxed the aortic ring preparations in high K+ contraction than that of vanadate. Vanadate-induced relaxation in NE-contracted aortic rings was reversed by application of BaCl2 (50 microM) or glibenclamide (10 microM). Furthermore, Vanadate hyperpolarized membrane potential of smooth muscle cells in endothelium-intact aortic strips and this effect was abolished by application of glibenclamide. The above results suggest that vanadate release EDHF (Endothelium-Derived Hyperpolarizing Factor), in addition to EDRF (Endothelium-Derived Relaxing Factor) from endothelial cell. This EDHF hyperpolarize the smooth muscle cell membrane potential via opening of the ATP-sensitive K+ channel and close a voltage dependent Ca++ channel. So it is suggested that the vanadate-induced relaxation of rabbit thoracic aortic rings may be due to the combined effects of EDRF and EDHF.
Animal ; Aorta/drug effects/physiology ; In Vitro ; Membrane Potentials/drug effects ; Potassium/pharmacology ; Potassium Channels/physiology ; Rabbits ; Support, Non-U.S. Gov't ; Tetraethylammonium Compounds/pharmacology ; Vanadates/*pharmacology ; Vasodilation/*drug effects

PURPOSE: Obtaining a detailed family history through detailed pedigree is essential in recognizing hereditary colorectal cancer (CRC) syndromes. This study was performed to assess the current knowledge and practice patterns of surgery residents regarding familial risk of CRC. METHODS: A questionnaire survey was performed to evaluate the knowledge and the level of recognition for analyses of family histories and hereditary CRC syndromes in 62 residents of the Department of Surgery, Seoul National University Hospital. The questionnaire consisted of 22 questions regarding practice patterns for, knowledge of, and resident education about hereditary CRC syndromes. RESULTS: Two-thirds of the residents answered that family history should be investigated at the first interview, but only 37% of them actually obtained pedigree detailed family history at the very beginning in actual clinical practice. Three-quarters of the residents answered that the quality of family history they obtained was poor. Most of them could diagnose hereditary nonpolyposis colorectal cancer and recommend an appropriate colonoscopy surveillance schedule; however, only 19% knew that cancer surveillance guidelines differed according to the family history. Most of our residents lacked knowledge of cancer genetics, such as causative genes, and diagnostic methods, including microsatellite instability test, and indicated a desire and need for more education regarding hereditary cancer and genetic testing during residency. CONCLUSION: This study demonstrated that surgical residents' knowledge of hereditary cancer was not sufficient and that the quality of the family histories obtained in current practice has to be improved. More information regarding hereditary cancer should be considered in education programs for surgery residents.
Appointments and Schedules ; Colonoscopy ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; Genetic Testing ; Humans ; Microsatellite Instability ; Pedigree ; Surveys and Questionnaires