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

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*

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

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*

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

A sarcomatoid carcinoma of the urinary system is a rare malignant tumor, composed of both epithelial and stromal cells, is regarded as a similar disease entity to a carcinosarcoma. In Korea, only 1 case of primary sarcomatoid carcinoma and 4 cases of carcinosarcoma involving the bladder have been reported, but to date, no case of primary sarcomatoid carcinoma involving the renal pelvis has been reported. Recently, we experienced a case of sarcomatoid carcinoma involving the right renal pelvis in a 67-year-old male patient with intermittent gross hematuria. A CT scan demonstrated a 5x4cm sized mass in the right renal pelvis. Under the diagnosis of a right renal pelvic tumor, a right nephroureterectomy, with bladder cuff excision, was performed. The tumor was composed mostly of pleomorphic spindle cells, and in the peripheral part of the tumor and renal pelvis, a high grade transitional cell carcinoma and adenocarcinoma was also found. The tumor was pathologically confirmed as a primary sarcomatoid carcinoma of the renal pelvis.
Adenocarcinoma ; Aged ; Carcinoma, Transitional Cell ; Carcinosarcoma ; Diagnosis ; Hematuria ; Humans ; Kidney Pelvis* ; Korea ; Male ; Pelvis ; Stromal Cells ; Tomography, X-Ray Computed ; Urinary Bladder

Methemoglobinemia is an uncommon but potentially fatal disorder. Most cases have no adverse clinical consequence and require no treatment, but methemoglobinemia is often overlooked as a cause of low oxygen saturation, and often mistaken for the more common causes of hypoxia by anesthesiologists despite simple bedside tests that indicate the presence of this treatable abnormality. We present a 68-year-old female patient who underwent gastrectomy for advanced gastric cancer with bleeding. In the preoperative period, the patient showed cyanosis and oxygen saturation was 85% by pulse oximeter, but oxygen saturation by arterial blood gas analysis was 100%. After tracheal intubation, the methemoglobin level was 18.3%. Ascorbic acid and methylene blue were administered. During preanesthetic evaluation, the patient had not informed the anesthesiologist that she had been taking dapsone.
Aged ; Anesthesia, General ; Anoxia ; Ascorbic Acid ; Blood Gas Analysis ; Cyanosis ; Dapsone ; Female ; Gastrectomy ; Hemorrhage ; Humans ; Intubation ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Oximetry ; Oxygen ; Preoperative Period ; Stomach Neoplasms