PURPOSE: To report the relationship between the extent of rupture of the trabecular meshwork and intraocular pressure changes in traumatic hyphema patients. METHODS: Ninety-five trabecular meshwork rupture patients were selected from a group of traumatic hyphema patients. Identification and measurement of the rupture of the trabecular meshwork were performed by gonioscopy, and intraocular pressure was measured by Goldmann applanation tonometry until 3 months after the trauma. RESULTS: There were statistically significant differences of IOP between the traumatic eyes and the contralateral eyes at day 2, 3, 5, and 1 month (p=0.000, 0.018, 0.001, 0.040, respectively). IOP was highest at the 2nd day post-trauma, and dropped by the 5th day, after which it rose slightly. The relationship between the extent of trabecular meshwork rupture and the difference of IOP was positive at the 2nd day post-trauma (r=0.259) and negative at the 6th day post-trauma (r=-0.296); these differences are statistically significant (p=0.020, p=0.041, respectively). CONCLUSIONS: A rupture of the trabecular meshwork can be measured using gonioscopy, and the change of IOP in a trabecular meshwork rupture increases as the extent of the rupture of the trabecular meshwork increases.
Eye ; Gonioscopy ; Humans ; Hyphema ; Intraocular Pressure ; Manometry ; Rupture ; Trabecular Meshwork

No abstract available.
Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic*

This study was designed to identify doxorubicin as a permanent chemomyectomy agent that overcomes reversible effect of botulinum toxin A. Doxorubicin was assessed for its ability to bring about a permanent chemomyectomy and the effects of pretreatment were observed to assess its ability to prevent any complications brought about by doxorubicin. A total of thirteen rabbits were assigned to the control group(n=3) and two experimental groups(n=5 for each group). To investigate the myopathic changes following the injections of the agent, both orbicularis oculi muscles of the lower eyelids of each rabbit in the control group were directly injected with single dose of 0.2ml normal saline. Group I were injected with 0.5mg/0.2ml of doxorubicin into the right eyelid and 1.0 mg/0.2 ml of doxorubicin into the left. Group II were given an intravenous injection of 35mg/kg of allopurinol as the pretreatment, then 30minutes later injected with 0.5mg/0.2ml of doxorubicin into the right and 1.0mg/ 0.2ml of doxorubicin into the left. The rabbits were examined daily to monitor the onset, duration and size of skin necrosis and histologically examined two and four months after initial injections. The myopathic change after doxorubicin injection was persistent and irreversible. The dose related effects of doxorubicin chemomyectomy were confirmed by the histologic finding. Skin necrosis occurred in all cases of doxorubicin injection(both 0.5mg and 1.0mg), however the allopurinol pretreatment decreased the size of the skin necrosis in case of the high dose(1.0mg) of doxorubicin. The combined use of allopurinol and doxorubicin reduced the myopathic change more effectively than doxorubicin use alone. Further study is needed to determine optimal dose and administration method, which we feel will contribute to safer and permanent chemomyectomy.
Allopurinol* ; Botulinum Toxins ; Doxorubicin* ; Eyelids ; Injections, Intravenous ; Muscles ; Necrosis ; Rabbits ; Skin

No abstract available.
Leukemia, Myelomonocytic, Chronic*

A short nose is one that extends less than one third of the vertical height of the face or whose distance from nasion to tip-defining point is short. Lengthening short noses has been regarded as one of the most challenging and at times vexing tasks in secondary nasal surgery. For correction of short nose, nasal tip supporting tissues from alar cartilages are released and nasal tip is positioned and fixed again. There are five important nasal tip supporting tissues, fibrous connection between upper lateral cartilage and lower lateral cartilage, hinge region(fibrous connection between lateral border of lateral crus and pyriform aperture), interdormal attachment to anterior septal angle (fibrous tissue between anterior septal angle and middle crus), fibrous connection between septum and foot plate of medial crus and dermocartilaginous ligament. This study is to find out which one of the five nasal tip supporting tissues is the most important in short nose correction except dermocartilaginous ligament which has to be released during rhinoplasty. We dissected ten noses from ten fresh cadavers. Five were male and five were female with an average age of sixty three for all ten. We measured the distance between anterior septal angle and tip-defining point in every step of soft tissue dissection releasing the alar cartilage and mucosa, that are often released in short nose corrections and caudally pulling them to the direction of tip-defining point. First, distances were measured in resting and in pulling of alar cartilage. Further, changed distance were measured after releasing nasal tip supporting tissues beginning from the dissection of soft tissues between lateral crus and upper lateral cartilage to that of mucoperichondrium underneath upper lateral cartilage and septal mucoperichondrium. In each process, we found the average and standard variation, confirmed effects of those values to the lengthening of short noses. Dissecting upper lateral cartilage and lateral crus of alar cartilage was most effective in short nose correction. We also found it effective to release the hinge area and dissect the mucoperichondrium under upper lateral cartilage in lengthening the short noses.
Cadaver ; Cartilage ; Female ; Foot ; Humans ; Ligaments ; Male ; Mucous Membrane ; Nasal Surgical Procedures ; Nose* ; Rhinoplasty

For the correction of facial wrinkles and skin contour defects, commercially prepared nonanimal stabilized hyaluronic acid(Restylane(R)) is now widely used. Although this suspension has been shown to be relatively safe and convenient to administer, varying degrees of resorption have required repeated percutaneous injection. Therefore, this study was undertaken to evaluate the feasibility of Restylane(R) combined with cultured human dermal fibroblasts to enhance the persistence of the injected implant. For the experimental group, fibroblasts from the dermis of healthy adults were isolated and cultivated. Five hundred thousand fibroblasts suspended in 200mul of Dulbecco's phosphate buffered saline(DPBS) were then dispersed in 200mul of Restylane(R) to form a human fibroblast mixed Restylane(R) that measured 400mul in volume. For the control group, 200mul of DPBS without fibroblasts was mixed with 200mul of Restylane(R) These implants were injected subdermally into the back of athymic nude mice at six sites; control group into the left three sites and experimental group into the right three sites. Twelve nude mice were injected to form total of 36 injections per group. The nodular swellings that resulted from the injections were excised wide enough to include skin beyond the swelling points down to panniculus carnosus layer using 5 mm punches, and the weights were measured at 1, 2, 4, 8, 12, and 16 weeks after the injections. Histologic comparisons were also made to confirm the presence of human collagen in the fibroblast mixed Restylane(R) group using immunohistochemical study with anti-human collagen type I polyclonal antibody. The mean weight of the control group nodules decreased throughout the examination period. The mean weight at 16th week was 60% of the weight at first week. On the other hand, the mean weight of the experimental group nodules decreased over the first 2 weeks only. Beyond 2 weeks, there was no further significant weight change. The mean weight at 16th week was 91% of the weight measured at first week. Histologic examination of the control group taken at each examination period exhibited negative immunohistochemical staining for human collagen. That of experimental group exhibited positive staining after 2 weeks, indicating the presence of human collagen. These results indicated that Restylane(R) mixed with cultured human dermal fibroblasts could be successfully injected as living grafts for long-term retention of the implants.
Adult ; Animals ; Collagen ; Collagen Type I ; Dermis ; Fibroblasts* ; Hand ; Humans ; Mice ; Mice, Nude ; Skin ; Transplants ; Weights and Measures

BACKGROUND: The respiratory cycle alters the size of the right internal jugular vein (RIJV). We assessed the changes in RIJV size during the respiratory cycle in patients under positive pressure ventilation. Moreover, we examined the effects of positive-end expiratory pressure (PEEP) and the Trendelenburg position on respiratory fluctuations. METHODS: A prospective study of 24 patients undergoing general endotracheal anesthesia was performed. Images of the RIJV were obtained in the supine position with no PEEP (baseline, S0) and after applying three different maneuvers in random order: (1) a PEEP of 10 cmH2O (S10), (2) a 10degrees Trendelenburg tilt position (T0), and (3) a 10degrees Trendelenburg tilt position combined with a PEEP of 10 cmH2O (T10). Using the images when the area was smallest and largest, cross-sectional area (CSA), anteroposterior diameter, and transverse diameter were measured. RESULTS: All maneuvers minimized the fluctuation in RIJV size (all P = 0.0004). During the respiratory cycle, the smallest CSA compared to the largest CSA at S0, S10, T0, and T10 decreased by 28.3 8.5, 8.0, and 4.4%, respectively. Furthermore, compared to S0, a 10degrees Trendelenburg tilt position with a PEEP of 10 cmH2O significantly increased the CSA in the largest areas by 83.8% and in the smallest areas by 169.4%. CONCLUSIONS: A 10degrees Trendelenburg tilt position combined with a PEEP of 10 cmH2O not only increases the size of the RIJV but also reduces fluctuation by the respiratory cycle.
Anesthesia ; Head-Down Tilt* ; Humans ; Jugular Veins* ; Positive-Pressure Respiration ; Prospective Studies ; Supine Position

Triple antiplatelet therapy has been known to be superior to the conventional dual regimen for preventing stent thrombosis after coronary stenting, and the addition of oral anticoagulation to antiplatelet therapy is also considered an option. However, the risks and benefits of a triple antiplatelet regimen plus additional oral anticoagulation must be taken into account. Here, we report a case of fatal renal bleeding in a patient treated with triple antiplatelet plus oral anticoagulant therapy for the prevention of recurrent stent thrombosis.
Coronary Thrombosis ; Drug Combinations ; Drug-Eluting Stents ; Hemorrhage ; Humans ; Risk Assessment ; Stents ; Thrombosis

PURPOSE: To investigate the characteristics of the clear oil-drop residue observed in the vitreous cavity after intravitreal injection of different brands of triamcinolone acetonide (TA), and to compare this ingredient's effects in those products. METHODS: Intravitreal injections of four different brands of triamcinolone acetonide (4 mg/0.1 mL), which are commercially available in Korea, were given to 40 eyes for the treatment of macular edema due to a variety of causes from October 2005 through February 2006. Regular slit-lamp biomicroscopy of fundus had been performed periodically with digital image acquisition equipment after injection of TA for at least two months. We analyzed the characteristics of this residue and compared the number and size of this residue in each product. RESULTS: Four TA products commercially available in Korea were used, with vehicles composed of preservatives and suspending agents. There were differences between products in respect to ingredients and content, as well as the characteristics of the intravitreal clear oil droplet-like residue. CONCLUSIONS: Each TA product has a variable frequency and variable amounts of clear oil droplet-like residue, which seems to be a component of the vehicle. This variation could generate differences in efficacy, side effects, and retaining duration. It should be verified whether commercial TA products are consistently safe and effective.
Excipients ; Eye ; Intravitreal Injections ; Korea ; Macular Edema ; Triamcinolone ; Triamcinolone Acetonide

Ovarian myoma is a rare mesenchymal tumor, accounting for only 1% of benign ovarian neoplasm. These tumors only originate from smooth muscle on the walls of blood vessels in the cortical stroma, in the corpus luteum and in the ovarian ligaments at the point of attachment to the ovary. Most patients are asymptomatic and the tumors are usually found incidently during operations or at autopsies. Two cases of ovarian myoma experienced in our hospital recently are reported with a brief review of the literatures."
Autopsy ; Blood Vessels ; Corpus Luteum ; Female ; Humans ; Leiomyoma* ; Ligaments ; Muscle, Smooth ; Myoma ; Ovarian Neoplasms ; Ovary