BACKGROUND: There are some variables including chamber size in irritant patch test responses. Several non-invasive bidengineering methods for quantifying and obtaining information have been developed in recent decades. OBJECTIVE: Our study was done to compare the effect of chamber size and the volume effect on the irritation potential of 1% SLS solution. METHODS: Patches with 1% sodium lauryl sulfate(SLS) solution were applied to the volar forearm of 14 healthy volunteers for 24 h. Finn chambers with 8mm(20ul), 12mm(60pl), 18mm(80ul, 200ul) inner diameters were used. Visual score and transepidermal water loss (TEWL) were measured at 30 min after removal of the patches, and every 24 h up to 4 days. RESULTS: The results are summarized as follows. 1. Visual scores were 0.18+0.32(8mm), 0.75+0.33(12mm) and 0.64+0.41(18mm) at 24 h after removal of 1% SLS and were 0.11+0.29, 0.50+0.34 and 0.25+0.26 on 4 days after removal. They were inereased 30 min and 24 h after removal and decreased towards normal 4 days after removal. By chamber size, the skin response with the large Finn chamber(12mm) increased more significantly than with the small Finn chamber(8mm). However, there were no significant differences in skin response between large and extralarge Finn chambers(18mm). 2. TEWL values were 11.86+4.09, 23.05+6.1l and 22.24+7.54g/m/h at 30 min after removal and were 9.37+2.30, 1..49+3.08 and 14.56+5.00g/m/h on 4 days after removal. They were increased 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as visual scores. 3. By visual score and TEWL, the skin response with 200pl of 1% SLS increased more significantly than 80pl in the extralarge Finn chamber. CONCLUSION: The small Finn chamber may be too small to elicit sufficient cutaneous irritation for evaluation. The large Finn chamber having larger test areas may be suitable to yield positive reactions to certain irritants. Also, the quantity of test solution per mm skin may be of importance for the skin response.
Forearm ; Healthy Volunteers ; Irritants ; Patch Tests ; Skin ; Sodium

PURPOSE: To determine the risk factors of intraoperative complications in femtosecond laser-assisted cataract surgery. METHODS: This study included 598 eyes of 337 patients who underwent femtosecond laser-assisted cataract surgery (FLACS) between July, 2012 and January, 2017. All eyes had corneal incisions, anterior capsulotomy, nuclear fragmentation, and limbal relaxing incisions (if required). Intraoperative complications were analyzed by watching videos, and the related factors of each complication were retrospectively reviewed alongside the medical records. RESULTS: The mean age of the patients was 62.1 ± 11.9 years. Among the study group, 18 eyes required manual creation of corneal incisions; because the corneal incisions could not be made due to corneal central opacity, corneal peripheral degeneration, ptreygium, conjunctival chalasis, or idiopathic. The anterior capsulotomy was incomplete in 43 cases and manual capsulorrhexis was required for completion. These cases were associated with various conditions, including hypermature cataract, anterior polar or subcapsular cataract, corneal central opacity, pupillary abnormality, lens subluxation, poor pupil dilation, and idiopathic. Overall, 22 eyes had difficulties with nuclear fragmentation, with either mature cataract, lens subluxation, corneal central opacity, anterior polar or subcapsular cataract, or pupillary abnormality. Using the Laser SoftFit™ patient interface decreased the incidences of incomplete corneal incision (from 3.56% to 2.24%, p = 0.367), anterior capsulotomy (from 9.31% to 4.03%, p < 0.05), and nuclear fragmentation (from 5.20% to 1.34%, p < 0.05). The incidences of complications in the experienced group was statistically lower compared with the novice group (p < 0.05 for all comparisons). CONCLUSIONS: The femtosecond laser platform was effective and safe for cataract surgery. However, in the presence of related factors, use of this platform might need to be re-assessed and should be considered for intraoperative complications. Additionally, with the Laser SoftFit™ patient interface and improved surgeon experience, better intraoperative results can be expected for FLACS surgery.
Capsulorhexis ; Cataract* ; Corneal Opacity ; Humans ; Incidence ; Intraoperative Complications ; Lens Subluxation ; Medical Records ; Pupil ; Retrospective Studies ; Risk Factors*

BACKGROUND: Alpha hydroxy acids (AHAs) are known to diminish corneocyte cohesion at the innermost levels of the stratum corneum and have been used in the treatment of various disorders of keratinization. However, their effect on skin barrier function and their irritant potential is not fully understood. OBJECTIVE: Our study was done to evaluate the skin irritancy of AHAs in normal human skin. METHODS: Patches with 1%, 5% and 10% solutions of lactic acid (LA) and glycolic acid (GA) were applied to the volar forearm of 20 healthy volunteers for 24 hours using large Finn chambers with filter paper. Visual scores, erythema (E-) index and transepidermal water loss (TEWL) were measured at 30 min, 24 h and 48 h after removal of the patches. RESULTS: The results are summarized as follows. 1. Visual scores were 0.1+/-0.3 (1%), 0.5+/-0.6 (5%) and 1.1+/-0.8 (10%) at 24 h after removal of LA, and were 0.2+/-0.4 (1%), 0.6+/-0.6 (5%) and 1.0+/-0.7 (10%) at 24 h after removal of GA. They were increased in proportion to the concentrations and there were significant differences in skin responses between the control and each concentration of the solutions. 2. E-indices were 9.1+/-2.1 (control), 8.8+/-1.8 (1%), 9.0+/-2.6 (5%) and 10.5+/-3.9 (10%) at 24 h after removal of LA, and were 9.4+/-1.8 (control), 9.3+/-2.3 (1%), 10.0+/-3.0 (5%) and 11.1+/-3.5 (10%) at 24 h after removal of GA. They were not increased in the patch areas of 1% and 5% solutions in both the LA and GA group, but were significantly increased in the patch areas of 10% solutions in both the LA and GA group. 3. TEWL values were 7.3+/-2.3 (control), 8.3+/-4.0 (1%), 9.8+/-4.5 (5%) and 16.7+/-9.1 (10%) at 24 h after removal of LA, and were 8.1+/-3.2 (control), 7.8+/-3.8 (1%), 8.6+/-3.0 (5%) and 10.9+/-4.1 (10%) at 24 h after removal of GA. They were not increased in the patch areas of 1% LA, 1% GA and 5% LA, but there were high significant differences between the controls and 10% solutions of both LA and GA. CONCLUSION: Visual scores were increased in all concentrations of AHAs tested, but the increase in E-index and TEWL values were not significant or minimal in 1% and 5% solutions of AHAs. These findings suggest that AHAs could be classified as non-corrosive irritants.
Erythema ; Forearm ; Healthy Volunteers ; Humans* ; Hydroxy Acids* ; Irritants ; Lactic Acid ; Skin*

Paroxysmal Nocturnal Hemoglobinuria (PNH) is an uncommon hematologic disease characterized by an abnormal sensitivity of blood cells to the lytic action of serum complement. We experienced one case of PNH in Yeungnam University Hospital from May 1983 to May 1989. The patients was followed up without severe complications of 4 years since diagnosis with the only conservative treatments such as washed blood transfusion, adrenal corticosteroids, androgens, folate and iron preparation, intermittently.
Adrenal Cortex Hormones ; Androgens ; Blood Cells ; Blood Transfusion ; Complement System Proteins ; Diagnosis ; Folic Acid ; Hematologic Diseases ; Hemoglobinuria, Paroxysmal* ; Humans ; Iron

BACKGROUND: Sodium lauryl sulfate(SLS) is the most widely utilized model for studying acute and cumulative irritation. Sodium lauroyl glutamate(SLG) has exhibited a low irritation potential and an anti-irritating effect on other anionic surfactants. OBJECTIVE: Our study was done to compare the skin irritancy of SLS and SLG using non-in- vasive techniques. METHODS: Patches with 1% SLS and SLG solution were applied to the volar forearm of 20 healthy volunteers for 24 h. Finn chambers with 8mm(20pl) and 12mm(60pl) inner diameters were used. Visual scores, transepidermal water loss(TEWL) and an erythema(E)-index were measured at 30 min after removal of the patches, and every 24hours(h) up to 4 days. RESULTS: The results are summarized as follows. 1. Visual scores were 0.20+0.30(8mm) and 0.73+0.34(12mm) at 24 h after removal of 1% SLS and were 0.15+0.29(8mm) and 0.30+0.41(12mm) at 24 h after removal of 1% SLG. They were increased at 30 min and 24 h after removal and decreased towards normal at 4 days after removal. By chamber size, the skin response with large Firin chamber(12mm) increased more significantly than with the small Finn chamber(8mm). In the small Finn chamber, there were no significant differences in the skin response between 1% SLS and 1% SLG. In the large Finn chamber, the skin response with 1% SLS increased more significantly than with 1% SLG. 2. TEWL values were 11.14+4.77(8mm) and 20.48+10.61(12mm) at 24 h after removal of 1 % SLS and were 10.38+3.99 and 14.87+7.46 at 24 h after removal of 1% SLG. They were increased at 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as the visual scores. Also, on comparison between 1% SLS and 1% SLG, their results were the same as the visual scores. 3. E-index was 10.05+2.70(8mm) and 11.15+2.56(12mm) at 24 h after removal of 1% SLS and was 10.15+2.16 and 10.60+2.26 at 24 h after removal of 1% SLG. They were increased at 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as the visual scores. In the small and large Finn chamber, there were no significant differences in the skin response between 1% SLS and 1% SLG. CONCLUSION: SLS is more irritating than SLG. The large Finn chamber may be more suitable to yield positive irritant reactions than the small Finn chamber. Also, TEWL measurements may be a more accurate and sensitive method than the E-index.
Forearm ; Glutamic Acid* ; Healthy Volunteers ; Skin ; Sodium Dodecyl Sulfate* ; Sodium* ; Surface-Active Agents

PURPOSE: To evaluate the change of iris-trabecular contact index (ITC index) after cataract surgery in acute angle closure glaucoma. METHODS: Twelve patients (17 eyes) who had a history of acute angle closure glaucoma underwent swept source optical coherence tomography before and after cataract surgery. Correlations between lens vault (LV), ITC index and intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV), and angle parameters were analyzed before and after cataract surgery. RESULTS: IOP (p = 0.007), ACD (p < 0.001), ACV (p < 0.001), angle parameters (p = 0.001), and ITC index (p = 0.012) were improved after cataract surgery. ITC index decreased from 88.42 ± 23.59% to 48.91 ± 35.13% after cataract surgery (p = 0.012). There was no correlation between LV and ACD (p = 0.075), ACV (p = 0.864), angle parameter (p = 0.112-0.707), or ITC index (p = 0.288) before cataract surgery. The correlations between ITC index and IOP (p = 0.021), ACD (p = 0.002), ACV (p < 0.001), and angle parameter (p = 0.001-0.030) were statistically significant before surgery but not statistically significant (p = 0.223/0.206/0.761/ 0.096-0.819) after surgery. CONCLUSIONS: ITC index significantly improved after cataract surgery, but part of angle closure was not resolved in some cases of acute angle closure glaucoma.
Anterior Chamber ; Cataract* ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Tomography, Optical Coherence

BACKGROUND: It has been demonstrated that patients with atopic dermatitis(AD) show an impaired capacity of their T cells to release of interleukin-2(IL-2) in vitro and elevated serum levels of soluble IL-2 receptor(sIL-2R). Both immunosuppressive agents, cyclosporin A(CsA) and FK-506 can block early events in T lymphocyte activation and FK-506 is 10- to 100-fold more potent in the inhibition of IL-2 and other lymphokines production. OBJECTIVE: We compared the effects of CsA and FK-506 on PHA-induced lymphokine and sIL-2R production and compared the effects of CsA and FK-506 on PHA-induced IL-4 production in a high IgE group and a low IgE group in patients with AD. METHODS: A total of 32 peripheral blood samples from 17 patients with AD and 15 control groups were tested. Lymphocytes were isolated from blood samples and were cultured with PHA(positive control), PHA and CsA(10 ng/ml), PHA and FK-506 (1 ng/ml), and without stimulation (negative control). The amount of cytokines such as IL-2, IL-3, IL-4 and sIL-2R were measured using an enzyme-linked immunosorbent assay(ELISA). RESULTS: CsA and FK-506 inhibited significantly the production of IL-2, IL-3, IL-4 in PHA-stimulated lymphocytes of both the AD patients and the control groups. FK-506(1 ng/ml) inhibited cytokines production more significantly than CsA(10 ng/ml). However, CsA and FK-506 did not significantly inhibit the production of sIL-2R. There were no significant differences in the inhibitory effect of CsA and FK-506 on IL-4 production upon PHA-stimulation between AD patients with a high IgE level and with a low IgE level. CONCLUSION: Both FK-506 and CsA inhibit lymphokine production, but not the production of sIL-2R. FK-506 inhibited more significantly lymphokine production at a 10-fold lower concentration than CsA. Our data suggest that FK-506 could be more effective in the treatment of severe AD than CsA, and both these agents show their immunosuppressive activity through the suppression of lymphokine production, not via the suppression of sIL-2R production in AD.
Cyclosporine* ; Cytokines ; Dermatitis, Atopic* ; Humans ; Immunoglobulin E ; Immunosuppressive Agents ; In Vitro Techniques ; Interleukin-2 ; Interleukin-3 ; Interleukin-4 ; Lymphocyte Activation ; Lymphocytes* ; Lymphokines ; T-Lymphocytes ; Tacrolimus*

Contact urticaria refers to a wheal-and-flare response occurring on the application of chemicals to intact skin. When contact urticaria is accompanied by systemic symptoms, it is known as the urticaria syndrome. Fourteen cases of cefotiam-induced contact urticaria have been reported in the foreign literature, but no such case, as far as we know, has been described in the Korean dermatology literature. We report a case of contact urticaria syndrome occurring in a 23-year-old nurse due to occupational contact exposure to cefotiam. She experienced generalized urticaria, itching of the skin, difficulty in breathing, and abdominal pain, when she was preparing an injection of cefotiam. An open patch test showed positive reactions to cefotiam, cefmetazole, and ceftriaxone. Since avoiding cefotiam, the symptoms disappeared and did not recurred.
Abdominal Pain ; Cefmetazole ; Cefotiam ; Ceftriaxone ; Dermatology ; Humans ; Patch Tests ; Pruritus ; Respiration ; Skin ; Urticaria* ; Young Adult

BACKGROUND: In order to investigate the efficacy and safety of cilazapril, a recently developed angiotensin converting enzyme inhibitor, a clinical study was performed in the patients with mild to moderate essential hypertension. METHODS: The study subject consisted of 31 patients with diastolic blood pressure of 95mmHg~115mmHg (mean age : 56.0+/-8.1 years, 16 males and 15 females). Cilazapril was administered orally in a daily dose of 2.5mg~5.0mg Q.D. for 8 weeks. During cilazapril medication, anti-hypertensive efficacy, side effects and laboratory changes were monitored. RESULTS: Cilazapril decreased blood pressure from baseline value of 162.2+/-4.7/98.4+/-2.8mmHg to 144.6+/-10.0/89.7+/-5.7mmHg after 4weeks of medication (p<0.05) and 138.2+/-4.5/87.8+/-4.0mmHg after 8 weeks of medication (p<0.05). Heart rate change was not significant (72.3+/-4.7/min vs 71.7+/-3.6/min). Body weight change was not significant (66.6+/-9.8 Kg vs 66.8+/-9.9 Kg). There were no significant change in blood chemistry and hematologic examination except mild elevation of alanine transaminase and serum creatinine values but these date were within normal ranges. The side effects were dry cough (4 case, 12.9%), headache (2 case, 6.4%), indigestion (1 case, 3.2%) and dry mouth (1 case, 3.2%). One patient dropped out due to severe dry cough but others were mostly mild in nature. CONCLUSIONS: Cliazapril 2.5mg~5.0mg once daily regimen was effective and well tolerated in patients with mild to moderate essential hypertension.
Alanine Transaminase ; Blood Pressure ; Body Weight Changes ; Chemistry ; Cilazapril* ; Cough ; Creatinine ; Dyspepsia ; Headache ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth ; Peptidyl-Dipeptidase A ; Reference Values