PURPOSE: To compare electroretinogram (ERG) waveforms acquired using an ERG-jet electrode and a Burian-Allen electrode. METHODS: ERGs were recorded with an ERG-jet electrode and a Burian-Allen electrode from both eyes of 29 volunteers. Three consecutive recordings were obtained with both electrodes from the left eye of another 6 volunteers. Peak-to-trough amplitudes and peak implicit times were compared between both eyes, and between the 2 types of electrodes. Interpersonal and intrapersonal variation were also compared. RESULTS: The differences in amplitude and implicit time between the right and left eyes were not influenced by the type of electrode. The amplitude of the ERG acquired using the Burian-Allen electrode, however, showed significant differences between both eyes, contrary to the amplitude acquired using the ERG-jet electrode. ERG recordings obtained using the ERG-jet electrode generally showed higher amplitude, shorter implicit time, and less interpersonal and intrapersonal variation than ERG recordings obtained using the Burian-Allen electrode. CONCLUSIONS: In this application, the ERG-jet ERG electrode appeared to be superior to the Burian-Allen electrode in terms of both usefulness and consistency.
Electrodes ; Eye

The aim of this study was to evaluate the histopathologic changes of the pigmented rabbit ratina after endocryopexy. We investigated the differences or similarity among endocryopexy, transscleral cryopexy and laser phocoagulation. Their ultrastructural changes were observed with light and electron microscope. The results were as follows; 1. The first day after endocryopexy, we observed rupture of the internal limiting membrane, breakdown the inner and outer retina, separation of intercellular gap junction of pigment epithelial cells, and accumulation of exudation within subretinal space. 2. In the 8th days, there are mull iplication of retinal pigment epithelial cell layer and development of basal infolding. 3. The present study suggested that effects of endocryopexy on the retina to cause chorioretinal adhesion was similar to transscleral cryopexy or laser photocoagulation However it should be operated on the premise that in requires technical skill for the purpose of clinical application.
Epithelial Cells ; Gap Junctions ; Light Coagulation ; Membranes ; Retina* ; Retinaldehyde ; Rupture

Specific values for amplitude and implicit time may differ among laboratory due to normal variations in recording electrodes, equipment, and protocol. We presented the results of fulHield and focal macular electroretinography in normal subjects using MacADIOS 411 and Maculoscope. Full-field electroretinograms were obtained in 87 normal subjects (65 males, 22 females) and focal macular electroretinograms were recorded in 33 valunteers(18 males, 15 females) under controlled condition. Age-matched norms were given in table, and for the purpose of clinical application, range of values was given for each group.
Electrodes ; Electroretinography* ; Humans ; Male

PURPOSE: To report a case of periorbital infantile capillary hemangioma treated with propranolol. CASE SUMMARY: A 6-month-old girl visited our clinic for a mass on the right upper eyelid, which had been present since birth. A dome-shaped, red-purple colored mass occupying almost the entire right upper eyelid was observed, and overlying branch-shaped telangiectases were also detected. The visual axis of the right eye was partially obscured, due to the ptotic eyelid, and her ability to fix and follow was poor in the right eye. The patient was diagnosed with infantile capillary hemagioma. Because amblyopia in her right eye was suspected, treatment with propranolol was initiated. After 2.5 months of propranolol treatment, the hemangioma decreased in size and volume dramatically, changed from red-purple to light red color, and softened. The ptosis of the right upper eyelid improved, as well as the ability of the right eye to fix and follow. No significant adverse effects (e.g. hypotension, bradycardia, hypoglycemia, bronchospasm, or elevated liver enzymes) were observed, except transient QTc prolongation during cotreatment with ibuprofen, due to an upper respiratory infection. CONCLUSIONS: Propranolol should be considered as a treatment option for periorbital infantile capillary hemangioma. Further clinical studies are required to establish the optimal guidelines and long-term outcome.
Amblyopia ; Axis, Cervical Vertebra ; Bradycardia ; Bronchial Spasm ; Capillaries ; Eye ; Eyelids ; Hemangioma ; Hemangioma, Capillary ; Humans ; Hypoglycemia ; Hypotension ; Ibuprofen ; Infant ; Light ; Liver ; Parturition ; Propranolol ; Telangiectasis

PURPOSE: Transanal endoscopic microsurgery (TEM) has gained increasing acceptance as a treatment of choice for early rectal cancer. The purpose of this study was to compare the results of TEM and radical surgery in patients with T1 and T2 rectal cancer. METHODS: From October 1994 to December 2000, 74 patients with T1 and T2 rectal adenocarcinoma treated with TEM were compared with 100 patients with T1N0M0 and T2N0M0 rectal adenocarcinoma treated with radical surgery. Retrospective analysis was made regarding to recurrence and survival rate. Neither group received adjuvant chemo-radiation. There was no significant difference in age, gender, tumor location and follow-up period between two groups, except tumor size. RESULTS: Of 74 patients in TEM group, 52 patients were T1 (70.3%) and 22 patients were T2 (29.7%). Of 100 patients in radical surgery group, 17 patients were T1 (17.0%) and 83 patients were T2 (83.0%). Five-year local recurrence rates were 4.1% for T1, 19.5% for T2 after TEM, 0% for T1 and 9.4% for T2 after radical surgery. There was no statistical difference between T1 rectal cancer (P=0.95), but in T2 rectal cancer, it was higher after TEM than after radical surgery (P=0.04). Five-year disease free survival rates showed no statistical difference between two groups (TEM group: 95.9% for T1, 80.5% for T2, radical surgery group: 94.1% for T1, 83.3%for T2; P=0.35, P=0.12). Five-year survival rate were 100% for T1, 94.7% for T2 after TEM and 92.9% for T1, 96.1% for T2 after radical surgery. There were no significant statistical difference between two groups (P=0.07, P=0.48). CONCLUSIONS: In T1 rectal cancer, there were no difference in recurrence and five-year survival rate between TEM and radical surgery group. In T2 rectal cancer, five-year survival rate showed no statistical difference between two groups, but TEM carried higher risk of local recurrence. Therefore careful selection of the patients is required for TEM and when proper muscle invasion is proven after TEM, further treatment should be considered.
Adenocarcinoma ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Microsurgery* ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: To evaluate the surgical results of lower eyelid retraction using autologous ear cartilage graft. METHODS: Fifty patients (54 eyes) who received surgical correction of lower eyelid retraction by lower eyelid retractors and conjunctiva recession from the tarsal plate with autologous ear cartilage grafts from March 2002 to July 2010 were evaluated. Medical records were reviewed and clinical characteristics, surgical outcomes, and postoperative complications were analyzed retrospectively. RESULTS: The use of prosthesis due to anophthalmos or microphthalmos (22 eyes) was the most common cause of lower eyelid retraction. The mean postoperative follow-up period was 16.6 months (1-98 months). Lower eyelid retraction was successfully corrected in 52 of 54 eyes. Postoperatively, 2 cases of corneal erosions, 1 case of conjunctival erosion, and 2 pyogenic granulomas developed. Corneal and conjunctival erosions resolved with conservative management and granulation tissues were removed by excision. CONCLUSIONS: Correction of lower eyelid retraction using autologous ear cartilage graft is an excellent surgical procedure with low complication rates for eyelid retraction of various etiologies.
Anophthalmos ; Conjunctiva ; Ear ; Ear Cartilage ; Eye ; Eyelids ; Follow-Up Studies ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Medical Records ; Microphthalmos ; Postoperative Complications ; Prostheses and Implants ; Transplants

Individual susceptibility to cancers may result from several factors including differences in xenobiotics metabolism, DNA repair, altered oncogenes and suppressor genes, and environmental carcinogen exposures. To determine the frequencies of the genotypes of phase I (CYP1A1 and CYP2E1) and phase II (GSTM1 and NAT2) metabolizing enzymes and to identify the high-risk genotypes of these metabolic enzymes to colon cancer in Korean, we have analyzed 113 colorectal cancer patients and corresponding age and sex matched healthy controls using polymerase chain reaction-restriction fragment length polymorphi(PCR-RFLP). In analysis of phase I enzymes, m1/m2, m2/m2 and Val/Val genotypes in CYP1A1 enzyme polymorphisms and C1/C2 genotype in CYP2E1 polymorphism were associated with high relative risks to colorectal cancers (Odds ratio; 1.51, 1.59, 1.76 and 1.38, respectively). Among the phase II enzymes polymorphisms, GSTM (-) genotype of GSTM1 enzyme and slow acetylator (S/S) of NAT2 enzyme had 1.48 and 1.34 times of relative risks to colorectal cancers, respectively. In combined genotyping of phase I enzymes and GSTM1 polymorphisms, the patients with m1/m2 and GSTM (-), Val/Val and GSTM (-), and C1/C2 and GSTM (-) combined genotypes had higher relative risk than the patients with each baseline of combined genotypes (Odds ratio; 2.15, 5.81 and 2.20, respectively). In combined genotyping of phase I enzyme and NAT2 polymorphisms, the combined genotypes of m1/m2 with slow acetylator and C1/C2 with slow acetylator were more susceptible to colorectal cancer (Odds ratio; 3.5 and 4.5, respectively). These results suggest that the combined genotypes of Val/Val and GSTM (-), m1/m2 and slow acetylator, and C1/C2 and slow acetylator were more susceptible to colorectal cancer in Korean. And genotyping of xenobiotics metabolizing enzymes could be useful for predicting an individual susceptibility to colorectal cancer.
Colonic Neoplasms ; Colorectal Neoplasms* ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2E1 ; DNA Repair ; Genes, Suppressor ; Genotype ; Humans ; Korea* ; Metabolism ; Oncogenes ; Polymorphism, Genetic* ; Xenobiotics*

PURPOSE: The aims of this study were to identify the clinicopathological features and treatment outcome of primary small bowel tumors. METHODS: Sixty-five patients, with primary small bowel tumors, treated at the Samsung Medical Center, between November 1994 and February 2002, were retrospectively analyzed. The mean follow-up was 20.8 months, ranging from 2 to 93 months. RESULTS: The mean age of the patients was 55.5 years, ranging from 26 to 84 years, with 42 men and 23 women. The most common symptom was abdominal pain (58.5%), followed by bleeding and an abdominal mass. The mean duration of the symptoms was 4.6 months, ranging from 2 days to 24 months. Diagnostic studies were performed by an abdominal CT scan, small bowel series, enteroclysis and angiography. The primary sites of the tumors were the jejunum and the ileum in 33 and 32 patients, respectively. Thirteen (20.0%) patients had benign tumors, including 8 (12.3%) benign stromal tumors, 2 lipomas, 2 hamartomatous polyps and 1 cavernous hemangioma. Fifty-two (80.0%) of the patients had malignant tumors, including 26 (40.0%) malignant stromal tumors, 21 (32.3%) lymphomas and 5 (7.7%) adenocarcinomas. Surgery was performed on all patients; a resection and anastomosis in 45 (69.2%), a right hemicolectomy in 10 (15.3%), an ileocecectomy in 5 (7.6%) and a wedge resection in a further 5 (7.6%). Metastasis was found on initial presentation in 21 (40.4%) patients. Combined liver, bladder and colon resections were performed in 7 (10.7%) patients. Four (6.1%) patients died during the perioperative period. The overall 3 year survival rate of the patients with malignant small bowel tumors was 58.6%. CONCLUSION: Performing aggressive surgical manipulation in suspected small bowel tumors, and the use of postoperative adjuvant therapy in lymphomas, will result in better outcomes for patients.
Abdominal Pain ; Adenocarcinoma ; Angiography ; Colon ; Female ; Follow-Up Studies ; Hemangioma, Cavernous ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Lipoma ; Liver ; Lymphoma ; Male ; Neoplasm Metastasis ; Perioperative Period ; Polyps ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome ; Urinary Bladder

PURPOSE: To report a rare case of medulloepithelioma originating from the retina. CASE SUMMARY: A nine-year-old boy visited our clinic with conjunctival injection and decreased visual acuity in the left eye, which had developed two month previously. Slit lamp examination revealed a distorted pupil and an anteriorly protruding ciliary body displacing the peripheral iris toward the cornea on the inferonasal side. Funduscopic examination showed total retinal detachment accompanied by an inferior hypervascular mass. The examination of the right eye was unremarkable. On computer tomography imaging, a calcified mass was identified behind the iris of the left globe in the inferomedial aspect, and ultrasound biomicroscopy revealed a medium to high echogenic tumor with an uneven oval cystic cavity in the ciliary body. At the follow-up examination, the size of the mass was increased, so we performed enucleation of the left eye. Pathology demonstrated that the retrolental mass abutting the lens had arisen from the retina. Histological examination revealed that the tumor had originated from the retina and extended into the ciliary body, and most of the tumor was composed of hyaline cartilage with calicification. Tumor cells were identified in the periphery, forming elongated tubules and cord-like structures that were immunohistochemically positive for vimentin, neuron-specific enolase, and CD56 compatible with a teratoid medulloepithelioma. The patient was followed up for eight months without any metastasis in the orbit or elsewhere. CONCLUSIONS: Medulloepithelioma should be considered in the differential diagnosis of pediatric orbital mass accompanied by calcification.
Ciliary Body ; Cornea ; Diagnosis, Differential ; Eye ; Follow-Up Studies ; Humans ; Hyaline Cartilage ; Iris ; Microscopy, Acoustic ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Orbit ; Phosphopyruvate Hydratase ; Pupil ; Retina ; Retinal Detachment ; Vimentin ; Visual Acuity

Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30~50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn's disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11~12 g/dl.
Anemia ; Anemia, Iron-Deficiency ; Capsule Endoscopy* ; Crohn Disease ; Eating ; Endoscopy ; Female ; Gastrointestinal Tract ; Guaiac ; Hemorrhage ; Humans ; Iron ; Jejunum ; Lower Gastrointestinal Tract ; Mucous Membrane ; Pathology ; Tuberculosis ; Ulcer ; Young Adult