No abstract available.
Cytokines

Capsule contraction syndrome is severe constriction of the anterior capsular opening and equatorial capsular bag diameter after extracapsular cataract surgery. It is relatively common in patients with continuous curvilinear capsulorhexis, but rarely in can-opener capsulotomy or anterior radial capsular tears. It is due to capsular bag contraction from fibrous dysplasia of residual lens epithelial cells with weakened zonular resistance. We experienced a case of capsule contraction syndrome in a 72-year old woman with retinitis pigmentosa, who had phacoemulsification following an intact 5.0mm-continuous curvilinear capsulorhexis 4 months before. After successful YAG laser radial anterior relaxing capsulotomy, her visual acuity restored to 0.3, limited by cystoid macular edema.
Aged ; Capsulorhexis* ; Cataract ; Constriction ; Epithelial Cells ; Female ; Humans ; Lasers, Solid-State ; Macular Edema ; Phacoemulsification ; Retinitis Pigmentosa ; Visual Acuity

BACKGROUND: Long-term phototherapy can induce the changes of photoaging and it is reported that there is an increased chance of cutaneous squamous cell carcinomas in patients exposed to large amounts of UV radiation. OBJECTIVE: The main objective was to investigate the degree of photoaging and the presence of p53 mutations in normal skin in patients undergoing long-term phototherapy. METHOD: We performed hematoxylin-eosin and special stains, p53 and p21 immunohistochemical stains and polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) on the normal skin of patients subject to long-term UV therapy. RESULT: 1. The typical features of photoaging were not observed in patients undergoing long-term UV therapy. 2. In p53 immunohistochemical staining performed at 1 week after cessation of long-term PUVA treatment, the patient group with a culmulated UV dosage of more than 1,000J/cm2 demonstrated an increased number of p53 positive epidermal cells compared to exposed as well as unexposed normal skins. 3. The patterns of p21 immunohistochemical staining performed at 1 week after cessation of long-term PUVA and UVB treatments were similar to that of p53 immunohistochemical staining performed at 1 week after cessation of phototherapy. 4. In p53 immunohistochemical staining performed at 4 months after cessation of UV treatment, the number of p53 positive epidermal cells decreased significantly compared to that of p53 positive epidermal cells found at 1 week after cessation of UV treatment. 5. The mutation of p53 genes was not found in PCR-SSCP analysis of biopsied skins done at 1 week after cessation of long-term PUVA and UVB treatment. CONCLUSION: Long-term phototherapy did not induce the typical changes of photoaging and p53 overexpression in the epidermis of UV treated skin was a reactive process. Therefore, UV therapy can be a relatively safe treatment modality, although a closer observation for cutaneous malignancy is warrented in the patients whose cumulated UV dosage is much higher than 1,000J/cm2.
Aging* ; Carcinoma, Squamous Cell ; Coloring Agents ; Epidermis ; Genes, p53 ; Humans* ; Phototherapy ; Skin*

No abstract available.

Many injuries of the hand have been occured in these days because of frequent industrial hazards and frequent handling of tools in modern civilizing life. A voluminous amount of literature has been recently concerned with many problems and questions posed by tendon surgery. Many investigations have been devoted to discussion of suture materials, tendon suturing, grafting, healing, rate of healing, nutrition and related clinical and laboratory endeavors. Because of these efforts, the designation of Zone II as“no man's land” is no longer significant and should be called “skilled man's land”. With regard to to secondary reconstructive surgery, in cases without much scarring and few associated lesions, we routinely select the one-stage graft and use early motion in the postoperative programs. This paper aimed to review our experience with 215 patients with flexor tendon injuries in hand who were treated with primary repair or tendon graft with average follow up of 8.5 months from June, 1973 to May, 1987 and the following results were obtained. 1. The most frequent site of injury was Zone V. 2. The over all end result of primary repair was satisfactory in 86.5% by White and Kleinert criteria. 3. The over all end result of tendon graft in Zone Il was satisfactory in 51.0% by White and Kleinert criteria. 4. In Zone lI, primary repair obtained satisfactory result in 36.4% but the tendon graft obtained satisfactory result in 51.0%. 5. In tendon graft, the preoperative stste was supposed to have close relation to postoperative result and the duration from injury to graft was supposed to have little relation to postoperative results. 6. In primary repair, the cases using Bunnells suture technique obtained satisfactory result in 85.1% and the cases using modified Kesslers suture technique obtained satisfactory result in 91.2%.
Cicatrix ; Clinical Study ; Follow-Up Studies ; Hand ; Humans ; Suture Techniques ; Sutures ; Tendon Injuries ; Tendons ; Transplants

The increased survival of patients with breast cancer has given rise to other problems associated with the complications of chemotherapy. One major complication is premature ovarian failure, an especially harmful outcome for women of reproductive age. This study was performed to evaluate the efficacy of GnRH agonist (GnRHa) treatment on protecting ovarian function in young breast cancer patients (30.59+/-5.1 yr) receiving chemotherapy after surgery. Twenty-two women were enrolled and given subcutaneous injections of leuprolide acetate (3.75 mg) every 4 weeks during chemotherapy. Follow-up laboratory tests (luteinizing hormone [LH], follicle stimulating hormone [FSH], and estradiol) were performed 1, 3, and 6 months after chemotherapy. Menstruation patterns and clinical symptoms were followed up for a mean duration of 35.6+/-1.7 months. FSH and LH levels were normal in all patients 6 months after completing chemotherapy (8.0+/-5.3, 4.4+/-2.7 mIU/mL, respectively). During follow-up, none of the patients complained of menopausal symptoms and 81.8% experienced recovery of menstruation. This report is the first trial of GnRHa as a treatment modality to protect ovarian function during adjuvant chemotherapy in young Korean breast cancer patients.
Adult ; Antineoplastic Agents/adverse effects/therapeutic use ; Antineoplastic Agents, Hormonal/therapeutic use ; Breast Neoplasms/diagnosis/*drug therapy/surgery ; Combined Modality Therapy ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Female ; Follicle Stimulating Hormone/analysis ; Gonadotropin-Releasing Hormone/*agonists ; Humans ; Leuprolide/administration & dosage ; Luteinizing Hormone/analysis ; Menstruation ; Ovarian Function Tests ; Primary Ovarian Insufficiency/etiology/*prevention & control ; Republic of Korea ; Tamoxifen/therapeutic use ; Time Factors

This study was designed to investigate effectiveness of fragmentation during lithotripsy using 103 intrahepatic stones collected from 10 patients. Who had previously undergone biliary surgery. The size of each stones was measured and sonography was performed for the evaluation of the sonographic type of the stones. In vitro lithotripsy was performed on individual stones using piezoelectric lithotriptor to evaluate the fragmentation rate and average number of shock waves for fragmentation. Chemical analysis of each stone was done to determine chemical composition including calcium, bilirubin, and cholesterol. The size of the stones was from 5mm to 20 mm in diameter. Sonographic type I(echo of whole stone with posterior acoustic shadow) was 68, and type II(are-like strong surface echo of stone with clear posterior acoustic shadow) was 35 in number. The majority(78%) of stones I group 1 (5-9mm in diameter) showed sonographic type I characteristics, and 62% of stones in group 3(larger than 15mm in diameter) showed sonographic type Ii characteristics. There was a positive correlation between the size and sonographic type of stones. Fragmentation rates of stones were 100% in group 1. 71.9% in group 2 (10-15 mm in diameter), 43.8% in group 3. Respectively. Fragmentation rates of stones with sonographic type I and II were 91.2%, 65.7%. respectively. The average number of shock waves for partial and complete fragmentation was 2753±4937 and 6219±10133. Respectively. There was a positive correlation between the number of shock waves for fragmentation and diameter of stones (r=0.618. p<0.05). There was no correlation between the number of shock waves for fragmentation and chemical composition of stones. In conclusion, the most important variable determining the degree of fragmentation of intrahepatic stones using ESWL is not their chemical composition but their size and sonographic characteristics.
Acoustics ; Bilirubin ; Calcium ; Cholesterol ; Humans ; In Vitro Techniques* ; Lithotripsy* ; Shock* ; Ultrasonography

We report two cases of angiokeratoma circumcriptum. One of them was 20 year- old male, who had multiple dark erythematous 0.5 cm to 2 cm sized keratotic papules and nodules surrounding irregular shaped erythema scattered or grouped on the right lower leg. The other case was 36 year-old male, who had Q. 7 cm sized dark erythematous papules and 2 cm sized dark brown colored nodule with central ulceration on the medial part of the left upper thigh, The two patients had skin lesions at birth. Histopathologic finding disclosed markedly dilated vessels containing many red blood cells mainly in the papillary dermis, which in some, were surrounded by elongated rete ridge. Cavernous hemangioma like lesion was present in the lower dermis and subcutaneous fat in case 2.
Adult ; Angiokeratoma* ; Dermis ; Erythema ; Erythrocytes ; Hemangioma, Cavernous ; Humans ; Leg ; Male ; Parturition ; Skin ; Subcutaneous Fat ; Thigh ; Ulcer

Satisfactory surgical reconstruction of the external ear and nose is still a major challenge for the plastic surgeon. Therefore, the use of prosthesis in selected cases should be considered as viable alternative. During the period from December, 1995 to January, 1998, 10 patients, including 9 patients of ear defect and 1 patient of nose defect resulting from the resection of recurrent tumor ablation, were reconstructed by using osseointegration and prosthesis. The surgery was performed in two stages. All procedures were performed under local anesthesia and on an outpatient. At the first stage, the fixtures of titanium implant were placed in the mastoid process and maxilla. These implants were then left for 3 months before the second stage takes place, in which the skin penetrating abutments were attached. After 3-4 weeks, the impression of the defect area were taken and the silicone prosthesis was made by Anaplastologist. Two patients had focal infection but healed without problem. One patient had soft tissue infection, then flap was excised and skin graft performed. There was one loss from 20 fixtures, that was 3 years after implantation. We have concluded that osseointegration for reconstruction of the ear and nose defect is simple, soft, reliable method, which is more than autologous reconstruction and provides excellent aesthetic results.
Anesthesia, Local ; Ear ; Ear, External ; Focal Infection ; Humans ; Mastoid ; Maxilla ; Nose* ; Osseointegration* ; Outpatients ; Prostheses and Implants ; Silicones ; Skin ; Soft Tissue Infections ; Titanium ; Transplants

A clinical observation was performed on 15 cases of the primary renal pelvic and the ureteral tumors, observed in our clinic during the period from Jan. 1962 to Dec. 198O. The results were as follows; The incidence of the renal pelvic and the ureteral tumors among the 335 genitourinary tumors during the period was 4.5% (15 cases). Male to female ratio was 2.8:1 and right to left ratio was 2:1 in the renal pelvic and the ureteral tumors. The seventy five percent of the ureteral tumor occurred in the lower ureter. 2. The most common symptom was hematuria in the renal pelvic and the ureteral tumors. 3. Urographic findings in the renal pelvic tumor were filling defect in 5 cases (71.4%) and non functioning kidney in 2 cases (28.6%). In the ureteral tumor, hydronephrosis was 5 cases (62.5%), non functioning kidney in 3 cases (37.5%) and filling defect in 2 cases (25.0%). 4. Treatment of the renal pelvic and the ureteral tumors was performed surgery in all cases. In the renal pelvic tumor, 5 nephroureterectomies, 1 nephrectomy and 1 nephroureterctomy with excision of the bladder cuff were performed. In the ureteral tumor, 5 nephroureterectomies with excision of bladder cuff and 3 nephroureterectomies were done. 5. Histologic analysis showed transitional cell carcinoma in all cases. Histologic grade and stage showed a close correlation with prognosis.
Carcinoma, Transitional Cell ; Female ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Kidney Pelvis* ; Male ; Nephrectomy ; Prognosis ; Ureter* ; Urinary Bladder