There are some effective methods for removing layers of skin to improve aging face and dermatologic defects : chemabrasion (chemical peeling), dermabrasion(surgical removal), laserabrasion. Chemabrasion, generally performed with a chemical solution, is most useful for removal of fine facial wrinkles and abnormal pigmentation. The application of chemical caustics, especially TCA (trichloroacetic acid), is known to be an effective and is now commonly practiced to improve the surface of the facial skin that has been blemished by pigmentation, wrinkles, solar damage and certain scars. Trichloroacetic acid is a colorless melting crystal and derivatives of acetic acid which das protein precipitating properties. It has specific odor but there is not systemic toxic effect like a phenol. It has heavy caustic effect on skin and mucosa and cause the coagulation necrosis of the skin and therefore, it must be handled carefully and stored in the proper condition. Especially, moderate to high concentrated TCA solution must be treated by well-trained persons. A 46-year-old woman visited a private clinic for removal of fine wrinkles around the lip. She was refered to our department because of acute upper lip coagulation necrosis which was caused by injection of 35% TCA solution mistaken for lidocaine, which was supposed to be used for anesthesia. At her arrival, cental half of upper lip showed severe coagulation necrosis. The lesion was well discriminated in a few days, then debridement and immediate reconstruction was done using an Abbe flap. Chemical peeling is a relatively effective procedure for improvement of aging skin lesion in a lower cost with a short time operation, if the practitioner has much experience and optimal indication is properly selected. But not so as, side effect and complication may be often ocurred in a mistake and as a result irreversible scars are remained. We experienced a rare case of upper lip necrosis which was caused by TCA injection mistaked for lidocaine in a private clinic and so, We report this case with the results of experiment of rabbit model which was observation of macroscopic and microscopic changes of the abdominal skin of the rabbit injected with serially diluted TCA solution.
Acetic Acid ; Aging ; Anesthesia ; Caustics ; Cicatrix ; Debridement ; Female ; Freezing ; Humans ; Lidocaine ; Lip* ; Middle Aged ; Mucous Membrane ; Necrosis* ; Odors ; Phenol ; Pigmentation ; Skin ; Trichloroacetic Acid

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

PURPOSE: The survival of bone marrow derived stem cell was reported several times. But the survival of adipose tissue derived stem cells(hASCs) was not mentioned on. We studied the adipose tissue derived stem cell's survival and effect on articular cartilage in rabbits. METHODS: Osteoarthritis was induced in twenty New Zealand white rabbits by intraarticular injection of monosodium iodoacetate(MIA). After four weeks, hASCs were also injected into the knee joints space without any vehicle, but the control group received phosphate buffered saline only. The histologic grade of articular cartilage was measured in 4 and 8 weeks after the transplantation of hASC and the viability of injected stem cells measured by Fluorescent in situ Hybridization (FISH) examination. RESULTS: After 4 and 8 weeks from hASCs transplantation, histologic grade was not significantly difference between two groups(p>0.05), and the Y chromosome of the transplanted hASCs was not detected in articular cartilage. CONCLUSION: We found that direct injection of hASC in joint space didn't work on damaged articular cartilage repair.
Adipose Tissue ; Bone Marrow ; Cartilage, Articular ; Humans ; In Situ Hybridization, Fluorescence ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Osteoarthritis ; Rabbits ; Stem Cells ; Transplants ; Y Chromosome

Pseudoxanthoma elasticum (PXE) is an uncommon heritable disorder of elastin characterized by cutaneous, ocular and vascular abnormalities. Typical skin lesion shows yellowish papules and redundant skin folds on the neck, axilla and groin due to degeneration and calcification of elastic fibers in deep dermis. As in all heritable disorders of connective tissue, no curative therapy is presently know. Redundant and unsightly skin folds about the neck can be improved by surgery, but irregular papular lesion on skin does not improved by surgery. A-44-year-old female who had a skin lesion and angioid streak was treated as follows: Skin folds on the neck were excised successfully without any significant problem such as intraoperative bleeding, wound dehiscence or hypertrophic scar formation. To evaluate whether we could smooth the irregular skin surface due to multiple papules, laserbrasion with a SLT contack Nd:YAG laser system was performed experimentally on a limited area which was located on the right supracla-vicular area about 2 x 3cm in size. An acceptable aesthetic appearance was achieved with surgical excision 12 months after the operation. Biopsy of the laserbrasion site revealed disappearance of the calcium deposit. This study emphasizes the possibility of using laserbrasion in solving troblesome skin lesion of the PXE.
Angioid Streaks ; Axilla ; Biopsy ; Calcium ; Cicatrix, Hypertrophic ; Connective Tissue ; Dermis ; Elastic Tissue ; Elastin ; Female ; Groin ; Hemorrhage ; Humans ; Neck* ; Pseudoxanthoma Elasticum ; Skin ; Wounds and Injuries

PURPOSE: To compare postoperative clinical outcomes, optical quality, and patient satisfaction between two types of diffractive multifocal intraocular lens (IOL, Acri Lisa 366D and Acrysof ReSTOR +3.00 D). METHODS: In a total of 68 eyes, one of two diffractive multifocal IOL (Acri Lisa 366D and Acrysof ReSTOR +3.00 D) was implanted after cataract extraction. Visual acuity was measured postoperatively at one week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function were determined via questionnaire at postoperative 1 month. RESULTS: Intermediate visual acuity of Acri Lisa 366D and Acrysof ReSTOR at 6 months were 0.31 +/- 0.14, and 0.24 +/- 0.11 (log MAR), respectively. At 6 months, near and distant visual acuity results showed no significant differences between the two groups. The photopic contrast sensitivity of Acri Lisa 366D at 6 cycles/degree was 55.36 +/- 7.40 and showed significant differences with Acrysof ReSTOR (47.25 +/- 9.67). The mesopic contrast sensitivity values of Acri Lisa 366D and Acrysof ReSTOR were 40.26 +/- 11.38 and 28.97 +/- 10.45, respectively, and the spherical aberration values were 0.037 +/- 0.039 microm and 0.105 +/- 0.066 microm. The spherical aberration of Acri Lisa 366D was significantly lower than that of Acrysof ReSTOR. Total and high order aberration, coma, and trefoil show no significant differences between the two groups. CONCLUSIONS: The Acri Lisa 366D multifocal IOL showed better contrast sensitivity and spherical aberration compared to Acrysof ReSTOR multifocal IOL, which had an effective intermediate visual acuity.
Cataract Extraction ; Coma ; Contrast Sensitivity ; Lenses, Intraocular* ; Lotus ; Patient Satisfaction ; Visual Acuity

The association of major fetal malformations with amniotic bands has been known for many years. However, we are apt to ignore the possibility of amniotic band syndrome. In this case, fetal anencephaly was diagnosed at 17 weeks, menstrual age on the basis of sonographic findings. Following pregnancy termination, examination of the abortus rev- ealed the cerebral remnant which is similar to that found in dysraphic anencephaly, but collateral evidence of amniotic band was found. Therefore, when confronted with severe cranial or cerebral malformation amniotic band syndrome should be in the differential dia- gnosis.
Amniotic Band Syndrome* ; Anencephaly* ; Infant, Newborn ; Pregnancy ; Skin* ; Ultrasonography

Malformations of cortical development (MCD) cover a broad spectrum of developmental disorders which cause the various clinical manifestations including epilepsy, developmental delay, and intellectual disability. MCD have been clinically classified based on the disruption of developmental processes such as proliferation, migration, and organization. Molecular genetic studies of MCD have improved our understanding of these disorders at a molecular level beyond the clinical classification. These recent advances are resulted from the development of massive parallel sequencing technology, also known as next-generation sequencing (NGS), which has allowed researchers to uncover novel molecular genetic pathways associated with inherited or de novo mutations. Although an increasing number of disease-related genes or genetic variations have been identified, genotype-phenotype correlation is hampered when the biological or pathological functions of identified genetic variations are not fully understood. To elucidate the causality of genetic variations, in vivo disease models that reflect these variations are required. In the current review, we review the use of NGS technology to identify genes involved in MCD, and discuss how the functions of these identified genes can be validated through in vivo disease modeling.
Classification ; Disease Models, Animal ; Epilepsy ; Genetic Association Studies ; Genetic Variation ; Intellectual Disability ; Malformations of Cortical Development* ; Molecular Biology*

A 46-year-old male patient developed jaundice after 23 days' treatment of propylthiouracil (PTU) for Graves' disease. Serum alkaline phosphatase was elevated markedly with moderate increase in serum aminotransferase, and the peak level of total bilirubin was 7.3 mg/dL. After withdrawal of PTU, serum aminotransferase and bilirubin began to decrease simultaneously, and completely normalized. One week after the discharge from hospital, he received radioiodine treatment for Graves' disease, but he showed aggravation of hyperthyroidism and ophthalmopathy. So we prescribed methimazole inevitably 16 days' after the radiodiodine treatment. He developed jaundice again after 69 days' treatment of methimazole, but the pattern of hepatotoxicity was slightly different from that of the previous PTU-nduced hepatotoxicity. Serum aminotransferase increased slightly and quickly normalized after discontinuance of methimazole, but serum total bilirubin increased continuously and reached to 24.6 mg/dL. Eosinophilia was prominent and the result of liver biopsy was compatible with cholestatic jaundice. The patient was treated with prednisolone and recovered from jaundice rapidly.
Alkaline Phosphatase ; Bilirubin ; Biopsy ; Eosinophilia ; Graves Disease ; Humans ; Hyperthyroidism ; Jaundice ; Jaundice, Obstructive ; Liver ; Male ; Methimazole* ; Middle Aged ; Prednisolone ; Propylthiouracil*

BACKGROUND/AIMS: The endoscopic mucosal resection has now been adopted for a useful modality in both curative therapy and accurate diagnosis of early gastric cancer. A retrospective study was done to evaluate the indication and the limitation of endoscopic mucosal resection of early gastric cancer. METHODS: We studied 20 cases of early gastric cancer treated by endoscopic mucosal resection in Chungnam National University Hospital from November, 1995 to July, 1997. RESULTS: 1) The size affected the curability: 83. 3% of lesions less than 2 cm and 50. 0% of those larger than 2 cm were resected completely. 2) The depth of cancer invasion affected the curability: 87. 5% of lesion confined to mucosa were resected completely, while all of submucosal cancers were resected incompletely. 3) Among fourteen cases resected completely, three cases of lesions larger than 2 cm were residual cancer and two of those less than 2 cm were recurred locally. CONCLUSIONS: To be a curative therapy by endoscopic mucosal resection of early gastric cancer, we think that careful selection of the lesion, that is lesion less than 2cm and confined to mucosa, is necessary
Chungcheongnam-do ; Diagnosis ; Mucous Membrane ; Neoplasm, Residual ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: To determine the efficacy of CarnitilR (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. MATERIALS AND METHODS: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of CarnitilR daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. RESULTS: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after CarnitilR treatment showed an increase in volume (2.64+/-1.65 ml vs. 3.10+/-1.60 ml), motility (35.1+/-17.7% vs. 45.9+/-20.4%) and viability (51.4+/-20.3% vs. 59.3+/-13.6%) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after CarnitilR treatment showed an increase in sperm count (10.7+/-54.4 million/ml vs. 38.4+/-32.5 million/ml) respectively. CONCLUSIONS: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.
Acetylcarnitine* ; Carnitine ; Follow-Up Studies ; Humans ; Infertility, Male ; Male ; Semen ; Semen Analysis ; Sperm Count