PURPOSE: In this study we investigated the histopathologic characteristics of conjunctivochalasis and its association with lymphangiectasis using impression cytology and conjunctival excisional biopsy in patients with conjunctivochalasis. METHODS: This prospective study included 14 outpatients diagnosed with conjunctivochalasis, and who had excisional biopsies performed between March 1, 2012 and November 30, 2012. Preoperative slit-lamp examination, dry eye diagnostic test and impression cytology were also performed. For histological analysis, conjunctival sections were stained with hematoxylin and eosin (H&E), Verhoeff-van Gieson (VVG) elastic staining, and monoclonal antibody D2-40, a lymphatic endothelial marker. RESULTS: Tear break-up time and Schirmer's value were decreased in patients with conjunctivochalasis. Impression cytology showed a decrease in goblet cell density and an increase in nucleoplasmic/cytoplasmic ratio. The patients' conjunctival tissues exhibited an infiltration increase of chronic inflammatory cells on H&E stain, and a decrease in collagen density with degeneration of elastic fibers on VVG stain compared to tissues from the control subjects. D2-40 immunohistochemistry revealed the dilated subconjunctival lymphatics in patients with conjunctivochalasis. CONCLUSIONS: This study suggests that the characteristic histopathological features of conjunctivochalasis include dilated lymphatic vessels as well as decreased goblet cell and collagen densities with degeneration of elastic fibers.
Antibodies, Monoclonal, Murine-Derived ; Biopsy ; Collagen ; Diagnostic Tests, Routine ; Elastic Tissue ; Eosine Yellowish-(YS) ; Eye ; Goblet Cells ; Hematoxylin ; Humans ; Immunohistochemistry ; Lymphangiectasis ; Lymphatic Vessels ; Outpatients ; Prospective Studies

OBJECTIVE: The presence of the various cytokines in human peritoneal fluid has been evaluated incompletely. Changes in cytokine lefels may be related to activation of peritoneal macrophage and T-lymphocyte, development of endometriosis, and infertility. This study assesses peritoneal fluid levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-alpha) in infertile women with endometriosis and normal women without endometriosis. Design : Prospective and case-control study in university hospital. MATERIALS AND METHODS: Cytokine levels in peritoneal fluid obtained during laparotomy or laparoscopy from 21 patients in infertile patients in infertile patients with endometriosis and 24 controls undergoing laparotomy or laparoscopy with no evidence of pelvic endometriosis were determined by enzymelinked immunosorbent assay. RESULTS: The mean levels of interleukin-6 in infertile patients with endometriosis and controls were 72.7+/-23.7 pg/ml and 18.5+/-9.7 pg/ml respectively (p=0.02). Similarly, the mean levels of interleukin-8 in infertile patients with endometriosis was significantly higher than that of controls (445.0+/-89.6, vs 45.1+/-48.4, p=0.04). The mean concentration of interleukin-10 in infertile patients with endometriosis was significantly lower than that of controls (1.09+/-0.04 vs 2.19+/-0.03, p=0.03). The level of tumor necrosis factor-alpha was not significantly different between the two study groups. CONCLUSIONS: Increased IL-6 and IL-8 and decreased IL-10 levels in the peritoneal fluid may be related to pathogenesis in the endometriosis and infertility, suggesting that partially contribute to the disturbed immune regulation observed in infertili women with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Cytokines ; Endometriosis* ; Female ; Humans ; Infertility ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Laparoscopy ; Laparotomy ; Macrophages, Peritoneal ; Prospective Studies ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

Purpose: This study was performed to identify the effects of the alpha1A adrenoceptor antagonist on the urethral perfusion pressure (UPP), and also to assess its therapeutic potentials for female bladder outlet obstruction (BOO). Materials and Methods: A cannula was placed in the femoral artery for drug administration and systemic blood pressure monitoring in each female rat. The UPP and vesical pressure (Pves) were monitored using a triple-lumen catheter. Tamsulosin (group I), doxazosin (group II) and phentolamin (group III) were injected into female rats via the femoral cannula. Tamsulosin was also injected to male rats (group IV) for comparison with Group I. Results: After administration of tamsulosin in group I, the frequency was significantly decreased and the duration of minimal urethral relaxation with high frequency oscillations (Dhfo) was significantly prolonged. None of the parameters were significantly different compared with groups II and III, with the exception of the mean arterial blood pressure (MAP). The changes of MAP after tamsulosin were significantly lower than those after doxazosin and phentolamin. In the male rats (group IV), prior to the administration of tamsulosin, the UPP and Pves curves were similar to those of the female rats, but the maximal Pves was significantly higher than in group I. After the administration of tamsulosin to group IV, the prolongation of the frequency and Dhfo were significant. Conclusions: In the female rat urethra, the alpha1A adrenergic receptor may be a functional subtype. The alpha1A adrenoceptor antagonist was found to prolong the Dhfo and decrease the frequency of involuntary bladder contraction. It might be possible that the alpha1A adrenoceptor antagonist improves not only the obstructive symptoms, but the bladder irritative symptoms also, by prolonging the Dhfo and frequency of an involuntary bladder contraction.
Adrenergic alpha-Antagonists ; Animals ; Arterial Pressure ; Blood Pressure Monitors ; Catheters ; Doxazosin ; Female* ; Femoral Artery ; Humans ; Male ; Perfusion* ; Rats* ; Receptors, Adrenergic ; Relaxation ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction

OBJECTICES AND METHODS: The purpose of this study was to examine availabilities of stop-signal task as a screening test for ADHD and as a research tool. Stop-signal task was applied to 40 ADHD patients and 18 normal children. Followings are the results of this study. RESULTS: There were significant differences between ADHD group and control group in ZRFT, mean delay x block and primary-RT of stop-signal task performance(p<0.05). There was no significant difference in results of continuous performance test. SSRT of stop-signal task had significant correlation with hit reaction time of continuous performance test, and primary-RT and primary-SD with attentiveness and hit reaction time of continuous performance test. There was no significant correlation between scores of ADDES-HV and stop-signal task performance. In change of primary-SD according to intelligence, primary-SD decreased as intelligence increased but made plateau after IQ 110, and in change of SSRT according to age, SSRT decreased as intelligence increased but made plateau after 10 year-old. In discriminant ability, mean delay x block and primary-RT showed highest discriminant ability (each 75%). In addition P-inhibit showed 63.89%, SSRT showed 58%, ZRFT showed 67%, and primary-SD showed 58% in discriminant ability. There was no significant difference in stop-signal task performance between ADHD with hyperactivity and ADHD without hyperactivity. CONCLUSION: In this point of view, stop-signal task was proved to be a useful research tool for attention deficit hyperactivity disorder as well as useful screening test tool.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Executive Function ; Humans ; Intelligence ; Mass Screening ; Reaction Time ; Task Performance and Analysis

PURPOSE: To investigate the clinical characteristics and treatment methods for pediatric thyroid-associated orbitopathy in pediatric patients with thyroid disorders. METHODS: To determine the prevalence and clinical characteristics of pediatric thyroid-associated orbitopathy, we retrospectively analyzed the medical records of 34 patients admitted to the Pediatrics Department of our institution between September 2010 and September 2012. The patients had been diagnosed with autoimmune thyroid disorder and were admitted for treatment of thyroid-associated orbitopathy. RESULTS: In the 24.1 months of follow-up observation, 14 patients were diagnosed with Graves' disease (41.2%) and 20 patients with Hashimoto's thyroiditis (58.8%). Of the 34 patients, 15 (44.1%) developed eye symptoms. Among the eye symptoms, lid swelling was the most prevalent in 41.2% of patients, followed by eyelid retraction in 23.5%, lid lag in 17.6%, conjunctival injection in 14.7%, proptosis in 8.8%, and extraocular muscle hypertrophy in 17.6%. Severe impairment of visual acuity, visual field, and ocular motility were not observed in our study. Although eyelid surgery was performed in 3 cases, most patients were treated conservatively. CONCLUSIONS: Pediatric thyroid-associated orbitopathy was frequently observed in patients with Graves' disease and Hashimoto's thyroiditis. Compared to adults, children showed milder disease manifestation and progression, and the disease could be managed with conservative treatment.
Adult ; Child ; Exophthalmos ; Eye ; Eyelids ; Follow-Up Studies ; Graves Disease ; Humans ; Hypertrophy ; Medical Records ; Muscles ; Pediatrics ; Prevalence ; Retrospective Studies ; Thyroid Gland ; Thyroiditis ; Visual Acuity ; Visual Fields

CATCH 22 is a medical acronym for cardiac defects, abnormal faces, thymic hypoplasia, cleft palate, and hypocalcemia, and a variable deletion on chromosome 22. It includes DiGeorge syndrome, conotruncal anomaly face syndrome, and velo-cardio-facial syndrome. It has a prevalence estimated at 1:3,000-1:6,000. Most deletions occur at de novo, but autosomal dominant inheritance is observed in 6-10% of cases. Hormonal disorders are common in patients with CATCH22 syndrome. While hypoparathyroidism was the predominant endocrine disturbance that has been documented in the DiGeorge syndrome, other hormonal defects, such as growth hormone deficiency, hypothyroidism, and hyperthyroidism have been occurred in patients with CATCH22 syndrome. The spectrum of parathyroid gland dysfunction in this syndrome ranges from severe neonatal hypocalcemia to normal parathyroid function. Most patients are usually diagnosed in young age, but a few patients with mild abnormality are presented later in life. We report a case of CATCH22 syndrome with normal parathyroid hormone and calcium level in an adult. The diagnosis of CATCH22 syndrome was confirmed by fluorescence in situ hybridization analysis.
Adult ; Calcium ; Chromosomes, Human, Pair 22 ; Cleft Palate ; DiGeorge Syndrome ; Fluorescence ; Growth Hormone ; Humans ; Hyperthyroidism ; Hypocalcemia ; Hypoparathyroidism ; Hypothyroidism ; In Situ Hybridization ; Parathyroid Glands ; Parathyroid Hormone ; Prevalence ; Wills

The purpose of this study was to evaluate the shear bond strengths between various hybrid computer-aided design (CAD)/computer-aided manufacturing (CAM) restorative materials and repairing resin. Two resin network-based hybrid (Lava Ultimate and Polyglass), one ceramic framework-based hybrid (Enamic), and one zirconia (Zenotec Zr bridge) CAD/CAM restorative materials were used in this study. The shear bond strength test and failure modes of four experimental groups designated LUS (Lava Ultimate), ENA (Enamic), PGB (Polyglass), and ZBR (zirconia control group) were characterized in this study. The hybrid CAD/CAM restorative materials showed stronger shear bond strengths in the sequence of PGB, LUS, and ENA (P < 0.05). The shear bond strengths of PGB and LUS groups showed significantly higher than those of ZBR (P < 0.05), while ENA did not show any significant difference from ZBR (P < 0.05). The PEG and LUS groups mostly exhibited cohesive failure, but the ENA and ZBR groups predominantly showed adhesive failure. Therefore, resin network-based hybrid CAD/CAM restorative materials such as Lava Ultimate and Polyglass should be more useful for intra-oral repairs.
Adhesives ; Ceramics ; Composite Resins ; Computer-Aided Design ; Prostaglandins B

PURPOSE: To evaluate cross-sectional areas of conjunctiva and tear meniscus of conjunctivochalasis using Fourier-Domain RTVue-100 optical coherence tomography (OCT) before and after conjunctivochalasis surgery. METHODS: Thirty-one patients (33 eyes) with symptomatic conjunctivochalasis were recruited for this study between June 2013 and April 2014. All patients underwent crescent-shaped conjunctiva resection and amniotic membrane transplantation. Anterior segment OCT (AS-OCT) imaging was performed and tear break-up time was evaluated prior to and 3 months after the conjunctivochalasis surgery. Cross-sectional areas of conjunctiva and tear meniscus of conjunctivochalasis at 7 locations (1 center, 3 nasal and 3 temporal areas) were measured in all patients. RESULTS: The mean age of patients was 66.3 +/- 10.8 years. Cross-sectional areas of conjunctivochalasis at all locations significantly decreased from 0.487 +/- 0.42 mm2 to 0.007 +/- 0.011 mm2 (p < 0.001), whereas no significant changes in cross-sectional areas of tear meniscus at all 7 locations were observed after the surgery. Mean tear break-up time significantly increased from 2.26 +/- 0.69 sec to 3.81 +/- 1.22 sec following the surgery. CONCLUSIONS: Using AS-OCT, in this study we showed that areas of conjunctiva decreased and areas of tear meniscus were unchanged after conjunctivochalasis surgery.
Amnion ; Conjunctiva* ; Humans ; Tears* ; Tomography, Optical Coherence*

PURPOSE: Conflicting results have been reported for western populations on associations of serum insulin-like growth factor I (IGF-I) and major IGF-binding protein-3 (IGFBP-3) with the risk of prostate cancer. However, few data have been available for oriental populations. We undertook a matched case-control study in a low-risk Korean population to extend our knowledge about potential associations. MATERIALS AND METHODS: Serum IGF-I and IGFBP-3 levels were determined for 330 men (165 cases and 165 healthy age-matched controls). Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the association between plasma IGF levels and prostate cancer. We also investigated the potential influence of the associations according to clinical risk for advanced disease at diagnosis. RESULTS: We noted that the risks of prostate cancer were unrelated to the IGF-1 level and IGF-I/IGFBP-3 molar ratio. In contrast, a strong inverse association was observed between IGFBP-3 levels and the risk for prostate cancer. Men in the highest quartile of IGFBP-3 levels had a 71% reduced risk of prostate cancer compared with men in the lowest quartile (OR=0.29, 95% CI: 0.11-0.64, P(trend)<0.001). Subgroup analysis revealed a significant inverse association between plasma IGFBP-3 and the likelihood of a high risk prostate cancer. CONCLUSIONS: Plasma IGFBP-3 levels were inversely associated with the risk of prostate cancer and the likelihood for high-risk disease, suggesting that IGFBP-3 plays a protective role against prostate cancer in the Korean population.
Case-Control Studies ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Logistic Models ; Male ; Molar ; Odds Ratio ; Plasma ; Prostate ; Prostatic Neoplasms

STUDY DESIGN: Case report. OBJECTIVES: To report a huge epidural hematoma after epidural neurolysis. SUMMARY OF LITERATURE REVIEW: No complications have been reported regarding to hematoma formations after neurolysis using NaviCath(R). MATERIAL AND METHODS: A 67-year-old male with normal serum coagulation parameter experienced excruciating back and leg pains after neurolysis using NaviCath(R). RESULTS: After performing prompt multilevel laminotomy with hematoma evacuation, the patient recovered from pains without any neurological sequelae. CONCLUSIONS: It is important to be cautious while performing neurolysis with NaviCath(R) to avoid the epidural hematoma. Surgical treatment is an effective option to resolve the spinal epidural hematoma.
Hematoma ; Hematoma, Epidural, Spinal ; Humans ; Laminectomy ; Leg ; Male ; Nerve Block