Although MDR was previously thought to be predominantly caused by the expression of the MDR1 gene, it is now increasingly believed to be caused by other mechanism. Recently, over-expression of the multidrug resistance-associated protein (MRP) was suggested a possible mechanism for non-Pgp mediated MDR. Recent studies showed that MRP can confer resistance to a wide spectrum of natural product drug, but the clinical relevance of MRP-mediated MDR in human cancer is poorly understood. p53 is the most widely known tumor suppressor gene. It has been suggested that mutant p53 is related to abnormal proliferation of cell and some what is been related to cellular apoptosis. To determine the clinical significance of MRP and/or p53 expression in colorectal carcinoma, the authors investigated the expression of the MRP and p53 in 81 cases of primary colorectal carcinoma, the relationship between the MRP and/or p53 expression and clinical parameters including 5-yr. survival rate, and the relationship between the expression of MRP and p53. The results were as follows: 1) Of the 81 colorectal carcinomas, 36 (42%) were MRP positive and 28 (34%) were p53 positive. 2) The expression of MRP and/or p53 was not significantly correlated with sex, age, histologic grades, tumor invasion, tumor location, tumor size, lymph node metastasis, TNM stage and survival of patients. In conclusion, these results suggest that expression of MRP and/or p53 is neither related to the known prognostic factors nor a prognostic factor by itself.
Apoptosis ; Colorectal Neoplasms* ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Multidrug Resistance-Associated Proteins ; Neoplasm Metastasis ; Prognosis ; Survival Rate

Purpose: The characteristics of pediatric dermoid cyst patients. Methods: This was a retrospective chart review of 64 dermoid cyst patients (65 eyes) aged < 18 years. Results: Limbal dermoids and conjunctival dermolipomas were observed in 49 and 16 eyes (48 and 16 patients), respectively. Limbal dermoids were more common in the left eye (61%), particularly on the inferotemporal side (80%). Three (6%) of the patients were diagnosed with Goldenhar syndrome. The horizontal diameter (3.76 ± 1.30 mm) was greater than the vertical diameter (3.74 ± 1.30 mm). Most of the lesions were yellow (35.2%) in color, mildly elevated (n = 19, 55.9%), and not visible when the eyes were closed. The mean best corrected visual acuity was 0.8 ± 0.2 in 23 patients, with mean astigmatism and mean corneal astigmatism values of -2.1 ± 2.2 diopters (D) and -2.0 ± 1.1 D, respectively. None of the conjunctival dermolipoma patients had any ocular history. The left eye (75%), particularly the temporal and superiotemporal conjunctival fornix, was the most commonly affected site. The mean best corrected visual acuity was 0.9 ± 0.0 in seven patients, with an average astigmatism of -0.3 ± 0.2 D. Conclusions Dermoid cysts are congenital benign tumors that may be associated with congenital diseases. They vary in size, location, color, and extent of invasion, and may cause functional problems, such as astigmatism and amblyopia. Therefore, timely surgical treatment is desirable.

Purpose: Granular corneal dystrophy type 1 (GCD1) is a genetic disorder characterized by grayish-white granular deposits in the corneal stroma, typically manifesting before age 10. The specific characteristics of GCD1 in the Korea population remain insufficiently described. This study investigated the morphological features of GCD1 corneas with confirmed genetic mutations in this population. Methods: Medical records of GCD1 patients with the R555W mutation confirmed through transforming growth factor β induced (TGFBI) gene testing on oral epithelium or blood samples from 2005-2022, were analyzed. Corneal photographs obtained using a slit lamp biomicroscope were also examined. Results: The study group included 11 males and 19 females with an average age of 35.7 years, ranging from 3-70 years. All participants were heterozygotes. In 28 individuals (56 eyes, representing 93.3% of the total), there were signs of corneal deposit detachments, known as “drop-off”, observed in patients aged 6 years and above. Surface deposits reemerged at the peripheral margin of previous locations and expanded toward the center. The number and shape of opacities significantly changed with age, showing cycles of deposition and shedding. There were variations in the severity of opacities within the same family, particularly with advancing age, and distinct opacities extending into deeper stromal layers. Conclusions This study outlines the morphological characteristics of corneas in Korean GCD1 patients, based on corneal photograph analysis. These findings provide a basis for future comparative studies with GCD2 and may aid rapid clinical diagnosis based on clinical findings, prior to genetic testing confirmation.

Anal incontinence following pelvic trauma, surgery or neurologic disorder has significant medical and social implications. When no known functioning sphincter muscles are present, surgical correction of this distressing condition other than by stomal fecal diversion is aimed at recreating a sphincter mechanism under voluntary control. The use of the gluteus maximus encircling the neorectum with a contractile muscualr ring provides an active control of continence and reserves the anorectal angulation. The sacrifice of the entire gluteus maximum muscle in an ambulatory patient will cause difficulty in climbing stairs; however, the use of the anatomically dissected lower half will preserve its function. With careful dissection, the lower half of the g1uteus maximus muscle together with its neurovascular supply can be developed for anal sphincter reconstruction. Three Patient, (two men and one woman) underwent g1uteus maximus transposition for complete anal incontinence. The indication for operation were sphincter destruction secondary to extensive soft tissue necrosis on perianal, perineal and buttock area due to necrotizing fascitis(n=2), and soft tissue defect on perianal, buttock area due to trauma(n=1). The procedure is performed with the use of a diverting colostomy. The inferior portion of the origin of each gluteus maximus is detached from the sacrum and coccyx, bifurcated,and tunneled subcutaneously to encircle the anus. The ends were sutured together to form two opposing slings of voluntary muscles. Postoperatively two patient regained continence to solid stool, one to liquid stool as well. The technique of constructing sphincter is simple and utilizes principles of muscle tendon transfer without jeopardizing function of gait. Furthermore the gluteus maximus muscle, being an accessory muscle of anal continence, is an ideal structure for this reconstruction.
Anal Canal ; Buttocks ; Coccyx ; Colostomy ; Fecal Incontinence ; Gait ; Humans ; Male ; Muscle, Skeletal ; Muscles ; Necrosis ; Nervous System Diseases ; Sacrum ; Tendon Transfer

PURPOSE: To investigate the impact of menopause on the quality of life (QoL) of middle-aged and older women, including their general well-being, voiding-related symptoms, and sexual distress. MATERIALS AND METHODS: To assess QoL, we administered a questionnaire that included questions about voiding-related symptoms and female sexual distress and part of the Women's Health Questionnaire. The self-administered questionnaires were completed by 1,679 women in the Korea. Data for 1,262 women were available for analysis, including premenopausal (n=307), perimenopausal (n=240), and postmenopausal (n=715) groups. RESULTS: Voiding-related discomfort increased significantly in perimenopausal and postmenopausal women compared with premenopausal women (p<0.001). General well-being worsened as menopause progressed (p<0.001). Menopausal women who were older (p=0.014), had a hysterectomy (p=0.005), or had urinary incontinence (p=0.001) had more voiding-related symptoms. Hypertension (p=0.026), cardiac disease (p=0.013), and arthritis (p=0.001) resulted in significantly decreased general well-being. Women with a hysterectomy (p=0.017) and those with arthritis (p=0.004) had high sexual distress. In the menopausal group, employed women had better general well-being than did unemployed women. CONCLUSIONS: Menopause negatively affected the QoL of middle-aged and older women because of decreased general well-being and increased voiding-related symptoms. General health, even in menopausal women, was important to maintain a better QoL. To preserve the QoL of women undergoing menopause, control of menopause and underlying disease should be considered.
Arthritis ; Female ; Heart Diseases ; Humans ; Hypertension ; Hysterectomy ; Korea ; Menopause ; Postmenopause ; Quality of Life ; Sexual Dysfunctions, Psychological ; Urinary Incontinence ; Urination Disorders ; Women's Health

Purpose: To report a rare case of slow progression of carotid cavernous fistula (CCF) with central retinal vein occlusion (CRVO).Case summary: A 66-year-old man presented with conjunctival injection and proptosis in the right eye. Best-corrected visual acuity was 0.8 and 0.5 in the right and left eye, respectively, and conjunctival vessel enlargement and subconjunctival hemorrhage were observed in the right eye on slit lamp examination. Due to suspicion of CCF, computed tomography, computed tomography angiography, magnetic resonance imaging, and magnetic resonance angiography were performed. These analyses showed no vascular abnormalities associated with arteriovenous shunt, so the patient was followed up closely. About 1 month later, his conjunctival vessel engorgement became severe and CRVO derived from venous stasis by CCF occurred, so transfemoral cerebral angiography was performed and a diagnosis of CCF was made. Intravitreal anti-vascular endothelial growth factor injection was performed for CRVO, and best corrected visual acuity improved to 1.0 in the right eye. Conclusions Slowly progressing CCF can be accompanied with rare intraocular disease, such as CRVO, so appropriate diagnosis through detailed evaluation is important for treatment.

PURPOSE: To compare the corneal measurements of Sirius and Pentacam in normal cornea and post-corneal refractive surgery patients. METHODS: Subjects were tested by Pentacam (OCULUS, Wetzlar, Germany), and Sirius (CSO, Firenze, Italy). Measurements included central corneal thickness, thinnest corneal thickness, anterior chamber depth, anterior chamber volume, iridocorneal angle, corneal volume, pupil size, and curvature of cornea. RESULTS: A total of 88 eyes from 44 patients were included in the present study. When comparing Sirius and Pentacam in the normal cornea, corneal thickness (p = 0.693), thinnest corneal thickness (p = 0.386), anterior chamber depth (p = 0.155), anterior chamber volume (p = 0.650), and pupil diameter (p = 0.124) did not differ significantly. Corneal curvature (p < 0.001), corneal volume (p = 0.023), and iridocorneal angle (p < 0.001) were statistically different. When comparing Sirius and Pentacam in post-corneal refractive surgery patients, corneal thickness (p = 0.056) did not differ significantly. There was a statistical difference in corneal curvature (p < 0.001), thinnest corneal thickness (p = 0.019), anterior chamber depth (p < 0.001), anterior chamber volume (p < 0.001), iridocorneal angle (p < 0.001), corneal volume (p < 0.001), and pupil diameter (p < 0.001). CONCLUSIONS: Anterior segment measurements with Pentacam and Sirius showed differences in post-corneal refractive surgery patients.
Anterior Chamber ; Cornea ; Eye ; Humans ; Pupil ; Refractive Surgical Procedures

PURPOSE: To compare the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) and refractive change after cataract surgery between 3-piece and 1-piece aspheric intraocular lens (IOL) implantation. METHODS: The present study consisted of 16 patients (25 eyes) having 3-piece aspheric Tecnis(R) ZA9003 IOL and 21 patients (30 eyes) having 1-piece aspheric Tecnis(R) ZCB00 IOL. The ACD, ACV, and ACA were measured using an anterior eye segment analysis system (Pentacam, Oculus, Wetzlar, Germany) preoperatively and postoperatively 1 week and 1 month. Refractive outcomes were evaluated using an autokeratometer. RESULTS: When comparing the 3-piece (Tecnis(R) ZA9003) and 1-piece (Tecnis(R) ZCB00) IOL with the same optic, ACD, ACV, and AVA increased significantly after cataract surgery. The 1-piece IOL showed deeper ACD than the 3-piece IOL at postoperative 1 week and 1 month. Postoperative refraction showed slight myopic shift compared with target diopter, but was stable in both groups. CONCLUSIONS: There was significant increase in ACD, ACV, and ACA after cataract surgery in both IOL-inserted groups. Results showed stable refraction after cataract surgery in both groups. Consideration of the A-constant will be needed because of myopic change with the 1-piece IOL.
Anterior Chamber ; Anterior Eye Segment ; Cataract ; Humans ; Lenses, Intraocular

PURPOSE: To compare the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) and refractive change after cataract surgery between 3-piece and 1-piece aspheric intraocular lens (IOL) implantation. METHODS: The present study consisted of 16 patients (25 eyes) having 3-piece aspheric Tecnis(R) ZA9003 IOL and 21 patients (30 eyes) having 1-piece aspheric Tecnis(R) ZCB00 IOL. The ACD, ACV, and ACA were measured using an anterior eye segment analysis system (Pentacam, Oculus, Wetzlar, Germany) preoperatively and postoperatively 1 week and 1 month. Refractive outcomes were evaluated using an autokeratometer. RESULTS: When comparing the 3-piece (Tecnis(R) ZA9003) and 1-piece (Tecnis(R) ZCB00) IOL with the same optic, ACD, ACV, and AVA increased significantly after cataract surgery. The 1-piece IOL showed deeper ACD than the 3-piece IOL at postoperative 1 week and 1 month. Postoperative refraction showed slight myopic shift compared with target diopter, but was stable in both groups. CONCLUSIONS: There was significant increase in ACD, ACV, and ACA after cataract surgery in both IOL-inserted groups. Results showed stable refraction after cataract surgery in both groups. Consideration of the A-constant will be needed because of myopic change with the 1-piece IOL.
Anterior Chamber ; Anterior Eye Segment ; Cataract ; Humans ; Lenses, Intraocular

PURPOSE: To evaluate changes in clinical outcomes, inflammatory cytokine levels, and tear osmolarity in the tears of patients with moderate to severe dry eye syndrome before and after the application of topical 1% methylprednisolone. MATERIALS AND METHODS: Thirty-two patients with moderate to severe dry eye unresponsive to previous aqueous enhancement therapy were enrolled. Five patients were lost to follow up, and twenty-seven patients were eligible for analysis. Patients were instructed to apply topical 1% methylprednisolone four times per day, as well as to continue applying their current therapy of preservative-free 0.1% sodium hyaluronate four times per day. Corneal and conjunctival staining scores, tear film breakup time (TFBUT), Schirmer test, and tear osmolarity were assessed at baseline, 4 weeks, and 8 weeks. Tear samples were collected at every visit for cytokine analysis. RESULTS: Corneal and conjunctival staining scores and TFBUT showed significant improvement at 4 (p<0.001, <0.001, <0.001 respectively) and 8 (p<0.001, <0.001, <0.001 respectively) weeks. Tear osmolarity decreased significantly at 8 weeks (p=0.008). Interleukin (IL)-1beta, IL-8, and monocyte chemoattractant protein-1 were significantly decreased at 8 weeks compared with those at baseline (p=0.041, 0.001, 0.008 respectively). CONCLUSION: Short-term treatment with topical 1% methylprednisolone not only improved clinical outcomes, but also decreased tear osmolarity and cytokine levels. By measuring the changes in cytokine levels and tear osmolarity, we could objectively evaluate the anti-inflammatory effects of topical methylprednisolone applied in the treatment of patients with moderate to severe dry eye syndrome.
Adult ; Aged ; Cytokines/*metabolism ; Dry Eye Syndromes/*drug therapy/metabolism ; Female ; Humans ; Male ; Methylprednisolone/administration & dosage/*therapeutic use ; Middle Aged ; Osmolar Concentration ; Prospective Studies ; Tears/*chemistry/*metabolism