PURPOSE: Matriderm(R) is a highly porous dermal substitute consisting of a collagen matrix (collagen type I, III, and V) cross-linked to an elastin hydrolysate. The 1 mm thickness Matriderm(R) is used in a one-stage procedure. On the other hand, 2 mm thickness Matriderm(R) has been used in two-stage procedures in combination with split thickness skin grafts (STSG) for reconstruction as dermal substitute. To the best our knowledge, there is no case that reports the single stage procedure with 2 mm thickness Matriderm(R). There are many expected advantages if a two-stage surgery could be performed by one-stage procedure as long as the result is guaranteed. The purpose of this study is to present capacity of 2 mm thickness Matriderm(R) as a dermal substitute in single stage skin grafting by the successful results of six cases. METHODS: We performed this one-stage procedure in five patients instead of soft tissue reconstruction. Those patients were required soft tissue reconstruction after trauma injuries or radial forearm harvest as a donor site in the period between 2011 and 2012. Five Patients were treated with a combination of STSG and 2 mm thickness Matriderm(R) solely. Three out of five patients who were injured by trauma got transplanted splint thickness skin that were range from 4/1000~8/1000 inches (Table 1). Patients' data were analyzed retrospectively by chart review and patients interviews. Each patient's chart was reviewed for age, gender, type of injury, complications, final outcome and successful rates. RESULTS: The patient group consisted of 4 men and 1 woman between ages of 5 and 70. The clinical results of these five treated patients concerning skin-quality and coverage of exposed soft tissue were very good. Using 2 mm thickness Matriderm(R) the wound could gain more dermal substitute compare to 1 mm thickness Matriderm(R). CONCLUSION: Matriderm(R) is a single-use three-dimensional matrix composed of native, structurally intact collagen fibrils and elastin for supporting dermal regeneration. In this study five patients with trauma injuries or radial forearm harvest as a donor site were treated with 2 mm thickness Matriderm(R) as a dermal substitute and STSG as a single-stage procedure to cover exposed structures. Compare to 1 mm Matriderm(R), 2 mm thickness Matriderm(R) provide more dermal collagen and enhance skin-elastisity. Achieving single stage STSG with 2 mm thickness Matriderm(R), patient's hospital days were reduced in half and infection chances were also decreased. In conclusion, single skin grafting with 2 mm thickness Matriderm(R) is feasible and it is time-effient and cost effective procedure.
Collagen ; Elastin ; Female ; Forearm ; Hand ; Humans ; Male ; Regeneration ; Retrospective Studies ; Skin Transplantation ; Skin* ; Splints ; Tissue Donors ; Transplants ; Wounds and Injuries

PURPOSE: To compare the effects of bifocal versus trifocal diffractive intraocular lens (IOL) implantation on visual quality after phacoemulsification in patients with cataracts. METHODS: Eighty-eight eyes from 63 patients were analyzed. Trifocal (AT LISA tri 839MP), bifocal (AcrySof IQ ReSTOR) and bifocal (Tecnis MF ZLB00) IOLs were implanted into 53, 18, and 17 eyes, respectively. Uncorrected distance, intermediate and near visual acuity, refractive errors, contrast sensitivity, and patient satisfaction were measured at 1 week and 1 month after surgery. Refractive error was converted to a spherical equivalent and compared to predicted refraction calculated by IOL calculation formulas. RESULTS: Uncorrected distance, intermediate, and near visual acuity did not differ significantly between groups. One month after surgery, the mean refractive errors were −0.07 diopters (D) in the AT LISA tri 839MP group, +0.18 D in the AcrySof IQ ReSTOR group, and +0.31 D in the Tecnis MF ZLB00 group (p < 0.001). The predictive accuracy of IOL calculation formulas did not differ between groups. Contrast sensitivity, satisfaction, and spectacle independence in the trifocal group were comparable with those of the two bifocal groups. CONCLUSIONS: Trifocal IOL and two different types of bifocal IOL implantation were all effective for improving visual quality, although refractive error in patients with trifocal IOL shows myopic tendencies.
Cataract ; Contrast Sensitivity ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Patient Satisfaction ; Phacoemulsification ; Presbyopia ; Refractive Errors ; Visual Acuity

We introduce a new silicone implanting method to correct facial depression caused by trauma or congenital anomaly. It resulted in good facial aesthetics in patients with facial depression. From August 1997 to January 1999, 5 patient (3 males and 2 females), in ages from 19 to 34 years, underwent silicone implantation for facial depression using our method. Three males were injured by traffic accident and had facial depression with or without bone defect. Two females had congenital forhead depression and requested aesthetic contouring. An impression of the face was taken with alginate backed with quick setting plaster. When set, a further stone plaster model was taken from the alginate-plaster, which was removed after fixation. Wax was then carved into the patient's stone model to fill the depression. Another stone cover was taken to cover this was-stone model. Then wax was melted away and medical implant grade room temperature vulcanized silicone adhesive was squeezed into the empty space. After cured, this precisely-shaped silicone imlant was inserted into the patient. We did not experience major complicaion such as infection, implant extrusion during 4 to 18 months' follow-up periods. All patients were satisfied with the results. The clinical result of this technique would be useful for accurate and excellent aesthetic implantation.
Accidents, Traffic ; Adhesives ; Depression* ; Esthetics ; Female ; Follow-Up Studies ; Humans ; Male ; Silicones*

BACKGROUND: Cardiogenic shock is the most common cause of in-hospital mortality after acute myocardial infarction. Despite improvement in coronary care, the in-hospital mortality rate of cardiogenic shock is very high in conventional conservative therapy. Recently, it was suggested that coronary angioplasty may reduce the mortality associated with cardiogenic shock. METHOD: Thirteen consecutive patients with cardiogenic shock who underwent coronary angioplasty were studied. Shock was not induced by mechanical complications, arrhythmia, hypovolemia and other reversible cause. We collected and analyzed the clinical, hemodynamic survivor groups. RESULTS: Of 13 patients, 11 had successful reperfusion of the infarct-related coronary artery and 2 had unsuccessful reperfusion. Of 11 patients with successful angioplasty, 8 survived at the time of hospital discharge. All patents with unsuccessful angioplasty died in the hospital. Therefore overall hospital survival rate was 62% and the rate increased to 73% in patients with successful reperfusion. Survivor and non-survivor groups in clinical, hemodynamic and angiographic variables were similar except systolic blood pressure and the presence of successful reperfusion. CONCLUSION: In patients with cardiogenic shock, the patency of infarct-related coronary artery was strongly associated with in-hospital mortality. This findings support aggressive interventional strategy in patient with cardiogenic shock complicating acute myocardial infarction.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Vessels ; Hemodynamics ; Hospital Mortality ; Humans ; Hypovolemia ; Mortality ; Myocardial Infarction* ; Reperfusion ; Shock ; Shock, Cardiogenic* ; Survival Rate ; Survivors

BACKGROUND: Cardiogenic shock is the most common cause of in-hospital mortality after acute myocardial infarction. Despite improvement in coronary care, the in-hospital mortality rate of cardiogenic shock is very high in conventional conservative therapy. Recently, it was suggested that coronary angioplasty may reduce the mortality associated with cardiogenic shock. METHOD: Thirteen consecutive patients with cardiogenic shock who underwent coronary angioplasty were studied. Shock was not induced by mechanical complications, arrhythmia, hypovolemia and other reversible cause. We collected and analyzed the clinical, hemodynamic survivor groups. RESULTS: Of 13 patients, 11 had successful reperfusion of the infarct-related coronary artery and 2 had unsuccessful reperfusion. Of 11 patients with successful angioplasty, 8 survived at the time of hospital discharge. All patents with unsuccessful angioplasty died in the hospital. Therefore overall hospital survival rate was 62% and the rate increased to 73% in patients with successful reperfusion. Survivor and non-survivor groups in clinical, hemodynamic and angiographic variables were similar except systolic blood pressure and the presence of successful reperfusion. CONCLUSION: In patients with cardiogenic shock, the patency of infarct-related coronary artery was strongly associated with in-hospital mortality. This findings support aggressive interventional strategy in patient with cardiogenic shock complicating acute myocardial infarction.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Vessels ; Hemodynamics ; Hospital Mortality ; Humans ; Hypovolemia ; Mortality ; Myocardial Infarction* ; Reperfusion ; Shock ; Shock, Cardiogenic* ; Survival Rate ; Survivors

PURPOSE: There are only a few cytogenetic studies in gastric cancer and so far no consistent specific chromosomal abnormalities have been described. In this study, we have used comparative genomic hybridization (CGH), a powerful molecular cytogenetic technique for detecting changes of the copy number throughout the genome, to screen for genetic alterations in gastric cancer cell lines. The CGH results were compared with those derived from G-banding and chromosome painting. MATERIALS AND METHODS: Conventional cytogenetic analysis was performed on five human gastric cancer cell lines, AGS, SNU-1, SNU-16, SNU-620, and SNU-719, by a G-banding staining technique. In CGH, equal amounts of differently labeled DNA from the cell lines and normal reference DNA were hybridized simultaneously to normal metaphase chromosomes. They were visualized by different fluorochromes, and the signal intensities were quantitated separately as gray levels along the single chromosomes. The over- and under- represented DNA segments were determined by computation of ratio images and average ratio profiles. To confirm the CGH results, fluorescence in situ hybridization (FISH) with chromosome specific painting was performed using indirectly labeled chromosome specific paints. RESULTS: Complex unbalanced chromosomal aberrations that could not be identified reliably by conventional cytogenetics in gastric cancer cell lines were successfully resolved by CGH analysis. CGH results were validated by using FISH with chromosome specific probes. In gastric cancer cell lines, gains of DNA copy number were more common than losses. Gains were detected on 1p, 1q, 2p, 3q, 6p, 7q, 10q, 11p, and 19q, and losses were observed on 4p, 4q, 5q, 12p, 12q, and 18q. Interestingly, all the five gastric cancer cell lines tested showed gain of DNA copy number on the chromosome 20, suggesting an existence of oncogene. CONCLUSION: Conventional cytogenetics, CGH, and FISH using painting probes represent complementary approaches that, when employed in combination, could greatly facilitate the comprehensive analysis of chromosomal imbalances in gastric cancer cell lines. Our results suggest the existence of an oncogene or oncogenes on chromosome 20 that play a role in the development and/or the progression of gastric carcinogenesis.
Carcinogenesis ; Cell Line* ; Chromosome Aberrations ; Chromosome Painting ; Chromosomes, Human, Pair 20 ; Comparative Genomic Hybridization* ; Cytogenetic Analysis ; Cytogenetics ; DNA ; Fluorescence ; Fluorescent Dyes ; Genome ; Humans ; In Situ Hybridization ; Metaphase ; Oncogenes ; Paint ; Paintings ; Stomach Neoplasms*

PURPOSE: There have only been a few cytogenetic studies of hepatocellular carcinoma (HCC), and so far, no consistent specific chromosomal abnormalities have been described. Here, we have used comparative genomic hybridization (CGH), a powerful molecular cytogenetic technique for detecting changes of the copy number throughout the genome, to screen for genetic alterations in HCC cell lines. The CGH results were compared with those derived from G-banding and chromosome painting. MATERIALS AND METGODS: Conventional cytogenetic analyses were performed on five HCC cell lines, SNU-354, SNU-368, SNU-387, SNU-449 and SNU-475, using a G- banding staining technique. In CGH, equal amounts of differently labeled DNA from the cell lines, and normal reference DNA, were hybridized simultaneously to normal metaphase chromosomes. They were visualized by different fluorochromes, and the signal intensities quantified separately as gray levels along the single chromosomes. The over- and under-represented DNA segments were determined by computation of ratio images and average ratio profiles. To confirm the CGH results, florescence in situ hybridization (FISH), with chromosome specific painting, was performed using indirectly labeled chromosome specific paints. RESULTS: Complex unbalanced chromosomal aberrations, which could not be identified reliably by conventional cytogenetics in HCC cell lines, were successfully resolved by CGH analysis. CGH results were validated using FISH with chromosome specific probes. In HCC cell lines, gains in DNA copy number were more common than losses. The most prominent changes were gains of 1q12- qter (80% of cases), 1q41-qter (100%), 7 (80%), 8q12-qter (60%), 8q23-qter (80%) and 20q12-qter (60%). Recurrent losses were mapped on 4q13-qter (60%), 16q12-qter (60%), 16q21-qter (80%), 13q12-q14.2 (60%) and Yq11.2 (100%). All four male HCC cell lines showed loss or rearrangement of the Y chromosome. CONCLUSION: Conventional cytogenetics, CGH and FISH using painting probes, represent complementary approaches that, when employed in combination, could greatly facilitate the comprehensive analysis of chromosomal imbalances in HCC cell lines. Our results suggest the existence of an oncogene, or protooncogenes, on chromosome 1q41-qter, and the tumor suppressor genes on Yq11.2, that play a role in the development and/or progression of hepatocellular carcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Line* ; Chromosome Aberrations ; Chromosome Painting ; Chromosomes, Human, Pair 1 ; Comparative Genomic Hybridization* ; Cytogenetic Analysis ; Cytogenetics ; DNA ; Fluorescent Dyes ; Genes, Tumor Suppressor ; Genome ; Humans ; In Situ Hybridization ; Male ; Metaphase ; Oncogenes ; Paint ; Paintings ; Y Chromosome

PURPOSE: To investigate the epidemiology of contact lens (CL)-related complications in Korea. METHODS: A questionnaire regarding CL-related complications including patient's gender, age, causative factors, and signs and symptoms was distributed to members of the Korean Ophthalmological Society by The Korean Contact Lens Study Society and the results of the questionnaire analyzed. RESULTS: Responses to the questionnaire written by ophthalmologists from 22 institutes and clinics were collected from 499 subjects over a 20-month period starting in October 2008 and analyzed. The mean age of respondents was 22.9 years and the male-to-female ratio was 1:8.1. The soft CL and cosmetic colored lens comprised the majority (46.6% and 42.1%, respectively) of the reported cases, followed by the rigid gas permeable lens (RGP lens; 10.6%) and orthokeratology lens (0.8%). In subjects using a cosmetic colored lens, 62.2% showed emmetropia and 89.1% of the lenses were prescribed by opticians. The main complications included corneal erosion, sterile corneal infiltrate, allergic disease, conjunctival injection, corneal ulcer, and dry eye syndrome. The most common causative factor of complications was excessive lens wear. Comparing main causative factors according to the RGP lens prescriber, the most common factor was poor lens fit. CONCLUSIONS: The number of cosmetic colored lens-related complications in the emmetropic eyes of young patients is increasing rapidly. Considering opticians are the main CL prescribers in CL-related complications, Korean ophthalmologists need to pay more attention to CL fitting and constant education of patients regarding proper CL wear and care.
Academies and Institutes ; Conjunctival Diseases ; Corneal Ulcer ; Surveys and Questionnaires ; Dry Eye Syndromes ; Emmetropia ; Epidemiology ; Humans ; Korea* ; Patient Education as Topic

Dermatoglyphics (fingerprints, palmprints, and palm creases) are helpful in early diagnosis of numeral aberrations of chromosome, each of which has specific dermatoglyphic characteristics. In this study, for early diagnosis of numeral aberrations of chromosome in the Korean population, the dermatoglyphic characteristics of the Korean patients who had various numeral aberrations of chromosome were compared with those of the normal Korean people. The hands of 28 Korean patients, who were previously diagnosed to have numeral aberrations of chromosome (24 Down, 1 Turner, 2 Klinefelter, and 1 cri du chat syndromes) by karyotyping, were imprinted to the paper using watersoluble ink; their dermatoglyphic characteristics were analyzed, and compared with those of 3,216 normal Korean people. In fingerprints of the patients with Down syndrome, ulnar loop pattern was frequent whereas whorl pattern was infrequent, which was more prominent in Mongolian than in Caucasian. In palmprints of the patients with Down syndrome, distances not only between a and b but also between b and c were short; and D was frequently found to traverse the palm. In palm creases of the patients with Down syndrome, palm creases were frequently found to join together; and the total degree of transversality of the normal and simian creases was high whereas that of the Sydney crease was low. In fingerprints of the patients with Turner (XO) and Kinefelter (XXY) syndromes, the X chromosome count was inversely proportional to the total ridge count. These results showed that there is a close relationship between dermatoglyphics and numeral aberrations of chromosome in the Korean population. In order to use dermatoglyphics as a more helpful diagnostic tool, dermatoglyphics of the more patients with numeral aberrations of chromosome should be analyzed using various methods.
Dermatoglyphics* ; Down Syndrome ; Early Diagnosis ; Hand ; Humans ; Ink ; Karyotyping ; X Chromosome

BACKGROUND: The diagnostic significance of the serological detection of antibodies to Helicobacter pylori (H. pylori) has been reported by many investigators. But the comparison data between the various serological kits were not established in Korea. METHODS: Forty nine patients with upper gastrointestinal symptoms were studied from June 1997 to September 1997 in Yonsei University College of Medicine, Severance hospital. Endoscopic gastric biopsy specimens were obtained for microscopic examination of the bacteria and rapid urease test (CLO test). The sera of these patients were obtained for the serological test at the same time. The six commercial kits (Cobas Core II, G.A.P. test IgG, PYLORAGEN, QuickVue, BIOCARD Helicobacter pylori IgG, EZ-H.P.) for the detection H. pylori antibodies were evaluated for diagnosis and screening of H. pylori infection. RESULTS: Sensitivities for the six kits were from 71% to 96%, specificities were from 24% to 71%, positive predictive values were from 68% to 81%, negative predictive values were from 60% to 80%, respectively. There were statistically significant differences in four groups, between G.A.P. test and Cobas Core, G.A.P. test and PYLORAGEN, QuickVue and Cobas Core, QuickVue and PYLORAGEN. CONCLUSIONS: Sensitivities and specificities obtained in different studies revealed as great differences in the results with the same kits as between the results obtained with different kits in the same study. So, the serologic method alone for the diagnosis of H. pylori infection is not recommended. But in the screening of H. pylori infection, it can be used, because sensitivities and negative predictive values are relatively high.
Antibodies ; Bacteria ; Biopsy ; Diagnosis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G* ; Korea ; Mass Screening ; Research Personnel ; Serologic Tests ; Urease