PURPOSE: To investigate the difference in corneal endothelial cell loss between diabetic and non-diabetic patients who were divided by the degree of phacoemulsification time after phacoemulsification with intraocular lens implantation. METHODS: Forty eyes of 30 patients with diabetes and 47 eyes of 36 patients without diabetes were divided by phacoemulsification time into 3 groups: less than 40 seconds, from 40 to 80 seconds and over 80 seconds. The corneal endothelial cell density was compared before and 1, 4 and 16 weeks after phacoemulsification by one-way ANOVA. Bivariate correlation analysis was used to identify the correlation between phacoemulsification time and the endothelial density before and 1, 4 and 16 weeks after phcoemulsification. RESULTS: The endothelial cell densities in diabetic and non-diabetic patients with different phacoemulsification time were not significantly different when compared before and 1, 4 and 16 weeks after phacoemulsification (P>0.05). Phacoemulsificaiton time and endothelial cell loss at 1, 4 and 16 weeks also showed no significant correlation. CONCLUSIONS: Diabetes and differences in phacoemulsification time had no significant influence on corneal endothelial cell loss. This result suggests uncomplicated phacoemulsificaion is a safe method for cataract extraction in patients with or without diabetes.
Cataract ; Cataract Extraction ; Cornea ; Corneal Endothelial Cell Loss ; Endothelial Cells* ; Endothelium ; Humans ; Lens Implantation, Intraocular ; Phacoemulsification*

PURPOSE: To compare the levels of calcium and phosphorus in the aqueous humor and serum of diabetics and non-diabetics. METHODS: We divided patients into two groups: seventy-six non-diabetic cataract patients and fifty-two diabetic cataract patients. The diabetic group was divided again into three subgroups: twenty-six patients with no diabetic retinopathy, thirteen patients with non-proliferative diabetic retinopathy, and thirteen patients with proliferative diabetic retinopathy. The authors compared the levels of calcium and phosphorus in the serum and aqueous humor of cataract patients. Statistic analysis was performed to form two comparisons: 1) a comparison between non-diabetics and diabetics and 2) a comparison among non-diabetics and the three subgroups of diabetics. RESULTS: In serum, calcium levels did not statistically differ between non-diabetics and diabetics. The phosphorus level was also not significantly different. In the aqueous humor, however, while calcium levels did not differ significantly, the phosphorus levels in diabetics were considerably higher than those in non-diabetics. When non-diabetics were compared to the three diabetic subgroups, calcium levels did not differ in serum or aqueous humor, but the phosphorus levels in diabetics with proliferative diabetic retinopathy were significantly higher than those in non-diabetics, diabetics without diabetic retinopathy, and diabetics with non-proliferative diabetic retinopathy. CONCLUSIONS: The level of phosphorus in the aqueous humor and serum of diabetics was significantly increased, especially in diabetics with proliferative diabetic retinopathy. This result may be related to hydrophilic acrylic IOL opacification. Future studies regarding the pathogenic role of a high concentration of aqueous humor and serum phosphorus are required.
Aged ; Aged, 80 and over ; Aqueous Humor/*chemistry ; Biological Markers/analysis ; Calcium/*analysis ; Cataract/complications/*metabolism ; Diabetic Retinopathy/complications/*metabolism ; Female ; Humans ; Male ; Middle Aged ; Phosphorus/*analysis ; Regression Analysis ; Retrospective Studies

PURPOSE: To compare the levels of calcium and phosphorus in the aqueous humor and serum of diabetics and non-diabetics. METHODS: We divided patients into two groups: seventy-six non-diabetic cataract patients and fifty-two diabetic cataract patients. The diabetic group was divided again into three subgroups: twenty-six patients with no diabetic retinopathy, thirteen patients with non-proliferative diabetic retinopathy, and thirteen patients with proliferative diabetic retinopathy. The authors compared the levels of calcium and phosphorus in the serum and aqueous humor of cataract patients. Statistic analysis was performed to form two comparisons: 1) a comparison between non-diabetics and diabetics and 2) a comparison among non-diabetics and the three subgroups of diabetics. RESULTS: In serum, calcium levels did not statistically differ between non-diabetics and diabetics. The phosphorus level was also not significantly different. In the aqueous humor, however, while calcium levels did not differ significantly, the phosphorus levels in diabetics were considerably higher than those in non-diabetics. When non-diabetics were compared to the three diabetic subgroups, calcium levels did not differ in serum or aqueous humor, but the phosphorus levels in diabetics with proliferative diabetic retinopathy were significantly higher than those in non-diabetics, diabetics without diabetic retinopathy, and diabetics with non-proliferative diabetic retinopathy. CONCLUSIONS: The level of phosphorus in the aqueous humor and serum of diabetics was significantly increased, especially in diabetics with proliferative diabetic retinopathy. This result may be related to hydrophilic acrylic IOL opacification. Future studies regarding the pathogenic role of a high concentration of aqueous humor and serum phosphorus are required.
Aged ; Aged, 80 and over ; Aqueous Humor/*chemistry ; Biological Markers/analysis ; Calcium/*analysis ; Cataract/complications/*metabolism ; Diabetic Retinopathy/complications/*metabolism ; Female ; Humans ; Male ; Middle Aged ; Phosphorus/*analysis ; Regression Analysis ; Retrospective Studies

No abstract available.
Cesarean Section* ; Female ; Pregnancy ; Pulmonary Embolism*

BACKGROUND: Baseline prostate volume (PV) is related with the progression of benign prostatic hyperplasia (BPH). Although recent studies have reported the relationship between BPH and metabolic syndrome, the findings are inconsistent. Thus, this study was performed to investigate the association of PV with metabolic factors and prostate-specific antigen (PSA) in individuals with normal PV and clarify the factors associated with benign prostate enlargement (BPE), including PSA. METHODS: We selected 3,915 health examinees aged >40 yr with a PSA level <4 ng/mL who underwent ultrasonography of the prostate as part of a routine health check-up. These individuals were classified into two groups according to PV: normal PV (PV <30 mL) and BPE (PV > or =30 mL). We investigated the association of PV with metabolic factors and PSA using multiple linear regression analysis, and clarified the factors associated with BPE using logistic regression analysis. RESULTS: The factors associated with PV were PSA, age, and waist circumference in individuals with normal PV. The factors associated with BPE were age, body mass index (BMI), and PSA. The logistic regression analysis adjusted for age and confounding factors showed that individuals with a BMI of 23-24.9 kg/m2, 25-29.9 kg/m2, and > or =30 kg/m2 had higher odds ratios of 1.580 (95% confidence interval, 1.171-2.131; P=0.003), 1.767 (1.332-2.344; P<0.001), and 2.024 (1.042-3.933; P=0.038), respectively, for BPE than individual with a BMI <23 kg/m2. CONCLUSIONS: Abdominal obesity was significantly associated with PV in individuals with normal PV, whereas obesity was an associated metabolic factor of BPE. PSA level was positively associated with PV.
Body Mass Index ; Linear Models ; Logistic Models ; Obesity ; Obesity, Abdominal ; Odds Ratio ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Ultrasonography ; Waist Circumference

PURPOSE: The aim of this study was to compare three types of hernioplasty using a mesh: Lichtenstein, Mesh-plug and Prolene Hernia System. METHODS: From February 2002 to April 2007, we retrospectively studied the clinical outcome of 138 cases of adult inguinal hernia patients who had operations performed with the use of mesh. Three types of mesh operations were composed of Lichtenstein repair group (LR group; N=18), Mesh plug repair group (MR group; N=38) and Prolene hernia system group (PHS group; N=82). The Clinical features and outcomes of the three groups were compared by age, sex, operation time, lengths of hospital stay, numbers of post-operative intravenous analgesics, complications, and recurrence. RESULTS: Mean age of three groups was 50.2+/-20.7, 51.0+/-18.4 and 61.5+/-15.9 years for LR. MR, PHS groups, respectively. The PHS group was significantly older than other two groups (P=0.002). The sex, operation time and lengths of hospital stay were not significantly different among the three groups. Numbers of intravenous analgesics used after the operations were 1.7+/-1.2, 2.7+/-2.2, 3.3+/-2.0 in the LR, MR, PHS groups, respectively. A lesser amount of IV analgesics was injected into the LR group than the PHS group. Although some complications occurred such as wound infection, hematoma, dehiscence, testicular edema in the three groups, there were no significant differences among the three groups. There were no recurrences in all three groups. CONCLUSION: We could not find any better outcome among the LR, MR and PHS groups.
Adult ; Analgesics ; Edema ; Hematoma ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Polypropylenes ; Recurrence ; Retrospective Studies ; Wound Infection

Tubular apocrine adenoma and papillary eccrine adenoma are rare sweat gland neoplasms that appear as a small solitary lesion on the scalp or extremities, respectively. Although these lesions are thought to be distinct entities, there are enough similarities between them to group them under the term tubulopapillary hidradenoma or papillary tubular adenoma. We describe a case showing many tubular structures with papillary projection, syringocystadenoma-like structures, and eccrine hirocystoma-like structures in the axillary area. The term of papillary tubular adenoma or tubulopapillary hidradenoma may be prefered in this case.
Acrospiroma ; Adenoma* ; Extremities ; Scalp ; Sweat Gland Neoplasms

The effect of hyperbaric tetracaine spinal anesthesia was studied in 40 patients having genitourinary surgery in the horizontal lithotomy position. Patients were randomly assigned to one of two groups, after spinal injection, patients in one group were placed immediately in the supine and horizontal lithotomy position, and patients in the second group were placed immediatley in the supine and horizontal position for 10 minutes and then placed into the horizontal 1thotomy position. There were no statistically significant differences in anesthesia sensory level and heart rate of patients placed immediately in the horizontal lithotomy position compared to the patients kept in the supine position for the first 10 minutes after receiving the spinal anesthetic. The ranges of systolic blood pressure were all within normal limits, although systolic blood pressure showed a difference at 5,10 and 60 minute intervals after anesthesia. We conclude that immediate application of the horizontal lithotomy position can be safely practiced in the anesthesia of genitourinary surgery.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Heart Rate ; Humans ; Injections, Spinal ; Supine Position ; Tetracaine*

BACKGROUND: Progression of atherosclerotic plaques is known to be correlated with elevated circulating homocysteine (Hcy). However, whether the level of Hcy is related with coronary atherosclerosis in the subclinical state is unclear. Therefore, we performed this study to investigate the relationship between blood Hcy levels and subclinical atherosclerosis in asymptomatic self-referred subjects. METHODS: We retrospectively enrolled 2,968 self-referred asymptomatic subjects (1,374 men, 1,594 women) who had undergone both coronary CT angiography (CCTA) and coronary artery calcium scoring. The relationships between atherosclerosis, Hcy, and other clinical factors were assessed. RESULTS: Higher levels of Hcy were related with age, male gender, body mass index (BMI), waist circumference, blood pressure, high density lipoprotein (HDL), triglyceride, blood glucose, HbA1c, hsCRP, and coronary artery calcium score (CACS). Coronary plaque was more frequently found in higher Hcy quartile groups (21.3%, 28.8%, 34.4%, and 34.3%, P<0.001). Significant coronary artery stenosis (stenosis>50%) was also more frequent in higher Hcy quartile groups (1.8%, 5.4%, 5.0%, and 6.6%, P<0.001). The factors associated with CACS included age, male gender, levels of HbA1c, Hcy and hsCRP. Logistic regression analysis adjusted for gender and confounding factors showed that the third- and fourth-quartile Hcy groups had higher odds ratios [odd ratio (OR) 3.980 (1.723-9.194), P=0.001, 7.355 (3.291-16.439), P<0.001, respectively] for high CACS (CACS >400) than the first quartile group. CONCLUSIONS: Blood Hcy levels were associated with an increased risk of the presence and extent of subclinical atherosclerosis in asymptomatic subjects.
Angiography ; Atherosclerosis ; Blood Glucose ; Body Mass Index ; Calcium ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels ; Homocysteine* ; Humans ; Hypertension ; Lipoproteins ; Logistic Models ; Male ; Odds Ratio ; Plaque, Atherosclerotic ; Retrospective Studies ; Triglycerides ; Waist Circumference

PURPOSE: To assess the feasibility of the da Vinci(R) surgical system in performing gastrectomies for gastric cancer. METHODS: Between 31 December 2007 and 30 June 2008, twenty patients underwent robotic gastrectomies using the da Vinci(R) surgical system for gastric cancer. Retrospectively, clinicopathologic and postoperative surgical outcomes were retrieved from the Stomach Cancer Database at Dong-A University Medical Center. RESULTS: Two patients with serosa invasion required conversion to laparotomy. Seventeen robotic distal gastrectomies and one robotic total gastrectomy were performed. Most patients underwent D1+beta or D2 lymph node dissection. The average number of retrieved lymph nodes was 41. Mean operative time was 271 minutes. Estimated blood loss was 30 ml and mean postoperative hospital stay was 5.1 days. No postoperative complications were reported. CONCLUSION: While application of robotic technology for gastric cancer is technically feasible, problems of long operative times and extremely high costs remain. More randomized studies comparing long-term surgical outcomes between robotic, conventional open, and laparoscopic surgery are needed.
Academic Medical Centers ; Gastrectomy ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Serous Membrane ; Stomach Neoplasms