PURPOSE: Metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) have been linked to the angiogenic process in general. In order to understand the potential roles of MMPs and TIMPs in corneal neovascularization process, we examined the expression and activities of MMP-2, MMP-9, TIMP-1 and TIMP-2 during the course of suture-induced corneal neovascularization in rat model. METHODS: Corneal neovascularization of rat cornea was induced by suturing. The expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 in sutured corneas was examined by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). The activities of MMP-2 and MMP-9 were measured before and after suture by gelatin zymography. RESULTS: MMP-2 proenzyme, and TIMP-1, -2 were expressed in normal corneas, predominantly in corneal epithelium. After injury, expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 increased, notably in healing corneal epithelium, infiltrating inflammatory cells, stromal fibroblasts, and ingrowing vascular endothelial cells. The intensity of immunostaining and enzymatic activities of MMP-2 and MMP-9 paralleled the magnitude of inflammatory cell infiltration, which peaked around day 7 after suture. Immunoreactivity of MMP/TIMP decreased significantly two weeks after suturing. At day 35 after suture, staining of MMP-2, TIMP-1, -2 remained visible only in corneal epithelium and vascular endothelial cells. CONCLUSIONS: MMPs as well as TIMPs were upregulated during suture-induced corneal neo-vascularization, suggesting that both may take part in extracellular matrix remodeling in the corneal wound healing, inflammatory, and neovascularization processes.
Animals ; Cornea ; Corneal Neovascularization* ; Endothelial Cells ; Epithelium, Corneal ; Extracellular Matrix ; Fibroblasts ; Gelatin ; Immunohistochemistry ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Metalloproteases ; Models, Animal ; Rats ; Stromal Cells ; Sutures ; Tissue Inhibitor of Metalloproteinase-1* ; Tissue Inhibitor of Metalloproteinase-2 ; Wound Healing

PURPOSE: The purpose of this study is to evaluate the efficacy of CCA (Cone for controlled Atmosphere) in Meditec Mel 70 Excimer laser in the extent of correction of myopic astigmatism in comparison with VISX 20/20 with Large beam. METHODS: We evaluated 256 eyes of 132 patients who had been followed for 6 months or longer after LASIK. Group I included 126 eyes operated by Meditec Mel 70 excimer laser : in group Ia (35 eyes), Meditec Mel 70 was used without CCA setting, and in group Ib (91 eyes), Meditec Mel 70 with CCA setting. Group II included 130 eyes operated by VISX 20/20. We analyzed the clinical results of each group and compared with each other. RESULTS: Mean preoperative astigmatic refraction was -0.93+/-0.42 diopter in group Ia, -1.12+/-0.89 diopter in group Ib, -1.06+/-0.79 diopter in group I and -1.30+/-1.06 diopter in group II. Six months after procedure, difference vector was -0.59+/-0.56 diopter in group Ia, -0.32+/-0.24 diopter in group Ib, -0.43+/-0.42 diopter in group I and -0.96+/-0.65 diopter in group II. The effect of astigmatic correction was more superior in group Ib than in group Ia, and in group I than in group II (P<0.01). At 6 months follow-up, residual astigmatism within +/-1.0 diopter was in 77.1% of group Ia, 96.7% of group Ib, 91.3% of group I, and 65.4% of group II. The deviation of the cylindrical axis was less in group Ib than in group Ia, and less in group I than in group II : 57.2% in group Ia, 86.8% in group Ib, 78.5% in group I and 57.7% in group II. Among eyes with mean preoperative astigmatic refraction over -1.50 diopter, group Ib and group I showed significantly better effect compared with group Ia and group II(P<0.01). CONCLUSIONS: LASIK operation using Meditec Mel 70 of German Aesculap-Meditec company especially with CCA showed higher predictibility in the correction of myopic astigmatism. The more severe was the extent of astigmatism, the more excellent was the efficacy of correction.
Astigmatism* ; Axis, Cervical Vertebra ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ ; Lasers, Excimer

BACKGROUND: This study used the National Emergency Department Information System (NEDIS) data to analyze the flow of emergency and critical emergency patients and to identify the patterns of emergency medical service usage in Korea. METHODS: The relevance index (RI) and commitment index (CI) were calculated from the 2016 NEDIS data. In this study, the number of clusters was determined using NbClust, and cluster analysis was used to analyze the usage patterns of emergency and critical emergency patients. RESULTS: The RI and CI were calculated using 8,389,766 cases of 214 districts. The results of the RI and CI suggested that there were 3 types of clusters among the emergency patients. In Cluster 1, 54 districts (25.2%) had low RI and high CI, and it was of outflow type. Cluster 2 was categorized as the influx-type in 58 districts (27.1%) irrespective of RI and low CI. Cluster 3 was categorized as the self-sufficient type found in 102 districts (47.7%), with high RI and high CI. The cluster analysis of the critical emergency patients was divided into 2 types. Cluster 1 was categorized as outflow type with high CI found in 129 districts (60.3%), while Cluster 2 was categorized as inflow type with low CI found in 85 districts (39.7%). CONCLUSIONS This study elucidates the regional status of usage patterns of emergency and critical emergency patients in Korea. This study might serve as a basis for the establishment and selection of emergency medical service areas and vulnerable emergency medical service areas.
Cluster Analysis ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Models, Theoretical ; Republic of Korea

PURPOSE: Endoleak is a common complication following endovascular aortic aneurysm repairs (EVAR). The aim of this study was to discover the frequency and characteristics after EVAR with on-label use. METHODS: A retrospective review was performed on 25 patients who underwent EVAR in Inha University Hospital between December 2005 and February 2009. The data included in this study accounted for patient characteristics, anatomic features, operative technical details, and types of devices used. The results of EVAR were analyzed for clinical success, technical success and endoleak. RESULTS: Endoleaks were observed during 11 (47.8%) procedures. Type I endoleaks were observed in 2 (18.2%) cases. A total of 6 type II intraoperative endoleaks (54.5%) were observed. 3 type III endoleaks (27.3%) occurred. But all endoleaks were resolved without additional intervention CT scan after 6 months. CONCLUSION: Although the endovascular management of AAAs is less invasive than open surgery, many complications including endoleak were still the most common adverse event during the first postoperative month. However, observation may be a good treatment for minor endoleak after EVAR.
Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Endoleak ; Humans ; Retrospective Studies

PURPOSE: Endovascular treatment for peripheral arterial obstructive disease (PAOD) is replacing traditional arterial bypass in the western world. Yet there are few reports to evaluate the pattern of clinical practice pattern for PAOD in Korea. This study was conducted to evaluate the treatment pattern for PAOD between endovascular treatment and arterial bypass, and to compare their clinical characteristics. METHODS: We conducted a retrospective study on the prospectively maintained database of patients who underwent endovascular treatment and arterial bypass for PAOD from March 2005 to December 2009 in Inha University Hospital. The aortoiliac lesions and femoropopliteal lesions were categorized by the Trans Atlantic Inter-Society Consensus (TASC) II classifications. Their treatments and clinical characteristics were compared between the former period (2005~2007 y) and the latter period (2008~2009 y). RESULTS: Three hundred nine cases (178 patients) were treated for PAOD by either arterial bypass or endovascular treatment. The patients' mean age was 69.1+/-11.3 year old. There was no difference in clinical characteristics between the two periods except for age. Endovascular treatments of both aortoiliac and femoropopliteal arterial lesions were increased in the latter period (P=0.023, P<0.001). Also, the endovascular treatments were increased in the TASC C and D aortoiliac and femoropopliteal lesions in the latter period (P=0.020, P<0.001). CONCLUSION: Endovascular treatment for PAOD is increasing in clinical practice and this shows feasibility in critically ill patient with TASC C and D lesions, although arterial bypass is still important.
Angioplasty ; Arterial Occlusive Diseases ; Atherosclerosis ; Consensus ; Critical Illness ; Humans ; Korea ; Physician's Practice Patterns ; Prospective Studies ; Retrospective Studies ; Western World