We used the fluorophotometry to investigate the corneal epithelial barrier function after excimer laser photorefractive keratectomy (PRK). Twenty-five eyes of 21 subjects (13 women, 8 men) underwent PRK to correct rnyopia. Corneal epithelial healing time was measured and corneal epithelial permeability to sodiurn fluorescein was evaluated by fluorophotoinetry at I, 2, and 3 weeks after surgery. The corneal epithelial permeability increased significantly 1 week after surgery and returned to preoperative level 2 weeks after surgery. The permeability differences according to epithelial healing days and corrected diopters were not statistically significant(p>0. 05). These results suggest that PRK delays complete reconstruction of corneal epithelial barrier function. The corneal epithelium regained its functional barrier 2 weeks after PRK in patients, so, at least, during the first 2 weeks, care should be taken to miniinize further epithelial trauma from topical inedication or surgical manipulation.
Epithelium, Corneal ; Female ; Fluorescein ; Fluorophotometry ; Humans ; Lasers, Excimer* ; Permeability ; Photorefractive Keratectomy*

PURPOSE: In the pathogenesis of proliferative vitreoretinopathy (PVR), retinal pigment epithelial (RPE) cells do not undergo apoptosis after separation from the basement membrane. In order to investigate the mechanism by which RPE cells resist apoptosis in PVR, the expression of focal adhesion kinase after cryotherapy was studied. METHODS: After lensectomy and vitrectomy was performed on rabbit eyes, a retinal tear was created. Cryotherapy was applied to the tear site one week after the tear creation. Rabbits were sacrificed at 1, 4 and 7 days after the tear formation and 30 minutes, 1, 4, 7, 9, 21 days after cryotherapy. Eyes were stained with anti-focal adhesion kinase (FAK) antibody. RESULTS: Expression of FAK increased after the tear formation and remained increased until 21days after cryotherapy. CONCLUSIONS: These data show that creation of a retinal tear and cryotherapy increases FAK expression and may contribute to resistance to apoptosis.
Apoptosis ; Basement Membrane ; Cryotherapy* ; Epithelial Cells* ; Focal Adhesion Protein-Tyrosine Kinases* ; Focal Adhesions* ; Phosphotransferases ; Rabbits ; Retinal Perforations ; Retinaldehyde* ; Vitrectomy ; Vitreoretinopathy, Proliferative

Purpose: The purpose of this study was to investigate the effects of the scapulothoracic mobilization on subject with lateral epicondylalgia. This was done through lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion. Methods: Before the experiment, Lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion were measured. Scapulothoracic joint mobilization was applied and then measurements were taken again to compared the changes. Results: After applying the scapulothoracic joint mobilization, lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion significantly improved. Conclusion This study found that the scapulothoracic mobilization was effective in improving functional aspects and pain on subject with lateral epicondylalgia. The results suggest that the scapulothoracic joint mobilization is a significant considered intervention method that could be used for subject with lateral epicondylalgia.

This study was performed to detect the oxidative stress in the cornea and lens in vivo by fluorophotometer after excimer laser photorefractive keratectomy(PRK). Twenty New Zealand white rabbits(20 eyes)were divided into two groups, control group(10 eyes)and PRK group(10 eyes). Rabbits of PRK group underwent PRK(8 diopters)and 2', 7'-dichlorofluorescein diacetate(DCFH-DA)was applied on the central cornea 6 hours after PRK in both groups. Fluorophotometric readings of the cornea and lens were measured 15 minutes(F15)and 30 minutes(F30)after DCFH-DA application in both groups. The cornea and lens was observed with slit lamp biomicroscope for 8 weeks. F15 and F30 of the cornea in PRK group(3.83+/-1.22 ng/ml, 5.12+/-1.57 ng/ml)were significantly higher than those in control group(2.61+/-0.59 ng/ml Eq, 3.26+/-0.76 ng/ml Eq)(p=0.01, p=0.005). F15 and F30 of the lens in PRK group(409.7+/-157.2 ng/ml, 594.9+/-242.2 ng/ml Eq)were significantly higher than those in control group(74.1+/-48.3 ng/ml Eq, 310.1+/-249.8 ng/ml Eq)(p=0.0004, p=0.01). No lens opacity developed and F15 and F30 of the cornea did not correlate with corneal haze determined at postoperative 8 weeks. In this study, we demonstrated increased oxygen free radicals in the cornea and lens after PRK by fluorophotometer in vivo and this method can be used as a useful tool to investigate the possible damage induced by oxygen free radicals in the cornea and lens after excimer laser corneal ablation.
Cataract ; Control Groups ; Cornea* ; Free Radicals* ; Lasers, Excimer* ; New Zealand ; Oxidative Stress ; Oxygen* ; Rabbits ; Reading

Grisel’s syndrome is a non-traumatic atlantoaxial rotatory subluxation for which the underlying mechanism has not yet been identified. It is known to occur following upper respiratory infections, tonsillitis, ear, nose, and throat (ENT) surgeries such as tonsillectomy and adenoidectomy. The diagnosis of Grisel’s syndrome can be made by plain x-ray, CT scanning, and/or MRI scanning. The first choice of treatment is conservative therapy such as bed rest, muscle relaxation, analgesic therapy, antibiotics, and simple traction. While Grisel’s syndrome occurs rarely, delayed treatment may lead to neurological complications or requires surgical treatment. Early diagnosis and treatment are important in preventing fatal outcome. We report the case of a 9-year-old male who developed Grisel’s syndrome after tonsillectomy and adenoidectomy.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
Anti-Bacterial Agents ; Carbapenems ; Cross Infection* ; Delivery of Health Care ; Dichlorodiphenyldichloroethane ; Glycopeptides ; Infection Control ; Korea ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Seoul ; Staphylococcus aureus* ; Staphylococcus*

A 75-year-old woman with hypertension presented with acute suppurative cholangitis. Chest radiography revealed severe kyphosis. Abdominal computed tomography revealed a large stone impacted in the common bile duct (CBD). The patient underwent emergent endoscopic retrograde cholangiopancreatography, and cholangiography revealed a large stone (7×3 cm) in the CBD that could not be captured using a large basket. We could not use the percutaneous approach for stone fragmentation by using a cholangioscope because of severe degenerative kyphosis. Finally, we performed holmium laser lithotripsy under peroral cholangioscopy by using an ultraslim endoscope, and the large stone in the CBD was successfully fragmented and removed without complications.
Aged ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Common Bile Duct* ; Endoscopes ; Female ; Gallstones ; Humans ; Hypertension ; Kyphosis* ; Lasers, Solid-State ; Lithotripsy ; Lithotripsy, Laser* ; Radiography ; Thorax

PURPOSE: To report cases of transplanting a donor's 2 corneas to 5 patients suffering from several corneal diseases. CASE SUMMARY: Two corneas were donated from a 66-year-old donor, who suffered from brain damage due to asphyxia, one hour after being pronounced dead by doctors. Two penetrating keratoplasties and 3 partial lamellar keratoplasties were performed for patients with corneal opacity, corneal ulcer and corneal perforation. After the procedure all grafts were stable. CONCLUSIONS: Under the present circumstances of decreasing donations of corneas after death and the increasing demand for keratoplasty in Korea, the mutual cooperation among hospitals to treat more than one patient using one donated cornea is a method the authors believe can alleviate this situation.
Aged ; Asphyxia ; Brain ; Cornea ; Corneal Diseases ; Corneal Opacity ; Corneal Perforation ; Corneal Transplantation ; Corneal Ulcer ; Humans ; Keratoplasty, Penetrating ; Korea ; Stress, Psychological ; Tissue Donors ; Transplants

Cutaneous tuberculosis is an infrequent form of extrapulmonary tuberculosis. It is often clinically and histopathologically confused with various cutaneous disorders. A 36-year-old man attended our clinic with slowly progressive, asymptomatic, annular skin lesions on both the thighs and buttocks for 10 years. He consulted with many physicians and was improperly treated with an oral antifungal agent for several months under the diagnosis of tinea cruris, but no resolution of his condition was observed. A diagnosis of lupus vulgaris was made based on the histopathologic examination and the polymerase chain reaction assay. Anti-tuberculosis therapy was administered and the lesions started to regress.
Adult ; Buttocks ; Humans ; Lupus Vulgaris ; Polymerase Chain Reaction ; Skin ; Thigh ; Tinea ; Tuberculosis ; Tuberculosis, Cutaneous

PURPOSE: To compare the clinical results of BRTO in the gastric varices with those of TIPS. MATERIALS AND METHODS: From January 2004 to March 2006, eight patients who had been followed up for more than 1 month after BRTO were enrolled in this study. This study compared the clinical efficacy of BRTO with that of TIPS in 13 patients who had undergone TIPS from January 2000 to March 2006. The change in laboratory parameters before and after each procedure and the incidence of rebleeding, encephalopathy, asictes and varices were analyzed after each procedure. Results:In the BRTO group, the level of albumin increased, and the levels of ammonia and the Child-Pugh score decreased. The TIPS group showed no improvement in the liver function. In the BRTO group, the gastric varices were eradicated in 7 patients. Gastric variceal rebleeding and encephalopathy did not occur. However, the esophageal varices worsened in 6 patients. In the TIPS group, rebleeding (n=4), encephalopathy (n=7) and a worsening of the gastric (n=5) or esophageal varices (n=2) occurred. CONCLUSION: BRTO improves the metabolic activity of the liver and has a lower incidence of encephalopathy. Hence, BRTO is a good alternative to TIPS in the gastric varices accompanied by a gastrorenal shunt although a treatment for a worsening of the esophageal varices may be needed after BRTO.
Ammonia ; Esophageal and Gastric Varices* ; Humans ; Incidence ; Liver ; Portasystemic Shunt, Surgical* ; Varicose Veins