No abstract available.
Colorectal Neoplasms* ; Neoplasm Metastasis*

The effect of topical steroid application on clinical results of 215 eyes(126 patients) performed with excimer laser photorefractive keratectomy (PRK) from July 1993 to July 1994 was evaluated, postopertively. The range of myopia was between -2.5 and -11.5 diopter and followed for 9 months after PRK with Summit Omnimed(TM). Topical corticosteroid or non-steroidal antiinflammatory drug (NSAID) was not applied for one month after operation in all cases. After one month, in cases of 115 eyes showing myopic regression of more than -1 diopter or stromal haziness of more than grade 1(delayed steroid group; DSG), 0.1% fluorometholone was applied 4 times daily for 4 weeks, then tapered according to the planned schedule. 46.5% (100 eyes, non-steroid group;NSG) did not show the myopic regression nor stromal haziness without treatment of fluorometholone throughout the follow-up period. Uncorrected visual acuity, spherical equivalent and corneal haziness were evaluated 1, 2, 4, 8, 12, 24, 36 week after operation. 73%(73 eyes) of NSG and 27%(30 eyes) of DSG showed a myopia less than 6.0 diopters preoperatively. The proportion of male was 36% in NSG and 50.4% in DSG. 88.1% of male high myopia(>6.0 diopters) needed 0.1% fluorometholone, while 17.6% of female moderate and mild myopia( Appointments and Schedules ; Female ; Fluorometholone ; Follow-Up Studies ; Humans ; Incidence ; Lasers, Excimer* ; Male ; Myopia ; Photorefractive Keratectomy* ; Visual Acuity

External ventricular drainage (EVD) is a common procedure performed in neurosurgical field. The purpose of this study was to introduce the linear intracranial calcification formed along EVD tract and to investigate its incidence, predisposing factors, and clinical impact. A total of 59 patients who underwent EVD insertion over a 1-year period were included in this study. The clinical factors and radiographic features between the occurrence and the non-occurrence groups were analyzed to investigate the predisposing factors and clinical impact related to the linear intracranial calcification in EVD tract. The linear intracranial calcification following EVD insertion occurred in 7 patients (11.9%). Among various risk factors assessed, only usage of bone dust (p =0.003) had contributed to linear intracranial calcification with statistical significance in univariate logistic regression analysis. Housefield unit (HU) scale was different between calcification (872.57 ± 46.15 HU) and EVD catheter (169.00 ± 61.35 HU). This study indicates that using bone dust for sealing a burr hole is the only predisposing factor for linear intracranial calcification formed in EVD tract.
Catheters ; Causality* ; Drainage* ; Dust ; Humans ; Incidence ; Logistic Models ; Risk Factors

No abstract available.
Anemia, Hypoplastic, Congenital*

PURPOSE: To determine the benefit of optical coherence tomography (OCT) in the diagnosis of vitreomacular traction syndrome and evaluate the vitreoretinal interface before and after vitreous surgery. METHODS: Medical records of five patients with vitreomacular traction syndrome who had undergone vitrectomy were reviewed. Preoperative and postoperative visual acuity and preoperative and postoperative OCT were reviewed. In all patients OCT demonstrated posterior vitreous detachment and a focal adhesion of hyaloid membrane to macula with traction on the foveal retinal tissue. All of them underwent pars plana vitrectomy with peeling of poterior hyaloid face. RESULTS: Visual acuity improved in 4 eyes after the first vitrectomy. One eye developed postoperatively a macular hole, which was treated with the second vitrectomy and intravitreal gas tamponade with subsequent improvement in vision. In 4 eyes, OCT showed elimination of vitreous strand, relief of vitreous traction and restoration of normal foveal contour after vitrectomy. CONCLUSION: Optical coherence tomography is a useful tool in the diagnosis of vitreomacular traction syndrome and in the evaluation of status of vitreoretinal interface before and after vitrectomy. Following pars plana vitrectomy, vision improved and normal foveal contour was restored.
Diagnosis* ; Focal Adhesions ; Humans ; Medical Records ; Membranes ; Retinal Perforations ; Retinaldehyde ; Tomography, Optical Coherence* ; Traction* ; Visual Acuity ; Vitrectomy ; Vitreous Detachment

BACKGROUND: Asymptomatic vancomycin-resistant enterococci (VRE) colonization precedes infection. VRE-colonized patients serve as silent reservoirs of enterococci that go on to colonize other patients. Rapidly identifying colonized patients is crucial to prevent the spread of VRE. The culture-based method of VRE screening is time-consuming. We evaluated the diagnostic performance of a recently developed multiplex real-time PCR for the detection of VRE. METHODS: We obtained 105 rectal swabs from patients who were being monitored for carriage of VRE. After 24 hour incubation of swabs in enterococcosel broth (EB) supplemented with 6 microg/mL vancomycin, multiplex real-time PCR was performed using the Anyplex(TM) VanR Real-time Detection (VanR) kit (Seegene, Inc., Seoul, Korea). The results of multiplex real-time PCR were compared to those of culture. We evaluated the specificity and detection limits of multiplex real-time PCR using VanR for VRE. RESULTS: A total of 96/105 (91.4%) samples were VRE positive according to multiplex real-time PCR with EB while 85/105 (80.9%) samples were positive in culture. Eleven discordant results (10.4%) (multiplex real-time PCR positive, culture negative) were noted. All non-enterococcal bacteria and vancomycin-susceptible enterococci were negative. The DNA detection limits of VanR were 0.035 pg per reaction (3 microL) for Enterococcus faecium and 0.35 pg for Enterococcus faecalis. CONCLUSION: The application of multiplex real-time PCR after EB incubation allows rapid and sensitive detection in 26-28 hours for VRE screening from rectal swabs. This method could facilitate the timely implementation of contact isolation to prevent the spread of VRE.
Bacteria ; Colon ; DNA ; Enterococcus ; Enterococcus faecium ; Humans ; Limit of Detection ; Mass Screening ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Vancomycin

PURPOSE: The aim of the study was to clarify the anatomy of the male rat urethra, and to establish a more accurate and consistent method for analyzing external urethral sphincter (EUS) contractility based on this clarified anatomy by comparing different muscle strip orientations. MATERIALS AND METHODS: The whole urethra in male rats was investigated histologically using H/E and immunohistochemical staining. The contractility of the spiral (S) orientation of the entire proximal urethral (EUS) was then compared with the transverse (T) and the ring (R) orientations of the optimal portion, via electrical stimulation in an organ bath. RESULTS: In male rats, the urethral tract consisted of following parts: proximal urethra, transient urethra, urethral diverticula, and penile urethra. Throughout the proximal urethra, a layer of striated muscle fibers encircled the smooth muscle layers. The EUS contraction of the S, TM (Transverse, Middle of proximal urethra) and RM (Ring, Middle of proximal urethra) groups were 4.66+/-0.33mN, 2.92+/-0.33mN and 2.47+/-0.38mN, respectively. The strength of the EUS contraction of the S group was significantly higher than that of the TM. Group, but after adjusting the length, there was no statistically significant difference between the two groups. CONCLUSIONS: Unlike previous studies, showing striated muscle fibers limited to the lower half of the proximal urethra, we noted them throughout the whole proximal urethra. From our results, the spiral orientation of the entire urethra was found to be the optimal configuration for evaluating the contractility of the EUS using fast twitch muscle contractile testing.
Animals ; Baths ; Diverticulum ; Electric Stimulation ; Humans ; Male* ; Muscle, Smooth ; Muscle, Striated ; Rats* ; Urethra*

The traditional light microscopy has limitations for precise growth assays of malaria parasites in culture or for assessment of new compounds for antimalarial activity; the speed and high reproducibility of flow cytometry can overcome these limitations. A flow cytometric method using PicoGreen, a DNA-binding fluorochrome, was developed with optimal precision suitable for performing growth assays of low-parasitemia field isolates. In addition, intra- and inter-person reproducibility of the flow cytometric and the microscopic method were compared in order to quantitatively demonstrate the improved precision. RNase treatment contributed to the precision of the flow cytometric measurements by enhancing the signal-to-noise ratios. Coefficients of variation of the method were smaller than 10% for 0.1% or higher parasitemia samples. The intra- and inter-person coefficients of variation of the flow cytometric method were three to six times smaller than those of the microscopic method. The flow cytometric method developed in this study yielded substantially more precise results than the microscopic method, allowing determination of parasitemia levels of 0.1% or higher, with coefficients of variation smaller than 10%. Thus, the PicoGreen method could be a reliable high sensitivity assay for analysis of low parasitemia samples and might be applied to a high throughput system testing antimalarial drug activity.
*Flow Cytometry ; Fluorescent Dyes/chemistry ; Humans ; *Microscopy ; Organic Chemicals/chemistry ; Parasitemia/*diagnosis ; Plasmodium falciparum/*isolation & purification ; Reproducibility of Results ; Ribonucleases/metabolism ; Signal-To-Noise Ratio

BACKGROUND: Infections caused by vancomycin-resistant enterococci (VRE) are becoming increasingly prevalent throughout the world. VRE can spread by direct patient-to-patient contact as well as on the hands of personnel and contaminated environmental surfaces. The purpose of this study was to examine the incidence of VRE among total enterococci from clinical specimen and investigate the antimicrobial characteristics and resistance genotypes of isolated VRE. METHODS: A total of 790 enterococcal isolates from patients over a period of 12 months were screened for vancomycin resistance using brain heart infusion agar plates supplemented with 6 g/mL of vancomycin. The incidence of VRE among enterococcal isolates was calculated from microbiology statistics program. Twenty three isolates of VRE were tested for minimal inhibitory concentrations (MIC) of vancomycin, penicillin, and gentamicin and resistance genotypes. RESULTS: In the first half period, the incidence of VRE was 1.9%, and in the second half, the incidence increased to 7.7%. Thirteen strains were found to be highly resistant to vancomycin, penicillin and gentamicin (MIC, >128 g/mL). According to the direct PCR analyses, the frequency of vanB, vanC1, and vanC2 types was 13, 7, and 3 strains, respectively. CONCLUSIONS: Continued vigilance, strict enforcement of infection control, and curtailment of vancomycin use seem to be our best approaches to controlling this increasingly important problem. For this purposes, accurate and timely detection of vancomycin-resistance and periodic investigation for incidence are essential.
Agar ; Brain ; Genotype* ; Gentamicins ; Hand ; Heart ; Humans ; Incidence* ; Infection Control ; Penicillins ; Polymerase Chain Reaction ; Vancomycin ; Vancomycin Resistance

Various remedies have been developed for broad damage to soft tissue in limbs by traffic accidents and mechanical mishaps that have greatly increased in modern society. If the damaged part is trivial, it may be generally treated with local flap or skin graft. However, this has been limited by the ability to choose the flap available depending on the condition of the wounded part, so that, if it is rather large or severly inflamed, or if it occurred with a bone-fracture, it is inevitable to practice the free flap. In the past, the focus was on whether the free flap would survive or not. However, the function of donor the and recipient, as well as the problem of aesthetic appearance, gas become a matter of increqsing interest and concern as the survival rate of the flap has greatly improved due to the development of precise operations. In thes study, therefore, some complications were analyzed which may develop in a donor by a variety of free flaps. Preoperative plans, as well as intraoperative and postoperati-ve treatment were also studied to minimize the cause of complications. To investigate these questions, we undertook a clinical analysis of 91 followed patients from 1990 to 1997. There were 68 male and 23 female patients ranging in age from 6 to 67 years, with an average of 34.7 years. The length of follow-up ranged from 8 months to 6 years. The results of this study were as follows: Sufficient plans must be made on the donor before operation, single textures like muscle or fascia should be used if possible, and incision should be arranged along Langer`s line. Some measures to reduce wound tension should be pursued, and plans must be made to immobilize the site for an ample period after the operation. Some precautious should also be considered during the operation, such as avoiding traction surrounding nerves and vessels, preserving paratenon, practicing osteotomy with great care and properly stopping any bleeding. In addition, formation of a hematoma or seroma should be preventcd and the donor must be sutur-ed as soon as possible to reduce infection. With the application of the basic operational principles on the treatment of donors, the complications which might be caused by each free flap can be reduced, and furthermore, be protected against.
Accidents, Traffic ; Extremities ; Fascia ; Female ; Follow-Up Studies ; Free Tissue Flaps* ; Hematoma ; Hemorrhage ; Humans ; Male ; Osteotomy ; Seroma ; Skin ; Survival Rate ; Tissue Donors* ; Traction ; Transplants ; Wounds and Injuries