As a modality of effective treatment for trichiasis, authors performed experimental study of the radio frequency application(Mehl's method) to the cilia of four rabbit eyes with the different application times(10, 30, 60, 180 seconds). For the control, electrolysis to the cilia of the two eyes, and two eyes without any application were observed histopathologically. Regardless of the radio frequency application time, the radio frequency applied eyelids did not reveal any gross changes, and the selective degenerative changes(pyknotic, vacuolar, and karyorrhaxis) were observed microscopically in the hair regeneration part(internal root sheath of hair, hair matrix, and papillae of hair). In the electrolysed eyelids, gross scar and severe necrotic changes were appeared in microscopic findings. As a result of our observation, it is indicated that the application of radio frequency as a treatment for trichiasis, in compare with the electrolysis, revealed less destructive to the adjacent tissue, with more selective changes on the portion for hair regeneration.
Cicatrix ; Cilia* ; Electrolysis ; Eyelids ; Hair ; Regeneration ; Trichiasis

BACKGROUND AND OBJECTIVES: Angiotensin-II receptor blockers (ARBs) are known to reduce the development of atrial fibrillation (AF) through reverse-remodeling. However, the effect of ARBs on thrombogenicity in AF remains unknown. MATERIALS AND METHODS: Twelve dogs were assigned to control (n=4), ARB (candesartan cilexitil 10 mg/kg/day p.o., 12 weeks; n=4), or sham (n=4) groups. Sustained AF was induced by rapid atrial pacing. Both arterial and venous serum levels of tissue inhibitor of matrix metalloproteinase-1, von Willebrand factor, P-selectin, and vascular cell adhesion molecule-1 (VCAM-1) were measured at baseline and during AF (0, 4, and 12 weeks) with enzyme-linked immunosorbent assay. Biopsies from both atria including the appendages were performed to semi-quantitatively assess endocardial and myocardial fibrosis after 12 weeks. RESULTS: The serum levels of bio-markers were not significantly different at baseline or during AF between the control and the candesartan groups. The levels were not significantly different over time, but there was a trend toward a decrease in arterial VCAM-1 from 4 to 12 weeks in the candesartan group compared to the control group. The grades of endocardial fibrosis after 12 weeks but not those of myocardial fibrosis were slightly reduced in the candesartan group compared to the control group. CONCLUSION: This study did not show that the ARB candesartan significantly reverses thrombogenicity or fibrosis during AF. Future studies using a larger number of subjects are warranted to determine the therapeutic effect of renin-angiotensin-aldosterone system blockade on prothrombogenic processes in AF.
Angiotensin II ; Animals ; Atrial Fibrillation* ; Biomarkers ; Biopsy ; Dogs ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Matrix Metalloproteinase 1 ; P-Selectin ; Renin-Angiotensin System ; Thromboembolism ; Vascular Cell Adhesion Molecule-1 ; von Willebrand Factor

OBJECTIVE: It has been recognized that cold knife conization has higher incidence of postoperative hemorrhage and many techniques have been developed in an attempt to control hemorrhage. The aim of this study was to evaluate complications of Sturmdorf's suture in cold knife conization and to investigate various measures employed to reduce blood loss. METHODS: The results of 85 patients who had cold knife conization for diagnosis or treatment of cervical intraepithelial neoplasia (CIN) from August, 1997 to July, 2003 were reviewed. RESULTS: Among 85 patients, 83 patients (97.7%) had negative cut margins on conization specimen while 2 patients (2.3%) positive cut margins. 54 patients received no further treatment after cold knife conization and complications occurred in 9 patients (16.7%). Postoperative hemorrhage requiring additional hemostatic procedures occurred in 7 patients (13%), of which 6 patients were rehospitalized and 1 patient was managed at outpatient clinic with gauze packing only. Among 6 rehospitalized patients, hysterectomy was done in 2 patients and electrocoagulation in 1 patient. Packed red cell was transfused in 1 patient and 2 patients were managed with gauze packing only. Postoperative infection was found in 2 patients (3.7%). No other significant complications were noted. CONCLUSION: Cold knife conization using Sturmdorf's suture could be done to get much more accurate results of biopsy with relatively mild complication in magement of CIN, although several days? admission is needed and the other alternative methods seem to be more convenient.
Ambulatory Care Facilities ; Biopsy ; Cervical Intraepithelial Neoplasia ; Conization* ; Diagnosis ; Electrocoagulation ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Postoperative Hemorrhage ; Sutures*

Intercellular adhesion molecule-1 (ICAM-1) is a membrane protein, exists as a dimer on the cell surface, and interacts with leukocyte function associated antigen-1 (LFA-1), a member of beta2-integrin family. A soluble circulating form of ICAM-1 (sICAM-1) is also detected in human serum, and has been implicated as a regulator for LFA-1-dependent cell-cell interaction in vivo. However, previous reports demonstrated that sICAM-1 shows little inhibitory effect on LFA-1 binding to ICAM-l, indicating that sICAM-1 is unlikely to antagonize LFA-1/ICAM-1-mediated cellular events in vivo. Here, we investigated the property of the dimeric sICAM-1 as an inhibitor of LFA-1 interaction with ICAM-3, since the lower avidity of LFA-1 for ICAM-3 compared with ICAM-1 or ICAM-2 had been speculated. Using recently constructed heterodimeric sICAM-1 joined at the C terminus via an a-helical coiled coil (ACID-BASE) (Jun, CD. et al., 2001, Proc Natl Acad Sci 98, 6830-6835), we also tested whether the structural integrity in dimer could affect the inhibitory action of sICAM-1. Engineered sICAM-1 dimer that contained intact ectodomain (E34/E34) significantly blocked SKW3 cell (LFA-1+) binding to ICAM-3, but not to ICAM-1 and ICAM-2, indicating the lower avidity of LFA-1 to ICAM-3 than that of both ICAM-1 and ICAM-2. A one binding site knock out mutant (E34/K34) showed -2-fold reduction in efficiency compared with E34/E34 to inhibit cell binding. Interestingly, a one binding domain deletion mutant (E34/deltaD1-D2) showed significant reduction (~5-fold) compare with E34/K34, suggesting that structural integrity, which is precluded in E34/deltaD1-D2, is necessary for optimal binding of dimeric sICAM-1 to LFA-1, thereby inhibiting LFA-1/ICAM-3-dependent adhesion. Furthermore, BIAcore affinity measurements revealed that E34/deltaD1-D2 bound to immobilized soluble open LFA-1 I domain with an -3-fold reduced affinity compared with E34/K34. Overall, our results demonstrate that maintaining the structural integrity in dimer is necessary for optimal binding of sICAM-1 to LFA-1, and further suggest the therapeutic potential of dimeric sICAM-1 to antagonize LFA-1/ICAM-3-mediated cellular events in vivo.
Binding Sites ; Humans ; Intercellular Adhesion Molecule-1 ; Leukocytes* ; Lymphocyte Function-Associated Antigen-1* ; Membrane Proteins

EDTA-dependent pseudothrombocytopenia (PTCP) is the phenomenon of a spurious low platelet count due to EDTA-induced aggregation of platelets. Since the failure to recognize EDTA-dependent PTCP may result in incorrect diagnosis and inappropriate treatment, the recognition of this phenomenon is very important. We report an insidious case of EDTA-dependent PTCP confirmed by supplementation of kanamycin to anticoagulant in a 53-year-old women. Although sodium citrate and heparin usually prevented the aggregation of platelets in EDTA-dependent PTCP patients, these anticoagulants failed in preventing PTCP in our case. EDTA-dependent PTCP was confirmed by the findings that the clumping of platelets on microscopic evaluation was found in EDTA-anticoagulated blood samples, whereas thrombocytopenia and platelet aggregation were not revealed in the sample supplemented with kanamycin.
Antibiotics, Aminoglycoside/*pharmacology ; Anticoagulants/*adverse effects/pharmacology ; Case Report ; Edetic Acid/*adverse effects ; Female ; Human ; Kanamycin/*pharmacology ; Middle Age ; Platelet Aggregation/*drug effects ; Platelet Aggregation Inhibitors/*therapeutic use ; Platelet Count ; Thrombocytopenia/*blood/chemically induced

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hypo-osmotic hyponatremia. There are several etiologies of SIADH including neuroendocrine tumor, pulmonary disease, infection, trauma, and medications. Here, we report a case of SIADH associated with a schwannoma involving the mediastinum in a 75-year-old woman who presented with nausea, vomiting, and general weakness. Laboratory testing showed hypo-osmolar hyponatremia, with a serum sodium level of 102mmol/L, serum osmolality of 221mOsm/kg, urine osmolality of 382mOsm/kg, urine sodium of 55 mmol/L, and plasma antidiuretic hormone (ADH) of 4.40 pg/mL. Chest computed tomography identified a 1.5-cm-sized solid enhancing nodule in the right lower paratracheal area. A biopsy specimen was obtained by video-assisted thoracoscopic surgery, which was diagnosed on pathology as a schwannoma. The hyponatremia was completely resolved after schwannoma resection and plasma ADH level decreased from 4.40 pg/mL to 0.86 pg/mL. This case highlights the importance of suspecting and identifying the underlying cause of SIADH when faced with refractory or recurrent hyponatremia, and that on possibility is mediastinal schwannoma
Aged ; Biopsy ; Female ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Lung Diseases ; Mediastinum ; Nausea ; Neurilemmoma* ; Neuroendocrine Tumors ; Osmolar Concentration ; Pathology ; Plasma ; Sodium ; Thoracic Surgery, Video-Assisted ; Thorax ; Vomiting

OBJECTIVE: To evaluate the association of level of CA-125 and severity of dysmenorrhea with lesion depth in adenomyosis. METHODS: Sixty-eight women who had undergone hysterectomy and were found to have pure adenomyosis on histopathologic examination were reviewed retrospectively. Specimens were stratified according to the degree of adenomyosis penetration into 4 groups: group A consisted of specimens with adenomyosis penetration into myometrium of up to 25%; group B, 26-50%; group C, 51-75%, and group D, >75%. All women were submitted to serum determination of CA-125. Severity of dysmenorrhea was assessed by means of a modification of 10-point verbal rating scale. RESULTS: Each group was not correlated with severity of dysmenorrhea (p=0.7394 Fisher's exact test). The means of serum CA-125 levels was increased corresponding to depth of adenomyosis (p=0.0441 ANOVA test). CONCLUSION: In this study, serum CA-125 level is associated with the depth lesion and severity of dysmenorrhea is not. Therefore, the level of serum CA-125 might be useful indicator in management of adenomyosis before surgery.
Adenomyosis* ; Animals ; Dysmenorrhea* ; Female ; Humans ; Hysterectomy ; Mice ; Myometrium ; Retrospective Studies

BACKGROUND AND OBJECTIVES: In recent years, much attention has been directed towards cell adhesion molecules. This study was designed to confirm the significance of E-cadhcrin as a marker for differentiation and invasiveness of squamous cell carcinomas of the head and neck. MATERIALS AND METHODS: Twenty-nine patients with squamous cell carcinoma of the head and neck were used in this study. The specimens of formalin-fixed paraffin-embedded tissues were investigated by immunohistochemical analysis using monoclonal anti-E-cadherin antibody. RESULTS: The results showed that here was a statistically significant correlation in the head and neck squamous cell carcinoma between the T and the N stage and the expression of E-cadherin (p=0.025, p=0.015). The cell differentiation was also correlated with the reduction of E-cadherin (p =0.005). CONCLUSION: E-cadherin may be linked to progression and differentiation of the head and neck squamous cell carcinoma. E-cadherin immunostaining in the primary tumor appear to be a good marker for the invasiveness and the metastasis of tumors.
Cadherins* ; Carcinoma, Squamous Cell* ; Cell Adhesion Molecules ; Cell Differentiation ; Head and Neck Neoplasms ; Head* ; Humans ; Neck* ; Neoplasm Metastasis

OBJECTIVES: Workers from a factory was selected to compare 8 standard threshold shift criteria with the Korean diagnostic criteria of noise-induced hearing loss for this cohort study. METHODS: From 1990 to 1999, 491 workers at a manufacturing company with complete record of the hearing test covering the range of 0.5~6 kHz for 10 consecutive years were finally selected. Eight standard threshold shift criteria (15 dB once, NIOSH (1972), 10 dB average 3~4 kHz, OSHA STS, AAOHNS, 15 dB twice, 15 dB 1~4 kHz, OSHA STS twice) along with the Korean standard for diagnosing the noise-induced hearing loss (the average hearing threshold at 0.5, 1 and 2 kHz) were compared to calculate the degree of the threshold shift and the minimum time required to detect the change. RESULTS: Those workers showing at least one positive shift in the 'once'criteria of NIOSH (1972) were 92.5%; the 'average'criteria of 10 dB average 3~4 kHz were 35.8%; 'twice'criteria of 15 dB twice were 44.4%. The duration from the baseline to the year showing the first positive shift was from 3.2 +/- 3.1 years (NIOSH, 1972) to 6.0 +/- 2.1 years (OSHA STS twice). The percentage of true positive shift ranging from 20.4% (AAO-HNS) to 69.8% (NIOSH, 1972). There were 10 (2%) which met the Korean diagnostic criteria of noise-induced hearing loss. CONCLUSIONS: Currently the concept of hearing threshold shift in diagnosing the hearing loss was adopted in Korea thus in this study we determined the validity and the effect of the various hearing threshold shift criteria and showed that NIOSH (1972) criteria was the best of all. In the future, hearing data from various manufacturing workers should be compared to thoroughly evaluate the threshold shift criteria and to establish adequate standard for Korean workers.
Cohort Studies ; Hearing Loss ; Hearing Loss, Noise-Induced ; Hearing Tests ; Hearing* ; Korea ; National Institute for Occupational Safety and Health (U.S.) ; United States Occupational Safety and Health Administration

BACKGROUND: Although electrocardiographic manifestations of idiopathic dilated cardiomyopathy (DCMP) are usually nonspecific, several studies have suggested that electrocardiogram (ECG) might be used to predict the prognosis. METHODS: The present study was performed to determine the role of standard 12-lead ECG variables as a prognostic factor of patients with idiopathic DCMP. We retrospectively analyzed the ECG findings at the time of the diagnosis in 89 patients with DCMP during a mean follow-up period of 53.2+/-37.1 months. RESULTS: Twenty-eight (31.5%) of the 89 patients died and the cumulative survival rate was 87% at 2 years and 68% at 5 years. By univariate life table analysis, premature ventricular contraction, left bundle branch block, and age were proved as significant predictors. Multivariate analysis using Cox proportional hazards model identified premature ventricular contraction (p=0.014) and left bundle branch block (p=0.02) as an independent predictor for cardiovascular mortality in DCMP. The presence of a premature ventricular contraction increased the mortality 2.8 times and left bundle branch block 2.6 times. CONCLSUION: The present study demonstrates that independent ECG predictors for prognosis of idiopathic DCMP are premature ventricular contraction and left bundle branch block and ECG may be useful in predicting the prognosis of idiopathic dilated cardiomyopathy.
Bundle-Branch Block ; Cardiomyopathy, Dilated* ; Deoxycytidine Monophosphate ; Diagnosis ; Electrocardiography* ; Follow-Up Studies ; Humans ; Life Tables ; Mortality ; Multivariate Analysis ; Prognosis* ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Ventricular Premature Complexes