No abstract available.
Antibody Formation* ; Immunoglobulin A* ; T-Lymphocytes*

The surgical outcome of excimer laser photorefractive keratectomy(PRK) depends on the accuracy of ablation and the smoothness of the surface ablated. The purpose of this study was to investigate the clinical usefulness of a new eyeball fixation device(EK fixation device). First, the PRK was done on the cornea of New Zealand white rabbit (-8 D, 5.5 mm). The surface with the device was smoother compared to that without. Second, The PRK (-4 D, 6 mm)was done on the surface of the contact lens over the cornea of human volunteers. The ablation surface with the device was smoother than that without(0.20+/-0.04 micrometer vs. 0.34 +/-0.14 micrometer, p=0.028). The epithelial healing experiment in New Zealand white rabbit after myopic PRK (-8 D, 5.5 mm)showed more rapid wound healing in the fixation group (66.49+/-0.03 micrometer/hr vs 47.93+/-1.80 micrometer/hr, p=0.0001). In conclusion, the EK fixation device during the PRK procedures creates a smoother ablation surface and enhances corneal epithelial healing, thus may be a useful clinical device.
Cornea ; Healthy Volunteers ; Lasers, Excimer ; New Zealand ; Wound Healing

This study aims to investigate the anatomical information of the sphenopalatine foramen with special reference to the bleeding control of the sphenopalatine artery and to the blockage of the pterygopalatine ganglion during functional endoscopic sinus surgery. Forty-three midsagittal sectioned Korean heads were used in the study. The mucosa on the lateral nasal wall was removed for showing the sphenopalatine foramen. The shapes of the sphenopalatine foramen were classified by 4 types. Angle from the akanthion and distances from akanthion, conchae, sphenoidal sinus and greater palatine foramen were measured. The sphenopalatine foramen was frequently found as oval shape and bilateral symmetry of 28.6%. The vertical length was 5.5 mm, the horizontal length was 5.3 mm. The most anterior point of the sphenopalatine foramen was located on 54.4 mm few and angles were between 15.9degrees and 22.1degrees from akanthion. The distances were 36.2 mm from anterior end of middle nasal concha, 6.2 mm from posterior end of middle nasal concha, 27.2 mm from greater palatine foramen. The uppermost point of the sphenopalatine foramen was located on 22.3 mm from the most superoanterior end of the sphenoidal sinus, 18.6 mm from the lowermost end of the sphenoidal sinus. This study could be useful to provide the confidence about the location of the sphenopalatine foramen during functional endoscopic sinus surgery.
Arteries ; Ganglion Cysts ; Head ; Hemorrhage ; Mucous Membrane ; Turbinates

PURPOSE: In patients with acute neurological symptoms, brain computed tomography (CT) is usually used to exclude hemorrhagic stroke. After CT imaging, there is no rapid, effective biologic marker for differentiating between acute cerebral ischemia and other etiologies, precluding rapid triage for further evaluation. We evaluated the diagnostic value of a panel of biochemical markers. METHODS: We performed the Triage Stroke Panel (Biosite Inc., UK) test using blood samples of patients who were admitted to the emergency department with suspected acute stroke between December, 2007, and March, 2008. The TSP is represented as MMX (multimarker index) compiles from individual biomarker values, based on quantitative measurement of B-type natriuretic peptide (BNP), fibrin degradation products containing D-dimer, matrix metalloproteinase-9 (MMP-9), and S100. All patients were prospectively evaluated with imaging and laboratory tests for final diagnosis. RESULTS: Of 105 patients, 51.4% had ischemic stroke and 48.6% had non-ischemic, non-organic abnormalities, primarily peripheral vertigo. High levels of BNP and MMX were observed in patients with ischemic stroke (both p <0.001). Independent predictors (odds ratio with CIs are given) of ischemic stroke were: female (OR=0.1 [0.2-0.8]), hypertension (OR=5.0 [1.2-21.3]), BNP (BNP >54.7 pg/mL, OR=99.4 [8.5-1,171.0]). A model combining BNP and MMX had 92% specificity and a 91% positive predictive ratio for prediction of acute ischemic stroke. CONCLUSION: Using biomarkers may improve the differential diagnosis of ischemic stroke after initial brain CT imaging for hemorrhagic stroke, rapidly guiding further evaluation and treatment initiation in the emergency department.
Biomarkers ; Brain ; Brain Ischemia ; Diagnosis, Differential ; Emergencies ; Female ; Fibrin Fibrinogen Degradation Products ; Humans ; Hypertension ; Matrix Metalloproteinase 9 ; Natriuretic Peptide, Brain ; Prospective Studies ; Sensitivity and Specificity ; Stroke ; Triage ; Vertigo

PURPOSE: To compare preoperative and postoperative ocular biometry in patients with iris-fixated phakic intraocular lens (pIOLs): Artisan and Artiflex. MATERIALS AND METHODS: This study included 40 eyes with Artisan and 36 eyes with Artiflex pIOL implants. Anterior chamber depth (ACD) and axial length (AL) were measured by applanation ultrasonography (A-scan) and partial coherence interferometry (IOLMaster) preoperatively and 3 months after pIOL implantation. RESULTS: ACD measurements after Artisan or Artiflex pIOL implantation were smaller than preoperative measurements. Specifically, the difference after Artisan pIOL implantation was -1.07+/-0.17 mm by A-scan and -0.08+/-0.08 mm by IOLMaster. The difference after Artiflex pIOL implantation was -1.31+/-0.15 mm by A-scan and -0.05+/-0.07 mm by IOLMaster. After Artisan pIOL implantation, differences in AL measurements by A-scan were insignificant (difference: -0.03+/-0.15 mm), whereas postoperative AL measurements by IOLMaster were significantly longer than preoperative measurements (difference: 0.12+/-0.07 mm). After Artiflex pIOL implantation, AL measurements by both A-scan and IOLMaster were significantly longer than preoperative measurements (difference: 0.09+/-0.16 mm by A-scan and 0.07+/-0.10 mm by IOLMaster). In the Artiflex group, differences in AL measurements by A-scan correlated with the central thickness of the Artiflex pIOL. CONCLUSION: ACD and AL measurements were influenced by iris-fixated phakic IOL implantation.
Adult ; Biometry ; Eye/ultrasonography ; Female ; Humans ; Interferometry ; Lens Implantation, Intraocular/*adverse effects ; Male ; Middle Aged ; Postoperative Complications

We report two cases of toxic methemoglobinemia caused by an inert ingredient in pesticide product after intentional ingestion of pesticide. First, 51-year-old male visited to the emergency department (ED) after the ingestion of pesticide in a suicide attempt. Initial methemoglobin (MetHb) level was 25.6%. We did not know the cause of methemoglobinemia at that time. Second, 56-year-old female visited to the ED after the ingestion of the same pesticide in a suicide attempt. MetHb level after 30 minutes was 16.1%. The patients were treated with methylene blue. We contacted to the Korean Rural Development Administration and estimated that magnesium nitrate was more likely to cause methemoglobinemia. This report highlights the importance of considering the possibility of methemoglobinemia caused by inert ingredient in pesticide and early antidotal therapy.
Eating* ; Emergency Service, Hospital ; Female ; Humans ; Magnesium ; Male ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Middle Aged ; Pesticides ; Social Planning ; Suicide

PURPOSE: Emergency physicians are often asked to predict a patient's functional outcome after an acute stroke. However, very little information is usually available to a physician to help predict the likelihood of severe permanent disability. The purpose of this study was to determine useful Initial prognostic predictors in patients with an acute stroke presenting to the emergency department. METHODS: Between March 1, 2004 and May 31, 2004, we analyzed 74 patients diagnosed to have an acute stroke by diffusion weighted magnetic resonance imaging obtained within 24 hours from symptom onset at the emergency department. Seven factors were evaluated as prospective variables including The National Institutes of Health Stroke Scale (NIHSS) measured by emergency physician (NIHSSEM) and neurologist (NIHSS-NR) at the time of presentation to the emergency department. The outcome variables were Barthel Index (BI), modified Rankin Scale (mRS), and the NIHSS measured at the time of discharge from hospital. RESULTS: The intraclass correlation coefficient between NIHSS-EM and NIHSS-NR was 0.94 (p < 0.001). History of stroke, gender, NIHSS-EM, large vessel disease and lacuna infarctions were statistically significant outcome predictors. In a multivariate logistic regression analyses, NIHSSEM was the only independent variable that correlated with NIHSS, mRS, and BI at hospital discharge. CONCLUSION: Among the many prognostic predictors studied, the NIHSS appeared to be the only independent variable showing a correlation with the patients's prognosis. The NIHSS perfomed in the emergency department may help emergency physicians provide more accurate initial prognosis in an acute stroke patient.
Diffusion ; Emergencies ; Emergency Service, Hospital ; Humans ; Infarction ; Logistic Models ; Magnetic Resonance Imaging ; National Institutes of Health (U.S.) ; Prognosis* ; Prospective Studies ; Stroke*

Ischemic-reperfusion injury of skeletal muscles takes place in the phase of reperfusion and induces cellular damages through activating various transcription factors and genes, which initiate signal transduction. The purpose of this study was to observe changes of expression of NF-kappa B and AP-1, which are known as a redox sensitive transcription factors in ischemic-reperfused rat skeletal muscles, and PKC theta which activate NF-kappa B and AP-1. Sprague-Dawley male rats of nine, thirty, and sixty-five weeks old were divided into control and ischemia groups. Ischemia was performed by occlusion of left common iliac artery for 4 hours using rodent vascular clamps. The animals were sacrificed at hours 0, 1, 3 and 6 after onset of reperfusion and tibialis anterior and soleus muscles were removed. The distributions of PKC theta, NF-kappa B, and AP-1 immunoreactivity (IMR) were examined using immunohistochemical methods. The results as follows; In control groups, PKC theta IMR was decreased with age and was higher in tibialis anterior than that in soleus muscles. In ischemia groups, PKC theta IMR was increased with age and was higher in soleus than that in tibialis anterior muscles. In control groups, NF-kappa B IMR was decreased with age. In ischemia groups, NF-kappa B IMR was increased with age and was higher in soleus than that in tibialis anterior muscles. In control groups, AP-1 IMR was decreased with age. In ischemia groups, AP-1 IMR was increased with age and was higher in tibialis anterior than that in soleus muscles. Increase or decrease of PKC theta IMR was associated with the increase or decrease of NF-kappa B and AP-1 IMR in ischemic-reperfused rat skeletal muscles, respectively. These results suggested that the increased expression of PKC theta may induce the upregulations of NF-kappa B and AP-1 in ischemic-reperfusion injury of rat skeletal muscle. It is also suggested that the ischemic injury may be increased with age, and tibialis anterior muscle is more susceptabile to ischemic-reperfusion injury than soleus muscle.
Animals ; Humans ; Iliac Artery ; Ischemia ; Male ; Muscle, Skeletal ; Muscles* ; NF-kappa B* ; Oxidation-Reduction ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Rodentia ; Signal Transduction ; Transcription Factor AP-1* ; Transcription Factors

Hormone therapy for peri- and postmenopausal women is widely used for relieving vasomotor symptoms or preventing osteoporosis. Even though exogenous hormone is the most common cause of vaginal bleeding in postmenopausal women under hormone therapy, in clinical practice, physicians must never exclude the possibility of endometrial disorders, such as endometrial hyperplasia or cancer. Taking thorough medical history and performing physical and pelvic examinations are essential for the evaluation of abnormal uterine bleeding in menopausal hormone therapy. Transvaginal ultrasonography, endometrial aspiration biopsy, dilatation and curettage, and hysteroscopy are the options which physicians may use. This case is about a woman with continuous combined hormone therapy for 5 years who had experienced rather sudden onset of vaginal spotting lasting for several months and was finally diagnosed as having malignant mixed Mullerian tumor. Our purpose is to inquire into the proper approaching steps for vaginal bleeding in menopausal hormone therapy.
Biopsy, Needle ; Dilatation and Curettage ; Endometrial Hyperplasia ; Female ; Gynecological Examination ; Humans ; Hysteroscopy ; Metrorrhagia ; Osteoporosis ; Uterine Hemorrhage

PURPOSE: It is well known that papillary thyroid cancer (PTC) has a good prognosis and high incidence in young women. The objective of the study was to review our criteria to select surgical modality and surgical results and to confirm the feasibility of endoscopic thyroidectomy according to the preoperative risk stratification in the treatment of papillary thyroid cancer. METHODS: Between May 2009 and April 2012, 197 patients underwent either a conventional open or an endoscopic thyroidectomy with the preoperative consideration of risk group using clinical parameters of AMES system (patient age, size of tumor, extrathyroid extension, and presence of distant metastasis). A retrospective analysis of the pathologic data according to AMES system after surgery was also conducted. The endoscopic thyroidectomy was performed using the BABA (bilateral axillo-breast approach) method. RESULTS: Based on the method of operation, the low-risk group patients (n=197) were divided into two groups: endoscopic group (n=78) and open group (n=119). Procedure time, postoperative complication rates, and length of hospital stay were tracked, albeit these were not significantly different between the two groups. From the pathologic findings, it was reported that there were no significant differences in tumor size, extrathyroid extension, and metastasis and also in the Off T4 – thyroglobulin level between the two groups. CONCLUSION: Endoscopic thyroidectomy is a feasible method for the treatment of selected cases of thyroid cancer such as low-risk group according to the appropriate preoperative risk stratification.
Female ; Humans ; Incidence ; Length of Stay ; Methods ; Neoplasm Metastasis ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*