The amniotic membrane has some characteristics. First, it does not express the human leukocyte antigens, and therefore immunologic rejection is not a concern. Second, it can be obtained easily and sufficiently. Third, because it has antimicrobial properties, transplantation of the amniotic membrane has fewer risks of post-operative infection. So it is under research for the amniotic membrane transplantation in cases of sterile corneal ulcer, pterygium excision,severe chemical and thermal corneal burns, ocular surface defects, conjunctival surface reconstruction after removal of large conjunctival lesions. We have experienced a good result of amniotic membrane transplantation for the conjunctival defect resulting from conjunctival necrosis, in enucleated eye having undergone scleral graft for scleral necrosis. Therefore, we report this case with a review of the literature.
Amnion* ; Burns ; Corneal Ulcer ; HLA Antigens ; Necrosis* ; Pterygium ; Transplants

As a new concept of resistive exercise, isokinetic exercise was developed during the early 1950's. In isokinetic exercise, the subject works at a fixed speed against variable and totally accommodating resistance. The isokinetic equipment has been used widely as a therapeutic modality in clinical setting, as a training and testing device for sports practicians, and as a method for scientific examination of postoperative status of muscles and joint function for orthopedists. In order to acquire the isokinetic normative data of the knee for clinical use, we examined the flexor and extensor muscle force of the knee joint in 160 subjects with Cybex II. The results were as follows; 1. Mean values of extensor strength were 76.04 ft.-1bs in right knee 75.45 ft.-lbs in left knee, 78.42 ft.-1bs in dominent hand side leg 73.84 ft.-1bs in non-dominent hand side leg, and 82.52 ft.-1bs in dominent leg 71.93 ft.-lbs in non-dominent leg. 2. Sex difference of extensor strength were 95.13 ft.-lbs in male 55.98 ft.-1bs in female, and that of flexor strength were 54.90 ft.-1bs in male 33.68 ft.-1bs in female. 3. Mean of position angle of maximal torque were between 58° and 65° for extensors, 35° and 45° for flexors. 4. Mean of total range of motion at working isokinetically with 60°/sec speed was 99°. 5. Mean values of extensor power were 54.43 ft.-1bs in male 30.63 ft.-lbs in female, and that of flexor power were 35.99 ft.-1bs in male 22.42 ft.-1bs in female. 6. Strength and power decreased as ages getting old, and there was significant diminish between 4th decade and 5th decade. 7. Power endurance had more difference when it was compared with occupation. Mean value of power endurance was between 12 times and 18 times.
Female ; Hand ; Humans ; Joints ; Knee Joint ; Knee ; Leg ; Male ; Methods ; Muscles ; Occupations ; Range of Motion, Articular ; Sex Characteristics ; Sports ; Torque

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.
Actinomycosis* ; Communicable Diseases ; Cough ; Empyema* ; Fever ; Fibrosis ; Humans ; Infusions, Intravenous ; Lung ; Middle Aged ; Necrosis ; Penicillin G ; Pleural Effusion ; Sulfur ; Tomography, X-Ray Computed

PURPOSE: To evaluate the effect of amniotic membrane and additional use of 2% methylcellulose(Methocel(R)) in reducing the postoperative adhesions following strabismus surgery. METHODS: Twenty white rabbits (40 eyes) were divided into 4 groups: control group C (12 eyes), trial group A (12 eyes), trial group B (12 eyes), and normal group N (4 eyes). In group C, the superior rectus was detached and scleral scratching was done to provoke a fibrotic reaction, and then, the superior rectus was reattached to the original insertion site. In group A, the above procedure was done and in addition, the superior rectus was covered with two-folded amniotic membrane. In group B, the same procedure was done as in group A and in addition, Methocel(R) was coated between the muscle and adjacent tissues. Eight weeks later, we divided each group into two subgroups. In one group, we examined the degree of adhesion by the blunt dissection between the muscle and adjacent tissues, and in the other group, the histologic findings with a light microscope between the muscle and adjacent tissues. RESULTS: The adhesion degree on the blunt dissection and histologic examination was significantly reduced in groups A and B. But no statistically significant difference between groups A and B was shown in the postoperative adhesion. CONCLUSIONS: From these findings, it is expected that the use of amniotic membrane may reduce the postoperative adhesion after strabismus surgery and theadditional use of Methocel(R) may not be useful.
Amnion* ; Methylcellulose* ; Rabbits ; Strabismus*

We described a population-based study of the epidemiology of herpes zoster in military personnel of Korea. A total of 132 cases of herpes zoster were ascertained from May 2004 to April 2005. The most common site of involvement was thoracic area (55%). The annual incidence, based on 132 cases in about 80,000 person-years, was 165 per 100,000 person (95% CI, 138-196). It is noted that herpes zoster occurred frequently in otherwise healthy military personnel.
Epidemiology ; Herpes Zoster* ; Humans ; Incidence* ; Korea ; Military Personnel*

We described a population-based study of the epidemiology of herpes zoster in military personnel of Korea. A total of 132 cases of herpes zoster were ascertained from May 2004 to April 2005. The most common site of involvement was thoracic area (55%). The annual incidence, based on 132 cases in about 80,000 person-years, was 165 per 100,000 person (95% CI, 138-196). It is noted that herpes zoster occurred frequently in otherwise healthy military personnel.
Epidemiology ; Herpes Zoster* ; Humans ; Incidence* ; Korea ; Military Personnel*

No abstract available.
Gene Expression ; Humans ; Keratinocytes ; Skin ; Transcriptome

PURPOSE: To assess the tolerance, complete response rate, bladder preservation rate and survival rate in patients with muscle-invading bladder cancer treated with selective bladder preservation protocol. METHOD AND MATERIALS: From October 1990 to June 1998, twenty six patients with muscle-invading bladder cancer (clinical stage T2-4, N0-3, M0) were enrolled for the treatment protocol of bladder preservation. They were treated with maximal TURBT (transurethral resection of bladder tumor) and 2 cycles of MCV chemotherapy (methotrexate, crisplatin, and vinblastine) followed by 39.6~45 Gy pelvic irradiation with concomitant cisplatin. After complete urologic evaluation (biopsy or cytology), the patients who achieved complete response were planed for bladder preservation treatment and treated with consolidation cisplatin and radiotherapy (19.8 Gy). The patients who had incomplete response were planed to immediate radical cystectomy. If they refused radical cystectomy, they were treated either with TURBT followed by MCV or cisplatin chemotherapy and radiotherapy. The median follow-up duration is 49.5 months. RESULT: The patients with stage T2-3a and T3b-4a underwent complete removal of tumor or gross tumor removal by TURBT, respectively. Twenty one out of 26 patients (81%) successfully completed the protocol of the planned chemo-radiotherapy. Seven patients had documented complete response. Six of them were treated with additional consolidation cisplatin and radiotherapy. One patient was treated with 2 cycles of MCV chemotherapy due to refusal of chemo-radiotherapy. Five of 7 complete responders had functioning tumor-free bladder. Fourteen patients of incomplete responders were further treated with one of the followings : radical cystectomy (1 patient), or TURBT and 2 cycles of MCV chemotherapy (3 patients), or cisplatin and radiotherapy (10 patients). Thirteen patients of them were not treated with planned radical cystectomy due to patients' refusal (9 patients) or underlying medical problems (4 patients). Among twenty one patients, 12 patients (58%) were alive with their preserved bladder, 8 patients died with the disease, 1 patient died of intercurrent disease. The 5 years actuarial survival rates according to CR and PR after MCV chemotherapy and cisplatin chemoradiotherapy were 80% and 14%, respectively (p=0.001). CONCLUSION: In selected patients with muscle-invading bladder cancer, the bladder preservation could be achieved by MCV chemotherapy and cisplatin chemo-radiotherapy. All patients tolerated well this bladder preservation protoco. The availability of complete TURBT and the responsibility of neoadjuvant chemotherapy and chemoradiotherapy were important predictors for bladder preservation and survival. The patients who had not achieved complete response after neoadjuvant chemotherapy and chemoradiotherapy should be immediate radical cystectomy. A randomized prospective trial might be essential to determine more accurate indications between cystectomy or bladder preservation.
Chemoradiotherapy ; Cisplatin ; Clinical Protocols ; Combined Modality Therapy* ; Cystectomy ; Disulfiram ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: Idiopathic pulmonary fibrosis(IPF) is a devastating illness for which there is little effective treatment. The key cytokines currently implicated in the fibrotic process are the transforming growth factor-β1(TGF-β1), tumor necrosis factor-α(TNF-α), endothelin-1(ET-1) and interferon-γ(IFN-γ). The rat model for paraquat-induced pulmonary fibrosis was chosen to investigate the role of ET-1 in this disease. Both ET-1 and TGF-β1 expression in lung lesions were examined using immunohistochemical staining. After Bosentan® administration, an orally active ET-1A and ET-1B receptor antagonist, the degree of pulmonary fibrosis and ET-1 and TGF-β1 expression were analyzed. METHOD: Sprague-Dawley rats were divided into three groups, the control group, the fibrosis group, and the fibrosis-Bosentan®-treated group. The animals were sacrificed periodically at 1, 3, 5, 7, 10, 14 days after administering saline or paraquat. The effects between groups were compared with the results of light microscopy and immunohistochemical staining for ET-1 and TGF-β1. The degree of fibrosis was evaluated by H&E and Masson's trichrome staining, which were graded by a computerized image analyzer. The degree of immunohistochemical staining was categorized by a semi-quantitative analysis method. RESULTS: The lung collagen content had increased in the paraquat instillated animals by day 3, and continued to increase up to day 14. A daily treatment by gavage with Bosentan®(100mg/kg) did not prevent the increase in collagen deposition on the lung that was induced by paraquat instillation. There were increased imunohistochemical stains of ET-1 on the exudate, macrophages, vascular endothelial cells and pneumocytes in the paraquat instillated group. Furthermore, TGF-β1 expression was higher on the exudate, macrophages, some infalmmatory cells, pneumocytes(type I, and II), vascular endothelium and the respiratory epithelial cells around the fibrotic area. After Bosentan treatment, there were no definite changes in ET-1 and TGF-β1 expression. CONCLUSION: Fibrosis of the Paraquat instillated group was more advanced when compared with the control group. In addition, there was increased ET-1 and TGF-β1 expression around the fibrotic area. ET-1 is associated with lung fibrosis but there was little effect of the ET-1 receptor blocker(Bosentan®) on antifibrosis.
Animals ; Collagen ; Coloring Agents ; Cytokines ; Endothelial Cells ; Endothelin-1* ; Endothelium, Vascular ; Epithelial Cells ; Exudates and Transudates ; Fibrosis ; Lung ; Macrophages ; Microscopy ; Models, Animal ; Necrosis ; Paraquat* ; Pneumocytes ; Pulmonary Fibrosis* ; Rats* ; Rats, Sprague-Dawley ; Receptor, Endothelin A*

The pathogenesis of antiepileptic drug (AED) resistance is multifactorial. However, most candidate gene association studies typically assess the effects of candidate genes independently of each other, which is partly because of the limitations of the parametric-statistical methods for detecting the gene-to-gene interactions. A total of 200 patients with drug-resistant epilepsy and 200 patients with drug-responsive epilepsy were genotyped for 3 representative the single nucleotide polymorphisms (SNPs) of the voltage-gated sodium channel genes (SCN1A, SCN1B, and SCN2A) by polymerase chain reaction and direct sequencing analysis. Besides the typical parametric statistical method, a new statistical method (multifactor dimensionality reduction [MDR]) was used to determine whether gene-to-gene interactions increase the risk of AED resistance. None of the individual genotypes or alleles tested in the present study showed a significant association with AED resistance, regardless of their theoretical functional value. With the MDR method, of three possible 2-locus genotype combinations, the combination of SCN2A-PM with SCN1B-PM was the best model for predicting susceptibility to AED resistance, with a p value of 0.0547. MDR, as an analysis paradigm for investigating multi-locus effects in complex disorders, may be a useful statistical method for determining the role of gene-to-gene interactions in the pathogenesis of AED resistance.
Adolescent ; Adult ; Alleles ; Anticonvulsants/*therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Data Interpretation, Statistical ; Drug Resistance ; Epilepsy/drug therapy/*genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Infant ; Male ; Polymorphism, Single Nucleotide ; Sodium Channels/*genetics