No abstract available.
Spina Bifida Occulta*

PURPOSE: To investigate the characteristics of the limbal epithelial cells auto-cultivated in vivo on amniotic membrane (LIVAMs) designed for the treatment of limbal stem cell deficiency. METHODS: We removed the epithelium of AM with a No.15 blade after it was blotted with 20% ethanol and made a 360 degrees stromal flap along the epithelial defect. We then mounted over-sized AM (1 mm larger in diameter than the defect) over the defect with the border of AM inserted under the flap, and performed interrupted suture with 10-0 nylon. A therapeutic contact lens was fitted over the AM and a temporary tarsorrhaphy was performed. To examine whether the limbal epithelial cells grew well onto AM, we observed the cornea after fluorescein dye staining using a slit lamp. To explore the characteristics of LIVAMs, we performed hematoxylin-eosin (H&E) staining, immunochemical staining with AK-2, AE-5, AM-3 monoclonal antibodies, and transmission electron microscopy. RESULTS: Three of four rabbits had successful epithelial growth on the amniotic membrane. The epithelial growth on the amniotic membrane was stained using immunohistochemical staining (AK-2, AE-5). Electron microscopy showed a structure similar to that of a normal corneal epithelium. CONCLUSIONS: The technique of auto-cultivation of limbal epithelial cells in vivo on amniotic membrane can be an efficient and convenient method and preserves the characteristics of limbal epithelial cells for the treatment of limbal stem cell deficiency.
Amnion* ; Antibodies, Monoclonal ; Cornea ; Epithelial Cells* ; Epithelium ; Epithelium, Corneal ; Ethanol ; Fluorescein ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Nylons ; Rabbits* ; Stem Cells ; Sutures

Recently, cell cycle regulators have been suggested as new prognostic factors of the lung cancer. In this study, we evaluated the expression of cyclin D1, p21, and p53 using the X2-test, with regard to the stage of the patients, histologic type, and histologic differentiation in the 135 cases of non-small cell lung carcinomas (NSCLC). To evaluate the confounding effects among cyclin D1, p21, and p53 on X2-test analysis, we used the Mantel-Haenzel test. The NSCLC in this study included 82 cases of squamous cell carcinoma and 53 cases of adenocarcinoma. Each nuclear staining of cyclin D1, p21, and p53 was observed in 65 cases (48.1%), in 54 cases (40.0%), and in 81 cases (60.0%) of NSCLCs, respectively. Only p53 expression was significantly associated with the stage (stage I, II, IIIa) (p<0.05) and squamous cell carcinoma (p<0.05). On the other hand, cyclin D1 expression was significantly associated with the histologic differentiation. The confounding effects among cyclin D1, p21, and p53 revealed that only p21 expression changed the relationship between p53 and stage. In this regard, further study is needed.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Hand ; Humans ; Lung Neoplasms ; Lung* ; Prognosis*

PURPOSE: The purpose of this study was to investigate the phenotype of conjunctival epithelial cells auto-cultivated in vivo on human amniotic membrane (CIVAMs) in rabbits for ocular surface reconstruction. METHODS: A fornix based-conjunctival flap 8 mm in diameter was made in 12 eyes of rabbits. Amniotic membrane was implanted into the conjunctival defects. Rabbit conjunctival epithelial cells were cultivated in vivo on amniotic membrane for a week. A frozen section was made of the excised specimen. To investigate the phenotype of CIVAMs, Hematoxylin-eosin staining, immunohistochemical staining to anti-MUC5AC (monoclonal antibody to conjunctival goblet cell mucin), and transmission electron microscopy were performed. RESULTS In 11 of 12 eyes, conjunctival epithelial cells grew successfully on amniotic membrane. Light microscopy demonstrated two to three layers of cuboidal epithelial cells and two to three layers of stratified epithelial cells in CIVAMs. CIVAMs exhibited non-goblet epithelial differentiation as determined by immunohistochemistry to anti-MUC5AC. Transmission electron microscopy of CIVAMs showed fine structure similar to that of normal conjunctival epithelial cells. CONCLUSIONS: CIVAMs showed morphological findings similar to normal conjunctival epithelial cells and are expected to accomplish more rapid reconjunctivalization than simple amniotic membrane transplantation. We expect that CIVAMs will be adopted in treating conjunctival burn, symblepharon, conjunctiva-scleral ulcer, and filtering bleb leakage with conjunctival defects.
Amnion* ; Blister ; Burns ; Epithelial Cells* ; Frozen Sections ; Goblet Cells ; Humans* ; Immunohistochemistry ; Microscopy ; Microscopy, Electron, Transmission ; Phenotype ; Rabbits* ; Ulcer

PURPOSE: The purpose of this study was to investigate the phenotype of conjunctival epithelial cells auto-cultivated in vivo on human amniotic membrane (CIVAMs) in rabbits for ocular surface reconstruction. METHODS: A fornix based-conjunctival flap 8 mm in diameter was made in 12 eyes of rabbits. Amniotic membrane was implanted into the conjunctival defects. Rabbit conjunctival epithelial cells were cultivated in vivo on amniotic membrane for a week. A frozen section was made of the excised specimen. To investigate the phenotype of CIVAMs, Hematoxylin-eosin staining, immunohistochemical staining to anti-MUC5AC (monoclonal antibody to conjunctival goblet cell mucin), and transmission electron microscopy were performed. RESULTS In 11 of 12 eyes, conjunctival epithelial cells grew successfully on amniotic membrane. Light microscopy demonstrated two to three layers of cuboidal epithelial cells and two to three layers of stratified epithelial cells in CIVAMs. CIVAMs exhibited non-goblet epithelial differentiation as determined by immunohistochemistry to anti-MUC5AC. Transmission electron microscopy of CIVAMs showed fine structure similar to that of normal conjunctival epithelial cells. CONCLUSIONS: CIVAMs showed morphological findings similar to normal conjunctival epithelial cells and are expected to accomplish more rapid reconjunctivalization than simple amniotic membrane transplantation. We expect that CIVAMs will be adopted in treating conjunctival burn, symblepharon, conjunctiva-scleral ulcer, and filtering bleb leakage with conjunctival defects.
Amnion* ; Blister ; Burns ; Epithelial Cells* ; Frozen Sections ; Goblet Cells ; Humans* ; Immunohistochemistry ; Microscopy ; Microscopy, Electron, Transmission ; Phenotype ; Rabbits* ; Ulcer

Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Bowen's Disease* ; Follow-Up Studies ; Hematoporphyrin Derivative ; Humans ; Lasers, Gas ; Light ; Middle Aged ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin

OBJECTIVE: To compare the visibility and procedural parameters between a standard spinal needle and a new laser-etched needle (LEN) in real-time ultrasonography guided lumbar medial branch access in a phantom of the lumbosacral spine. METHODS: We conducted a prospective single-blinded observational study at a rehabilitation medicine center. A new model of LEN was manufactured with a standard 22-gauge spinal needle and a laser etching machine. Thirty-two inexperienced polyclinic medical students performed ultrasonography-guided lumbar medial branch access using both a standard spinal needle and a LEN with scanning protocol. The outcomes included needle visibility score, needle elapsed time, first-pass success rate, and number of needle sticks. RESULTS: The LEN received significantly better visibility scores and shorter needle elapsed time compared to the standard spinal needle. First-pass success rate and the number of needle sticks were not significantly different between needles. CONCLUSION: A new LEN is expected to offer better visibility and enable inexperienced users to perform an ultrasonography-guided lumbar medial branch block more quickly. However, further study of variables may be necessary for clinical application.
Humans ; Needles* ; Needlestick Injuries ; Observational Study ; Phantoms, Imaging ; Prospective Studies ; Rehabilitation ; Spine ; Students, Medical ; Ultrasonography ; Zygapophyseal Joint

A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
Acinetobacter baumannii ; Aged, 80 and over ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Emergency Medical Technicians ; Erectile Dysfunction* ; Hemoptysis* ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Male ; Pneumonia ; Prescriptions ; Respiratory Insufficiency ; Sepsis ; Tranexamic Acid ; Ventilators, Mechanical ; Sildenafil Citrate