PURPOSE: This study was performed to investigate the cellular characteristics of the secondary pupillary membrane. METHODS: The secondary pupillary membrane was removed from the anterior lens surface during cataract extraction from 2 patients with cataract associated with uveitis. Specimen from one patient was stained with hematoxylin-eosin with flat preparation method. Specimen from the other patient cultured for 1 and 2 weeks was observed with transmission electron microscopy. RESULTS: The flat preparation showed the neovascular membrane with pigment-laden cells. The cultured cells consisted of the well preserved vascular components which had the vascular endothelial cells and pericyte and pigment-laden cells lined by basement membrane on first week of culture. The iris pigment epithelial cell which contained the pigment granules within cytoplasm and lined by basement membrane were observed on second week of culture. CONCLUSIONS: These results suggest that the secondary pupillary membrane consists of vascular membrane and pigment epithelial cell of iris which is a major component of secondary pupillary membrane and secrets extracellular matrix.
Basement Membrane ; Cataract ; Cataract Extraction ; Cells, Cultured ; Cytoplasm ; Endothelial Cells ; Epithelial Cells ; Extracellular Matrix ; Humans ; Iris ; Membranes* ; Microscopy, Electron, Transmission ; Pericytes ; Uveitis

BACKGROUND: Until recently lateralization or localization of language area was possible only by electrical stimulation or Wada test. We describe here a convenient and noninvasive method of language localization with functional magnetic resonance image (MRI). METHOD: Twelve healthy right-handed Korean young volunteers (M:F=9:3, mean age: 24 years) were recruited for this study. We collected brain activation image of 6 slice using gradient echo EPI (Echo-planar imaging) during 8 sets of resting and activation periods. During resting periods, each of 10 Korean nouns composed of two to four syllables was shown continuously every 3 seconds and the subjects were required to simply read the words. The activation task was to generate words as many as possible beginning with the same initial syllable seen on screen without any movement. The data were analyzed using SPM (statistical parametric mapping) and the activated signals were overlayed on a T1-weighed image. RESULT: The activated areas were observed in the perisylvian areas including inferior frontal gyrus and middle superior temporal gyri in 9 subjects. (left in 7, right in 2) Another one subject showed nonsignificant activation in left pre-& postcentral gyrus. The remaining two subjects showed only motion artifacts. Therefore, except motion artifact we localized motor speech areas in 9 of 10 subjects. CONCLUSION: Activation of motor speech area is observed by functional MRI using EPI technique efficiently, quickly and noninvasively. Such functional mapping may have value for the neurosurgical planning.
Artifacts ; Brain ; Electric Stimulation ; Magnetic Resonance Imaging* ; Volunteers

PURPOSE: Papillary thyroid carcinoma (PTC) is the most common malignancy that develops from the thyroid gland and its prognosis is quite excellent. One of the characteristic behaviors of PTC is that it often occurs at multiple foci. The purpose of this study was to investigate the clinicopathologic features and risk factors of multifocal papillary thyroid cancer. METHODS: A retrospective review was carried out on 624 patients with PTC and who underwent surgery from January 2005 to December 2007. Two hundred twenty-nine of them were found to have multiple tumor foci (≥2 foci). The risk factors that included gender, age at diagnosis, tumor size, capsular invasion, extrathyroidal extension (ETE), cervical lymph node (LN) involvement, the TNM classification, local recurrence and distant metastasis were comparatively analyzed between the solitary PTC and multifocal PTC groups. RESULTS: The enrolled patients were 59 male and 565 females. The mean age was 46 years (range: 15~77 years). Age (P=0.025), tumor size (P=0.027), capsular invasion (P<0.001), ETE (P<0.001) and cervical LN metastasis (P=0.002) were the significantly related factors for multifocal papillary thyroid cancer. However, gender was not significantly related with multifocality. CONCLUSION: The results of this study showed that multifocal tumors were significantly associated with age, tumors size, capsular invasion, ETE and cervical LN metastasis in patients with PTC. LN metastasis was mostly influenced by multifocality in the PTC patients. It seems certain that total thyroidectomy and formal central node dissection with postoperative adjuvant therapy are essential treatment for these patients, and closely surveying the nodal status is needed on the follow up of patients with multifocal PTC.
Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. MATERIALS AND METHODS: Young Holstein-Friesian cows (130~140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery (LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital (0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion (5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist (only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. RESULTS: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. CONCLUSIONS: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.
Anesthesia ; Angioplasty ; Biopsy ; Blister ; Body Weight ; Cell Death ; Chromatin ; Contracture ; Coronary Vessels* ; Diet ; Heart* ; Infusions, Intravenous ; Ischemia ; Ligation* ; Microvessels ; Muscle Cells ; Myocardial Ischemia ; Myocardium ; Neutrophils ; Nuclear Matrix ; Pentobarbital ; Reperfusion Injury ; Reperfusion* ; Respiration ; Sarcomeres ; Silk ; SNARE Proteins ; Sodium

No abstract available.
Cardioplegic Solutions* ; Ischemia*

Objective: To analyze the computational fluid dynamics (CFD) of femoral artery pseudoaneurysm (FAP), identify a suitable location and timing for percutaneous thrombin injection (PTI) based on this analysis, and report our clinical experience with the procedure. Materials and Methods: CFD can be used to analyze the hemodynamics of the human body. An analysis using CFD recommended that the suitable location of the needle tip for PTI is at the center of the aneurysm sac and the optimal timing for starting PTI is during the early inflow phase of blood into the sac. Since 2011, seven patients (three male and four female; median age, 60 years [range, 43–75 years]) with FAP were treated with PTI based on the devised suitable location and time. Prior to the procedure, color Doppler ultrasonography was performed to determine the location and timing of the thrombin injection. Results: The technical success rate of the PTI was 100%. The amount of thrombin used for the procedure ranged from 200 IU to 1000 IU (median, 500 IU). None of the patients experienced any symptoms or signs of embolic complications during the procedure. Follow-up CT images did not reveal any embolism in the lower extremities and showed complete thrombosis of the pseudoaneurysm. Conclusion Based on our study of CFD, PTI administered centrally in the FAP during early inflow, as seen on color Doppler, can be an effective technique.

BACKGROUND: Although skin cancer incidence has recently increased, there has been little research into the incidence, clinical manifestations, and prognosis of skin cancers in Korea, especially in Daegu City and the Kyungpook Province. OBJECTIVE: To analyze changes over the recent two decades in incidence and clinical patterns, including recurrence of skin cancers diagnosed at a university hospital in Daegu City. METHODS: We reviewed 1,566 skin cancer cases from 1994 to 2013 at the Department of Dermatology in Kyungpook National University Hospital (KNUH). We also divided them into first (1994~2003) and second group (2004~2013) to examine changes over the years. RESULTS: The average incidence of skin cancers among the total number of outpatients was 1.39% through whole study period including 0.38% in the first and 2.10% in the second decade. Basal cell carcinoma (BCC) was the most commonly diagnosed skin cancer (total:1st:2nd=0.60%:0.16%:0.91%), followed by squamous cell carcinoma (SCC) (0.43%:0.12%:0.65%) and malignant melanoma (MM) (0.22%:0.05%:0.34%). The most common skin cancer site was the face in each decade. The recurrence of three major skin cancers (BCC, SCC and MM) was diagnosed in 49 of the 1,402 patients (3.50%). In each disease, the recurrence rate (1st:2nd) was 1.64% (BCC, 4.11%:1.34%), 3.51% (SCC, 11.11%:2.55%), and 8.57% (MM, 4.35%:9.01%). CONCLUSION: This epidemiological study provided useful information about the incidence and prognosis of skin tumors in Korea, especially in Daegu City and Kyungpook Province.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Daegu* ; Dermatology ; Epidemiologic Studies ; Gyeongsangbuk-do* ; Humans ; Incidence ; Korea ; Melanoma ; Outpatients ; Prognosis ; Recurrence ; Skin ; Skin Neoplasms

PURPOSE: This study was conducted to evaluate the results of internal fixation for stable femoral neck fractures occurring in patients over 65 years old. MATERIALS AND METHODS: Between 2008 and 2014, we evaluated 25 patients over 65 years old with Garden type 1 and 2 femoral neck fractures that were treated with internal fixation after a minimum follow up of 1 year. There were 5 males and 20 females and the average age was 72.3 years (range, 65-84 years) at the time of surgery. Fracture site union, horizontal shortening and complications were evaluated as radiographic parameters and change of walking ability (as measured using Koval walking ability score) was investigated as a clinical parameter. RESULTS: Union of fracture site was achieved in 24 out of the 25 cases (96.0%). The average length of horizontal shortening was 6.5 mm (range, 0.2-19.7 mm). At final follow up, 3 cases experienced complications: nonunion (n=1), avascular necrosis (n=1), and subtrochanteric fracture after minor trauma (n=1). Walking ability decreased an average of 1 step at the final follow up. CONCLUSION: Internal fixation for stable femoral neck fractures occurring in patients over 65 years showed satisfactory union rates. However, care should be taken with this technique given the possibility of decreased walking ability resulting from horizontal shortening.
Aged* ; Female ; Femoral Neck Fractures* ; Femur ; Femur Neck* ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Necrosis ; Walking

PURPOSE: The purpose of this study was to evaluate clinical and radiographic results of revision total hip arthroplasty with constrained liner in patients with abductor insufficiency. MATERIALS AND METHODS: In this study, 30 patients treated with constrained liner during revision total hip arthroplasty due to abductor insufficiency were evaluated after minimum 2-year follow-up. There were 14 men and 16 women and the mean follow-up period was 4.6 years. Re-dislocation and aseptic loosening of the implant were defined as a failure of the constrained liner. Harris hip score and ambulatory function were evaluated as a clinical parameter and osteolysis, aseptic loosening of the implant and other complications were evaluated as a radiologic parameter. RESULTS: During the follow-up period, there were 4 cases (13.3%) of constrained liner failure including two cases of re-dislocation and two cases of acetabular cup aseptic loosening. The average Harris hip score was improved from 38.3 points preoperatively to 73.4 points at last follow up. At the final follow-up, there were 20 cases (66.7%) of improvement in ambulatory function. There was 1 case of infection and 1 case of periprosthetic fracture. CONCLUSION: Use of a constrained liner during revision total hip arthroplasty showed satisfactory results for prevention of re-dislocation in patients with abductor insufficiency. However longer term studies on loosening of implants are needed.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Female ; Follow-Up Studies ; Hip ; Humans ; Male ; Osteolysis ; Periprosthetic Fractures

The right and left hemispheres of the brain play somewhat different roles but help each other perform higher cortical functions. A 43 year-old right-handed woman was admitted due to a intraventricular hemorrhage followed by hydro-cephalus. A brain MRI revealed an intraventricular hemorrhage in the lateral, 3rd, and 4th ventricle and the hemorrhage in the lateral ventricle was compressing the genu of the corpus callosum. When asked to draw the face of a clock, she placed the numbers in reverse order (counter clockwise) when performing the task with her right hand, whereas the same task performed by the left hand was normal. In addition, when she wrote out simultaneously with right and left hands , she wrote Korean words in their mirror image with her left hand . When she wrote Chinese characters, she performed better with her right hand. These findings revealed some aspects of interhemispheric interaction in processing the images of a clock, and the orthographic lexicon of Korean and Chinese characters.
Adult ; Asian Continental Ancestry Group ; Brain ; Corpus Callosum ; Female ; Hand ; Hemorrhage* ; Humans ; Hydrocephalus* ; Lateral Ventricles ; Magnetic Resonance Imaging