PURPOSE: Suction ring is needed to fix the cornea during LASIK procedure. But if we choose the suction ring inappropriately, we meet the various problems such as conjunctival edema, conjunctival hemorrhage, ocular pain, and prolongation of operation time. To investigates various factors affecting the thickness of suction ring(1-4) in LASIK procedure. METHODS: We performed LASIK procedure by using SCMD microkeratome and VISX STAR laser on 398 eyes from Dec. 1996 to Feb. 1999. We compared difference on pachymetry, keratometry, corneal diameter, spherical equivalent according to the thickness of suction ring and analyzed these factors with One-Way ANOVA test. RESULTS: The results are that keratometry affected size of suction ring significantly. The flap size and hinge size are affected by size of suction ring significantly, but others did not show significant results. CONCLUSIONS: These results suggest that we need to choose the size of suction ring according to keratometry during LASIK procedure for decreasing various complications.
Cornea ; Edema ; Hemorrhage ; Keratomileusis, Laser In Situ* ; Suction*

No abstract available.
Ichthyosiform Erythroderma, Congenital*

Apoptosis is an intrinsic and fundamental biological process that plays a critical role in the normal development of multicellular organisms and in maintaining tissue homeostasis. Some of the well known regulators of apoptosis are cytokines of the tumor necrosis factor(TNF) ligand family, such as Fas ligand(Fas L) and TNF, which induce apoptosis by activation of their corresponding receptors, Fas and TNFR-1. Recently, a new member of the TNF family known as TRAIL (TNF-related apoptosis-inducing ligand) was identified and shown to induce p53-independent apoptosis in a variety of tumor cell lines but not in normal cells, Four human receptors for TRAIL were also recently identified and designated TRAIL-R1, -R2, -R3, and -R4. The aim of this study is to examine whether TRAIL and TRAIL receptots(-R1, -R2, -R3) are expressed in uterine cervical cancer and whether it is correlated with apoptosis, TRAIL and TRAIL receptors. The subjects were 20 patients who were diagnosed with cervical cancer. Western blotting was performed in 9 cases, immunohistochemical staining for TRAIL and TRAIL receptors(-R1, -R2, -R3) and TUNEL method for detection of apoptosis in 11 cases. There were proteins for TRAIL, TRAIL-R1, -R2, and -R3 in tissues from cervical cancer. All TRAIL receptors were expressed in both normal cervical epithelium and tumor cells, and TRAIL-Rl and -R2 were more strongly expressed in tumor cells than normal epithelium(p<0.05). Apoptosis correlated with expression of TRAIL-Rl and -R2(p<0.05). This study suggests that TRAIL induces apoptosis in cervical cancer through its receptors.
Antigens, CD95 ; Apoptosis ; Biological Processes ; Blotting, Western ; Cell Line, Tumor ; Cytokines ; Epithelium ; Homeostasis ; Humans ; In Situ Nick-End Labeling ; Necrosis ; Receptors, TNF-Related Apoptosis-Inducing Ligand* ; Uterine Cervical Neoplasms*

Renal allografts frequently suffer from ischemia/reperfusion injury, which is a major cause of delayed graft function in renal transplantation(Tx). Cyclosporine(CsA) is known to aggravate ischemic injury, which may further heighten graft dysfunction. To know the histopathologic features of renal ischemic/reperfusion injury and cyclosporoine nephrotoxicity, we performed renal Tx between Lewis rats with cold ischemia and with/without CsA. Rats were sacrificed 3, 5, 7 days, 2, 3 and 4 weeks post-Tx. Control rats received sham operation. The kidney was processed for light microscopy and stained with H-E, PAS. Furthermore, to know the distribution of thioredoxin peroxidase(TPx), a recently cloned antioxidant in this model, the kidney tissue was stained with antibodies against three subtypes of TPx; NKEF-A /PAG(TPx A), NKEF-B/TPx(TPx B) and Mer 5. Renal isografts showed acute tubular necrosis from 3 days and recovery by 7 days, which was prolonged in CsA treated rats with signs of tubular and vascular toxicity. In sham operated rats, TPx A was distributed in all tubular segments, most prominently in distal tubules(DT). TPx B was stained in DT and collecting ducts(CD) exclusively. Mer 5 was present mainly in S3 segment. Glomerular or vascular expression was not found. In isografts TPx A expression was increased in both proximal(PT) and DT, markedly in the nonnecrotic S1 segment till 1 week postTx and returned to normal pattern by 2 weeks. TPx B and Mer 5 expression were increased till 5 days postTx with stronger staining in DT than in PT. CsA sustained the tubular expression of TPx till 4 weeks postTx. In summary, TPx expression was increased in renal tubules of rat renal isografts suffering cold ischemia, and more prolonged with CsA therapy. Marked increase of TPx A expression in S1 segment of ischemic kidneys may indicate resistance against oxidant injury, especially in S1 segment.
Allografts ; Animals ; Antibodies ; Clone Cells ; Cold Ischemia ; Cyclosporine* ; Delayed Graft Function ; Isografts* ; Kidney ; Kidney Transplantation ; Microscopy ; Necrosis ; Peroxiredoxins ; Pilot Projects* ; Rats* ; Reactive Oxygen Species ; Thioredoxins ; Transplants

BACKGROUND: Postoperative pruritus following the administration of epidural narcotics is a very common and undesirable side effect. Therefore, we evaluated the use of a combination of naloxone and sufentanil via patient controlled epidural analgesia to determine if the incidence of pruritus was decreased when compared to the use of sufentanil alone. METHODS: Patients scheduled for subtotal gastrectomy under general anesthesia were enrolled in a prospective, double-blinded and randomized trial. All patients received a 20 microgram epidural bolus of sufentanil in 5 ml of 0.2% ropivacaine. Following administration of the epidural, patients in the sufentanyl group (S) received a continuous epidural comprised of sufentanil (0.75 microgram/ml) in 0.2% ropivacaine, whereas patients in the naloxone group (N) received an epidural infusion comprised of naloxone (4 microgram/ml) and sufentanil (0.75 microgram/ml) in 0.2% ropivacaine. The infusion rate, demand dose and lockout interval were 5 ml/hr, 0.5 ml and 15 minutes respectively. Next, the occurrence of postoperative analgesia and side effects were evaluated by blinded observers. RESULTS: The incidence of pruritus (47.4% versus 20.0%, P = 0.013) and nausea (42.1% versus 20.0%, P = 0.043) were lower in group N than in group S. In addition, there were no significant differences observed in the visual analogue scale, the incidence of vomiting or the incidence of sedation. Furthermore, epidural infusion of naloxone at 0.25-0.4 microgram/kg/hr did not affect the requirement for postoperative sufentanil. CONCLUSIONS: Epidural naloxone reduces epidural sufentanil induced pruritus and nausea without reversing its analgesic effects.
Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Anesthesia, General ; Gastrectomy ; Humans ; Incidence ; Naloxone* ; Narcotics ; Nausea ; Prospective Studies ; Pruritus* ; Sufentanil* ; Vomiting

Spindle cell hemangioendothelioma was first described in 1986 to characterize a particular angiomatous lesion which shows different clinical features, however, it has recently been designated as spindle cell hemangioma (SCH) due to its benign nature. Microscopically, this peculiar vascular tumor consists of cavernous blood vessels intermixed with solid areas predominantly composed of spindle cells, resembling Kaposi sarcoma. A 39-year-old woman presented with a bean-sized, tender, bluish nodule on the pulp of her right thumb. The 1 year old lesion had increased slowly in size over this time. Histologic examination of the lesion showed that it was composed of large irregularly-dilated, thin-walled cavernous blood spaces containing organizing thrombi, numerous red blood cells, and a spindle cell mass which was partially connected with the vessel wall and invaded the stroma. A diagnosis of SCH was made based on histologic and immunohistochemical findings. After the lesion was totally excised, there has been neither recurrence nor occurence of new lesions to date.
Adult ; Blood Vessels ; Diagnosis ; Erythrocytes ; Female ; Hemangioendothelioma ; Hemangioma* ; Humans ; Recurrence ; Sarcoma, Kaposi ; Thumb

BACKGROUND: Lipoprotein(a)(Lp(a))is known as an independent risk factor of the coronary artery disease(CAD). However, it is not clear whether the level of the Lp(a) is elevated in the presence of atherosclerotic peripheral vascular disease(PVD) of lower extremities. MATERIALS AND METHODS: Considering high prevalence of the coronary artery disease in PVD, the association between the serum level of Lp(a) and the presence of PVD was investigated by comparing Lp(a) level in PVD patients with CAD(PVD+CAD group, N=15), PVD patients without CAD(PVD-CAD group, N=12), and control group who had normal coronary angiograms and no clinical evidence of PVD(Control group, N=22). In all PVD patients coronary angiograms were performed simultaneously with peripheral angiograms. Clinical characteristics, lipid profiles and the level of lipoprotein(a) were compared between two PVD group. The serum level of Lp(a) was measured with ELISA technique. RESULTS: Serum levels of lipoprotein(a) in patients with PVD as a whole(20.4+/-18.7mg/dl, mean standard deviation) were not significantly higher than those in control group(14.9+/-10.5mg/dl). In patients with PVD and CAD, the levels were significantly higher(27.0+/-20.2mg/dl) than those in patients with PVD but without CAD(12.2+/-13.3mg/dl). There was no significant difference between two groups with PVD in age, sex, association of hypertension, smoking, and other lipid profiles. CONCLUSIONS: Lipoprotein(a) level might not be related to the presence of PVD, but rather associated with CAD.
Coronary Artery Disease ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypertension ; Lipoprotein(a)* ; Lower Extremity* ; Peripheral Vascular Diseases* ; Prevalence ; Risk Factors ; Smoke ; Smoking

The teratogenic effects of alcohol have been recognized in fetal alcohol syndrome (FAS). FAS is a collection of signs and symptoms seen in some children exposed to alcohol in the prenatal period. An 8 month-old-male with an alcoholic mother was diagnosed as a case of FAS according to the following : 1) early-onset intrauterine growth retardation and persistent postnatal growth failure 2) psychomotor retardation 3) craniofacial dysmorphism. Early diagnosis and continued education are advantageous at all levels, benefiting both the individual and all of society. We present this case with a brief review of related literatures.
Alcoholics ; Child ; Early Diagnosis ; Education ; Fetal Alcohol Spectrum Disorders* ; Fetal Growth Retardation ; Humans ; Mothers

BACKGROUND/AIMS: The precancerous lesion of colorectal cancer is adenoma. Adenoma with high grade dysplasia has been known as the lesion having high malignant potentials. The cancer with invasion to mucosa is limted to the mucosa, and it is difficult to pathologically differentiate the adenoma with high grade dysplasia. METHODS: Fifty three adenomas with high grade dysplasia (type I group) and 40 cancers with invasion to mucosa (type II group) for 4 years, were analyzed for the colonoscopic findings and pathological findings before and after EMR. RESULTS: Mean ages were 57.0 years old for type I group and 60.4 for type II group. Chief complaint for colonoscopy was rectal bleeding (21.0%) for type I group, and rectal bleeding (35.0%) for type II group. Mean sizes of the lesions were 1.18 cm for type I group, and 1.71 cm for type II group. Locations of the lesion were rectum 43.4%, sigmoid colon 32.1%, proximal colon 24.5% for type I group, and rectum 45.7%, sigmoid colon 42.9%, proximal colon 11.4% for type II group. Shapes of the lesions were Is 46.9%, Ip 30.6%, Isp 18.4%, LST 4.1% for type I group, and Isp 34.2%, Ip 31.6%, Is 18.4%, LST 5%, IIa depression 5%, Is+IIc 5% for type II group. Methods for therapy were EMR 60.4%, operation 1.9%, electrocoagulation 11.3%, observation 26.4% for type I group, and EMR 85.0%, operation 15.0% for type II group. Pathological agreement before and after EMR was 57.1% for type I group and 31.3% for type II group. CONCLUSIONS: Type II group had more rectal bleeding, larger, more Isp type, more EMR therapy, more pathological disagreement ratio before and after EMR, than type I group.
Adenoma* ; Colon ; Colon, Sigmoid ; Colonoscopy ; Colorectal Neoplasms* ; Depression ; Electrocoagulation ; Hemorrhage ; Mucous Membrane ; Rectum

Nodular fasciitis represents reactive fibroblastic or myofibroblastic proliferative lesions which may be misdiagnosed as sarcomas due to the rich cellularity, mitotic activity and variant morphologic pattern. It arises in the subcutaneous tissue, skeletal muscles, and fascia. Uncommon clinical and pathological variants of nodular fasciitis, such as intradermal, intravascular, cranial, ossifying, parosteal and proliferative fasciitis, have been described. We present a 23-year-old man with a one year history of a 2x1.5cm sized hard tender nodule on the scalp which is partially depressed at the margin. Histological examination revealed clusters of spindle cells in a myxoid background, chronic inflammatory cells and extravasated red cells in the dermis. Immunohistochemically, the spindle cells showed positivity of vimentin or smooth muscle actin, and negativity of desmin or S-100 protein. The staining results support its myofibroblastic origin. There is no involved bony lesion on the brain computed tomography (CT). Therefore we report a rare case of intradermal fasciitis arising on the scalp.
Male ; Humans