PURPOSE: We examined the effect of induced interocular difference of retinal illuminanace on stereopsis. METHODS: Fifty adults who have normal binocularity were examined with neutral density filters. The mean age was 29.1 years. While the monocular retinal illuminance was gradually reduced by increasing the value of neutral density filters, we measured the best corrected visual acuity and stereoacuity with Titmus test and Lang test. We used neutral density filter from 1.0 neutral density (ND, 10% transmit) to 3.0ND (0.1% transmit) with intervals of 0.2ND. RESULTS: The best corrected visual acuity began to decrease significantly when the value of neutral density filter reached 2.0ND (1% transmit). Stereoacuity also began to decline when the value was 1.4ND(4% transmit) with Titmus test and 1.6ND (2.5% transmit) with Lang test. CONCLUSIONS: Change of retinal illuminance effects more on stereoacuity than visual acuity as stereoacuity decreased earlier by increasing the value of density filters. These results imply that the stereopsis test could be more useful than visual acuity test for detecting ocular abnormalities influencing the retinal illuminance.
Adult ; Depth Perception* ; Humans ; Retinaldehyde* ; Telescopes* ; Visual Acuity

No abstract available.
Anti-Bacterial Agents* ; Ascorbic Acid* ; beta Carotene* ; Tretinoin*

No abstract available.
Antifungal Agents* ; Candida albicans* ; Candida*

This study was conducted to clarify the strategy of surgical treatment for stage IV hepatocellular carcinoma (HCC), for which no effective treatment modality is present so far. There were 29 patients (20.3%) with stage IV HCC among 143 HCC patients who underwent partial liver resection during the period from Jan. 1985 through Jul. 1996 at our department. The mean age was 53 years with a range of 18 to 76 years. There were 23 men and 6 women with a ratio of 4:1. Positive rates for HBsAg and HCV Ab were 55.2% and 12.5%, respectively. Ninety per cent of the patients were complicated by chronic liver disease. Abdominal pain and/or mass were the predominating symptoms in about 60% of the patients. Serum AFP level was elevated above 20 ng/ml in 72.4% of the cases. Twenty-three patients harbored stage IV-A disease and 6 patients IV-B disease. The main surgical procedures used in the cases were trisegmentectomy in 3, lobectomy in 12, segmentectomy in 12, subsegmentectomy in 1 and wedge resection in 1. Additionally wedge resection of the liver was performed in 6 cases and ethanol injection in 9 cases. Among 11 cases with tumor thrombus in large portal veins, successful tumor thrombectomy was conducted in 7 of them. Out of 22 patients with stage IV-A HCC, complete tumor removal was possible in 8 and ethanol injection into the residual tumor was executed in another 6. The mean operation time was 282 minutes and the mean transfusion 4 pints. Four patients (13.8%) suffered from postoperative complications, 2 of whom succumbed to liver failure 2 months postoperatively. The cumulative survival rates at 1, 2, and 3 years after surgery were 33.5%, 15.7%, and 10.5%, respectively, with a median survival time of 10 months. The longest survivor is alive 58 months after surgery. Significant prognostic factors were gross portal vein thrmobosis, invasion into adjacent tissues, tumor rupture, and the development of complications. In particular, the survival of patients with stage IV-A HCC who underwent complete tumor removal was not statistically different from that of those who had an absolute noncurative operation plus intraoperative ethanol injection into the residual tumors. For stage IV-A HCC surgical treatment is considered to be effective when all the tumors can be removed or when the residual tumors can be treated by intraoperative ethanol injection.
Abdominal Pain ; Carcinoma, Hepatocellular* ; Ethanol ; Female ; Hepatitis B Surface Antigens ; Humans ; Liver ; Liver Diseases ; Liver Failure ; Male ; Mastectomy, Segmental ; Neoplasm, Residual ; Portal Vein ; Postoperative Complications ; Rupture ; Survival Rate ; Survivors ; Thrombectomy ; Thrombosis

No abstract available.
Gastric Emptying*

BACKGROUND: Hypothermia protects the brain by suppressing the cerebral metabolism and it is performed well enough before the total circulatory arrest(TCA) in the operation of aortic disease. Generally, TCA has been performed depending on the rectal or nasopharyngeal temperatures; however, there is no definite range of optimal temperature for TCA or an objective indicator determining the temperature for safe TCA. In this study, we tried to determine the optimal range of temperature for safe hypothermic circulatory arrest by using the intraoperative electroencephalogram(EEG), and studied the role of EEG as an indicator of optimal hypothermia. MATERIAL AND METHOD: Between March, 1999 and August 31, 2000, 27 patients underwent graft replacement of the part of thoracic aorta using hypothermia and TCA with intraoperative EEG. The rectal and nasopharyngeal temperatures were monitored continuously from the time of anesthetic induction and the EEG was recorded with a ten-channel portable electroencephalography from the time of anesthetic induction to electrocerebral silence(ECS). RESULT: On ECS, the rectal and nasopharyngeal temperatures were not consistent but variable(rectal 11degree C -25degree C, nasopharynx 7.7degree C -23degree C). The correlation between two temperatures was not significant(p=0.171). The cooling time from the start of cardiopulmonary bypass to ECS was also variable(25-127min), but correlated with the body surface area(p=0.027). CONCLUSION: We have found that ECS appeared at various body temperatures, and thus, the use of rectal or nasopharyngeal temperature were not useful in identifying ECS. Conclusively, we can not fully assure cerebral protection during hypothermic circulatory arrest in regards to the body temperatures, and therefore, the intraoperative EEG is one of the necessary methods for determining the range of optimal hypothermia for safe circulatory arrest.
Aorta, Thoracic ; Aortic Diseases ; Body Temperature ; Brain ; Cardiopulmonary Bypass ; Electroencephalography* ; Humans* ; Hypothermia ; Metabolism ; Nasopharynx ; Transplants

We have recently experienced a rare case of extradural epidermoid cyst in the left middle cranial fossa associated with trigeminal neuralgia. A 22-year old female has intermittently developed lancinating pain in the left of face and dark reddish rhinorrhea for 5 years. Plain skull films showed an elevation of lesser wing of sphenoid bone and protrusion of left zygomatic arch with deepening of left middle cranial fossa. Carotid angiograms and brain scan with technetium 99m revealed a large cystic mass in left middle cranial fossa. A left temporal craniotomy was done and a large cystic mass filled with dark bluish colored fluid was removed at the left middle cranial fossa. Postoperatively the trigeminal neuralgia subsided completely. We have discussed the pathogensis and clinical symptoms with the review of the literatures.
Brain ; Cranial Fossa, Middle* ; Craniotomy ; Epidermal Cyst* ; Female ; Humans ; Skull ; Sphenoid Bone ; Technetium ; Trigeminal Neuralgia* ; Young Adult ; Zygoma

OBJECTIVE: The Id family of helix-loop-helix proteins are thought to affect the balance between cell growth and differentiation by negatively regulating the function of basic-helix-loop-helix (bHLH) transcriptional factors. The aim of this study was to investigate the expression pattern of Ids (Id-1,-2,-3, and -4) in preimplantation mouse embryos at mRNA and protein levels. METHODS: Oocytes and preimplantation embryos were collected from reproductive organs of female ICR mice following superovulation. RT-PCR was performed to investigate the mRNA expression patterns of Id genes and their protein were localized by immunofluorescence analysis. RESULTS: Id-1 and Id-3 mRNAs were strongly expressed at the germinal vesicle (GV) oocyte and the blastocyst stages. Id-2 mRNA was expressed throughout preimplantation embryo development, but Id-4 was not expressed. Immunofluorescence showed that Id-1 and Id-2 were predominantly localized in cytoplasmic region, but the immunofluorescence signal of Id-3 was weak throughout preimplantation embryo development. CONCLUSION: These data show for the first time that Ids are expressed in preimplantation mouse embryos and suggest that Ids may play an important role in early preimplantation embryo development and uterine physiological changes.
Animals ; Blastocyst ; Cytoplasm ; Embryonic Development ; Embryonic Structures* ; Female ; Fluorescent Antibody Technique ; Humans ; Mice* ; Mice, Inbred ICR ; Oocytes ; Pregnancy ; RNA, Messenger ; Superovulation

No abstract available.
Umbilical Cord*

Blunt head injury can concuss the membranous labyrinth against the otic capsule. This results in acute hypofunction of some portion of the vestibular neural substrate within the affected labyrinth. Both labyrinthine concussions and transverse temporal bone fractures produce acute unilateral vestibular hypofunction. We describe a 21-months-old child who presented with a ataxic gait for two days. It is difficult to make diagnosis of labyrinthine concussions and temporal bone fractures in children, for we can not know the exact history of trauma and can not perform complete neurologic examination in children. When child present with ataxic gait, the emergency physician should consider labyrinthine concussion and temporal bone fracture in the differential diagnosis and take temporal bone CT.
Ataxia ; Child* ; Diagnosis ; Diagnosis, Differential ; Ear, Inner ; Emergencies ; Gait* ; Head Injuries, Closed ; Humans ; Neurologic Examination ; Post-Concussion Syndrome ; Temporal Bone*