OBJECTIVE : To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in recurrent spontaneous abortion associated with hyperhomocysteinemia. MATERIAL AND METHOD: The blood Sample of habitual aborter with high fasting homocysteine level was tested by PCR-RFLP method. RESULTS: The patient was found to be a homozygosity for MTHFR gene mutation that was confirmed by the finding which is consistent with the mutation at the nucleotide 677 C to T, Corresponding to Ala to Val. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the MTHFR mutation should be examined in the workup of recurrent spontaneous abortion showing hyperhomocysteinemia.
Abortion, Spontaneous* ; Fasting ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

PURPOSE: The expected corneal ablation amount was compared to the achieved corneal ablation amount in two different excimer laser systems. METHODS: One hundred twenty eyes were recieved Laser In Situ Keratomileusis (LASIK) for the correction of myopia. LASIK was performed with MEL-60 excimer laser and Schwind Multiscan excimer laser system. The central corneal thickness was measured preoperatively, 1 week and 1 month postoperatively by using ultrasonic pachymetry. RESULTS: In eyes with MEL-60 excimer laser, the average expected corneal ablation amount was 81+/-26micro meter and average achieved corneal ablation amount at postoperative one week was 65+/-26 micro meter. There was statistical difference between expected and achieved ablation amount. (p<0.001, paired samples test) In eyes with Schwind Multiscan excimer laser, the average expected corneal ablation amount was 69+/-25 micro meter and average achieved corneal ablation amount at postoperative one week was 69+/-25 micro meter. There was no statistical difference between expected and achieved ablation amount (p=0.761, paired samples test). CONCLUSIONS: The pachymetry at postoperative one week appears to be an useful method to measure the real corneal ablation amount by LASIK with various excimer lasers. Residual stromal bed thickness after LASIK can be presumed, and it helps to decide modality of retreatment.
Keratomileusis, Laser In Situ ; Lasers, Excimer* ; Myopia ; Retreatment ; Ultrasonics

PURPOSE: LASIK, one of the currently popular ophthalmic procedures, can sometimes result in dry eye symptoms. In the patient who had underwent LASIK operation, the periorbital surgery may be more likely to lead to such a complication as dry eye symptom. We would like to report a case of corneal abrasion occurred after transconjunctival blepharoplasty in post-LASIK state and suggest the method about preventing the complication. METHODS: A 30-year-old female patient underwent transconjunctival blepharoplasty and microfat graft into the face. She had history of LASIK operation 2 years ago. Corneal protector was applied to both eye during transconjunctival operation. After the surgery, she complained of visual blurring at left side. Ophthalmic examination revealed corneal abrasion of left eye. RESULTS: Cornea protecting lens was applied to left eye for 2 weeks. Steroid and antibiotic eye drops were applied for relieving the symptoms and the prevention from progressing of complication. After 1 week, visual power and acuity was recovered to preoperative state. No other specific complications happened. CONCLUSION: Post-LASIK patient may have possibility of decreased corneal sensation and tear production. Preoperative ophthalmic examination is recommended for the prevention of complication. When corneal protector is applied, we suggest Optagel(R) as a useful lubricant.
Adult ; Blepharoplasty ; Cornea ; Eye ; Female ; Humans ; Keratomileusis, Laser In Situ ; Ophthalmic Solutions ; Sensation ; Tears ; Transplants

PURPOSE: We estimated the incidence of retinal lesions at preoperative evaluation of retina for LASIK and investigate its clinical importance. METHODS: We estimated retrospectively the incidence of retinal lesions of the patients who visited our hospital with the purpose of correction of refractive error. The examination of retina upto periphery was done preoperatively. RESULTS: The mean spherical value and axial length were -6.5 +/- 3.4 diopters (range -26.0 ~ +17.0) and 25.4 +/- 2.0mm (range 15.7 ~ 34.5), respectively. The retinal lesions were found in 189 eyes of 139 persons (12.4%). Among them degenerative changes were found in 48 eyes of 34 persons, chorioretinal scars in 7 eyes of 7 persons, pigmented lesions in 28 eyes of 24 persons, and miscellaneous lesions in 106 eyes of 74 persons. There was a significant increase of spherical value and axial length in the group with retinal lesions -7.9 +/- 4.5 diopters (range -26.00 ~ -2.25), 26.5 +/- 2.3mm (range 23.1 ~ 34.5) compared to that without retinal lesions -6.1 +/- 3.4 diopters (range -25.00 ~ 17.00), 25.4 +/- 2.1mm (range 15.7 ~ 35.4). And the incidence of degenerative change and retinal tear was significantly increased in moderate myopes more than -4 diopters. CONCLUSIONS: LASIK is relatively a kind of safe refractive surgery, but to prevent the unexpected postoperative retinal complications, it is essential to thoroughly examine the retina upto periphery before surgery.
Cicatrix ; Humans ; Incidence ; Keratomileusis, Laser In Situ* ; Refractive Errors ; Refractive Surgical Procedures ; Retina ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies

A closed eyeball model was designed to estimate the chorioretinal adhesion of the laser-photocoagulated region. We used it to measure the duration of development of retinal detachment during vitrectomy before and after killing the test rabbits. During testing, negative pressure was applied into the vitreous cavity of the pigmented rabbits. Laser burns were produced in the posterior retina by exposure to an argon blue-green laser beam with a focus diameter of 200 microns of 0.1 to 0.2 second duration and 150 to 250 mW intensity. One hour and one, two, five, seven and fourteen days following laser photocoagulation, vitrectomy was done with a cutting rate of 500 per minute, aspiration pressure of 50 mmHg and infusion pressure of 55.2 mmHg. After core vitrectomy, the rabbit was killed with an intravenous bolus of 100 mg sodium pentobarbital solution. After killing the rabbit, the vitreous cavity was continuously aspirated under the pressure of 25 mmHg while the infusion was stopped. The changes of the fundus, especially development of retinal detachment, were observed in the laser-treated and untreated regions before and after killing the rabbit. When retinal detachment was noted anywhere before killing the rabbit, this postmortem change was not observed. One hour following laser photocoagulation, the laser-treated retina was detached during core vitrectomy before killing the rabbit, and the untreated area was not detached. One day following photocoagulation, the retina was intact before killing the rabbit. After killing the rabbit, the laser-treated retina was detached in four minutes and the untreated retina in 18 minutes postmortem.
Adhesiveness ; Animal ; *Laser Coagulation ; Pigment Epithelium of Eye/*physiology ; Rabbits ; Retina/*physiology ; Retinal Detachment/prevention & control ; Time Factors

No abstract available.
Breast* ; Female* ; Humans

Inflammatory mediators, such as oxidants, TNF-alpha, and IL-6, play a major role in the systemic response to bum injury It has been known that a continuing inflammatory response cause a sepsis and subsequent multiple organ failure. Recent studies have shown that burn patients receiving recombinant human growth hormone(rhGH) therapy have an improvement of the general condition, but the mechanism by which rhGH exerts its effects has not been clearly understood. The aim of this study was to evaluate the effect of rhGH on the early bum injury. Female Sprague-Dawley rats were divided into four groups : control group, bum group, burn plus rhGH treated group, and rhGH only treated group. Animals were killed at 30min., 3, 6, 24, and 48 hours after treatment. Histology and biochemical changes including malondialdehyde(MDA) content, tissue reduced glutathione(GSH) and catalase activity in the lung and liver, and plasma TNF-alpha and IL-6 levels were examined. Lung histology in the bum plus rhGH treated group showed decreased inflammtory response such as neutrophil and lymphocyte infiltrations, interstitial thickening, and edema compared with the bum group. Liver histology in the bum group revealed mild neutrophil and lymphocyte infiltrations, vacuolization .of hepatocytes, disrupted lobular structures, and dilated sinusoids. But liver histology of the bum plus rhGH was similar to control group. Lung and liver MDA in the burn plus rhGH and rhGH only treated groups were decreased with time compared with the burn group. Lung and liver GSH and catalase activities in the bum plus rhGH and GH only treated groups remained significantly increased compared with the bum group for the 48-hours period. Plasma TNF-alpha levels in the bum group remained elevated for the 48-hours period compared with the bum plus rhGH and rhGH only treated groups. Plasma IL-6 levels in the burn group were significantly increased only at first compared with the bum plus rhGH and rhGH only treated groups. These results suggested that rhGH showed inhibitory effects on the inflammatory cell infiltration and lipid peroxidation in the lung and liver after bum injury. Increased GSH levels and catalase activities seemed to be associated with the antioxidant effect of rhGH. But the inhibitory effect of rhGH on plasma TNF- and R-6 levels was not clearly demonstrated.
Animals ; Antioxidants ; Burns ; Catalase ; Edema ; Female ; Hepatocytes ; Human Growth Hormone* ; Humans* ; Interleukin-6* ; Lipid Peroxidation* ; Liver ; Lung ; Lymphocytes ; Multiple Organ Failure ; Neutrophils ; Oxidants ; Plasma* ; Rats* ; Rats, Sprague-Dawley ; Sepsis ; Tumor Necrosis Factor-alpha*

Most proximal humeral fractures respond satisfactorily to conservative treatment. It is only the occasional displaced fracture or fracture-dislocation that demaads special treatment. The purpose of this study is to analysis the results of closed and open reduction of displaced proximal humeral fractures according to Neers classification. Fifty-two cases of these fractures, followed up more than five months, are presented. 1. The average age of patients was 40. I years. 2. The fractures were classified according to Neers method. Nearly half (48.1%) of the cases were one-part fractures. Next, two-part fractures rated 42.3%, while three-part fractures, only one (l.9%). 3. Among the total 52 patients, 42 cases(80.8%) were treated conservatively and 10 were operated. We performed surgical operations in seven cases among 22 two-part fractures, aix were reduced with Kirschner wires and one treated with Kirschner wire and staple. The average age of these seven cases was 26. 6 years and the resulta were good except one. 4. The results of these patients were evaluated by the Neers criteria. Of 52 caaes, 40 had good results, five, fair, and the remaining seven poor results. Twenty-three cases (92%) in 25(100%) one-part fractures were good and 17 cases (77.3%) in 22 (100%) two-part fractures were also good. In three-part and four-part fractures the results were all poor.
Bone Wires ; Classification ; Humans ; Methods ; Shoulder Fractures

There are many reports about the snapping syndrome in the hip, shoulder, ankle, but the snapping knee has rarely been reported. In general, the symptom of this disease was relatively tolerable for that seldom requires operative treatment. We experienced one case of snapping knee, for which the pain, easy fatigability and feeling of instability on both knee joint were main complaints. During an exploratory operation, we confirmed the gracilis and semitendinosus tendon passing over the medial tibial condyle. The clinical, radiologic and operative findings were reviewed.
Ankle ; Hip ; Knee Joint ; Knee ; Shoulder ; Tendons

The major purpose for the use of autotransfusion is to prevent the transmission of blood borne infectious agents, such as human immunodeficiency virus and non-A & non-B hepatitis virus. To evaluate the efficacy and quality of autolgous shed blood for autotransfusion, eighty patients who had total knee arthroplasty from Dec. 1992 to Mar. 1994, were included in one of two groups: Group I, who received the autotransfusion, or Group II, who did not. Each group included 20 patients of unilateral TKR and 20 patients of bilateral TKR. The Orth-evac system(Deknatel, USA) was used to salvage drained blood in the first six hours after the operation. All of the patients were evaluated for the postoperative blood loss, transfusion requirements, hemoglobin, hematocrit, platelet count, blood pressure and body temperatures. l. In bilateral TKR, the reinfusion of shed blood reduced the requirements for homologous blood by 41.4%(1.2 pints in group I versus 2.9 pints in group II). In unilateral TKR, it was decreased to 36.4%(0.4 pint in group I vs 1.1 pint in group II). 2. In bilateral TKR, the requirements for homologous transfusion was decreased from 95% of patients in control group to 55% in group I .In unilateral TKR, it was decreased from 60% to 20%. 3. There were four patients who had high fever above 39℃ after autotransfusion. 4. At the immediate postoperative period there were two patients who had hypovolemic shock in group I patients who had bilateral TKR. 5. There was no clotting abnormality, no transfusion reaction and no thromboembolic disease in group I patients. In conclusion, the reinfusion of autologous shed blood after TKR is an acceptable alternative to the homologous transfusion without untoward effect.
Arthroplasty, Replacement, Knee ; Blood Transfusion, Autologous ; Body Temperature ; Fever ; Hematocrit ; Hepatitis Viruses ; HIV ; Humans ; Knee ; Platelet Count ; Postoperative Hemorrhage ; Postoperative Period ; Shock ; Transfusion Reaction