PURPOSE: To assess the effect of surface area extension with pericardial membrane on the hypertensive phase and surgical success in Ahmed glaucoma valve implant surgery. METHODS: This prospective study included 10 eyes of 8 patients who underwent Ahmed glaucoma valve implant surgery with pericardial membrane(Preclude(R)) which were designed to have surface area of 300 mm2 (Group I) and 10 eyes of 9 patients who underwent Ahmed glaucoma valve implant surgery without surface area extension (Group II). The mean follow-up was 11.5+/-5.1 months and 14.9+/-4.3 months for the group I and group II, respectively. RESULTS: Two eyes (20%) exhibited hypertensive phase in group I and 8 eyes (80%) in group II (p=0.007). The complete success rate was 90% in group I and 70% in group II (p=0.291). The mean number of preoperative antiglaucoma medication was 2.4+/-0.5 and 1.9+/-0.3 for the group I and group II, respectively, and the mean number of postoperative antiglaucoma medication was 0.1+/-0.3 and 0.4+/-0.7 for the group I and group II, respectively. CONCLUSIONS: Surface area extension with pericardial membrane (Preclude(R)) in Ahmed glaucoma valve implant surgery affords statistically significantly lower hypertensive phase rate and trends toward high complete success rate and less number of postoperative antiglaucoma medications.
Follow-Up Studies ; Glaucoma* ; Humans ; Membranes* ; Prospective Studies

PURPOSE: Bronchial asthma is a disorder that is characteized by symptoms of reversible airway obstruction and increased responsiveness of the bronchus and to quantify the degree of br onchial hyperresponsivenes can be very helpful in determing the severity of disease and the prognosis. But the Methacholine provocation test is not always easy to be performed in all patients. Thus we designed this trial to know the relationship between the degree of bronchial hype rresponsiveness by Methacholine and the severity of asthma symptoms, pulmonary function te st and atopic findings. METHODS: Methacholine provocation test was performed on 60 clinically stable asthma patients who visited the pediatric allergy clinic of Taegu Fatima Hospital from July, 1992 to June, 1 993. All patients were free of URI for at least 6 weeks and medications were withhold for 2 weeks for corticosteroid or beta receptor agonist and at least 2 days for theophylline. All subjects ha d FEV1 more than 70% of predicted value, and more than 20% of reversible obstruction. Disease severity score(DSS) was compared by the number of asthmatic attacts, clinical picture, therapeutic medications and the Airway reactivity score(ARS) was measured on the number of nonspecipic irritants provoking the bronchial hyperresponsivess. Methacholine provocation test was performed as follows; Normal saline was inhaled 5 times by tidal breath through De Vilbiss 646 inhaler and FEV1 was measured as baseline. According to Chai standardized method, Mathacholine was diluted to 0.075-25mg/ml concentration and inhaled 5 times and accumulated Methacholine was graded 0.375-225.0 Breath Units(One BU = 1 inhalation of 1 mg/ml). PD20 was determined to the concentration at which the FEV1 faIled to 20% below the baseline. RESULTS: 1) PD20 were distributed variably between 0.375 BU and 225.0 BU 2) Bronchial hyperresponsiveness was high on asthma with allergic rhinitis(p<0.05). 3) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation both DSS(r= -0.473; p<0.01) and ARS(r= -0.32; p<0.05). 4) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation to baseline FEV1/FVC ratio(r= -0.63; p<0.01). 5) Bronchial hyperresponsiveness by Methacholine provocation test had no statistical significant correlation to serum IgE value(r= -0.24; p<0.05). CONCLUSIONS: The severity of bronchial hyperresponsiveness by Methacholine provocation t est had significant correlation with DSS and ARS, and there was a close relation BHR to the baseline FEV1/FVC1 ratio too. Thus exact history about clinical pictures, medications, provocating irritants in asthmatic patients and baseline FEV1/FVC ratio can be very helpful in assessing the bronchial hyperresponsiveness.
Airway Obstruction ; Asthma* ; Bronchi ; Daegu ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inhalation ; Irritants ; Methacholine Chloride* ; Nebulizers and Vaporizers ; Prognosis ; Respiratory Function Tests ; Theophylline

PURPOSE: Nasal turbinate mucosal graft provides an appropriate sturdiness and smooth mucosal surface and has added benefit of mucus production. We report one case of correction of severe upper and lower cicatricial entropion with shared nasal turbinate mucosal graft procedure. METHODS: A 40-year-old male patient who had past medical history of Stevens-Johnson syndrome in his early twenties had severe upper and lower cicatricial entropion and trichiasis irritating the cornea. We corrected the severe upper and lower entropion simultaneously with shared inferior nasal turbinate mucosal graft. RESULTS: A successful correction of severe upper and lower cicatricial entropion and improvement of dry eye symptom by plentiful mucus secretion were achieved and there was no recurrence during the followup of 14 months. CONCLUSIONS: We report a case of good anatomical, functional and cosmetic results achieved by shared nasal turbinate mucosal graft procedure in the correction of severe upper and lower cicatricial entropion which cannot be corrected successfully with other conventional methods.
Adult ; Cornea ; Entropion* ; Follow-Up Studies ; Humans ; Male ; Mucus ; Recurrence ; Stevens-Johnson Syndrome ; Transplants* ; Trichiasis ; Turbinates*

PURPOSE: To report three cases of LASIK (Laser in situ keratomileusis) for myopia and astigmatism after PKP (penetrating keratoplasty). METHODS: We performed LASIK in three eyes with myopic astigmatism following PKP which could not be corrected with spectacles or contact lens due to high anisometropia and contact lens intolerance. Visual acuity with or without correction, manifest refraction, corneal topography were checked before and after LASIK. The surgical complications were also monitored intraoperatively and postoperatively. RESULTS: There was no remarkable complications concerning LASIK. Mean follow-up period after LASIK was 8.7 months. Spherical equivalent was reduced from -11.5, -10.3, -5.5 D to -6.5, +0.62, -2.0 D and astigmatism was also reduced from -3.0, -4.5, -8.0 D to -1.0, -1.25, -3.0 D in each case. Uncorrected visual acuity was improved in all three cases and best spectacle-corrected visual acuity was not reduced in all cases. Postoperative corneal topography showed reduced central keratometric powers and astigmatism, but there was a tendency toward irregular astigmatism compared with that of normal LASIK eyes. CONCLUSIONS: LASIK can be a relatively safe and effective procedure in treating high myopia and astigmatism following PKP when contact lenses are not indicated. Further investigations are required for the timing of surgery, different nomogram compared with normal eyes, tendency toward irregular astigmatism and long-term follow-up results.
Anisometropia ; Astigmatism* ; Contact Lenses ; Corneal Topography ; Eyeglasses ; Follow-Up Studies ; Keratomileusis, Laser In Situ* ; Keratoplasty, Penetrating* ; Myopia* ; Nomograms ; Visual Acuity

Larger animal models, such as porcine, have been validated as appropriate models of the human disc with respect to biomechanics and biochemistry. They are advantageous for research as the models are relatively straightforward to prepare and easily obtainable for research to perform surgical techniques. The intention of this study was to quantitatively analyze gene expression for collagen and proteoglycan components of the extracellular matrix and for collagenase (MMP-1) in porcine discs of varying ages (Newborn; 2-3weeks, Mature; 6-9 month, Older; 2-3 years). In this study, we observed that the cell number and GAG (glycosaminoglycan) formation dramatically decreased with aging. Also, gene expression in the annulus fibrosus (AF) and nucleus pulposus (NP) cells changed with aging. The level of MMP-1 mRNA increased with age and both type I, II collagens decreased with age. The level of aggrecan mRNA was highest in the mature group and decreased significantly with aging. In the mature group, MMP-1 expression was minimal compared to the newborn group. In AF cells, type II collagen was expressed at a high level in the mature group with a higher level of aggrecan, when aged NP showed a decrease in type II collagen. The model of IVD degeneration in the porcine disc shows many changes in gene expression with age that have been previously documented for human and may serve as a model for studying changes in IVD metabolism with age. We concluded that the porcine model is excellent to test hypotheses related to disc degeneration while permitting time-course study in biologically active systems.
Age Factors ; Aggrecans/genetics/metabolism ; Aging/genetics/*metabolism ; Animals ; Animals, Newborn ; Collagen Type I/genetics/metabolism ; Collagen Type II/genetics/metabolism ; Glycosaminoglycans/genetics/metabolism ; Humans ; Intervertebral Disk Degeneration/genetics/*metabolism ; Matrix Metalloproteinase 1/genetics/*metabolism ; *Models, Animal ; Reverse Transcriptase Polymerase Chain Reaction ; Spinal Cord/*metabolism/pathology ; Swine

No abstract available.
Female ; Ovary* ; Teratoma*

There are many hemodynamic and physiologic changes during liver transplantation much more than other surgical interventions. The oxygen delivery and oxygen consumption are af- fected by depressed hemodynamic and metabolic status during the operation. At the lower levels of oxygen present in venous blood, a linear relationship exists between saturation and tension. The use of fiberoptic oximetry system in conventional pulmonary artery flotation catheters has made the bedside application of this relationship of practical value in the continuous assessment of mixed venous oxygen saturation. This study was performed to determine changes in SvO2 and other variables of oxygen kinetics during canine OLT and study the correlation between SvO2 and cardiac output, SvO2 and oxygen consumption and oxygen utilization ratio. The continuous rnixed venous oxygen saturation and cardiac output by SO2/CO computer were monitored and the oxygen delivery, oxygen consumption and oxygen utilization ratio were calculated by arterial and venous blood gas analysis and modified Fick's equation during orthotopic liver transplantation in 20 dogs. The results were as follow as ; 1. There was no significant difference in tissue oxygen extraction between preoperative control and anhepatic phase, while cardiac output were decreased during anhepatic phase. 2. By utilizing centrifugal pump(venovenous bypass) oxygen delivery and oxygen utilization ratio were well maintained even though suppressed the change of oxygen delivery and oxygen consumption during anhepatic phase. 3. There was a significant decrease in SvO2 immediately after declamping the suprahepatic vena cava, whereas the oxygen utilization rate and oxygen consumption following reperfusion were significantly increased than just prior to reperfusion of transplanted liver. 4. A Statistically significant correlation was found between SvO2 and cardiac output, oxygen consumption in all surgical stages except reperfusion(CO;r=0.478, p<0.001, VO2,r=-0. 272, p=0.004), but their correlations were relatively poor. However, there was highly significant correlation among SvO2 and oxygen utilization ratio in all surgical stages(O2UR; r=- 0.834, P<0.001). In conclusion, continuous monitoring mixed venous oxygen via a fiberoptic pulmonary catheter could be used as the index for evaluation of hemodynamics and oxygen kinetics during canine OLT, but further research should be performed to determine whether these measurements indicate viability of the grafted liver.
Animals ; Blood Gas Analysis ; Cardiac Output ; Catheters ; Dogs ; Hemodynamics ; Kinetics ; Liver Transplantation* ; Liver* ; Oximetry ; Oxygen Consumption ; Oxygen* ; Pulmonary Artery ; Reperfusion ; Transplants

Metastatic squamous cell carcinoma from a cancer of unknown primary (CUP) affecting the intrathoracic lymph node is very rare. We reported a case of metastatic squamous cell carcinoma in the hilar and interlobar lymph node from a patient with CUP and reviewed the associated literature. Abnormal mass in the right hilar area was incidentally detected. A chest computed tomography scan showed a 2.5-cm diameter mass in the right hilum that had changed little in size for 3 years. The patient underwent a right pneumonectomy and mediastinal lymph node dissection. A metastatic squamous cell carcinoma in the hilar and interlobar lymph nodes without a primary lung or other lesion was diagnosed. The patient received adjuvant chemotherapy for a diagnosis of T0N1M0 lung cancer.
Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Diagnosis ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Lymph Nodes* ; Pneumonectomy ; Thorax

Follicular dendritic cell (FDC) sarcoma is an extremely rare malignant neoplasm arising from FDCs. The exact origin of FDCs remains unclear; both a hematopoietic lineage origin and a stromal cell derivation have been proposed. Proliferation of FDCs can lead to benign reactive lesions or generate neoplastic conditions. The lesions are most commonly found in lymph nodes and usually involve the head and neck area. Castleman's disease is a rare non-neoplasitic lymphoproliferative disorder. Rare cases of hyaline-vascular Castleman's disease have been associated with FDC sarcoma, but a clonal relationship has not been convincingly demonstrated. A pathway toward tumor evolution, beginning with hyperplasia and dysplasia of FDCs, has been proposed. Despite this known association between Castleman's disease and FDC sarcoma, there have only been few reported cases of sarcoma arising as a complication of pre-existing Castleman's disease, especially in abdominal lesions. We describe here a 51-year-old female with an FDC sarcoma arising from unicentric, hyaline-vascular type Castleman's disease in an intra-abdominal mass. Pathologically, the lesion showed a series of changes during the process of transformation from Castleman's disease to FDC sarcoma.
Abdomen/ultrasonography ; Abdominal Neoplasms/*diagnosis/etiology/pathology ; Dendritic Cell Sarcoma, Follicular/*diagnosis/etiology/pathology ; Female ; Giant Lymph Node Hyperplasia/complications/*diagnosis ; Humans ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed

Background/Aims: We developed a new endoscopic submucosal dissection (ESD) simulator and evaluated its efficacy and realism for use training endoscopists. Methods: An ESD simulator was constructed using polyvinyl alcohol hydrogel sheets and compared to a previous ESD simulator. Between March 1, 2020, and December 30, 2021, eight expert endoscopists from three different centers analyzed the procedure-related factors of the simulator. Five trainees performed gastric ESD exercises under the guidance of these experts. Results: Although the two ESD simulators provided overall favorable outcomes in terms of ESD-related factors, the new simulator had several benefits, including better marking of the target lesion’s limits (p<0.001) and overall handling (p<0.001). Trainees tested the usefulness of the new ESD simulator. The complete resection rate improved after 3 ESD training sessions (9 procedures), and the perforation rate decreased after 4 sessions (12 procedures). Conclusions We have developed a new ESD simulator that can help beginners achieve a high level of technical experience before performing real-time ESD procedures in patients.