Background and objectives: Carvedilol is a cardiovascular drug, beta- and alpha1-adrenoceptor antagonist, currently approved for the treatment of hypertension, angina, congestive heart failure by FDA. Carvedilol has been shown to attenuate oxygen free radical-initiated lipid peroxidation and to inhibit neointimal formation of aorta following vascular injury by balloon angioplasty. We have investigated the effect of carvedilol on DNA synthesis of vascular smooth muscle cells (VSMC) stimulated by platelet-derived growth factor (PDGF)-BB. MATERIALS AND METHOD: Rat aortic smooth muscle cells were obtained by the combined collagenase and elastase methods. Cells between the 4th and 8th passages were used for the experiments. Incorporated radioactivity of [3H]-thymidine was measured by liquid scintillation spectrometry. RESULTS: PDGF-BB (1 nM) increased [3H]-thymidine incorporation about 70-100% over basal value in cultured VSMC. PDGF-stimulated increase in DNA synthesis was significantly suppressed by simultaneous administration of carvedilol. In contrast, propranolol did not significantly affect 3[H]-thymidine uptake in rat aortic VSMC. CONCLUSION: The present study demonstrate that carvedilol significantly inhibits the proliferation of vascular smooth muscle cell in our condition. These results indicate that carvedilol may be effective in the treatment of cardiovascular diseases principally associated with abnormal vascular smooth muscle growth.
Angioplasty, Balloon ; Animals ; Aorta ; Cardiovascular Diseases ; Cell Proliferation ; Collagenases ; DNA ; Heart Failure ; Hypertension ; Lipid Peroxidation ; Muscle, Smooth, Vascular* ; Myocytes, Smooth Muscle ; Oxygen ; Pancreatic Elastase ; Platelet-Derived Growth Factor ; Propranolol ; Radioactivity ; Rats ; Spectrum Analysis ; Vascular System Injuries

Malocclusion is a serious complication of open reduction surgery for facial fractures. It is often caused by the lack of adequate consideration for the occlusal relationship before the trauma and intermaxillary fixation during the operation. This is a case report of postoperative malocclusion that occurred in a patient with a midfacial complex fracture.
Fracture Fixation ; Humans ; Jaw ; Malocclusion* ; Postoperative Complications

PURPOSE: To investigate the relationship between photoreceptor inner/outer segment (IS/OS) integrity and macular sensitivity after epiretinal membrane (ERM) surgery using spectral-domain optical coherence tomography combined with microperimetry. METHODS: 20 eyes of 20 patients with idiopathic ERM who underwent pars plana vitrectomy for ERM removal were prospectively reviewed. The IS/OS defect diameter, BCVA, macular sensitivity, and fixation stability were measured using spectral-domain optical coherence tomography combined with microperimetry. The correlation of these factors was analyzed. RESULTS: The macular sensitivity improved after successful ERM surgery (p < 0.001), but the IS/OS defect diameter has not improved. The preoperative and postoperative macular sensitivity were negatively correlated with preoperative IS/OS defect diameter (p = 0.035, p = 0.006). The fixation stability was not correlated with preoperative IS/OS defect diameter. CONCLUSIONS: Macular sensitivity showed significant correlation with IS/OS defect diameter. Macular sensitivity is vital functional parameter allows subjective quantification of the retinal function and reflects morphologic changes.
Epiretinal Membrane ; Eye ; Humans ; Prospective Studies ; Retinaldehyde ; Tomography, Optical Coherence ; Vitrectomy

BACKGROUND: Atherosclerosis is a diffuse disease process that produce thickening of the vascular wall because of intimal deposition of lipid, fibrous tissue, and calcific material. Nowadays it is possible to evaluate atherosclerotic changes of carotid arteries accurately by developed noninvasive techniques such as ultrasonography. Left ventricular hypertrophy (LVH) is known to be an important risk factor for cardiovascular events in hypertension. The purpose of this study was to establish whether the carotid intimal - medial thickness (IMT) correlates with the severity of LVH. METHOD: We measured intimal-medial thickness (IMT) for 12 sites in carotid arteries (near and far walls in common carotid, bifurcation, and internal carotid arteries of both sides) by B-mode ultrasonography in both 38 normotensive and 72 hypertensive patients. Left ventricular measurements were made according to the recommendations of the American Society of Echocardiography. Left ventricular mass was derived from the formula described by Devereux et al. and each left ventricular mass value was indexed to body surface area. And then we have investigated whether hypertensive patients have significant changes of carotid IMT and IMT correlates with left ventricular mass index (LVMI). RESULTS: (1) Most hypertensive patients had diffuse thickening of the carotid artery and some had focal or multiple plaques. (2) In general, mean IMT was widest in the carotid bifurcation. (3) The mean IMT of all 12 segments increased about 40% in hypertensive patients compared with normal control group. (4) LVMI significantly correlates with IMT of carotid artery, especially bifurcation site and mean all 12 segments. CONCLUSION: The mean IMT may serve as a useful marker of the severity of atherosclerosis in hypertensive patients. The significant association between carotid IMT and LVMI suggests a simultaneous correlation of carotid atherosclerosis with left ventricular hypertrophy in hypertension.
Atherosclerosis ; Body Surface Area ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Artery, Internal ; Echocardiography ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Risk Factors ; Ultrasonography

BACKGROUND: Recently, balanced anesthesia (BA: halogenated volatile anesthetics + remifentanil) has been useful for abdominal surgery. The authors therefore performed a retrospective study about the difference in the dose of vasoactive drugs and rocuronium according to the general anesthesia type. METHODS: BA was compared with inhalational anesthesia (IA: halogenated volatile anesthetics + N2O) and total intravenous anesthesia (TIVA: propofol + remifentanil). The records of a total of 415 patients (IA : TIVA : BA = 126 : 157 : 132) who received open gastrectomy between 2004 to 2010 were analyzed. The types of vasoactive drugs and dosage as well as infusion time were calculated. The total amounts of vasoactive drugs were scored by two different methods. Infusion drugs were scored as 30 points, whereas bolus drugs were scored as 5 points. Drug score is the total sum of each score, where each drug score point split either into Plus or Minus. Plus means raising the blood pressure whereas Minus means the opposite. For rocuronium dosage, a total of 286 patients (IA : TIVA : BA = 89 : 78 : 119) who met the criteria were enrolled, and this formula was used (total rocuronium/weight/time, microg/kg/hr). RESULTS: The BA group showed a lower (P = 0.01) Minus score (1.8 +/- 4.0) compared to the IA group (3.6 +/- 5.2). Less amount of rocuronium (P = 0.001) was administered in the BA (327 +/- 72 microg/kg/hr), compared to the IA (368 +/- 93 microg/kg/hr) and TIVA (356 +/- 81 microg/kg/hr). CONCLUSIONS: BA seems to require less hypotensive agent and rocuronium compared with IA and TIVA for open gastrectomy. But, well-designed prospective studies are required.
Androstanols ; Anesthesia ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics ; Balanced Anesthesia ; Blood Pressure ; Gastrectomy ; Humans ; Piperidines ; Propofol ; Retrospective Studies

OBJECTIVES: The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. MATERIALS AND METHODS: A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. RESULTS: The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. CONCLUSION: This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures.
Adolescent ; Facial Bones ; Facial Injuries ; Female ; Hospitalization ; Human Body ; Humans ; Incidence ; Male ; Malocclusion ; Mandible ; Mandibular Condyle ; Maxillofacial Injuries ; Nasal Bone ; Orbit ; Postoperative Complications ; Retrospective Studies* ; Seoul ; Zygoma

PURPOSE: To measure retinal nerve fiber layer (RNFL) volume in normal children using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 79 eyes of 54 normal children between 4 and 15 years of age evaluated from February 2012 to November 2012. All participants underwent ocular examination and 3D-disc scanning using SD-OCT. RNFL volume was calculated between 2.5 and 5 mm diameter circles using the length, width, and height of each pixel derived from the RNFL thickness map with Matlab software. The relationship between RNFL volume and thickness was analyzed. RESULTS: The RNFL volumes of the mean total, superior, nasal, inferior, and temporal areas were 1.48 ± 0.09 mm3, 0.45 ± 0.04 mm3, 0.29 ± 0.04 mm3, 0.46 ± 0.03 mm3, and 0.29 ± 0.04 mm3, respectively. Comparing RNFL volume and conventional circumpapillary RNFL thickness measured using built-in software, a strong correlation between mean total, superior, and inferior areas (R = 0.980, 0.953 and 0.932, respectively) and a moderate correlation between the nasal and temporal areas were observed (R = 0.545 and 0.514, respectively). The negative correlations between RNFL thickness and RNFL volumes of the mean total, superior, nasal, inferior, and temporal areas and age were not significant (p > 0.05). CONCLUSIONS: This study reports RNFL volume measured from RNFL thickness map analysis in normal children. These data regarding RNFL volume of normal children may provide useful information for diagnosis and monitoring of pediatric glaucoma.
Child* ; Diagnosis ; Glaucoma ; Humans ; Nerve Fibers* ; Retinaldehyde* ; Tomography, Optical Coherence*

PURPOSE: This study was aimed to determine the role of the VEGF and MVD expression in infiltrating ductal carcinoma of breast and to observe the correlation between the expression of these VEGF/MVD, and other prognostic factors. MATERIALS AND METHODS: Immunohistochemical staining of VEGF and MVD with monoclonal antibody in pathologic specimens of 35 patients of infiltrating ductal carcinoma of breast was carried out. Reiationship between the expression of the VEGF/MVD and prognostic factors were assessed. RESULTS: The VEGF/MVD expression was closely related to tumor size, lymph node metastasis, and clinical stage, but not related to histologic grade, nuclear grade, estrogen receptor, and progestrone receptor. And the VEGF expression was closely related to MVD. CONCLUSION: The VEGF expression and microvessel density in infiltrating ductal carcinoma of breast may play an important prognostic factors, closely related to the tumor size, lymph node metastasis, and stage.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Estrogens ; Humans ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

PURPOSE: The authors report a case of bilateral simultaneous central retinal vein occlusion caused by Waldenstrom's macroglobulinemia. CASE SUMMARY: A 65-year-old man presented to our department complaining of decreased visual acuity for the duration of about 6 months. On his initial visit, best-corrected visual acuity was 0.02 in the right eye and 0.06 in the left eye. Based on the findings of a funduscopic examination, the patient had bilateral diffuse retinal hemorrhages, dilated tortuous veins, and macular edema. He had experienced recurrent spontaneous epistaxis 6 months previously and had undergone treatments such as intravitreal bevacizumab injection and intravitreal dexamethasone implantation at another hospital. Laboratory tests at that hospital showed anemia and hyperproteinemia, for which he was referred to our hemato-oncology department. Bone marrow biopsy was consistent with Waldenstrom's macroglobulinemia/lymphoplasmacytoid lymphoma, and he was treated with systemic chemotherapy. One year after the systemic chemotherapy, his best-corrected visual acuity was 0.15 in the right eye and 0.6 in the left eye. Funduscopy showed decreased bilateral retinal hemorrhages and macular edema. CONCLUSIONS: When simultaneous bilateral central retinal vein occlusion occurs in a patient with no other underlying disease such as hypertension or diabetes, it might be a sign of serum hyperviscosity, and there should be a very high level of suspicion for presence or progression of systemic disease. If such a disease is properly and timely diagnosed, effective early systemic evaluation and therapy can be administered, and it is important to have initial general treatment as well as ophthalmic treatment.
Aged ; Anemia ; Bevacizumab ; Biopsy ; Bone Marrow ; Dexamethasone ; Drug Therapy ; Epistaxis ; Humans ; Hypertension ; Lymphoma ; Macular Edema ; Retinal Hemorrhage ; Retinal Vein* ; Veins ; Visual Acuity ; Waldenstrom Macroglobulinemia*

A patient, who underwent partial masseter muscle resection and mandibular angle reduction at a plastic surgery clinic, visited this hospital with major complaints of trismus and dysesthesia. A secondary angle formation due to a wrong surgical method was observed via clinical and radiological examinations, and the patient complained of trismus due to the postoperative scars and muscular atrophy caused by the masseter muscle resection. The need for a masseter muscle resection in square jaw patients must be approached with caution. In addition, surgical techniques must be carefully selected in order to prevent complications, and obtain effective and satisfactory surgery results.
Cicatrix ; Humans ; Jaw ; Masseter Muscle* ; Methods ; Muscular Atrophy ; Paresthesia ; Surgery, Plastic ; Trismus*