We observed the changes of IOP after contact transscleral cyclophotocoagualtion with Diode laser which emit 810mm beam and we tride to investigatethe suitable level and range of energy when Diode laser was applied to the refractory glaucoma patients. Fifteen eyes underwent contact transscleral cyclophotocoagulation with energy 3J(Group A, 6eyes), 4J(Group B, 9eyes) separately and intraocular pressure(IOP) was measured at 1 day, 1 week, 1 month, 2 month, 3 month, 4month, 5month, 6month, postoperatively. The intraocular pressure(IOP) decreasing rate was 83.02% in A group and 64.72% in B group. The success rate was 50% in A group and 66.7% in B group at 6 month postoperatively. It is suggested that contact transscleral cyclophotocoagulation with Diode laser si useful in lowering IOP in refractory glaucoma patients.
Glaucoma* ; Humans ; Lasers, Semiconductor*

We investigated the outcome of needling revision with adjunctive subconjunctival 5-fluorouracil(5-FU) injection performed on 20 eyes of 20 consecutive glaucoma patients with failed filtering blebs. Follow-up time was 44.5+/-53.9 weeks from the first needling revision and 31.8+/-43.5 weeks from the last needling procedures. We divided the patients into the success group and the failed group depending on the change of the intraocular pressure(IOP) after needling, and analysed the multi-factors which influenced the success rate of needling by logistic regression analysis. Thirteen(65%) of the eyes were classified treatment success after 1.6+/-0.8 needling revision, with a mean intraocular presure(IOP) of 19.8+/-1.9mmHg on 1.1+/-0.9 medications, significantly lower mean IOP and number of medications than before the procedure(28.1+/-15.7mmHg [P<0.01, paired t-test]). Needling revision with adjunctive 5-FU appears to be a safe and effective means of reestablished filtration.
Blister* ; Filtration ; Fluorouracil ; Follow-Up Studies ; Glaucoma ; Humans ; Logistic Models ; Trabeculectomy*

It is been known that the deltoid ligament of the ankle joint plays an important role in the stabiliy of the ankle joint. In cases of deltoid ligament rupture, associated with lateral malleolar fractures, cannot be maintained the integrity of the mortise and the stability of the talus. Controversy remains about the treatment of deltoid ligament injuries. Many authors advocate an operative repair for deltoid ligament ruptures for optimal reduction of lateral malleolar fracture. However, according to recent cadaveric studies and many satisfactory results of clinical studies, excellent results have been reported regarding the ankle joint stability by anatomical reduction of the lateral structure, but only without surgical repair of the medial structure. Fourteen patients with lateral malleolar fractures with associated deltoid ligament injuries treated at Sun General Hospital between January 1990 and June 1995. There were examined clinically and radiologically. We concluded that deltoid ligament repairs should be considered unnecessary as long as fibular fracture are stabilized anatomically with normal medial joint space. However, in cases with higher fracture levels of lateral malleolus, associated with syndesmotic injury, we recommend syndesmotic screw fixation or deltoid ligament repair.
Ankle ; Ankle Injuries ; Ankle Joint ; Cadaver ; Fibula* ; Hospitals, General ; Humans ; Joints ; Ligaments* ; Rupture ; Solar System ; Talus

BACKGROUND: Systemic hypertension produces varying degree of LVH which is associated with increased cardiovascular morbidiity. Previous studies have documented regression of LVH with various antihypertensives including calcium channel blockers, except diuretics and vasodilators. Recently echocadiographic assessment of the change of left ventricular mass(LVM) after antihyertensive therapy have been reported to offer prognostic cardiovascular information. The aim of this echocardiographic study is determining the influence of nicardipine, a calcium channel blocker, on the change of LVM in patients with essential hypertenison. METHODS: Left ventricular mass(LVM) and left ventricular mass index(LVMI) were measured by M-mode echocardiography in 15 patients with essential hypertension. Nicardipine, a calcium channel blocker, was administered for 6 months and two echocardiographies were done before and after administering, respectively. RESULTS: In the 15 patients treated for 6 months, systolic and diastolic pressure remained very significantly decreased compared with pressure before before therapy(135+/-15mmHg vs 168+/-26mmHg, and 86+/-7mmHg vs 105+/-16mmHg, both p<0.01). Concomitantly both LVM and LVMI decreased significantly(209+/-49g vs 235+/-71g, and 116+/-6g/m2 vs 131+/-38g/m2,both p<0.05). And no change was noted in left ventricular cavity size, demonstration that LVM reduction was due to regression of hypertrophy. CONCLUSION: This study showed that nicardipine produced a significant decrease in blood pressure, LVM, and LVMI over the 6 months period. And large and longterm controlled studies are needed for the clarification of the association between nicardipine and regression of LVH in hypertensive patients.
Antihypertensive Agents ; Blood Pressure ; Calcium Channel Blockers ; Calcium Channels ; Diuretics ; Echocardiography ; Humans ; Hypertension ; Hypertrophy ; Nicardipine* ; Vasodilator Agents

The imprinted tumour suppressor NOEY2 is downregulated in various cancer types, including ovarian cancers. Recent data suggest that NOEY2 plays an essential role in regulating the cell cycle, angiogenesis and autophagy in tumorigenesis. However, its detailed molecular function and mechanisms in ovarian tumours remain unclear. In this report, we initially demonstrated the inhibitory effect of NOEY2 on tumour growth by utilising a xenograft tumour model. NOEY2 attenuated the cell growth approximately fourfold and significantly reduced tumour vascularity. NOEY2 inhibited the phosphorylation of the signalling components downstream of phosphatidylinositol-3’-kinase (PI3K), including phosphoinositide-dependent protein kinase 1 (PDK-1), tuberous sclerosis complex 2 (TSC-2) and p70 ribosomal protein S6 kinase (p70S6K), during ovarian tumour progression via direct binding to vascular endothelial growth factor receptor-2 (VEGFR-2). Particularly, the N-terminal domain of NOEY2 (NOEY2-N) had a potent anti-angiogenic activity and dramatically downregulated VEGF and hypoxia-inducible factor-1α (HIF-1α), key regulators of angiogenesis. Since no X-ray or nuclear magnetic resonance structures is available for NOEY2, we constructed the threedimensional structure of this protein via molecular modelling methods, such as homology modelling and molecular dynamic simulations. Thereby, Lys15 and Arg16 appeared as key residues in the N-terminal domain. We also found that NOEY2-N acts as a potent inhibitor of tumorigenesis and angiogenesis. These findings provide convincing evidence that NOEY2-N regulates endothelial cell function and angiogenesis by interrupting the VEGFR-2/PDK-1/GSK-3β signal transduction and thus strongly suggest that NOEY2-N might serve as a novel anti-tumour and anti-angiogenic agent against many diseases, including ovarian cancer.

The human papillomavirus (HPV)-18 E7 (E7) oncoprotein is a major transforming protein that is thought to be involved in the development of cervical cancer. It is well-known that E7 stimulates tumour development by inactivating pRb. However, this alone cannot explain the various characteristics acquired by HPV infection. Therefore, we examined other molecules that could help explain the acquired cancer properties during E7-induced cancer development. Using the yeast two-hybrid (Y2H) method, we found that the Elk-1 factor, which is crucial for cell proliferation, invasion, cell survival, anti-apoptotic activity, and cancer development, binds to the E7. By determining which part of E7 binds to which domain of Elk-1 using the Y2H method, it was found that CR2 and CR3 of the E7 and parts 1–206, including the ETS-DNA domain of Elk-1, interact with each other. As a result of their interaction, the transcriptional activity of Elk-1 was increased, thereby increasing the expression of target genes EGR-1, c-fos, and E2F. Additionally, the colony forming assay revealed that overexpression of Elk-1 and E7 promotes C33A cell proliferation. We expect that the discovery of a novel E7 function as an Elk-1 activator could help explain whether the E7 has novel oncogenic activities in addition to p53 inactivation. We also expect that it will offer new methods for developing improved strategies for cervical cancer treatment.

The imprinted tumour suppressor NOEY2 is downregulated in various cancer types, including ovarian cancers. Recent data suggest that NOEY2 plays an essential role in regulating the cell cycle, angiogenesis and autophagy in tumorigenesis. However, its detailed molecular function and mechanisms in ovarian tumours remain unclear. In this report, we initially demonstrated the inhibitory effect of NOEY2 on tumour growth by utilising a xenograft tumour model. NOEY2 attenuated the cell growth approximately fourfold and significantly reduced tumour vascularity. NOEY2 inhibited the phosphorylation of the signalling components downstream of phosphatidylinositol-3’-kinase (PI3K), including phosphoinositide-dependent protein kinase 1 (PDK-1), tuberous sclerosis complex 2 (TSC-2) and p70 ribosomal protein S6 kinase (p70S6K), during ovarian tumour progression via direct binding to vascular endothelial growth factor receptor-2 (VEGFR-2). Particularly, the N-terminal domain of NOEY2 (NOEY2-N) had a potent anti-angiogenic activity and dramatically downregulated VEGF and hypoxia-inducible factor-1α (HIF-1α), key regulators of angiogenesis. Since no X-ray or nuclear magnetic resonance structures is available for NOEY2, we constructed the threedimensional structure of this protein via molecular modelling methods, such as homology modelling and molecular dynamic simulations. Thereby, Lys15 and Arg16 appeared as key residues in the N-terminal domain. We also found that NOEY2-N acts as a potent inhibitor of tumorigenesis and angiogenesis. These findings provide convincing evidence that NOEY2-N regulates endothelial cell function and angiogenesis by interrupting the VEGFR-2/PDK-1/GSK-3β signal transduction and thus strongly suggest that NOEY2-N might serve as a novel anti-tumour and anti-angiogenic agent against many diseases, including ovarian cancer.

PURPOSE: To investigate the result of combined trabeculotomy and trabeculectomy as an initial operative treatment of congenital glaucoma. METHODS: We retrospectively reviewed the medical records of 8 patients (14 eyes) who were operated with combined trabeculotomy and trabeculectomy as an initial operative treatment of congenital glaucoma from October 13, 1998 to February 20, 2001. The mean age of patients was 1.2 years (ranging from 0.75 to 2 years) and the mean follow-up period was 12.4 months (12.3+/-8.18). We assessed the mean age at surgery, preoperative corneal diameter, preoperative and postoperative intraocular pressure, preoperative and postoperative C/D ratio, postoperative complications. RESULTS: The mean age at first surgery was 4.4 months (4.3+/-2.45), the mean postoperative intraocular pressure (IOP) at the end of follow-up period was 13.2+/-2.01mmHg, significantly lower than the mean preoperative IOP which was 25+/-5.23mmHg (P<0.05), the mean postoperative C/D ratio at the end of follow-up period was 0.38+/-0.14, significantly lower than the mean preoperative C/D ratio which was 0.55+/-0.15 (P<0.05), C/D ratio of 3 eyes among them was decreased by more than 0.2. The overall success rate was 71.4% (10 eyes) after single procedure. All the 4 failed eyes underwent trabeculectomy again and the IOP was well controled. The complications included hyphema(5 eyes), corneal edema (3 eyes), vitreous prolapse (3 eyes), posterior synechiae (2 eyes), and they were all resolved spontaneously. CONCLUSIONS: The combined surgery of trabeculotomy and trabeculectomy as an initial single procedure of congenital glaucoma lowered the IOP without serious complications.
Corneal Edema ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Medical Records ; Postoperative Complications ; Prolapse ; Retrospective Studies ; Trabeculectomy*

PURPOSE: To evaluate the distribution of normal intracranial artery diameter according to sex and age, using three-dimensional reconstruction rotational angiography. MATERIALS AND METHODS: One hundred and twenty-five adults with normal intracranial arteries who underwent 3D rotational angiography (n=177) were included in this study. The arterial diameter was measured at four sites of the internal carotid artery (cavernous, paraophthalmic, supraclinoid, and distal), that of the middle cerebral artery at two (proximal and distal), and that of the anterior cerebral artery at one (middle). For each sex and age group (<30, 30-39, 40-49, 50-59, > or = 60 years), the mean diameter of the artery at these seven sites was calculated, and differences analysed. In addition, the middle cerebral artery diameter was compared between a younger group (<50 years) and an older group (> or = 50 years). RESULTS: The mean diameter at each site for each sex was as follows: male (mean+/-SD): 4.61+/-0.69, 3.96+/- 0.60, 3.48+/-0.45, 3.61+/-0.50, 2.44+/-0.32, 2.44+/-0.37, 1.81+/-0.32; female: 4.29+/-0.57, 3.83+/-0.56, 3.37+/-0.56, 3.52+/-0.48, 2.32+/-0.37, 2.30+/-0.36, 1.76+/-0.34. For those in their 40s, the diameter at five sites (all four sites of the internal cerebral artery and a distal middle cerebral artery) was significantly greater in males than in females. For other age groups, however, the difference between the sexes was absent, or was significant at only one (cavernous internal cerebral artery for those in their 30s) or two (proximal and distal middle cerebral artery for those in their 50s) of the seven sites. In the older age group, the diameter of the proximal middle cerbral artery was 2.59+/-0.35 mm in males and 2.38+/-0.37 mm in females. For the distal middle cerebral artery, the corresponding figures were 2.63+/-0.43 and 2.39+/-0.35 mm, respectively. For both sexes, the differences between the two age groups were significant. CONCLUSION: For those in their 40s, the normal diameter of the intracranial artery at most arterial sites was significantly greater in males than in females. The normal diameter of the middle cerebral artery was significantly greater or tended to be greater among the older group than the younger group (for males and females, respectively, 2.59+/-0.35 mm and 2.38+/-0.37 mm at the proxinal site, and 2.63+/-0.43 mm and 2.39+/-0.35 mm at the distal site).
Adult ; Angiography ; Anterior Cerebral Artery ; Arteries* ; Carotid Artery, Internal ; Cerebral Angiography ; Cerebral Arteries ; Female ; Humans ; Male ; Middle Cerebral Artery

PURPOSE: To determine, by means of a phantom study, the distortion-related factors and appropriate iodine concentration for three-dimensional reconstruction rotational angiography. MATERIALS AND METHODS: Four phantoms were created: crossed metal rods, one metal rod, one contrast rod, and a contrast rod under water. Iodine concentrations were 300, 250, 200, and 150 Img/ml, respectively. For each phantom, rotational angiography was performed in the rotational, right-angled (90 degree to rotational), intermedial (45 degree), close to rotational (20 degree), and close to right-angled (70 degree) planes. Two-dimensional projection images were transferred to a workstation at which 3D images were produced using the volume rendering technique. Image quality in each plane was evaluated in terms of opacity, homogeneity, and margin sharpness, which were graded as low, intermediate or high by two neuroradiologists who used images obtained in the right-angled plane as the standard reference. The same assessors evaluated in terms of the same parameters, cross-sectional images obtained at the central, intermedial, and peripheral portions of one metal rod positioned in the right-angled, close to right-angled, and intermedial planes, and in order to compare the values at different sites, one neuroradiologist measured the horizontal and vertical diameters of each cut image. RESULTS: Three-dimensional images of all four phantoms were high quality in the close to right-angled and intermedial plane, but in the rotational and close to rotational plane were degraded. In particular, metal rod images obtained in the rotational plane were poor for all three items. In these two planes, image quality was better for the contrast rod than the metal rod, and at 200 and 250 Img/ml concentrations than at 300 and 150 Img/ml concentrations. There was no significant difference in image quality, nor in measured values of the diameter between cut images. CONCLUSION: A three-dimensional image was more distorted when a linear object was placed at a lesser angle to the rotational plane and when inherent X-ray attenuation was greater, a finding which must be closely related to the beam-hardening artifact. Distortion was least at 200-250 Img/ml of iodine concentration, the concentration thought to be most appropriate for in-vitro 3D angiography.
Angiography ; Angiography, Digital Subtraction ; Artifacts ; Imaging, Three-Dimensional ; Iodine ; Water