Most of cataract surgeons have made a great effort to minimize or nullify corneal 'astigmatism resulted from the incision and closure, but a completely ideal wound system still eludes us. The scleral pocket incision and continuous single knotted shoelace suture of it has been known as one of the technique for reducing postoperative astigmatism. Recently, horizontal suture closure of scleral pocket incisior has been introduced because it doesn't cause suture induced wound compression. We implanted standard PMMA intraocular lenses in the bag of 400 patients through 7mm scleral pocket incision following CCC (continuous circular capsulorhexis) and bimanual phacoemulsification. The incision was closed with either the shoelace or horizontal suture. The keratometric measurement was maded at postoperative 1 day, 1 week, 1 month, 2 month, 3 month and 6 month. In shoelace suture group, the preoperative corneal astigmatism appeared -0.14 +/- 0.15D of with the rule astigmatism (WTR); at one day postoperatively -2.75 +/- 1.61 of WTR, at 3 month 0.18 +/- 1.14D of against the rule astigmatism (ATR), 6 month 0.3 +/- 1.22D of ATR. In horizontal suture group, the preoperative corneal astigmatism appeared -0.22 +/- 1.22D of WTR; at one day postoperatively -1.05 +/- 1.28 of WTR, at 2 month 0.57 +/- 1.0 of ATR, at 6 month 0.72 +/- 1.91 of ATR. The difference between two suture methods was statistically significant (p<0.01 until 3 month, p<0.05 until 3-6 month).
Astigmatism* ; Cataract ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Sutures* ; Wounds and Injuries

Small incision cataract surgery has many advantages such as less induced corneal astigmatism, fast visual recovery, and fast rehabilitation. We had implatned the newly developed Staar AA-4203 foldable silicone IOL in the ag of 100 cataractous eye and followed for at least 3 months (3-0 months, mean 6 months). Silicone IOLs were implanted using a specific injector through 4mm scleral pocket incision after continuous circular capsulorhexis and bimanual phacoemulsification. The lenses were centered well in 99% of eyes. Tear of anterior capsule occurred in one eye (1%), and tear of both anterior and posterior cassule occurred in another one eye (1%) during IOL implatation. The IOL was displaced into the vitreous in the latter eye, which was reoperated. The preoperative and postoperative cornedal astigmatism at 1 day, 1 month, 2 month and 3 month was -O.14 +/- 0.83 D of with the rule astigmatism (WTR), -0.55 +/- 1.06 D of WTR, -0.28 +/- 0.91 D of WTR, -0.07 +/- 0.81 D of WTR, and O.01 +/- 0.84 D of against the rule astigmatism respectively. Uncorrected VA of 1.0 was 35% at postoperative 1 day, 52% at 1 month, 48% at 2 month. Corrected VA of 1.0 was 65% at postoperative 1 day, 87% at 1 month, 88% at 2 month. Inflammatory reaction in the anterior chamber and vitreous had subsided within one or two months without any complications in 99% of eyes. Fibrinous membrane on the suface of IOL occurred in 2 eyes (2%), one of which caused grave sequelae. The results, although it showed early postoperative results, reflected that the above silicone foldable IOL fitted to the small incision cataract surgery guaranteed us the safety and fast visual recovery.
Anterior Chamber ; Astigmatism ; Capsulorhexis ; Cataract ; Fibrin ; Membranes ; Phacoemulsification ; Rehabilitation ; Silicones*

Temporal triangular alopecia is a triangular or oval shaped non-scarring alopecia, occurring on the temporal side of the scalp, which was first reported by Sabourand in 1950. It usually occurs in the childhood. There is no treatment for this disorder except for surgery. In this article, we report a case of focal alopecia which was successfully treated with micropigmentation.
Alopecia* ; Scalp

OBJECTIVE: Our purpose was to compare the pregnancy outcomes of nulliparous women aged 40 years and older with those of nulliparous women under 35 years of age. METHODS: From January 1989 to December 1998 total 57,563 deliveries were seen in Gachon Gil Medical Center. Among them we experienced 59 cases of nulliparas at 40 years and older. These women were compared with 188 young nulliparas under 35 years of age as the control group. The statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence rate of elderly nulliparas aged 40 years and older was increased from 0.04% in 1989 to 0.30% in 1998. The age distribution was from 40 years to 45 years. The gravidity of eldery nulliparas was 2.2 in comparison with 1.6 in control group. The incidence of uterine myoma, gestational DM, IUGR and oligohydramnios was significantly high rate in elderly nulliparas. There was significantly high rate of cesarean section in elderly nulliparas(88.1%) in comparison with control group(40.4%). The reasons of cesarean section were her demand(39.0%), CPD(15.3%) and breech presentation(13.6%) in decreasing order. The preterm delivery rate was 10.2% in elderly nulliparas in comparison with 4.3% in the control group. Placenta accreta and uterine atony were significantly high in elderly nulliparas and mean estimated blood loss was also high. There was no difference in 5-minute Apgar score between both group, but there were more cases of neonatal intensive care unit admission in neonates of elderly nulliparas(6.8% vs 0%). CONCLUSION: The incidence of elderly nulliparas is continuously increasing. The elderly nulliparas and their babies are at greater risk than young women. Therefore all elderly nulliparas aged 40 years and older can be regarded as high risk patients and they must be managed with careful attention.
Age Distribution ; Aged ; Apgar Score ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gravidity ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Leiomyoma ; Oligohydramnios ; Placenta Accreta ; Pregnancy ; Pregnancy Outcome ; Uterine Inertia

PURPOSE: Kabuki syndrome is a rare syndrome of multiple congenital anomalies and mental retardation, which is characterized by a peculiar face resembles Kabuki actor, postnatal growth retardation, and skeletal abnormalities. The ocular feature such as strabismus, amblyopia, ptosis, blue sclera and long palpebral fissure with eversion of the lateral portion of lower eyelid can be seen in this syndrome. We experienced a Kabuki syndrome patient with ocular feature. CASE SUMMARY: A 6 years old girl visited ophthalmology department for frequent blinking, abnormal movement of eyelid. She showed growth retardation, high palate arch, bifid uvula and low hairline. Best corrected visual acuity was 0.5 in the right eye and 0.4 in the left eye. She also presented with mixed astigmatism (right: +sph 1.00;-cyl 3.00 Ax 180, left: +sph 1.00;-cyl 3.50 Ax 180). In addition, Marcus-Gunn jaw winking in her left eye and a long palpebral fissure were noted. She had intermittent exotropia and a tilted optic disc in the left eye.
Amblyopia ; Astigmatism ; Blinking ; Child ; Dyskinesias ; Exotropia ; Eyelids ; Female ; Humans ; Intellectual Disability ; Jaw ; Ophthalmology ; Palate ; Sclera ; Strabismus ; Uvula ; Visual Acuity

The prognostic significance of the squamous cell carcinomas of the oral and oropharynx have been evaluated to identify those features associated with aggressive biologic behavior according to the immunologic and histologic characteristics. For determining prognostic indicators, the authors performed immunohistochemical staining of p53 and epidermal growth factor receptor(EGFR) in 29 cases of squamous cell carcinomas of the oral and oropharynx. The expression rate of p53 was 51.7%, that of EGFR was 96.6%, and overexpression rate of EGFR was 41.4%, however there were no statistical significance between the reactivity of EGFR, p53 and clinicopathological features such as primary stage, nodal stage, clinical stage, death and histologic grade.
Carcinoma, Squamous Cell* ; Epidermal Growth Factor* ; Oropharynx ; Receptor, Epidermal Growth Factor*

Papular elastolytic giant cell granuloma is an unusual variant of annular elastolytic giant cell granuloma, characterized by the development of asymptomatic, multiple, small erythematous papules on both sun-exposed and non-sun-exposed area. Histopathologically, it shows a granulomatous infiltration, accompanied by the absence of the elastic tissue and phagocytosis of elastic fibers by multinucleated giant cell. An 83-year-old man was presented with a 1 year history of multiple erythematous papules on his abdomen and lower legs. Histopathologic finding showed a non-palisading granulomatous infiltration with multinucleated giant cells and engulfing elastic fibers. We, herein, report an unusual case of papular elastolytic giant cell granuloma, which occurred on non-sun-exposed skin.
Abdomen ; Aged, 80 and over ; Elastic Tissue ; Giant Cells ; Granuloma, Giant Cell ; Humans ; Leg ; Phagocytosis ; Skin

BACKGROUND AND OBJECTIVES: The sense of smell is indispensable for men to appreciate food flavors and avoid potential dangers, such as spoiled foods, smoke, and gases. Despite these important roles, there have been only a few studies investigating the cause and nature of olfactory disorders. In this study, we investigated clinical aspects of olfactory disorders. MATERIALS AND METHODS: The demographic, medical, and chemosensory data of 497 patients who visited clinics complaining of smell loss were retrospectively analyzed with medical charts and a questionnaire. The statistical analyses were performed using ANOVA and chi-square test to compare several variables of data. RESULTS: Nasal and paranasal sinus disease, upper respiratory tract infection, idiopathic, and head trauma were the major causes of smell loss. The onset of smell loss, the distribution of gender and age, the incidence and severity of olfactory loss with gustatory dysfunction differed among causal groups. The association of olfactory score with allergies in nasal diseases was not noted in this study. In addition, the presence of intranasal polyp affected the severity of olfactory dysfunction, but we could not see this effect in patients who had the history of sinonasal surgery. CONCLUSION: We recommend that physicians have to consider many clinical aspects including the cause and nature of olfactory loss to treat patients with chemosensory dysfunction effectively.
Craniocerebral Trauma ; Gases ; Humans ; Hypersensitivity ; Incidence ; Male ; Nose Diseases ; Olfaction Disorders ; Paranasal Sinus Diseases ; Polyps ; Surveys and Questionnaires ; Respiratory Tract Infections ; Retrospective Studies ; Smell ; Smoke

BACKGROUND: The brachial-ankle pulse wave velocity (baPWV) is a useful parameter to assess arterial stiffness. However, it is difficult to evaluate arterial stiffness in hypertensive patients because the baPWV is affected by the blood pressure itself. This study was designed to estimate the relationship between the change of the blood pressure parameters and the baPWV (delta baPWV) when hypertensive patients were subjected to an acute reduction of blood pressure. METHODS: Thirty patients with essential hypertension and whose blood pressure was higher than 140/90 mmHg were enrolled. In all the patients, the blood pressure and baPWV were measured using an automatic waveform analyzer with the patients at a resting state. When the reduction of blood pressure was more than 10 mmHg after sublingual administration of nifedipine 10 mg, then the blood pressure and baPWV were measured again in the same manner and then they were compared with the baseline values. Spearman's correlation and multiple linear regression tests were performed to estimate the relationship between the change of the blood pressure parameters (delta SBP, delta DBP, delta MAP and delta PP) and the delta baPWV. RESULTS: The baPWV was significantly decreased shortly after the administration of nifedipine (1903.6+/-305.2 cm/sec vs. 1716+/-252.0 cm/sec, respectively, p<0.01). The delta baPWV was correlated with the delta SBP (r=0.550, p<0.01), delta DBP (r=0.386, p<0.05), delta MAP (r=0.441, p<0.05), and delta PP (r=0.442. p<0.05). On the multiple regression analysis, the delta SBP was the only significant variable for predicting the delta baPWV, and the linear equation was delta baPWV=8.7 x SBP-48. CONCLUSIONS: The baPWV is affected by the systolic blood pressure level to a large degree and careful attention must be paid to the blood pressure level when evaluating arterial stiffness with using the baPWV.
Administration, Sublingual ; Aged ; Blood Flow Velocity ; Blood Pressure/*drug effects/physiology ; Brachial Artery/*physiopathology ; Female ; Humans ; Hypertension/diagnosis/*physiopathology ; Male ; Middle Aged ; Nifedipine/administration & dosage ; Pulse ; Systole/physiology ; Vasodilator Agents/administration & dosage

The shortage of organ donors has stimulated interest in the possibility of using animal organs for transplantation into humans. In addition, pigs are now considered to be the most likely source animals for human xenotransplantation because of their advantages over non-human primates. However, the appropriate standard values for estimations of the liver of micropigs have not been established. The determination of standard values for the micropig liver using multi-detector row computed tomography (MDCT) would help to select a suitable donor for an individual patient, determine the condition of the liver of the micropigs and help predict patient prognosis. Therefore, we determined the standard values for the livers of micropigs using MDCT. The liver parenchyma showed homogenous enhancement and had no space-occupying lesions. The total and right lobe volumes of the liver were 698.57 +/- 47.81 ml and 420.14 +/- 26.70 ml, which are 51.74% and 49.35% of the human liver volume, respectively. In micropigs, the percentage of liver volume to body weight was approximately 2.05%. The diameters of the common hepatic artery and proper hepatic artery were 6.24 +/- 0.20 mm and 4.68 +/- 0.13 mm, respectively. The hepatic vascular system of the micropigs was similar to that of humans, except for the variation in the length of the proper hepatic artery. In addition, the diameter of the portal vein was 11.27 +/- 0.38 mm. In conclusion, imaging evaluation using the MDCT was a reliable method for liver evaluation and its vascular anatomy for xenotransplantation using micropigs.
Animals ; Female ; Hepatic Artery/anatomy & histology ; Humans ; Imaging, Three-Dimensional/methods/*veterinary ; Liver/*anatomy & histology/blood supply ; Liver Transplantation/*methods ; Living Donors ; Male ; Portal Vein/anatomy & histology ; Swine ; Swine, Miniature/*anatomy & histology ; Tomography, X-Ray Computed/methods/*veterinary ; Transplantation, Heterologous/*methods