To evaluate the change of corneal sensation following LASIK, the corneal sensation of 26 eyes(14 patients) were examined before and 1 week, 2 week, 1 month, 2 month, 3 month, and 6 month after LASIK. The corneal sensation was measured on the following points of the center, temporal, inferior, nasal, and superior side with an esthesiometer of Cochet-Bonnet type. Each measurement of side point was taken 3mm apart from corneal center. The eyes were divided into two groups; group I was eyes with a corneal ablation depth under 100micrometer and group II was those with a value over 100micrometer. Corneal sensations in all cases were not recovered to the level of preoperation until 6 month after LASIK. The pattern of recovery was indifferent among the various points on the cornea except for the hinge side, which has shown more rapid recovery than any other area. The recovery speed between the hinge side and other areas was statistically significant(P<0.05). A decrease of corneal sensation was more prominent in group I than group II. With these results, we are able to suggest that lamellar cut of the cornea by LASIK procedure makes a damage on the corneal sensation and the depth of ablation might cause an influence on the amount of loss and recovery of the corneal sensation.
Cornea ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Sensation*

No abstract available.
Aging* ; Humans ; Male*

Controlled hypotension and temporary clip of feeding artery are used to reduce bleeding and to facilitate the neurosurgical operations, especially in intracranial aneurysm surgery, but the microvasculature of acute ischemic brain from impaired blood flow is quite susceptible to decrease in blood pressure and blood volume. The reversibility of brain damage following an ischemic brain lesion depends on the amount of regional cerebral flow as well as the severity of ischemia. The present study was designed to elucidate the effect of controlled hypotension on cerebral blood flow, cerebrovascular resistance, and pathological changes in acute ischemic brain lesion. Cerebral ischemia was induced in cats by middle cerebral artery occlusion for 6 hours through the transorbital approach. Forty-nine cats were divided into 3 groups, namely control group with mean blood pressure maintained at normal after right middle cerebral artery occlusion, hemorrhagic hypotension group with mean blood pressure decreased to 80, 60, and 40mmHg by with drawing of blood after right middle cerebral artery occlusion and drug-induced hypotension group with mean blood pressure decreased to 80, 60, and 40mmHg with arfonad infusion after right middle cerebral artery occlusion. Regional cerebral blood flow was measured by the hydrogen clearance method following middle cerebral artery clipping and gradual decreasing mean blood pressure. Cerebrovascular resistance was calculated after regional cerebral blood flow was measured and size of infarct were examined in each groups after the experiment was completed. Results were as follows : 1) In control group, regional cerebral blood flow and cerebrovascular resistance of the right parietal area with mean blood pressure maintained at normal after right middle cerebral artery occlusion were 19.4+/-2.1ml/2.1ml/100g/min and 5.5+/-0.4mmHg/ml/100g/min. The size of cerebral infarct was minimal in 71% of the control group. 2) In hemorrhagic hypotension group, regional cerebral blood flow of the right parietal area with mean blood pressure decreased to 80, 60, and 40mmHg was 17.6+/-1.5, 15.4+/-3.8, 7.8+/-2.9ml/100g/min respectively, thus 6, 25, and 57% lower than the control group. Cerebrovascular resistance of the right parietal area with mean blood pressure. With mean blood pressure reduced to 40mmHg, the cerebrovascular resistance drastically increased to 5.1+/-0.5mmHg/ml/100g/min. When mean blood pressure was reduced to 60 and 40mmHg, the size of infarct was marked in 57 and 85% of the hemorrhagic hypotension group. 3) In drug-induced hypotension group, regional cerebral blood flow of the right parietal area with mean blood pressure reduced to 80, 60, and 40mmHg was 19.1+/-2.3, 17.8+/-3.1, and 7.4+/-2.7ml/100g/min respectively, thus 2, 10, and 38% lower than the control group. the regional cerebral blood flow of the right parietal area in the drug-induced hypotension group was slightly higher than the hemorrhagic hypotension group when mean blood pressure was reduced to 80 or 60mmHg, while there was no significant difference of regional cerebral blood flow in the both groups when mean blood pressure was reduced to 40mmHg. Cerebrovascular resistance of the right parietal area with mean blood pressure at 80 and 60mmHg was 4.1+/-0.3 and 3.1+/-0.2mmHg/ml/100g/min respectively, thus showing a gradual decrease in relation to decreasing mean blood pressure. With mean blood pressure reduced to 40mmHg, the cerebrovascular resistance was 5.6+/-0.9mmHg/ml/100g/min, thus higher than the hemorrhagic hypotension group. When mean blood pressure was decreased to 60 and 40mmHg, the size of infarct was marked in 42 and 85% of the drug-induced hypotension group. The extent of cerebral infarct was more extensive in the hemorrhagic hypotension group than in the drug-induced hypotension group. 4) In the contralateral hemisphere of the infarct, there was no change in regional cerebral blood flow when the mean blood pressure was decreased to 80 and 60mmHg but when the mean blood pressure decreased to 40mmHg, the regional cerebral blood flow was markedly reduced in all groups. When the mean blood pressure decreased to 60mmHg there was no change in cerebrovascular resistance, however when the mean blood pressure was at 40mmHg, there was a drastic increase in cerebrovascular resistance in all groups. Due to to loss of autoregulation in the ischemic brain lesion, the regional cerebral blood flow depends on the brain perfusion and accordingly when there is ischemic brain lesion, the hemorrhagic hypotension produces serious brain infarction and edema than drug-induced hypotension.
Animals ; Arteries ; Blood Pressure ; Blood Volume ; Brain Infarction ; Brain Ischemia ; Brain* ; Cats ; Edema ; Hemorrhage ; Homeostasis ; Hydrogen ; Hypotension ; Hypotension, Controlled* ; Infarction, Middle Cerebral Artery ; Intracranial Aneurysm ; Ischemia ; Microvessels ; Middle Cerebral Artery ; Perfusion ; Rabeprazole

This experiment was performed to define the paricipation of a discrete hypothalamic neural structure in the genesis of pulmonary edema and the effect of alpha adrenergic blockade. Fifty adult cats weighing 2.5 to 4.0 Kg, were used in this study. The components of the pathophysiological systemic changes, lung weight, and histopathological changes of lung and hypothalamus were studied in groups of animals when intracranial pressure(ICP) was raised to 200 mmH2O of 300 mmH2O for 2 hours by intraventricular infusion with normal saline. The animals were divided into 5 groups : The normal control group was comprised in 10 normal cats. Control and phentolamine treated animal groups which had an elevated ICP of up 200 mmH2O consisted of 10 cats each. Control and phentolamine treated animal groups which had an elevated ICP of up to 300 mmH2O consisted of 10 cats each. The results obtained were as follows : 1) In the animal groups of elevated ICP to 200 mmH2O or 300 mmH2O, there were hemodynamic systemic changes which were neurogenically mediated and caused an immediate elevation in blood pressure of 30 mmHg to 60 mmHg. The hemodynamic data of the animals that had an elevated ICP of up to 300 mmH2O were significantly more deviated from normal control values than the 200 mmH2O ICP groups. The hemodynamic responses of the phentolamine treated animal with elevated ICP of up to 200 and 300 mmH2O were less deviated from normal control values. 2) The lung weights of the animals with an elevated ICP of up to 200 and 300 mmH2O were significantly heavier than the normal control value(p<0.05) and the lung weights of the animals with an elevated ICP of 300 mmH2O were significantly heavier than those with an ICP of 200 mmH2O(p<0.01). The lung weights of the phentolamine treated animal groups were significantly lighter than the control group but showed little increase in the lung weight when compared to the normal value. 3) By controlling the elevated ICP above 200 mmH2O in the experimental animals we have confirmed gross and microscopic appearances of hemorrhagic pulmonary edema. Histopathological changes of the phentolamine treated animals were significantly less sever than in the control groups. 4) By elevating ICP above 200 mmH2O in the experimental animals, we have confirmed discrete bilateral hemorrhagic spots of the anterior hypothalamus, preoptic region induced by increased intracranial pressure. Histopathological changes of the phentolamine treated animals with the elevated ICP were significantly less severe than of the control groups. 5) This experimental model may define the specific particification of the hypothalamus in the pathophysiological pathogenesis of neurogenic pulmonary edema. These results suggest that the lungs are directly affected by the intense sympathetic discharge evoked by release phenomenon from the sympathoinhibitory influence of the hypothalamus, and pulmonary edema was effectively eliminated by alpha adrenergic blockade.
Adult ; Animals ; Blood Pressure ; Cats* ; Edema* ; Hemodynamics ; Humans ; Hypothalamus ; Hypothalamus, Anterior ; Infusions, Intraventricular ; Intracranial Pressure ; Lung* ; Models, Theoretical ; Phentolamine* ; Pulmonary Edema ; Reference Values ; Weights and Measures

Brainstem auditory response abnormalities directly reflect disturbance of neural function rather than the underlying anatomic cause of that disturbance. The test has advantage in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity, displace surrounding structures or change vascular supply and permeability. A sequence of seven low-amplitude potentials that occur in the initial 10 msec following click signals can be recorded from scalp electrodes in 44 patient with focal brain lesions using computer averaging techniques. The potentials, termed auditory brainstem responses, are thought to be the far-field reflection of electrical events originating in the auditory pathway during its course through the brainstem. We have studied auditory brainstem evoked potential responses in a variety of focal brain lesions and found them to be of assistance in evaluating the localization of pontomedullary, pons, midbrain, thalamus, subcortical and functional recovery. 1) Distortion of early components (type I) was occured in the brainstem lesions. 2) Distortion of late components (type II) was developed in the diencephalon or subcortical lesions. 3) Distortion of all components (type III) was developed in the brainstem and diffuse brain contusions. 4) Serial recordings provided information about the evolution of brain stem lesions and good functional recovery marker.
Auditory Pathways ; Brain Injuries ; Brain Stem* ; Brain* ; Diencephalon ; Electrodes ; Electrophysiology ; Evoked Potentials* ; Evoked Potentials, Auditory, Brain Stem ; Humans ; Mesencephalon ; Permeability ; Pons ; Scalp ; Thalamus

Brainstem auditory response abnormalities directly reflect disturbance of neural function rather than the underlying anatomic cause of that disturbance. The test has advantage in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity, displace surrounding structures or change vascular supply and permeability. A sequence of seven low-amplitude potentials that occur in the initial 10 msec following click signals can be recorded from scalp electrodes in 44 patient with focal brain lesions using computer averaging techniques. The potentials, termed auditory brainstem responses, are thought to be the far-field reflection of electrical events originating in the auditory pathway during its course through the brainstem. We have studied auditory brainstem evoked potential responses in a variety of focal brain lesions and found them to be of assistance in evaluating the localization of pontomedullary, pons, midbrain, thalamus, subcortical and functional recovery. 1) Distortion of early components (type I) was occured in the brainstem lesions. 2) Distortion of late components (type II) was developed in the diencephalon or subcortical lesions. 3) Distortion of all components (type III) was developed in the brainstem and diffuse brain contusions. 4) Serial recordings provided information about the evolution of brain stem lesions and good functional recovery marker.
Auditory Pathways ; Brain Injuries ; Brain Stem* ; Brain* ; Diencephalon ; Electrodes ; Electrophysiology ; Evoked Potentials* ; Evoked Potentials, Auditory, Brain Stem ; Humans ; Mesencephalon ; Permeability ; Pons ; Scalp ; Thalamus

Since every component of the evoked response is considered to relate with topographically specific neural structure, it is possible that the location and severity of brain dysfunction could be defined by careful analysis of evoked responses. The purpose of this investigation was to study the change in cardiopulmonary functions, somatosensory evoked potential(SEP) following a right occipitofrontal missile injury in cats and to evaluate the effects of mannitol on them. Forty adult cats weighing 2.7 to 4.2 Kg were divided into operated control(n=20) group and mannitol treated group(n=20). In each group cardiopulmonary functions and SEP were checked on 1 min, 10 min, 30 min, 1 hour and 6 hours after missile injury. 1) After injury with a pellet at 90m/sec, there was rapid rise in intracranial pressure, bradycardia, changes in blood pressure and marked alteration in respiration. 2) The somatosensory evoked potential was detected shortly after injury and markedly altered in shape. The early components(N0, N1) of the SEP were suppressed first, followed by the late component(N2) of the SEP in the control group. This suggests that the specific somatosensory pathways are most vulnerable to high kinetic missile-injury. The late component of SEP(N2) was easily and severely suppressed possibly used due to functionally interrupted brainstem multisynaptic pathway and nearly not recovered. At an intracranial pressure(ICP) of 29 cmH2O, the early components(N0, N1) of SEP were significantly suppressed to 80% of the normal control. At the ICP higher than 40 cmH2O, not only N0, N1 appeared flat, but also the N2 was suppressedzz.
Adult ; Animals ; Blood Pressure ; Bradycardia ; Brain ; Brain Stem ; Cats ; Craniocerebral Trauma ; Evoked Potentials, Somatosensory* ; Humans ; Intracranial Pressure ; Mannitol* ; Respiration ; Wounds, Gunshot

No abstract available.
Humans ; Infant* ; Intracranial Aneurysm* ; Middle Cerebral Artery

PURPOSE: Psychometric properties of the overactive bladder questionnaire (OAB-q) were recently examined. However, since the cross-cultural adaptation of a non-English version of the OAB-q has never been demonstrated, we evaluated the psychometric properties of a Korean version of the OAB-q in a Korean population with OAB. METHODS: A prospective cohort study involving 116 women with 58 OAB and 58 control subjects was performed and convergent validity was assessed. Total and subscale OAB-q scores of the control and OAB groups were compared to their sensitivity to score changes before and after administering anti-cholinergic medication for 12 weeks. Short form 36 and King's health questionnaire (KHQ) were also used for comparison or correlation. RESULTS: Assessment of face validity showed that the Korean version of the OAB-q was reasonable with OAB-q subscale scores being significantly different between the control and patient groups. Significant correlation (range, -0.29 to -0.81) was found between the OAB-q scores and KHQ results for the OAB patients. Cronbach's alpha coefficients (range, 0.77 to 0.95) indicated excellent internal consistency and test-retest analysis involving 35 OAB patients showed that each questions as well as subscale scores were reproducible. Each score of OAB-q also showed statistically significant sensitivity to changes following anti-muscarinic treatment for OAB (n=27, P<0.001 except for social, P=0.059). CONCLUSIONS: The Korean version of the OAB-q is a valid and reliable instrument to measure outcomes in Korean patients with OAB.
Cohort Studies ; Female ; Humans ; Prospective Studies ; Psychometrics ; Quality of Life ; Urinary Bladder, Overactive

With increasing life expectance and improvement of the overall health of the elderly, the understanding of geriatric disease becomes an important aspect of medical services. In the elderly, the frequencies of hypertension, DM, & anemia are increased according to aging and renal function is decreased progressively. As screening test for cervical cancer Papanicolaou smear is recommended due to its cost-effective benefits in females. In age-adjusted elderly male and female study populations, authors investigated the alterations of the above diseases, hypercholesterolemia, liver disease, obesity, & proteinuria distributions. METHODS: This study included 1,181 aged 40 years (600 males, 581 females) visitors between January 1, 1997 and December 31, 1997 in National Medical Center, Seoul, South Korea. Authors divided these populations into two large groups such as group A and B. Group A was composed of 40-59 years, group B 60 years and older. Group A and B were subdivided into 4 subgroups each other, such as A-1, A-2, A-3 and A-4, B-1, B-2, B-3 and B-4 by means of age-adjusted dividing scale. We used our inclusion criteria to define each disease. RESULTS: Hypertension was the most common disease in males of group B, but obesity was in females. The age-adjusted frequencies of hypertension, anemia, obesity & proteinuria were increased according to aging in the elderly aged 60 years and older. Though hypercholesterolemia revealed non-specific distribution in each group, increased frequency was observed in females compared to males in group B. With increasing their age, abnormal findings of Papanicolaou smear were found in females of group B. CONCLUSIONS: As the frequencies of hypertension, anemia, obestiy, proteinuria & abnormal findings of Papanicolaou smear were increased in the elderly aged 60 years and older as increasing their age. Much more attentions and follow up plans for these disease should be needed in the elderly.
Aged* ; Aging ; Anemia ; Attention ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Liver Diseases ; Male ; Mass Screening ; Obesity ; Papanicolaou Test ; Proteinuria ; Seoul ; Uterine Cervical Neoplasms