Early detection of glaucoma by mass screening is the most practical approach for prevention of blindness. An epidemIOlogical study gives the most essential information on prevalence an distribution of the disease in relation to diverse background factors. But, before now, an epidemiological study for glaucoma has not been carried out in Korea. Our glaucoma survey was conducted in the health examination center of Yongdong Severance hospital during 1990 and 1991. The total numbers of subjects examined was 4424 persons aged 30 years or older. A mainstay of the screening consisted of applanation tonometry and fundus photography with a non-mydriatic camera, followed by automated perimetry as a recall examination. Overall prevalences of glaucoma obtained were primary open angle glaucoma 0.23% (10 patients), low tension glaucoma 2.04% (108 patients), and ocular hypertension 0.23% (10 patients). The mean lOP obtained with applanation tonometry was 14.04 +/- 2.99 mmHg for men and 14,07 +/- 2.67 mmHg for women. In additon, our data have pointed out that the lOP in different ages tends to be constant, whereas prevalences of glaucoma and low tension glaucoma increase with aging.
Adult* ; Aging ; Blindness ; Epidemiologic Studies ; Female ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Korea ; Low Tension Glaucoma ; Male ; Manometry ; Mass Screening ; Ocular Hypertension ; Photography ; Prevalence* ; Visual Field Tests

BACKGROUND: Intense pulsed light(IPL) systems are high intensity pulsed sources which emit noncoherent, defocused, polychromatic light in a broad wavelength spectrum of 400-1200nm. The mechanism of action of such light systems corresponds to the selective photothermolysis.Nowdays, IPL system widely used in dermatologic field such as unwanted hair removal, epidermal melanocytic lesions, vascular lesions, and photorejuvenation OBJECTIVE: The purpose of this study was to evaluate the clinical results of diverse epidermal melanocytic lesions after treatment with an IPL source. METHOD: Twenty patients with epidermal melanocytic lesions were enlisted. IPL treatment was administered to the patients in a 4-week sessions. Irradiation wavelength was controlled using cutoff filters ranging from 400 to 700nm, with a fluence of 10-13.5J/cm2 with double pulse illumination and a pulse width of 7msec. RESULTS: By the end of the study, three attending physicians assessed the results for 85% of the subjects as excellent or good, with 85% of the patients reporting that same results; however, deep lesion such as Becker's nevus showed an average clearance of fair. No specific adverse effects except two case of blisters were observed after treatment. CONCLUSION: Treatment of epidermal melanocytic lesions in Asian skin using IPL is an effective, safe, and rapid treatment, with relatively few side effects and high patient satisfaction.
Asian Continental Ancestry Group ; Blister ; Hair Removal ; Humans ; Lighting ; Nevus ; Patient Satisfaction ; Skin

BACKGROUND: Preoperative identification of systemic and pulmonary venous return is essential for surgical design in situs ambiguus. This study was carried out to evaluate anatomy of systemic and pulmonary venous return and to assess clinical efficacy of magnetic resonance imagine(MR) by comparing with results of cardiac catheterization(Cath) and echocardiography(Echo). MATERIALS AND METHODS: MR performed on 22 patients with cardiac situs ambiguus(right isomerism ; 13, left isomerism ; 9). MR findings were compared with the findings of Cath and Echo for the assessment of diagnostic accuracy of MR in 19 patients. RESULTS: 1) Interruptions of IVC with azygous continuation were found in all patients of left isomerism. But IVC was drained to right of left sided atria in right isomerism. 2) Brlateral SVC were found in 12 of 22 situs ambiguus(left isomersm ; 5, right isomerism ; 8). 3) Total anomalous pulmonary venous returns(TAPVR) were found in 7 of 12 right isomerism. Location of vertical veins were as follows ; prearterial(n=1), retroarterial-prebronchial(n=3), retrobronchial(n=3). In 5 patients of remained 6 right isomerism, pulmonary venous returns(PAPVR) in which right and left pulmonary veins entered to right and left atrium respectively, were found in 5 of 9 left isomerism. 4) Compared with Cath and Echo findings(n=19) in which MR, Cath and Echo were performed simultaneously, TAPVR were found in 6 cases on MR but 2 cases on Cath and Echo. The cases that were not detected by Cath showed severe decrement of pulmonary flow due to hypoplasia of pulmonary artery or obstruction of pulmonary vein. On MR, accurate anatomy of PAPVR were found only in 4 cases. CONCLUSIONS: MR can provide accurate and complete imaging of systemic and pulmonary venous return in sitrs ambiguus. Especially, MR is superior to Cath or Echo in depiction of TAPVR with severe decrement of pulmonary flow of obstruction of pulmonary vein, PAPVR and bilateral SVC.
Heart ; Heart Atria ; Heterotaxy Syndrome* ; Humans ; Isomerism ; Pulmonary Artery ; Pulmonary Veins ; Scimitar Syndrome ; Veins

A radioisotope first pass study was done on patients over a period of 1 to 15 years (average 4.6 years) after repair for ventricular septal defect or arterial septal defect with a left to right shunt. The age of the patients ranged from 6 to 32 years (average 14.2 year) at the time of the study. The total work of exercise and the right and left ventricular ejection fraction(EF) were evaluated at rest and after exercise. The results were compared with the preoperative hemodynamic findings and with the age of patient at the time of the operation. 1) When the total work of exercise was divided with the maximal exercise capacity of the normal individual corresponding to the patients' height and body surface area (the percentage of total work), it were very low with the average of 40% of normal. There was no sexual difference, but the percentage of total work of exercise had significant correlation with the patients' age at the time of operation (r = -0.52,p<0.01) and post-exercise left ventricular ejection fraction (LVEF)(r = -0.39,p<0.05). 2) LVEF at rest had some correlation with the preoperative mean pulmonary arterial pressure (r = -0.29, p = 0.05), but showed no relationship with Qp/Qs or Rp/Rs ratios. The right ventricular ejection fraction (RVEF) at rest had no relations with the preoperative hemodynamic findings with maximal workload. 3) The post-exercise RVEF showed linear correlation with the preoperative Rp/Rs ratio (r = -0.49,p<0.005), and mean pulmonary arterial pressure (r = -0.37,p<0.05). The post-exercise LVEF had no significant correlation with any preoperative hemodynamic factors. 4) When greater than 5% increase in ventricular EF after exercise is considered normal, the group with the normal right and left ventricular responses (n = 11) showed normal preoperative Rp/Rs ratio (7.6 +/- 4.1). In the group with normal left, but abnormal right ventricular response (n = 9) and the group with abnormal biventricular response (n = 11), both demonstrated incremental increase in Rp/Rs ratio (20.1 +/- 11.3, 26.3 +/- 19.8 respectively). Normal right, but abnormal left ventricular reaction (n = 2) was noted in patients with residual aortic valvular insufficiency and residual ventricular septal defect. In conclusion, post-operative ventricular response was much more sensitive and informative than that of ventricular function at rest and to detect subclinical cardiac dysfunction. Post-exercise RVEF was closely correlated with preoperative pulmonary vascular hemodynamics, while post-exercise LVEF seemed to be a majo determinant of working capacity after repair.
Adolescent ; Adult ; Child ; Child, Preschool ; Exercise Test ; *Exertion ; Female ; Heart Defects, Congenital/*physiopathology/radionuclide imaging/*surgery ; Human ; Infant ; Male ; *Stroke Volume

We performed this study to evaluate hepatic venous drainage in atrial isomerism by MR and the clinical significance of anomalous hepatic venous return in total cavopulmonary shunt operation. Numbers and locations of hepatic veins in twenty-two patients with isomerism(thirteen with right isomerism and nine with left isomerism) were evaluated by MR. Operative procedure of hepatic veins and postoperative arterial oxygen saturation were compared with hepatic vein connection in six patients after total cavopulmonary shunt operation. Among nine patients with left isomerism, hepatic venous return was totally anomalous via a single opening in eight, and via two separate openings in one. Among thirteen patients with right isomerism, partial anomalous hepatic venous connection directly to the atrium was seen in four. One showed total anomalous hepatic venous connection to atrium through one opening. Total cavopulmonary shunt operation was performed in 6 patients. Hepatic veins were connected to pulmonary arteries in four patients who had one atrial opening of hepatic vein and/or IVC, or two ipsilateral atrial opening of hepatic veins and IVC. In conclusion, hepatic vein drainage to atrium is variable in atrial isomerism. MR is useful for evaluation of hepatic vein drainage in atrial isomerism and surgical planning.
Drainage ; Heart Bypass, Right ; Heart Defects, Congenital ; Hepatic Veins ; Humans ; Isomerism* ; Magnetic Resonance Imaging ; Oxygen ; Pulmonary Artery ; Surgical Procedures, Operative

PURPOSE: The purpose of this retrospective study is to evaluate the prognostic significance of lymph node dissection in gastric cancer surgery. MATERIALS AND METHODS: We analysed the survival curves of 1661 cases of gastric cancer patients who received gastric resection from 1987 to 1991, in whom the number of dissected lymph nodes is more than 9 (to minimize stage migration). We used modified TNM system with numeric classification. RESULT: The average number of resected lymph nodes of the study group was 31.5 and there was no significant difference in the average number of resected lymph nodes during the study period. In stage I, IIa, IIb and IV, there was no significant difference in survival curves according to the number of resected lymph nodes (25, 35 or 45). However, in stage IIIa, the 5-year survival rate (5YSR) was better in the patients (n=171) of more than 25 lymph nodes than in the patiens (n=104) of less than 26 resected lymph nodes (64.1% vs. 59.9%, p=0.031). In stage IIIb, 5YSR was better in the patients (n=206) of more than 35 lymph nodes than in the patients (n=307) of less than 36 lymph nodes (33.2% vs. 18.3%, p=0.029). In multivariate analysis, number of dissected lymph node was an independent prognostic factor. CONCLUSION: Survival benefit of extended lymph node dissection in the gastric cancer surgery is limited in the stage IIIa and IIIb and the recommended number of dissection is more than 35. This study also suggests a positive correlation between tumor stage and required quantity of lymph node dissection for better survival (>25 for stage IIIa and >35 for stage IIIb).
Classification ; Humans ; Lymph Node Excision* ; Lymph Nodes* ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

Purpose : Early colorectal cancer is defined as the depth of tumor invasion limited to mucosa or submucosa regardless of the presence or absence of lymph node metastasis. We performed a retrospective study to determine the chronological changes in frequencies of early colorectal cancer and clinicopathologic differences between early colorectal cancer (ECC) and advanced colorectal cancer (ACC). Methods : We reviewed hospital records of the patients with colorectal cancer operated between January 1990 and December 1995. We classified the patients into two groups, ECC and ACC, according to the depth of tumor invasion and compared the clinicopathologic characteristics. Results : Fifty eight patients (5.2%) were diagnosed with early colorectal cancer among 1113 colorectal cancer patients operated at the same period. The frequency of ECC has increased from 1.9% in 1970~1989 to 5.2% in 1990~1995. The average age of patients with ECC at the time of surgery was 55.8 compared to 56.5 for patients with ACC group (p>0.05). Most patients (72.4%) with ECC had bleeding symptoms and majority of the ECCs were located in the rectum (72.4%). The mean size of tumors was 2.6 cm in its greatest diameter and was significantly smaller than that of ACC (5.7 cm). Compared to ACC, ECC had better histologic differentiation and fewer lymph node metastases (p<0.05). Thirty six of the ECC patients underwent bowel resection and remaining 22 underwent local excision. After a mean follow up period of 39.1 months (range 2~81months), recurrence was detected in one case. There was no death during the follow up period. Conclusion : The frequency of ECC has increased recently. Compared to patients with ACC, patients with ECC had more favorable clinicopathologic characteristics and better outcome. In selected patients, minimal operation can be applied without compromising the clinical outcome.
Colorectal Neoplasms* ; Follow-Up Studies ; Hemorrhage ; Hospital Records ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies

BACKGROUND: S100A6 is a calcium-binding protein overexpressed in several tumor cell lines including melanoma with high metastatic activity and involved in various cellular processes such as cell division and differentiation. To detect S100A6 protein in patient' samples (ex, blood or tissue), it is essential to produce a monoclonal antibody specific to the protein. METHODS: First, cDNA coding for ORF region of human S100A6 gene was amplified and cloned into the expression vector for GST fusion protein. We have produced recombinant S100A6 protein and subsequently, monoclonal antibodies to the protein. The specificity of anti-S100A6 monoclonal antibody was confirmed using recombinant S100A recombinant proteins of other S100A family (GST-S100A1, GST-S100A2 and GST-S100A4) and the cell lysates of several human cell lines. Also, to identify the specific recognition site of the monoclonal antibody, we have performed the immunoblot analysis with serially deleted S100A6 recombinant proteins. RESULTS: GST-S100A6 recombinant protein was induced and purified. And then S100A6 protein excluding GST protein was obtained and monoclonal antibody to the protein was produced. Monoclonal antibody (K02C12-1; patent number, 330311) has no cross-reaction to several other S100 family proteins. It appears that anti- S100A6 monoclonal antibody reacts with the region containing the amino acid sequence from 46 to 61 of S100A6 protein. CONCLUSION: These data suggest that anti-S100A6 monoclonal antibody produced can be very useful in development of diagnostic system for S100A6 protein.
Amino Acid Sequence ; Animals ; Antibodies, Monoclonal ; Cell Division ; Cell Line ; Cell Line, Tumor ; Clinical Coding ; Clone Cells ; DNA, Complementary ; Ecthyma, Contagious ; Humans* ; Melanoma ; Recombinant Proteins ; Sensitivity and Specificity

BACKGROUND: S100A6 is a calcium-binding protein overexpressed in several tumor cell lines including melanoma with high metastatic activity and involved in various cellular processes such as cell division and differentiation. To detect S100A6 protein in patient' samples (ex, blood or tissue), it is essential to produce a monoclonal antibody specific to the protein. METHODS: First, cDNA coding for ORF region of human S100A6 gene was amplified and cloned into the expression vector for GST fusion protein. We have produced recombinant S100A6 protein and subsequently, monoclonal antibodies to the protein. The specificity of anti-S100A6 monoclonal antibody was confirmed using recombinant S100A recombinant proteins of other S100A family (GST-S100A1, GST-S100A2 and GST-S100A4) and the cell lysates of several human cell lines. Also, to identify the specific recognition site of the monoclonal antibody, we have performed the immunoblot analysis with serially deleted S100A6 recombinant proteins. RESULTS: GST-S100A6 recombinant protein was induced and purified. And then S100A6 protein excluding GST protein was obtained and monoclonal antibody to the protein was produced. Monoclonal antibody (K02C12-1; patent number, 330311) has no cross-reaction to several other S100 family proteins. It appears that anti- S100A6 monoclonal antibody reacts with the region containing the amino acid sequence from 46 to 61 of S100A6 protein. CONCLUSION: These data suggest that anti-S100A6 monoclonal antibody produced can be very useful in development of diagnostic system for S100A6 protein.
Amino Acid Sequence ; Animals ; Antibodies, Monoclonal ; Cell Division ; Cell Line ; Cell Line, Tumor ; Clinical Coding ; Clone Cells ; DNA, Complementary ; Ecthyma, Contagious ; Humans* ; Melanoma ; Recombinant Proteins ; Sensitivity and Specificity

PURPOSE: to assess the role of MR imaging in determining of the atrial situs in complicated congenital heart disease with situs ambiguus. MATERIALS AND METHODS: In order to classify the situs, the morphology of atrial appendages, on bronchial length ratio, the superior-inferior relation of the pulmonary artery (PA) and main bronchi on each side, and splenic abnormality were evaluated by MR imaging in 22 patients (12 boys and 10 girls), and the results were compared. RESULTS: In all patients, the superior-inferior relation of the PA and main bronchi tended to lateralize, and in one, bronchial length ratio was not consistent with the relation between the PA and bronchus. Bronchial and atrial situs, as determined by appendage morphology, were consistent in ten of 13 right isomerism patients, and in only three of nine of these with left isomerism. All 13 right isomerism patients, classified by the relation of the PA and main bronchi, showed asplenia, whereas eight of nine of these with left isomerism had polysplenia. CONCLUSION: In the assessment of atrial situs by MR imaging, the positional relation of a bronchus and the PA, bronchial length ratio, and splenic abnormality are constant and reliable. The accuracy of classification of situs on the basis of atrial appendage morphology is, however, limited.
Atrial Appendage ; Bronchi ; Classification ; Heart Defects, Congenital* ; Heterotaxy Syndrome* ; Humans ; Isomerism ; Magnetic Resonance Imaging* ; Pulmonary Artery