PURPOSE: To describe the appearance and average thickness of the internal anal sphincter with anal endosonography in healthy Korean adults. MATERIAL AND METHODS: 184 subjects(male: 96, female: 88) with no history of anorectal disease or surgery were studied with anal endosonography. The average thickness of internal sphincter was meas ured at the mid-anal canal. For the internal sphincter, which is often asymmetric, the thickness of each 4 part(12, 3, 6 and 9 o'clock direction) were measured in left lateral decubitus position. RESULTS: The anal wall was well visualized in 5 layers(mucosa, submucosa, internal anal sphincter, intersphincteric plane, external anal sphincter) with anal endosonography. The anal endosonogram showed the internal anal sphincter as a homogenous, well-defined, hypoechoic, circular band, and slightly asymmetric. The average thickness of the internal anal sphincter in the area of mid-anal portion was 2.0 0.3 mm(range: 1~3 mm). There was no sexual difference; however, a significant positive correlation with age was found in average thickness of the internal anal sphincter. The correlation with lean body mass was not found. CONCLUSION: The internal anal sphincter is well-visualized, best defined structure by anal endosonography. Average thickeness of the sphincter in Korean appeared to be the same as in the Western.
Adult* ; Anal Canal* ; Endosonography ; Female ; Humans

p53 is a tumor suppressor gene product identified in a wide range of tumor including colorectal carcinoma. Genetic alterations in the p53 tumor suppressor gene are common in human colorectal carcinoma. bcl-2 is a protooncogene that inhibits apoptosis. The products of mutant p53 gene and bcl-2 have been associated with prognosis in several malignancies including colorectal carcinomas. This study was undertaken to evaluate values of p53 and bcl-2 oncoproteins as prognostic factors relative to clinicopathological factors and correlation of their expression. Analyses were made on achieval pathologic tissues of 80 patients with colorectal carcinomas including 34 patients able to follow-up over 5 years. The oncoproteins were localized using commercially available monoclonal antibodies:DO-7 for p53, clone124 for bcl-2. Expression of bcl-2 was cytoplasmic, whereas nuclear p53 expression was localized in carcinoma cells. The patients were 17 to 83 years of age. The expression of p53 and bcl-2 was determined respectively in 30 (37.5%) and 21 (26.3%)cases. The expression of p53 nuclear expression was not correlated with tumor location, size, histologic grade, Duke's classification, regional lymph node metastasis and tumor recurrence. The cytoplasmic expression of bcl-2 was not correlated with tumor location, size, histologic grade, Duke's classification, regional lymph node metastasis and recurrence. Univariate analysis showed that patients with p53 nuclear expression were not associated with poorer overall survival than patients with p53 negative, and also showed in patients with bcl-2 expression. The expression of p53 did not affect to that of bcl-2. We concluded that the p53 nuclear and bcl-2 cytoplasmic expression were not independent prognostic factors in colorectal carcinomas. Evidence of reciprocity of bcl-2 and p53 expression was not found.
Apoptosis ; Classification ; Colorectal Neoplasms* ; Cytoplasm ; Follow-Up Studies ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogene Proteins ; Prognosis ; Recurrence

There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

No abstract available.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Humans

No abstract available.
Durapatite*

Twenty seven patients with known rectal cancer were evaluated with CT and CT findings were correlated with surgical and pathologic results on the aspect of perirectal fat infiltration and lymph node involvement. The accuracy in assessment of perirectal fat infiltration was 77.8% (21 of 27); sensitivity, 73.3% (11 of 13); specificity, 83.3% (10 of 12). In the detection of lymph node involvement, lymph nodes were divided into five groups according to the arterial teritories. Overall accuracy in the evaluation of lymph node involvement was 86.7%. Accuracy of peritumoral lymph node involvement was 51.9% (14 of 27); sensitivity, 42.9%(9 of 21); specificity 83.3% (5 of 6). Accuracy of internal iliac lymph node involvement was 88.9% (24 of 27); sensitivity, 85.7% (6 of 7); specificity, 90.0% (18 of 20). Of the common and external iliac lymph node, accuracy was 100% (27 of 27); sensitivity, 100% (2 of 2); specificity, 100% (25 of 25). Of the aortic bifurcation and mid sacral lymph node, accuracy was 92.6% (25 of 27); sensitivity, 50% (2 of 4); specificity, 100% (23 of 23). In regard to the inferior mesenteric lymph node, no lymphadenopathy was found on CT and pathologic results. In conclusion, CT has limited value in evaluating rectal cancer but with the satisfactory outcome in assessment of perirectal fat infiltration and lymph node, involvement except peritumoral node preoperative CT is useful in the evaluation of rectal cancer.
Humans ; Lymph Nodes* ; Lymphatic Diseases ; Rectal Neoplasms* ; Sensitivity and Specificity

There are many methods in reconstruction for skin defect in hand and forearm. Among them, reverse ulnar artery forearm flap has several advantages which are versatile, safe and convenient flap. We report 6 cases of our experiences.
Forearm Injuries ; Forearm ; Hand ; Skin ; Ulnar Artery

PURPOSE: Arteriovenous fistula at the wrist has remained the procedure of choice for long-term chronic hemod ialysis since its development by Brecia and Cimino in 1966. Thrombosis is the most common cause of early failure after arteriovenous fistula procedure, should be reconized preoperatively or intraoperatively, but no consensus exits regarding the ideal preoperative or intraoperative screening method for access surgery. We describe a simple intraoperative maneuver that can be used to detect proximal stenotic vein segments. METHODS: From September 1998 to September 1999, a total of 117 arteriovenous fistulas were performed for permanent hemodialysis in patients with chronic renal failure. Of them, a intraoperative evoked thrill test was performed in 61 patients (A group), in 56 patients (B group or control group) was not. RESULTS: Early failure rate (<30 days) was 12.5% in A group, 9.8% in B group or control group. In this study, the specificity and positive predictive value of the evoked thrill test was 100%, indicating that this maneuver is highly accurate in predicting early failure. CONCLUSION: Evoked thrill test is a simple and useful intraoperative method for improving the patency rate of autologous arteroiovenous fistula.
Arteriovenous Fistula* ; Consensus ; Fistula ; Humans ; Kidney Failure, Chronic ; Mass Screening ; Renal Dialysis ; Sensitivity and Specificity ; Thrombosis ; Veins ; Wrist

PURPOSE: To report a case of corneal ulcer due to Alcaligenes faecalis in a patient with a preexisting corneal ulcer. CASE SUMMARY: A 58-year-old male patient presented with a corneal ulcer without a history of any trauma. The patient had a history of corneal ulcer 9 months earlier. The patient had previously been diagnosed with diabetic retinopathy and neovascular glaucoma, and his visual acuity was no light perception. Corneal scraping and culture yielded Alcaligenes faecalis susceptible to most antibiotics in the antibiotic susceptibility test. After treatment with empirical systemic antibiotics and eyedrops, his eye improved with a remaining corneal scar. CONCLUSIONS: Alcaligenes faecalis should be considered as a causal pathogen of corneal ulcer in patients with suspicious compromised ocular surface, such as previous corneal ulcer.
Alcaligenes ; Alcaligenes faecalis ; Anti-Bacterial Agents ; Cicatrix ; Corneal Ulcer ; Diabetic Retinopathy ; Eye ; Glaucoma, Neovascular ; Humans ; Light ; Male ; Middle Aged ; Ophthalmic Solutions ; Visual Acuity

PURPOSE: To investigate whether autologous platelet-rich plasma (PRP) treatment can improve regeneration of the endometrium in an experimental model of ethanol-induced damage. MATERIALS AND METHODS: Sixty female Sprague-Dawley rats were randomly assigned into three groups: control group, ethanol group, and PRP-treated group (administration of 0.25 mL of PRP into both uterine cavities 72 hours after ethanol injection). After 15 days of endometrial damage, all the animals were sacrificed during the estrous cycle, and samples were taken from the mid-uterine horn. Functional and structural recovery of the endometrium was analyzed by hematoxylin-eosin (H&E) and Masson trichrome (MT) staining, real-time polymerase chain reaction (PCR) assay, and immuno-histochemical (IHC) analyses. RESULTS: H&E and MT staining confirmed significantly decreased fibrosis and increased cellular proliferation in the PRP-treated group, compared to the ethanol group. The endometrial areas in the ethanol and PRP-treated groups were 212.83±15.84 µm² and 262.34±12.33 µm² (p=0.065). Significantly stronger IHC expression of cytokeratin, homeobox A10 (HOXA10), vascular endothelial growth factor (VEGF), and Ki-67 was found in the PRP-treated group, compared to the ethanol group. In real-time PCR analyses, interleukin-1β mRNA was down-regulated, while c-Kit mRNA was up-regulated, in the PRP-treated group, compared to the ethanol group. CONCLUSION: Intrauterine administration of autologous PRP stimulated and accelerated regeneration of the endometrium and also decreased fibrosis in a murine model of damaged endometrium.
Animals ; Cell Proliferation ; Endometrium* ; Estrous Cycle ; Ethanol ; Female ; Female* ; Fibrosis ; Genes, Homeobox ; Horns ; Humans ; Keratins ; Models, Theoretical ; Platelet-Rich Plasma* ; Rats* ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Regeneration* ; RNA, Messenger ; Vascular Endothelial Growth Factor A