PURPOSE: We examined the effect of induced interocular difference of retinal illuminanace on stereopsis. METHODS: Fifty adults who have normal binocularity were examined with neutral density filters. The mean age was 29.1 years. While the monocular retinal illuminance was gradually reduced by increasing the value of neutral density filters, we measured the best corrected visual acuity and stereoacuity with Titmus test and Lang test. We used neutral density filter from 1.0 neutral density (ND, 10% transmit) to 3.0ND (0.1% transmit) with intervals of 0.2ND. RESULTS: The best corrected visual acuity began to decrease significantly when the value of neutral density filter reached 2.0ND (1% transmit). Stereoacuity also began to decline when the value was 1.4ND(4% transmit) with Titmus test and 1.6ND (2.5% transmit) with Lang test. CONCLUSIONS: Change of retinal illuminance effects more on stereoacuity than visual acuity as stereoacuity decreased earlier by increasing the value of density filters. These results imply that the stereopsis test could be more useful than visual acuity test for detecting ocular abnormalities influencing the retinal illuminance.
Adult ; Depth Perception* ; Humans ; Retinaldehyde* ; Telescopes* ; Visual Acuity

In order to compare the accuracy of impression technique using the addition silicone putty and improved heavy body material, impression were taken for the natural 6 maxillary anterior teeth, and for the metal mast model that has full arch shape with 4 cylindrical abutment teeth, Marginal gingiva was retracted by routine method using retraction cord, and two techniques were tried to compare the length of impression materials in the gingival sulcus. This was aimed to see the effect of viscosity and hydraulic pressure of impression materials for the subgingival impression. Impressions for the full arch-shaped metal master model were taken to compare the linear stability of the different impression materials and their related techniques. The conclusions were as belows : 1. The one-step impression technique showed longer extension of impression material in gingival sulcus than two-step impression technique. 2. High viscosity and hydraulic pressure of impression material were useful to take subgingival impression. 3. There was no statistically significant difference for the two-dimensional accuracy of impression technique, but two-step technique showed better trend than one-step technique.
Gingiva ; Silicones ; Tooth ; Viscosity

This study was conducted to clarify the strategy of surgical treatment for stage IV hepatocellular carcinoma (HCC), for which no effective treatment modality is present so far. There were 29 patients (20.3%) with stage IV HCC among 143 HCC patients who underwent partial liver resection during the period from Jan. 1985 through Jul. 1996 at our department. The mean age was 53 years with a range of 18 to 76 years. There were 23 men and 6 women with a ratio of 4:1. Positive rates for HBsAg and HCV Ab were 55.2% and 12.5%, respectively. Ninety per cent of the patients were complicated by chronic liver disease. Abdominal pain and/or mass were the predominating symptoms in about 60% of the patients. Serum AFP level was elevated above 20 ng/ml in 72.4% of the cases. Twenty-three patients harbored stage IV-A disease and 6 patients IV-B disease. The main surgical procedures used in the cases were trisegmentectomy in 3, lobectomy in 12, segmentectomy in 12, subsegmentectomy in 1 and wedge resection in 1. Additionally wedge resection of the liver was performed in 6 cases and ethanol injection in 9 cases. Among 11 cases with tumor thrombus in large portal veins, successful tumor thrombectomy was conducted in 7 of them. Out of 22 patients with stage IV-A HCC, complete tumor removal was possible in 8 and ethanol injection into the residual tumor was executed in another 6. The mean operation time was 282 minutes and the mean transfusion 4 pints. Four patients (13.8%) suffered from postoperative complications, 2 of whom succumbed to liver failure 2 months postoperatively. The cumulative survival rates at 1, 2, and 3 years after surgery were 33.5%, 15.7%, and 10.5%, respectively, with a median survival time of 10 months. The longest survivor is alive 58 months after surgery. Significant prognostic factors were gross portal vein thrmobosis, invasion into adjacent tissues, tumor rupture, and the development of complications. In particular, the survival of patients with stage IV-A HCC who underwent complete tumor removal was not statistically different from that of those who had an absolute noncurative operation plus intraoperative ethanol injection into the residual tumors. For stage IV-A HCC surgical treatment is considered to be effective when all the tumors can be removed or when the residual tumors can be treated by intraoperative ethanol injection.
Abdominal Pain ; Carcinoma, Hepatocellular* ; Ethanol ; Female ; Hepatitis B Surface Antigens ; Humans ; Liver ; Liver Diseases ; Liver Failure ; Male ; Mastectomy, Segmental ; Neoplasm, Residual ; Portal Vein ; Postoperative Complications ; Rupture ; Survival Rate ; Survivors ; Thrombectomy ; Thrombosis

No abstract available.
Gastric Emptying*

The relationship between visual acuity, the level of visual field impairment, visual functioning, and the quality of life was evaluated in Korean patients with glaucoma. Forty-three consecutive glaucoma patients from the glaucoma service at Severance Eye and Ear Hospital were included in this study. Each subject underwent a vision-specific functional status questionnaire (VF-14), a modified VF-14 (VF'-14) and general quality-of-life questionnaires of the Medical Outcomes Study 36-Items Short Form Health Survey (SF-36). The visual acuity and visual field measurements with a Humphrey automated perimeter were taken within one month of the initial visit. The mean age of the subjects was 57.9 +/- 17.8. Among these patients, there were 23 males and 20 females. The mean deviation (MD) and the corrected pattern standard deviation (CPSD) by the automated perimeter in the eye with the better visual acuity were -5.87 +/- 5.16 dB and 3.92 +/- 2.74 dB respectively. The VF-14 and SF-36 scores were 41.28 +/- 14.56 and 52.39 +/- 6.61 respectively. There were significant correlations between the VF-14, VF'-14, and the MD of the better eye (p < 0.05). In Korean patients with glaucoma, the VF-14 and VF'-14 have significant relationship with the MD of the better eye in the visual field.
Female ; Glaucoma/physiopathology/*psychology ; Health Surveys ; Human ; Korea ; Male ; Middle Aged ; Quality of Life/*psychology ; Questionnaires ; Visual Acuity/*physiology ; Visual Fields

We have recently experienced a rare case of extradural epidermoid cyst in the left middle cranial fossa associated with trigeminal neuralgia. A 22-year old female has intermittently developed lancinating pain in the left of face and dark reddish rhinorrhea for 5 years. Plain skull films showed an elevation of lesser wing of sphenoid bone and protrusion of left zygomatic arch with deepening of left middle cranial fossa. Carotid angiograms and brain scan with technetium 99m revealed a large cystic mass in left middle cranial fossa. A left temporal craniotomy was done and a large cystic mass filled with dark bluish colored fluid was removed at the left middle cranial fossa. Postoperatively the trigeminal neuralgia subsided completely. We have discussed the pathogensis and clinical symptoms with the review of the literatures.
Brain ; Cranial Fossa, Middle* ; Craniotomy ; Epidermal Cyst* ; Female ; Humans ; Skull ; Sphenoid Bone ; Technetium ; Trigeminal Neuralgia* ; Young Adult ; Zygoma

OBJECTIVE: The Id family of helix-loop-helix proteins are thought to affect the balance between cell growth and differentiation by negatively regulating the function of basic-helix-loop-helix (bHLH) transcriptional factors. The aim of this study was to investigate the expression pattern of Ids (Id-1,-2,-3, and -4) in preimplantation mouse embryos at mRNA and protein levels. METHODS: Oocytes and preimplantation embryos were collected from reproductive organs of female ICR mice following superovulation. RT-PCR was performed to investigate the mRNA expression patterns of Id genes and their protein were localized by immunofluorescence analysis. RESULTS: Id-1 and Id-3 mRNAs were strongly expressed at the germinal vesicle (GV) oocyte and the blastocyst stages. Id-2 mRNA was expressed throughout preimplantation embryo development, but Id-4 was not expressed. Immunofluorescence showed that Id-1 and Id-2 were predominantly localized in cytoplasmic region, but the immunofluorescence signal of Id-3 was weak throughout preimplantation embryo development. CONCLUSION: These data show for the first time that Ids are expressed in preimplantation mouse embryos and suggest that Ids may play an important role in early preimplantation embryo development and uterine physiological changes.
Animals ; Blastocyst ; Cytoplasm ; Embryonic Development ; Embryonic Structures* ; Female ; Fluorescent Antibody Technique ; Humans ; Mice* ; Mice, Inbred ICR ; Oocytes ; Pregnancy ; RNA, Messenger ; Superovulation

BACKGROUND: Over the decade, Klebsiella pneumoniae resistant to broad-spectrum oephalosporins have been involved in hospital outbreaks, particulaly in intensive care units. Betwem March 20 and June 12. 1900. an outbreak of sepsis caused by multiresistant K. pneumoniae in the neonatal intensive care unit (NICU) of Asan Medical Center. This paper describes bacteriologic, molecular and epidemiologic features of the outbreak. METHODS: For surveillance purpose, stool specimens were obtained from all patients, nurses and house staff in NICU and cultured onto MacConkey agar medium containg cefotaxim, (10 microgram/ml). All K. pneumoniae isolated blood culture isolates form patients with sepsis were tested for antobiogram by microbroth dilution method and for detection of extended-spectrum beta-Iactamase (ESBL) by double disk synergy test and ESBL Etest. Restriction profiles of total genomic DNAs were compared by pulsed filed gel electrophoresis(PFGE) after cleavage by Xbal. beta-Lactamase was tested using nitroefin disks and characterized by transconjugation to Escherichia coli and isoelectric focusing. For infection control, all infected or colonized patients and nurses were cohorted into a separate room and strict barrier precautions were enforced. RESULTS: The outbreak involved 7 patients with sepsis form whom multiresistant. K. pneumoniae were isolated. Surveillance culture revealed that 9 of 37 patients and 2 of 48 nurses and house staff were colonized. The 18 isolates showed 8 different antimicrobial resistance patterns with cefotaxime resistance in all. Test for ESBL was positive in all 18 isolates but only 15 isolates by ESBL Etest. PFGE analysis showed that 6 of the 7 blood isolate from infected patient and 9 of the 11 fecal isolates from surveillance cultures were of the identical or very similar pattern. beta-Lactamase activities were transferable by conjugation in all but one isolate. No additional case of multiresistant. K. pneumoniae infection had been reproted for 6 months since the introduction of strict barrier precautious and other infection control measures. CONCLUSION: The outbreak was caused by ESBL-producing K. pneumoniae which appeared to be introduced into the NICU from multiple sources as was indicated by PFGE patterns. An optimal laboratory method for screening for ESBL remain to be developed as the double disk synergy test and ESBL Etest did not show complete agreement. As for infoction control our results emphasize the necessity of early recognition of outbreaks, cohorting of not only infected but also colonized patients and reinforcement of the barrier precuations for the prevention of further spread of cross-infections.
Agar ; beta-Lactamases* ; Cefotaxime ; Chungcheongnam-do ; Cohort Studies ; Colon ; Cross Infection* ; Disease Outbreaks ; DNA ; Escherichia coli ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care Units ; Intensive Care, Neonatal* ; Internship and Residency ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Mass Screening ; Pneumonia ; Sepsis

No abstract available.
Umbilical Cord*

In deep sclerectomy, collagen implant has been used to maintain space under the scleral flap. However, the effect of other implants has not been studied. In this retrospective study, we compared surgical outcomes between small collagen and chromic catgut used as implants in deep sclerectomy. Deep sclerectomy was performed on 23 patients (25 eyes) who either had an open angle and a high intraocular pressure (IOP) (> 22 mmHg) in spite of receiving the maximal tolerable medical treatment, or who were intolerant to medications. Our study consisted of 14 patients (15 eyes) in the small collagen group and 8 (9 eyes) in the chromic catgut group. The mean follow-up period was 8.6 +/- 3.3 months in the small collagen group and 4.4 +/- 1.2 months in the chromic catgut group. The mean preoperative IOP was not significantly different between the two groups. The complete success rate of the small collagen group was significantly better than that of the chromic catgut group at the final follow-up when data were analyzed using the Kaplan-Meier survival curve (87% versus 30%; P = .01). As for the qualified success rate, the small collagen group showed significantly better results at the final follow-up (93% versus 80%; P = .046). The mean number of postoperative medications was significantly lower in the small collagen group (0.26 versus 1.10; P < .05). These results confirmed that the use of small collagen implant in deep sclerectomy produced a higher success rate and a lowered need for postoperative medication compared to the use of chromic catgut implant. Because equal sized implants were used, the difference in biochemical properties, particularly the severity of inflammation caused by the implant, is presumed to be the cause of the different surgical outcomes.
*Absorbable Implants ; Adolescent ; Adult ; Aged ; *Catgut ; *Collagen ; Comparative Study ; Female ; Glaucoma, Open-Angle/*surgery ; Human ; Male ; Middle Aged ; *Postoperative Complications ; Retrospective Studies ; Sclerostomy/*methods ; Treatment Outcome