Purpose: To evaluate the effectiveness of an instrument devised for slit-lamp examination of donor corneas suspended in preservation medium. Methods: The study examined two donor corneas received at Yeouido St. Mary's Hospital in February 2023 and March 2023. The instrument has three main components: a plastic holder to hold the preservation medium bottle, a cube with a mirror for reflecting the slit beam, and a stand to attach the device to the slit-lamp. Using the instrument, the donor corneas were examined via slit-lamp: microscopy with the endothelium facing upward and downward. Specular microscopy and anterior segment optical coherence tomography (OCT) were also performed on the preserved donor corneas. Results: Slit-lamp examination of donor corneas in preservation medium using the instrument showed overall corneal buttoning and optical sections of the donor cornea. Using specular reflection and retroillumination, the endothelial layer was partially visible. However, specular microscopy and anterior segment OCT could not examine the donor cornea in preservation medium using the instrument. Conclusions The devised instrument facilitates slit-lamp examination of donor corneas in preservation medium, enabling a qualitative assessment of donor corneas before corneal transplantation surgery.

Purpose: Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods: A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion-weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retro-spectively. Results: All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion-restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.

BACKGROUND/AIMS: Colorectal cancer is associated with different anatomical, biological, and clinical characteristics. We determined the impact of the primary tumor location in patients with metastatic colorectal cancer (mCRC). METHODS: Demographic data and clinical information were collected from 1,115 patients from the Republic of Korea, who presented with mCRC between January 2009 and December 2011, using web-based electronic case report forms. Associations between the primary tumor location and the patient's clinical characteristics were assessed, and factors inf luencing overall survival were analyzed using Cox proportional hazards regression models. RESULTS: Of the 1,115 patients recruited to the study, 244 (21.9%) had right colon cancer, 483 (43.3%) had left colon cancer, and 388 (34.8%) had rectal cancer. Liver and lung metastases occurred more frequently in patients with left colon and rectal cancer (p = 0.005 and p = 0.006, respectively), while peritoneal and ovarian metastases occurred more frequently in patients with right and left colon cancer (p < 0.001 and p = 0.031, respectively). The median overall survival of patients with tumors originating in the right colon was significantly shorter than that of patients whose tumors had originated in the left colon or rectum (13.7 months [95% confidence interval (CI), 12.0 to 15.5] vs. 18.0 months [95% CI, 16.3 to 19.7] or 19.9 months [95% CI, 18.5 to 21.3], respectively; p = 0.003). Tumor resection, the number of metastatic sites, and primary tumor location correlated with overall survival in the univariate and multivariate analyses. CONCLUSIONS: Primary tumor location influences the metastatic sites and prognosis of patients with mCRC.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Liver ; Lung ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Rectum ; Republic of Korea

BACKGROUND/AIMS: The diagnosis of primary billiary cirrhosis (PBC)-autoimmune hepatitis (AIH) overlap syndrome remains challenging. In 2008, a simplified scoring system was proposed by the International Autoimmune Hepatitis Group, which aimed for wider applicability in routine clinical practice. We evaluated the performance of the new simplified AIH scoring criteria as a diagnostic tool for overlap syndrome. METHODS: We retrospectively reviewed the clinical histories, chemistry, autoimmune studies, and liver biopsy results of 25 patients diagnosed with PBC who visited Soonchunhyang University Hospital, Bucheon and Seoul, between November 2004 and December 2009. Parameters relevant to the revised and simplified scoring criteria were recorded, and outcomes were compared between those with and without features of overlap syndrome. RESULTS: Of 25 patients with a definite diagnosis of PBC, five (20%) were diagnosed with overlap syndrome using the revised criteria, and 18 patients (72%) were diagnosed with the simplified criteria. Those patients diagnosed according to the simplified scoring criteria revealed an increased frequency of anti-nuclear antibody (p = 0.030) and serum IgG levels (p = 0.092). Additionally, advanced fibrosis was significantly more frequent in patients with overlap syndrome (p = 0.017). CONCLUSIONS: The simplified scoring criteria seemed to be useful as a diagnostic tool to recognize overlap syndrome in Korea. However, a relatively small number of patients were included in our study, so further clinical trials based on larger populations should be performed.
Biopsy ; Fibrosis ; Hepatitis ; Hepatitis, Autoimmune ; Humans ; Immunoglobulin G ; Korea ; Liver ; Liver Cirrhosis ; Retrospective Studies

BACKGROUND: Malassezia is considered as major factor in dandruff of human scalp. OBJECTIVE: In order to develop an antimicrobial agent, bamboo oil was extracted by high temperture suction from dried bamboo truk abd then antimicrobial activities against Malassezia are investigated. METHODS: Minimum inhibitory concentration and antimicrobial activity were measured in Malassezia species. RESULTS: 1. Minimum inhibitory concentration of the Bamboo (Phyllosrachys bambusoides) Essential Oil Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis standard, Malassezia sympodialis patient, Malassezia dermatis standard, Malassezia dermatis patient were 10 microliter/ml, 5 microliter/ml, 5 microliter/ml, 10 microliter/ml, 5 microliter/ml and 10 microliter/ml respectively. 2. Minimum inhibitory concentration of the Itraconazole Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis standard, Malassezia sympodialis patient, Malassezia dermatis standardntia, Malassezia dermatis patient were 10 microgram/ml, 10 microgram/ml, 10 microgram/ml, 0.1 microgram/ml, 1 microgram/ml, and 0.01 microgram/ml, respectively. 3. Minimum inhibitory concentration of the ketoconazole Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis standard, Malassezia sympodialis patient, Malassezia dermatis standard, Malassezia dermatis patient were 0.01 microgram/ml, 10 microgram/ml, 10 microgram/ml, 0.1 microgram/ml, 0.01 microgram/ml, and 0.01 microgram/ml, respectively. 4. Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis patient and Malassezia dermatis patient showed the strongest antimicrobial effect on bamboo oil > ketoconazole > itraconazole. 5. Malassezia sympodialis standard, Malassezia sympodialis patient and Malassezia dermatis standard strongest antimicrobial effect on ketoconazole > bamboo oil > itraconazole. CONCLUSION: Bamboo oil might be applied as antidandruff treatment modality by its anti-malassezial effect.
Humans ; Itraconazole ; Ketoconazole ; Malassezia ; Microbial Sensitivity Tests ; Scalp ; Suction

OBJECTIVE: To compare inhibition of cell growth and apoptosis in human cervical cancer cell lines (CaSki) by paclitaxel, cisplatin, arsenic trioxide and tetraarsenic oxide. METHODS: Inhibition of cell growth was determined by the water-soluble tetrazolium salts (WSTs) -1 assay. For apoptosis analysis in CaSki cell line treated with single or combination of two agents, CaSki cell line treated with each agent was stained with annexin-V/PI and flow cytometry was performed. RESULTS: Progression of apoptosis in CaSki cell line treated with paclitaxel, cisplatin, arsenic trioxide, and tetraarsenic oxide was time dependent. Inhibition of cell growth in CaSki cell line by paclitaxel, cisplatin, arsenic trioxide, and tetraarsenic oxide was dose and time dependent. Especially, tetraarsenic oxide was more effective in inhibition of CaSki cell growth compared to arsenic trioxide. Group treated with combination of cisplatin and tetraarsenic oxide showed more progressive apoptosis compared to other combination group. CONCLUSION: Tetraarsenic oxide has more potent anti-tumor effects than other agents on CaSki cell line. We need to consider further study about antitumor effect of tetraarsenic oxide through clinical study.
Apoptosis ; Arsenic ; Arsenicals ; Cell Line ; Cisplatin ; Flow Cytometry ; Humans ; Oxides ; Paclitaxel ; Tetrazolium Salts ; Uterine Cervical Neoplasms

PURPOSE: This study was designed to determine whether transabdominal ultrasound can detect different hepatic stiffness between patients with cirrhosis and control subjects. MATERIALS AND METHODS: Sevent-three patients (Child-Pugh class A stage) with liver cirrhosis and 57 control subjects were included in this study. All patients were subdivided arbitrarily into two groups: early cirrhosis (n = 53) and overt cirrhosis (n = 20). Two sagittal images of the left lobe of the liver were obtained in the left hepatic vein level during the resting state and at full inspiration while pushing their belly out, by abdominal US (i.e., resting and stress image). The length between the inferior hepatic angle and the midpoint of the liver dome was measured in all images for the evaluation of liver distortion. The elongation was calculated by a formula: (L2-L1/L1) x 100(%); where L1 and L2 are the length of the liver for both the resting and stress image. The calculated elongated length (L2-L1, EL) and elongation rate were compared between cirrhotic patients and control subjects. RESULTS: For the control subjects, early cirrhosis, and overt cirrhosis groups, the mean ELs (elongation rate) were 2.34+/-0.98 cm (30.2+/-13.2%), 1.18+/-0.73 cm (14.9+/-9.5%) and 0.53+/-0.54 cm (6.3+/-6.6%), respectively. This difference among the three groups was statistically significant (p < 0.05). A possible best cut-off value of liver elongation rate is 17% for the prediction of cirrhosis (sensitivity: 90%, specificity: 75.3%). CONCLUSION: The liver of patients with liver cirrhosis is stiffer than that of control subjects. Calculation of the elongation rate in the left lobe of the liver during a respiratory maneuver may be used as an ancillary method of US for the evaluation of liver cirrhosis.
Fibrosis ; Hepatic Veins ; Humans ; Liver ; Liver Cirrhosis ; Respiration

OBJECTIVE: To study the relationship between serum human papillomavirus (HPV) deoxyribonucleic acid (DNA) and clinicopathologic prognostic factors and the clinical usefulness of serum HPV 16 DNA in cervical cancer patients. METHODS: All the patients were treated at our institution, from January, 2002 to February, 2007. DNA extracted from serum of 17 patients with HPV 16 infected carcinoma in situ and 65 patients with HPV 16 infected squamous cell carcinoma of the uterine cervix (stage IA-IIIB) were examined for HPV 16 DNA using polymerase chain reaction with types 16 specific E6 primer. Clinicopathological parameters were obtained from medical records, and the relationship between the discrete variables and serum HPV 16 DNA status were evaluated. RESULTS: HPV 16 DNA was not detected in serum from all patients with carcinoma in situ. However, among the 65 patients with HPV 16 infected squamous cell carcinoma of the uterine cervix, we detected 17 HPV 16 DNA positive samples (26.2%) in serum. Positive HPV 16 DNA in serum was correlated with age (P=0.0071), serum squamous cell carcinoma (SCC) antigen (P=0.0034), tumor size (P=0.0029), clinical stage (P<0.0001), deep stromal invasion (P=0.0048), resection margin positivity (P=0.0008), and pelvic lymph nodal metastasis (P=0.0040). CONCLUSION: The serum HPV 16 DNA in patients with cervical cancer was correlated with poor prognostic factors that need adjuvant treatment.
Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri ; DNA ; Female ; Human papillomavirus 16 ; Humans ; Medical Records ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

PURPOSE: To determine whether spontaneous a splenorenal shunt can be used as an imaging predictor of early renal hemodynamic changes in patients with cirrhosis. MATERIALS AND METHODS: The study included 82 cirrhotic patients and 41 control subjects. Three-phase CT was performed and CT attenuation values (Hounsfield units) of the renal cortex in three phases were measured to evaluate renal perfusion. Likelihood ratio tests for trend were conducted for age, presence of ascites, and Child's grade. RESULTS: The mean CT attenuation values of the renal cortex in cirrhotic patients were significantly lower than the values of control subjects in three phases: 153.3 +/- 37.9 versus 173.3 +/-25.2 in the arterial phase, 172.6 +/- 41.0 versus 197.6 +/- 26.5 in the portal phase and 136.9 +/- 26.0 versus 152.7 +/- 20.0 in the delayed phase, respectively. The mean CT attenuation value of cortices in patients with renal hypoperfusion was 119.9 +/- 11.8 in the portal phase. Child's class C (aOR: 58.4, 95% CI: 3.6-956.2; p < 0.01) and the presence of a renal shunt (aOR: 7.5, 95% CI: 1.8-30.5; p < 0.01) were associated with renal hypoperfusion. The incidence of renal hypoperfusion was associated with Child's grade (trend: p < 0.01), and not with the grade of ascites or age. CONCLUSION: A dilated spontaneous splenorenal shunt may be a risk factor for renal hypoperfusion in cirrhosis.
Ascites ; Fibrosis ; Hemodynamics ; Humans ; Incidence ; Liver ; Liver Cirrhosis ; Perfusion ; Risk Factors ; Splenorenal Shunt, Surgical

Foreign body ingestion in children is commonly encountered and this usually resolves spontaneously. Single magnet ingestion usually does not need additional medical treatment. However, multiple magnets can attract each other in intestinal loops and several complications can develop such as bowel obstruction and fistula formation. In this situation, endoscopic and/or surgical intervention is inevitably required. Therefore, making the correct diagnosis is needed for cases of magnets ingestion, and this should be done as soon as possible for children. We report here on a case of gastroduodenal fistula and duodenal obstruction caused by the interaction of four magnets.
Child ; Duodenal Obstruction ; Eating ; Fistula ; Foreign Bodies ; Humans ; Intestinal Fistula ; Intestinal Obstruction ; Magnets