Yun Il-sun's Studies in Japan and Medical Research during the Colonial Period / 의사학

In this article, I looked at the life of Yun Il-sun, a representative medical scientist of modern Korea, and examined the following problems. First, I took note of the position of the Korean people in the academic system of the Japanese colonial empire and restored the life of Yun Il-sun as specifically as possible. Yun was educated among Japanese people from elementary school to university. Although he received the best education at Old System High School and Imperial University and grew to be a prominent medical scientist, he could not overcome his identity as a colonized. Yun Il-sun, who moved from Keijo Imperial University to Severance Union Medical College, involved in activities founding of the Korean Medical Association and the Korean Medical Journal. Second, I the meaning of ‘culture’ to the intellectuals in the periphery. Old System High School and Imperial University where Yun Il-sun was educated were the hotbed of ‘culturalism.’ Yun's college days were the heyday of Taisho Democracy, and students were attracted to Marxism, Christian poverty movement, Buddhist cultivation movement and so on. Yun sought to overcome the ideological of young people through the acquisition of ‘culture.’ The ‘culture’ emphasized by Yun had an enlightenment characteristic that emphasized education, but it also functioned as a‘identity culture of educated elites.’ Third, I used the concept of ‘colonial academism’ and examined the aspects and characteristics of the colonial-periphery academic field, focusing on medicine. Yun Il-sun was a Korean professor at the Keijo Imperial University. He founded an academic society and published an academic journal for Koreans. He attempted to reproduce scholarship by doctoral dissertations. At the same time, several facts show that he was also in the affected area of ‘colonial academism’: the fact that he was kicked out of the Keijo Imperial University, the fact that the Korean Medical Association and the Korean Medical Journal were banned by Governor General, the fact that his students asked for doctoral degrees from Kyoto Imperial University where he studied. Yun Il-sun crossed the limits of ‘colonial academism’ and acted as the agent of empire. This was made possible by the characteristics of the academic discipline of medicine, the environment of the Severance Union Medical College, and personal traits of superior ability and indifference to politics. I the postcolonial evolution of the ‘colonial academism’ and ‘culturalism.’ The mix of continuity and discontinuity from ‘colonial academism’ and the hybrid of Japanese academism and American academism, the Korean characteristics of ‘postcolonial academism.’ Yun tried to harmonize the American academism with the Japanese academism and the purity of academism. This effort was revealed as an emphasis on basic medicine and natural sciences. As combined with culturalism and indifference to politics, he was recognized as the symbol of ivory tower and academism.

Expression of the p16(INK4a) and Ki-67 in relation to the grade of cervical intraepithelial neoplasia and high-risk human papillomavirus infection / 부인종양

OBJECTIVE: The purposes of this study were to evaluate the expression of p16(INK4a) (referred as to p16) and Ki-67 in cervical intraepithelial neoplasia (CIN), and the correlation between high-risk human papillomavirus (HPV) infection and the above biomarkers. METHODS: We analyzed 31 patients who were diagnosed with CIN at Kwandong University Myongji Hospital from October 2006 to September 2007. CIN specimens (CIN1, 12; CIN2, 6; CIN3, 13) were obtained by colposcopy-directed biopsy (CDB) or loop electrical excision procedure (LEEP). The expressions of p16 and Ki-67 were evaluated by immunohistochemical methods with antibodies to p16 and Ki67. The immunohistochemical staining results were classified into four grades: 0, 1, 2 and 3. HPV genotyping or Hybrid Capture-II test was used to detect high-risk HPV. RESULTS: The expression of p16 (p<0.001) and Ki-67 (p=0.003) were positively associated with CIN grade. p16 expressions increased significantly with high-risk HPV infection (p=0.014), especially HPV type 16 and 58. Ki-67 expression was not related with high-risk HPV. There was positive correlation between the expression of the p16 and Ki-67 (p=0.007). CONCLUSION: CIN grade were positively related to the expression of p16 and Ki-67. p16 expressions of high-risk HPV specimens significantly increased more than Ki-67. Therefore, in the diagnosis of CIN and high-risk HPV infection, p16 can be a useful biomarker.

A Case of Multiple Carcinoid Tumors of the Rectum / 대한소화기내시경학회지

Carcinoid tumors are rare and arise from enterochromaffin cells of the gastrointestinal tract. The rectum is the most common site for gastrointestinal carcinoids. The tumor usually present as small solitary submucosal nodules and multicentricity is rare, occurring in only a few percent of cases. The treatment for a rectal carcinoid tumor is based on the size of the lesion and depth of invasion. Although the present treatment guidelines for multiple rectal carcinoids are controversial, each small lesion of less than 1 cm without evidence of a metastasis can be adequately treated by local resection such as an endoscopic mucosal resection. We experienced a case of multiple rectal carcinoids that were completely resected after a hot biopsy and endoscopic mucosal resection.

Endometrial Stromal Sarcomas: A Retrospective Analysis of 28 Patients, Single Center Experience for 20 Years / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study was to evaluate the behavior of endometrial stromal sarcomas (ESSs) in relation to their clinical and pathogenic features, and to determine the optimal treatment strategy. MATERIALS AND METHODS: A retrospective analysis was performed involving 28 patients with histologic-proven ESSs treated at our institution between 1987 and 2006. RESULTS: The median follow-up was 54.7+/-63.1 months and the 5-year survival rate was 82.0%. Twenty-two (81.5%) and 5 patients (18.5%) had low- and high-grade disease, respectively. Univariate analysis revealed that the histologic grades, based on mitotic count, were associated with longer survival (p=0.004). However, among those patients with low-grade tumors, 5/20 patients (25%) had a recurrence and 2/21 patients (9.5%) had distant metastasis during the follow-up period. With the exception of 2 patients, 26 patients with ESSs underwent hysterectomy as primary treatment. Adjuvant treatment after surgery was administered to 14/26 patients (53.8%). Hormone therapy with progesterone, chemotherapy, and/or radiotherapy did not influence overall survival. However, the postoperative adjuvant therapy group, regardless of the treatment modality, was associated with relatively increased overall survival when compared to the surgery only group (p=0.054). CONCLUSION: The preoperative differential diagnosis of ESSs from other benign gynecologic diseases is often difficult. We recommend adjuvant therapy be administered after hysterectomy in patients with ESS to prevent recurrence or distant metastasis.

The Role of Bone Marrow Mononuclear Cells in Angiogenesis in Mouse Hind Limb Ischemic Model / 대한혈액학회지

BACKGROUND: Angiogenesis is enhanced in the ischemic tissues after the injection of bone marrow cells (BMCs). However the exact mechanisms for this are not yet fully understood. METHODS: A unilateral ischemic limb was surgically induced in mice and then BMCs were injected into the ischemic area. We measured the capillary/muscle ratio. Fluorescence-labeled BMCs were injected into the ischemic tissues and then the locations of the cells were examined by using a confocal microscope. Recruitment of bone marrow-derived cells into the ischemic tissue was examined in a sex-mismatched bone marrow transplantation (BMT) setting by identifying the Y chromosome with using the FISH technique. The expressions of VEGF, MMP-9, SDF-1 and CXCR-4 were measured by Western blot analysis. RESULTS: The capillary/muscle ratio was more increased in the BMC-injected group than in the control group (P<0.05). Florescence-labeled BMCs, which had been directly injected into ischemic tissue, were not detected in the tissue. In the sex-mismatched bone marrow transplantation models, the ischemic tissues of the BMC-injected group recruited a much greater number of Y chromosome-positive bone marrow- derived cells, as compared to the control group. The expressions of VEGF and MMP-9 were increased after injection of BMCs. SDF-1 was expressed on the seventh day in the BMC-injected group and CXCR-4 was highly expressed until 12 weeks in the BMC-injected group. CONCLUSION: We suggest that the injection of BMCs into ischemic tissue recruits CXCR-4-positvie cells from the bone marrow via the up-regulation of VEGF, MMP-9 and SDF-1, and these CXCR-4-positive cells may play a role in neovascularization.

A case of recurrent cervix cancer with lumbosacral nerve root metastasis / 대한산부인과학회지

Neoplastic plexopathy is usually associated with advanced systemic cancer, regional progression of the primary tumor and complication of cancer treatment including radiotherapy. Lumbosacral plexopathy is most commonly found in colorectal cancer and its symptom begins with leg pain, and thereafter numbness and weakness develops. Radiotherapy is generally considered as the 1st line therapy for metastatic plexopathy and it is also a way to relieve pain. We experienced one case of recurrent cervix cancer with lumbosacral nerve root metastasis after radical abdominal hysterectomy without additional radiation therapy and then we report it together with a brief review of literatures.

A Case of Idiopathic Colitis Developed after Barium Enema / 대한소화기학회지

It has been reported that colitis may be associated with intrarectally administered drugs or chemicals. Colonotoxicity may results from conventional medical therapy, herbal or other illicit drugs, contrast materials, and detergents. Clues that a colitis may be due to an intrarectally administered agent include perianal excoriation, segmental distal colitis due to a concentration gradient from enema administration, and recent diagnostic or therapeutic administration of high risk solutions such as hypertonic contrast agents or detergent enemas. Barium is a highly viscous contrast agent that is insoluble in water. Barium enemas are usually very safe. Also, no case report of barium-induced chemical colitis has been reported yet. We report a case of chemical colitis with colonic stricture occurring after the barium enema for diagnostic purpose.

A Case of Non-traumatic Hemobilia due to Warfarin Therapy / 대한소화기학회지

Hemobilia is a hemorrhage into the biliary tract that may follow surgical trauma, liver biopsy, aneurysms, extra- or intra-hepatic tumors of the biliary tract, gallstones, and inflammatory lesion of liver, especially helminthic or pyogenic. Sometimes, it is associated with primary liver cancer. An 84 year-old woman was admitted because of continuous right upper quadrant pain 4 days before admission. Physical examination revealed decreased skin turgor, icteric sclerae and severe tenderness on right upper quadrant abdomen. She had no hepatosplenomegaly, and no rebound tenderness. She has been taking warfarin for 3 weeks before admission because of atrial fibrillation. On admission, serum bilirubin and transaminase were elevated. The level of hemoglobin and hematocrit were 11.3 g/dL and 37.4%, respectively. HBsAg was negative, but IgG anti-HBc and anti-HBs were positive and anti-HCV was negative. Parasite skin test and stool ova count demonstrated non-specific findings. Stool occult blood was strongly positive, and prothrombin time was markedly prolonged. According to endoscopic retrograde cholangiopancreatography, common bile duct was dilated, and filled with blood clot but there was no stone in bile tree. After two weeks, serum transaminase, bilirubin, hemoglobin, hematocrit, and CA19-9 were normalized. We report a case of hemobilia, occurring in a patient with continuous warfarin use.

Change in the Beating Rate and Intercellular Adhesion Molecule of Cardiomyocytes in Culture / 대한해부학회지

This experiment was designed for the elucidation of relationships between the cell adhesion molecules and synchronous beating rates of cardiomyocytes isolated from ventricles of 3-day-old rats. These cells were grown on the culture vessel coated or non-coated with cardiogel for 1, 3, 5, and 7 days. The synchronous beating rate and morphologic changes of cells were investigated under the inverted microscope. Those changes of cardiomyocytes were observed by transmission elcectron microscopy (TEM). Connexin43, pan-cadherin, and alpha-sarcomeric actin were stained by indirect immunofluorescent (IF) technique. Western blotting were used for identifying unique bands of connexin43 and pan-cadherin in the regions of specific size. The synchronous beating numbers of cardiomyocytes in each group on the dish coated or non-coated with cardiogel were significantly different for 3, 5, and 7 days in culture. The maximum values of synchronized beating in the cells appeared on the day 5. The beating numbers of cells grown on coated dish comparing with non-coated dish were significantly increased on the day 5 and day 7. The proliferation of cardiomyocytes increased markedly in the cardiogel-coated dish on the day 5, while the number of fibroblasts in non-coated dish were obviously increased on the day 7. In indirect IF studies, a normal redistribution of connexin43, pan-cadherin, and alpha-sarcomeric actin of the cells was expressed in day 3 throughout day 5. The reaction intensity of those proteins were increased or decreased in the proportion to the beating numbers. The lack of reaction was appeared in the fibroblasts consisting of monolayer on the day 7. Unique bands of connexin43 and pan-cadherin having a specific size were marked on Western Blotting. The structures such as gap junction, fascia adherence and desmosome compatible with intercellular adhesion in cardiac muscle were abundant on day 3 to 7. In conclusion, the amount or reaction intensity of connexin43 and pan-cadherin in cardiomyocytes were stronger simultaneously with the increase of synchronous beating numbers, particularly for 3 and 5 days. The maximum beating rates of cardiomyocytes reached on the day 5, while the maximum beating rates of them were markedly decreased owing to the proliferation of fibroblasts on day 7. TEM findings consisting of intercalated discs might be explained regardless of coating with cardiogel on why the close relationships between the beating rates and the connexin43 and pan-cadherin of those cells in culture exist.

Corneal Edema Induced by Balafilcon A Contact Lens in Rabbits

PURPOSE: To compare the increase of corneal thickness by Balafilcon A (PureVision(R)) with that by HEMA hydrogel in rabbits. METHODS: 15 eyes of New Zealand white rabbits were divided into three groups. Each group was as follows: Group 1 recieved tasorraphy without contact lens insertion, group 2 had PureVision(R) lens insertion with tasorraphy and group 3 had New hypa day(R) lens insertion with tasorrhaphy. After anterior segment examination, tasorrhaphy was performed in group 1 and corneal thickness was measured at 24 and 48 hours. Five PureVision lenses were applied to left corneas of group 2 and transient tasorrhaphy was performed. After 24 and 48 hours, corneal thickness was measured. Same procedure was made in group 3 by applying five New hypa day(R) lenses on left eyes. Anterior segment was reexamined with slit lamp at 24 and 48 hours in all three groups. RESULTS: Baseline corneal thickness showed no statistical difference among three groups (p>0.05). At 24 hours, the corneal thickness of group 3 (New hypa day(R) lens inserted) increased significantly than that of the other groups (p0.05). CONCLUSIONS: Balafilcon A contact lens which has high oxygen transmissibility of silicone with high water content of hydrogel, induce less corneal swelling than conventional extended wear contact lens, HEMA hydrogel in short-term period. However long-term evaluation about Balafilcon A contact lens is required to get more data on corneal swelling and complications after long-term wearing.

Comparison of Burch Colposuspension, Pubovaginal Sling Operation and Tension-Free Vaginal Tape for Surgical Treatment of Stress Urinary Incontinence In Women / 대한산부인과학회잡지

OBJECTIVE: The object of this study was to compare the cure rate and confirm the clinical efficacy of three most frequent surgical procedures for stress urinary incontinence (Burch colposuspension, pubovaginal sling operation, tension-free vaginal tape). MATERIALS AND METHODS: We collected datas from the records of ninety-one patients who were diagnosed as stress urinary incontinence from Jan. 1999 to May 2001. Burch colposuspension was performed by department of gynecology, Severance hospital in thirty-three patients, pubovaginal sling operation was performed by department of urology in twenty-eight patients, and tension-free vaginal tape was performed by department of urology in thirty-one patients. We investigated the characteristics of patients, preoperative urodynamic study results, cure rates and complication rates for the result, and compared them by x2-test. RESULTS: There were statistically no significant differences between the cure rate of each operation after 3, 6 month of operation but after 12 months of follow up, the cure rate of pubovaginal sling operation was significantly higher than that of Burch operation and tension-free vaginal tape. CONCLUSION: The cure rate of pubovaginal sling operation was significantly higher after 12 months of follow up after surgery. There was no significant difference between cure rates of Burch operation and tension- free vaginal tape. We propose randomized prospective study with larger population in the future.

The Confocal Microscopic Findings of Cornea In Soft Contact Lens Wearer

PURPOSE: To investigate the change of morphometric characteristics of the corneal cells by confocal microscopy in long-term soft contact lens wearer. METHODS: Confocal microscopy (ConfoScan 2.0, Fortune Technology, Italy) was used to obtain data from healthy volunteers and soft contact lens wearers for 10 years. We evaluated the morphological images of the corneal epithelium (superficial cell, wing cell), Bowman's membrane, stromal cells (anterior, middle, and posterior keratocyte), Descemet's membrane, and endothelium. RESULTS: In comparison with control, the wing cells from corneal epithelium of contact lens wearer appeared to have irregular and blurred cell borders, and enlarged subepithelial nerve plexus. The bowman's membrane and the anterior stroma showed an increased reflectivity. The keratocyte from a highly reflective area showed no definite cell border anteriorly and more distinct shape with less cellularity posteriorly. Descemet's membrane showed an evidence of vertical fold and keratocytes with long processes were arranged in parallel. The endothelial layer showed polymegathism and polymorphism with some gutta. CONCLUSIONS: According to these data, it would be suggested that a long-term wearing of soft contact lens could influence the morphology of corneal epithelium and stroma as well as of corneal endothelium.

Confocal Microscopic Findings Associated with LASIK Flap with Foreign Corneal Epithelial Cells

PURPOSE: To evaluate the inflammatory response following the insertion of corneal epithelium into rabbit corneal stroma using confocal microscope. METHODS: Newzealand white rabbits were underwent corneal flap procedure using Microkeratome (Hansatome, Chiron, USA) and corneal epithelium was inserted. We divided the rabbits into three groups: Group A: flap only, Group B: flap with central epithelium insertion, Group C: flap with peripheral epithelium insertion. We examined the rabbit corneas at the time point of 4, 24, 72hours, 7days, and 1 month after surgery using confocal microscope and CD 11b immunohistochemical stain. RESULTS: At the early stage, the inflammatory cells were more frequently observed in the group C than in the group A and B, and at postoperative 72hours only in the group C. In stromal and total corneal thickness, there was a tendency of increase to the postoperative 24 hours and decrease in all groups, but the group C was more stronger tendency than other groups (P0.05). In immunohistochemical staining (CD11b), polynucleated cells and mast cells were more visible in group B and C than in group A. CONCLUSIONS: The postoperative inflammatory reaction of the LASIK flap may be related with corneal epithelial cells, and we think that more attention should be needed with the management of microkeratome.

Confocal Microscopic Findings of Keratoconus

PURPOSE: To report the confocal morphological changes of keratoconus in comparison with that of normal cornea. METHODS: Confocal microscopy (ConfoScan 2.0, Fortune Technology, Italy) was used to obtain data from healthy volunteers and keratoconus. We evaluated corneal morphological images of the corneal epithelium, Bowman's layer, stromal layer (anterior, middle, and posterior keratocyte), Descemet's membrane, and endothelium. RESULTS: In keratoconus cornea, the wing cells of epithelium had somewhat irregular margin, and the subepithelial nerve bundle was slightly enlarged. Near Bowman's membrane, highly reflective changes and tear like structure were visible. While the anterior stromal keratocyte had nuclei with a highly reflective density and indefinite cell border, posterior keratocyte had a more distinct shape with less cellularity. Near descemet's membrane, vertical fold (Vogt's striae) was observed and keratocytes with long processes arranged nearly in parallel. Morphological change was not observed in the endothelium. CONCLUSIONS: Our confocal microscopic findings of keratoconus may help early diagnosis and assessment of prognosis in the management of keratoconus.

Confocal Microscopic and Histopathologic Changes in Corneal Morphology Under Corneal Scraped Injury in Rabbit

PURPOSE: To investigate that the effects of early wound healing stage after corneal epithelial scrape injury. METHODS: We studied the change of scraped corneal wound like corneal cells, corneal thickness, acelluar zone, and celluar morphology occurring at the time points of 1, 4, 12, 24, 48, 72 hours, and 7 days after corneal epithelial scrape injury by the confocal microscopy and EM findings in 4 each group rabbits. RESULTS: By normal confocal microscopy, the mean cell density was 891 cells/mm2 in the anterior stroma and decreased to 814 cells/mm2 in the middle stroma, 731 cells/mm2 in the posterior stroma, and the endothelial density was 3236 cells/mm2. The change in the morphology of the keratocyte nuclei from an elliptical shape anteriorly, to a more elongated shape posteriorly. Apoptosis revealed like as condensation or fragmentation of chromatin and nuclei, vesicle formation, apoptotic bodies after corneal scraped injury by EM findings. The mean thickness of normal cornea was as follow; 47 micrometer in the epithelium, 334 micrometer in the stroma, and 392 micrometer in total cornea. The thickness of postoperative cornea including stromal thickness and total thickness increased at the early wound healing stage, and then decreased to the postoperative 48 hours(P<0.001). Mean range of acellular zone in the stroma increased at the early wound healing, but significantly decreased at the postoperative 48 hours, 79 micrometer(P<0.001). CONCLUSIONS: Keratocyte cell density and corneal thickness at the three portions of cornea, the thickness of stromal acelluar zone, and the changes of cellular morphology were related with a kind of the early post-inflammatory reaction, especially 24 hours, of corneal scraped injury. It should be needed more studies concerned with control of early post-inflammatory reaction.

A Comparative Study of Gene Array of Cell Cycle Modulators in Human Corneal Epithelial Cells Stimulated with Epidermal Growth Factor(EGF), Hepatocyte Growth Factor(HGF), or Keratinocyte Growth Factor(KGF)

PURPOSE: To identify and differentiate genes that are up-regulated or down-regulated in human corneal epithelial cells in response to epidermal growth factor(EGF), hepatocyte growth factor(HGF) or keratinocyte growth factor(KGF). METHODS: Primary cultures of human corneal epithelial cell(HCE) were treated with 25 ng/ml of EGF, 25 ng/ml HGF, 25 ng/ml KGF, or vehicle in serum-free medium for 8 hours. Total RNA was isolated with TRIZOL(GIBCO, NY), and treated with DNAse I.P 32-labeled complementary DNA(cDNA) probes were synthesized using 6 ug of total RNA made from HCE cells. Equivalent counts of P 32-labeled cDNA probes were hybridized with the membrane of Atlas human cell cycle array at 68degreesC overnight. After sequential washing, the membranes were exposed to X-ray film for three days. These results were analyzed using Atlas Image TM 1.1 Software. RNAse protection assay was used to confirm one of known genes on the array, which was up-regulated by EGF, KGF, and HGF in the human corneal epithelial cells. RESULTS: Autoradiographic analysis showed that out of 111 genes analyzed, 22 were up- or down-regulated in EGF, 26 in HGF and 7 in KGF compared to untreated corneal epithelial cell. After different signal intensity was normalized more than 2000 by Atlas Image TM 1.1 Software, 12 genes were up-regulated and 10 genes down-regulated in EGF. HGF have 6 up-regulated genes and 1 down-regulated gene and KGF had all up-regulated 7 genes. EGF, HGF and KGF all up-regulated the expression of cyclin D1(BCL-1 oncogene) and serine/threonine-protein kinase PITALRE in the primary cultured human corneal epithelial cells. EGF and KGF both up-regulated E2F-1 pRB-binding protein gene. HGF and KGF up-regulated cyclin D2 gene. Proto-oncogene raf was down-regulated by EGF and HGF. CONCLUSIONS: The three growth factors seemed to have similar effects on the genes that contribute to cell cycle control. Studies to analyze the significance of the differences among these growth factors are ongoing.

Inflammatory Response in the Rabbit Corneal Stroma after Corneal Epithelial Insertion

PURPOSE: To evaluate the inflammatory response following the insertion of corneal epithelium into rabbit corneal stroma. METHODS: Newzealand white rabbits were underwent corneal flap procedure using Hansatome and corneal epithelium was inserted. We divided the rabbits into three groups: Group A: flap only, Group B: flap with central epithelium insertion, Group C: flap with peripheral epithelium insertion. Eyes are enucleated, 4, 24, 48, 72 hours, 1 week, 1 month. Immunohistochemical stain fro CD4, CD8, and CD11b were used to test frozen section. RESULTS: Cd4 was expressed weakly at 24 hours in group A, B, C. around limbus and peripheral cornea. CD8 was expressed at 24 hours in group a, b, c especially strongly at group 3. In group B, C, CD8 was persistently expressed at 72 housr. CD11b was expressed at 24 hours in all groups. But in group C. CD11b was expressed strongly and persists at 72 hours and 1 week. CONCLUSION: Macrophage and Cytotoxic T cell maybe play an important role in corneal stromal wound healing after iatrogenic corneal epithelial insertion and further evaluation will be needed.

Clinical Outcome of LASIK with Different Flap Thickness

PURPOSE: Since a few cases of keratectasia after LASIK were reported, the importance of residual corneal thickness has been emphasized. This study was to analyze adverse effects which may occur in reducing corneal flap thickness to increase residual corneal thickness. METHODS: A total of 237 eyes of 149 patients who had been followed up for 6 months or more after LASIK were evaluated retrospectively. Intended corneal flap thickness was 130 micrometer in 116 eyes(group A), and 160 micrometer in 121 eyes(group B) using an Automated Corneal Shaper(Chiron, USA). Clinical outcomes were compared between two groups. RESULTS: Except for some cases with retinal complication after surgery, 3 eyes lost best-corrected visual acuity by 2 lines or more in group A and 1 eye in group B, which was not statistically significant.(p>0.05) Fourteen eyes lost 1 line or more best-corrected visual acuity by postoperative irregular astigmatism in group A and 10 eyes in group B, which showed no significant difference, either. The incidence of flap-related complications such as wrinkling and free cap did not differ significantly between two groups(p>0.05). CONCLUSIONS: To leave residual cornea of greater thickness using a 130 micrometer thick flap rather than 160 micrometer may be a useful method to avoid postoperative keratectasia, one of the most severe complications.

The Anti-angiogenic Effect of Recombinant Tissue Inhibitor of Metalloproteinase Type 2 (TIMP-2) in N-heptanol Induced Neovascularization of Rat Cornea

Corneal neovascularization is a challenging problem in ophthalmologic practice. We evaluated the anti-angiogenic effect of recombinant tissue inhibitor of metalloproteinase type 2 (rTIMP-2) which is an endogenous inhibitor of matrix metalloproteinases. Sprague-Dawley rats of 6 weeks of age were used in this study. N-heptanol was applied to the eyes of the rats to induce chemical injury and eventual neovascularization. The rats were divided into 4 groups, 5 rats for each. We instilled only the phosphate buffered solution once a day for 10 days to the eyes of rats in the control group. Rats in group 1 received subconjunctival injection of 0.05 mgof rTIMP-2, those in group 2 received intraperitoneal injection of 0.05 mg of rTIMP-2, and those in group 3 received intraperitoneal injection of 0.1 mg of rTIMP-2 once a day for 10 days respectively. After 4 weeks, photographs of corneas were taken with a built-in camera of the slit lamp, and the eyes were enucleated. We made histologic specimens of the corneas and examined them with a light microscope. The severity of the neovascularization was quantified with angiogenesis scoring system. The group 1, 2 and 3 showed significant suppression of angiogenesis compared with the control respectively, but there was no statistically significant difference among their angiogenesis scores. Under the light microscope, the corneas of control group showed much more severe infiltration of inflammatory cells and higher density of new vessels compared with group 1, 2 and 3. We hypothesize that TIMP-2 suppressed the angiogenesis in chemical injury of cornea and TIMP-2 might benefit those patients with corneal neo-vascularization, although careful further studies are required in humans.

The Comparisons of Clincal Results of Ac rySof and PMMA Intraocular Lens Implantation in Diabetic Cataract: Six Months Follow-up

To compare the clinical results of AcrySof intraocular lens (IOL)and Polymethyl methacrylate(PMMA)IOL implantation in diabetic patients,a total of 58 eyes(48 patients)were analyzed.AcrySof IOL was implanted in 24 eyes with small incision technique,and PMMA IOL was implanted in 34 eyes with enlarged scleral wound.Posterior capsular opacity(PCO)developed in only 2 eyes in AcrySof group,while it occurred in 4 eyes in PMMA group.Anterior capsular fibrosis developed in 4 eyes and IOL-iris synechiae developed in 2 eyes in PMMA group after follow-up of 6 months.No statis-tically significant difference was found in the incidence of PCO between two groups(p>0.05). AcrySof IOL leads to faster visual rehabilitation than PMMA lens. Therefore,use of AcrySof IOL can be more beneficial in diabetic cataractpatients who might need laser photocoagulation or pars plana vitrectomy in the future.