The Effect of Injection of Steroid and 5-Fluorouracil on Hypertrophic Scars of Rabbit

The immunosuppression effect of cyclosporine A on the allogenic calvarial bone graft in mice

INTRODUCTION: This study examined the effect of cyclosporine A (CsA) on the allogenic cranial bone graft in the mice. MATERIALS AND METHODS: Twenty eight 12-week-old male ICR mice weighing 40 g were used. The experimental group was injected subcutaneously with CsA (10 mg/kg/day) diluted in Caster oil for 7 days prior to the graft until sacrifice. The control group was injected with the same solution without CsA. RESULTS: In the experimental group, fibrous connective tissues and small amounts of inflammatory cells were observed. At 2 weeks after the allograft in the experimental group, new bone formation in fibrous collagenous tissue and around the allogenic bone was noted. At 4 weeks after the allograft, new bone formation was active along and at the periphery of the mature allogenic bone. The proliferation of blood vessels increased in bone marrow. In the control group, fibrous tissues and inflammatory cells were observed around the allogenic bone and existing bone at 1 week. At 2 weeks after the allograft, the proliferation of blood vessels accompanied by inflammatory cells were scattered in the fibrous connective tissues. New bone formation around the allogenic and existing bone could be observed. At 4 weeks after the allograft, inflammatory cells were severely infiltrated around the allogenic bone. Osteoclasts were scattered along the allogenic bone and induced bone resorption. CONCLUSION: These results suggest that the daily administration of CsA (10 mg/kg/day) induces efficient immunosuppression without serious complications ,and this protocol might be useful for the experimental model of allogenic bone grafts.

The effect of conservative neck dissection in the patients with oral cancer

INTRODUCTION: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. MATERIALS AND METHODS: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). RESULTS: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. CONCLUSION: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.

Effect of Triamcinolone Acetonide on Proliferative Vitreoretinopathy and Hepatocyte Growth Factor in a Rabbit Model

PURPOSE: To investigate the intravitreal level change of hepatocyte growth factor (HGF) in a rabbit model of proliferative vitreoretinopathy (PVR) and the effect of triamcinolone on PVR and intravitreal HGF concentration. METHODS: Experimental PVR was induced in 21 New Zealand white rabbits by performing a scleral laceration, followed by repair and intravitreal injection of 0.1 ml of autologous blood. Seven eyes (group A) were injected with a high -dose of triamcinolone (5 mg), 7 eyes (group B) with a low -dose of triamcinolone (1 mg), and 7 control eyes (group C) with only balanced salts solution (BSS), respectively. Intravitreal HGF levels were measured by ELISA test taken at 0, 3, 7, 14, 21, and 28 days after PVR induction. PVR grade was determined by serial indirect ophthalmoscopic examination at different time points mentioned. RESULTS: Elevated HGF levels were found in the vitreous peaking at 7 days after PVR -inducton in all 3 groups. The differences in HGF levels of treated groups A and B, and the control group C were statistically significant (p<0.001). The differences of PVR grades among the 3 groups were not statistically significant. However, gross and microscopic examinations of the control group C showed that proliferations and morphologic changes of retinal pigment epithelial cells were more prominent than in the treated groups. CONCLUSIONS: The intravitreal level of HGF varied with time in the rabbit PVR model. Also, our results suggest that intravitreal triamcinolone suppresses the expression of intravitreal HGF in the rabbit PVR model.

Comparison of A-scan, Scheimpflug Camera, and Orbscan for Measurement of Anterior Chamber Depth

PURPOSE: To assess the reproducibility and reliability of the A-scan, Scheimpflug camera and Orbscan Topography system in measuring anterior chamber depth (ACD) METHODS: In this prospective study of 207 eyes of 150 patients, ACD estimation prior to cataract surgery was done by three METHODS: A-scan, Scheimpflug camera, and Orbscan (in that order). One observer performed all measurements three times for each test. ACD was defined as the length between the center of anteror surface of cornea and the center of anterior lens surface. RESULTS: The mean ACD by the three methods were 2.86+/-0.46 mm, 3.22+/-0.46 mm, and 3.13+/-0.44 mm, respectively: the differences were statistically significant (P<0.01). The correlation coefficient between Scheimpflug camera and Orbscan was 0.93. The coefficient of variation for the three methods were 3.20% in the A-scan, 1.34% in the Scheimpflug camera, and 0.84% with Orbscan. CONCLUSIONS: Applanation A-scan gives lower measurements for ACD compared with Scheimpflug and Orbscan. There was good agreement between results obtained with the latter 2 methods based on optical principles. Orbscan had the best reproducibility of results among the three methods.

A Case of Retained Multiple Intraorbital Foreign Bodies

PURPOSE: A diagnosis of wooden intraorbital foreign bodies is common and their removal is often necessitated after complications become manifested. In case of operation, it is difficult to find and remove wooden foreign bodies completely. We have experienced a case of retained multiple intraorbital foreign bodies removed by the secondary operation. We report this case with a literature review. METHODS: A 39-year-old man visited our clinic complaining of diplopia, exophthalmos, and limitation of eyeball movement. He had fallen down and had a lacerated wound. Right after primary closure, he experienced strabismus, orbital cellulitis, and abscess. Several months later, he had a soft mass in the operated lower lid, and two wooden intraorbital foreign bodies were found. MRI detected granuloma and cellulitis near the cavernous sinus. RESULTS: More than ten intraorbital wooden foreign bodies were surgically removed. After the surgery exophthalmos and diplopia were improved, and limitation of eyeball movement disappeared. The MRI findings were also improved. CONCLUSIONS: Intraorbital wooden foreign bodies should be diagnosed with a thorough history taking and radiologic exam, due to a number of potential complications, such as orbital cellulitis, abscess, and diplopia. Furthermore, they should be removed in consideration that they can move spontaneously into the deep interior of the orbit.

The Effect of Intravitreal Triamcinolone Acetonide on Intraocular Pressure

PURPOSE: To Investigate the effect of intravitreal triamcinolone acetonide on intraocular pressure (IOP) and the risk factors for its elevation. METHODS: This retrospective case study comprised 25 patients (26 eyes) with diabetic macular edema and 7 (7 eyes) with retinal edema due to branch retinal vein occlusion. The IOPs before and after intravitreal injection of 4 mg triamcinolone acetonide (postoperative 2 hours, 1 day, 2, 4, 8, and 12 weeks and 6 months) were recorded by Goldmann applanation tonometer. RESULTS: The average time to maximum IOP was 3.9 weeks and the difference of maximum post-injection IOP and pre-injection IOP was statistically significant (P<0.0001). IOP at post-injection 2 hours and 8 weeks was elevated significantly (p=0.01 and p=0.028, respectively). During follow up of 6 months, 8 eyes (24.24%) demonstrated an increase in IOP of 5 mmHg or greater, and 4 eyes (12.12%) of 10 mmHg or greater. IOP was more elevated in BRVO, younger age (< 60years) and males. All eyes responded to topical glaucoma medication. CONCLUSIONS: Transient IOP elevation can develop after intravitreal triamcinolone injection, especially from 4 to 8 weeks. Patients with risk factors for the elevation of IOP should be observed closely.

Blepharoptosis after Ocular Surgery and Aponeurosis Repair

PURPOSE: We retrospectively investigated the etiological factors and evaluated the surgical results of aponeurosis repair for blepharoptosis after ocular surgery. METHODS: We investigated the types of ocular surgery, anesthesia, and other etiological factors related with postoperative blepharoptosis for 20 eyes of 20 patients and evaluated MRD1 (Margin Reflex Distance 1), IPF (Interpalpebral Fissure) and levator function preoperatively and after levator aponeurosis repair surgery. RESULTS: Types of previous ocular surgery were cataract surgery (15 eyes), penetrating keratoplasty (2 eyes), retinal surgery (2 eyes) and panretinal photocoagulation using gonioscopic lens (1 eyes). 18 eyes had received ocular surgery with rigid type eye speculum and 18 eyes with retrobulbar anesthesia. Mean levator function measured preoperatively was good (12 mm). We found dehiscence or detachment of levator aponeurosis in surgical field and performed aponeurosis repair or advancement with correction 2 mm more than MRD1 of normal contralateral eye. Mean IPF and MRD1 were improved 6 months after aponeurosis repair (from 4 mm, -0.5 mm to 7 mm, 2 mm respectively). CONCLUSIONS: This study indicates that blepharoptosis after ocular surgery can be induced by rigid type eye speculum, local anesthesia and various causes. Surgical findings of blepharoptosis after ocular surgery were dehiscence or detachment of levator aponeurosis and could be corrected by aponeurosis repair effectively.

The Effect of Basic Fibroblast Growth Factor on the Vascularization of Porous Polyethylene Orbital Implant(Medpor(R))

PURPOSE: We investigated the effect of basic fibroblast growth factor (bFGF) on the vascularization rate of Medpor(R), a synthetic polyethylene orbital implant. METHODS: Medpor(R), pretreated or untreated with bFGF (25 ng/ml), was inserted into one eye of 18 New Zealand white rabbits and removed at 1, 2, and 4 weeks after implantation, and stained with hematoxylineosin and Masson's trichrome. Degree of vascularization was classified into zone 1 (or=4.6 mm ingrowth). RESULTS: One and two weeks after implantation, the percentage of the vascularization area were 56.25% and 68.75% in bFGF-untreated group, while those of bGFG-treated group were 75% and 80.56% respectively, but there were no statistical difference between bFGF-untreated and treated group. However, four weeks after implantation it was significantly higher in bFGF-treated group (84.38%) than in bFGFuntreated group (66.25%) (P<0.05). CONCLUSIONS: BFGF enhanced more and early fibrovascular ingrowth of Medpor(R).

Changes of Anterior Chamber Depth and Anterior Chamber Angle after Photorefractive Keratectomy

PURPOSE: To investigate the structural changes of anterior chamber after photorefractive keratectomy in myopic eyes, we assessed the changes of anterior chamber(AC) depth, angle and correlations with ablation depth at sixth postoperative month. METHODS: We performed photorefractive keratectomy on 77 eyes of 40 patients and divided them into 3 groups by the degree of preoperative myopia; less than -4.0 diopter, between -4.0 and -6.0 diopter and greater than -6.0 diopter. We assessed the changes of AC depth and angle using Scheimpflug camera(EAS-1000, Nidek, Japan) after 6 months. RESULTS: The average preoperative AC depth and angle were 3.59+/-0.27 mm, 44.20+/-2.58 and 3.53+/-0.27 mm, 43.29+/-1.65 at sixth postoperative month. The reductions in AC depth and AC angle were statistically significant(P0.05). The changes of both AC depth and AC angle were not affected by ablation depth(P>0.05). CONCLUSIONS: Structural changes of anterior chamber were significant 6 months after photorefractive keratectomy and the changes were not affected by degree of myopia nor by ablation depth.

Correlation of Color Doppler Image and Thyroid Function Test in Diffuse Goiter

PURPOSE: To determine whether CDI can differentiate Graves' disease from other cases of thyroiditis and to determine the relationship between CDI findings and TFT. MATERIALS AND METHODS: Between October, 1995 and January, 1996, 22 cases of diffuse goiter without nodule were prospectively assessed for CDI and TFT. CDI was classified into three groups : Grade 1 (minimal), Grade 2 (moderate), and Grade 3 (marked) ; TFT was also classified into three groups : decreased, normal, and increased thyroid function. The correlation between CDI and TFT was statistically assessed ; each case was diagnosed by aspiration biopsy or clinical laboratory studies. RESULTS: All Graves' disease patients showed good correlation between marked color flows and increased thyroid function. The CDI findings of other cases of thyroiditis showed variable color flow and TFT. We found significant differences between the two disease groups. CONCLUSION: CDI can help differentiate Graves' disease from other cases of thyroiditis and additional assesment using TFT will help in the diagnosis of diffuse goiter. The "thyroidinferno" pattern is not a specific finding of Graves' disease.

Pulmonary Tuberculosis with Airspace Consolidation vs Mycoplasma Pneumonia in Adults: High-Resolution CT Findings

PURPOSE: To analyse and compare high-resolution CT findings of pulmonary tuberculosis with consolidation and mycoplasma pneumonia. MATERIALS AND METHODS: Twenty patients with pulmonary tuberculosis [confirmed by sputum culture (n=9) and bronchoscopic biopsy (n=11)] and airspace consolidation on high-resolution CT and 17 patientswith mycoplasma pneumonia, confirmed by serologic test, were included in this study. High-resolution CT findings were analyzed in terms of ground-glass opacities, distribution of consolidation, type of nodules, cavities, interlobular septal thickening, bronchial dilatations, bronchial wall thickening and pleural effusion. RESULTS: In patients with tuberculsis, average age was 33.5 years (range, 20-67) ; in those with mycoplasma pneumonia it was 32.5 years (range, 17-74). Segmental and subsegmental distributions were most common in both diseases ; the preferred site of consolidation was different, however ; for tuberculosis it was the upper lobes (13 cases, 65% ; bilateral involvement, 7 cases) ; for mycoplasma pneumonia it was the lower lobes (11 cases, 64.7%). Non-segmental (diffuse and random) distribution of ground-glass opacities were seen in two patients(11.8%) with mycoplasma pneumonia. Centrilobular nodules, branching linear opacities and alveolar nodules were not different in both diseases, but there were nodules above 10mm in 14 cases of tuberculosis and in only one case of mycoplasma pneumonia. Tree-in-bud appearances were seen in five cases of tuberculosis. Cavities without air-fluid level were noted in ten cases of tuberculosis. Other interlobular septal thickening, bronchial wall thickening, bronchial dilatation and pleural effusion were not different in both diseases. CONCLUSION: There was considerable overlap between high resolution CT findings of tuberculosis with airspace consolidation and those of mycoplasma pneumonia. The location of consolidation, type of nodules, and the presence of tree-in-bud appearance and cavities help in the differentiation of the two diseases, however.

CT Finding of Right Retroperitoneal Space: Analysis of Extension of Right Perirenal Hematoma

PURPOSE: To understand the structure and character of the right retroperitoneal space by analysis of the extension of retroperitoneal hematoma in patients with traumatic right renal injuries. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 13 patients with right retroperitoneal hematomas caused by right renal injury. At the renal level, we analyzed the relation of a hematoma contacting psoas muscle with other retroperitoneal compartmental hematomas. At the suprarenal level, a perirenal hematoma and a hematoma contacting the diaphragm were analyzed according to their relation with intrahepatic IVC and pericaval hematoma. RESULTS: Below renal hilar level, all hematomas contacting psoas muscle, observed in eight cases, were connected with retrorenal extension of anterior pararenal hematoma. At the suprarenal level, intrahepatic pericaval hematomas were not, in all 13 cases, connected with a hematoma contacting the diaphragm, but with a perirenal hematoma. At the upper suprarenal level, the only pericaval hematomas containing a medial component of perirenal hematoma extended superiorly to the upper one third of the tenth thoracic vertebral body. CONCLUSION: The anterior renal fascia envelops perirenal space except in its medial aspect. In the upper suprarenal region, the anterior and posterior planes of the anterior renal fascia unite to fuse with diaphragmatic fascia, but along the medial aspect they fuse with intrahepatic pericaval connective tissue and posteromedial diaphragm, respectively.