Comparison of cytotoxicities and wound healing effects of diquafosol tetrasodium and hyaluronic acid on human corneal epithelial cells

This study aimed to compare the cellular toxicities of three clinically used dry eye treatments; 3% diquafosol tetrasodium and hyaluronic acid at 0.3 and 0.18%. A methyl thiazolyltetrazoiun (MTT)-based calorimetric assay was used to assess cellular proliferation and a lactate dehydrogenase (LDH) leakage assay to assess cytotoxicity, using Human corneal epithelial cells (HCECs) exposed to 3% diquafosol tetrasodium, 0.3% hyaluronic acid (HA), or 0.18% HA or 1, 6 or 24 h. Cellular morphology was evaluated by inverted phase-contrast light microscopy and electron microscopy, and wound widths were measured 24 h after confluent HCECs were scratched. Diquafosol had a significant, time-dependent, inhibitory effect on HCEC proliferation and cytotoxicity. HCECs treated with diquafosol detached more from the bottoms of dishes and damaged cells showed degenerative changes, such as, reduced numbers of microvilli, vacuole formation, and chromatin of the nuclear remnant condensed along the nuclear periphery. All significantly stimulated reepithelialization of HCECs scratched, which were less observed in diquafosol. Therefore, epithelial toxicity should be considered after long-term usage of diquafosol and in overdose cases, especially in dry eye patients with pre-existing punctated epithelial erosion.

The Characteristics and Prognosis of Miller Fisher Syndrome

PURPOSE: In the present study, the clinical characteristics and prognosis of patients clinically diagnosed with classic Miller Fisher syndrome were evaluated. METHODS: We retrospectively investigated the clinical and laboratory findings as well as treatment outcomes using the medical records of patients diagnosed with Miller Fisher syndrome. Symptom triad including acute ophthalmoplegia, ataxia, and areflexia were evaluated. RESULTS: This study included 10 patients. Nine patients had antecedent infectious illness which took an average of 11 ± 9.7 days for onset of diplopia from antecedent infectious systemic illness. Seven patients showed bilateral paralytic strabismus. Specifically, 5 patients showed the involvement of vertical and horizontal extraocular muscles. Pupil impairment and blepharoptosis were observed in 4 patients, limb weakness in 3 patients, dysarthria in 3 patients and facial palsy in 1 patient. Two patients showed contrast enhancement of the abducens nerve on brain magnetic resonance imaging (MRI) and 2 patients showed albumin-cell dissociation on cerebrospinal fluid (CSF) analysis. Eight patients had anti-GQ1b antibodies in their blood serum analysis. Six patients were treated with intravenous immunoglobulins and the other patients were observed with regular follow-ups. The duration of diplopia was 2.9 ± 1.2 months in the treatment group and 3.1 ± 1.7 months in the control group (p > 0.05). The duration of ataxia was 1 ± 0.4 months in the treatment group and 1 ± 0.9 months in the control group (p > 0.05). CONCLUSIONS: Miller Fisher syndrome should be considered in patients with antecedent infection; acute ophthalmoplegia, ataxia and areflexia as well as anti-GQ1b antibody can be helpful for diagnosis. Final outcomes in the treated group were not significantly different from the control group and all patients showed good final outcomes.

Amoebicidal Effect of Nephrite-containing Contact Lens Storage Case

PURPOSE: To compare the amoebicidal effects of nephrite containing contact lens (CL) storage cases with conventional CL storage cases. METHODS: Acanthamoeba lugdunensis were inoculated onto 5% nephrite containing CL storage cases as well as conventional CL storage cases both with and without silicone hydrogel contact lenses (SHCLs). Then the amount of Acanthamoeba proliferation on CL storage cases and the number of adherent Acanthamoeba on SHCLs were determined and compared. The effects of multipurpose solution (MPS) with and without 1% or 5% nephrite solution on Acanthamoeba adhesion were analyzed. RESULTS: Nephrite containing CL storage cases showed more inhibitory effects on Acanthamoeba proliferation (p = 0.02) and significantly reduced the number of adherent Acanthamoeba on SHCLs compared with conventional CL storage cases, regardless of SHCLs generation (p = 0.001, p = 0.001 and p < 0.001, respectively). The number of adherent Acanthamoeba on the first generation of SHCLs was significantly reduced by MPS with 1% and 5% nephrite solutions (p = 0.03 and p = 0.004, respectively), but the numbers for the second and third generation SHCLs were not. CONCLUSIONS: Nephrite could be used as a new additive component for CL storage cases and multipurpose solutions to improve the disinfection effects on Acanthamoeba.

Reproliferation of Idiopathic Epiretinal Membrane after Spontaneous Separation

PURPOSE: To report the reproliferation of membrane after a spontaneous separation in a patient with idiopathic epiretinal membrane (ERM). CASE SUMMARY: A 62-year-old woman complained of metamorphopsia in the left eye. Her vision without correction was 0.8. On fundus examination, the epiretinal membrane was covering the fovea with posterior vitreous detachment. Optical coherence tomography (OCT) showed the ERM and thickened macula. Retinal break, intraocular inflammatory disease, and retinal vascular disease were not noted. We diagnosed her with idiopathic ERM and followed up regularly. At month 7, a partial separation of the membrane from the retinal surface was noted. At month 12, complete spontaneous separation of the ERM from the macula except that in the temporal area was accompanied by improvement of vision to 1.0. OCT, showing recovery of the fovea contour. However, her corrected vision decreased to 0.7 at month 17, and the ERM was again observed to cover the macula. Thickening of the ERM progressed further, and her corrected vision decreased to 0.5 at month 21. CONCLUSIONS: Spontaneous separation of membrane is a rare phenomenon in idiopathic ERM. Reproliferation of membrane can develop and induce visual impairment. Therefore, regular examination is recommended in patients with spontaneous separation of membrane.

Fitting the Miniscleral Contact Lens in Patients with Corneal Abnormalities

PURPOSE: To evaluate the clinical results of fitting the miniscleral contact lens (MSD; Happy Vision Corp., Anyang, Korea) in patients with corneal abnormalities. METHODS: Thirty-eight patients (56 eyes) fitted with MSD lenses were recruited for this study. Clinical indication, visual acuity, degree of comfort, mean wearing time, parameters of the finally prescribed lenses, number of fittings with trial lenses, success rate with the first prescribed lens, and adverse events were evaluated. RESULTS: Forty-two (75%) of 56 eyes were enrolled in this study due to keratoconus. Other conditions included Stevens-Johnson syndrome (6 eyes, 11%), high postkeratoplasty astigmatism (3 eyes, 5%), corneal scarring (3 eyes, 5%), and ectasia after laser in situ keratomileusis (LASIK; 2 eyes, 4%). The mean log MAR visual acuity improved from 1.01 ± 0.64 to 0.13 ± 0.19 after wearing lenses (p= 0.0001). In 53 eyes (94.6%), patients reported the miniscleral contact lenses to be comfortable, and the mean daily wear time was 12.9 ± 2.5 hours. The mean sagittal depth of finally prescribed lenses was 4.67 ± 0.37 mm (3.7-5.4). An average of 3.3 ± 1.5 (1-7) trials were needed for the trial fitting, and the average number of re-prescriptions to achieve the optimal fitting was 1.5 ± 0.48 (1-3). One patient discontinued the lenses after 3 months due to discomfort. CONCLUSIONS: Miniscleral contact lenses are a good alternative for patients with corneal abnormalities and result in both successful visual outcome and comfort.

Effect of Toric Orthokeratology Lenses in Patients with Limbus to Limbus Corneal Astigmatism

PURPOSE: To report the efficacy of toric orthokeratology lenses in patients with astigmatism within 1.5 D having difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. METHODS: Twenty-three eyes of 16 patients with limbus-to-limbus corneal astigmatism who had been wearing toric orthokeratology lenses for more than 6 months were recruited. The uncorrected visual acuity (UCVA), refractive error, and keratometric changes including eccentricity before and after wearing lenses were compared, and the correlations between corneal astigmatism as well as refractive astigmatism and lens toricity were assessed. RESULTS: After wearing the lens, UCVA (log MAR) significantly improved from 0.61 +/- 0.22 to 0.05 +/- 0.08 (p < 0.001). Myopia and spherical equivalent were also reduced significantly (p < 0.001 and p < 0.001, respectively). While Simulated K (Sim K) tended to be more flattened (p < 0.001) and the eccentricity showed significant decrease (p < 0.001), corneal and refractive astigmatism were not changed significantly (p = 0.330 and p = 0.124, respectively). Correlations between corneal and refractive astigmatism and lens toricity were not statistically significant (r = 0.244, p = 0.300; r = -0.051, p = 0.832). No patients showed lens decentration or visual discomfort. CONCLUSIONS: Corneal topography was essential in patients who had difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. Toric orthokeratology lenses may be an effective treatment option in patients with limbus-to-limbus corneal astigmatism.

Effect of Toric Orthokeratology Lenses in Patients with Limbus to Limbus Corneal Astigmatism

PURPOSE: To report the efficacy of toric orthokeratology lenses in patients with astigmatism within 1.5 D having difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. METHODS: Twenty-three eyes of 16 patients with limbus-to-limbus corneal astigmatism who had been wearing toric orthokeratology lenses for more than 6 months were recruited. The uncorrected visual acuity (UCVA), refractive error, and keratometric changes including eccentricity before and after wearing lenses were compared, and the correlations between corneal astigmatism as well as refractive astigmatism and lens toricity were assessed. RESULTS: After wearing the lens, UCVA (log MAR) significantly improved from 0.61 +/- 0.22 to 0.05 +/- 0.08 (p < 0.001). Myopia and spherical equivalent were also reduced significantly (p < 0.001 and p < 0.001, respectively). While Simulated K (Sim K) tended to be more flattened (p < 0.001) and the eccentricity showed significant decrease (p < 0.001), corneal and refractive astigmatism were not changed significantly (p = 0.330 and p = 0.124, respectively). Correlations between corneal and refractive astigmatism and lens toricity were not statistically significant (r = 0.244, p = 0.300; r = -0.051, p = 0.832). No patients showed lens decentration or visual discomfort. CONCLUSIONS: Corneal topography was essential in patients who had difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. Toric orthokeratology lenses may be an effective treatment option in patients with limbus-to-limbus corneal astigmatism.

Long-Term Effect and Safety of Contact Lenses for Keratoconus

PURPOSE: To evaluate the long-term clinical effect and safety of YK-KC lens(R) (LucidKorea Ltd., Seoul, Korea) for keratoconus. METHODS: In this study we investigated 152 keratoconic eyes fitted with YK-KC lens(R) and followed up for at least 5 years. We assessed retrospectively self-reported patient comfort, best corrected visual acuity, corneal topographic indices before and after contact lens fitting and complications during contact lens wearing. RESULTS: The study included 57 male and 40 female patients with a mean age of 28.6 +/- 8.5 years. The mean follow-up was 8.0 +/- 2.9 years. Regarding lens comfort, 126 eyes (82.9%) showed self-reported comfort for YK-KC lenses(R). The mean best corrected visual acuity (log MAR) improved from 0.49 +/- 0.42 before lens fitting to 0.19 +/- 0.27 after lens wearing, which was statistically significant (p < 0.001). Based on the keratometric values, after contact lens fitting both Simulated keratometry (Sim K) max and Sim K min tended to be steeper, but these differences were not statistically significant (p = 0.66 and 0.11, respectively). There were no statistically significant differences between the values before and after fitting with respect to the astigmatic powers (p = 0.22). Complications observed included punctate or coalesced epithelial corneal staining in 24 eyes (16%), however, persistent full-thickness epithelial defect was not observed. CONCLUSIONS: The YK-KC lens(R) in patients with keratoconus can provide excellent visual improvement and comfort without any significant influence on the progression of keratoconus or corneal complications during a long-term follow-up period.

Long-Term Effect and Safety of Contact Lenses for Keratoconus

PURPOSE: To evaluate the long-term clinical effect and safety of YK-KC lens(R) (LucidKorea Ltd., Seoul, Korea) for keratoconus. METHODS: In this study we investigated 152 keratoconic eyes fitted with YK-KC lens(R) and followed up for at least 5 years. We assessed retrospectively self-reported patient comfort, best corrected visual acuity, corneal topographic indices before and after contact lens fitting and complications during contact lens wearing. RESULTS: The study included 57 male and 40 female patients with a mean age of 28.6 +/- 8.5 years. The mean follow-up was 8.0 +/- 2.9 years. Regarding lens comfort, 126 eyes (82.9%) showed self-reported comfort for YK-KC lenses(R). The mean best corrected visual acuity (log MAR) improved from 0.49 +/- 0.42 before lens fitting to 0.19 +/- 0.27 after lens wearing, which was statistically significant (p < 0.001). Based on the keratometric values, after contact lens fitting both Simulated keratometry (Sim K) max and Sim K min tended to be steeper, but these differences were not statistically significant (p = 0.66 and 0.11, respectively). There were no statistically significant differences between the values before and after fitting with respect to the astigmatic powers (p = 0.22). Complications observed included punctate or coalesced epithelial corneal staining in 24 eyes (16%), however, persistent full-thickness epithelial defect was not observed. CONCLUSIONS: The YK-KC lens(R) in patients with keratoconus can provide excellent visual improvement and comfort without any significant influence on the progression of keratoconus or corneal complications during a long-term follow-up period.

Effect of Toric Orthokeratology Lenses on Patients with More Than 1.5 Diopter of Corneal Astigmatism

PURPOSE: To report the effect of toric orthokeratology lenses on myopic patients who have more than 1.5 diopter (D) of corneal astigmatism. METHODS: Seventeen patients (24 eyes) who wore toric orthokeratology lenses for more than 6 months were recruited for this study. The uncorrected visual acuity (UCVA), refractive error and keratometric changes including eccentricity before and after wearing lenses were compared. The correlations between corneal astigmatism as well as refractive astigmatism and lens toricity and between corneal astigmatism and improvement of UCVA after lens fitting were assessed. RESULTS: After wearing lenses, UCVA (log MAR) was significantly improved from 0.93 +/- 0.13 to 0.09 +/- 0.07 (p < 0.001). Myopia changed from -4.53 +/- 1.55 D to -0.67 +/- 0.80 D (p < 0.001), refractive astigmatism from -1.48 +/- 0.71 D to -0.99 +/- 0.72 (p = 0.008) and spherical equivalent from -5.27 +/- 1.56 D to -1.12 +/- 0.92 D (p < 0.001). Simulated K (Sim K) tended to be more flat (p < 0.001) and the eccentricity was significantly decreased from 0.45 +/- 0.08 to -0.69 +/- 0.45 (p < 0.001), but corneal astigmatism was not significantly changed from 2.05 +/- 0.41 D to 2.01 +/- 0.98 D (p = 0.803). Correlation between corneal astigmatism and lens toricity was statistically significant (r = 0.526, p = 0.012) but not between refractive astigmatism and lens toricity (r = 0.218, p = 0.329). The amount of corneal astigmatism was not correlated with the improvement of uncorrected visual acuity after lens fitting (r = 0.1804, p = 0.399). CONCLUSIONS: Toric orthokeratology lenses might be an effective treatment in patients with corneal astigmatism who cannot be fitted with spherical orthokeratology lenses. Lens toricity was correlated with corneal astigmatism and the amount of corneal astigmatism did not affect the improvement of uncorrected visual acuity after lens fitting.

Comparison of Evisceration with Primary Orbital Implant Surgery in Endophthalmitis and Phthisis Bulbi

PURPOSE: To evaluate the efficacy and prognosis of evisceration with primary orbital implant placement in patients with endophthalmitis and compare it to phthisis bulbi patients. METHODS: We retrospectively reviewed the medical records of patients who underwent evisceration with primary implant placement by a single surgeon from January 2005 to December 2011 at Pusan National University Hospital. Age, gender, underlying ocular disease, systemic illness, type and size of implant, follow-up period, and the causative organism were evaluated in patients with endophthalmitis. Success rates and prevalence of complications were compared between endophthalmitis and phthisis patients. RESULTS: The present study included 18 patients (18 eyes) with endophthalmitis and 23 patients (23 eyes) with phthisis. Patients in the endophthalmitis group were older than the patients in the phthisis group and no significant differences in gender, size of implant, and underlying diseases between endophthalmitis and phthisis patients were found. Sixteen endophthalmitis and 20 phthisis patients showed successful surgical outcomes with no significant differences (p = 0.31), and implant exchange rates were not significantly different between endophthalmitis and phthisis bulbi patients (p = 0.52). CONCLUSIONS: Evisceration with primary orbital implant placement in patients with endophthalmitis is a safe and effective treatment method. Comparison between endophthalmitis and phthisis showed no significant differences in success outcomes and complication rates.

Delayed Closure of Idiopathic Macular Hole after Vitrectomy, Internal Limiting Membrane Peeling, and Gas Tamponade

PURPOSE: To report a case of delayed idiopathic macular hole closure after vitrectomy, internal limiting membrane peeling, and gas tamponade. CASE SUMMARY: A 69-year-old female complained of visual disturbance in her left eye. At presentation, her visual acuity was 20/100 in the left eye. Fundus examination and optical coherence tomography revealed a full-thickness macular hole 489 microm in diameter as well as posterior vitreous detachment. Hence, vitrectomy, concurrent cataract surgery, internal limiting membrane peeling and gas tamponade were performed. One month postoperatively, the hole remained unclosed, although decreased in size to 378 microm. At 2 months, cystoid macular edema developed and postoperatively the hole diameter decreased gradually to 311 microm, 252 microm and 156 microm at 2, 3, and 5 months, respectively. Finally, the hole was closed upon the resolution of macular edema at 9 months. However, the visual acuity of 20/100 remained unchanged. CONCLUSIONS: Delayed closure of holes which may be related to cystoid macular edema, can develop after macular hole surgery.

The Relationship between Job Stress and hsCRP / 대한산업의학회지

OBJECTIVES: We wanted to investigate the relationship between job stress and high-sensitivity C-reactive proteins (hsCRP) with a view to using them as a predictor of future cardiovascular events. METHODS: The study subjects were 155 male bank workers. A structured, self-assesment questionnaire was used to analyze the sociodemographic characteristics and job stress of the participants. Seven levels of job stress, as described in the Korean Occupational Stress Scale-Short Form (KOSS-SF), were used to categorized the participants. We included tests for blood pressure, fasting blood sugar, blood lipid level (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides), and hsCRP in our analysis. Multiple logistic regression modeling was used to determine an association between job stress and cardiovascular risk factors including hsCRP. RESULTS: In the multiple logistic regression analyses adjusted for general and job characteristics and cardiovascular risk factors, interpersonal conflict (adjusted OR 1.69, 95% CI=1.11~2.57), job insecurity (adjusted OR 1.94, 95% CI=1.24~3.03) and, occupational climate (adjusted OR 1.89, 95% CI=1.19~3.01) were associated with hsCRP. CONCLUSION: This study suggests that job stress is associated with hsCRP which is a predictor of future cardiovascular events.

Factors for Approving Cerebrovascular Disorders and Cardiovascular Diseases as Work-related Diseases in Chronically Overworked Workers / 대한산업의학회지

OBJECTIVES: This study was conducted to analyze the factors that affected the decision of claims for cerebrovascular disorders and cardiovascular diseases in chronically overworked workers, that submitted their claims after the reformation of approval standards in the Industrial Accident Compensation Insurance Act on 1 July 2008. METHODS: Of 2909 cases, who claimed between January 1. and December 31. 2009, 1046 cases were selected based on their worker's compensation record and investigated following 6 provincial committees for work-related diseases. The approval rate and odds ratio were analyzed with respect to the general characteristics, past medical history and work-related information using a logistical regression and Student t-test. RESULTS: Of the 1046 selected cases, the approval rate was 18.5%(194 cases). In the multivariate logistical regression analysis, the factors for approving cerebrovascular disorders and cardiovascular diseases as work-related diseases were found to be the average working time over the last 1 week, occupational category, gender, age, death or survival, the presence of an associated disease, claimed province, and smoking. CONCLUSION: Factors for approving claims of cerebrovascular disorders and cardiovascular diseases as work-related diseases were the average working time over last 1 week, gender, age, death or survival, claimed disease, presence of associated disease, claimed province, smoking.

The Effect of a Stretching Exercise on Myofascial Pain Syndrome Patients in Small and Medium Sized Industries / 대한산업의학회지

OBJECTIVES: This study was conducted to identify the effect of a stretching exercise on myofascial pain syndrome patients that work in small and medium-sized industry. METHODS: Questionnaires surveys including general characteristics, work-related characteristics, and musculoskeletal symptoms on neck and shoulder area was administered to 393 subjects who worked in small and medium sized industries. Symptomatic workers were examined to identify whether they had myofascial pain syndrome (MPS). Of the 393 subjects, 108 MPS patients performed 6 weeks stretching exercise program. Intensity of pain was estimated with visual analogue scales (VAS). All patients were interviewed to estimate their compliance to stretching exercise program. RESULTS: Of the 393 workers, 119 workers were diagnosed with MPS of the neck and shoulder. Post-exercise VAS was significantly reduced compared to pre-exercise VAS (p<0.05). High compliance patients to stretching exercise were more effective to exercise therapy (OR 2.89, 95% CI 1.19~7.04), and overtime workers were less effective to exercise therapy (OR 0.41, 95% CI 0.17~0.95). CONCLUSION: The Stretching exercise program was identified to be effective in MPS patients in small and medium-sized industries. It is recommended that workers with MPS in small and medium-sized industries practice a well-designed stretching exercise program, and avoid overtime work.

Newly Designed Sheaths for Gastroduodenal Intervention: An Experimental Study in a Phantom and Dogs

OBJECTIVE: To evaluate the usefulness of newly designed sheaths for gastroduodenal intervention in a gastric phantom and dogs. MATERIALS AND METHODS: A regular sheath was made using a polytetrafluoroethylene tube (4 mm in diameter, 90 cm long) with a bent tip (4 cm long, 100 degree angle). For the supported type of sheath, a 5 Fr catheter was attached to a regular sheath to act as a side lumen. To evaluate their supportability, we measured the distance of movement of the sheath's tip within a silicone gastric phantom for three types of sheath, the regular type, supported type, and supported type with a supporting guide wire. The experiments were repeated 30 times, and the results were analyzed using ANOVA with the postHoc test. In addition, an animal experiment was performed in six mongrel dogs (total: 12 sessions) to evaluate the torque and supportability of the sheaths in the stomach, while pushing a guide wire or coil catheter under fluoroscopic guidance. RESULTS: In the guide wire application, the distances of movement of the sheath tip in the three types of sheath, the regular type, supported type, and supported type with supporting guide wire, were 8.40+/-0.51 cm, 6.23+/-0.41 cm, and 4.47+/-0.32 cm, respectively (p < 0.001). In the coil catheter application, the corresponding values were 7.22+/-0.70 cm, 5.61+/-0.31 cm and 3.91+/-0.59 cm, respectively (p < 0.001). All three types of sheath rotated smoothly and enabled both the wires and catheters to be guided toward the pylorus of the dog in all cases. CONCLUSION: The newly designed sheaths can be useful for gastroduodenal intervention.

Transluminal Radio-Frequency Thermal Ablation Using a Stent-Type Electrode: an Experimental Study

PURPOSE: To assess the feasibility of transluminal radiofrequency thermal ablation using a stent-type electrode and to determine, by means of in-vitro and in-vivo animal studies, the appropriate parameters. MATERIALS AND METHODS: In vitro: The radiofrequency electrode used was a self-expandable nitinol stent with 1cm insulated ends. A stent was placed in the portal vein of bovine liver, and ablations at target temperatures of 70, 80, 90, and 100degrees C were performed. Ablated sizes were measured longitudinally. In vivo: Four mongrel dogs were anesthetized, and a stent was inserted in the common bile duct under fluoroscopic guidance through an ultrasound-guided gall bladder puncture site. The ablation temperature was set at 80 degrees C, and each dog underwent proximal and distal esophageal ablations lasting 12 minutes. They were sacrificed immediately. RESULTS: In-vitro: Ablated sizes showed significant correlation with target temperatures (r>0.04; p<0.05). Although most lesions were fusiform, dumbbell-shaped lesions with central thinning were found in two cases in the 70degrees C group. In all cases in the 70 degrees C and 80 degrees C group, the length of the insulated segment was less than 1 cm. In-vivo: At microscopy, tissues at the center of the biliary stent showed more prominent pathological change than those at the periphery while those remote from the stent showed minimal or no change. In esophageal ablations, the mean highest temperature was 48.6 degrees C. Microscopy demonstrated the destruction and shedding of mucosa, edema, and coagulation necrosis of submucosa, but in muscle layers no abnormalities were apparent. CONCLUSION: Transluminal radio-frequency thermal ablation using a stent-type electrode may be useful for elongating patency. The appropriate target temperature for biliary ablation is 80 degrees C.

Development of an Abdominal Aortic Aneurysm Model for Stent-graft Insertion

PURPOSE: To determine the efficacy of an abdominal aortic aneurysm model for stent-graft placement. MATERIALS AND METHODS: The model consists of two parts, the heart and the vascular system. A peristaltic pump and a solenoid valve were used to simulate a pulsatile flow from the heart. A ball-shaped piece of clay was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed and a silicone tube was used to connect the heart model and the aneurysm model. The silicone tube was also used to simulate the iliac arteries and one end of the artery was clamped and the other one was extended to a water bath. Water at 37 degrees was circulated through the model, and the pressure at the thoracic aorta, aneurysm and iliac artery was measured with the outlet valve opening at 25, 50, and 100% before and after stent-graft placement. RESULTS: The liquid pressure measurements were 253/252, 271/162 and 264/166 mmHg at the thoracic aorta, aneurysm and iliac artery, respectively, when the outlet was 100% open. They were 173/121, 145/99, 145/106 mmHg when the outlet was 50% open, and 35/28, 61/44, 24/22 mmHg when it was 25% open. After placement f the stent-graft, the pressure measurements were 170/132, 174/128, and 167/128 mmHg, respectively. CONCLUSION: Since it was easy to produce, the model was useful for in-vitro stent-graft testing, and a wide range of pressure could be applied.

Lipoma Arborescens in the Knee Joint: A Case Report

Lipoma arborescens is a rare intra articular lesion consisting of a villous lipomatous proliferation of the synovial lining and occurs mainly in the knee joint. It is mostly found in older patients with joint trauma, meniscal lesions or chronic synovitis. The authors describe one case of a 29-year-old male with multiple lipomas in the right knee joint who has a history of joint trauma. He had joint effusion, pain, giving way and restricted terminal extension of the right knee. Histology and gross findings are consistent with the lipoma arborescens. After arthroscopic excision of the masses, symptom was relieved completely and the patient had gained full range of motion of the right knee joint.