OBJECTIVE: Surgical removal of a thyroglossal duct cyst (TGDC) and its tract is usually accomplished through an external neck incision, including the removal of the middle part of hyoid bone and a block of tissues extending to the foramen cecum. However, this procedure inevitably results in neck scarring. We implemented a modified approach to TGDC removal in a 28-year-old woman through the floor of the mouth using an endoscope system. CASE REPORT: Here, we describe the detailed procedure of the endoscope-assisted intra-oral resection for TGDC. The total operative time was 130 minutes. The patient complained of swelling and pain in the floor of the mouth for 2 days, but did not require any intervention. Follow-up imaging studies confirmed no recurrence (18 months) without any sequelae, and the patient was satisfied with her surgical outcome. CONCLUSION: The intra-oral approach through the floor of the mouth is a technically feasible alternative surgical option that allows for complete removal of a TGDC without the neck scar.

Since first discovered in chick skeletal muscles, stretch-activated channels (SACs) have been proposed as a probable mechano-transducer of the mechanical stimulus at the cellular level. Channel properties have been studied in both the single-channel and the whole-cell level. There is growing evidence to indicate that major stretch-induced changes in electrical activity are mediated by activation of these channels. We aimed to investigate the mechanism of stretch-induced automaticity by exploiting a recent mathematical model of rat atrial myocytes which had been established to reproduce cellular activities such as the action potential, Ca(2+) transients, and contractile force. The incorporation of SACs into the mathematical model, based on experimental results, successfully reproduced the repetitive firing of spontaneous action potentials by stretch. The induced automaticity was composed of two phases. The early phase was driven by increased background conductance of voltage-gated Na(+) channel, whereas the later phase was driven by the reverse-mode operation of Na(+)/Ca(2+) exchange current secondary to the accumulation of Na(+) and Ca(2+) through SACs. These results of simulation successfully demonstrate how the SACs can induce automaticity in a single atrial myocyte which may act as a focus to initiate and maintain atrial fibrillation in concert with other arrhythmogenic changes in the heart.

PURPOSE: To identify the prevalence, risk factors, and subtypes of age-related macular degeneration (AMD) in a screened South Korean population. METHODS: A total of 10,890 participants (aged 50-92) who underwent a health check-up at Kangbuk Samsung Hospital from January to December 2006 were included. Fundus photographs and systemic risk factors were assessed. Subtype frequencies of neovascular AMD were recorded according to angiograms. AMD was defined in accord with the international classification and grading system. Logistic regression analyses were performed to identify risk factors for AMD. RESULTS: The mean age of the 10,890 participants was 57.2 +/- 6.3 years (50-92 years), and 56.2% were men. The age-gender-adjusted prevalence of early AMD was 5.07%. Multiple logistic regression analysis showed that age (OR per 10-year increment, 2.22) and high blood pressure (adjusted OR: 1.35) were independent risk factors for early AMD. The age-gender-adjusted prevalence of late AMD was 0.34%. Only age was significantly associated with late AMD. Of 9 exudative AMD patients who received fluorescein angiography or indocyanine green angiography, 6 eyes (66.7%) showed choroidal neovascularization, 2 eyes (22.2%) had polypoidal choroidal vasculopathy (PCV), and 1 eye (11.1%) had retinal angiomatous proliferation. CONCLUSION: In this study, the prevalence of early AMD was similar to other studies though the prevalence of late AMD was low. High blood pressure as well as age was a risk factor of early AMD. South Koreans may have a higher prevalence of PCV than white populations. These findings provide preliminary information for further investigation of AMD in South Koreans.

KIOM-79, a mixture of ethanol extracts from four herbs (parched Puerariae radix, gingered Magnoliae cortex, Glycyrrhizae radix and Euphorbiae radix), has been developed for the potential therapeutic application to diabetic symptoms. Because screening of unexpected cardiac arrhythmia is compulsory for the new drug development, we investigated the effects of KIOM-79 on the action potential (AP) and various ion channel currents in cardiac myocytes. KIOM-79 decreased the upstroke velocity (V(max)) and plateau potential while slightly increased the duration of action potential (APD). Consistent with the decreased V(max) and plateau potential, the peak amplitude of Na(+) current (I(Na)) and Ca(2+) current (I(Ca,L)) were decreased by KIOM-79. KIOM-79 showed dual effects on hERG K(+) current; increase of depolarization phase current (I(depol)) and decreased tail current at repolarization phase (I(tail)). The increase of APD was suspected due to the decreased I(tail). In computer simulation, the change of cardiac action potential could be well simulated based on the effects of KIOM-79 on various membrane currents. As a whole, the influence of KIOM-79 on cardiac ion channels are minor at concentrations effective for the diabetic models (0.1-10 microg/mL). The results suggest safety in terms of the risk of cardiac arrhythmia. Also, our study demonstrates the usefulness of the cardiac computer simulation in screening drug-induced long-QT syndrome.

Sclerosing stromal tumor (SST) is a rare benign neoplasm of ovarian stromal origin and predominantly affects young women in the second and third decades. This tumor characteristically differentiates itself histologically and clinically from both thecomas and fibromas. We present a case of huge SST of the ovary weighing 10 kg in a 71-year-old postmenopausal woman with a brief review of the literature.

PURPOSE:: To measure central corneal thickness (CCT) and investigate serial changes in CCT, using anterior segment optical coherence tomography (AS-OCT) on corneas in storage medium. METHODS:: Between July and August 2006, 10 human corneoscleral discs from 5 donors between 19 and 57 years of age were obtained. Corneoscleral rims were excised and were transferred to Optisol-GS (Bausch & Lomb, Irvine, CA). After preservation, AS-OCT (Visante OCT; Carl Zeiss Meditec) was performed on all corneoscleral discs to detect serial changes in CCT. The corneas were measured with AS-OCT at 0.5, 1, 2, 3, 4, 6, and 12 hours and then at 1, 2, 3, and 4 days after preservation. RESULTS:: The mean of the baseline CCT measurements obtained with the ultrasound pachymeter was 632.7 mum. The average CCT on AS-OCT decreased to 534 mum in the first day of preservation. As time proceeded, the CCT of each cornea generally decreased. CCT decreased significantly between 30 minutes and 1 hour after preservation (P = 0.004). Also, CCT changes in the interval from preservation to 30 minutes showed a greater decline than during other intervals. Therefore, the most significant change in CCT occurred in the first hour after preservation. CONCLUSION:: AS-OCT offers a fast easy method for evaluating human donor corneas for corneal thickness and structural changes without the risk of bacterial contamination or mechanical damage.

PURPOSE: To compare early postoperative clinical outcomes of photorefractive keratectomy (PRK) and lamellar epithelial debridement (LED). SETTING: Department of Ophthalmology, Kangbuk Samsung Hospital, Seoul, Korea. METHODS: This prospective study was of patients randomly assigned to have PRK or LED. In the LED group, an epithelial flap was created using an Amadeus II epikeratome. Postoperative follow-up was at 1, 3, and 7 days and 1, 3, and 6 months. The outcome parameters were uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), higher-order aberrations (HOAs), epithelial healing time, and corneal haze. RESULTS: The study comprised 39 patients (76 eyes). The mean preoperative spherical equivalent (SE) was -3.96 diopters (D)+/- 1.24 (SD) in the PRK group and -4.06 +/- 1.39 D in the LED group. Postoperative UCVA was significantly better in the LED group 1 day postoperatively. The UCVA was 20/20 or better in 14.6% in the PRK group and 42.9% in the LED group (P =.006); 20/25 or better in 41.5% and 82.9%, respectively (P =.000); and 20/40 or better in 80.5% and 100%, respectively (P =.006). On subsequent follow-up visits, the UCVA was comparable between groups. No eye lost lines of BCVA at 3 months. There was no difference between groups in postoperative SE refraction, HOAs, or corneal haze. CONCLUSIONS: Lamellar epithelial debridement and PRK had comparable safety and efficacy in the surgical correction of low to moderate myopia. The UCVA was significantly better after LED than after PRK 1 day postoperatively and equivalent thereafter.

Purpose: To investigate if the measurement of retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) is affected by soft contact lens wear. Methods: This prospective, observational, cross-sectional clinical study looked at 66 eyes in 66 patients who usually wear soft contact lenses everyday and 36 eyes in 36 patients who did not wear contact lenses during the 6 months prior to the study. No patients had pre-existing retinal or optic nerve pathology or other media opacities that might influence the RNFL thickness. All eyes were scanned using the fast RNFL program of the Stratus OCT with and without soft contact lenses on. Results: The mean RNFL thickness in eyes with and without soft contact lenses was 99.4 +/- 9.7 (SD) mu m and 100.8 +/- 10.3 mu m, respectively, in contact lens wearers. The mean RNFL thickness in eyes with and without soft contact lenses was 102.8 +/- 10.8 mu m and 105.3 +/- 9.9 mu m, respectively, in non-contact lens wearers. The mean RNFL thickness in eyes with and without soft contact lenses was significantly different in both groups of patients (p = 0.006, p = 0.001, respectively). The average RNFL thickness without soft contact lenses was statistically significantly increased in non-contact wearers compared with soft contact lens wearers (p = 0.035). Conclusions: Soft contact lenses may affect the measurement of RNFL thickness using OCT. It is recommended that clinicians be careful in measuring RNFL thickness using OCT with myopic patients using soft contact lenses.

Under physiological conditions, hypochlorous acid (HOCl) is the major product of myeloperoxidase, a ferric heme enzyme released in inflammatory diseases. In the present study, we investigated the effect of HOCl compared to hydrogen peroxide (H(2)O(2)) on the vasoactive intestinal polypeptide (VIP)-induced relaxation of feline lower esophageal sphincter (LES) strips. Isometric tension on LES strips was measured using a force transducer. VIP induced the relaxation of basal LES tone in a concentration-dependent manner. Pretreatment with HOCl (10(-4) M) significantly reduced the VIP-induced relaxation at smaller concentrations than H(2)O(2)(10(-3) M). VIP-induced relaxation is mediated via the Gi/o protein, since pretreatment with Pertussis Toxin (PTX) showed an inhibitory effect on the relaxation. HOCl showed an additional inhibitory effect on the reduced relaxation by PTX, indicating that HOCl might affect another G protein as well as Gi/o. However, HOCl did not affect SNP-, SIN-1-, and 8-br-cGMP-induced relaxation. Nor did HOCl modify the relaxation induced by either forskolin or db-cAMP in LES muscle strips. These results suggest that during short-term treatment, HOCl may damage the upstream events including G protein level, and result in alteration of LES tone in the feline esophagus, similar to the inhibitory effects of H(2)O(2)..

PC-9S (N-Ethanol-2-mirystyl-3-oxo-stearamide) is a synthetic ceramide and has been known to be effective in atopic and psoriatic patients. K112PC-5 (2-Acetyl-N-(1,3-dihydroxyisopropyl)-tetradecanamide) is a novel ceramide derivative of PC-9S. In the present study, we examined the effect of K112PC-5 on macrophage and T lymphocyte function in primary macrophages and splenocytes, respectively, as well as the effect of topical application of K112PC-5 on skin inflammation and atopic dermatitis (AD) in mouse models. K112PC-5 inhibited lipopolysaccharide-induced nitrite generation in mouse peritoneal macrophages in a dose-dependent manner. However, K112PC-5 did not affect concanavalin A-induced proliferation, interleukin (IL)-2 secretion and IL-4 secretion in mouse splenocytes. In addition, K112PC-5 significantly suppressed the increase in phorbol ester-induced ear thickness in BALB/c mice. Further study demonstrated that topical application of K112PC-5 also inhibited AD induced by extracts of dust mites, Dermatophagoides pteronyssinus and Dermatophagoides farinae, in NC/Nga mice. Taken together, these results showed that K112PC-5 exerted an anti-inflammatory effect both in vitro and in vivo and proved to be beneficial in an animal model of AD. Our results suggest that K112PC-5 might be beneficial as a topical agent for the treatment of AD.