The cilio-retinal artery appears on the temporal side of the optic disc margin and is concerned with the supply of the portion between the optic disc and the macula. So, the cilio-retinal artery preserves vision when occlusion of the central retinal artery occurs. The aberrant macular artery is very rare and in most of the cases have been derived from the inferior temporal arterial or venous trunks. When this artery is appeared, the corrected vision is normal but sometimes diminished. The authors have experienced two aberrant retinal vessels of a large cilio-retinal artery and aberrant macular artery combined with the Stargardt's maculopathies. It was reviewed clinically with the literature.
Arteries ; Retinal Artery ; Retinal Vessels* ; Retinaldehyde*

The eye tumors are divided into intraocular and extraocular, and mainly involve lids, conjunctiva, cornea, and orbit. The authors analysed histopathological and clinical review of 9 cases of eye tumors that had experienced.
Conjunctiva ; Cornea ; Orbit

Cholangiocarcinoma is a form of adenocarcinoma arising from the intrahepatic or extrahepatic biliary epithelium. Apparent predisposing factors include some chronic hepatobiliary parasitic infsttations, congenital anomalies with ectatic ducts, sclerosing cholangitis and chronic ulcerative colitis and occupational exposure to possible biliary tract carcinogens. Patients with cholangiocarcinoma usually present with biliary obstruction, painless jaundice, pruritus, weight loss and acholic stools. Because the obstructing process is gradua1, the cholangiocarcinoma is often far advanced by the time it presents clinically. The diagnosis is most frequently made by cholangiography following ultrasound demonstration of dilated intrahepatic bile ducts. We report a case of common bile duct cancer spreading to gallbladder and common hepatic duct along the biliary mucosal epitherium and submucosal tissue in 68-year-old female patient along with a review of literature.
Adenocarcinoma ; Aged ; Bile Ducts, Intrahepatic ; Biliary Tract ; Carcinogens ; Causality ; Cholangiocarcinoma ; Cholangiography ; Cholangitis, Sclerosing ; Colitis, Ulcerative ; Common Bile Duct* ; Diagnosis ; Epithelium ; Female ; Gallbladder* ; Hepatic Duct, Common* ; Humans ; Jaundice ; Occupational Exposure ; Pruritus ; Ultrasonography ; Weight Loss

Paraquat is a bipyridilium nonselective contact herbicide and well-known pulmonary toxicants. Concentrated solution of paraquat may causes severe corrosive injury and multiple system organ failure. It is poorly absorbed from GI tract, but is extremely toxic and so one swallowed mouthful of Gramoxone(about 5ml) will be fatal. We experienced 3 cases of paraquat poisoning through injection and examined pathologic findings, medical records and concentration of paraquat in blood and tissues. We reviewed the mechanism of action of paraquat, pathologic changes of organ system, concentration of compound in the various organ and cause of death in autopsy cases.
Autopsy* ; Cause of Death ; Gastrointestinal Tract ; Medical Records ; Mouth ; Paraquat* ; Poisoning*

BACKGROUND: Identifying the donor and isolation-related factors during the islet isolation would be greatly helpful to improve the result of human islet isolation for successful clinical islet transplantation. METHODS: Sixty-nine pancreata from cadaveric donors were isolated with standard protocol and analyzed to identify the donor factors and isolation variables for successful isolation. Islet isolations recovered > or = 100,000 Islet Equivalent (IEQ, n=53) were compared to islet mass less than 100,000 IEQ (n=16). RESULTS: The mean islet recovery was 216.0 x 10(3) +/- 173.7 x 10(3) (IEQ) before purification and 130.6 x 10(3) +/- 140.2 x 10(3) (IEQ) after purification. Mean purity was 54 +/- 31%. Mean age of donor was 31.2 +/- 13.2 year and mean cold ischemic time was 6.9 +/- 6.2 hour. Quality of isolated islets was acceptable in terms of bacterial culture, viability and secretory function in vitro and in vivo. In univariate analysis on successful isolation, status of pancreas was the only significant factor and sex, duration of collagenase expansion and digestion time were marginal factors. Stepwise multivariate logistic regression analysis showed donor sex, status of pancreas and digestion time were significant factors for the successful islet isolation. CONCLUSION: This study confirms some donor factors and variables in isolation process can influence the ability to obtain the successful isolation of human islet. Enough experiences and pertinent review of donor and isolation factors can make islet isolation successful, supporting the clinical islet transplantation without spending of cost.
Cadaver ; Cold Ischemia ; Collagenases ; Digestion ; Humans* ; Islets of Langerhans Transplantation ; Logistic Models ; Pancreas* ; Tissue Donors

PURPOSE: Islet cell transplantation, as an alternative approach to endocrine cell replacement to treat the diabetes mellitus, has received significant attention because it holds several advantages over whole gland transplantation. However cell damage from islet isolation and immunologic rejection after transplantation prevent from successful clinical application for diabetic patients. Culture of cells at low temperature has known to stabilize the cell viability, and to decrease the immunologic antigenicity. Aim of this study is to investigate the effect of culture at 24oC on cell viability, cellular function, immunogenicity and cytokine profiles in rat pancreas islet. METHODS: Pancreas islets were isolated from Lewis rat and cultured at 24oC or 37oC during 14 days. Islet recovery after culture period was counted as islet equivalent number, and islet viability was examined with fluorescent vital staining (FDA/PI). Islet function was measured with glucose stimulation test. Annexin V expression and MHC class I and II expression were measured with flow cytometric assay for apoptosis and immunogenicity respectively. Lymphocyte cell proliferation through mixed lymphocyte islet culture was examined with WST-1 proliferation assay. Cytokine profiles were analyzed with quantitative real time RT-PCR. All these parameters were measured on 1, 3, 5, 7, 14 culture days after islet isolation. RESULTS: Islet recovery was higher in islet cultured at 24oC than in islet cultured at 37oC without change of viability. Insulin secretion after glucose stimulation was more effective in 24oC culture condition. Decrease of apoptotic cell death was demonstrated in 24oC cultured islet. MHC class I and II expression on islets and lymphocyte proliferation when cocultured with islets were less prominent in 24oC cultured islet. TNF-alpha and IL-4 cytokine expression was higher in islet cultured at 24oC than in islet cultured at 37oC. IL-1beta and IL-10 cytokine expression were similar in both culture condition. CONCLUSION: This study demonstrated that cell recovery and function are increased in islet cultured at 24oC than in islet cultured at 37oC while antigenicity and proinflammatory cytokine expression are decreased. Low temperature culture can be a good approach to prevent the loss of islet mass, and to reduce the immunologic rejection of transplanted islet for successful clinical islet transplantation.
Animals ; Annexin A5 ; Apoptosis ; Cell Death ; Cell Proliferation ; Cell Survival ; Diabetes Mellitus ; Endocrine Cells ; Glucose ; Humans ; Insulin ; Interleukin-10 ; Interleukin-4 ; Islets of Langerhans Transplantation ; Islets of Langerhans* ; Lymphocytes ; Pancreas* ; Rats* ; Tumor Necrosis Factor-alpha

PURPOSE: It has been studied prognostic factors about secondary displacement after conservative treatment of the distal radius fracture, but each study showed different results. Authors retrospectively evaluated factors known to be involved secondary displacement of the distal radius fracture to determine its significance. METHODS: One hundred eighteen cases of the radiographically unstable distal radius fractures that closed reduction was adequately performed were retrospectively studied and the radiographic images were taken at 1, 2, 3, 4, 6 weeks after closed reduction. During follow-up, dorsal tilt more than 15°, volar tilt more than 20°, ulnar positive variance more than 4 mm, radial length less than 6 mm, radial inclination less than 10° were thought of the loss of reduction. RESULTS: In 41 cases (34.7%), the loss of reduction occurred. Sex, intra-articular fracture, dorsal and volar comminution, concomitant ulnar fracture and involvement of the distal radio-ulnar joint were statistically not significant. Analysis results of the binomial logistic regression model were as follows: age (p=0.003), radial shortening (p=0.010) and ulnar positive variance (p=0.010) were statistically significant as the predictive prognostic factors. Analysis results of the multinomial logistic regression model showed age (p=0.006) as an only statistically significant factor. CONCLUSION: As the predictive prognostic factors for development of secondary displacement after conservative treatment of the unstable distal radius fracture, age was determined as most significant factor. Also radial shortening and ulnar positive variance were thought of the predictive factors for secondary displacement.
Colles' Fracture ; Follow-Up Studies ; Intra-Articular Fractures ; Joints ; Logistic Models ; Radius Fractures* ; Radius* ; Retrospective Studies

Purpose: To assess characteristics the application of mobile medication system and medication administration error (MAE) alerts in a general hospital. Methods: The subject hospital adopted a mobile medication system in 2016. All medication administrations in the general wards and ICUs were automatically recorded in real-time using identification barcodes, drug barcodes, and hand-held point-of-care devices. MAE alert logs were recorded from April 1st 2017 to March 31st 2018. For this study analysis was done using Pearson’s chi-squared test for potentially related factors of MAE alerts included administration time, order type, medication route, and length of nurse’s employment. Results: The total number of medications during the period of this study was 3,227,990. Among them, 2,698,317 medication doses were recorded, resulting in the system application rate of 83.6%. The system application rate was significantly correlated with all factors related to potential MAE alters. In this study 23,314 MAE alerts(0.9% of the total medication doses) were identified. The MAE alerts were related to new (OR=2.26, p<.001) and emergency (OR=2.25, p<.001) orders, and administration at a non-standard time (OR=2.032, p<.001). Medication route (p<.001), and nurse’s employment duration(p<.001) were also related. Conclusion A mobile medication system contributes to improving patient safety by preventing potential MAEs. The MAE alerts were related to administration time, order type, medication route, and duration of nurse’s employment. In order to prevent medication administration errors, it is necessary to standardize the process of medication and create an environment in which medication administration can be performed in a planned situation.

Background/Aims: We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients. Methods: The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references. Results: The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden’s J to classify frailty by both the CHS scale and CGAFI. Conclusions The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.

Background/Aims: We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients. Methods: The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references. Results: The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden’s J to classify frailty by both the CHS scale and CGAFI. Conclusions The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.