PURPOSE: Keratomileusis was performed in rabbits to investigate the effects of corneal epithelium on the corneal stromal keratocyte apoptosis and the effect of human IL-1alpha and TNFalpha on apoptotic genes in human corneal stromal cells was evaluated. METHODS: Fifty six New Zealand white rabbits underwent corneal flap procedure and corneal epithelium was inserted between the corneal flap and underlying stroma. Keratocyte apoptosis was detected with the TUNEL assay. Gene array technique was used to evaluate changes in apoptosis gene in human stromal fibroblasts in response to human recombinant IL-1alpha and TNFalpha in vitro. RESULTS: Keratocyte apoptosis was significantly greater in group for flap with insertion of peripheral epithelium at 4 hours after surgery(p=0.0249). IL-1alpha or TNFalpha regulated the expression of several genes (insulin like growth factor, stress activated protein kinase, GTP binding protein, IGFBP4) up and down in human stromal fibroblasts in culture. CONCLUSIONS: We think that the differences in the stromal cell apoptosis after keratomileusis were due to stromal cell response to various factors of inserted corneal epithelium. We found various new apoptosis gene expression in cultured human keratocytes mediated by IL-1alpha and TNFalpha that were secreted in corneal epithelium. These genes likely trigger the apoptosis of keratocyte following epithelial insertion associated with corneal surgery.
Apoptosis* ; Epithelium ; Epithelium, Corneal* ; Fibroblasts ; Gene Expression ; GTP-Binding Proteins ; Humans ; In Situ Nick-End Labeling ; Keratomileusis, Laser In Situ ; Protein Kinases ; Rabbits ; Stromal Cells ; Tumor Necrosis Factor-alpha

To evaluate the postoperative prognostic factors of pars plana vitrectomy for the proliferative diabetic retinopathy, the authors studied retrospectively the surgical results of 65 eyes that have been followed over 6 months postoperatively. The surgical results were varied according to the indication. Seventy six percent of eyes with vitreous hemorrhage obtained final vision of 5/200 or better. Similar results were obtained in 73% of eyes with macular traction detachment, 47% of eyes with rhegmatogenous-traction detachment. Rhegmatogenous-traction detachment has less favorable outcome than vitreous hemorrhage and macular traction detachment. Factors associated with a favorable visual prognosis were as follows: (1) preoperative visual acuity of 5/200 or better, (2) the avoidance of performing lensectomy, (3) the avoidance of using intraocular gas bubbles, (4) the absence of preoperative retinal detachment. Thirteen eyes resulted in anatomic failure ; vitreous hemorrhage was the cause of failure in 4 eyes(31%) and anterior hyaloid fibrovascular proliferation in 3 eyes(23%), The causes of poor visual outcome included optic atrophy in 3 eyes, ischemic maculopathy in 2 eyes, submacular fibrosis in 1 eye and cataract in 1 eye.
Cataract ; Diabetic Retinopathy* ; Fibrosis ; Hemorrhage ; Optic Atrophy ; Prognosis ; Retinal Detachment ; Retrospective Studies ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

We report a case of type III hyperlipoproteinemia which is called a broad-beta disease. A 53 year old female patient visited our clinic for the evaluation of multiple yellowish papules on extremities and eyelids. The patient showed various types of xanthoma includiiig eruptive, tuberous, tendinous xanthomas and xanthelasma palpebrarum, xanthoma striatum palmare. The blood chemistry revealed a marked elevstion of cholesterol and triglycerides and agarose gel electrophoresis showed a single peak at prebeta and beta portion without separation. On histopathologic studies, typical foam cells were showen.
Chemistry ; Cholesterol ; Electrophoresis, Agar Gel ; Extremities ; Eyelids ; Female ; Foam Cells ; Humans ; Hyperlipoproteinemia Type III* ; Hyperlipoproteinemias ; Middle Aged ; Triglycerides ; Xanthomatosis

Eales disease is an uncommon idiopathic vasoproliferative retinal disease that primarily affects the peripheral retina. We experienced a 17-year-old male patient who was referred to our clinic because of retinal hemorrhage at the superior temporal quadrant of his left eye. After excluding other causes of branch retinal vein occlusion with medical evaluation, the primary branch retinal vein occlusion was diagnosed. During the follow-up period, retinal vasculitis developed in the peripheral retina of his both eyes along with rapid development of the neovascularization in the left eye. Eales disease was diagnosed. In spite of scattered laser photocoagulation, vitreous hemorrhage eventually occurred, requiring pars plana vitrectomy. We emphasize the occurrence of the branch retinal vein occlusion in young patient with Eales disease.
Adolescent ; Follow-Up Studies ; Humans ; Light Coagulation ; Male ; Retina ; Retinal Diseases ; Retinal Hemorrhage ; Retinal Vasculitis ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Vitrectomy ; Vitreous Hemorrhage

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

No abstract available.
Knee* ; Ligaments*

The first description on the discoid meniscus was made by Young in 1889 and was known as it affects only the lateral meniscus for a long time. However, Cave and Staples had reported the two cases of discoid changes on medial meniscus in 1941. Smillie(1948) had stated that the menisci exist as cartilagenous discs at an early stage of fetus and remain in discoid shape congenitally. Kaplan(1957) reported that the discoid meniscus is not caused by congenitally but acquired in relation of joint motion. A clinical analysis is made on the 22 discoid meniscus which were removed surgically and summarized as follows: 1. The click sound on walking, tenderness and positive McMurray test were important as diagnostic criteria and were present all of the cases. 2. The most of the discoid meniscus were found in first and second decade in 13 cases(76.5%) out of 22. The five cases were bilateral. 3. The discoid change of the meniscus had no sex defferences in their incidence but lateral involvement were far superior than in ten times. 4. The discoid meniscus shows degenerative change microscopically 17(77.3%). 5. The clinical result of surgical removal of discoid meniscus was satisfactory in resuming their full activities in six weeks.
Clinical Study ; Fetus ; Incidence ; Joints ; Menisci, Tibial ; Walking

OBJECTIVE: The aim of this study was to explain what the relationship is between identity and psychological well-being and how these are related to successful aging of old-aged women. METHODS: The subjects were thirty females above 60 years old in the first study where we interviewed each ten subjects for 2 hours in three groups. In the second study we surveyed 320 old-aged men and women by questionnaire for about 15 minutes. RESULTS: From focus-group interview we found the freedom from everything in life was perceived as an important change in old-aged women. But their identity was mainly derived from family relationship in aspects of economy and/or care of their grandson/-daughter. The results from analyses of questionnaire survey (n=320) were as follows ; first, women were more positive than men (female 63.1% versus male 56.5%) in the evaluation of their past life. Second, women were also more positive (female 23.7% versus male 15.2%) in the expectation for the future. Third, the successful aging had positive relationships with acceptance for aging, cohabitation with family members, income, female gender and age (65-69 years) ; and negative relationships with stress and loneliness/depression, but no relationships with decreased memory and poor sleep. CONCLUSION: We concluded that identity for the successful aging in old-aged women is mainly derived from family relationship.
Aging* ; Family Relations ; Female ; Freedom ; Humans ; Male ; Memory ; Mental Health* ; Surveys and Questionnaires

Usual managements of flat anterior chamber following filtering surgery are deepening of anterior chamber using cycloplegics and mydriatics, and pressure patch technique compressing the fistula. But the pressure patch technique may worsen chamber depth problem because exact compression on the filtering area is difficult by pressure patching. Prolonged pressure patching may also cause deterioration of filtering function. The tampon with glaucoma shell provides enough resistance to excessive outflow, allows the anterior chamber to reform promptly, and can prevent choroidal separation. We treated the flat anterior chamber following trabeculectomy using glaucoma shell in 7 eyes. The anterior chamber in each eye was restored promptly within 2-4 days after the placement of glaucoma shell. Glaucoma shell is easy to handle, gives minimal discomfort to patient, and may need less time to restore flat anterior chamber than pressure patching.
Anterior Chamber* ; Choroid ; Filtering Surgery ; Fistula ; Glaucoma* ; Humans ; Mydriatics ; Trabeculectomy*

The combination of an intradermal nevus with epidermal cyst or other adnexal tumors has often been described since 1952. Most of these reports have involved the coexistence of common epidermal cysts and melanocytic nevi. Herein, we report a 21-year-old Korean male, who initially presented to our department with a rapidly enlarging preexisting nevus on his back. The mass was surgically excised and histopathologically showed intradermal nevus combined with epidermal cyst.
Epidermal Cyst ; Humans ; Male ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented ; Young Adult