No abstract available.
Hemangioma*

PURPOSE: To investigate the therapeutic potential of anti-CD4 antibody as an anti-inflammatory agent for the experimental autoimmune anterior uveitis. METHODS: Lewis rats were immunized with melanin-associated antigen and treated with anti-CD4 antibody for a week and then received secondary immunization with the same antigen at 8 weeks after primary immunization. The clinical grading of the uveitis and the effect of anti-CD4 on cell death and cytokine (IFN-gamma, IL-10) expression were followed. RESULTS: The cell death of CD4+ T cells was dependent on the dose of the antibody. The prevention of the primary uveitis paralleled the deletion of CD4+ T cells. The secondary uveitis was suppressed in the eyes treated early with lower doses (0.1, 1 mg/kg) of the antibody, even though mild degree of intraocular inflammation appeared in the primary uveitis in these groups. In the eyes treated with higher doses (10, 20 mg/kg), the severity of secondary uveitis was slightly reduced despite complete suppression of primary uveitis. IFN-gamma producing CD4+ T cells decreased and IL-10 producing CD4+ T cells increased after early anti-CD4 mAb treatment with a lower dose (1.0 mg/kg). CONCLUSIONS: These results show that anti-CD4 antibody treatment could be used in the future for the treatment of endogenous uveitis.
Animals ; Cell Death ; Immune Tolerance* ; Immunization ; Immunization, Secondary ; Inflammation ; Interleukin-10 ; Rats ; T-Lymphocytes ; Uveitis ; Uveitis, Anterior*

BACKGROUND: Chronic suppurative otitis media is one of the most common disease in the otolaryngologic field. It is important to choose of antibiotics in the management of chronic suppurative otitis media. OBJECTIVES: Bacteriologic studies can make it possible to use appropriate antibiotics. MATERIALS AND METHODS: The bacteriologic study was made on 98 cases of chronic suppurative otitis media who visited the department of otolaryngology, Dae Dong Hospital in Pusan from Nov. 1989 to Dec. 1995 and the following results were obtained. RESULTS: 1) In 90 cases in which pathogenic organism was isolated, single infection was 81 cases(90%) and mixed infection was 9 cases(10%). 2) The most frequent pathogenic organism was Staphylococcus(46.5%) and Proteus(16.1%), Pseudomonas(14.1%), Providencia(10.1%) were the next. 3) In the aspect of the sensitivity to antibiotics, Ciprofloxacin, Ceftriaxon and Amikacin were sensitive drug generally. 4) Staphylococcus was sensitive to Vancomycin and Ciprofloxacin. 5) Proteus was sensitive to Amikacin, Ciprofloxacin, and Ceftriaxon. 6) Pseudomonas was sensitive to Ciprofloxacin, Amikacin and Piperacin. 7) Providencia was sensitive to Ciprofloxacin, Ceftriaxon, Amikacin and Piperacin. 8) Methicillin Resistant Staphylococcus Aureus(MRSA) was 19 Strains(45.5%). CONCLUSION: Recently, pathologic strain and it's sensitivity to antibiotics has changed. So, we recommand that periodic bacteriologic study and sensitivity test should be done for effective management of chronic otitis media.
Amikacin ; Anti-Bacterial Agents ; Bacteriology ; Busan ; Ceftriaxone ; Ciprofloxacin ; Coinfection ; Methicillin Resistance ; Otitis Media ; Otitis Media, Suppurative* ; Otolaryngology ; Proteus ; Providencia ; Pseudomonas ; Staphylococcus ; Vancomycin

OBJECTIVE: Various procedures have been introduced for anterior interbody fusion in degenerative cervical disc disease including plate systems with autologous iliac bone, carbon cages, and cylindrical cages. However, except for plate systems, the long-term results of other methods have not been established. In the present study, we evaluated radiologic findings for cylindrical cervical cages over long-term follow up periods. METHODS: During 4 year period, radiologic findings of 138 patients who underwent anterior cervical fusion with cylindrical cage were evaluated at 6, 12, 24, and 36 postoperative months using plain radiographs. We investigated subsidence, osteophyte formation (anterior and posterior margin), cage direction change, kyphotic angle, and bone fusion on each radiograph. RESULTS: Among the 138 patients, a minimum of 36 month follow-up was achieved in 99 patients (mean follow-up : 38.61 months) with 115 levels. Mean disc height was 7.32 mm for preoperative evaluations, 9.00 for immediate postoperative evaluations, and 4.87 more than 36 months after surgery. Osteophytes were observed in 107 levels (93%) of the anterior portion and 48 levels (41%) of the posterior margin. The mean kyphotic angle was 9.87degrees in 35 levels showing cage directional change. There were several significant findings : 1) related subsidence [T-score (p=0.039) and anterior osteophyte (p=0.009)], 2) accompanying posterior osteophyte and outcome (p=0.05). CONCLUSION: Cage subsidence and osteophyte formation were radiologically observed in most cases. Low T-scores may have led to subsidence and kyphosis during bone fusion although severe neurologic aggravation was not found, and therefore cylindrical cages should be used in selected cases.
Carbon ; Follow-Up Studies ; Humans ; Kyphosis ; Osteophyte

The purpose of this study was to evaluate the usefulness of retinal nerve fiber layer [RNFL] photography and Heidelberg Retina Tomograph [HRT, Heidelberg, Germany] in early detection of glaucoma. Among 2802 people who underwent routine health checkup at. Seoul National University Hospital from July I to Decernber 31, 1996, forty-nine persons were included whose IOP was above 21mmHg or cup/disc ratio was 0.5 or greater. RNFL photography, HRT and automated perimetry [Humphrey Field Analyzer, program C30-2] were performed. Twelve eyes were diagnosed as glaucoma and one sye as glaucoma suspect. Four eyes with glaucoma had RNFL defect with normal visual field and 7 eyes with glaucoma had both RNFL defect and glaucomatous visual field defect. Of 26 eyes suggested as glaucoma by FSM classification of HRT, only 8 eyes met the diagnostic cri-teria of glaucoma of this study. Among 21 eyes with decreased hump height in HRT only 7 eyes were diagnosed as glaucoma. RNFL photography increased the detection rate for glaucoma by 50% over that with visual field test. only. RNFL photography will be a valuable method for early detection of glaucorna while HRT may play a suppleinentary role.
Classification ; Glaucoma* ; Humans ; Nerve Fibers* ; Photography ; Retina ; Retinaldehyde* ; Seoul ; Visual Field Tests ; Visual Fields

The authors investigated the anatomical results of pars plana vitrectomy for diabetic retinopathy and analyzed the cases which resulted in poor functional outcome in spite of successful anatomical result. The medical records of 133 vitrectomized eyes for the complications of diabetic retinopathy were reviewed retrospectively.The surgical failure was defined as detached retina involving macula or media opacity due to vitreous hemorrhage on final examination. Fourteen eyes (10.5%)had surgical failure and risk factors associated with poor anatomical results included difficulty in bleeding control during the surgery and incomplete removal of traction membrane.Fourteen eyes (10.5%) had poor visual outcome (final visual acuity less than 0.01)even though they had successful anatomical result.Cataract was the cause in 5 eyes (3.8%), neovascular glaucoma in 4 eyes (3%), optic nerve atrophy in 2 eyes (1.5%), secondary glaucoma associated with silicone oil injection in 2 eyes (1.5%), and corneal opacity in 1 eye (0.8%). This study showed that the complete removal of traction membrane and intraoperative bleeding control were significantly associated with the anatomical success of diabetic vitrectomy.
Atrophy ; Corneal Opacity ; Diabetic Retinopathy* ; Glaucoma ; Glaucoma, Neovascular ; Hemorrhage ; Medical Records ; Membranes ; Optic Nerve ; Retina ; Risk Factors ; Silicone Oils ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

The relationship between the amount of posterior displacement of the retinal surface at the temporal disc margin and the reference height(HRef)in analyzing optic disc using Heidelberg Retina Tomograph(HRT;Heidelberg Engineering, Heidelberg, Germany)was evaluated. The displacement was measured as mean height of contour(MHC)in the temporal 40degrees C segment(20degrees C superior and 20degrees C inferior to the horizontal midline)of optic disc. HRef is a value representing the location of the standard reference plane. The accordances of HRef and stereometric parameters between right and left disc were also evaluated. MHC in the temporal 40 degrees C and nasal 40 degrees C segment, HRef, and stereometric parameters of optic disc were measured with the HRT in 244 eyes of 122 subjects. HRef was 0.376+/-0.099 mm in the right disc and 0.385+/-0.090 mm in the left disc. There was good correlation between HRef and MHC in the temporal 40degrees C segment(r=0.97, p<0.01), but poor in the nasal 40 degrees C segment(r=0.29, p<0.01). The accordances of HRef and stereometric parameters increased as the difference of MHC in the temporal 40degrees C segment between right and left disc decreased. HRef was affected by the amount of posterior displacement of the retinal surface at the temporal disc margin, which occurs in instances such as a tilted disc. We should find the method to adjust stereometric parameters to the amount of disc tilt.
Retina* ; Retinaldehyde*

The authors present 12 cases of far lateral disc herniation(FLDH) diagnosed and treated in our institution from march, 1992 to February, 1994. In the author's series the incidence of far lateral disc herniation was 5% of all lumbar disc herniations. The average age of the patients was 4 years and there were 7 men and 5 women. The L4-5 intervertebral disc level was the most commonly involved level. All patients initially presented with symptoms of radiculopathy. Cases with double herniations at the same level and on the same side seemed to have the most potential source of misdiagnosis and mismanagement, and a careful surgical consideration was needed for such cases. In 4 cases, a combined intraspinal and extraforaminal approach was performed with preservation of facet joints and in 2 cases, paramedian muscle splitting approach was performed. Chemonucleolysis and the usual partial hemilaminectomy were undertaken in 5 cases and in 1 case, respectively. The combined approaches proved to be an effective means of treatment for cases with double herniations, but misdiagnosis of such lesion can lead to an inappropriate and an ineffective treatment and poor surgical results. Furthermore, in the diagnosis of far lateral disc herniation, differentiation must be made from symptoms of conjoined nerve root and congested epidural vein.
Diagnosis ; Diagnostic Errors ; Estrogens, Conjugated (USP) ; Female ; Humans ; Incidence ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Male ; Radiculopathy ; Veins ; Zygapophyseal Joint

OBJECTIVES: To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. METHODS: A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer? ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. RESULTS: The 5 dimensions were as follows ; 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness. A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. CONCLUSIONS: The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.
Consumer Satisfaction ; Cross-Sectional Studies ; Delivery of Health Care ; Factor Analysis, Statistical ; Gyeonggi-do ; Hospitals, General ; Humans ; Outpatients* ; Quality Improvement ; Quality of Health Care ; Surveys and Questionnaires ; Reproducibility of Results

PURPOSE: Fas ligand is known to play a key role in intraocular inflammation. We investigated the change of the expression of Fas ligand in the eye with experimental melanin-induced uveitis (EMIU). METHODS: EMIU was induced in 16 Lewis rats after immunization with melanin-associated antigen. Immunohistochemistry, in situ hybridization, and Western blot for Fas ligand were performed serially after immunization. RESULTS: The expression of Fas ligand was higher in the inflammatory eyes at cornea, iris, ciliary body, choroids and retina compared with control eyes. The expression of FasL remained elevated ever at 30 days after immunization in comparison with control eyes even though the inflammation of the eyes had subsided. CONCLUSIONS: These results suggest that the spontaneous regression of intraocular inflammation may be mediated by Fas ligand in EMIU.
Animals ; Apoptosis* ; Blotting, Western ; Choroid ; Ciliary Body ; Cornea ; Fas Ligand Protein ; Immunization ; Immunohistochemistry ; In Situ Hybridization ; Inflammation ; Iris ; Rats ; Retina ; Uveitis*