PURPOSE: To investigate the asymmetry of the retinal nerve fiber layer thickness (RNFLT) with respect to the horizontal and vertical meridian and between the right and left eye in normal subjects. METHODS: The RNFLT was measured in 121 normal volunteers by optical coherence tomography (OCT). The RNFLT was analyzed by dividing the circle scanning area (diameter 3.4 mm) around the optic disc into 4 quadrants and 12 sectors. RESULTS: There was a significant difference between the RNFLT of the nasal and temporal quadrant in individual eyes. There was a significant difference between the RNFLT of corresponding sectors with respect to the vertical or horizontal meridian in individual eyes. The nasal and temporal RNFLTs were asymmetrical between the right and left eye in the quadrant and sector analysis. The RNFLT of the nasal and temporal quadrant was thicker in the right eye. The nasal and inferior RNFLT measured by OCT had a significant correlation with degree of refractive error. CONCLUSIONS: In normal subjects without significant anisometropia, there was significant asymmetry of the RNFLT for each eye as well as between the right and left eye.
*Tomography, Optical Coherence ; Retinal Ganglion Cells/*ultrastructure ; Retina/*cytology ; Reference Values ; Optic Disk/cytology ; Nerve Fibers/*ultrastructure ; Male ; Humans ; Female ; Adult

PURPOSE: To assess the accuracy of estimating postoperative deviation in large-angle exotropia over 40 prism diopters (PD). METHODS: A retrospective analysis was performed on 61 exotropia patients with over 40 PD exotropia who had undergone 2-muscle surgery by two surgeons and with at least 6 months follow-up. The accuracy was assessed by analyzing the discrepancy between preoperatively predicted residual deviation and deviation at postoperative 6weeks. Successful surgery was defined as deviation within +/- 10 PD at the last postoperative visit. RESULTS: More accurate residual deviation was predicted in exotropia with prism diopters between 40 and 59 (97.8%) than in exotropia with 60 PD or more (62.5%). And there was no significant difference between two surgeons. Surgical success rates at six months and one year after surgery were 96.8%, 94.7% in exotropia with 40 to 49 PD, 71.4%, 60.0%, 50 to 59 PD, 50.0%, 45.5%, 60 PD or more, respectively. There were four patients of whom the postoperative deviation angle exceeded more than 10 PD of the estimated deviation. CONCLUSIONS: The accuracy of estimating residual deviation prior to surgery was higher and more successful surgery was achieved in exotropia ranging in 40 to 59 PD than in exotropia with 60 PD or more. Therefore, 2- muscle surgery will be suitable for large-angle exotropia with less than 60 PD.
Exotropia ; Follow-Up Studies ; Humans ; Muscles ; Retrospective Studies

Natriuretic peptides comprise a family of three structurally related peptides; atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). The present study was performed to investigate the effect of ANP on the proliferation and activity of ROS17/2.8 and HOS cells which are well-characterized osteoblastic cell lines. ANP dose-dependently decreased the number of ROS17/2.8 and HOS cells after 48-hour treatment. ANP generally increased the alkaline phosphatase activity of ROS17/2.8 and HOS cells after 48 hr treatment, regardless of the fact that basal activity of alkaline phosphatase was much lower in HOS cells compared to that of ROS17/1.8 cells. ANP increased the NBT reduction by ROS17/2.8 and HOS cells. ANP showed the variable but no significant effect on the nitric oxide production by ROS17/2.8 and HOS cells. ROS17/2.8 and HOS cells produced and secreted gelatinase into culture medium, and this enzyme was thought to be the gelatinase A type with the molecular weight determination. The gelatinase activity produced by ROS17/2.8 cells was increased by the treatment of ANP. However, the enzyme activity was not affected by ANP treatment in the HOS cell culture. In summary, ANP decreased the proliferation and increased the alkaline phosphatase activity and NBT reduction of osteoblasts. These results indicate that ANP is one of the important regulators of bone metabolism.
Alkaline Phosphatase ; Atrial Natriuretic Factor ; Cell Culture Techniques ; Cell Line ; Gelatinases ; Humans ; Matrix Metalloproteinase 2 ; Metabolism ; Molecular Weight ; Natriuretic Peptide, Brain ; Natriuretic Peptide, C-Type ; Natriuretic Peptides ; Nitric Oxide ; Osteoblasts* ; Peptides

A 63-year-old woman presented to the hospital with gross hematuria and acute renal failure. Kidney function deteriorated rapidly and progressively. A renal biopsy revealed segmental or circumferential crescents associated with linear deposits of immunoglobulin G, typical of anti-glomerular basement membrane disease. Both c-ANCA and anti-GBM antibody were detected in serum. She was treated with hemodialysis, plasmapheresis, high dose steroid and cyclophosphamide. However, she died 7 weeks after treatment because of pneumonia, without recovery of renal function. Serologic positivity of both ANCA and anti-GBM antibody are becoming more frequently recognized in rapidly progressive glomerulonephritis. The influence of c-ANCA on the clinical course of anti-GBM glomerulonephritis remains to be determined.
Acute Kidney Injury ; Anti-Glomerular Basement Membrane Disease ; Antibodies, Antineutrophil Cytoplasmic ; Basement Membrane* ; Biopsy ; Cyclophosphamide ; Cytoplasm* ; Female ; Glomerulonephritis* ; Hematuria ; Humans ; Immunoglobulin G ; Kidney ; Middle Aged ; Plasmapheresis ; Pneumonia ; Renal Dialysis

Adenomas of the major duodenal papilla are rare but clinically important since they are a premalignant condition. Endoscopic mucosal resection has emerged as the first line therary for ampullary adenoma. However, various complications such as pancreatitis, bleeding or duodenal perforation have been reported after endoscopic mucosal resection. To our knowledge, cholangitis has not been reported as a complication of the procedure in the literature. We report a case of papillary stenosis and cholangitis caused by endoscopic mucosal resection of ampullary adenoma. We performed the endoscopic biliary spincterotomy followed by biliary stenting and cholangitis was successfully controlled.
Adenoma* ; Ampulla of Vater ; Cholangitis* ; Constriction, Pathologic* ; Hemorrhage ; Pancreatitis ; Stents

Adenomas of the major duodenal papilla are rare but clinically important since they are a premalignant condition. Endoscopic mucosal resection has emerged as the first line therary for ampullary adenoma. However, various complications such as pancreatitis, bleeding or duodenal perforation have been reported after endoscopic mucosal resection. To our knowledge, cholangitis has not been reported as a complication of the procedure in the literature. We report a case of papillary stenosis and cholangitis caused by endoscopic mucosal resection of ampullary adenoma. We performed the endoscopic biliary spincterotomy followed by biliary stenting and cholangitis was successfully controlled.
Adenoma* ; Ampulla of Vater ; Cholangitis* ; Constriction, Pathologic* ; Hemorrhage ; Pancreatitis ; Stents