No abstract available.
Magnetic Resonance Imaging* ; Tomography, Emission-Computed, Single-Photon*

For the purpose of correction of high myopia, we had implanted Worst-Fechner Biconcave Lens (Ophtec B.V., Groningen, Holland) in the 10 phakic eyes which were more myopic than -8.0 D. We examined postoperative visual acuity and complications. Postoperative uncorrected visual acuity was from 0.3 to 1.0. Cataract, glaucoma, chronic iridocyclitis and macular edema or retinal detachment did not occur and during the iris fluorescein angiography of 4 eyes there was no leakage of dye at the fixation site of iris by haptic of the lens. But all patients complained of glare. In the 3 eyes which were followed up for 12 months, corneal endothelial cell loss occurred continuously and the endothelial cell loss was 17.2% at the central cornea and 19.5% at the paracentral cornea. Therefore, long term follow up is necessary.
Cataract ; Cornea ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Fluorescein Angiography ; Follow-Up Studies ; Glare ; Glaucoma ; Humans ; Iridocyclitis ; Iris ; Macular Edema ; Myopia* ; Retinal Detachment ; Visual Acuity

We evaluated pseudophakia in high myopic patients whose an axial lenght were 26mm and over. Cataract surgery was performed with ECCE and posterior chamber intraocular lens implantations from May 1986 to May 1991 on 69 patients (80 eyes). The results were as follows; 1. Most myopic patients were good candidates for posterior chamber intraocular lens implantation regardless of axial length. 2. Posterior chamber intraocular lens implantations in high myopia were a good refractive surgery. 3. The theoretical formula had better predictabilized than the empirical formula in apredictive accuracy.
Cataract ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Myopia* ; Pseudophakia ; Refractive Surgical Procedures

We analyzed autopsy findings of 5 neonates and infants who suddenly died after DTaP and Polio Coimmunization. Microscopically, there were multifocal small amounts of pinkish amorphous materials within the alveolar spaces with marked proliferation of alveolar macrophages. Immunohistochemical stain using anti-human alpha-lactalbumin shows intense staining to these foreign materials. We concluded that milk aspiration and asphyxia may play an important role in course of death after DTaP and Polio Co-immunization and assumed that hypotonic-hyporesponsive episodes as an adverse events of immunization could be a preceding cause of milk aspiration. Education of parents about the risk of milk aspiration after immunization should be included in guideline.
Asphyxia ; Autopsy ; Education ; Humans ; Immunization ; Infant ; Infant, Newborn ; Lactalbumin ; Macrophages, Alveolar ; Milk* ; Parents ; Poliomyelitis*

PURPOSE: The aim of this study was to define the reference range of the peritoneal solute transfer in Korean CAPD patients and to investigate the change in peritoneal kinetics in long-term patients. METHODS: Routine PET was done 14 days after catheter break-in in 102 new CAPD patients and using our reference range of PET, the patients were categorized into 4 groups as described by Twardow- ski. In 35 long-term (>3 yrs) CAPD patients, D/Pcr, D/D0 glucose and drain volume in last follow- up (mean duration, 60+/-23 months) PET were compared with those in initial PET. RESULTS: Dialysate to Plasma creatinine ratio (D/ Pcr) at 0 hour, 2 hours and 4 hours was 0.045+/-0.062, 0.408+/-0.151 and 0.612+/-0.154, respectively. D/D0 glucose at 2 hours and 4 hours was 0.594+/-0.129 and 0.398+/-0.121, respectively. Peritoneal solute transfer rate in Korean patients was slightly lower than previously reported results in North American patients (P=0.08). Mean drain volume was 2360+/-270ml and mean residual volume was 436+/-178ml. Drain volume was well correlated with D/D0 glucose (positively, r=0.375, P<0.01) and D/Pcr (negatively, r=-0.345, P<0.01). There were no difference in peritoneal solute transfer, drain volume and residual volume according to sex, age, body surface area and diabetes. In initially high and high average trans- porters, solute transfer rate decreased significantly in followup PET. Out of 7 initially high transporters, 3 remained in high and 4 became high average transporters. Out of 12 initially high average transporters, 3 became low average transporters. Out of 8 initially low average transporters, 2 became high average transporters. And out of 8 initially low transporters, 2 became high average and 1 became high transporters. The number of episodes of perito- nitis do not significantly correlated with the changes of peritoneal solute transport rate. CONCLUSION: These data suggest that peritoneal solute transfer rate in Korean patients is slighthly lower compared with that in North American patients and in long-term CAPD patients the peri- toneal solute transport rate changed to centropetal directions (towards to mean) according to initial PET result.
Body Surface Area ; Catheters ; Creatinine ; Follow-Up Studies ; Glucose ; Humans ; Kinetics* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Plasma ; Reference Values* ; Residual Volume

This report describes two cases of complete heart block associated with acute myocarditis. Both cases developed Adams-Stokes attack. One patients was considered to be due to viral infection as judged by clinical course and the other patient was confirmed as Korean hemorrhagic fever by indirect immunofluorescent antibody test. Both cases improved during about 4 weeks admission without sequelae with general supportive treatment only.
Heart Block* ; Heart* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Myocarditis*

PURPOSE: Vascular endothelial growth factor (VEGF) is a vascular endothelial cell specific mitogen and a major regulator of angiogenesis. VEGF secretion is activated in some thyroid cancers and that VEGF secretion is stimulated by TSH. So we postulated that TSH may promote growth and invasion in some thyroid cancers by stimulating VEGF secretion and angiogenesis. METHODS AND RESULTS: We investigated the TSH effect for the VEGF secretion, endothelial cell proliferation and invasion in vitro with the primary cultured normal thyroid cell (NT-1) and thyroid cancer cell line (TPC-1). And to evaluate the relationship between TSH and VEGF, angiogenesis and tumor growth in vivo, we xenografted human dermal matrix inoculated with thyroid cells into nude mice or directly injected subcutaneously. For the study, mice were made hypothyroid (Group 1) by antithyroid hormone p.o, hyperthyroid (Group 2) by L-thyroxine injection and euthyroid (Group 3). One week after the treatment, significant difference were noted in T3, T4 and TSH level between each group, but the VEGF level showed significant difference in group 1 only compared with group 2 and 3. NT-1 or TPC-1 were seeded in the upper chamber of Transwell and HUVEC were cultured in lower chamber, and added different concentration of TSH. NT-1 and TPC-1 secreted VEGF under basal condition, but the level were similar. TPC-1 cells secreted significantly more VEGF than NT-1 after TSH (1, 10, 100 mIU/dl) stimulation, which were also parallel with the concentration of TSH. In low concentration of TSH (0, 1 mIU/dl), there were no difference of HUVEC proliferation between NT-1 and TPC 1. In high concentration of TSH (10, 100 mIU/dl), however, TPC-1 enhanced HUVEC proliferation than NT-1 significantly (p<0.05). Similar findings were noted in thyroid cell invasion. Invasion was higher in TPC-1 than in NT-1 in high concentration of TSH (10, 100 mIU/dl). In vivo study using the dermal matrix showed that number of blood vessels ingrowth were higher in Group 1 (25/HPF) than Group 2 (16/HPF) or Group 3 (17/HPF). But there was no difference between Group 2 and Group 3. Level of TSH and VEGF were also increased significantly in Group 1 compared with in Group 2 and Group 3. The size of tumor did not showed significant difference between each group during observation. The tumor from Group 1 (6.2 gm) were larger compared with Group 2 (5.1 gm) or Group 3 (5.6 gm), but this difference was not significant statistically (p>0.05). The number of blood vessels in tumor were also more increased in Group 1 and were commonly located in the peripheral portion of tumor. CONCLUSION: We conclude that thyroid cancer cell line secrete the VEGF and TSH secretion is more enhanced by the stimulation of TSH. And increased VEGF promote the vascular endothelial cell proliferation, invasion and angiogenesis in thyroid cancer.
Animals ; Blood Vessels ; Cell Line ; Endothelial Cells ; Heterografts ; Humans ; In Vitro Techniques ; Mice ; Mice, Nude ; Neoplasm Metastasis* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroxine ; Vascular Endothelial Growth Factor A*

Gaucher's disease is an autosomal recessive genetic disorder of lipid metabolism. A deficiency of beta-glucocerebrosidase causes an accumulation of glucocerebroside in the reticulo-endothelial system and bone marrow. Total or partial splenectomy has been used in case of massive splenomegaly with hypersplenism and/or mechanical pressure symtoms. Partial splenectomy is preferred to prevent susceptibility to overwhelming postsplenectomy sepsis and to delay the massive deposition of glucocerebroside in the liver and bones. We report the case of a 20-year-old woman with Gaucher's disease and who had a splenic embolization 4 years ago. The spleen cross the midline of the abdomen reached to the true pelvis and elevated the left diaphragm. Angiotensin-converting enzyme, acid phophatase and ESR were increased but beta-glucocerebrosidase was normal. Osteosclerotic changes of the distal femur was observed. Hepatomegaly and splenomegaly with mutiple accessory spleens were seen on abdominal CT. On isotope scan for liver and spleen, multiple accessory spleens had isotope uptake, but spleen did not. We noted severe adhesion of spleen to neighboring structure and no viable splenic tissue for preservation. Total splenectomy with preservation of four accessory spleens was performed. We needed multiple transfusion during dissection and bleeding was continuous for 3 days postoperatively. The patient was discharged without problems on the postoperative 15 th day.
Abdomen ; Bone Marrow ; Diaphragm ; Female ; Femur ; Gaucher Disease* ; Glucosylceramidase ; Hemorrhage ; Hepatomegaly ; Humans ; Hypersplenism ; Lesser Pelvis ; Lipid Metabolism ; Liver ; Sepsis ; Spleen* ; Splenectomy* ; Splenomegaly ; Tomography, X-Ray Computed ; Young Adult

Spontaneous renal allograft rupture is an uncommon complication of renal transplantation, but it represents a life-threatening emergency that requires prompt recognition and treatment. The incidence of spontaneous renal allograft rupture is variable and range between 3.6 and 9.6 percent of all transplants. In the majority of cases the rupture is associated with acute rejection episodes and with renal vein thrombosis. Most frequently, the allograft rupture occurs within the first 2 weeks of transplantation. in addition, most ruptures reported have occurred in cadaveric renal allograft. Debate on the management of such allograft salvage versus transplant nephrectomy. It appears that the recent trend is toward performing surgical repair of the graft if the rupture is secondary to rejection and oo evidence of renal vein thrombosis ; otherwise, graft nephrectomy be done. We report a case of spontaneous renal allograft rupture due to renal vein thrombosis occurred in a 21-year-old woman 6 days after transplantation. Unusual severe localized pain, swelling over at allograft site, and hypotension, a triad frequently seen in renal allograft rupture, were present. Management by graft nephrectomy was inevitable because of the patient's downhill course.
Allografts* ; Cadaver ; Emergencies ; Female ; Humans ; Hypotension ; Incidence ; Kidney Transplantation ; Nephrectomy ; Renal Veins ; Rupture ; Rupture, Spontaneous* ; Thrombosis ; Transplants ; Young Adult

PURPOSE: VEGF, a potent angiogenic factor, increases vascular permeability and induces the fluid accumulation in the peritoneal and pleural cavities. This study is designed to know whether the VEGF concentration are associated with the formation of cystic fluid of thyroid nodules and the results of treatment. METHODS: To know whether thyroid follicular cells produce VEGF, we measured the VEGF concentration in the conditioned medium after primary culture of the normal thyroid follicular cells (NT 1.0). Thirty seven patients, who had visited Ajou University Medical Center, were divided into two groups; group A (n=19) is patients whose cystic nodules disappeared completely with 1 or 2 times fine needle aspirations. In Group B (n=18), the cystic nodules recurred rapidly and required aspiration more than 3 times. Clinical records of patients were analyzed and compared with TSH and VEGF levels in cystic fluids. RESULTS: The VEGF concentration in basal conditioned medium were 8.2±1.2 ng/ml in NT 1.0 and 8.2±0.6 ng/ml in thyroid cancer cell line (FTC-133). NT 1.0 was not affected by TSH stimulation. Mean concentration of TSH of all cystic fluids was 4.36µIU/ml (0.13~21.7) and there was no difference between 2 groups. Mean concentration of VEGF of all cystic fluids was 140.7 ng/ml (11.1~688.8). The VEGF concentration (287.9±289.6 ng/ml) in group B was significantly higher than that (104.2±97.1 ng/ml) in group A (P<0.05). CONCLUSION: This study suggests that thyroid follicular cells produce and secrete VEGF, and VEGF is related with the accumulation of cystic fluid in degenerative cysts of thyroid. Cysts with high VEGF concentration promote rapid reaccumulation of the cystic fluid and possibly necessitate operation in selected patients.