Many patients undergoing vitrectomy due to proliferative diabetic retinopathy also have diabetic ephropathy.Hence, to figure out the surgi-cal results of vitrectomy and the survival rate after vitrectomy in diabetic patients having diabetic nephropathy, we reviewed medical records of 70 patients[83 eyes]who had been followed for 3 months or longer after vitrectomy. Among them, 28 patients[33 eyes]were complicated by diabetic nephropathy.Visual acuity improved in 21 out of 33 eyes [63.6%]among the patients with nephropathy while vision improved in 29 out of 50 eyes[58.0%] among those without nephropathy.The two groups showed significant improvement of visual acuity postoperatively and the difference in visual acuity improvement between two groups was not statistically significant. The factors which affected postoperative visual acuity improvements in patients with diabetic nephropathy were preoperative panretinal photocoagulation[p=0.013]and intraoperative intraocular silicone oil injection[p=0.021]. Rate of occurrence of complications after vitrectomy and the types of the complications were similar in the two groups. During the 4-year follow up, 4 of 11 patients who had been on peritoneal dialysis or emodialysis died. These results showed that the result of vitrectomy for proliferative diabetic retinopathy in patients with iabetic nephropathy was not poor and suggested that diabetic nephropathy might not be a contraindication of vitrectomy for proliferative diabetic retinopathy.
Diabetic Nephropathies* ; Diabetic Retinopathy* ; Follow-Up Studies ; Humans ; Medical Records ; Peritoneal Dialysis ; Silicone Oils ; Survival Rate ; Visual Acuity ; Vitrectomy*

PURPOSE: The development of fever in neutropenic cancer patients is frequently a sign of infection. Infection remains the major cause of death in the patient with cancer, primarily as a consequence of the profound alterations of normal host defences which result from the malignancy, its treatment or both. Fever in the patient with neutropenia is generally recognized as an indication of the need for prompt initiation of antibiotic therapy, but in spite of intensive efforts to identify infections in these patients and to institute appropriate antibiotic therapy, high mortality rate have continued to occur. This study was performed to identify the current etiologic agents, differences in frequency and/or type of infection in patients with hematologic malignacy as compared to those with solid tumor and to assess the period of neutropenia and treatment. METHODS: Between May 1994, and Feburuary 1994, we retrospectively evaluated 84 febrile episodes occurring in 46 patients with neoplastic diseases which were identified at Korea university hospital. Neutropenic fever has been defined as three episode of elevation of temperature above 38degrees C or a single elevation above 38.5degrees C in neutropenic patient (granulocyte<500/mm3) RESULTS: 1) Eighty-four episodes of fever and neutropenia were identified in 47 patients whose mean age was 6.6 years. 2) Thirty-three patients had leukemia or lymphma, representing 70.2% of the episodes of fever and neutropenia. 3) Microbiologically documented infection, clinically documented infection and unexplained fever accounted for 13%, 23%, 64% of the febrile episodes respectively. 4) Gastroenteritis and pharyngitis were the most common type of infection. 5) The common organism were Escherichia coli, Klebsiella pneumoniae, Staphyrococci aureus were common in decreasing order. 6) The mean duration of febrile neutropenia was 11.9 days in hematologic malignacy and 6.5 days in solid tumor. 7) The mean duration of receiving G-CSF was 13.1 days in hematologic malignancy and 5.8 days in solid tumor. 8) There was no significant difference in duration of neutropenia, times of receiving treatment and ANC level at fever in patients with MDI compared to CDI or UF. CONCLUSIONS: Gram negative bacilli are dominant pathogens of neutropenic fever in Korea university hospital.
Cause of Death ; Drug Therapy* ; Escherichia coli ; Febrile Neutropenia* ; Fever ; Gastroenteritis ; Granulocyte Colony-Stimulating Factor ; Hematologic Neoplasms ; Humans ; Klebsiella pneumoniae ; Korea ; Leukemia ; Mortality ; Neutropenia ; Pharyngitis ; Retrospective Studies

We studies 8 eyes of 7 patients with neovascular glaucoma from June 1, 1995 to May 31 1997 retrospectively in order to note the clinical characteristics of disease. The mean age of the patients was 54. 3 years and the mean period of follow up was 9.5 months. Predisposing factors were proliferative diabetic retinopathy [7 eyes] , central retinal vein occlusion [I eye]. Vision at first visit was mainly hand motion or finger counting. Vision after operation was increased in 4 eyes, but deteriorated to no light perception in 3 eyes. The mean IOP at preoperative period was 35mmHg, at just postoperative period 20mmlHg at I week after operation, 25mmHg at last follow-up. Neovascularization of anterior chamber and angle were regressed in 6 eyes, but progressed in 2 eyes. Additional medical treatment was needed in all 8 eyes after operation. To treat. the early neovascular glaucoma, we used endoscopic laser photocoagulation. The endoscopy was good for observing far peripheral retina, pars plana, ciliary body and posterior segment of iris. We found the endoscopic laser was suitable for wider photocoagulation of ischemic retina against corneal opacity, miosis, cataract and intraocular gas.
Anterior Chamber ; Cataract ; Causality ; Ciliary Body ; Corneal Opacity ; Diabetic Retinopathy ; Endoscopy ; Fingers ; Follow-Up Studies ; Glaucoma, Neovascular* ; Hand ; Humans ; Iris ; Light Coagulation* ; Miosis ; Postoperative Period ; Preoperative Period ; Retina ; Retinal Vein ; Retrospective Studies ; Veins

We used endoscopic laser photocoagulation to treat neovascular glaucoma in eight eyes of seven patients. New vessels of the iris and anterior chamber disappeared or stabilized after photocoagulation in seven eyes (88%), while the vision improved in four eyes (50%). The endoscopy was excellent for observing the peripheral retina and ciliary process tissue. We found the endoscopic laser was suitable for wider photocoagulation of ischemic retina against media opacity.
Adult ; Aged ; Endoscopy ; Female ; Glaucoma, Neovascular/therapy* ; Glaucoma, Neovascular/physiopathology ; Human ; Intraocular Pressure ; Laser Coagulation* ; Male ; Middle Age

This study was performed to investigate the subcellular changes of rat atrial muscle cells by immobilization stress. Sprague -Dawley rats weighting 200 gm were immobilized in small round plastic tube for 2, 6, 12, and 24 hours respectively. The atrial tissue obtained from each animals were observed by transmission electron microscopes. In the heart of rat subjected 2 hours immobilization stress no significant morphological changes were found in electron microscopy, similarly as in control animal. After 6 and 12 hours immobilization stress, the following electron -microscopic changes of atrial myocytes were observed at the swelling of mitochondrial matrix with disturbance in cristea, focal loss of cytoplasmic matrix, vacuoles with myeline -like structure, apoptotic changes of myocytes, focal widening of intercalated disc interspace and lysis of myofibrils. After 24 hours immobilization stress, very small sized mitochondria, similarly as small sized secretory granules and various sized granules are observed in the perinuclear region of atrial myocytes. Atrial specific granules are moved centripetally toward the central region of the atrial myocytes after immobilization stress. Above results will be aid in understanding the structures of atrium with dual function of blood circulation and endocrine, and in research of modulation of secretory granules in atrial muscle cells.
Animals ; Blood Circulation ; Cytoplasm ; Heart ; Immobilization* ; Microscopy, Electron ; Mitochondria ; Muscle Cells* ; Myelin Sheath ; Myofibrils ; Plastics ; Rats* ; Secretory Vesicles ; Vacuoles

BACKGROUND: Toluene diisocyanate (TDI) can cause contact allergy and occupational asthma, but the mechanism underlying sensitization to this chemical compound remains controversal. Also the correlation of mast cell with contact hypersensitivity (CHS) and the role of mast cell in the TDI-induced CHS is unknown. This issue was investigated by administrating TDI on the skin of genetically mast cell-deficient WBB6F1/J-Kit(W)/ Kit(W-v) (W/W(V)) and congenic normal WBB6F1/J-Kit +/+ (+/+) mice. METHODS: To development of animal model of TDI-induced CHS and to investigate the correlation of mast cell with CHS and the role of mast cell in the TDI-induced CHS, W/W(V) and +/+ mice were sensitized with TDI on the back skin at day 1 and day 8, and then challenged with 1% TDI on the ear at day 15. At 1, 2, 4, 8, and 24 hours after 1% TDI challenge, the ear thicknesses were measured. It was investigated the histologic changes of dermis in the ear of W/W(V) and +/+ mice at 24 hours after 1% TDI challenge. RESULTS: TDI induced a significant ear swelling response in W/W(V) and +/+ mice. TDI induced the significant infiltrations of polymorphonuclear leukocytes and eosinophils in W/W(V) and +/+ mice, but not of mast cells in normal mice. And TDI increased a characteristic extent of mast cell degranulation in normal mice. There were no significant differences in the ear swelling and the infiltrations of polymorphonuclear leukocytes and eosinophils of normal versus W/W(V) mice, either at baseline or after TDI-induced CHS. CONCLUSION: From the above results, TDI can be used as a murine CHS model, and the mast cells may not be essential in TDI-induced CHS.
Animals ; Asthma, Occupational ; Dermatitis, Contact* ; Dermis ; Ear ; Eosinophils ; Hypersensitivity ; Mast Cells ; Mice ; Models, Animal ; Neutrophils ; Skin ; Toluene 2,4-Diisocyanate ; Toluene*

BACKGROUND: Toluene diisocyanate (TDI) can cause contact allergy and occupational asthma, but the mechanism underlying sensitization to this chemical compound remains controversal. Also the correlation of mast cell with contact hypersensitivity (CHS) and the role of mast cell in the TDI-induced CHS is unknown. This issue was investigated by administrating TDI on the skin of genetically mast cell-deficient WBB6F1/J-Kit(W)/ Kit(W-v) (W/W(V)) and congenic normal WBB6F1/J-Kit +/+ (+/+) mice. METHODS: To development of animal model of TDI-induced CHS and to investigate the correlation of mast cell with CHS and the role of mast cell in the TDI-induced CHS, W/W(V) and +/+ mice were sensitized with TDI on the back skin at day 1 and day 8, and then challenged with 1% TDI on the ear at day 15. At 1, 2, 4, 8, and 24 hours after 1% TDI challenge, the ear thicknesses were measured. It was investigated the histologic changes of dermis in the ear of W/W(V) and +/+ mice at 24 hours after 1% TDI challenge. RESULTS: TDI induced a significant ear swelling response in W/W(V) and +/+ mice. TDI induced the significant infiltrations of polymorphonuclear leukocytes and eosinophils in W/W(V) and +/+ mice, but not of mast cells in normal mice. And TDI increased a characteristic extent of mast cell degranulation in normal mice. There were no significant differences in the ear swelling and the infiltrations of polymorphonuclear leukocytes and eosinophils of normal versus W/W(V) mice, either at baseline or after TDI-induced CHS. CONCLUSION: From the above results, TDI can be used as a murine CHS model, and the mast cells may not be essential in TDI-induced CHS.
Animals ; Asthma, Occupational ; Dermatitis, Contact* ; Dermis ; Ear ; Eosinophils ; Hypersensitivity ; Mast Cells ; Mice ; Models, Animal ; Neutrophils ; Skin ; Toluene 2,4-Diisocyanate ; Toluene*

PURPOSE: The effect of intra-portal infusion of glucose-insulin-potassium (GIK) solution on the energy metabolism during cold preservation was investigated using a small-animal liver transplantation model. METHODS: Fifteen white rats were divided into 3 groups: the group A (feeding group) were fed normally before experiment. The group B (fasting group) and group C (GIK group) were fasted from 3 days before experiment, by which acute nutritional deficiency state was induced. In group A and B, the whole liver was procured after intra-portal perfusion of HTK solution and serial liver biopsies were performed during the cold preservation period with 4degrees C HTK solution. In group C, intra-portal GIK solution infusion for 1 hour preceded liver graft harvest. From the liver tissues, the relative intracellular glycogen contents and the ATP concentration were measured. RESULTS: Relative glycogen contents in group A were 100% at 0 h, 64.6% at 2 h, 54.9% at 4 h, and 16.2% at 8 h; 10.3%, 8.3%, 4.9% and 0%, respectively in group B; 109.2%, 96.9%, 54.2% and 9.7%, respectively in group C. There was a temporary supercharge of ATP level in group C only at 0 h. Apoptosis was less expressed in group C comparing with group A and B. CONCLUSION: Rapid intra- portal infusion of GIK solution could make intrahepatic glycogen content fully restored to the normal level. Considering that intracellular glycogen is the main energy source during immediate post-transplant period, its restoration may contribute to improvement of post-transplant graft function.
Adenosine Triphosphate ; Animals ; Apoptosis ; Biopsy ; Cold Temperature ; Energy Metabolism ; Glucose ; Glycogen ; Humans ; Insulin ; Liver ; Liver Transplantation ; Malnutrition ; Mannitol ; Perfusion ; Potassium ; Potassium Chloride ; Procaine ; Rats ; Transplants