In order to evaluate the possible roles of secretory proteases in the pathogenesis of amoebic keratitis, we purified and characterized a serine protease secreted by Acanthamoeba lugdunensis KA/E2, isolated from a Korean keratitis patient. The ammonium sulfate-precipitated culture supernatant of the isolate was purified by sequential chromatography on CM-Sepharose, Sephacryl S-200, and mono Q-anion exchange column. The purified 33 kDa protease had a pH optimum of 8.5 and a temperature optimum of 55 degrees C. Phenylmethylsulfonylfluoride and 4- (2- Aminoethyl) -benzenesulfonyl-fluoride, both serine protease specific inhibitors, inhibited almost completely the activity of the 33 kDa protease whereas other classes of inhibitors did not affect its activity. The 33 kDa enzyme degraded various extracellular matrix proteins and serum proteins. Our results strongly suggest that the 33 kDa serine protease secreted from this keratopathogenic Acanthamoeba play important roles in the pathogenesis of amoebic keratitis, such as in corneal tissue invasion, immune evasion and nutrient uptake.
Acanthamoeba/*enzymology/isolation & purification/pathogenicity ; Acanthamoeba Keratitis/*parasitology ; Animals ; Cornea/parasitology ; Humans ; Hydrogen-Ion Concentration ; Korea ; Serine Endopeptidases/chemistry/*isolation & purification/*metabolism ; Substrate Specificity ; Temperature ; Virulence Factors

To evaluate the differences and factors to be considered when measuring intraocular pressure after photorefractive keratectomy[PRK]and laser in situ keratomileusis[LASIK], we prospectively reviewed the medical records of myopic eyes between -4~-7 diopters. Among them, 14 patients, 22 eyes underwent PRK and 10 patients, 18 eyes recieived LASIK. We measured intraocular pressures by Goldmann applanation tonometry preoperatively, 1 month, 3 months and 6 months postoperatively in each group. Corneal curvatures, central corneal thicknesses were measured and compared when measuring intraocular pressure. The postoperative intraocular pressure was lower than the preoperative value in both groups[p<0.01], and the decreased amount of IOP were not statistically different in both groups[p=0.29]. Targeted ablation depth[p=0.19]and ablation diameter[p=0.16]did not show statistically significant correlation to postoperative IOP decrease. In measuring intraocular pressure after PRK or LASIK, attention should be given to the pressure and its interpretation.
Humans ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Manometry ; Medical Records ; Prospective Studies

To evaluate the differences and factors to be considered when measuring intraocular pressure after photorefractive keratectomy[PRK]and laser in situ keratomileusis[LASIK], we prospectively reviewed the medical records of myopic eyes between -4~-7 diopters. Among them, 14 patients, 22 eyes underwent PRK and 10 patients, 18 eyes recieived LASIK. We measured intraocular pressures by Goldmann applanation tonometry preoperatively, 1 month, 3 months and 6 months postoperatively in each group. Corneal curvatures, central corneal thicknesses were measured and compared when measuring intraocular pressure. The postoperative intraocular pressure was lower than the preoperative value in both groups[p<0.01], and the decreased amount of IOP were not statistically different in both groups[p=0.29]. Targeted ablation depth[p=0.19]and ablation diameter[p=0.16]did not show statistically significant correlation to postoperative IOP decrease. In measuring intraocular pressure after PRK or LASIK, attention should be given to the pressure and its interpretation.
Humans ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Manometry ; Medical Records ; Prospective Studies

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: To assess effectiveness, safety and stability of laser epithelial keratomileusis(LASEK), versus conventional photorefractive keratectomy(PRK) for low to moderate myopia. METHODS: 27 patients with a manifest refraction of -3.00 to -6.50 diopters were treated and followed-up for 3 months. In each case, one eye received PRK and the other LASEK. The surgical method and the sequence between the eyes were randomized. Postoperative pain, epithelial healing time, uncorrected visual acuity, manifest refraction, corneal haze and surgical preference were examined after the operation. RESULTS: During a 3-month-follow-up, we found no significant differences in epithelial healing time, uncorrected visual acuity and refractive error. However, LASEK treated eyes had lower postoperative pain scores(P=0.047), and corneal haze scores(1 month; P=0.02) than those of PRK. Seventeen patients(63%) preferred the LASEK procedure. CONCLUSION: LASEK and PRK has an equal effect in correction of myopia, but LASEK reduced incidence of postoperative pain and early postoperative corneal haze. This suggests LASEK can be an alternative procedure for correction of low to moderate myopia.
Humans ; Incidence ; Keratectomy, Subepithelial, Laser-Assisted ; Myopia* ; Pain, Postoperative ; Refractive Errors ; Visual Acuity

PURPOSE: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. METHODS: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. RESULTS: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, 6.54+/-1.06 years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was 1.57+/-0.34 and 14.07+/-1.91 minutes, respectively, the mean catheter dwell time was 14.73+/-2.5 days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). CONCLUSION: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.
Catheterization* ; Catheters* ; Central Venous Catheters ; Child ; Critical Illness* ; Emergencies ; Female ; Humans ; Intensive Care Units ; Internship and Residency ; Jugular Veins* ; Male ; Nervous System Diseases ; Outcome Assessment (Health Care) ; Pneumothorax ; Punctures ; Sepsis ; Skin ; Ultrasonography

Closure of interdental spaces using proximal build-ups with resin composite is considered to be practical and conservative. However, a comprehensive approach combining two or more treatment modalities may be needed to improve esthetics. This case report describes the management of a patient with multiple diastemas, a peg-shaped lateral incisor and midline deviation in the maxillary anterior area. Direct resin bonding along with orthodontic movement of teeth allows space closure and midline correction, consequently, creating a better esthetic result.
Diastema ; Esthetics ; Humans ; Incisor ; Tooth ; Tooth Movement

No abstract available.
Exanthema* ; Humans ; Infant* ; Leukemia* ; Leukemia, Myeloid, Acute

OBJECTIVE: 5-HTTLPR (5-HT transporter-linked polymorphic region), located in the promoter region of 5-HT transporter gene, was reported to be associated with several neuropsychiatric illnesses. In this study, we investigated the genotype distribution and allele frequency of serotonin transporter gene 5-HTTLPR in schizophrenic patients and normal controls using an independent Korean sample. METHODS: Subjects were 156 schizophrenic patients fulfilling the DSM-IV criteria for schizophrenia who had taken antipsychotics for at least 6 months and 96 normal controls who had no past and family history of psychiatric illnesses. Two negative symptoms of PANSS, blunted affect and emotional withdrawal, were rated in all patients by two experienced psychiatrists. We examined the genotype distribution and allele frequency of the serotonin transporter gene 5-HTTLPR in all subjects, using polymerase chain reaction (PCR) of genomic DNA with primers flanking the promoter regions of the 5-HTT gene. Between-group comparisons of the genotype distribution and allele frequency were performed by using score test for trend, Fisher's exact test, and chi-square test. RESULTS: There was no significant difference in 5-HTTLPR genotype distribution and allele frequency between schizophrenic patients and normal controls. There was also no significant difference in 5-HTTLPR genotype distribution and allele frequency between schizophrenic patients with and without the two negative symptoms, blunted affect or emotional withdrawal, respectively. CONCLUSION: These results suggest that 5-HTTLPR polymorphism had no significant association with schizophrenia and negative symptoms in a Korean sample.
Antipsychotic Agents ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Gene Frequency ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Psychiatry ; Schizophrenia* ; Serotonin ; Serotonin Plasma Membrane Transport Proteins

BACKGROUND: This study was performed to examine 1) whether propofol prevented the increases in intracellular calcium and radical oxygen species (ROS) induced by lysophosphatidic acid (LPA) in endothelial cell; 2) whether these two types of increases were mediated by common underlying mechanisms. METHODS: Intracellular Ca2+ ([Ca2+]i) and H2O2 were measured in endothelial cell line (ECV 304) using a laser scanning confocal microscope. The cells, cultured and serum-starved on round coverslips, were incubated with various concentrations of propofol for 30 minutes, and then stimulated with various concentrations of LPA. The samples were excited by a 488 nm argon laser and images were filtered by a 515 nm longpass emission filter. The results were expressed as relative fluorescence intensity (RFI) and fold stimulation (fold). RESULTS: LPA increased in intracellular ROS in the endothelial cell in a dose-dependent manner. In addition, LPA-induced increase in ROS were alleviated by ROS scavengers such as Aspergillus niger catalase and n-(2-mercaptopropionyl)-glycine (2-MPG). LPA also increased in [Ca2+]i in a dose-dependent fashion. Propofol prevented LPA-induced increase in ROS and [Ca2+]i whereas 2-MPG did not affect the change of calcium level induced by LPA application. CONCLUSIONS: These results suggested that propofol prevented the increases in intracellular calcium and ROS induced by LPA in endothelial cell, and these two types of increases might be mediated by different underlying mechanisms.
Argon ; Aspergillus niger ; Calcium ; Catalase ; Cells, Cultured ; Endothelial Cells* ; Fluorescence ; Oxygen ; Propofol* ; Reactive Oxygen Species*