PURPOSE: To reduce complications and provide proper management for better clinical outcomes in the treatment of macular edema through a large-scale analysis of the incidence and risk factors for complications of intravitreal triamcinolone injection. METHODS: The medical records of 490 eyes that received intravitreal triamcinolone (4.0 mg) injection for treatment of macular edema caused by various diseases were retrospectively reviewed, and relevant parameters were included in a multivariate regression model. RESULTS: Vitrectomized (p < 0.001) and pseudophakic (p = 0.054) eyes were less likely to exhibit an intraocular pressure increase, but glaucoma (p < 0.001) and young age (p = 0.073) were found to be significant risk factors for this complication. Vitrectomized eyes (p = 0.011), diabetic macular edema (p < 0.001), secondary ocular hypertension (p = 0.029) and old age (p = 0.059) were associated with cataract progression. Three consecutive case of sterile endophthalmitis, which differs from bacterial endophthalmitis in clinical course and prognosis, occurred during the same period. CONCLUSIONS: Risk factors and the incidence of complications after intravitreal triamcinolone injection should be evaluated through regular follow-up evaluation to ensure proper management and a better prognosis.
Cataract ; Dietary Sucrose ; Endophthalmitis ; Eye ; Follow-Up Studies ; Glaucoma ; Incidence ; Intraocular Pressure ; Macular Edema ; Medical Records ; Ocular Hypertension ; Prognosis ; Retrospective Studies ; Risk Factors ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To evaluate the antiproliferative and antifibrotic effects of alpha-tocotrienols in primary cultured orbital fibroblasts from thyroid-associated ophthalmopathy (TAO) patients. METHODS: Orbital fibroblasts were cultured (5 eyes from TAO patients, 5 eyes from normal patients) and classified into a control group, alpha-tocotrienol group and alpha-tocopherol group. The cell viability was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The proliferation of orbital fibroblasts was measured using the Click-iT(TM) assay. The collagen production of the control and alpha-tocotrienol groups was measured using a hydroxyproline assay. RESULTS: The alpha-tocotrienol and alpha-tocopherol groups showed no cytotoxicity up to 150 microm in orbital fibroblasts from TAO and normal patients. The proliferation of orbital fibroblasts from TAO and normal patients was significantly inhibited with alpha-tocotrienol at 80 microm and 120 microm. The collagen production of orbital fibroblasts from TAO patients was significantly inhibited with alpha-tocotrienol at 120 microm. CONCLUSIONS: The results from the present study indicate that non-toxic concentrations of alpha-tocotrienol have significant antiproliferative and antifibrotic effects on orbital fibroblasts from TAO patients.
alpha-Tocopherol ; Cell Survival ; Collagen ; Eye ; Fibroblasts ; Fibrosis ; Graves Ophthalmopathy ; Humans ; Hydroxyproline ; Orbit ; Tetrazolium Salts ; Thiazoles ; Troleandomycin ; Vitamin E

PURPOSE: To report 2 different cases of postoperative endophthalmitis caused by Stenotrophomonas maltophilia after cataract surgery. CASE SUMMARY: A 73-year-old male with diabetes mellitus developed severe pain in the right eye 2 weeks after cataract surgery. The patient was hospitalized with a diagnosis of infectious endophthalmitis, and vitrectomy was performed. Cultures of aqueous humor and vitreous aspirate revealed S. maltophilia. On day 30 after vitrectomy, his visual acuity had improved to 20/20 and there were no recurrences. A 61-year-old female with no significant past medical history was referred for uveitis or delayed onset endophthalmitis 30 days after cataract surgery. An anterior chamber tapping and cultures were performed. S. maltophilia and Aspergillus fumigatus were isolated. The patient received antibiotics and antifungal agents and her visual acuity improved to 20/25. CONCLUSIONS: S. maltophilia has been considered a life-threatening systemic opportunistic infection; however, the organism has recently been reported as an exogenous pathogen of endophthalmitis following cataract surgery. Herein, 2 different cases of S. maltophilia endophthalmitis after cataract surgery are presented and compared with previous case reports.
Aged ; Anterior Chamber ; Anti-Bacterial Agents ; Antifungal Agents ; Aqueous Humor ; Aspergillus fumigatus ; Cataract ; Coinfection ; Diabetes Mellitus ; Endophthalmitis ; Eye ; Female ; Humans ; Male ; Middle Aged ; Recurrence ; Stenotrophomonas ; Stenotrophomonas maltophilia ; Uveitis ; Visual Acuity ; Vitrectomy

PURPOSE: To report three various cases of retinal hemorrhages caused by Plasmodium vivax malaria. CASE SUMMARY: Two 55-year-old male patients and a 52-year-old male patient with cyclic high fever were admitted to the department of internal medicine. Three of the patients were diagnosed with malaria caused by P. vivax based on a peripheral blood smear. The patients were treated with hydroxychloroquine and premaquine but complained of decreased visual acuity. The patients were examined with funduscopy, fluorescein angiography, and optical coherence tomography. The first case showed 2 areas of retinal hemorrhages on the macular in the right eye and 1 area of retinal hemorrhage in the left eye. The second case showed many cotton-wool spots along with a number of small retinal hemorrhages and tortuous blood vessels in both eyes. The third case showed 1 area of retinal hemorrhage in the right eye and many cotton-wool spots in both eyes. CONCLUSIONS: P. vivax malaria rarely causes retinal hemorrhage. Manifestations of retinal hemorrhage and degree of visual acuity loss may vary among patients. P. vivax malaria should be considered when patients with unexplained high fever present with retinal hemorrhage, even without a history of overseas travel.
Blood Vessels ; Eye ; Fever ; Fluorescein Angiography ; Humans ; Hydroxychloroquine ; Internal Medicine ; Malaria ; Malaria, Vivax ; Male ; Middle Aged ; Plasmodium ; Plasmodium vivax ; Retinal Hemorrhage ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity

OBJECTIVES: To evaluate the effects of sperm motility stimulants on the hyperactivation (HA), acrosomal reaction (AR) and sperm penetration assay (SPA) in fresh and frozen-thawed spermatozoa from fertile men. METHODS: We treated the semen samples obtained from 20 normospermic men (fresh semens from 10 and cryopreserved ones from 10) with pentoxiphylline (PF) and 2-deoxyadenosine (2-DXA) to evaluate the change of the patterns of motility using the computerized motility analyzer. The semen samples treated with motility stimulants were incubated in the medium with calcium ionophore A23187 for the examination of the proportion of acrosome lost spermatozoa. Finally we performed SPA in both groups for the evaluation of fertilizing capacity after stimulant treatments. RESULTS: In both fresh and cryopreserved semen samples, the addition of PF and 2-DXA significantly altered the patterns of motility (ALH, VCL, HA) known to have association with sperm quality without increasing the number of sperms with progressive motility and velocity. A23187 induced AR was also augmented by the treatment with PF and 2-DZA. Although the treatment with PF did not increase the mean rates of egg penetration significantly, in selected cases in the cryopreserved semen group, the improvement of the motility pattern was impressive. CONCLUSION: PF and 2-DXA can improve the quality of sperm function in both fresh and frozen-thawed semen from normal fertile men and may increase the sperm penetration rate of zona-free hamster eggs in selected samples of the frozen-thawed semen. The results suggest that PF and 2-DXA pretreatment can be used in the clinical practice for intrauterine insemination (IUI) program with frozen-thawed sperms as well as with samples from men with abnormal semen parameters. In addition, it may be a cost- effective therapy to try IUI combined with such a pretreatment for the couples planned to enter into the ART program.
Acrosome ; Acrosome Reaction ; Animals ; Calcimycin ; Calcium ; Cricetinae ; Eggs ; Family Characteristics ; Fertilization in Vitro* ; Humans ; Insemination ; Male ; Ovum ; Semen ; Sperm Motility* ; Sperm-Ovum Interactions ; Spermatozoa*

PURPOSE: The purpose of this study was to determine the pharmacogenetic effects of complement factor H (CFH) Y402H, LOC387715 and high-temperature requirement factor A1 (HTRA1) genotypes on the treatment of exudative age-related macular degeneration (AMD) by intravitreal bevacizumab injection in a Korean population. METHODS: Seventy-five patients diagnosed with exudative AMD were treated with intravitreal bevacizumab (2.5 mg) monotherapy. All patients received three initial intravitreal bevacizumab injections every four weeks and were then treated "as needed" based on clinical findings, optical coherence tomography and fluorescein angiography during the 12 month follow-up period after the third injection. RESULTS: The difference in visual acuity improvement among the three genotypes of LOC387715 were statistically significant at six months post-treatment (logarithm of the minimum angle of resolution; TT, 0.346; GT, 0.264; GG, 0.188; p = 0.037). Among the LOC387715 genotypes, the number of additional injections was lower in patients who had the risk T allele (GG, 2.143; GT, 2.000; TT, 1.575; p = 0.064). There was no significant difference between visual acuity and central macular thickness change in the CFH Y402H polymorphism group during the 12 month follow-up period. However, the TC group of CFH Y402H required more additional bevacizumab injections than the TT group (TT, 1.517; TC, 3.363; p = 0.020). CONCLUSIONS: This study demonstrated that different LOC387715/HTRA1 genotypes resulted in different bevacizumab treatment responses on exudative AMD. Patients with the risk allele had an improved treatment response and less need for additional injections. However, patients with the CFH Y402H risk allele needed more additional injections of bevacizumab in order to improve visual acuity. This study illustrates how pharmacogenetic factors may help determine treatment modality and dosing. This could ultimately provide basic data for 'personalized medicine' in AMD.
Aged ; Alleles ; Angiogenesis Inhibitors/administration & dosage/therapeutic use ; Antibodies, Monoclonal, Humanized/*administration & dosage/therapeutic use ; DNA/*genetics ; Female ; Follow-Up Studies ; Genotype ; Humans ; Intravitreal Injections ; Macular Degeneration/drug therapy/epidemiology/*genetics ; Male ; Pharmacogenetics/*methods ; *Polymorphism, Genetic ; Retrospective Studies ; Serine Endopeptidases/*genetics/metabolism ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity

An appendicocolic fistula is a rare disease. It seems likely that the appendix becomes adherent to the viscus either before or after its perforation due to appendicitis, so surgeons may become confused when an emergency appendectomy in done. We report one case of an appendicocolic fistula to draw attention to the importance of this fistula and to describe the clinical, the diagnostic, and the therapeutic aspects of the disease.
Appendectomy ; Appendicitis ; Appendix ; Emergencies ; Fistula* ; Rare Diseases

The hyaline membrane disease is not a common disease in Korea. Only a few reports of small scale are avaiable in the literature. We have experienced 5 cases of HMD during approximately 1 year period. The diagnosis was made either on characteristic clinical and roentgenological features or postmortem examination. The birth weights of these cases were in the range of 1,000-1,500gm in 2 cases and 2,000-2,500gm in 3 cases. And their gestational age was 28-34 weeks in most of the cases. Three cases were delivered by C-section. There was 1 case of placenta previa. Four of these 5 cases died after average 18 hours postnatum. Postmortem findings in two cases were characterized by typical hyaline membrane lining th respiratory bronchioles and alveolar ducts. Other prominent findings were atelectasis, interstitial edema and congestion and lymphatic dilatation. One case complicated with multifocal bronchopneumonia and perinatal telencephalic leukoencephalopathy. The other case showed acute subarachnoid hemorrhage probably from germinal matrix hemorrhage.
Autopsy* ; Birth Weight ; Bronchioles ; Bronchopneumonia ; Diagnosis ; Dilatation ; Edema ; Estrogens, Conjugated (USP) ; Gestational Age ; Hemorrhage ; Humans ; Hyalin* ; Hyaline Membrane Disease* ; Infant, Newborn ; Korea ; Leukoencephalopathies ; Membranes ; Placenta Previa ; Pulmonary Atelectasis ; Subarachnoid Hemorrhage

Duodenal abscess is a rarely reported disease throughout the entire world. Duodenal abscesses are developed mostly from the complication of duodenal ulcer perforation, and only small percentage of duodenal abscesses are the result of cholecysto-duodenal fistula which was made by gall bladder perforation. We report a 84-year-old male patient who presented to the emergency department with severe anorexia and generalized weakness for 2 weeks. The upper gastrointestinal endoscopy done and revealed a protruding mass at the lesser curvature of the duodenal bulb. As soon as the mass was punched with a biopsy forceps, a large amount of abscess began to pour out into the intestinal lumen. Abdominal CT scan demonstrated the presence of an air-fluid level the in gall bladder and also abscess in the porta hepatitis which was located between the gall bladder and the duodenum. Because the patient refused any surgical intervention, we treated him conservatively with intravenous antibiotics. Patient's symptom of anorexia was slowly resolved, and patient was discharged 10 days later.
Abscess* ; Aged, 80 and over ; Anorexia ; Anti-Bacterial Agents ; Biopsy ; Duodenal Ulcer ; Duodenum ; Emergency Service, Hospital ; Endoscopy ; Endoscopy, Gastrointestinal ; Fistula ; Hepatitis ; Humans ; Male ; Surgical Instruments ; Tomography, X-Ray Computed ; Urinary Bladder

Cancer results from mutations that disrupt the harmonious checks and balances that regulate normal cellular growth and development. These mutations arise in two classes of interacting genes:those that facilitate cell growth and tumor formation(oncogenes), in which mutation or overexpression is oncogenic, and those that inhibit these processes(tumor supp-ressor genes) whose loss is oncogenic. The human retinoblastoma(Rb) protein, a tumor suppressor, acts as transcription factor or/and cell cycle regulator. Heterogenous expression of the Rb gene product contributes to the genesis of a diverse group of human neoplasma such as breast, prostate, small cell lu- ng, bladder carcinoma and leukemia. Its structural aberrations were observed in 25% of br- east tumor cell lines studied and 7% of the primary tumors, such as homozygous internal deletions and total deletion. These observations suggest that Rb protein is involved in bre- ast cancer development. Here we report that Rb protein represses steroid receptor function and its involvement of cell cycle process in human breast cancer cell line, MCF7 cells. 1. The overexpression of Rb protein repressed the steroid receptor function in breast cancer cell line, MCF 7. 2. When we introduced the mutant type Rb expression vector(deletion of exon 22), such repression was not observed. 3. By introducing E2F expression vector, the action of Rb protein was repressed. 4. Rb protein modulated the binding patterns of proteins to Kil-GRE site. 5. Flow cytometry analysis showed that Rb protein acts on G0/G1 stage of cell cycle process. These findings provide the molecular basis of breast cancer therapy using Rb protein.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Cell Line* ; Cell Line, Tumor ; Exons ; Flow Cytometry ; Growth and Development ; Humans ; Leukemia ; MCF-7 Cells ; Prostate ; Receptors, Steroid* ; Repression, Psychology ; Retinoblastoma Protein* ; Retinoblastoma* ; Transcription Factors ; Urinary Bladder