Hypotony and choroidal detachment have been found to be the most common complication after trabeculectomy, with a mean onset time of 5.6 days. We experienced five eyes of four patients with glaucoma, which developed a flat anterior chamber, hypotony, and choroidal detachment two to nine days after technically uncomplicated trabeculectomy. After treatment with topical and systemic corticosteroids and mydriatic-cycloplegic eyedrops, four of five eyes showed clinical improvement within six days. The one remaining eye eventually improved after surgical drainage of the choroidal detachment and reformation of the anterior chamber performed on the seventh postoperative day.
Adrenal Cortex Hormones ; Anterior Chamber ; Choroid* ; Drainage ; Glaucoma ; Humans ; Ophthalmic Solutions ; Trabeculectomy*

BACKGROUND: Theophylline has been used in the treatment of asthma for decades as a broncho- dilator, but recent studies suggested that it has anti-inflammatory and immunomodulatory properties. OBJECTIVE: The aim of this study was to determine the effect of theophylline therapy on urinary excretion of leukotriene B4 (LTB4) and C4 (LTC4), which have been known to play a role in the airway inflammation in asthmatic patients. METHODS: Fifty-one patients, aged 13 months to 6 years, who were hospitalized with asthma were randomized in to 3 groups according to treatment regimen. Twenty-one patients were administered theophylline with budesonide and salbutamol inhalation (Group 1). Fifteen patients were treated with budesonide and salbutamol inhalation (Group 2) and the other fifteen patients with salbutamol inhalation only (Group 3). Urine samples for the determination of LTB4 and LTC4 were collected on admission and on the fifth hospital day in each patient. The concentrations of urinary leukotrienes were measured by ELISA (Neogen, U.S.A.) and corrected by urinary creatinine levels. Ten controls were also studied. RESULTS: The initial urinary LTC4 levels in asthmatic children were significantly higher than in controls. Urinary LTC4 was significantly decreased after treatment compared with the initial level in group 1 (p<0.05), but not in groups 2 and 3. Urinary LTB4 did not show significant difference between patients and controls on admission and showed no significant change after treatment compared with the initial levels in all three groups. CONCLUSION: These results suggest that the suppression of LTC4 synthesis is one of the anti-inflammatory mechanisms of theophylline and support the use of theophylline as a the rapeutic agent in asthmatic patients.
Albuterol ; Asthma* ; Budesonide ; Child* ; Creatinine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Inhalation ; Leukotriene B4* ; Leukotriene C4 ; Leukotrienes ; Theophylline*

OBJECTIVE: To evaluate whether co-culture of oocytes on vero cell monolayers from Day 0 (Day 0 group) after egg retrieval results in an increase in developmental capacity such as fertilization rate, embryo quality, blastulation and clinical pregnancy rate compared with co-culture of oocytes from Day 1 (Day 1 group). METHODS: Sperms were treated with Hams F-10 supplemented with 10% human follicular fluid (hFF). Vero cells for co-culture were prepared in TCM-199 with 10% FBS. Oocytes were co-cultured from Day 0 and fertilized oocytes were co-cultured from Day 1 on vero cell monolayers in DMEM with 10% and 20% hFF, respectively after egg retrieval. On day 1, 2 and 5, fertilization rate and grade of embryos and blastocysts were evaluated. Results (fertilization rate, cleavage rate, grade of embryos and blastocysts and pregnancy rate) were considered statistically significant when p value was less than 0.05 using t-test and ci2. RESULTS: In sibling oocytes of same cycles, no differences were found in fertilization rate (94.6 vs. 91.4%), cleavage rates (94.6 vs. 91.4%), embryo grade (on day 2 and 3) and blastulation (65.6 vs. 57.0%) and their grade. In different oocytes of different cycles (patients), no differences were found in fertilization (79.8 vs. 78.3%), cleavage rates (77.7 vs. 76.4%) and blastulation (56.0 vs. 45.3%), but pregnancy rate was higher in the Day 0 group than in the Day 1 group (60.0 vs. 42.9%). CONCLUSIONS: This study revealed that the embryonic development capacities were not affected by the different co-culture time in the sibling oocytes of same cycles. Although no statistical significance, because of small size of study, there was a trend for higher pregnancy rates in Day 0 group compared to Day 1 group in different oocytes of different cycles.
Blastocyst ; Coculture Techniques* ; Embryonic Development* ; Embryonic Structures ; Female ; Fertilization ; Follicular Fluid ; Humans ; Oocytes* ; Ovum ; Pregnancy ; Pregnancy Rate ; Siblings ; Spermatozoa ; Vero Cells

When a glaucoma filtering operation fails, the causes may be categorized as intraocular, scleral, or extraocular. Some authors have implicated that extraocular causes of failure are due to closure of the external opening by connective tissue. This histologic investigation was undertaken to examine the surgical wounds of 8 experimental subjects including 4 albino and 4 pigmented rabbits. Under general anesthesia by pentothal sodium, a single punch sclerectomy was performed on each right eye. A trabeculectomy was performed on the left eye. Seven and ten days following surgery, globes were removed and immediately fixed in Karnovsky's fixation solution. Following fixation, globes were bisected through surgical wounds, and one-half was studied using standard light microscopy. The other one-half specimens were blocked and processed for transmission electron microscopy. The results of the evaluations were as follows: 1. Full thickness sclerectomy wounds healed by ingrowth of fibroblasts from subconjunctival and episcleral tissue, but trabeculectomy wounds showed no communication with extrascleral tissue. 2. Quantitatively, proliferation of fibroblasts were more exuberant in the sclerectomied eyes compared to trabeculectomies. 3. There was no evidence of significant difference between albino and pigmented rabbits. 4. The granulation tissue composed mainly of fibroblasts resembles smooth muscle cell(myofibroblasts) and extracellular collagen constituents. Ultrastructurally, these cells showed massive bundles of intracytoplasmic microfilaments with scattered dense bodies, wrinkled and folded nuclei indicative cellular contraction, and abundant cisternae of rough endoplasmic reticulum informative activity of cellular proliferation. From those results, author conclude that smooth muscle antagonists may inhibit the proliferation of myofibroblasts after glaucoma filtering operations.
Actin Cytoskeleton ; Anesthesia, General ; Cell Proliferation ; Collagen ; Connective Tissue ; Endoplasmic Reticulum, Rough ; Fibroblasts ; Glaucoma ; Granulation Tissue ; Microscopy ; Microscopy, Electron, Transmission ; Muscle, Smooth ; Myofibroblasts ; Rabbits ; Sodium ; Thiopental ; Trabeculectomy ; Wounds and Injuries*

No abstract available.
Animals ; Fertilization in Vitro* ; Herpes Zoster* ; Mice* ; Oocytes*

PURPOSE: To evaluate the characteristics of peripheral anterior synechiae (PAS) in primary angle-closure glaucoma (PACG). METHODS: We reviewed the charts of 155 patients (244 eyes) with PACG. We divided these patients into one of four clinical subtypes: acute angle-closure glaucoma (ACG), chronic ACG, angle-closure hypertension, and ACG suspect. The prevalence, extent, and location of PAS were evaluated according to PACG subtypes. Correlation analysis was used to evaluate relationships between the highest IOP level without treatment and the extent of PAS. RESULT: The average degree of angle-closure with PAS was 14.6+/-9.1 in eyes that were classified as ACG suspect, 83.8+/-48.3 in angle-closure hypertension, 140.5+/-31.3 in acute ACG, and 180.3+/-31.9 in chronic ACG (ANOVA test, P<0.05). PAS was most frequently found in the superior part of the eye, especially from 12 to 1 o'clock. The incidence of broad PAS (PAS over 30 degrees in width) was highest in superior part, but the medium and narrow PAS (PAS limited to within 30 degrees in width) was distributed throughout all 12 sectors relatively equally. Prior to a laser iridotomy (LI) and other medical treatments, a positive correlation was found between the highest IOP (intraocular pressure) levels and the extent of PAS in chronic ACG (r=0.423, P<0.0001). However, statistically significant relationships were not found between the highest IOP levels before treatment and the extent of PAS in any of the other clinical subtypes. CONCLUSIONS: Our results suggest that acute and chronic ACG patients are most likely to have a greater extent of PAS than patients in the angle-closure hypertension or ACG suspect subtypes. PAS may be narrower in earlier stages and broader in later stages. PAS was also found most frequently in the superior part of the eye. The extent of synechial closure of the angle may play a role in raising IOP levels in later stages of the disease rather than early on.
Severity of Illness Index ; Retrospective Studies ; Male ; Laser Surgery/methods ; Iris/surgery ; Intraocular Pressure ; Humans ; Gonioscopy ; Glaucoma, Angle-Closure/*pathology/physiopathology/surgery ; Follow-Up Studies ; Female ; Anterior Chamber/*pathology ; Aged

BACKGROUND: When used to reverse the anticoagulant effect of heparin, protamine administration after cardiovascular bypass often can lead to systemic hypotension. During the reversal of heparin-induced anticoagulation, the effects of protamine on both a heparin-protamine complex and free protamine on the cardiovascular system should be considered. METHOD: To determine whether the hypotensive effect of heparin-protamine and/or protamine could be caused by endothelium-dependent and-independent component, we studied rings of the arotic arteries in rats suspended in organ chambers containing Tris Tyrode solution at 37oC and 100% O2. Arterial rings with or without endothelium were contracted with 40 mM KCl or 3 +/- 10-6M phenylephrine and then exposed to increasing concentrations of protamine (final organ bath concentration, 40~400 g/ml) both in the absence and presence of heparin (200 U/ml). RESULTS: Protamine induced concentration-dependent relaxation in arterial rings with endothelium, which were significantly greater than in rings without endothelium. The endothelium-dependent relaxation induced by protamine was inhibited by NG-monomethyl-L-arginine (L-NMMA) (10-5M) pretreatment, but was not inhibited by indomethacin (3x10-6M) pretreatment on rings with endothelium. Furthermore, the contractile inhibition was enhanced by superoxide dismutase (100 U/ml). Also, such vasodilating actions were not influenced in the presence of heparin (200 U/ml). In endothelium-denuded strips, protamine (400ug/ml) inhibited Ca++ induced contraction, which was evoked in Ca++-free solution containing 40 mM K+, and also inhibited the norepinephrine (NE)-induced contraction. Protamine inhibited on the NE-induced contraction, but not the caffein-induced contration in Ca++ free, 2 mM EGTA solution. Also, such inhibition of contracions were not inluenced in the presence of heparin (40 U/ml). CONCLUSION: This study demonstrates that protamine (in the presence or absence of heparin) acts on endothelial cell receptors to stimulate the production of nitric oxide and inhibits both Ca++-influx and the NE-induced Ca++ release from intracellular stores.
Animals ; Arteries* ; Baths ; Cardiovascular System ; Egtazic Acid ; Endothelial Cells ; Endothelium ; Heparin* ; Hypotension ; Indomethacin ; Nitric Oxide ; Norepinephrine ; omega-N-Methylarginine ; Phenylephrine ; Rats* ; Relaxation ; Superoxide Dismutase ; Vasodilation*

PURPOSE: To compare the characteristic MR findings of infectious sacroiliitis (IS) and ankylosing spondylitis(AS). MATERIALS AND METHODS: We retrospectively reviewed MR findings in eight patients with IS (pyogenic in six, tuberculosis in two) confirmed by culture and clinical follow-up, and in six with AS by HLA-B27 typing. A control group of 13 asymptomatic volunteers was formed, and they underwent MRI. Findings were analysed for morphology, degree of bone erosion, and adjacent soft tissue change. CT findings of AS in four patients and IS in four were also compared to MR findings. RESULTS: MR characteristics of IS included unilaterality (100 %), abnormal cartilage signal intensity (100 %), bone marrow change (100 %), contrast enhancement (100 %), erosion (63 %), and soft tissue change (63 %). MR findings of AS showed bilaterality (67 %), abnormal cartilage signal intensity (80%), bone marrow change (80 %), erosion (80 %), contrast enhancement (44 %) and soft tissue change (10 %). CT scan showed bony sclerosis and erosion (86 %), and abnormal joint space (71 %). CONCLUSION: MR findings of sacroiliitis were loss of thin zone of a cartilage and erosions on T1-weighted image, and increased signal intensity on T2-weighted image. MRI is regarded as a useful diagnostic method where conventional diagnosis is difficult, and is able to image cartilage abnormalities directly and noninvasively. Significant differences in MR findings between IS and AS were not noted, however.
Arthritis ; Bone Marrow ; Cartilage ; Diagnosis ; Follow-Up Studies ; HLA-B27 Antigen ; Humans ; Joints ; Magnetic Resonance Imaging ; Retrospective Studies ; Sacroiliac Joint ; Sacroiliitis* ; Sclerosis ; Tomography, X-Ray Computed ; Tuberculosis ; Volunteers

Soft contact lenses have become a popular modality for the cosmetic correction of refractive errors. Recent reports of bacterial corneal ulcer in cosmetic soft contact lens wearers prompted the evaluation of the possible sources of bacterial contamination which are wetting saline solution, soft contact lens case, concurrent conjunctivitis, lens surface abnormalities, inadequate temperature and duration of disinfection, poor hygiene in contact lens handling and aging of the lens. Of these factors, the authors considered that the wetting solution and cases of contact lens were most important sources. The extensive bacteriologic study and sensitivity test to antibiotics were done with 200 soft contact lens cases containing; wetting saline solution in 100 patients. The study showed that 149 cases containing wetting saline solution(74.5%) were contaminated with bacteria which serve as a possible source of corneal ulcers. Form 149 contaminated cases of soft contact lens, a total of 231 isolates were cultured. Of these 231 isolates, 32 isolates(13.9%) showed gram positive bacteria; 199 isolates(86.1%) gram negative bacteria. Major organisms were Enterobacter species(21.2%), Serratia marcescens(19.9%), pseudomonas species(17.7%), Adnetobacter calco var. antitrat(10.4%) and Bacillus subtilis(10.0%). Therofore, it should be emphasized that adequate and meticulous home disinfection of contact lens cases and wetting solution is done for prevention of bacterial contamination of soft contact lens.
Aging ; Anti-Bacterial Agents ; Bacillus ; Bacteria ; Conjunctivitis ; Contact Lenses, Hydrophilic* ; Corneal Ulcer ; Disinfection ; Enterobacter ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Hygiene ; Pseudomonas ; Refractive Errors ; Serratia ; Sodium Chloride ; Ulcer

Thirty years have passed since the Korean Association of Pediatric Allergy and Respiratory Disease was founded. There have been great changes in the pattern of respiratory diseases in Korean children during the last 30 years with economic development in the country. Pneumonia remains the leading cause of childhood morbidity, despite advances in the prevention and management. The incidence and mortality of pneumonia caused by typical bacterial pathogens have been reduced. However, the predominance of Mycoplasma pneumoniae or virus-associated diseases is emerging, which suggests that novel diagnostic and therapeutic strategies are needed. Viral bronchiolitis is one of the most substantial health burdens for infants and young children worldwide. Although respiratory syncytial virus is the most common pathogen, molecular diagnostic techniques have identified many other viruses including human rhinovirus causing bronchiolitis. Bronchiectasis is a chronic respiratory condition characterized by chronic infection, airway inflammation, and progressive lung function decline. Research into the interactions between early life respiratory infections and development of bronchiectasis is imperative to halt the disease in its origin and improve adult outcomes. Acute respiratory distress syndrome (ARDS) is a severe, life-threatening lung disease with diffuse inflammatory lung injury leading to pulmonary edema and hypoxia. Although many modalities to treat ARDS have been studied, supportive therapies and lung protective ventilator support remains the mainstay. This review focuses on the current trends in research on these childhood respiratory diseases through literature review and aims to investigate the impact of Korean study results in this field.
Adult ; Anoxia ; Bronchiectasis ; Bronchiolitis ; Bronchiolitis, Viral ; Child ; Economic Development ; Humans ; Hypersensitivity ; Incidence ; Infant ; Inflammation ; Korea* ; Lung ; Lung Diseases ; Lung Injury ; Molecular Diagnostic Techniques ; Mortality ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Rhinovirus ; Ventilators, Mechanical