The common causes of visual loss in branch retinal vein occlusion[BRVO] have been reported as the macular edema, macular non-perfusion and the vitreous hemorrhage due to neovascularization.These factors have close relationship with the status of the posterior vitreous. The purpose of this study was to evaluate the factors of visual prognosis in BRVO and the relationship between visual prognosis and vitreomacular status.Fifty-two patients with branch retinal vein occlusion in the department of ophthalmology, Yeungnam University college of Medicine were included for vitreo macular examination.The eyes were classified as two groups, vitreomacular attachment[Group I]and posterior vitreous detachment[Group II]. The incidence of macular edema was significantly lower in eyes with group I [Fisher's exact Test:p<0.05].Final visual acuity was better than the initial visual acuity, regardless of the presence of posterior vitreous detachment [Paired t-test:p<0.01].Group I developed higher rate of neovascularization and vitreous hemorrhage, but statistical significance was not noted.
Humans ; Incidence ; Macular Edema ; Ophthalmology ; Prognosis* ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Visual Acuity ; Vitreous Detachment* ; Vitreous Hemorrhage

35 neurogenic tumors of the thorax were analyzed with plain film and CT scan. Radiological analysis emphasizedshape, location calcification, bone change, pleural change in plain film and calcification, cystic change, bonechange, pleural change, presence of contrast enhancement in CT scan. The results were as follows; 1. Age may bethe most important clinical factor for differential diagnosis. 2. Plain film findings(35 cases); 1) The mostcommon shape in the ganglion series tumor (ganglioneuroma, ganglioneuroblastoma, neuroblastoma), was elongation(80%) and these tumors generally had tapered borders(50%). In contrast with those of the genglion series, nervesheath tumors(schwannoma, neurofibroma, malignant Schwannoma) showed a definite tendency to be roudn (95%) and thesulcus effect was more frequetnly seen(67.5%). Most of the masses were smooth. The lobulated masses were commonlymalignant ganglion series tumors. 2) Though overall incidence of calcification was low(8.6%), it was observed morefrequently in ganglion series tumors(20%). 3) Associated bony abnormality were generally observed in large tumorsabove 5cm in long axis, especially in neuroblastoma and ganglioneuroblastoma. 4) Tumors showed pleural effusionwere all malignant. 3. CT findings (17 cases); 1) The overall incidence of cystic change of the mass was 23.6%. Itwas most common in Schwannoma(60%). 2) The contrast enhancement was noted in 64.7%. It's degree was variable andshowed no predilection to any specific tumors. 3) The incidence of calcification, associated bony abnormality andpleural effusion were similiar to plain film. Confident specific diagnosis can be made in most of the neurogenictumors of the thorax by shape of the mass in plain film and internal architecture in CT combined with patient'sage as clinical information.
Diagnosis ; Diagnosis, Differential ; Ganglion Cysts ; Ganglioneuroblastoma ; Incidence ; Neuroblastoma ; Neurofibroma ; Thorax ; Tomography, X-Ray Computed

The records of the patients with the orbital wall fracture were reviewed from January 1985 through December 1994 in the Department of Ophthalmology, Yeungnam University Medical Center. Eighteen patients were repaired orbital wall fracture using Medpor and 44 patients were repaired orbital wall fracture using silicone plate. Surgical effect of Medpor was evaluated and compared with that of silicone plate in the reconstruction of orbital wall fracture. Postoperative improvement of diplopia, extraocular muscle movement, enophthalmos and complications were evaluated after the follow-up period of 6 months. The incidence of the orbital fracture was more common in men than in women(p<0.05). The traffic accident was the most common cause of the wall fracture and the most common combined lesion was the lid laceration. The most common fracture site were the inferior wall, and combined medial and inferior walls. There were no significant difference between the two materials in improvement of limitation of the extraocular movement and diplopia(p>0.05). the improvement of enophthalmos were 1.2mm in case of Medpor and 1.1mm in silicone plate, but the difference between the two materials was insignificant(p>0.05). Six cases (33%) of the Medpor group and the nine cases (20%) of the silicone plate group caused the infraorbital hypoesthesia, but there was no significant diference between the two groups(p>0.05). Prolapse of the implant was noted in one case of silicone plate implantation, but it was not found in any case of Medpor implantation yet. Postoperative complications such as retrobulbar hematoma, optic nerve injury and lower eyelid retraction were not noted in the two procedures. In this study, Medpor revealed similar surgical effect as silicone palte in reconstruction of orbital wall fracture. However, Medpor has a remarkable characteristic of fibrovascular ingrowth keeping from prolapse or dislocation. Therefore it could be the most ideal implant for the repair of the orbital wall fracture at present.
Academic Medical Centers ; Accidents, Traffic ; Diplopia ; Dislocations ; Enophthalmos ; Eyelids ; Follow-Up Studies ; Hematoma ; Humans ; Hypesthesia ; Incidence ; Lacerations ; Male ; Ophthalmology ; Optic Nerve Injuries ; Orbit* ; Orbital Fractures ; Postoperative Complications ; Prolapse ; Silicones

Safety and effect of intraocular lens implantation in pediatric cataract patients were studied. And properness of intraocular lens along postoperative refractive changes was evaluated. In the department of ophthalmology, Yeung-Nam University college of medicine, twenty-eight patients were performed lens aspiration with intraocular lens implantation for pediatric cataract from May 1992 to October 1996. Preoperative and postoperative visual acuity, refractive power and postoperative complication along operative methods were evaluated, retrospectively. After follow up period of 6-30 months(mean 17.7 months), visual improvement more than 2 lines was noted 28 eyes(77.8%) by Hahns visual acuity chart. The trends of myopic shift had no significance in statistically, it is proper that we selected intraocular lens power adjust to emmetropia in over 3 years old patients. The difference between preoperative and postoperative refractive power measured within 0 and -2 Diopters in 30 eyes(83%). Aimed intraocular lens power was calculated by using SRK/T fomula for emmetropia and adjustment for refractive error of fellow eye. Best corrected vision was obtained after medical treatment of amblyopia.
Amblyopia ; Cataract* ; Child, Preschool ; Emmetropia ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Ophthalmology ; Postoperative Complications ; Refractive Errors ; Retrospective Studies ; Visual Acuity

Hydrofluoric acid is one of the strongest irritating, corrosive and poisonous inorganic chemicals. The most significant chronic consequence of excessive fluoride exposure is the disorder of skeletal system and connective tissue. The first stage of osteofluorosis consists of an increase in the density of flatbone such as pelvic bone and vertebral bones, with coarseness and blurring of bone trabecular. Therefore we wanted to observe the change of the bone density among workers exposed to hydrofluoric acid. Questionnaires and radiological investigations were performed for 39 hydrofluoric acid manufacturing factory worker sexposed to hydrofluoric acid. And then authors checked urinary fluoride level by fluoride ion method. the radiographs were doubly read by two radiologists for reliability. The results were as follows; 1. There was a significant difference in urinary fluoride level (p<0.01), but not in age, in tenure(p>0.05) among workers by the job title. 2. By the two radiologists, eight cases were read as bone fluorosis. The prevalence rate of bone fluorosis was 20.5%. 3. There was not a significant difference in general characteristic such as age, tenure and in muculoskeletal signs and symptoms between the fluorosis group and the normal group. 4. However, a close relationship between the occurence of the change of bone density and the degree of fluorde exposure such as burn was found. The difficulties in diagnosing fluorosis result from the questionable sensitively of x-ray techniques and from the non-specific associated signs and symptoms. A quantitative method such as densitometry to assessosteosclerosis and bone structure alteration and a follow-up study are needed.
Bone Density* ; Burns ; Connective Tissue ; Densitometry ; Fluorides ; Follow-Up Studies ; Hydrofluoric Acid* ; Inorganic Chemicals ; Pelvic Bones ; Prevalence ; Questionnaires

Thiopental sodium, a water-soluble barbiturate derivative with pH 10.0, reaches brain tissue in its highest concentration in about 50 seconds after intravenous injection. Blood concentration then decreases according to redistribution. Patients who are given midazolam as an induction agent are known to awake from general anesthesia relatively more slowly than those given pentothal sodium. Fentanyl, a potent analgesic, has been used in balanced anesthesia because of its minimal cardiovascular effects. In the present study, the effects of pentothal sodium, midazolam and midazolam-fentanyl on cardiovascular changes to endotracheal intubation during anesthetic induction were compared. Sixty patients of ASA class I or II scheduled to undergo elective operations were classified randomly into 3 groups. Group I and II were injected with thiopental sodium 5.0 mg/kg and midazolam 0.2 mg/kg, respectively. Group III received midazolam 0.1 mg/kg and fentanyl 2 ug/kg. The results were as follows ; 1) The onset time (time from intravenous injection to loss of eyelid reflex) of group III (137+/-10.29 seconds, p<0.05) was longer than those of group I (10+/-3.22 seconds) and group II (37+/-12.49 seconds). 2) The change of the mean arterial pressure : Group III showed minimal change (4% decrease, p<0.05) at 1 minute after endotracheal intubation as compared with group I (21% increase) and group II (6% increase). 3) The change of the heart rate ; Group III showed the least change (6% increase, p<0.05) at 1 minute after endotracheal intubation as compared with group I (18% increase) and group II (12% increase). From these results, it is suggested that the combined use of midazolam and fentanyl may cause less effect on the cardiovascular system during endotracheal intubation than midazolam or thiopental sodium alone.
Anesthesia, General ; Arterial Pressure ; Balanced Anesthesia ; Brain ; Cardiovascular System ; Eyelids ; Fentanyl ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Injections, Intravenous ; Intubation, Intratracheal* ; Midazolam ; Sodium ; Thiopental

Despite the high prevalence of chronic dermatitis and the accompanied intractable itch, therapeutics that specifically target itching have low efficacy. Increasing evidence suggests that TLRs contribute to immune activation and neural sensitization; however, their roles in chronic itch remain elusive. Here, we show that the RBL-2H3 mast cell line expresses TLR4 and that treatment with a TLR4 antagonist opposes the LPS dependent increase in mRNA levels of Th2 and innate cytokines. The pathological role of TLR4 activation in itching was studied in neonate rats that developed chronic itch due to neuronal damage after receiving subcutaneous capsaicin injections. Treatment with a TLR4 antagonist protected these rats with chronic itch against scratching behavior and chronic dermatitis.TLR4 antagonist treatment also restored the density of cutaneous nerve fibers and inhibited the histopathological changes that are associated with mast cell activation after capsaicin injection. Additionally, the expression of IL-1β, IL-4, IL-5, IL-10, and IL-13 mRNA in the lesional skin decreased after TLR4 antagonist treatment. Based on these data, we propose that inhibiting TLR4 alleviated itch in a rat model of chronic relapsing itch, and the reduction in the itch was associated with TLR4 signaling in mast cells and nerve fibers.

PURPOSE: Mesenteric lymphadenitis is classified into acute and chronic, specific and nonspecific types according to clinical aspect and causative disease. We under took this study to find out clinical aspects, associated diseases and hospital course of mesenteric lymphadenitis in children. METHODS: We examined 98 children aged from 18 months to 14 years who visited Dongsan Medical Center for abdominal pain between March 1998 and May 2002. Ultrasonography was performed and medical records were analysed. The specific group had a causative disease, and the chronic group had persistent clinical symptom over three months. RESULTS: Symptoms were chronic in 4% of the patients and acute in 96%. Most of the patients were in oen to five years of age. In the acute group, abdominal pain, vomiting, fever and diarrhea were shown commonly in order, and average WBC count was normal. Gastroduodenitis, tonsillitis, pneumonia and enterocolitis were accompanied in the acute specific group. Ultrasonograms of abdomens showed lymph node enlargement. In the acute group, symptoms were improved within one week. Lymph node enlargement was noted on follow up ultrasonograms in the chronic group. Gastrocolonoscopy of chronic group showed one case of H. pylori positive duodenitis, one case of ulcerative colitis, and two cases of Crohn's disease. CONCLUSION: There was no statistical significance in clinical aspect, laboratory findings and hospital course between the patients with specific etiology and nonspecific etiology. Symptoms improved within one week in patients in the acute group. If abdominal pain persists, additional examinations such as endoscopic biopsy, stool cultures, or small bowel studies should be performed to determine the underlying cause.
Abdomen ; Abdominal Pain ; Biopsy ; Child* ; Colitis, Ulcerative ; Crohn Disease ; Diarrhea ; Duodenitis ; Enterocolitis ; Fever ; Follow-Up Studies ; Humans ; Lymph Nodes ; Medical Records ; Mesenteric Lymphadenitis* ; Palatine Tonsil ; Pneumonia ; Tonsillitis ; Ultrasonography ; Vomiting

BACKGROUND: The efficacy of oral corticosteroids in the treatment of chronic asthma is undisputed, but their long-term use is associated with adverse side-effects, including supression of the hypothalamic-pituitary adrenal axis function, osteoporosis, weight gain, hypertension and impaired glucose tolerance. The introduction of inhaled corticosteroids in the early 1970's represented a significant therapeutic advance in the management of asthma, since these compounds combined high topical potency with low systemic activity. Fluticasone propionate is a new topically active synthetic glucocorticosteroid that combinds a high degree of efficacy with negligible systemic bioavailability. This study was perfomed to determine the effect of inhaled fluticasone propionate on the adreocortical supression in patients with bronchial asthma or chronic obstructive pulmonary disease. METHODS: The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o'clock in morning and free cortisol in 24 hour urine collection at intervaL Absolutely, no steroid was taken during pretreatment period of l0days. There after each subject inhaled fluticasone aerosol, in daily doses of 500 or l000 mierograms for l2days. The dose was delivered by metered dose inhaler(MDI). RESULTS: The serum cortisol and 24hour urinary free cortisol were not decreased during the treatment period in patients with inhaled fluticasone propionate in daily doses of 500 micrograms. In contrast, serum cortisol was significantly decreased on 9th and 12th day(p less than 0.05). And, 24hour urinary free cortisol was also significantly decreased on 3rd and 12th day of treatement period(p less than 0.05) in patients with inhaled fluticasone in daily doses of 1000 micrograms. CONCLUSION: These results suggested that endogenous cortisol secretion was not supressed after short-term inhalation of fluticasone in daily dose of 500 micrograms, but in daily dose of 1000 micrograms, the endogenous cortisol secretion was supressed.
Adrenal Cortex Hormones ; Asthma ; Axis, Cervical Vertebra ; Biological Availability ; Diethylpropion* ; Glucose ; Humans ; Hydrocortisone* ; Hypertension ; Inhalation ; Osteoporosis ; Plasma ; Pulmonary Disease, Chronic Obstructive ; Urine Specimen Collection ; Weight Gain ; Fluticasone

PURPOSE: The behavior of invasive carcinomas in human can be very varied with different individual responses to chemotherapy. Individualization is crucial to the optimization of chemotherapy. Therefore, the prediction of a tumor's sensitivity to anticancer agents has been the subject of intensive investigation. In order to investigate the pathobiology of breast cancer, it is necessary to maintain or recreate the characteristics of the three-dimensional architecture of the tissues in culture. In this study, we have evaluated the relationship between the Histoculture Drug Response Assay (HDRA) assessment and chemotherapy responses in breast cancer patients. METHODS: Tumor specimens from 30 patients with breast cancer were evaluated using the HDRA. Tumor tissues were cultured on gelfoam sponge gel in 24-well plates, followed by treatment with a variety of chemotherapeutic agents. All treatments were conducted in triplicate. The sensitivity of a chemotherapy regimen was defined as a tumor inhibition rate (IR) in excess of 30%. Neoadjuvant or palliative chemotherapy for patients, using anthracycline or taxane, was conducted on the basis of the established protocols. The responses to treatments were compared with the results of the HDRA. RESULTS: The mean IR for the combinations of doxorubicin and docetaxel and for FAC and AC were 48, 45, and 36%, respectively. The above partial rate of response to chemotherapy was 81.1%. The sensitivity and specificity of the HDRA assessment, with a 30% inhibition rate, were 81.5 and 66.7%, respectively. The positive and negative response prediction values were 91.7 and 44.4%, respectively. The responses to treatments and the results of the HDRA assessment were not correlated with the expressions of the hormonal receptor or c-erbB2. CONCLUSION: In cases in which the inhibition rate is in excess of 30%, the HDRA assessment yielded a high positive response prediction value. The sensitivity to chemotherapy, as determined by the HDRA, appears to be a good guide for selection in breast cancer patients. Thus the results presented herein should be integrated into future research on the subject.
Antineoplastic Agents ; Breast Neoplasms* ; Breast* ; Doxorubicin ; Drug Therapy* ; Gelatin Sponge, Absorbable ; Humans ; Porifera ; Sensitivity and Specificity