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

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

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

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.

OBJECTIVE: To evaluate spine magnetic resonance imaging (MRI) inter-reader and intra-reader reliabilities using the thoracolumbar injury classification system and severity score (TLICS) and to analyze the effects of reader experience on reliability and the possible reasons for discordant interpretations. MATERIALS AND METHODS: Six radiologists (two senior, two junior radiologists, and two residents) independently scored 100 MRI examinations of thoracolumbar spine injuries to assess injury morphology and posterior ligamentous complex (PLC) integrity according to the TLICS. Inter-reader and intra-reader agreements were determined and analyzed according to the number of years of radiologist experience. RESULTS: Inter-reader agreement between the six readers was moderate (k = 0.538 for the first and 0.537 for the second review) for injury morphology and fair to moderate (k = 0.440 for the first and 0.389 for the second review) for PLC integrity. No significant difference in inter-reader agreement was observed according to the number of years of radiologist experience. Intra-reader agreements showed a wide range (k = 0.538-0.822 for injury morphology and 0.423-0.616 for PLC integrity). Agreement was achieved in 44 for the first and 45 for the second review about injury morphology, as well as in 41 for the first and 38 for the second review of PLC integrity. A positive correlation was detected between injury morphology score and PLC integrity. CONCLUSION: The reliability of MRI for assessing thoracolumbar spinal injuries according to the TLICS was moderate for injury morphology and fair to moderate for PLC integrity, which may not be influenced by radiologist' experience.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; *Injury Severity Score ; Ligamentum Flavum/pathology ; Lumbar Vertebrae/*injuries/pathology ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Observer Variation ; Reproducibility of Results ; Retrospective Studies ; Spinal Injuries/*classification/*pathology ; Thoracic Vertebrae/*injuries/pathology ; Thoracic Wall/pathology ; Young Adult

OBJECTIVE: To investigate the interobserver reproducibility and diagnostic feasibility of a visual grading system for assessing atrophy of the supraspinatus muscle on magnetic resonance imaging (MRI). MATERIALS AND METHODS: Three independent radiologists retrospectively evaluated the occupying ratio of the supraspinatus muscle in the supraspinatus fossa on 192 shoulder MRI examinations in 188 patients using a 3-point visual grading system (1, > or = 60%; 2, 30-59%; 3, < 30%) on oblique sagittal T1-weighted images. The inter-reader agreement and the agreement with the reference standard (3-point grades according to absolute occupying ratio values quantitatively measured by directly contouring the muscles on MRI) were analyzed using weighted kappa. The visual grading was applied by a single reader to a group of 100 consecutive patients who had undergone rotator cuff repair to retrospectively determine the association between the visual grades at preoperative state and postsurgical occurrences of retear. RESULTS: The inter-reader weighted kappa value for the visual grading was 0.74 when averaged across three reader pairs (0.70-0.77 for individual reader pairs). The weighted kappa value between the visual grading and the reference standard ranged from 0.75 to 0.83. There was a significant difference in retear rates of the rotator cuff between the 3 visual grades of supraspinatus muscle atrophy on MRI in univariable analysis (p < 0.001), but not in multivariable analysis (p = 0.026). CONCLUSION: The 3-point visual grading system may be a feasible method to assess the severity of supraspinatus muscle atrophy on MRI and assist in the clinical management of patients with rotator cuff tear.
Adult ; Aged ; Feasibility Studies ; Female ; Humans ; Joint Diseases ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscular Atrophy/diagnosis/*pathology ; Observer Variation ; Reference Standards ; Reproducibility of Results ; Retrospective Studies ; Rotator Cuff/*pathology ; Young Adult

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