Retinal pigment epithelial cells(RPE) from a monolayer on the outer portion of sensory retina and have important physiologic functions that include solute transport, phagocytiosis and digestion of membrances shed from photoreceptor outer segments, and drug detoxication. Recently, transplantation of normal RPE has been proposed as a potential therapeutic modality in the surgical management of subretinal neovascularization in age related macular degeneration(ARMD). The viability of RPE at the time of transplantation is important for a good result after transplantation. This viability can be influenced by the period and environmental conditions of storage after harvest.In this study, the influence of these two factors on the viability was evaluated under controlling other remaining factors in vitro. And limitation of masimal time and optimal environmental conditions of storage were investigated.From November 1997 to February 1998, RPE cell sheets from six donor eyeballs for corneal transplantation in the department of ophthalmology of Severance Hospital were harvested and stored in -70degrees C, 4degrees C, or room temperature condotion. The viability of RPE cells at 0, 24 and 48 hours after havest was assessed and compared statistically.The viability was highest at 4degrees C condition. During storage, the viability was about 95% at 24 hours for and decreased abruptly to below 90% at 48 hours. Therefore, RPE cells for transplantation are to be stored at 4degrees C condition and transplantation should be performed within 24 hours after harvest.
Corneal Transplantation ; Digestion ; Epithelial Cells* ; Humans* ; Macular Degeneration ; Ophthalmology ; Retina ; Retinaldehyde* ; Tissue Donors*

PURPOSE: To evaluate the usefulness of 3 dimensional-volume MR imaging technique for demonstrating the facial nerves and to describe MR findings in facial palsy patients and evaluate the significance of facial nerve enhancement. MATERIALS AND METHODS: We reviewed the MR images of facial nerves obtained with 3 Dimensional-volume imaging technique before and after intravenous administration of Gadopentetate dimeglumine in 13 cases who had facial paralysis and 33 cases who had no facial palsy. And we analyzed the detectabilty of anatomical segments of intratemporal facial nerves and facial nerve enhancement. RESULTS: When the 3 Dimensional-volume MR images of 46 nerves were analyzed subjectively, the nerve courses of 43(93%) of 46 nerves were effectively demonstrated on 3 Dimensional-volume MR images. Internal acoustic canal portions and geniculate ganglion of facial nerve were well visualized on axial images and tympanic and mastold segments were well depicted on oblique sagittal images. 10 of 13 patients(77%) were visibly enhanced along at least one segment of the facial nerve with swelling or thickening, and nerves of 8 of normal 33 cases(24%) were enhanced without thickening or swelling. CONCLUSION: MR findings of facial nerve paralysis is asymmetrical thickening of facial nerve with contrast enhancement. The 3 Dimensional-volume MR imaging technique should be a useful study for the evaluation of intratemporal facial nerve disease.
Acoustics ; Administration, Intravenous ; Facial Nerve Diseases ; Facial Nerve* ; Facial Paralysis ; Gadolinium DTPA ; Geniculate Ganglion ; Humans ; Magnetic Resonance Imaging* ; Paralysis

PURPOSE: We assessed the usefulness of magnetic resonance angiography(MRA) and its techniques for differential diagnosis of hemorrhagic causes in patients with non-traumatic intracranial hemorrhagic disease. MATERIALS AND METHODS: We retrospectively reviewed 74 patients with non-traumatic intracranial hemorrhagic diseases, which were confirmed by radiological examinations(36 cases) and operations(38 cases). We compared the usefulness of magnetic resonance imaging(MRI) alone from MRI with MRA in evaluation of hemorrhagic causes. MRA was obtained by Time-of-Flight(TOF) and Phase Contrast(PC) technique. We investigated the usefulness of TOF and PC technique. RESULTS: MRI with MRA for detection of hemorrhagic causes(89%, 66 cases) was better than MRI only (64%, 47 cases). PC was better than TOF for evaluation of arteriovenous malformation and aneurysm due to subtraction of background noise(hemorrhage). CONCLUSION: MRI with MRA in more useful than MRI alone for evaluation of non-traumatic intracranial hemorrhagic causes.
Aneurysm ; Angiography* ; Arteriovenous Malformations ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

PURPOSE: The purpose of this study was to analyze the results of an immediate and mid-term angiographic and clinical follow-up of endovascular treatment for paraclinoid aneurysms. MATERIALS AND METHODS: From January 2002 to December 2012, a total of 113 consecutive patients (mean age: 56.2 years) with 116 paraclinoid saccular aneurysms (ruptured or unruptured) were treated with endovascular coiling procedures. Clinical and angiographic outcomes were retrospectively evaluated. RESULTS: Ninety-three patients (82.3%) were female. The mean size of the aneurysm was 5.5 mm, and 101 aneurysms (87.1%) had a wide neck. Immediate catheter angiography showed complete occlusion in 40 aneurysms (34.5%), remnant sac in 51 (43.9%), and remnant neck in 25 (21.6%). Follow-up angiographic studies were performed on 80 aneurysms (69%) at a mean period of 20.4 months. Compared with immediate angiographic results, follow-up angiograms showed no change in 38 aneurysms, improvement in 37 (Fig. 2), and recanalization in 5. There were 6 procedure-related complications (5.2%), with permanent morbidity in one patient. CONCLUSION: Out study suggests that properly selected patients with paraclinoid aneurysms can be successfully treated by endovascular means.
Aneurysm* ; Angiography ; Catheters ; Female ; Follow-Up Studies ; Humans ; Neck ; Retrospective Studies

PURPOSE: This study was performed to compare the: i) 1-year survival rate of patients with hip fractures, ii) factors affecting mortality in patients with hip fractures, and iii) results of functional recovery at commissioned hospitals (CH) and veterans hospitals (VH) to characterize the quality of care provided in the Korean commissioned hospital system. MATERIALS AND METHODS: The study population consisted of 183 veteran patients (84 and 99 treated at a single VH and 39 CH, respectively) who underwent hip fracture surgery between January 2010 and February 2015. This study compared baseline characteristics (i.e., age, comorbidities, fracture types and surgical treatment approaches) of the two groups vs. clinical outcomes, and evaluated the waiting time, length of hospital stay, total medical expenses, mortality rate within one year, and functional recovery at last follow up. RESULTS: There were no significant differences in age, fracture types, comorbidities, ambulatory status before fracture, waiting time, or length of hospital stay between the two groups, however, the total medical cost was higher in the CH group (P=0.009). There was no significant difference in mortality within one year after hip fracture (P=0.224) or functional recovery at last follow-up (P=0.463) between the two groups. CONCLUSION: The results of this study confirm that the Korean commissioned hospitals system is operating in accordance with its purpose. However, further studies are needed to better characterize the medical expenses of CHs vs. veterans hospitals.
Comorbidity ; Follow-Up Studies ; Hip Fractures ; Hip ; Hospitals, Veterans ; Humans ; Length of Stay ; Mortality ; Survival Rate ; Veterans

Purpose: Here, we report a case of a fungal corneal ulcer caused by Talaromyces allahabadensis (T. allahabadensis).Case summary: A 69-year-old male was admitted to our hospital with pain and hyperemia in his left eye after 2 months of treatmentat a local clinic for herpetic keratitis. The patient had a previous history of trauma to his left eye caused by a persimmon treebranch. He had a peripheral epithelial defect, stromal infiltration, and severe corneal edema in his left eye. Gram staining, a KOHsmear, and a culture were performed using corneal specimens; the results were all negative. With the assumption of herpetickeratitis, antiviral and empirical antibiotic treatments were started. After 2 weeks, the stromal infiltrations on his left eye increased,so we again conducted staining and culture studies. T. allahabadensis was isolated from a specimen, so treatment wasstarted using antifungal agents, and a conjunctival flap graft was performed due to the risk of a corneal perforation. Conclusions A case of corneal ulcer caused by T. allahabadensis in a patient with posttraumatic herpetic keratitis was successfullytreated with antifungal agents and conjunctival flap surgery.

Keratolytic winter erythema is an autosomal dominant skin disorder of unknown etiology. It is charaterised by cyclical erythema, hyperkeratosis, and peeling of the skin of the palms and soles, arresting at major skin creases. The symptoms are noticeable during winter. We present clinical and histological data of a 22-year-old male with the attributes of keratolytic winter erythema.
Erythema* ; Humans ; Male ; Skin ; Young Adult

In our country the ICD-10(International classification of disease) is used to classify disease. But it has many problems in classifying and managing statistics in the field of dermatology. For instance, there are many diseases that are not included in the ICD-10, and the classification is not organized. Also, in many cases the classification of ICD-10 has problems in computerizing. Even though we need a classification overcoming these problems, National health insurance corporation is using the ICD-10. In this study, we corrected the problems of the ICD-10 to make an improved ICD-10 to use in dermatologic fields. To do this, we had to search all the dermatologic disease code contained in the ICD-10, and find all the disease listed in the book of domestic and foreign. We had to compare and analyse these. Subsequently, we add the diseases that are not contained in the ICD-10, organized the classification and improved the dermatologic disease code of ICD-10. This classification would be useful for the management of disease in the dermatologic field.
Classification* ; Dermatology ; International Classification of Diseases ; National Health Programs

BACKGROUND: Becker's nevus is a relatively common pigmented smooth muscle harmatoma that develops during adolescence and occurs primarily in young men. The nevus, characterized by hypertrichosis and hyperpigmentation, is usually located unilaterally over the shoulder, upper arm, and scapula. These nevi are not only cosmetically undesirable but also psychologically distressing, as traditional surgical therapies have been either unsuccessful or have resulted in scarring. OBJECTIVE: We evaluated the clinical improvement of 14 patients with a becker's nevus who were treated with a Q-switched (QS) frequency doubled ND: YAG laser in order to decrease pigmentation. METHODS: Our study was designed by analyzing the clinical improvement of outpatients with becker's nevus via clinical examination and photography. RESULTS: The results were as follows; Male to female ratio of 2.5: 1. The mean age was 19.7 years old and the subjects in most of the studies were young adult. The mean age of onset was 5.7 years old (below 5 years old: n=8, 57%). We treated 14 patients with a QS ND: YAG laser. The patients' response to treatment was; excellent; 14%, good; 36%, fair; 21%, and poor; 29%. Conparison, was made, of the positive clinical improvement in patients who received treatment once (n=10) and those who received treatment more than twice (n=4). Multiple treatments (75%) showed superior improvement compared with single treatment (40%). The clinical improvement, the according to the area of lesions, was the best in the neck (100%) and the worst in the trunk (25%). The lesions were accompanied by hair in 6 cases. Among these, the excellent or good cases were 33%. The other patients (8 cases) without hairs had more positive results (63%). Treatment effects according to laser fluence were not shown to be significant. During the study, the most common complication was hyperpigmentation (36%), followed by transient erythema (14%). Scarring or hypopigmenatation had resulted in none. CONCLUSION: Our data suggested that QS ND: YAG laser irradiation is an effective and safe method to treat the hyperpigmentation characteristic of a becker's nevus. Long-term further evaluation will be necessary to determine whether the favorable results observed in these patient will be permanent.
Adolescent ; Age of Onset ; Arm ; Child, Preschool ; Cicatrix ; Erythema ; Female ; Hair ; Humans ; Hyperpigmentation ; Hypertrichosis ; Lasers, Solid-State* ; Male ; Muscle, Smooth ; Neck ; Nevus* ; Outpatients ; Photography ; Pigmentation ; Scapula ; Shoulder ; Young Adult

BACKGROUND: Postoperative nausea and vomiting (PONV) is a distressing adverse effect of anesthesia. This study was designed to evaluate antiemetic effects of metoclopramide, ondansetron and granisetron in middle ear surgery. METHODS: We compared the antiemetic activity of prophylactic administration of metoclopramide, ondansetron and granisetron in 103 patients undergoing middle ear surgery (tympanomastoidectomy and tympanoplasty). All Study drugs were given as a short intravenous infusion 30 minutes before the end of anesthesia. The incidence of PONV were assessed by direct questioning of patients at 6, 12, 24 and 48 hr after recovery from anesthesia. RESULTS: For the first 6 hr recovery period after surgery, the percentages of emesis in patients were 46.7%, 16%, 12% and 16% in the control, metoclopramide, ondansetron and granisetron groups respectively. After 6 hr, the percentage of emesis in patients significantly decreased in the control, ondansetron and granisetron groups when compared with the first 6 hr, but in the metoclopramide group there was no changes after 6 hr. CONCLUSIONS: The antiemetic drugs, metoclopramide, ondansetron and granisetron, were all effective in controling PONV in middle ear surgery.
Anesthesia ; Antiemetics* ; Ear, Middle* ; Granisetron* ; Humans ; Incidence ; Infusions, Intravenous ; Metoclopramide* ; Ondansetron* ; Postoperative Nausea and Vomiting ; Vomiting