Proliferative vitreoretinopathy is characterized by proliferation of retinal pigment epithelial cells, fibroblasts, glial cells and excessive fibrous tissue production. Recently minoxidil has been found to inhibit the proliferation of cultured fibroblast and retinal pigment epithelium. Minoxidil also inhibits the mRNA expression and protein production of lysyl hydroxylase, a key-enzyme involved in cross-linking of collagen. Therefore, the author investigated the effects of minoxidil on cultured mouse fibroblast and the result was compared with those of 5-fluorouracil and dexamethasone. Dexamethasone demonstrated bimodal effect of stimulation of proliferation at low concentrations and inhibition at higher concentrations. Fifty percent inhibition of growth (ID50) was seen at a concentration of 316mg/L. 5-fluorouracil had the most potent antiproliferative activity with ID50 of 0.8mg/L. Minoxidil had more potent antiproliferative properties on cultured mouse fibroblasts than dexamethasone. Fifty percent inhibition of growth (ID50) was 200mg/L. Reduction in cell number was seen after a 30 minute treatment and was half-maximal after 48 hours of treatment with 1000mg/L minoxidil.
Animals ; Cell Count ; Collagen ; Dexamethasone ; Epithelial Cells ; Fibroblasts* ; Fluorouracil ; Mice* ; Minoxidil* ; Neuroglia ; Procollagen-Lysine, 2-Oxoglutarate 5-Dioxygenase ; Retinal Pigment Epithelium ; Retinaldehyde ; RNA, Messenger ; Vitreoretinopathy, Proliferative

Pilocarpine is a direct cholinergic agonist and reduces intraocular pressure by enhancing aqueous outflow. A recent study reveals that pilocarpine induces apoptotic cell death in retinal ganglion cells; activation of bax and caspase-3 is a possible mechanism of the cell death. The objective of this study is to determine whether nitric oxide is involved in apoptotic retinal ganglion cell death which is induced by pilocarpine. R18A5 retinal ganglion cells were treated with 1 mM pilocarpine. After 20 hours of incubation, NADPH-d staining assay and immunocytochemistry of nNOS, iNOS, and NF-KB were performed. In retinal ganglion cells treated with pilocarpine, intense NADPH-d histochemical reactivity was present, whereas NADPH-d reactivity was weak in control. The immunoreactivity of iNOS was increased significantly and the immunoreactivity of nNOS was increased slightly in retinal ganglion cells treated with pilocarpine. The activation of NF-KB was demonstrated by staining of nuclei in retinal ganglion cells exposed to pilocarpine, whereas such features were not seen in untreated control cells. This study provides the first evidence that nitric oxide synthase is increased in retinal ganglion cells treated with pilocarpine, and nitric oxide may be a mediator of the cell death mechanism.
Apoptosis ; Caspase 3 ; Cell Death ; Cholinergic Agonists ; Immunohistochemistry ; Intraocular Pressure ; NF-kappa B ; Nitric Oxide Synthase* ; Nitric Oxide* ; Pilocarpine* ; Retinal Ganglion Cells* ; Retinaldehyde*

PURPOSE: Soft tissue or muscle adhesion to the Porous Polyethylene Sheet Implant (PPSI) can cause postoperative extraocular motility disturbance after orbital fracture repairs using PPSI. This study was designed to examine the efficacy of amniotic membrane transplantation in the suppression of fibrosis between orbital connective tissue and PPSI. METHODS: Twelve New Zealand white rabbits were grouped as A, B, and C and conventional PPSI were implanted between orbital connective tissue and orbital floor in group A; PPSI with a barrier surface (PPSI-B) in group B; PPSI with amniotic membrane transplantation in group C. The implants were harvested at 8 weeks postoperatively, and stained with Masson trichrome and hemaoxylin and eosin staining techniques. RESULTS: In group A, the PPSI demonstrated dense adhesion on both the soft tissue implant and the bone implant interfaces. A lot of fibroblasts were observed on the surface of PPSI. In group B, the PPSI-B demonstrated less fibrosis over the barrier surface, and less fibroblasts than in group A. In group C, the PPSI with amniotic membrane transplantation manifested least fibrous adhesion among three groups. CONCLUSIONS: In orbital fracture repair, amniotic membrane transplantation could reduce the fibrosis between orbital connective tissue and PPSI, and might prevent the postoperative extraocualr motility disturbance.
Amnion* ; Connective Tissue* ; Eosine Yellowish-(YS) ; Fibroblasts ; Fibrosis* ; Orbit* ; Orbital Fractures ; Polyethylene* ; Rabbits

5-fluorouracil(5-FU) and its derivatives have been prescribed preoperatively in Korea for oral administration to patients with gastric cancer as an adjuvant therapy. Since the conditions of the patients after gastrectomy may be different and thereby influence the absorption of 5-fluorouracil, we were interested in the pharmacokinetic changes of 5-fluorouracil absorption after gastric resection. Fourteen of 40 gastric cancer patients, who underwent radical subtotal gastrectomy with D2 lymphnode dissection for gastric cancer, were selected at Ewha Womans University Mok-Dong Hospital from May 1996 to December 1996. The plasma concentrations of 5-fluorouracil were determined before oral administration of 5-FU(500 mg/M2) at 15-min intervals for two hours, and then at 30-min intervals for two hours after oral administration during the pre- and the post-operative periods. High pressure liquid chromatography was used to determine the plasma concentrations of 5-FU. The pharmacokinetic indices included the area under the curve (AUC), the peak concentration (Cmax), and the time to peak concentration (Tmax). The mean postoperative AUC for 5-FU was 25.8+/-14.8% of the mean preoperative AUC, which was a significant decrease in the amount of 5-FU absorption postoperatively. The mean postoperative Cmax was 33.4+/-30.2% of the mean preoperative Cmax, which also meant a significant decrease of the peak concentration postoperatively. The Tmax of most patients were delayed postoperatively, but there was no significant change statistically. In conclusion, we found that the amount of absorbed 5-FU, as calculated by the AUC and the Cmax, significantly decreased after a subtotal gastrectomy by as much as 75 percent compared to the preoperation. Hence, it may be necessary to increase the dose of 5-FU after a subtotal gastrectomy by more than 75% of the preoperative dose. The subtotal gastrectomy did not have a significant effect on the absorptive velocity of 5-FU.
Absorption* ; Administration, Oral ; Area Under Curve ; Chromatography, Liquid ; Female ; Fluorouracil* ; Gastrectomy* ; Humans ; Korea ; Pharmacokinetics ; Plasma ; Stomach Neoplasms

5-fluorouracil(5-FU) and its derivatives have been prescribed preoperatively in Korea for oral administration to patients with gastric cancer as an adjuvant therapy. Since the conditions of the patients after gastrectomy may be different and thereby influence the absorption of 5-fluorouracil, we were interested in the pharmacokinetic changes of 5-fluorouracil absorption after gastric resection. Fourteen of 40 gastric cancer patients, who underwent radical subtotal gastrectomy with D2 lymphnode dissection for gastric cancer, were selected at Ewha Womans University Mok-Dong Hospital from May 1996 to December 1996. The plasma concentrations of 5-fluorouracil were determined before oral administration of 5-FU(500 mg/M2) at 15-min intervals for two hours, and then at 30-min intervals for two hours after oral administration during the pre- and the post-operative periods. High pressure liquid chromatography was used to determine the plasma concentrations of 5-FU. The pharmacokinetic indices included the area under the curve (AUC), the peak concentration (Cmax), and the time to peak concentration (Tmax). The mean postoperative AUC for 5-FU was 25.8+/-14.8% of the mean preoperative AUC, which was a significant decrease in the amount of 5-FU absorption postoperatively. The mean postoperative Cmax was 33.4+/-30.2% of the mean preoperative Cmax, which also meant a significant decrease of the peak concentration postoperatively. The Tmax of most patients were delayed postoperatively, but there was no significant change statistically. In conclusion, we found that the amount of absorbed 5-FU, as calculated by the AUC and the Cmax, significantly decreased after a subtotal gastrectomy by as much as 75 percent compared to the preoperation. Hence, it may be necessary to increase the dose of 5-FU after a subtotal gastrectomy by more than 75% of the preoperative dose. The subtotal gastrectomy did not have a significant effect on the absorptive velocity of 5-FU.
Absorption* ; Administration, Oral ; Area Under Curve ; Chromatography, Liquid ; Female ; Fluorouracil* ; Gastrectomy* ; Humans ; Korea ; Pharmacokinetics ; Plasma ; Stomach Neoplasms

Object of this study was to make comparison between acetazolamide and dipyridamole activated SPECT for measurement of cerebral vascular reserve capacity. This study was also carried out to evaluate response in acetazolamide and dipyridamole activated SPECT in relation to clinical parameters, such as Glasgow Coma Scale, Hunt & Hess grade, Fisher grade and Glasgow Outcome Scale. It is concluded from study that. Acetazolamide and dipyridamole activated SPECT study proved to be valuable for cerebral vascular reserve capacity. Dipyridamole activated SPECT study was somewhat equivocal because of systemic vascular dilatation effect, but this problem could be resolved by Gamma Count Ratio. Although there were minimal transient side effect of dipyridamole such as dizziness, no complication.
Acetazolamide* ; Dilatation ; Dipyridamole* ; Dizziness ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Subarachnoid Hemorrhage ; Tomography, Emission-Computed, Single-Photon*

Cardiac involvement in systemic lupus erythematosus(SLE) is common and has been reported in more than 50% of the patients at the same stage during their illness. SLE can affect the heart in a number of ways;myocarditis, pericarditis, aortic insufficiency, hypertensive heart disease, and coronary arteritis. In recent years, with prolonged survival and improvement in diagnostic modalities, the cardiovascular manifestations of SLE have become more apparent. Coronary artery disease has a number of possible pathogenic mechanisms;atherosclerosis, coronary arteritis, spasm, and hypercoagulability. For management purposes, differentiation between arteritis and artheroslerosis is important. Atherosclerosis in the coronary as well as other vessels appears to be accelerated by SLE. Cardiovascular care to the SLE patients should be emphasized, because corticosteroid treatment and auto-immune mechanisms of SLE are able to promote the atherosclerosis of coronary arteries. We report 36-year-old otherwise healthy female with SLE who presented with severe ischemic heart disease requiring coronary by-pass surgery.
Adult ; Arteritis ; Atherosclerosis ; Coronary Artery Disease* ; Coronary Vessels ; Female ; Heart ; Heart Diseases ; Humans ; Lupus Erythematosus, Systemic* ; Myocardial Ischemia ; Pericarditis ; Spasm ; Thrombophilia

BACKGROUND: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickining in the treatment of loculated tuberculous pleural effusion. METHODS: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were teated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase (LDH), glucose, proteins, and adenosine deaminase (ADA) were compared. RESULTS: 1) The residual pleural thickening (RPT) (5.08 +/- 6.77 mm) of UK group was significantly lower than that (20.32 +/- 26.37 mm) of Non-UK group (P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT >or=10 mm(5.23 +/- 3.89 wks) was significantly longer than the patients with RPT <10 mm(2.63 +/- 1.99 wks) (P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT >or=10 mm and the patients with RPT <10 mm. CONCLUSION: The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.
Adenosine Deaminase ; Biochemistry ; Catheters* ; Drainage* ; Drug Therapy ; Dyspnea ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Oxidoreductases ; Pleural Cavity ; Pleural Effusion* ; Prospective Studies* ; Tuberculosis ; Urokinase-Type Plasminogen Activator*

Purpose: We evaluated the feasibility, safety, and learning curve of extraperitoneal single-port robot-assisted radical prostatectomy (SP-RARP) and introduced innovative surgical techniques to maintain the instrument positions during the procedures. Materials and Methods: A cohort of 100 patients underwent extraperitoneal SP-RARP at our institution from December 2021 to April 2023. The procedures were performed by an experienced urology surgeon utilizing two surgical techniques for dissecting the posterior aspect of the prostate—“changing instrument roles” and “using camera inversion”—to prevent positional shifts between the camera and instruments. Results: The mean operation time for SP-RARP was 93.58 minutes, and the mean console time was 65.16 minutes. The mean estimated blood loss during the procedures was 109.30 mL. No cases necessitated conversion to multi-port robot, laparoscopy, or open surgery, and there were no major complications during the hospital stay or in the short-term follow-up. Early outcomes of post-radical prostatectomy indicated a biochemical recurrence rate of 4.0% over a mean follow-up duration of 6.40 months, with continence and potency recovery rates of 92.3% and 55.8%, respectively. Analysis of the learning curve showed no significant differences in operation time, console time, and positive surgical margin rates between the initial and latter 50 cases. Conclusions Extraperitoneal SP-RARP is a feasible and safe option for the treatment of localized prostate cancer in skilled hands.Continued accrual of cases is essential for future comparisons of SP-RARP with multiport approaches.

Purpose: We evaluated the feasibility, safety, and learning curve of extraperitoneal single-port robot-assisted radical prostatectomy (SP-RARP) and introduced innovative surgical techniques to maintain the instrument positions during the procedures. Materials and Methods: A cohort of 100 patients underwent extraperitoneal SP-RARP at our institution from December 2021 to April 2023. The procedures were performed by an experienced urology surgeon utilizing two surgical techniques for dissecting the posterior aspect of the prostate—“changing instrument roles” and “using camera inversion”—to prevent positional shifts between the camera and instruments. Results: The mean operation time for SP-RARP was 93.58 minutes, and the mean console time was 65.16 minutes. The mean estimated blood loss during the procedures was 109.30 mL. No cases necessitated conversion to multi-port robot, laparoscopy, or open surgery, and there were no major complications during the hospital stay or in the short-term follow-up. Early outcomes of post-radical prostatectomy indicated a biochemical recurrence rate of 4.0% over a mean follow-up duration of 6.40 months, with continence and potency recovery rates of 92.3% and 55.8%, respectively. Analysis of the learning curve showed no significant differences in operation time, console time, and positive surgical margin rates between the initial and latter 50 cases. Conclusions Extraperitoneal SP-RARP is a feasible and safe option for the treatment of localized prostate cancer in skilled hands.Continued accrual of cases is essential for future comparisons of SP-RARP with multiport approaches.