No abstract available.
Gardner Syndrome*

The aim of this study is to characterize the epidemiological features of typhoid fever, categorized as class 1 notifiable disease in Korea and to analyze the recent change of antimicrobial resistance of Salmonella enterica serotype Typhi isolated nationwide. We retrospectively analyzed the 1,692 culture-proven cases from 1992 to 2000, using the data of the Korean National Institute of Health. The overall incidence of culture-proven typhoid fever was 0.41 per 100,000 population. It occurred all over the country, but the southeastern part of Korean peninsula had the higher incidence rate than other areas. There were several outbreaks suspected, of which two outbreaks were confirmed. The resistance rate against chloramphenicol showed mild increase, but the ampicillin, trimethoprim/sulfamethoxazole, kanamycin, or nalidixic acid resistance remained at the similar levels for the past 9 yr. There were 21 (1.3%) multidrug-resistant (MDR) strains isolated since 1992, and the number of those has increased. Two strains resistant to ciprofloxacin were first identified in Korea.
Ampicillin/pharmacology ; Anti-Bacterial Agents/pharmacology ; Chloramphenicol/pharmacology ; *Drug Resistance, Microbial ; Drug Resistance, Multiple ; Human ; Kanamycin/pharmacology ; Korea ; Nalidixic Acid/pharmacology ; Retrospective Studies ; Salmonella Infections/*epidemiology ; Salmonella enterica/*metabolism ; Seasons ; Serotyping ; Support, Non-U.S. Gov't ; Time Factors ; Trimethoprim/pharmacology

PURPOSE: To evaluate the efficacy and safety of vitreoretinal surgery using a 23-gauge transconjunctival sutureless vitrectomy (TSV) system for various vitreoretinal diseases. METHODS: A retrospective, consecutive, interventional case series was performed for 40 eyes of 40 patients. The patients underwent vitreoretinal procedures using the 23-gauge TSV system, including idiopathic epiretinal membrane (n=7), vitreous hemorrhage (n=11), diabetic macular edema (n=10), macular hole (n=5), vitreomacular traction syndrome (n=5), diabetic tractional retinal detachment (n=1), and rhegmatogenous retinal detachment (n=1). Best corrected visual acuity (BCVA), intraocular pressure (IOP), and intra- and post-operative complications were evaluated. RESULTS: Intraoperative suture placement was necessary in 3 eyes (7.5%). The median BCVA improved from 20/400 (LogMAR, 1.21+/-0.63) to 20/140 (LogMAR, 0.83+/-0.48) at 1 week (p=0.003), 20/100 (LogMAR, 0.85+/-0.65) at 1 month (p=0.002), 20/100 (LogMAR, 0.73+/-0.6) at 3 months (p=0.001). In 1 eye, IOP was 5 mmHg at 2 hours and 4 mmHg at 5 hours, but none of the eyes showed hypotony after 1 postoperative day. No serous postoperative complications were observed during a mean follow-up of 8.4+/-3.4 months (range 3-13 months) CONCLUSIONS: The 23-gauge TSV system shows promise as an effective and safe technique for a variety of vitreoretinal procedures. It appears to be a less traumatic, more convenient alternative to 20-gauge vitrectomy in some indications.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Retinal Diseases/*surgery ; Retrospective Studies ; *Suture Techniques ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*methods ; Vitreous Hemorrhage/*surgery

This study aimed to evaluate the protective effect of heat shock protein70 (hsp70) on retinal photic injuries, and to determine the relationship between hsp70s from hsp70.1 and 70.3. C57BL/6 wild type (hsp70.1+/+) and knockout type (hsp70.1-/-) mice from the same littermates were placed in light of 11000 lux for 6 hours, and were sacrificed at 1, 4, 7, and 14 days after stress. H & E staining, immunohistochemistry, and western blot analysis were performed. The hsp70.1-/- mice exhibited more disarranged and more diffusely destroyed photoreceptors than the hsp70.1+/+ mice. Hsp70 induction by light in both the hsp70.1 +/+ and hsp70.1 -/- mice peaked at 1 day after light stress. The Hsp70 level in the hsp70.1 +/+ mice reduced slowly and was almost constant for 7 days. However, in the hsp70.1 -/- mice, it decreased rapidly and returned, after 7 days, to a similar level to that prior to light exposure. According to which gene they originate from, hsp70s may play specific roles in protecting the retina against stresses. Hsp70 from the hsp70.1 gene may act as a sustained responder to retinal photic injury.
Animals ; Blotting, Western ; Heat-Shock Proteins 70/*physiology ; Immunohistochemistry ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Radiation Injuries/*prevention& control ; *Radiation Protection ; Retina/*radiation effects ; Support, Non-U.S. Gov't

The purposes of this study are to elucidate the retinal changes of heat shock protein 70.1 (hsp70.1) knockout mice and to compare them between in normal and in retinal degeneration (rd) mice. Eyes of hsp70.1 wild type (+/+) and knockout (-/-) mice in the C57BL/6 or FVB genetic backgrounds respectively, which were reared in the normal environment, were examined by fundus photography, electroretinography, light microscopy, terminal dUTP nick-end labeling (TUNEL) stain, and immunohistochemistry. In C57BL/6 mice, fundus photography showed no changes between hsp70.1+/+ and -/- mice at 1 and 6 months of age. Electroretinographic examination showed a tendency of decreased amplitude of a- and b-wave with aging in both genotype, but there were not different statistically. The ratios of the thickness of inner nuclear and outer nuclear layer to the retinal thickness were respectively decreased with aging in both genotype, but there were not different statstically. TUNEL assay showed a few positively labeled cells in the ganglion cell, inner nuclear and outer nuclear layers and the immunohistochemistry showed no immunopositivity of hsp70 in the inner segments of photoreceptor cell layer in both genotype. In rd mice, fundus photography showed a narrowing of the retinal vessels at the age of 4 weeks, however, there were no differences of retinal changes including pigment epithelial layer in both genotype. Electroretinographic examination at the postnatal 2, 3 and 4 weeks showed no differences between them. Loss of photoreceptor cell and outer nuclear layers showed no differences in both genotype. In conclusion, there were no differences of the retinal changes at least under the normal environmental condition in hsp70.1+/+ and -/- mice. These results show that hsp70.1-/- mice can be used to study the role of hsp70.1 to the external stress to the retina.
Animal ; Electroretinography ; Fundus Oculi ; Heat-Shock Proteins 70/*deficiency/genetics ; Mice ; Mice, Inbred C57BL ; Mice, Knockout/genetics ; Photoreceptors, Vertebrate/*metabolism ; Protozoan Proteins/genetics ; Reference Values ; Retinal Degeneration/metabolism/*pathology/*physiopathology

OBJECTIVE: In selected cases, the transsphenoidal approach(TSA) can be extended anteriorly to the tuberculum sellae, chiasmatic sulcus, and planum sphenoidale to obtain direct exposure of the suprasellar cisterns and its contents. We applied this modification of the TSA to various lesions of the presellar and suprasellar areas. We evaluate our clinical experience of this technique and review the related literature. METHODS: From 1999 to 2004, we used the transsphenoidal supradiaphragmatic intradural approachs(TSIAs) in 9 patients who had various lesions at the pre- and suprasellar regions. Concomitant presellar extension of the bone window was performed with the sublabial or transnasal transseptal transphenoidal techniques. After removal of the lesions, sellar or anterior cranial floor was repaired with silicone plate substitute. RESULTS: The TSIAs have been applied in the following cases: four tuberculum sellae meningiomas, two craniopharyngiomas, two Rathke's cleft cysts, and one non-functioning macroadenoma. The complications were one case of visual acuity decrease and one cerebrospinal fluid rhinorrhea. CONCLUSION: The TSIA is easily applicable through a minor modification of the standard TSA. It is suitable for removing lesions located in the presellar and suprasellar area adjacent to the pituitary stalk with minimal brain manipulation and decreased morbidity.
Brain ; Central Nervous System Cysts ; Cerebrospinal Fluid Rhinorrhea ; Craniopharyngioma ; Humans ; Meningioma ; Pituitary Gland ; Silicones ; Temazepam ; Visual Acuity

BACKGROUND: Tuberculosis is still one of the most seriously threatening infections in Korea, because of multidrug resistant tuberculosis. Results of antituberculosis drug susceptibility test can provide clinicians very important informations for selection of proper regimens for treatment. METHODS: In this study the results of antituberculosis drug susceptibility test of 298 cases at Kyunghee Medical Center from 2000 to 2003 were retrospectively analysed to evaluate the trend of antituberculosis drug susceptibility. The procedure of drug susceptibility test was based on the absolute concentration method using Lowenstein-Jensen solid media. RESULTS: The resistance rate of Mycobacterium tuberculosis to one or more drugs was increased from 29.3% in 2000 to 48.2% in 2003, and the rates of multiple resistance to two or more drugs increased from 13.3% in 2000 to 20.5% in 2003. The increase in resistance rate to individual drug during study period were 20.0% to 24.1% in isoniazid, 9.3% to 19.3% in rifampicin, 5.3% to 15.7% in ethambutol, 4.0% to 10.8% in para-aminosalicylic acid, 2.7% to 6.0% in kanamycin, 1.3% to 7.2% in ethionamide, 1.3% to 6.0% in capreomycin, 1.3% to 7.2% in prothionamide, 0.0% to 12.1% in ofloxacin, 6.7%to 3.6% in streptomycin, 6.7% to 7.2% in cycloserine, 10.7% to 8.4% in pyrazinamide, respectively. CONCLUSIONS: The resistance rate of M. tuberculosis has been increased with years and multidrug resistant M. tuberculosis was commonly encountered in the specimens from the patients visited Kyunghee Medical center.
Aminosalicylic Acid ; Capreomycin ; Cycloserine ; Ethambutol ; Ethionamide ; Humans ; Isoniazid ; Kanamycin ; Korea ; Mycobacterium tuberculosis ; Ofloxacin ; Prothionamide ; Pyrazinamide ; Retrospective Studies ; Rifampin ; Streptomycin ; Tuberculosis

Background and Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease resulting from inflammation of the nasal cavity and paranasal sinuses. Systemic allergic inflammation is an important cause of CRSwNP; however, the effect of local allergic inflammation is unclear. This study was designed to investigate the effect of local allergic inflammation in CRSwNP. Materials and Methods: The study included 11 patients with CRSwNP and 18 control subjects. Olfactory function was measured with the Korean Version of Sniffin’s stick test. Nasal lavage fluids (NLFs) were collected from all subjects and analyzed for total IgE, eosinophilic cationic protein (ECP), and cytokines (tumor necrosis factor [TNF]-α, interleukin [IL]-4, IL-10, IL-17A, interferon-γ). Flow cytometry was used to measure various inflammatory cells in the NAL fluids. Results: On analysis of flow cytometry and enzyme-linked immunosorbent assay, we found that CRSwNP patients had significantly increased eosinophil (%) and ECP levels in NLFs. In addition, there was significant local-systemic correlation between ECP level in NLFs and blood eosinophils (%) (r=0.391); however, there was no significant association between eosinophils (%) in NLFs and blood eosinophils. Moreover, in CRSwNP patients, the severity of disease was related with blood eosinophil (%), eosinophil (%), and ECP levels in NLFs, whereas olfactory function was associated with blood eosinophil (%) and ECP levels in NLFs. Conclusion CRSwNP is a disease with high allergic inflammation that has negative impacts on the severity of disease and olfactory function. Therefore, we suggest that control of local allergic inflammation will be helpful to treat CRSwNP patients.

OBJECTIVE: The aims of this study were designed to determine that serum soluble Fas and Fas ligand levels are altered in women with preeclampsia and HELLP syndrome, and to assess the expression of placental Fas and Fas ligand in women with preeclampsia and HELLP syndrome. METHODS: Blood samples were obtained from 31 women with normal pregnancy, 27 women with preeclampsia and five women with HELLP syndrome. Serum Fas/Fas ligand levels were measured by enzyme linked immunoassay. Immunohistochemical stain with polyclonal antibodies of Fas/Fas ligand were used to identify apoptosis. Mann-Whitney test, x2 test, Pearson correlation coefficients and multiple regression test were used for statistical analysis. RESULTS: Both soluble Fas ligand and Fas were detected in the sera of normal pregnancy, preeclampsia and HELLP syndrome. The mean serum level of soluble Fas was 5.83+/-0.37 U/mL in women with normal pregnancy, 10.84+/-0.93 U/mL in women with preeclampsia, and 10.79+/-00.69 U/mL in women with LELLP syndrome. The mean serum level of soluble Fas ligand was 0.59+/-0.03 U/mL in women with normal pregnancy, 0.51+/-0.21 U/mL in women with preeclampsia, and 0.60+/-0.01 U/mL in women with LELLP syndrome. The mean serum levels of soluble Fas were significantly higher in women with preeclampsia and HELLP syndrome than in women with normal pregnancy, but those of Fas ligand were no significant difference in each group. Apoptosis was conclusively demonstrated within placental tissue. The immunohistochemical analysis of Fas revealed diffuse immunoreactive stains were increased in women with preeclampsia than in women with normal pregnancy. But the immunohistochemical analysis of Fas ligand revealed diffuse immunoreactive stains were decreased in women with preeclampsia than in women with normal pregnancy. CONCLUSION: Placental apoptosis and altered expression of Fas and Fas ligand in trophoblast might influence the pathogenesis or pathophysiologic mechanism of preeclamsia. Elevated serum soluble Fas levels is associated with preeclampsia and HELLP syndrome. The source of elevated serum soluble Fas in preeclampsia and HELLP snydrome remains to be determined.
Antibodies ; Apoptosis ; Coloring Agents ; Fas Ligand Protein ; Female ; HELLP Syndrome ; Humans ; Immunoassay ; Placenta* ; Pre-Eclampsia* ; Pregnancy ; Trophoblasts

PURPOSE: To compare changes in choroidal hyperpermeability after half-energy photodynamic therapy (PDT) and intravitreal ranibizumab in the treatment of chronic central serous chorioretinopathy (CSC). METHODS: Post-hoc analysis was performed in a randomized, controlled trial comparing half-energy PDT versus intravitreal ranibizumab for chronic CSC; during the experiments, the other treatment was available for salvage treatment if the original was unsuccessful at 3 months. A commercially available image analysis program (Adobe(R) Photoshop(R) CS6 [Adobe Systems, Inc., San Jose, CA]) was used for quantification of change in choriodal hyperpermeability on indocyanine green angiography after half-energy PDT or three consecutive intravitreal injections of ranibizumab. Post-treatment images were subtracted from pre-treatment images after adjustments were made to create images depicting the change in choroidal hyperpermeability with treatment. Integrated gray scale values per area in this image were used for analysis of change in choroidal hyperpermeability. RESULTS: The calculated change in choroidal hyperpermeability was significantly greater in the half-energy PDT group (17.36 +/- 8.74) than in the ranibizumab group (6.78 +/- 5.03) (p < 0.001). All eyes in the half-energy PDT group showed complete resolution of subretinal fluid, and no significant difference in change of choroidal hyperpermeability was found in eyes that received half-energy PDT as primary or salvage treatment. In the ranibizumab-treated group, subretinal fluid resolution was accomplished in 5 eyes, and these eyes showed a significantly larger decrease in choroidal hyperpermeability when compared with eyes showing poor response (10.31 +/- 4.00 vs. 2.74 +/- 2.16, p = 0.005). In the successfully treated eyes with ranibizumab, there was no significant difference in choroidal hypopermeability change when compared to half-energy PDT (p = 0.124). CONCLUSIONS: Using our novel method of analysis of change in choroidal hyperpermeability following treatment for chronic CSC, greater change was found in eyes with good response, and the superior outcome of half-energy PDT over ranibizumab may be attributed to greater influence on choroidal hyperpermeability.
Angiography ; Central Serous Chorioretinopathy* ; Choroid* ; Indocyanine Green ; Intravitreal Injections ; Photochemotherapy* ; Subretinal Fluid ; Ranibizumab