BACKGROUND:With the application of early reperfusion by thrombolysis after acute MI, the importance of nontransmural infarction is increasing. We evaluated 1) the changes of LV dimension, LV fibrosis and transforming growth factor-beta1 (TGF-beta1) mRNA expression in a rat model of nontransmural infarction and 2) effects of angiotensin converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ATRB) treatment after nontransmural infarction. METHOD AND RESULTS: Female Sprague-Dawley rats were subjected to 45 minutes of coronary occlusion followed by reperfusion, and at 5 days after the operation, animals were randomized to untreated (MI-vehicle, n=19), captopril-treated (MI-captopril, n=15) and losartan-treated (MI-losartan, n=14) groups. LV dimension, measured by transthoracic echocardiography, was significantly increased at 26 days after MI, and both captopril and losartan treatment inhibited LV cavity dilatation (LV end-diastolic dimension (mm): MI-vehicle, MI-captopril, MI-losartan; 8.6 +/- 0.2, 7.8 +/- 0.2, 8.0 +/- 0.2, p<0.05 vs. MI-vehicle each). Interstitial fibrosis was reduced with both captopril and losartan treatment (p<0.05 vs. MI-vehicle). TGF-beta1 mRNA increased 2.6 fold at 10 days (p<0.05 vs. pre-MI), and normalized at 26 days after nontransmural MI. Captopril and losartan treatment blocked the induction of TGF-beta1 expression after nontransmural MI (p=S vs. pre-MI). CONCLUSION: After large nontransmural MI, ACEI and ATRB treatments attenuate LV remodeling and decrease interstitial fibrosis, at least partly by blocking the acute induction of TGF-beta1 mRNA expression.
Angiotensins* ; Animals ; Captopril ; Coronary Occlusion ; Dilatation ; Echocardiography ; Female ; Fibrosis ; Humans ; Infarction ; Losartan ; Models, Animal ; Peptidyl-Dipeptidase A* ; Rats, Sprague-Dawley ; Receptors, Angiotensin ; Reperfusion ; RNA, Messenger ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Ventricular Remodeling*

Sertoli-Leydig cell tumor is an uncommon tumor that may manifest itself by a characteri-stic virilization symptom. It is a rare gonadal tumor of sex-cord type, representing only 0.1~0.5% of all primary ovarian neoplasm. These tumors are the most common virilizing tumors in women of reproductive age. However, only one-third of patients develop masculinization. We have seen two cases of Sertoli-Leydig cell tumors without the virilizing symptom. These two cases have been confirmed by permanent tissue biopsies and have been presented in a 32-year old female who has had only amenorrhea and in a 56-year old postmenopausal female who has not manifested virilizing symptom. These cases are presented with brief review of the literature.
Adult ; alpha-Fetoproteins ; Amenorrhea ; Biopsy ; Female ; Gonads ; Humans ; Middle Aged ; Ovarian Neoplasms ; Sertoli-Leydig Cell Tumor* ; Testosterone ; Virilism

No abstract available.
Pyelonephritis*

PURPOSE: To evaluate the efficacy of argon laser in the ablation of benign conjunctival pigmented nevi. METHODS: We conducted a prospective, observational case study, on a series of argon laser ablations of conjunctival pigmented nevi, in 30 eyes of 28 patients. Laser ablation was applied directly to the conjunctival pigmented nevus in all patients. The mean age of the patients was 33.0 +/- 9.3 years old, and the male to female ratio was 3: 25. All patients were followed up over a period of at least 6 months. RESULTS: The mean size of the conjunctival lesions was 3.9 X 2.8 mm. In all patients, the conjunctival lesions to which the argon laser was applied disappeared almost completely within two days after treatment. No lesion recurrence was detected in any patient during the follow-up period, nor were there any conjunctival scars or conjunctival injection. All patients were satisfied with the results of the procedure. CONCLUSIONS: Argon laser ablation of conjunctival pigmented nevi resulted in uniformly excellent clinical outcomes. Therefore, this study concludes that argon laser ablation is a safe and effective modality for the treatment of benign conjunctival nevi, and that this method is capable of replacing the classical surgical procedure.
Argon* ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Laser Therapy* ; Male ; Nevus* ; Nevus, Pigmented ; Prospective Studies ; Recurrence

PURPOSE: To analyze the changes of astigmatism and keratometric cylinder by using the scalar and vector analysis method in children who had undergone surgery for epiblepharon or ptosis. METHODS: The study subjects were 142 eyes of 79 patients who had undergone surgery for epiblepharon or ptosis. We examined the cycloplegic refractive error and keratometric astigmatism by auto-refractometry before and 2 months after surgery. Astigmatic changes were analyzed through the scalar and vector analysis method. RESULTS: The mean age of the patients was 5.27+/-2.18 years of age, and the male to female ratio was 35: 44. There were 98 eyes of 49 patients in the epiblepharon surgery group, 28 eyes of 22 patients in the ptosis surgery group, and 16 eyes of 8 patients in the epiblepharon and ptosis surgery (combined surgery) group. The epiblepharon surgery group demonstrated a decrease in with-the-rule astigmatism, and the changes in magnitude (p<0.001) and vector (p<0.05) of keratometric cylinder were statistically significant. The ptosis surgery group demonstrated an increase in with-the-rule astigmatism and the changes in magnitude and vector of astigmatism were statistically significant (both p<0.01). The combined surgery group demonstrated an increase in with-the-rule astigmatism and the changes in vector of astigmatism and magnitude of keratometric cylinder were statistically significant (both p<0.05). CONCLUSIONS: Our results showed significant astigmatic change in eyes that underwent surgery for epiblepharon or ptosis. Therefore, careful cycloplegic refraction is necessary after epiblepharon or ptosis surgery.
Astigmatism* ; Child ; Female ; Humans ; Male ; Refractive Errors

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). Results: A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). Conclusions Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). Results: A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). Conclusions Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

Brimonidine Tartrate ; Disease Management ; Drug Combinations ; Drug-Related Side Effects and Adverse Reactions ; Glaucoma, Open-Angle ; Humans ; Incidence ; Intraocular Pressure ; Retrospective Studies

No abstract available.
Lymphoma ; Lymphoma, Large-Cell, Anaplastic

PURPOSE: Acute renal failure (ARF) is one of the common complications after liver transplantation (LT) and could be fatal unless promptly treated. Identification of risk factors is needed to prevent ARF and to attenuate the unfavorable outcomes of ARF after LT. The aim of this study was to analyze risk factors for development of postoperative ARF (between day 0 and day 30 after LT). METHODS: Total 72 LTs were performed between 1996 and 2005. Sixty six patients' records, excluding 6 patients with preoperative serum creatinine level more than 2.5 mg/dl, were reviewed retrospectively for preoperative, intraoperative, and postoperative variables to compare patients presenting ARF with the remaining patients. RESULTS: Postoperative ARF occurred in 36 transplants (54.5%) after LT. Preoperative serum sodium, bilirubin and BUN, creatinine level were higher in ARF group. ARF group had more child-pugh class C, and more episodes of preoperative hepatic encephalopathy. During intraoperative period, anhepatic time was longer and total doses of intraoperative furosemide was larger in ARF group. Also, postoperative blood immunosuppressant level was higher, and postoperative episodes of bleeding and hypotension were more common in ARF group. In multivariate analysis, preoperative child-pugh class C (P=0.041), preoperative serum creatinine level (> or =1.0 mg/dL, P=0.032), and postoperative episodes of hypotension and bleeding (P=0.045, P=0.03 respectively) were identified as risk factors for postoperative ARF. CONCLUSION: This study showed that preoperative renal and liver function, and postoperative hemodynamic condition were independent risk factors for development of ARF after LT.
Acute Kidney Injury* ; Bilirubin ; Creatinine ; Furosemide ; Hemodynamics ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Hypotension ; Intraoperative Period ; Liver Transplantation* ; Liver* ; Multivariate Analysis ; Retrospective Studies ; Risk Factors* ; Sodium