PURPOSE: In the pathogenesis of proliferative vitreoretinopathy (PVR), retinal pigment epithelial (RPE) cells do not undergo apoptosis after separation from the basement membrane. In order to investigate the mechanism by which RPE cells resist apoptosis in PVR, the expression of focal adhesion kinase after cryotherapy was studied. METHODS: After lensectomy and vitrectomy was performed on rabbit eyes, a retinal tear was created. Cryotherapy was applied to the tear site one week after the tear creation. Rabbits were sacrificed at 1, 4 and 7 days after the tear formation and 30 minutes, 1, 4, 7, 9, 21 days after cryotherapy. Eyes were stained with anti-focal adhesion kinase (FAK) antibody. RESULTS: Expression of FAK increased after the tear formation and remained increased until 21days after cryotherapy. CONCLUSIONS: These data show that creation of a retinal tear and cryotherapy increases FAK expression and may contribute to resistance to apoptosis.
Apoptosis ; Basement Membrane ; Cryotherapy* ; Epithelial Cells* ; Focal Adhesion Protein-Tyrosine Kinases* ; Focal Adhesions* ; Phosphotransferases ; Rabbits ; Retinal Perforations ; Retinaldehyde* ; Vitrectomy ; Vitreoretinopathy, Proliferative

We used the fluorophotometry to investigate the corneal epithelial barrier function after excimer laser photorefractive keratectomy (PRK). Twenty-five eyes of 21 subjects (13 women, 8 men) underwent PRK to correct rnyopia. Corneal epithelial healing time was measured and corneal epithelial permeability to sodiurn fluorescein was evaluated by fluorophotoinetry at I, 2, and 3 weeks after surgery. The corneal epithelial permeability increased significantly 1 week after surgery and returned to preoperative level 2 weeks after surgery. The permeability differences according to epithelial healing days and corrected diopters were not statistically significant(p>0. 05). These results suggest that PRK delays complete reconstruction of corneal epithelial barrier function. The corneal epithelium regained its functional barrier 2 weeks after PRK in patients, so, at least, during the first 2 weeks, care should be taken to miniinize further epithelial trauma from topical inedication or surgical manipulation.
Epithelium, Corneal ; Female ; Fluorescein ; Fluorophotometry ; Humans ; Lasers, Excimer* ; Permeability ; Photorefractive Keratectomy*

Purpose: The purpose of this study was to investigate the effects of the scapulothoracic mobilization on subject with lateral epicondylalgia. This was done through lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion. Methods: Before the experiment, Lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion were measured. Scapulothoracic joint mobilization was applied and then measurements were taken again to compared the changes. Results: After applying the scapulothoracic joint mobilization, lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion significantly improved. Conclusion This study found that the scapulothoracic mobilization was effective in improving functional aspects and pain on subject with lateral epicondylalgia. The results suggest that the scapulothoracic joint mobilization is a significant considered intervention method that could be used for subject with lateral epicondylalgia.

This study was performed to detect the oxidative stress in the cornea and lens in vivo by fluorophotometer after excimer laser photorefractive keratectomy(PRK). Twenty New Zealand white rabbits(20 eyes)were divided into two groups, control group(10 eyes)and PRK group(10 eyes). Rabbits of PRK group underwent PRK(8 diopters)and 2', 7'-dichlorofluorescein diacetate(DCFH-DA)was applied on the central cornea 6 hours after PRK in both groups. Fluorophotometric readings of the cornea and lens were measured 15 minutes(F15)and 30 minutes(F30)after DCFH-DA application in both groups. The cornea and lens was observed with slit lamp biomicroscope for 8 weeks. F15 and F30 of the cornea in PRK group(3.83+/-1.22 ng/ml, 5.12+/-1.57 ng/ml)were significantly higher than those in control group(2.61+/-0.59 ng/ml Eq, 3.26+/-0.76 ng/ml Eq)(p=0.01, p=0.005). F15 and F30 of the lens in PRK group(409.7+/-157.2 ng/ml, 594.9+/-242.2 ng/ml Eq)were significantly higher than those in control group(74.1+/-48.3 ng/ml Eq, 310.1+/-249.8 ng/ml Eq)(p=0.0004, p=0.01). No lens opacity developed and F15 and F30 of the cornea did not correlate with corneal haze determined at postoperative 8 weeks. In this study, we demonstrated increased oxygen free radicals in the cornea and lens after PRK by fluorophotometer in vivo and this method can be used as a useful tool to investigate the possible damage induced by oxygen free radicals in the cornea and lens after excimer laser corneal ablation.
Cataract ; Control Groups ; Cornea* ; Free Radicals* ; Lasers, Excimer* ; New Zealand ; Oxidative Stress ; Oxygen* ; Rabbits ; Reading

Grisel’s syndrome is a non-traumatic atlantoaxial rotatory subluxation for which the underlying mechanism has not yet been identified. It is known to occur following upper respiratory infections, tonsillitis, ear, nose, and throat (ENT) surgeries such as tonsillectomy and adenoidectomy. The diagnosis of Grisel’s syndrome can be made by plain x-ray, CT scanning, and/or MRI scanning. The first choice of treatment is conservative therapy such as bed rest, muscle relaxation, analgesic therapy, antibiotics, and simple traction. While Grisel’s syndrome occurs rarely, delayed treatment may lead to neurological complications or requires surgical treatment. Early diagnosis and treatment are important in preventing fatal outcome. We report the case of a 9-year-old male who developed Grisel’s syndrome after tonsillectomy and adenoidectomy.

Pseudo-inflammatory tumors are also known as plasma cell granuloma, inflammatory pseudo-tumor and inflammatory myofibroblastic tumor, and these tumors are a group of highly variable proliferations of myofibroblastic cells that are associated with a prominent inflammatory infiltrate. This tumor is known to most commonly occur in the lungs, bladder and gastrointestinal system with only a few cases having been reported in the skin. A previously healthy 26-year-old man presented with a 6-year history of an intermittently pruritic lesion on his back. On the histologic examination, there were spindle cells in fascicles and a mixed inflammatory cellular infiltrate of plasma cells and lymphocytes. A diagnosis of inflammatory fibroblastic tumor was made and the nodule was surgically removed. We report here on an additional case of this rare cutaneous entity, and it is probably the first such report from Korea.
Adult ; Fibroblasts ; Granuloma, Plasma Cell ; Humans ; Korea ; Lung ; Lymphocytes ; Myofibroblasts ; Plasma Cells ; Skin ; Urinary Bladder

PURPOSE: To report a case of high dose steroid-responsive Purtscher's retinopathy which was developed after operation for diaphragmatic laceration sustained in motorcycle accident. CASE SUMMARY: A 68-year-old man came to our hospital with complaining of decreased visual acuity in the right eye after diaphragmatic laceration operation. Best corrected visual acuity was 0.1 in the right eye. Anterior segment was nonspecific. However, afferent pupillary defect was observed. Superficial intraretinal hemorrhage, numerous cotton-wool spots, peripapillary hemorrhage, and macular edema were detected on fundus examination. Fluorescein angiography revealed capillary nonperfusion and fluorescein filling defect due to retinal hemorrhage in arteriovenous phase and fluorescein leakage from the macula and capillary nonperfusion area in the late venous phase. Accordingly, Purtscher's retinopathy was diagnosed and the patient was observed without specific treatment. After 2 weeks of observation, symptoms and fundus findings were not changed. High-dose steroid therapy was begun with injection of one gram of methylprednisone for three days, switched to oral prednisolone, and then slowly tapered in period of 3 weeks. 7 days after the treatment, visual acuity was improved to 0.2 in the right eye but afferent pupillary defect was still observed. Cotton-wool spots slightly decreased, peripapillary hemorrhage was absorbed but macular edema was remained. 14 days after the treatment, visual acuity greatly improved to 0.63 and afferent pupillary defect was not observed. Cotton-wool spots and macular edema were decreased but fluoroscein leakage from capillary nonperfusion area was remained. CONCLUSIONS: In the case of Purtscher's retinopathy, high-dose steroid therapy can be a useful management method for the improvement of visual acuity and other symptoms.
Aged ; Capillaries ; Eye ; Fluorescein ; Fluorescein Angiography ; Hemorrhage ; Humans ; Lacerations ; Macular Edema ; Motorcycles ; Porphyrins ; Prednisolone ; Pupil Disorders ; Retinal Hemorrhage ; Visual Acuity

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
Anti-Bacterial Agents ; Carbapenems ; Cross Infection* ; Delivery of Health Care ; Dichlorodiphenyldichloroethane ; Glycopeptides ; Infection Control ; Korea ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Seoul ; Staphylococcus aureus* ; Staphylococcus*

A 75-year-old woman with hypertension presented with acute suppurative cholangitis. Chest radiography revealed severe kyphosis. Abdominal computed tomography revealed a large stone impacted in the common bile duct (CBD). The patient underwent emergent endoscopic retrograde cholangiopancreatography, and cholangiography revealed a large stone (7×3 cm) in the CBD that could not be captured using a large basket. We could not use the percutaneous approach for stone fragmentation by using a cholangioscope because of severe degenerative kyphosis. Finally, we performed holmium laser lithotripsy under peroral cholangioscopy by using an ultraslim endoscope, and the large stone in the CBD was successfully fragmented and removed without complications.
Aged ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Common Bile Duct* ; Endoscopes ; Female ; Gallstones ; Humans ; Hypertension ; Kyphosis* ; Lasers, Solid-State ; Lithotripsy ; Lithotripsy, Laser* ; Radiography ; Thorax

PURPOSE: To report cases of transplanting a donor's 2 corneas to 5 patients suffering from several corneal diseases. CASE SUMMARY: Two corneas were donated from a 66-year-old donor, who suffered from brain damage due to asphyxia, one hour after being pronounced dead by doctors. Two penetrating keratoplasties and 3 partial lamellar keratoplasties were performed for patients with corneal opacity, corneal ulcer and corneal perforation. After the procedure all grafts were stable. CONCLUSIONS: Under the present circumstances of decreasing donations of corneas after death and the increasing demand for keratoplasty in Korea, the mutual cooperation among hospitals to treat more than one patient using one donated cornea is a method the authors believe can alleviate this situation.
Aged ; Asphyxia ; Brain ; Cornea ; Corneal Diseases ; Corneal Opacity ; Corneal Perforation ; Corneal Transplantation ; Corneal Ulcer ; Humans ; Keratoplasty, Penetrating ; Korea ; Stress, Psychological ; Tissue Donors ; Transplants