PURPOSE: To evaluate the short-term effects of a single intravitreal injection of bevacizumab (Avastin) for the management of new vessels (NV) associated with proliferative diabetic retinopathy (PDR). METHODS: A non-randomized study of 19 PDR patients (20 eyes) who had active NV was analyzed prospectively. Standardized ophthalmic evaluation was performed at baseline and at weeks 1, 4, and 8 after intravitreal injection of 1.25 mg of bevacizumab. The main outcome measures included changes in total area of fluorescein leakage from active NV and best corrected visual acuity (BCVA). RESULTS: Twenty eyes of 19 patients (12 men [63.2%], 7 women [36.8%]) were included and all patients completed the 8-week study follow-up period. The mean age of participants was 47.05+/-12.48 years. At baseline, NV area was 23.02+/-21.80 mm2. The area of active NV decreased significantly to 4.96+/-9.18 mm2, 1.11+/-4.96 mm2 and 4.55+/-5.11 mm2 (p<0.05) at 1, 4 and 8 weeks after injection, respectively. At week 4, no leakage was observed in 19 eyes. The mean logMAR BCVA improved from 0.59+/-0.49 at baseline to 0.56+/-0.47, 0.55+/-0.73 and 0.51+/-0.50 at weeks 1, 4, and 8, respectively. No significant adverse events were observed. CONCLUSIONS: Short-term results suggest that intravitreal injection of bevacizumab is associated with a rapid regression of retinal neovascularization secondary to PDR.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Eye ; Female ; Fluorescein ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Male ; Outcome Assessment (Health Care) ; Prospective Studies ; Retinal Neovascularization ; Retinaldehyde ; Visual Acuity ; Bevacizumab

Alveolar macrophages participate in the host defense against P. carinii, but the mechanisms in degradation and clearance of the organism from lung has not been well established. We observed the transmission and scanning electron microscopic features and evaluated the expression of TNF-alpha and Surfactant-D in the interaction of P. carinii with alveolar macrophages. Expression of TNF-alpha and Surfactant-D in the experimentally induced P. carinii pneumonia in rat was examined by immunohistochemistry and immunoelectron microscopy. Electron microscopically, the alveolar macrophages phagocytized trophozoites and cysts of P. carinii micro-organisms. Immunohistochemically TNF-alpha was strongly expressed in the cytoplasms of alveolar macrophages. Postembedding immunogold labeling for Surfactant-D protein was expressed on the pellicles of trophozoites and cysts, P. carinii micro-organisms in the cytoplasms of macrophages, free floating surfactant materials and multilamellar bodies of type II epithelial cells. We conclude that alveolar macrophages interacted with P. carinii micro-organisms respond with increased expression of TNF-alpha. TNF-alpha may bind to P. carinii and exert a direct toxic effect upon the micro-organisms. Surfactant-D protein may augment binding of P. carinii to the alveolar macrophages and enhance the clearance of the micro-organisms.
Animals ; Cytoplasm ; Epithelial Cells ; Immunohistochemistry ; Lung ; Macrophages ; Macrophages, Alveolar* ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Rats ; Trophozoites ; Tumor Necrosis Factor-alpha*

PURPOSE: To report the first case of a solitary eyelid fibrofolliculoma and to review the literature. METHODS: A 37-year-old female patient visited the outpatient department with a lesion in the right upper lid that had been growing steadily for a year. The patient had visited the local clinic, and under the diagnosis of chalazion had received incision and curettage twice, but the lesion had recurred. RESULTS: The 5 x 5 mm lesion was located near the upper lid margin. It was a red, hemispheric, smooth nodule, relatively solid to palpation and not painful. Excision and biopsy were performed, and through a histological exam, the diagnosis of fibrofolliculoma was later confirmed. CONCLUSIONS: Solitary fibrofolliculoma is rare, and to the authors' knowledge, a lesion arising in the eyelid has not yet been reported. Fibrofolliculoma should be included in the differential diagnosis when a localized mass lesion arising in the eyelid is encountered.
Adult ; Chalazion/*diagnosis ; Diagnosis, Differential ; Eyelid Neoplasms/*diagnosis/pathology/surgery ; Female ; Fibroma/*diagnosis/pathology/surgery ; Humans ; Ophthalmologic Surgical Procedures

The thirteen DRB1, 6 DQA1, and 5 DQB1 alleles were defined in 362 healthy Korean controls using reverse dot blot hybridization method. The twenty-four immobilized SSOs for DRB1, 8 for DQA1, and 6 for DQB1 were used for this study. The frequencies of genotypes were DRB104 (17.1'Yo), '09 (13.1%), and '13 (11.6%); DQA1'01 (46.7%), 03 (30.8%), and '05 (11.7%); DQB1*03 (39.5%), '06 '(29.8%), and 05 (16.0%). ...continue...
Alleles* ; Genotype ; Haplotypes* ; HLA-DRB1 Chains

PURPOSE: To report a case of a 9-year-old girl who complained of a floater symptom due to preretinal hemorrhage, subdural hemorrhage and arachnoid cyst. CASE SUMMARY: A 9-year-old girl presented to our clinic with floater symptom in her right eye and a headache. Her corrected visual acuities were 20/20 in both eyes. Preretinal hemorrhage around the optic disc in both eyes was observed. Brain MRI revealed subdural hemorrhage on the frontal, temporal, and parietal lobes, and the arachnoid cyst in the right fronto-temporal lobe. One year later, the preretinal hemorrhages were absorbed. CONCLUSIONS: Arare case of concomitant preretinal and spontaneous subdural hemorrhage with arachnoid cyst was presented. The utilization of brain MRI is recommended to determine underlying causes when fundus examination reaveals retinal hemorrhage without trauma, systemic disease and neurologic symptom.
Arachnoid ; Brain ; Child ; Eye ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Neurologic Manifestations ; Parietal Lobe ; Retinal Hemorrhage ; Visual Acuity

No abstract available.
Brain Neoplasms* ; Brain* ; Tomography, Emission-Computed, Single-Photon*

Moyamoya disease(MMD) is defined as the development of collateral anastomosis pathways, associated with bilateral chronic progressive stenosis of the carotid fork. We have reviewed the types of presentation, angiograms, and single photon emission computed tomographs(SPECT). Ninety-nine patients were divided into three groups (aged below 5 years, between 5 and 15 years, and 16 or over) to investigate whether there were differences in clinical presentation and hemodynamic characteristics between the age groups. Mean age of the 99 patients was 13.6 years and the mean duration of symptoms was 26.2 months. In the 17 children aged less than five, the duration of symptoms was shorter(4.8 months) than in older patients(p<0.05). The former presented mostly with cerebral infarction(59%) with a widespread cerebral perfusion defect(50%). Among 56 children who were 5 to 15 years old, 42 (75%) presented with transient ischemic attacks and 10(18%) with cerebral infarction; the latter was less frequent in this age group than in other age groups. Twelve(46%) out of 26 adult patients had hemorrhage at the initial diagnosis, which was the most frequent presentation in this age group. Stenosis of the posterior cerebral artery was detected in 27% of adult MMD patients, while it was detected in 39% of children. Moreover, no case showed widespread perfusion defects in the adult group. The results suggest that the patterns of presentation and the hemodynamic features differ according to the age at which initial major symptoms occur. Children aged less than five suffer rapid progression of the disease and severe cerebral pefusion defect, and should therefore undergo early surgery. The less frequent involvement of MMD in the posterior circulation and better-preserved cerebral perfusion are characteristic findings of the disease in adults, and this seems to account for its delayed onset.
Adolescent ; Adult ; Cerebral Infarction ; Child ; Constriction, Pathologic ; Diagnosis ; Hemodynamics* ; Hemorrhage ; Humans ; Infarction ; Ischemic Attack, Transient ; Moyamoya Disease* ; Perfusion ; Posterior Cerebral Artery

PURPOSE: To assess the location and associated findings of fractures of the posterior lumbar vertebral ring apophysis as seen on MRI. MATERIALS AND METHODS: We retrospectively evaluated MR findings in 77 patients (86 lesions) with lumbar apophyseal ring fractures. Their age ranged from ten to 67 (mean 33-1) years. To confirm the presence of verterbral ring fractures, CT was performed in 29 patients (31 lesions) within two weeks of MR imaging. Open laminectomy was performed in ten patients, percutaneous automated nucleotomy in three, and LASER operation in four. RESULTS: The most common location of fractures was the superior margin of L5 (36 lesions 41.9%), next was superior margin of S1 (21 lesions, 24.4%). On CT, a bony fragment was seen in 28 patients (30 lesions); the positive predictive value of MR was 99.7 %. Multiple lesions were seen in nine patients. Associated disc herniation and bulging were noted in 64 (74.4%) and 15 lesions (17.4%), respectively, and a high signal intensity rim aound the bony fragment on T1 weighted image was noted in 33 (38.4%). Other associated findings were spondylolysis in eight patients, retrolisthesis in five, and spondylolisthesis in three. Operative outcomes were variable. The results of open laminectomy were better than those of percutaneous automated laminectomy or LASER operation. CONCLUSION: In patients with lumbar apophyseal ring fractures, their exact location and associated findings could be evalvated by MRI, which was therefore useful in the planning of appropriate surgery.
Humans ; Laminectomy ; Lumbar Vertebrae* ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylolisthesis ; Spondylolysis

Retroperitoneal fibrosis is a fibroproliferative process involving the retroperitoneum. It may be idiopathic or can be caused by methysergide ingestion, perianeurysmal inflammation, a leaking aneurysm, urinoma or irradiation. The symptoms and signs of retroperitoneal fibrosis are variable, and for diagnosis, imaging is therefore essential. The typical imaging finding is a fibrotic lesion in front of the lower vertebrae with ureteral obstruction. Atypical lesions, however, may occur in other parts of the retroperitoneum. The aim of this report is to describe the clinical features and various imaging findings of etroperitoneal fibrosis.
Aneurysm ; Diagnosis ; Eating ; Fibrosis ; Inflammation ; Methysergide ; Retroperitoneal Fibrosis* ; Spine ; Ureteral Obstruction ; Urinoma

PURPOSE: Recently, as traffic and industrial accidents increase year by year, so the incidence of fracture and dislocation of the cervical spine tends to increase. The treatment of this condition is controversial. However, there is increasing tendency to stabilize unstable cervical spine injuries surgically. This study was undertaken to retrospectively analyze the results of surgical treatment of lower cervical spine fracture and dislocation, and to suggest a rational treatment method comparing of surgical approach, bone union, neurologic recovery and clinical symptoms. MATERIAL AND METHODS: Authors studied the medical records and roentgenograms of 48 patients, who were treated surgically for acute fracture and dislocation of the lower cervical spine since January, 1993 to April, 1999. 21 patients were treated by anterior plating and 27 patients were by posterior wiring method. 33 male and 15 female with average age of 38.3 years comprised the group. The most common cause of the injury was traffic accident(35 cases-73%). The most common site of injuries was cervical spine 5-6(20 cases-41%). 6 cases were compressive-flexion(C-F) injuries, 4 cases were vertical-compression(V-C) injuries, 22 cases were distractive-flexion(D-F) injuries, 16 cases were distractive-extension(D-E) injuries according to Allen's Classification. RESULTS: 6 C-F injury patients were treated surgically by 4 anterior approach and 2 posterior approach. All 4 V-C injury patients were by anterior approach. 22 D-F injury patients were by 6 anterior approach and 16 posterior approach. 16 D-E injury patients were by 9 anterior approach and 7 posterior approach. There were 95% radiologic bone union rate in anterior approach and 96% in posterior approach. There was no neurologic recovery in complete spinal cord injury and average 1-2 grade of recovery in incomplete and nerve root injury by Frankel's Classification. The postoperative complication were screw loosening in 1 case, instability on near site of the operation in 2 cases, superficial infection in 1 case. SUMMARY AND CONCLUSION: In the treatment of lower cervical spine fracture and dislocation anterior plating and posterior wiring were same results in bone union rate, neurologic recovery and stability. In flexion injuries with posterior disc herniation, posterior wiring by posterior approach could compressing the spinal cord or nerve root thus anterior discectomy and rigid fixation by anterior approach was necessary. In extension injuries with reduced facet joint dislocation by preoperative traction, anterior approach was effective. In combined fracture of posterior arch of cervical spine, it is difficult to operate posterior approach thus anterior approach was effective. Unreduced posterior facet joint by preoperative traction, posterior approach was effective in reduction and fixation.
Accidents, Occupational ; Classification ; Diskectomy ; Dislocations* ; Female ; Humans ; Incidence ; Male ; Medical Records ; Postoperative Complications ; Retrospective Studies ; Spinal Cord ; Spinal Cord Injuries ; Spine* ; Traction ; Zygapophyseal Joint