PURPOSE: To evaluate corneal biomechanical properties in eyes that had previously undergone penetrating keratoplasty (PK) using the ocular response analyzer (ORA). METHODS: We recruited 26 patients who had received unilateral PK. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and cornea-compensated intraocular pressure (IOPcc) were measured with the ORA and were compared to the measurements from the contralateral eyes that did not undergo PK. RESULTS: The CH was 8.95+/-2.59 mmHg in eyes that underwent PK and 9.78+/-1.45 mmHg in the contralateral eyes that did not undergo PK (p=0.077). The CRF was 10.26+/-2.64 mmHg in post-PK eyes and 9.75+/-1.45 mmHg in the contralateral eyes (p=0.509), and the CH-CRF was significantly smaller in post-PK eyes (-1.31+/-2.32 mmHg in post-PK eyes vs. 0.03+/-0.88 mmHg in fellow eyes, p=0.016). The IOPg and IOPcc were significantly higher in the PK group than they were in the control group. The IOPcc's were 20.81+/-7.81 mmHg and 16.27+/-2.49 mmHg in post-PK and control eyes, respectively (p=0.011); and the IOPg's were 19.22+/-7.34 mmHg and 15.07+/-3.03 mmHg in post-PK and control eyes, respectively (p=0.019). The IOPcc-g's were 1.59+/-2.81 mmHg and 1.21+/-1.30 mmHg in post-PK and control eyes, respectively (p=0.412), and the central corneal thickness (CCT)'s were 489.11+/-90.60 microm and 556.24+/-42.84 microm in post-PK and control eyes, respectively (p=0.068). CONCLUSIONS: Following PK, CH tended to decrease while CRF tended to increase, significantly decreasing CH-CRF. A significantly higher intraocular pressure and a thinner CCT following PK may have contributed to the observed changes in these corneal biomechanical parameters.
Adolescent ; Adult ; Aged ; Cornea/*physiopathology ; *Diagnostic Techniques, Ophthalmological ; Elasticity ; Female ; Humans ; Intraocular Pressure ; *Keratoplasty, Penetrating ; Male ; Middle Aged ; Postoperative Period ; Young Adult

PURPOSE: To compare the short term effects of topical 0.05% cyclosporine (CsA) and a mixture of 0.08% chondroitin sulfate and 0.06% sodium hyaluronate (CS-HA) on dry eye ocular surfaces. METHODS: 36 patients with moderate to severe dry eye (5 mm/5 min or less with Schirmer's test or tear break up time (BUT) less than 6 seconds), were treated with topical application of CS-HA on one eye and CsA on the other 4 times a day for 6-8 weeks. BUT, Schirmer's test without anesthesia, and conjunctival impression cytology (CIC; goblet cell density, nucleus to cytoplasmic ratio, and epithelial cell morphology) were evaluated and compared between eyes before and after treatment (repeated measurement of ANOVA). RESULTS: After treatment, BUT and tear wettings were significantly prolonged in each group. Topical CsA treated eyes had greater increase in BUT (p=0.026); there was no significant difference in tear wetting (p=0.132). While the 3 parameters of CIC improved in both groups, goblet cell density was significantly higher in eyes treated with CsA (p=0.033). CONCLUSIONS: While both CS-HA and 0.05% CsA eyedrops improve ocular surfaces, topical CsA may have a better effect on enhancing tear film stability and goblet cell density.
Adjuvants, Immunologic/administration & dosage ; Administration, Topical ; Cell Count ; Chondroitin Sulfates/*administration & dosage ; Conjunctiva/drug effects/pathology ; Cyclosporine/*administration & dosage ; Drug Administration Schedule ; Drug Combinations ; Drug Therapy, Combination ; Dry Eye Syndromes/*drug therapy/metabolism/pathology ; Epithelium/drug effects/pathology ; Female ; Follow-Up Studies ; Goblet Cells/drug effects/pathology ; Humans ; Hyaluronic Acid/*administration & dosage ; Immunosuppressive Agents/*administration & dosage ; Male ; Middle Aged ; Ophthalmic Solutions/administration & dosage ; Tears/drug effects/metabolism ; Time Factors ; Treatment Outcome

Exposure to light can induce photoreceptor cell death and exacerbate retinal degeneration. In this study, mice with genetic knockout of several genes, including rhodopsin kinase (Rhok-/-), arrestin (Sag-/-), transducin (Gnat1-/-), c-Fos (c-Fos-/-) and arrestin/transducin (Sag-/-/Gnat1-/-), were examined. We measured the expression levels of thousands of genes in order to investigate their roles in phototransduction signaling in light-induced retinal degeneration using DNA microarray technology and then further explored the gene network using pathway analysis tools. Several cascades of gene components were induced or inhibited as a result of corresponding gene knockout under specific light conditions. Transducin deletion blocked the apoptotic signaling induced by exposure to low light conditions, and it did not require c-Fos/AP-1. Deletion of c-Fos blocked the apoptotic signaling induced by exposure to high intensity light. In the present study, we identified many gene transcripts that are essential for the initiation of light-induced rod degeneration and proposed several important networks that are involved in pro- and anti-apoptotic signaling. We also demonstrated the different cascades of gene components that participate in apoptotic signaling under specific light conditions.
Animals ; Apoptosis/radiation effects ; G-Protein-Coupled Receptor Kinase 1/genetics ; GTP-Binding Protein alpha Subunits/genetics ; *Gene Expression Profiling ; Genes, fos/genetics ; Light/adverse effects ; Light Signal Transduction/*genetics/physiology/radiation effects ; Mice ; Mice, Knockout ; Oligonucleotide Array Sequence Analysis ; Retina/metabolism/pathology/radiation effects ; Retinal Degeneration/etiology/*genetics/physiopathology ; Transducin/genetics

PURPOSE: To investigate the short-term efficacy of topical immunosuppressive agents on the survival of cultivated allo-conjunctival equivalents. METHODS: Twenty-five eyes of New Zealand white rabbits were included. Temporal conjunctivae were trephined to a diameter of 7.5 mm, and then cultured allo-conjunctival epithelial cells on amniotic membrane were transplanted onto them. Various immunosuppressants including steroid, cyclosporine, and rapamycin were applied topically four times a day for a week. Epithelial defects and graft edema were graded daily. Numbers of inflammatory cells were measured in H&E. PKH26 and cytokeratin 4 and 7 were immunostained. RESULTS: Earlier epithelialization was observed in 1% steroid-treated eyes and defects persisted significantly in 0.5% CsA applied eyes. In histology, PKH26 positive cells considered as donor cells were only found in 1% steroid or 0.01% rapamycin applied eyes. 1% steroid- or 0.01% rapamycin-applied eyes both showed positive staining for keratin-4 and -7. Inflammatory cells were less found in 1% steroid or 0.01% rapamycin treated eyes. CONCLUSIONS: Topical steroid or rapamycin can help to suppress acute inflammation and enhance the acute survival of transplanted conjunctival cells.
Administration, Topical ; Animals ; Cell Count ; *Cell Transplantation ; Cells, Cultured ; Conjunctiva/*cytology ; Cyclosporine/pharmacology ; Epithelial Cells/metabolism/*transplantation ; Female ; Fluorescent Antibody Technique, Indirect ; Graft Survival/*drug effects ; Immunosuppressive Agents/*pharmacology ; Keratin-4/metabolism ; Keratin-7/metabolism ; Male ; Organic Chemicals/metabolism ; Prednisone/pharmacology ; Rabbits ; Sirolimus/pharmacology ; Transplantation, Homologous

To compare the stem niche in different culture conditions of limbal epithelial cells, the suspended human limbal epithelial cells (HLECs) were seeded on the 3T3-pretreated plates and the other suspended cells were plated on amniotic membranes (AMs) which were either cryo-preserved or freeze-dried. All were cultured for 10 to 12 days. Reverse transcription-polymerase chain reaction (RT-PCR) for ATP-binding casette, subfamily G, member 2 (ABCG2), p63, cytokeratin 12, and connexin 43 were performed in cultivated HLECs and their expression levels were compared. The mRNA expression of all markers examined showed no statistically significant differences between the cells on cryo-preserved and on freeze-dried AM. The expression of p63 and cytokeratin 12 in cultivated cells on AMs were significantly lower than those in 3T3-cocultured cells on RT-PCR and immunofluorescent staining. Cultivated HLECs on AMs showed reduced proliferation and differentiation while maintaining stem-property regardless of the preservative method of AM.
3T3 Cells ; Animals ; Cell Culture Techniques/*instrumentation/*methods ; Cells, Cultured ; Cytological Techniques ; DNA Primers/chemistry ; Epithelial Cells/*metabolism ; Humans ; Immunohistochemistry/methods ; Keratin-12/metabolism ; Mice ; Models, Biological ; Phosphoproteins/metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Stem Cells/cytology ; Trans-Activators/metabolism

Fat embolism syndrome is a rare clinical diagnosis of dyspnea with acute respiratory failure and neurological signs caused by a traumatic long bone fracture. We report a case of fat embolism in a 22 year-old man after a traffic accident. Dyspnea and stuporous mental changes developed on the 1st day after the external fixation operation of a left metaphyseal femur fracture. On the following day, he was transferred from a hospital to this one because of acute respiratory failure. After recovery, macrophages with fat droplets were found in the bronchoalveolar lavage fluid 1. It is important to diagnose a fat embolism as the correct cause of acute respiratory failure through the BAL in the acute state of fat embolism syndrome It is believed that clinically apparent or sometimes hidden fat embolism syndrome can be diagnosed from the BAL during the recovery state.
Accidents, Traffic ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Diagnosis ; Dyspnea ; Embolism, Fat* ; Femur ; Fractures, Bone ; Humans ; Macrophages ; Respiratory Insufficiency* ; Stupor ; Young Adult

The solid and papillary epithelial neoplasm of the pancreas is a relatively uncommon disease. It accounts for approximately 1 to 2 percent of all exocrine pancreatic tumors. This benign or low grade malignant tumor is reported to occur predominantly in young women and rarely in men. Recurrence and development of metastasis after resection are found only in a small fraction of the general population. A case is herein reported involving a solid and papillary epithelial neoplasm of the pancreas which extensively spread to nearby organs, in a 34 year-old man. Chief complaints were black stool. Physical examination revealed tenderness on the left upper quadrant of the abdomen. Esophagogastroduodenoscopy revealed multiple cardiac variceal bleeding. Abdominal sonography and CAT scan findings showed a huge lobulated mass on the left upper quadrant area with an internal necrotic portion. Surgical findings showed determined a splenic vein tumor thromboembolus, portal vein involvement, distal stomach involvement, and multiple colonic invasion. Therefore, distal pancreatectomy, wedge resection of the stomach, splenetomy, segmental resection of the transverse colon, and excision of the mass were all performed. Pathologic examination revealed a solid and papillary epithelial neoplasm in the pancreatic tail with a marked dilated splenic vein filled with tumor thromboembolus. The patient has been under chemotherapy since then, and is being closely observed.
Abdomen ; Adult ; Animals ; Cats ; Colon ; Colon, Transverse ; Drug Therapy ; Endoscopy, Digestive System ; Esophageal and Gastric Varices ; Female ; Humans ; Male ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancreatectomy ; Physical Examination ; Portal Vein ; Recurrence ; Splenic Vein ; Stomach

BACKGROUND: At present, lamivudine-interferon combination therapy is being tried on chronic hepatitis B patients who had no significant response to interferon-alpha mono-therapy. The therapeutic effect of lamivudine-interferon combination therapy is showing various outcomes depending on the period of therapy and the status of the patient. Thus we conducted this study to compare the therapeutic effect of lamivudine-interferon combination therapy versus interferon-alpha monotherapy in korean patients with chronic hepatitis B. METHOD: Among the chronic hepatitis B patients, 138 patients who showed positive to HBeAg, and serum HBV DNA levels are over 5 pg/mL and serum ALT levels are over 40 IU/L were allocated to IFN-alpha monotherapy group (70 patients) and lamivudine-interferon combination therapy group (66 patients). We compared two groups on ALT normalization rate, HBeAg seroconversion rate, HBV DNA loss rate and HBeAg loss rate in both group. IFN-alpha was percutaneously injected three times a week. Mean administered dose was 27125 (+/-11841) MU and mean administered duration was 6.4 (+/-1.6) months. Lamivudine was concomitantly and continuously administered with IFN-alpha for over 6 months (mean 13.2 +/- 16.5). The lamivudine therapy was terminated at the point when HBeAg turned positive into negative. RESULTS: Mean follow-up period was 28 months. HBeAg loss rate was 40.9% in lamivudine- interferon combination therapy group and 28.6% in IFN-alpha monotherapy group on the 12th month of the therapy, showing there was no significant difference between the two groups (p=0.13). HBeAg seroconversion rate was 40.9% in lamivudine-interferon combination therapy group and 21.4% in IFN-alpha monotherapy group on the 12th month of the therapy (p=0.014). HBV DNA loss rate was 90.9% in lamivudine-interferon combination therapy group and 88.6% in IFN-alpha monotherapy group within 12months of the therapy, showing there was no significant difference between the two groups (p=0.35). Serum ALT normalization rate was 92.4% in lamivudine-interferon combination therapy group and 85.7% in IFN-alpha monotherapy group within 12months of the therapy, showing there was no significant difference between the two groups (p=0.11). CONCLUSION: The lamivudine-interferon combination therapy compared to the Interferon-alpha monotherapy showed a statistically significant higher HBeAg seroconversion rate.
DNA ; Follow-Up Studies ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons* ; Lamivudine

We designed a randomized, double blinded, 3-months controlled prospective clinical study to investigate effects of oral uridine on the ocular surface in dry eye patients. Twenty-seven patients who diagnosed as dry eye with lower than 5 mm of wetting in the Schirmer strip, with corneal epithelial erosion and who completely followed-up till 3 months were enrolled. Corneal-conjunctival fluorescein staining, non-anesthetic Schirmer test, impression cytology, and Ocular Surface Disease Index (OSDI) were evaluated in the experimental and placebo groups at the baseline, 1 and 3 months after start of medication in a double blinded manner. Fluorescein stain score of the cornea was markedly decreased in oral uridine group compared to the placebo group at 3 months after medication (P=0.032, Mann-Whitney U test). The Schirmer wetting score for the oral uridine group was significantly increased (P=0.001, Wilcoxon signed rank test) at 3 months and its difference between two groups was statistically significant (P=0.030, Mann-Whitney U test). OSDI scores were significantly decreased at 1 and 3 months in treatment group. Oral uridine is effective in treatment of dry eyes.
Administration, Oral ; Adolescent ; Adult ; Aged ; Conjunctiva/pathology ; Cornea/pathology ; Double-Blind Method ; Dry Eye Syndromes/*drug therapy ; Female ; Fluorescent Dyes/pharmacology ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Uridine/administration & dosage/*therapeutic use

Pulmonary blastoma is a primary lung tumor consisting of a mixture of immature embryonal-like mensenchymal and epithelial components and in some areas resemble embryonal lung tissue of up to 3-4 months gestational age. The tumor was first described in 1945 by Barrett and Barnard and again in 1952 by Barmard, who named it an embryoma of the lung which resembled fetal lung histologically, with glandular structures lined by non-ciliated epithelium and a surrounding stroma resembling mesenchyme. In 1961 Spencer renamed them Pulmonary blastoma as he believed they represented neoplasms similar in pathogenesis to nephroblastoma. The prognosis of these tumors is poor, and the clinical course is not readily predicted from histological appearance. Untill now, more than one hundred cases have been reported in the literature in the word and there is no report in Korea. We report a case of biphasic pulmonary blastoma, which ruptured spontaneously, in a 31-year-old young man who was presented as sharp pain under the right subscapular area.
Adult ; Epithelium ; Gestational Age ; Humans ; Korea ; Lung ; Mesoderm ; Prognosis ; Pulmonary Blastoma* ; Wilms Tumor