Pneumocystis carinii causes serious pulmonary infection in immunosuppressed patients. This study was undertaken to observe the cytoskeletal proteins of P. carinii by immuno-electron microscopy. P. carinii infection was experimentally induced by immunosuppression of Sprague-Dawley rats for seven weeks, and their lungs were used for the observations of this study. The gold particles localized actin, tropomyosin, and tubulin. The actin was irregularly scattered in the cytoplasm of the trophic forms but was much more concentrated in the inner space of the cell wall of the cystic forms called the inner electron-lucent layer. No significant amount of tropomyosin was observed in either trophic forms or cystic forms. The tubulin was distributed along the peripheral cytoplasm and filopodia of both the trophic and cystic forms rather than in the inner side of the cytoplasm. Particularly, in the cystic forms, the amount of tubulin was increased and located mainly in the inner electron-lucent layer of the cell wall where the actin was concentrated as well. The results of this study showed that the cell wall of P. carinii cystic forms is a structure whose inner side is rich in actin and tubulin. The location of the actin and tubulin in P. carinii suggests that the main role of these proteins is an involvement in the protection of cystic forms from the outside environment by maintaining rigidity of the cystic forms.
Actins/analysis ; Animals ; Cytoskeletal Proteins/*analysis ; Fungal Proteins/*analysis ; Histocytochemistry ; Microscopy, Immunoelectron ; Pneumocystis/*chemistry/cytology ; Rats ; Rats, Wistar ; Support, Non-U.S. Gov't ; Tropomyosin/analysis ; Tubulin/analysis

Hypertension is a frequent complication after organ transplantation and remains risk factor for the development of cardiovascular disease and graft dysfunction after renal transplantation. The prevalence of hypertension after renal transplantation varies from 50% to 93%. There are multiple mechanisms for development of post-transplant hypertension. To examine the effects of hypertension on renal allograft survival, we studied the clinical course of 319 kidney transplant recipients(male:female=231:88, mean age=32.9+/-10.4 yrs) who had functioning graft at least 6 months. The patients were divided into three groups : normotensive groups(n=90), controlled hypertensive groups(n=176) and uncontrolled hypertensive groups(n=53). Among 319 patients, 229(72%) were hypertensive at the time of renal transplantation. The incidence of hypertension decreased progressively to 68%, 65% and 61% at 1, 3 and 5 years after transplantation (p<0.05). The numbers of antihypertensive medication at the time of operation was 1.35+/-1.09, which decreased significantly to 0.98+/-0.76 at 12 months after renal transplantation(p<0.05). Cumulative graft survival at 5 years for normotensive and controlled hypertensive patients were 44% and 50% respectively, 20% for uncontrolled hypertensive patients. The difference of 5 years graft survival between controlled hypertensive and uncontrolled hypertensive patietns was significant (p<0.01), whereas the difference between the normotensive and controlled hypertensive group was not significant. We conclude that hypertension per se may not be an important risk factor for renal graft survival. However, the control of hypertension appear to be a more important risk factor for renal allograft survivial.
Allografts* ; Cardiovascular Diseases ; Graft Survival ; Humans ; Hypertension* ; Incidence ; Kidney Transplantation* ; Kidney* ; Organ Transplantation ; Prevalence ; Risk Factors ; Transplants

PURPOSE: To describe surgical outcomes for transconjunctival anterior orbitotomy for intraconal cavernous hemangiomas. METHODS: The medical records of 9 consecutive patients with intraconal cavernous hemangiomas who underwent surgical removal by transconjunctival anterior orbitotomy were retrospectively reviewed. The conjunctiva was incised and retracted with a traction suture. For large tumors, a rectus muscle was temporarily disinserted. Tenon's capsule was separated and the tumor was removed with a cryoprobe or clamp. Surgical outcomes, positions of the tumors, methods of approach, and intra- and post-operative complications were evaluated. RESULTS: The mean follow-up period was 33 +/- 6.8 months. No bony orbitotomy was used in this technique and the cosmetic results were very satisfactory. All tumors were removed intact. In 4 patients, tumors were extirpated with the aid of a cryoprobe. No patients had residual proptosis or limitation of ocular movement. No signs of recurrence were noted in any cases at 33 months follow-up. No serious or permanent complications were observed during or after the operation. CONCLUSIONS: Transconjunctival anterior orbitotomy is an important surgical procedure in the treatment of intraconal cavernous hemangiomas. It can produce an excellent result, even if the posterior border of the tumor abuts the orbital apex.
Adult ; Conjunctiva/pathology/surgery ; Female ; Follow-Up Studies ; Hemangioma, Cavernous/pathology/radiography/*surgery ; Humans ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures/*methods ; Orbital Neoplasms/pathology/radiography/*surgery ; Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: We investigated the factors influencing the time to reach full enteral feeding in very low birth weight infants. We compared the days of life to start tube or oral feeding, to regain birth weight, and to establish full enteral feeding in very low birth weight infants and determined the risk factors delaying full enteral feeding. METHODS: We reviewed the medical records of 214 newborn infants less than 1,500 g at birth, who were delivered at Chonnam National University Hospital from January 1, 1997 to May 31, 2000. These infants were divided into three groups by birth weight (less than 1,000 g, 1,000-1,249 g, and 1,250-1,499 g). Gestational age, birth weight, the days of life to start first tube or oral feeding, to regain bith weight and to reach full enteral feeding, and the possible risk factors delaying the progress of enteral feeding were analyzed. RESULTS: The gestational age was 29.69+/-2.33 weeks and the birth weight was 1,212+/-194.3 g. The time to start tube or oral feeding, to regain birth weight, and to establish full enteral feeding were significantly later and longer in the lower birth weight group. The time to reach full enteral feeding was related to the duration of mechanical ventilation and oxygen therapy, and was significantly longer in the infants with severe respiratory distress syndrome (RDS), chronic lung disease (CLD), apnea, intraventricular hemorrhage (IVH), cystic periventricular leukomalacia, sepsis/disseminated intravascular coagulopathy, ricketts, and total parenteral nutrition. CONCLUSION: The time to reach full enteral feeding was inversely related to the birth weight, and the risk factors for delayed full enteral feeding were the presence and/or the severity of diseases related to the prematurity such as the duration of mechanical ventilation and oxygen therapy, RDS, CLD, apnea, IVH, and sepsis.
Apnea ; Birth Weight ; Enteral Nutrition* ; Gestational Age ; Hemorrhage ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Jeollanam-do ; Leukomalacia, Periventricular ; Lung Diseases ; Medical Records ; Oxygen ; Parenteral Nutrition, Total ; Parturition ; Respiration, Artificial ; Risk Factors ; Sepsis

Uterine myomas are the most common benign tumor of the female genital organ. Uterine artery embolization is well reported of primary treatment of uterine myoma. A 29 year-old nulliparous woman was diagnosed as uterine myoma by ultrasonogram. We embolize both uterine artery after treatment with GnRH analog and then we experience a case of improvement of menorrhagia, with reduction in uterine myoma size. So we report that case with a brief review.
Adult ; Female ; Genitalia ; Gonadotropin-Releasing Hormone ; Humans ; Leiomyoma* ; Menorrhagia ; Ultrasonography ; Uterine Artery Embolization* ; Uterine Artery*

Uterine myomas are the most common benign tumor of the female genital organ. Uterine artery embolization is well reported of primary treatment of uterine myoma. A 29 year-old nulliparous woman was diagnosed as uterine myoma by ultrasonogram. We embolize both uterine artery after treatment with GnRH analog and then we experience a case of improvement of menorrhagia, with reduction in uterine myoma size. So we report that case with a brief review.
Adult ; Female ; Genitalia ; Gonadotropin-Releasing Hormone ; Humans ; Leiomyoma* ; Menorrhagia ; Ultrasonography ; Uterine Artery Embolization* ; Uterine Artery*

PURPOSE: To evaluate differences between dominant and non-dominant eyes through analyzing refractive factors in determination of the dominant eye. METHODS: Sixty-two subjects without underlying ocular disease were recruited. Ocular dominance was determined using the hole-in-the-card test. Uncorrected visual acuity, refractive error, and intraocular pressure (IOP) were checked in both eyes. RESULTS: Mean uncorrected visual acuity of the dominant and non-dominant eye were 0.41 and 0.39, respectively. The number of patients whose uncorrected visual acuity of the dominant eye was superior to the non-dominant eye was 18(29%), and inferior to the non-dominant eye was 18(29%). Mean refractive power in the dominant eye was -3.2 diopter and -3.43 diopter degrees in the non-dominant eye, therefore no difference in degrees of myopia between the groups (P=0.282) was observed. The number of patients whose dominant eye had a greater degree of myopia than the non-dominant eye was 24(39%) and the patients with a lower degree of myopia in the dominant eye was 32(52%). Astigmatism of the dominant eye was lower than the non-dominant eye in 35(56%) of the patients, thus a significant relationship was shown between astigmatism and the dominant eye (P=0.0014). The mean IOP of the dominant eye was 15.4 mmHg and the non-dominant eye was 15.7 mmHg, showing no significant difference between eyes. CONCLUSIONS: The dominant eye showed a lower degree of astigmatism than the non-dominant eye. The previous belief that myopia is more progressed in the dominant eye than the non-dominant eye because of excessive accommodative use of the dominant eye requires further study.
Astigmatism ; Dominance, Ocular ; Eye ; Humans ; Intraocular Pressure ; Myopia ; Refractive Errors ; Visual Acuity

PURPOSE: To evaluate the characteristic CT and cerebral angiographic findings in patients with acutespontaneous subdural hematomas and correlate these imaging findings with causes of bleeding and clinical outcome. MATERIALS AND METHODS: Twenty-one patients with nontraumatic acute spontaneous subdural hematoma presentingduring the last five years underwent CT scanning and cerebral angiography was performed in twelve. To determinethe cause of bleeding, CT and angiographic findings were retrospectively analysed. Clinical history, laboratoryand operative findings, and final clinical outcome were reviewed. RESULTS: The 21 cases of acute spontaneoussubdural hematomas were caused by cerebral vascular abnormalities(n=10), infantile hemorrhagic disease(n=5), orwere of unknown origin(n=6). All ten cases of cerebral vascular abnormality were confirmed angiographically; sixwere aneurysms, three were arteriovenous malformations, and one was moyamoya disease. On CT, subarachnoidhemorrhage was seen to be associated with aneurysms, intracerebral hemorrhage with arteriovenous malformations,and intraventricular hemorrhage with moyamoya disease. All five patients with hemorrhagic disease were infantsaged 1-17 months ; characteristic diffuse distribution of subdural hematoma in both temporoparietal-occipitalregions is typical. The average overall mortality rate was 52.4%(11/21). In patients with cerebral vascularabnormalities, mortality was as low as 20%(2/10), but in hemorrhagic disease was high (60%). In cases of unknownorigin it was 100%. CONCLUSION: Acute spontaneous subdural hematoma is a rare condition, and the mortality rateis high. In patients with acute spontaneous subdural hematoma, as seen on CT, associated subarachnoid orintracerebral hemorrhage is strongly indicative of intracerebral vascular abnormalities such as aneurysm andarteriovenous malformation, and cerebral angiography is necessary. To ensure proper treatment and thus morkedlyreduce mortality, the causes of bleeding should be prompty determined by means of cerebral angiography.
Aneurysm ; Arteriovenous Malformations ; Cerebral Angiography ; Cerebral Hemorrhage ; Hematoma ; Hematoma, Subdural* ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Mortality ; Moyamoya Disease ; Retrospective Studies ; Tomography, X-Ray Computed

Hemangiomas are well known benign tumors that can occur in any sites of the human body. Although it is relatively common to find hemangiomas occurring in the head and neck areas, it rarely occurs in the external auditory canal. We present a case of capillary hemangioma arising from the external auditory canal with extension onto the adjacent outer layer of the tympanic membrane. It was treated with simple excision and myringoplasty. Early recognition may allow for simple excision without myringoplasty.
Capillaries* ; Ear Canal* ; Head ; Hemangioma ; Hemangioma, Capillary* ; Human Body ; Myringoplasty ; Neck ; Tympanic Membrane

Background: Reactive oxygen species (ROS) generated by neutrophils are closely correlated with the pathogenesis of a variety of inflammatory skin diseases. The aim of this study was to investigate whether the amount of reactive oxygen species (hydrogen peroxide) generated by neutrophils from patients with acne inflammation decrease after oral administration of standard doses of isotretinoin. Method: In order to measure neutrophil hydrogen peroxide production, phorbol myristate acetate (PMA, neutrophil stimulant), was added to whole blood. Intracellular dichlorofluorescein (DCF) fluorescence of neutrophils was determined by flow cytometry. In order to assess treatment efficacy, we used a Global Acne Grading Score (GAGS) and assessed the efficacy based on examinations at baseline and week 8. Results: Patients with acne inflammation showed a significantly increased level of hydrogen peroxide produced by neutrophils compared to healthy controls. Patients with acne inflammation treated with isotretinoin showed a significant decrease in the ability of neutrophils to produce hydrogen peroxide in accordance with a clinical improvement of acne lesions. Conclusion: Our result shows that the generation of ROS which induce a chemical insult to the integrity of the follicular epithelium in acne, can be suppressed in isotretinoin-treated acne patients.
Acne Vulgaris* ; Administration, Oral ; Epithelium ; Flow Cytometry ; Fluorescence ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Inflammation ; Isotretinoin* ; Neutrophils* ; Reactive Oxygen Species ; Skin Diseases ; Tetradecanoylphorbol Acetate ; Treatment Outcome