The effect of vitreous hemorrhage on the retinal structures was studied in twenty young adult pigmented rabbits weighing 2 to 3kgs. The autologous blood was injected intra-vitreally in one eye of the animals. Five animals of each group were sacrificed for light and electron microscopic studies of the retina near the visual streak in the posterior pole in one week, two weeks, one month and two months. In light microscopy of the rabbit retina, hemosiderin-laden macrophages are located in the vitreous cavity. Iron stain positive particles are present in the retina, particularly in the pigment epithelium. These particles are also scattered in the retina after two weeks on. By electron microscopy, there is no significant ultrastructural change in one week. Swelling of mitochondria in the bipolar and Miiller cells, and in the inner segments of the cone cells are noted along with disarrangement of disc stacking in 2 weeks. Many myelin figures appear in the cytoplasm of the inner segments of visual sells, outer plexiform and inner nuclear layers. Hemosiderin pigments appear in the pigment cells and in the cytoplasm Muller cells. In inner nuclear layer, a necrotizing cell demonstrates pyknotic nucleus and focal cytoplasmic degradation in one month. Hemosiderin pigments are present in ganglion cells, Miiller cells and pigment epithelial cells. Disc stacking is altered in outer segment of the visual cells, and the pigment epithelial cell demonstrate increased engulfment of outer segment of visual cells in two months. However, the electrophysiological study with ERG do not demonstrate any abnormality.
Animals ; Cytoplasm ; Ependymoglial Cells ; Epithelial Cells ; Epithelium ; Ganglion Cysts ; Hemosiderin ; Humans ; Iron ; Macrophages ; Microscopy ; Microscopy, Electron ; Mitochondria ; Myelin Sheath ; Rabbits ; Retina ; Retinaldehyde* ; Vitreous Hemorrhage* ; Young Adult

Ultra-structural changes in the retinal pigment epithelium in both pigmented and albino rabbits following a long term topical application of beta-adrenergic blocker were observed. One drop of 1% Befunolol hydrochloride solution was instilled into the conjunctival cul-de-sac twice daily in one eye of the animals. In the retinal pigment epithelium, mitochondria became swollen and numerous vaculoes were formed in the cytoplasm. The widening of the basal infolding were noted in both pigmented and albino rabbits. These changes were more remarkable in 7 months than 3 months. Furthermore, it was much more remarkable in the pigmented rabbits. Some degenerative changes were noted in the inner segment of photo-receptors of albino rabbits in 7 months. These swollen mitochondria and vacuole formations were also observed in the non-pigmented epithelium of the ciliary body.
Animals ; Ciliary Body ; Cytoplasm ; Epithelium ; Mitochondria ; Rabbits ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Vacuoles

PURPOSE: To investigate the clinical manifestation of thyroid orbitopathy among patients with thyroid dysfunction. METHODS: A cross-sectional study was conducted at 24 general hospitals in Korea. All dysthyroid patients who visited the endocrinology clinic for 1 week were included. Data were collected during an interviewer-administered questionnaire. Thyroid orbitopathy was diagnosed in cases with relevant symptoms according to the VISA classification for which an eye examination was performed. Three hundred seventy-one patients who had thyroid orbitopathy out of 1986 dysthyroid patients were evaluated. RESULTS: Vision symptoms were presented in 10.5% of thyroid orbitopathy patients, inflammation symptoms in 43.1%, strabismus in 15.1%, and appearance and exposure symptoms in 86.3% of patients. Among the eye symptoms, proptosis was most prevalent in 56.9% of patients followed by eyelid retraction in 31.5%, diplopia in 15.1% and optic nerve dysfunction in 2.4% of patients. Median value of exophthalmometry in the thyroid orbitopathy group was 16 mm and 17 mm in the proptosis group. Patient self assessment for thyroid orbitopathy from the onset of the disease was "greatly improved" in 12.1% of patients, "improved" in 19.5%, "unchanged" in 51.2%, "worse" in 19.6%, and "much worse" in 1.0% of patients. CONCLUSIONS: Among dysthyroid patients, significant amount was found to have symptoms related with thyroid orbitopathy. The patients with thyroid orbitopathy, except for the mildest cases, need to be managed by a thyroid eye disease specialist for further assessment and care.
Cross-Sectional Studies ; Diplopia ; Endocrinology ; Exophthalmos ; Eye ; Eye Diseases ; Eyelids ; Hospitals, General ; Humans ; Inflammation ; Korea ; Optic Nerve ; Surveys and Questionnaires ; Self-Assessment ; Specialization ; Strabismus ; Thyroid Gland ; Vision, Ocular

A number of studies have documented the reasonable efficacy and safety of radial keratotomy, but most based upon results obtained in low or moderate myopia or short term follow up after surgery. We complied 5 year and longer follow up data on 91 consecutive radial keratotomy surgeries on high myopia (over -6.00 diopters) performed by one surgeon 5 year-follow up was obtained on 21 (23%) of these eyes. The mean spherical equivalent before surgery was -11.02 diopters (D), the average keratometry value was 44.40 D, and all of the eyes had an uncorrected visual acuity of 0.04 or less. The average change in spherical equivalent was 3.44 D for eyes examined at 1 year, compared with 3.05 D for eyes at 3 years and 2.87 D at 5 years after surgery. Average keratometry value were 42.30 D at 1 year, 41.60 D at 3 years, and 41.30 D at 5 years after surgery. In our study, the decrease in spherical equivalent of 0.57 D was statistically significant (P < 0.05), as was the reduction in average keratometry value of 1.00 D. The effect of the surgery on spherical equivalent continued to regress through all the 5 years of follow up. However, the keratometric measurement decreased up to 5 years which indicated progressive flattening of the cornea. Also we divided these eyes into 2 groups, lower-myopic group (-6.00 D~-9.75 D) and higher-myopic group (over -10.00 D). In each category, the changes in spherical equivalent were 3.60 D, 2.21 D at 5 years, compared with 3.65 D, 3.25 D at 1 year respectively. The efficacy of radial keratotomy was lower, and the change of spherical equivalent between 1 year and 5 years was larger in the higher-myopic group than in the lower-myopic group. The results show that both radial keratotomy effectiveness and long term stability decrease in higher myopic cases.
Adolescent ; Adult ; Cornea/*surgery ; Female ; Follow-Up Studies ; Humans ; *Keratotomy, Radial ; Male ; Middle Aged ; Myopia/*surgery ; Treatment Outcome ; Visual Acuity

A number of studies have documented the reasonable efficacy and safety of radial keratotomy, but most based upon results obtained in low or moderate myopia or short term follow up after surgery. We complied 5 year and longer follow up data on 91 consecutive radial keratotomy surgeries on high myopia (over -6.00 diopters) performed by one surgeon 5 year-follow up was obtained on 21 (23%) of these eyes. The mean spherical equivalent before surgery was -11.02 diopters (D), the average keratometry value was 44.40 D, and all of the eyes had an uncorrected visual acuity of 0.04 or less. The average change in spherical equivalent was 3.44 D for eyes examined at 1 year, compared with 3.05 D for eyes at 3 years and 2.87 D at 5 years after surgery. Average keratometry value were 42.30 D at 1 year, 41.60 D at 3 years, and 41.30 D at 5 years after surgery. In our study, the decrease in spherical equivalent of 0.57 D was statistically significant (P < 0.05), as was the reduction in average keratometry value of 1.00 D. The effect of the surgery on spherical equivalent continued to regress through all the 5 years of follow up. However, the keratometric measurement decreased up to 5 years which indicated progressive flattening of the cornea. Also we divided these eyes into 2 groups, lower-myopic group (-6.00 D~-9.75 D) and higher-myopic group (over -10.00 D). In each category, the changes in spherical equivalent were 3.60 D, 2.21 D at 5 years, compared with 3.65 D, 3.25 D at 1 year respectively. The efficacy of radial keratotomy was lower, and the change of spherical equivalent between 1 year and 5 years was larger in the higher-myopic group than in the lower-myopic group. The results show that both radial keratotomy effectiveness and long term stability decrease in higher myopic cases.
Adolescent ; Adult ; Cornea/*surgery ; Female ; Follow-Up Studies ; Humans ; *Keratotomy, Radial ; Male ; Middle Aged ; Myopia/*surgery ; Treatment Outcome ; Visual Acuity

PURPOSE: To determine the prevalence of thyroid eye disease among dysthyroid Korean patients and to analyze the relationship between demographic data, lifestyle risk factors, and status of thyroid disease and thyroid eye disease. METHODS: All dysthyroid patients who visited endocrinology clinics in 24 general hospitals in Korea during a chosen one-week period were enrolled in this cross-sectional study. Data were collected during an interviewer-administered questionnaire and chart review. Demographic data, lifestyle risk factors, and status of thyroid disease variables were analyzed as risk factors using multivariable regression models to identify independent associations with thyroid eye disease. RESULTS: A total of 1,632 dysthyroid patients were included (1,301 females [79.7%] and 331 males [20.3%]). Two hundred eighty-three of these patients (17.3%) had thyroid eye disease. Multiple logistic regression analyses revealed that female gender, young age, Graves' disease, dermopathy, anti-thyroid medication treatment, and radioiodine treatment were independent risk factors for thyroid eye disease. CONCLUSIONS: The lower prevalence of thyroid eye disease in dysthyroid Korean patients and the influence of gender on risk factors in this study are novel findings compared to studies performed involving Europeans. Although the risk factors for thyroid eye disease are understood in part, a more in-depth comparative study of gender and ethnic groups is needed to fully understand the biological significance of the demographic factors.
Adult ; Age Factors ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Graves Ophthalmopathy/*epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; *Risk Assessment ; Risk Factors ; Sex Factors

PURPOSE: To evaluate the usefulness of spiral CT in predicting the depth of tumor invasion in patients with gastric cancer by comparing with histopathological finding. MATERIALS AND METHODS: We studied spiral CT scans of forty-eight patients, in whom gastric cancer was proven by gastrofibroscopic biopsy and surgery. After distending the stomach with 400ml tap water or effervescent granules, 100ml of contrast media was given intravenously at a rate of 3ml/sec. CT scanning was started at 45 sec after administration of the contrast material. Gastric tumors were subdivided into five types according to enhancing pattern from the inner layer of gastric wall to the outer layer. These pattern were correlated with histopathologic results. RESULT: The tumor masses were detected on CT scan in 10(77%) of 13 patients with early gastric cancer, while, the tumor masses were seen on CT scan in all patients with advanced gastric cancer. Of 9 patients with type 1 or type 2 enhancing pattern, early gastric cancer(T1) were proven in 7 patients(78%), serosal invasion (T3) in 2 patients(22%). In contrast, among 29 patients with type 4 and type 5, 22 patients(76%) were proven as serosal invasion(T3). Of 7 patients with type 3, 3 patients(43%) were proven as serosal invasion(T3), three(43%) as subserosal invasion(T2), one as early gastric cancer(T1). CONCLUSION: Analysis of morphological enhancing pattern on spiral CT is useful in predicting the depth of tumor invasion in patients with gastric cancer.
Biopsy ; Contrast Media ; Humans ; Stomach ; Stomach Neoplasms ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Water

Aortic saddle embolus accounts for approximately 10% of all peripheral arterial emboli. The most common sources of emboli are left atrial thrombi associated with atrial fibrillation and vegetation. A 22-year-old male patient was admitted due to acute onset of orthopnea, tachypea and cough. Transthoracic and transeophageal echocardiography showed huge vegetation (3X2cm) of the posterior mitral valve leaflet which was associated with severe mitral regurgitation. On 14th hospital day, he suffered from sudden onset of weakness, pain, and coldness on both lower extremities. Follow-up echocardiography showed marked size reduction of the original mitral valve vegetation. Angiography showed aortic saddle embolus. The embolectomy of aortic saddle embolus was performed through the transfemoral approach with a Forgarty catheter. At the same time, removal of the infected mitral valve and mitral valve replacement were performed.
Angiography ; Atrial Fibrillation ; Catheters ; Cough ; Echocardiography ; Embolectomy ; Embolism* ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Mitral Valve Insufficiency ; Mitral Valve* ; Young Adult

PURPOSE: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. MATERIALS AND METHODS: Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3+/-24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. RESULTS: Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9+/-12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. CONCLUSION:: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.
Acetazolamide ; Adolescent ; Basal Ganglia ; Brain* ; Cerebellum ; Child ; Female ; Frontal Lobe ; Healthy Volunteers ; Humans ; Male ; Occipital Lobe ; Parietal Lobe ; Perfusion ; Rabeprazole ; Reference Values ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon* ; Volunteers

PURPOSE: inhaled nitric oxide(iNO) is an excellent method for the postoperative pulmonary hypertension in congenital heart disease. But more detailed care is needed because of the development of rebound pulmonary hypertension after NO Withdrawal. We performed this study in order to discontinue the iNO successfully by way of presenting the adequate weaning and supplying methods. METHODS: Between January, 1998 and August, 1999 we sudied 10 patients who had rebound pulmonary hypertension(RPH) after iNO withdrawal. We completed the iNO in these patween the first the second trial of the weaning process. We tried to discover the differences between the first and second weaning process. We measured NO concentration at the start and just before NO withdrawal and during the period of weaning process. Moreover, to identify the iNO effects during the weaning of the iNO, we counted the degree of the change of PaO2/FiO2and mean PAP/SAP beween initial and at half of the initial NO concentration. RESULTS: Second weaning had a longer duration weaning process(11+/-0 cersus 5+/- hours, P<0.05), lower NO concentration just before NO withdrawal(2+/-.6 versus 4+/-ppm, P<0.05). In the change of the mean PAP/SAP and PaO2/FiO2as iNO was weaning from the initial iNO concentration to a half of the initial iNO concentration, the degree of increase in mean PAP/SAP(0.026+/-.07 versus 0.054+/-.07, P<0.05) and the degree of decrease in PaO2/FiO2(49+/-4 versus 65+/-2, P<0.05) were smaller in the second in the second weaning process than the first weaning process. CONCLUSION: A successful weaning of iNO can be performed with a low iNO concentration at the start and just before withdrawal and with the long duration iNO weaning process. Moreover, We speculate that the degree of change in the mean PAP/SAP and PaO2/FiO2at the half of the iNO weaning process are an indicator for the development of RPH.
Heart Defects, Congenital ; Humans ; Hypertension, Pulmonary ; Nitric Oxide* ; Weaning*