Bacterial endogenous endophthalmitis is a rare, but devastating complication of septicemia.It has occurred in the process of systemic infection and its underlying conditions are Diabetes Mellitus, advanced liver disease and immunosuppressive state or drug abuse. Klebsiella endogenous endophthalmitis is especially rapidly progressive and visual outcome is typically poor. To evaluate the clinical aspect of this disease, particularly predisposing factors, causative microorganism, outcome of therapeutic modality and initial time of therapy, we performed a retrospective study on 9 eyes of 9 patients who had been treated with this diagnosis from September 1988 to January 1999 at Kyung-Hee Medical Center. Mean time between the onset of disease and the initiation of therapy was 4.33 days. Underlying systemic diasease consist of Daibetes Mellitus, advanced liver disease and chronic renal failure [5 patients:DM with advanced liver disease, 3 patients:DM alone, 1 patient:DM with CRF].The visual outcome was poor but it turned out better in two patients compared with initial visual acuity, no change in one patient and worse in six patients. We found that Diabetes Mellitus and advanced liver disease were leading underlying predisposing factors of Klebsiella Pneumoniae and visual outcome was poor despite the various intensive treatments.High index of suspicion and aggressive diagnostic and therapeutic approach might improve visual outcome.
Causality ; Diabetes Mellitus ; Diagnosis ; Endophthalmitis* ; Humans ; Kidney Failure, Chronic ; Klebsiella ; Klebsiella pneumoniae ; Liver Diseases ; Retrospective Studies ; Substance-Related Disorders ; Visual Acuity

PURPOSE: The purpose of this study to verify the symptom clusters of colorectal cancer patients and also identify the influence of the symptom clusters upon colorectal patient symptom clusters identify acording exper. METHODS: 101 colorectal cancer patients were the subjects of this study. As for a research tool, the global health status/QOL was used including the sub-scales of QLQ-C30. In the functional scales and the symptom scales, the sub-scales of QLQ-C30 and QLQ-CR29 were used. Results: The result of this study shows us there are 7 kinds of symptom clusters. RESULTS: The result of this study shows us there are 7 kinds of symptom clusters, bowel movement problems, abdominal-pelvic problems, feces problems, urination problems, dry mouth-taste problems, side effect problems, and elimination problems. CONCLUSION: Based on the result, the symptom clusters in colorectal cancer patients were confirmed to be influencing the subjects' quality of life and functions. The efficient management of symptom clusters that subjects experience leads to promoting colorectal cancer patients' physical and emotional status, thereby contributing to an improvement in their quality of life.
Classification* ; Colorectal Neoplasms* ; Feces ; Humans ; Quality of Life* ; Urination ; Weights and Measures

The authors investigated the possibility of transplantion of cultured retinal pigment epithelial cell to normal pigmented rabbit retina. Focal retinal detachment was made in the pigment rabbit retina, and the cultured RPE cells were injected into subretinal space. The neural retina spontaneously rettached withim 6 days. At 4 weeks after tranplantation, eyes were enucleated and examined with light-microscopy and electron-microscopy. The transplanted RPE cells were proliferated with multilayer in electronmicroscopic finding, and the tight-junction was found between proliferative RPE cells. The outer segment and nucleus of photoreceptor cell were well preserved in microscopic finding. As a result, the cultured RPE cells can be sucessfully transplanted to normal pigmented rabbit retina, and photoreceptor cell was not changed after transplantation.
Epithelial Cells ; Photoreceptor Cells ; Retina ; Retinal Detachment ; Retinal Pigment Epithelium* ; Retinaldehyde*

Although many risk factors were reported, the exact pathogenesis of diabetic retinopathy is still unknown. The platelet derived growth factor(PDGF) is released from platelet alpha granule and plays a major role in wound repair, embryogenesis, and the pathogenesis of artherosclerosis. To evaluate whether serum PDGF may be a risk factors for the development of vascular complications of diabetes mellitus, we reviewed 36 diabetic patients from June 1996 to March 1997. The serum PDGF level was higher in the group of proliferative diabetic retinopathy(23.49+/-23.77pg/ml) and the control group(23.74+/-16.26pg/ml) than in nonproliferative diabetic retinopathy group(19.19+/-18.21pg/ml). The difference was not statistically significant. Patients who had a history of vitrectomy or laser treatment for proliferative diabetic retinopathy had higher serum PDGF level than those with no treatment. We conclude that the PDGF may play a role as one of the risk factors in diabetic retinopathy or their growth factors, and however further study will be required to elucidate the influence of PDGF on the couse of diabetic retinopathy.
Blood Platelets ; Diabetes Complications ; Diabetic Retinopathy ; Embryonic Development ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; Plasma* ; Platelet-Derived Growth Factor ; Pregnancy ; Risk Factors* ; Vitrectomy ; Wounds and Injuries

PURPOSE: To evaluate the relation between recovery of visual function and microperimetric fixation area in eyes with idiophthic macular hole after vitrectomy. METHODS: We used SLO (Scanning laser microscope, Rodenstock, Germany) microperimetry to examine foveal retinal function and fixation area in 14 eyes with idiopathic macular hole following pars plana vitrectomy. The relation between those preoperative and postoperative best corrected visual acuity and fixation area was studied. RESULTS: The macular hole size was correlated with preoperative visual acuity (p=0.026) and the closure of hole was related to the size of fixation area (p=0.003). The postoperative visual acuity was related to symptom duration before the vitrectomy (p=0.03), but not related to preoperative macular hole size. The fixation area correlated with the postoperative best corected visual acuity (p=0.043) and the direction of movement was variable. In most eyes, fixation area was located above the horizontal meridian. CONCLUSIONS: The fixation area was correlated with postoperative visual acuity and we think functional macular hole closure as well as anatomical closure were useful parameter of the success of macular hole surgery.
Ophthalmoscopes* ; Retinal Perforations* ; Retinaldehyde ; Visual Acuity ; Vitrectomy*

PURPOSE: To report 2 cases of cytomegalovirus retinitis treated with intravitreal ganciclovir. CASE SUMMARY: A 29-year-old female (Case 1) who received immunosuppressive therapy with tacrolimus and mycophenolate mofetil for 3 months after pancreatic transplantation, was given an intravitreal Bevacizumab injection 4 times in each eye under the suspicion of bilateral central retinal vein occlusion. During follow-up, a new lesion with white opacification and multiple snowballs appeared in the left eye. Suspecting cytomegalovirus retinitis, we administered an intravitreal ganciclovir injection resulting in a decrease of white opacification and improvement of visual acuity. A 66-year-old male (Case 2) who was receiving treatment for general weakness and heart failure, presented with visual disturbance in both eyes. Fundoscopic examination revealed white opacification, multiple snowballs and retinal hemorrhage in the left eye; diagnostic vitrectomy was performed. Macular edema and subretinal fluid continued after the vitrectomy and the serologic testing revealed an IgG titer positive for cytomegalovirus, therefore, an intravitreal injection of ganciclovir was given. Macular edema and subretinal fluid decreased and visual acuity improved. CONCLUSIONS: Intravitreal ganciclovir can be an effective treatment option for the management of CMV retinitis.
Antibodies, Monoclonal, Humanized ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Eye ; Female ; Follow-Up Studies ; Ganciclovir ; Heart Failure ; Humans ; Immunoglobulin G ; Intravitreal Injections ; Macular Edema ; Male ; Mycophenolic Acid ; Retinal Hemorrhage ; Retinal Vein ; Retinitis ; Serologic Tests ; Subretinal Fluid ; Tacrolimus ; Transplants ; Visual Acuity ; Vitrectomy ; Bevacizumab

To make the human RPE sheet for the ideal RPE transplantation and to compare growth rate and morphology between the fetal RPE cells of different obsteric age (17, 24, 34 wks)and the adult RPE cells (24 yrs). The RPE sheet was made as follows : (1)the use of dispase for separation of RPE sheet from the choroid and culture dish; (2)cell culture and cryopreservation, (3)skin biopsy punch for adequate size of RPE sheet. The transplantation methods were:the transplantation of RPE sheet into the subretinal space of rabbit was performed by micropipet system after vitrectomy. The growth rate and the morphology between fetal RPE cells and adult RPE cells were compared by light microscope and electron microscope (scanning &transmission). The RPE sheet was made successfully by use of dispase, skin biopsy punch and the cryopreservation and transplanted effectively with micropipet system. There were significant differences not in morphology, but in growth rate (population doubling time: 28.9 (17 wks), 29.1 (24 wks), 30.2 (34 wks), 35.4 hours (24 yrs).p<0.05)between fetal and adult RPE cells. The human RPE sheet can be made and transplanted into rabbit successfully and timely. And fetal RPE cells may be more ideal than adult RPE cells for the RPE transplantation with respect to the higher cell growth rate.
Adult ; Biopsy ; Choroid ; Cryopreservation ; Humans ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Skin ; Vitrectomy

PURPOSE: The purpose of this study was to identify factors that influence fatigue in hospitalized women cancer patients receiving chemotherapy. METHODS: The participants were 117 women cancer patients receiving chemotherapy. The instruments used in this study were physical symptoms, mood state, family support, and fatigue scales for patients with cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the IBM SPSS 19.0 program. RESULTS: Fatigue showed significant correlation with physical symptoms such as side effects as well as sub-elements of mood status such as anxiety-depression, vitality, anger and family support. Fatigue-anticipating variables were found to be some sub-elements of mood state such as anxiety-depression (beta=.61, t=10.40, p<.001), digestion organ factor (beta=.78, t=2.54, p=.013) and pain/fatigue factor (beta=.86, t=0.43, p=.045). The total variance explained was 69.7%. CONCLUSION: These results showed that the factors affecting fatigue were physical symptoms, and the mood state of hospitalized women cancer patients receiving chemotherapy. The results of this study provided basic materials for a nursing intervention program to reduce fatigue.
Anger ; Digestion ; Drug Therapy* ; Fatigue* ; Female ; Humans ; Nursing ; Weights and Measures

PURPOSE: we clinically measured the temperature rise in real time and analyzed the difference of albino rabbit and pigmented rabbit in use of the specially designed thermometer. METHODS: Specially designed thermometer was attached into the subretinal pigment epithealial and choroidal space through the suprachoroidal space in three pigment and three albino rabbits, with diode laser of 810 nm wave length, 3 mm spot size. We examined the retinal temperature according to laser irradiance power at each ten seconds during sixty seconds and the laser power setting was 200 mW, 300 mW, 400 mW in pigmeted rabbit and 300 mW, 600 mW, 800 mW in albino rabbit. We analyzed the results based on the measurements at least three times per each irradiance power. RESULTS: In albino rabbit, the maximal range of retinal temperature change was 1.2 degrees C and 1.7 degrees C in 300 mW and 600 mW, 14.1 degrees C in 800 mW power of 810 nm diode laser irradiance. In pigmented rabbit, the maximal range of retinal temperature change was 12.1 degrees C in 200 mW of laser irradiance power, 16.2 degrees C in 300 mW, 24.3 degrees C in 400 mW during sixty seconds in 810 nm diode laser. CONCLUSIONS: We investigated the ratinal temperature at transpupillary thermotherapy in 810 nm wavelength diode laser on rabbits. The difference of retinal temperature change was in accordance with the amount of chorioretinal melanin pigment. Therefore if the laser power setting used in caucasians would be attempted in orientals, it is the point to be considered during transpupillary thermotherapy.
Choroid ; Hyperthermia, Induced* ; Lasers, Semiconductor ; Melanins ; Rabbits* ; Retinaldehyde* ; Thermometers

To determine the ocular toxicity after intrachoroidal steroid injection in the rabbit eye, 0.15ml(40 mg/ml) triamcinolone acetonide, 0.15ml(40 mg/ml) methylprednisol one acetate and 0.15ml balanced salt solution(as controls) were injected into the choroid. The results were shown normal in fundus examination, electroretinography, and electron microscopy throughout the two weeks course of the experiment. From these result, it would appear that intrachoroidal 6 mg steroid injection demonstrated the lack of ocular toxicity.
Choroid ; Electroretinography ; Microscopy, Electron ; Pathology ; Triamcinolone ; Triamcinolone Acetonide