Epiretinal membrane formation and membrane contraction are major complications in a variety of ocular conditions, including retinal detachment and penetrating ocular injuries. The epiretinal membrane was derived from pigment epithelial cell and glial cell. In rhegmatogenous retinal detachment, the retinal pigment epithelium was capable of proliferating through retinal tear into the vitreous contributing to preretinal membranes. In this study, we report the ultrastructural features of epiretinal membrane in rhegmatogenous retinal detachment removed during vitreous surgery from 4 patients.
Epiretinal Membrane* ; Epithelial Cells ; Humans ; Membranes ; Neuroglia ; Retinal Detachment* ; Retinal Perforations ; Retinal Pigment Epithelium ; Retinaldehyde*

BACKGROUND: In Korea, cerebrovascular accident (CVA) is the most significant cause of death among older people, and the incidence of cerebral hemorrhage is much higher than that of developed countries. There have been many investigations about the risk factors for CVA in both Korea as well as developed countries. A few papers reported various risk factors for cerebral hemorrhage in developed countries:however, well-designed studies of risk factors for the various causes of CVA were rare in Korea. Therefore, the purpose of this study was to compare the risk factors for the various causes of CVA and to evaluate the risk factors compared with age- and sex-matched control groups. In addition, duplex sonographic findings of the carotid artery were evaluated in patients with cerebral infarction. METHODS: One hundred and sixty-four patients admitted to the hospital in 1996 were enrolled. The four groups were divided based on the following states: cerebral infarction (n-63), cerebral hemorrhage (n-64), cerebral infarction with atrial fibrillation (n-19), and lacunar infarction (n-18). Major risk factors were compared with age- and sex-matched control groups and among CVA groups. Duplex sonography of the carotid artery was done in 14 patients with cerebral infarction. RESULTS: In multiple logistic regression analysis, patients with cerebral infarction had higher prevalence of diabetes mellitus and lower high density lipoprotein-cholesterol level than the control group, and hypertension showed borderline significance. Patients with cerebral hemorrhage had higher prevalence of hypertension, higher high density lipoprotein-cholesterol level, and more frequent prevalence of smoking compared with the control group. Patients with cerebral infarction showed lower high density lipoprotein-cholesterol, higher low density lipoprotein-cholesterol levels, more frequent diabetes mellitus, lower prevalence of hypertension and older age than patients with cerebral hemorrhage. Patients with cerebral infarction and atrial fibrillation showed only older age than patients with cerebral infarction only. There were no differences in risk factors between patients with cerebral infarction and lacuna infarction. Atheromatous plaque was found in 71% of patients with cerebral infarction. CONCLUSION: Metabolic abnormalities played more important role in the development of cerebral infarction and hemodynamic abnormalities in cerebral infarction. Sonographic examination of the carotid artery may be useful for predicting the occurrence of cerebrovascular accident in high risk patients.
Atrial Fibrillation ; Carotid Arteries* ; Cause of Death ; Cerebral Hemorrhage ; Cerebral Infarction* ; Developed Countries ; Diabetes Mellitus ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Infarction ; Korea ; Logistic Models ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar ; Ultrasonography*

BACKGROUND/AIMS: The retrocaval dissection, with venous collaterals, is sometimes difficult, making subsequent hemostasis less easy during orthotopic liver transplantation(OLT). We have recently applied a modified technique of vena caval preservation during OLT, and undertook this study to evaluate retrospectively its effects. METHODS: Five patients with liver cirrhosis underwent a modified OLT from March 1999 through July 2001. The procedure includes a side to side anastomosis between the IVC of the donor and the recipient without vena cava occlusion during OLT. RESULTS: This technique pemitted the avoidance of vena caval occlusion in all cases. We could performed OLT without venovenous bypass in 3 patients who tolerated the temporary portal clamping test before the recipient hepatectomy. As retrocaval dissection was not performed, hemostasis was esier during anhepatic phase. We could reduce anhepatic phase into average 60 minutes from only one caval anastomosis during OLT. CONCLUSIONS: We think this alternative technique, requiring only one caval anastomosis, can reduce the duration of the anhepatic phase and the need for venous bypass.
Constriction ; Hemostasis ; Hepatectomy ; Humans ; Liver Cirrhosis ; Liver Transplantation* ; Liver* ; Retrospective Studies ; Tissue Donors

Hemodynamic factors play an important role in the development and/or progression of diabetic nephropathy. We hypothesized that renal sodium transporter dysregulation might contribute to the hemodynamic alterations in diabetic nephropathy. Otsuka Long Evans Tokushima Fatty (OLETF) rats were used as an animal model for type 2 diabetes. Long Evans Tokushima (LETO) rats were used as controls. Renal sodium transporter regulation was investigated by semiquantitative immunoblotting and immunohistochemistry of the kidneys of 40-week-old animals. The mean serum glucose level in OLETF rats was increased to 235+/-25 mg/dL at 25 weeks, and the hyperglycemia continued up to the end of 40 weeks. Urine protein/ creatinine ratios were 10 times higher in OLETF rats than in LETO rats. At 40th week, the abundance of the epithelial sodium channel (ENaC) beta-subunit was increased in OLETF rats, but the abundance of the ENaC gamma-subunit was decreased. No significant differences were observed in the ENaC alpha-subunit or other major sodium transporters. Immunohistochemistry for the ENaC beta-subunit showed increased immunoreactivity in OLETF rats, whereas the ENaC gamma-subunit showed reduced immunoreactivity in these rats. In OLETF rats, ENaC beta-subunit upregulation and ENaC gamma-subunit downregulation after the development of diabetic nephropathy may reflect an abnormal sodium balance.
Animals ; Blood Glucose/analysis ; Diabetes Mellitus, Type 2/*metabolism ; *Disease Models, Animal ; Epithelial Sodium Channel/*analysis ; Hypertension/complications ; Immunoblotting ; Immunohistochemistry ; Kidney/*metabolism ; Male ; Rats ; Sodium/*metabolism ; Sodium-Hydrogen Antiporter/genetics ; Sodium-Potassium-Chloride Symporters/genetics

OBJECTIVE: Several studies have reported on the effectiveness of fronto-lateral craniotomy in reducing the operating time and post-operative complications. However, no study has practically evaluated this method from the cosmetic point of view. MATERIALS AND METHODS: We designed this study for comparison of the clinical differences and cosmetic outcomes between the frontolateral craniotomy and the conventional pterional craniotomy for clipping of unruptured intracranial aneurysms. We performed a retrospective analysis of the two groups based on their medical records and radiologic findings juxtaposed with their length of hospital stay, intensive care unit day and operation time, and the emergence of postoperative complication, mean size of aneurysm, and temporal depression. RESULTS: After careful comparison of the thickness of temporalis muscle between the craniotomy side and the contralateral side, the results clearly showed that the conventional pterional craniotomy group was asymmetric by a p value of 0.152 and the frontolateral craniotomy group was symmetric by a p value of 0.002. CONCLUSION: Frontolateral craniotomy could be a practical alternative for patients with an unruptured intracranial aneurysm in the anterior circulation including the posterior communicating artery, particularly those who are in a medically poor state or who highly demand minimal aesthetic mutilation.
Aneurysm* ; Arteries ; Craniotomy ; Depression ; Humans ; Intensive Care Units ; Intracranial Aneurysm ; Length of Stay ; Medical Records ; Postoperative Complications ; Retrospective Studies

Coronary artery anomalies are rare presentations in primary percutaneous coronary interventions of acute myocardial infarction. Herein, we report the case of a 59-year-old man with acute anterior myocardial infarction who had anomalous separate origin of left anterior descending artery (LAD) and left circumflex artery (LCX) from the left coronary aortic sinus. Coronary angiography showed a normal right coronary artery and LCX, but no visualization of the LAD. After several unsuccessful attempts to cannulate the LAD, we found the LAD ostium located by the side of the LCX ostium. There was total occlusion at proxymal LAD. Coronary computed tomography angiography demonstrated the precise, separate origin of LAD and LCX from the left coronary aortic sinus.
Angiography ; Anterior Wall Myocardial Infarction ; Arteries ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Sinus of Valsalva

Cowden's disease, a rare autosomal dominant disorder characterized by benign hamartomatous overgrowth of various tissues, increases the risk of cancer of the thyroid, breast, endometrium, prostate, and possibly other organs. Generally, germline mutations in the coding sequence for PTEN are found in 80% of patients with Cowden's disease. Here we report a rare case of incidentally discovered gastric polyposis during esophagogastroscopy for medical screening in a patient with a history of surgery for breast and thyroid cancer. Identifyng the mutation in the PTEN gene to a diagnosis of Cowden's disease.
Breast ; Clinical Coding ; Endometrium ; Endoscopy ; Female ; Germ-Line Mutation ; Hamartoma Syndrome, Multiple ; Humans ; Mass Screening ; Prostate ; Thyroid Neoplasms

PURPOSE: We studied the degree of changes in antibiotic sensitivity toward causative organisms, prevalence and clinical manifestations of extended-spectrum beta-lactamase(ESBL)- producers of urinary tract infection(UTI) for a period of three years. This serves to provide useful information in selecting adequate drugs for the treatment of UTI. METHODS: We recruited 137 patients who grew more than 105 CFU/mL in their urine culture among 250 patients who visited and were admitted to Handong University's Sunlin Hospital for UTI treatment from January 2003 to December 2005. We retrospectively analyzed the data from the medical records. RESULTS: The common pathogenic organisms were Escherichia coli(65.0%), Klepsiella pneumoniae(14.0%), Enterococcus faecalis(5.8%) and Proteus vulgaris(2.9%) in consecutive order. The prevalence of ESBL-producers among isolated E. coli and K. pneumoniae was 4.5%(4 cases) and 14.3%(2 cases), respectively. The antibiotic sensitivity rates of E. coli were relatively high to amikacin(100%), imipenem(100%), ceftriaxone(95.5%) and tobramycin(91.4%) while relatively low to TMP/SMZ(55.4%), ampicillin/sulbactam(29.4%) and ampicillin (24.2%). CONCLUSION: The use of ampicillin, ampicillin/sulbactam and TMP/SMZ, which have been the first choices in the treatment of UTI, should be reconsidered due to the low sensitivity rates towards these antibiotics. Due to the high incidence and antibiotic tolerance of ESBL that might have risen from the development of new antibiotics and increased antibiotic use, it is necessary to consider changing the standard antibiotics that have been used in the treatment of UTI.
Ampicillin ; Anti-Bacterial Agents ; Child* ; Enterococcus ; Escherichia ; Humans ; Incidence ; Medical Records ; Pneumonia ; Prevalence ; Proteus ; Retrospective Studies ; Urinary Tract

BACKGROUND: The present study was aimed to determine whether non-steroidal anti-inflammatory drugs (NSAID) alter the regulation of aquaporin (AQP) water channels in the kidney. METHODS: Male Sprague-Dawley rats were injected with indomethacin (5 mg/kg, twice a day, i.p.) for two days. Control group was injected with vehicle. The expression of AQP1-4 proteins was determined in the kidney by Western blot analysis. RESULTS: Following the treatment with indomethacin (5 mg/kg), the expression of AQP1 was not significantly affected in the cortex and outer medulla, but was decreased and inner medulla. The expression of AQP2 was significantly decreased in the cortex, outer medulla and inner medulla. The expression of AQP3 was not significantly affected in the cortex, but was decreased in the outer medulla and inner medulla. The expression of AQP4 was detected only in the inner medulla, which was also significantly decreased. A lower dose of indomethacin (2.5 mg/kg) or diclofenac (100 mg/kg, single dose) similarly decreased the expression of AQP2. Despite the changes in AQP proteins, there were no significant changes in the expression of heat shock proteins-25 and -70. CONCLUSION: These results suggest that NSAID specifically decrease the expression of AQP water channels in the kidney.
Animals ; Aquaporins* ; Blotting, Western ; Diclofenac ; Hot Temperature ; Humans ; Indomethacin* ; Kidney* ; Male ; Rats* ; Rats, Sprague-Dawley ; Shock

Twenty-our cases of pituitary adenoma, 13 males and 11 females with the age ranging from 11 to 65 years, received radiation therapy(RT) on the pituitary area with 6MV linear accelerator during past 25 months at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic Medical College. Of 24 case of RT, 20 were postoperative and 4 primary. To evaluate the effect of RT, we analyzed the alteration of the endocrinologic tests, neurologic abnormalities, major clinical symptoms, endocrinologic changes and improvement in visual problems after RT. The results were as follows ; 1. Major clinical symptoms were headache, visual defects, diabetes insipidus, hypogonadisms and general weakness in decreasing order of frequency. 2. All but the one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with an invasive tumor mass around supra and para-ellar area. 3. Endocrinological classifications of the patient were 11 prolactinoma, 4 growth hormonesecreting tumors, 3 ACTH-ecreting tumors consisting of one Cushing's disease and two Nelson's syndrome, and 6 nonfunctioning tumors. 4. Eleven of 14 patients, visual problems were improved after treatment but remaining 3 were unchanged. 5. Seven of 11 prolactinomas returned to normal hormonal level after postoperative and primary RT and 3 patients are being treated with bromocriptine (BMCP) but on lost case. 6. Two of 4 growth hormone-ecreting tumor returned to normal level after RT but the remaining 2 are being treated with BMCP, as well.
Bromocriptine ; Classification ; Diabetes Insipidus ; Female ; Growth Hormone* ; Headache ; Humans ; Male ; Particle Accelerators ; Pituitary Neoplasms* ; Plasma* ; Prolactinoma ; Sella Turcica