To understand the pathogenesis of proliferative vitreoretinal membrane formation which occurs in proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR), etc., accurate identification of the cellular components of the membrane is needed. This study was performed to identify cellular components of the membranes by means of immunohistochemical technique. 11 proliferative vitreoretinal membranes which were surgically obtained from 7 eyes with PVR and 4 eyes with PDR were stained with monoclonal antibodies against cytokeratin, glial fibrillary acidic protein (GFAP), or vimentin using immunoperoxidase technique (ABC method). In the PVR membranes, mean cell positivities for cytokeratin, GFAP and vimentin were 48%, 1% and 92%, respectively and in the PDR membranes, 0%, 5% and 93%, respectively. The above results suggest that retinal pigment epithelial cells and fibroblasts are major cellular components of PVR membranes, and that mesenchymal cells are major cellular components and glial cells are minor cellular components of PDR membranes.
Adolescent ; Adult ; Antibodies, Monoclonal ; Cell Membrane/metabolism/pathology ; Diabetic Retinopathy/metabolism/pathology ; Eye Diseases/metabolism/pathology ; Female ; Humans ; Immunoenzyme Techniques ; Intermediate Filament Proteins/*analysis ; Male ; Middle Aged ; Retinal Diseases/metabolism/*pathology ; Vitreous Body/metabolism/*pathology

Intracranial nerve sheath tumors unrelated to the cranial nerve roots are extremely rare, and the origin of the tumors are debatable. We report a case of pathologically-proven neurofibroma inside the lateral ventricle. A 49-year-old man presented with headache of 6 months duration, urinary incontinence, visual disturbance and right hemiplegia. Brain CT scan showed a well defined isodense mass with homogenous contrast enhancement and marginal calcification. At surgery the tumor was found to be a 4cm-sized lobulated mass attached only to the choroid plexus. Histologically, the tumor masses consisted of fasciculating bundles of wavy spindle cells, with a considerable collagen laydown.
Brain ; Choroid Plexus ; Collagen ; Cranial Nerves ; Headache ; Hemiplegia ; Humans ; Lateral Ventricles ; Middle Aged ; Nerve Sheath Neoplasms ; Neurofibroma* ; Tomography, X-Ray Computed ; Urinary Incontinence

To identify the cellular components of proliferative vitreoretinal membranes. 11 proliferative vitreoretinal membranes which were surgically obtained from 7 eyes with proliferative vitreo retinopathy (PVR) and 4 eyes with proliferative diabetic retinopathy (PDR) were stained with monoclonal antibodies against cytokeratin, glial fibrillary acidic protein(GFAP), or vimentin using immunoperoxidase technique (ABC method). In PVR membranes, mean cell positivities for cytokeratin, GFAP and vimentin were 48%, 1% and 92%, respectively and in PDR membranes, 0%, 5% and 93%, respectively. The above results suggest that retinal pigment epithelial celIs and fibroblasts are major cellular components of PVR membranes, and mesenchymal cells are major cellular components and glial cells minor cellular components of PDR membranes.
Antibodies, Monoclonal ; Diabetic Retinopathy ; Fibroblasts ; Immunoenzyme Techniques ; Keratins ; Membranes* ; Neuroglia ; Retinaldehyde ; Vimentin ; Vitreoretinopathy, Proliferative

BACKGROUND: Chronic suppurative otitis media is one of the most common disease in the otolaryngologic field. It is important to choose of antibiotics in the management of chronic suppurative otitis media. OBJECTIVES: Bacteriologic studies can make it possible to use appropriate antibiotics. MATERIALS AND METHODS: The bacteriologic study was made on 98 cases of chronic suppurative otitis media who visited the department of otolaryngology, Dae Dong Hospital in Pusan from Nov. 1989 to Dec. 1995 and the following results were obtained. RESULTS: 1) In 90 cases in which pathogenic organism was isolated, single infection was 81 cases(90%) and mixed infection was 9 cases(10%). 2) The most frequent pathogenic organism was Staphylococcus(46.5%) and Proteus(16.1%), Pseudomonas(14.1%), Providencia(10.1%) were the next. 3) In the aspect of the sensitivity to antibiotics, Ciprofloxacin, Ceftriaxon and Amikacin were sensitive drug generally. 4) Staphylococcus was sensitive to Vancomycin and Ciprofloxacin. 5) Proteus was sensitive to Amikacin, Ciprofloxacin, and Ceftriaxon. 6) Pseudomonas was sensitive to Ciprofloxacin, Amikacin and Piperacin. 7) Providencia was sensitive to Ciprofloxacin, Ceftriaxon, Amikacin and Piperacin. 8) Methicillin Resistant Staphylococcus Aureus(MRSA) was 19 Strains(45.5%). CONCLUSION: Recently, pathologic strain and it's sensitivity to antibiotics has changed. So, we recommand that periodic bacteriologic study and sensitivity test should be done for effective management of chronic otitis media.
Amikacin ; Anti-Bacterial Agents ; Bacteriology ; Busan ; Ceftriaxone ; Ciprofloxacin ; Coinfection ; Methicillin Resistance ; Otitis Media ; Otitis Media, Suppurative* ; Otolaryngology ; Proteus ; Providencia ; Pseudomonas ; Staphylococcus ; Vancomycin

To find out whether the cryotherapy for the treatment of the retinopathy of prematurity (ROP) causes structural changes of the extraocular muscle (EOM), and also whether the changes are related with the occurrence of strabismus. To examine the acute stage change, we conducted a transconjunctival cryotherapy around the superior rectus muscle of a rabbit and resected it 0, 3, 7, 14, and 28 days after the cryotherapy. In observing chronic changes, we first categorized patients who had an esotropia surgery into groups, one of which combined prematurity and cryotherapy and one group affected by prematurity but without having had cryotherapy. Then we compared the change of EOM with that of a fullterm infant group. In a rabbit, edema, acute inflammatory cells and a large amount of degenerated muscle fibers were observed immediately after the cryotherapy and on the 3rd day. On the 7th day, regenerated muscle fibers were observed and on the 14th day, the inflammatory cells decreased and the amount of regenerated muscle fiber increased. On the 28th day, abnormal findings were not observed any more and the muscle was found to be normal. When chronic changes of EOM in human on 1 1/2 to 8 1/2 years after cryotherapy, there were no abnormal findings observed in three groups. From the study, we can infer that cryotherapy can cause acute inflammation and necrosis of muscle fiber but such an acute change will improve and does not result in structural change in the long term. Therefore, the occurrence of strabismus in patients with ROP is considered to be attributable to reasons other than injury of EOM.
Animal ; Child ; Child, Preschool ; Cryotherapy/*adverse effects ; Human ; Infant ; Infant, Newborn ; Oculomotor Muscles/*surgery ; Rabbits ; Retinopathy of Prematurity/*pathology/*surgery ; Strabismus/*etiology

A Nationwide health care utilization survey was conducted from March 11 to September 19, 1985 to assess the level of illness and the magnitude of medical care utilization. A probability sample of 15,427 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. Of those 4,500 housewives were proxy respondents. A interview was conducted with pre-tested questionnaire schedule which was recorded by well trained interviewers. Age and sex compositions of the study population were similar to those of general population structure in 1985. The major findings of this survey are as follows: 1) A total of 64.5% of the study population lived in city area and 35.5% lived in county area. 2) While no difference was observed in interview rate between city and county area, it showed statistically significant difference in the medical security program coverage rate between the two areas(44.7% and 37.1%, respectively). 3) Morbidity rate was 79 per 1,000 persons during the two week periods. There was difference in age and sex adjusted morbidity rates between city and county area. Furthermore morbidity rates by the status of the program were significantly difference between the two areas. 4) Average ambulatory care utilization rate was 7.2 visits per person per year and average admission rate was 1.8 per 100 persons per year. There was significant difference in average ambulatory care utilization rate by the program. but no significant difference in medical utilization rate between city and county area. 5) The major symptoms of the perceived illness was the respiratory system(44.1%). 6) A total of 50.4% of the perceived illness among the covered group by the program were treated at the hospital and clinics, but those who are not covered used primarily drug stores(61.3%).
Ambulatory Care ; Appointments and Schedules ; Surveys and Questionnaires ; Delivery of Health Care* ; Humans ; Korea* ; Proxy ; Surveys and Questionnaires ; Sampling Studies

OBJECTIVE: This study was performed to be evaluated the adequacy on DRG classification in Obstetric group and analyzed the difference for medical benefit payment from the insurance and total medical reimbursement according to complication and age in vaginal delivery group and Cesarean section group. METHODS: This study has been analyzed for medical benefit payment from the insurance and total medical reimbursement of patients from University of hospital since Feburary 1999 to December 2000 and the data from Health Insurance Review Agency since Feburary 2001 to July 2001. RESULTS: Since these cases were not reported even 1 case in Korea, there were 113 cases needed to be deleted in DRG classification disease group. In the evaluation of disease severity for DRG classification disease group, there were 11 cases should be added to severe complicating diagnosis, 5 cases should be removed from severe complicating diagnosis, and 6 cases should be added to moderate complicating diagnosis in vaginal delivery and Cesarean section group. Medical benefit payment from the insurance and total medical reimbursement in the group with having severe complication were significantly higher than in the group without complication in Cesarean section group. Medical benefit payment from the insurance and total medical reimbursement in the group with having severe complication in primigravida vaginal delivery group and the group with having severe complication in multigravida vaginal delivery group were significantly higher in the group without complication in primigravida vaginal delivery group and the group without complication in multigravida vaginal delivery group, separately. CONCLUSION: Severity classification system-severe complication, multiple complication, moderate complication, non-complication-should be included in obstetric DRG classification system.
Cesarean Section ; Classification* ; Diagnosis ; Diagnosis-Related Groups* ; Female ; Humans ; Insurance ; Insurance, Health ; Korea ; Pregnancy

BACKGROUND: Somatosensory evoked potential (SSEP) has been used to help minimize neurologic morbidity during spinal surgery. But, SSEP is affected by various factors, namely technical errors, anesthetics and physiologic aspects (systemic blood pressure, temperature, blood gas tensions). We experienced 40 cases of spinal surgery done with total intravenous anesthesia under SSEP monitoring. We reviewed these cases with the availability of total intravenous anesthesia during SSEP monitoring. METHODS: Forty patients, ASA class I-II, free of neurologic disease and scheduled for elective spinal surgery were randomly selected for the study. All of the operations were performed under general anesthesia employing the method of total intravenous anesthesia with propofol and fentanyl, and monitored by SSEP. We recorded latency and amplitude of SSEP in the pre-induction, post-induction, during-instrument insertion and post-distraction periods. RESULTS: There were no statistical differences in latencies among pre-induction, post-induction, screw insertion and post-distraction period. The amplitude of the post-induction period was statistically higher than pre-induction period (p<0.05), but there were no differences in other periods. None of cases showed abnormal findings (i.e., delay of latency over 10% or decrease of amplitude over 50%). CONCLUSIONS: SSEP monitoring may be helpful in identifying potentially neurologically threatening surgical maneuvers during spinal surgery. To achieve better outcomes, we should consider the effects of various factors on SSEP. Total intravenous anesthesia may be useful method, which has lifter influence on SSEP monitoring.
Anesthesia, General ; Anesthesia, Intravenous* ; Anesthetics ; Blood Pressure ; Evoked Potentials* ; Evoked Potentials, Somatosensory ; Fentanyl ; Humans ; Propofol

The purpose of this study was to select the manageable diseases which are prevalent in Korea for periodic health examinations and to evaluate the sensitivity and specificity of periodic health examination in detecting these diseases. The data was derived from reimbursement data of the Korea Medical Insurance Corporation over a two year period (April 15, 1986 to April 14, 1988) and interviews with Yonsei Medical School professors. This study demonstrated that: 1. The manageable diseases which were selected for periodic health examinations are pulmonary tuberculosis, viral hepatitis, diabetes mellitus, syphilis groups, essential hypertension, renal disease groups, and iron deficiency anemia. 2. The sensitivity of the health screening for each disease was as follows: pulmonary tuberculosis 51.5%, viral hepatitis 60.3%, diabetes mellitus 64.7%, syphilis groups 63.3%, essential hypertension 49.9%, renal disease groups 44.0%, and iron deficiency anemia 80.9%. We conclude that peiodic health esaminations should focus on the manageable diseases that we have defined. The number of items in periodic health screening tests and hospital quality control should be increased for the diseases with a demonstrated low sensitivity.
Anemia, Iron-Deficiency ; Diabetes Mellitus ; Hepatitis ; Hypertension ; Hypertension, Renal ; Insurance ; Korea ; Mass Screening ; Quality Control ; Schools, Medical ; Sensitivity and Specificity ; Syphilis ; Tuberculosis, Pulmonary

BACKGROUND: Herpes zoster oticus is a reactivation of latent varicella-zoster infection associated with otalgia, vesicle, facial nerve palsy, sensorineural hearing loss & vertigo. Facial paralysis is rapid in onset, usually severe in degree, and poor in prognosis. OBJECTIVES: To evaluate the treatment and prognosis of Herpes zoster oticus. MATERIALS AND METHODS: Retrospective study of 12 cases of Herpes zoster oticus from May 1992 to February 1996, which had been treated with acyclovir and steroid was done. RESULTS: All patients had otalgia, vesicle and facial palsy. All patients had been treated with adequate dosage of prednisolone & acyclovir. The complete recovery rate from facial palsy was 58%. CONCLUSION: Factors predicting good prognosis are as follows. 1) low degree of facial palsy on admission 2) delayed onset of facial palsy from initial symptom 3) early treatment for facial palsy 4) electrical test: Nerve excitability test(<3.5 mA difference) Electroneurography(>10%).
Acyclovir ; Earache ; Facial Nerve ; Facial Paralysis ; Hearing Loss, Sensorineural ; Herpes Zoster Oticus* ; Herpes Zoster* ; Humans ; Paralysis ; Prednisolone ; Prognosis* ; Retrospective Studies ; Vertigo