OBJETIVE: To analyze the antithrombin III deficiency in patients with recurrent spontaneous abortion. MATERIALS AND METHOD: The blood samples were tested by chromogenic assay to evaluate the activity of antithrombin III. RESULTS: There was only one case of antithrombin III deficiency. This patient experienced one neonatal death after delivery and one FDIU (fetal death in utero). And also this patient showed a lupus anticoagulant and the prolongation of PTT. CONCLUSIONS: Women with recurrent miscarriage who have no obvious identified cause should consider hematologic screening. Antithrombin III deficiency could be a cause of recurrent spontaneous abortion. But the incidence is very rare in Korean patients.
Abortion, Habitual ; Abortion, Spontaneous* ; Antithrombin III Deficiency* ; Antithrombin III* ; Female ; Humans ; Incidence ; Lupus Coagulation Inhibitor ; Mass Screening ; Pregnancy

Retinal pigment epithelial cells(RPE) from a monolayer on the outer portion of sensory retina and have important physiologic functions that include solute transport, phagocytiosis and digestion of membrances shed from photoreceptor outer segments, and drug detoxication. Recently, transplantation of normal RPE has been proposed as a potential therapeutic modality in the surgical management of subretinal neovascularization in age related macular degeneration(ARMD). The viability of RPE at the time of transplantation is important for a good result after transplantation. This viability can be influenced by the period and environmental conditions of storage after harvest.In this study, the influence of these two factors on the viability was evaluated under controlling other remaining factors in vitro. And limitation of masimal time and optimal environmental conditions of storage were investigated.From November 1997 to February 1998, RPE cell sheets from six donor eyeballs for corneal transplantation in the department of ophthalmology of Severance Hospital were harvested and stored in -70degrees C, 4degrees C, or room temperature condotion. The viability of RPE cells at 0, 24 and 48 hours after havest was assessed and compared statistically.The viability was highest at 4degrees C condition. During storage, the viability was about 95% at 24 hours for and decreased abruptly to below 90% at 48 hours. Therefore, RPE cells for transplantation are to be stored at 4degrees C condition and transplantation should be performed within 24 hours after harvest.
Corneal Transplantation ; Digestion ; Epithelial Cells* ; Humans* ; Macular Degeneration ; Ophthalmology ; Retina ; Retinaldehyde* ; Tissue Donors*

OBJECTIVE AND METHODS: To determine correlations among ambulatory renin activity, ambulatory blood pressure and microalbumin excretion rate, 66 Korean essential hypertensives were studied after 4 week wash-out period. The ambulatory blood pressure was monitored every 30 minutes and mean BP were calculated automatically. Urinary microalbumin excretion rate(UAER) and ambulatory plasma renin activity(aPRA) collected at mid-day were measured by radioimmunoassays. Subjectives were divided into 2 groups by aPRA value(2ng/ml/hr). RESULT: 14 cases were high renin group and 52 cases low renin group. The mean BP were 148.83/94.69mmHg in low renin group, and 146.57/98.07mmHg in high-renin group without difference. UAER were not different also between both groups. 23.07%(4/14) of non-dippers were included in high renin group and 25.58%(12/52) in low renin group without statistical difference. The aPRA was significantly related to UAER and systolic and diastolic mean blood pressure. Also UAER was related significantly to day mean blood pressures. CONCLUSION: Thus aPRA is thought to be a meaningful indicator to predict hypertensive renal target organ damage as well as blood pressure measured with 24-hr ABPM.
Blood Pressure* ; Hypertension* ; Plasma* ; Radioimmunoassay ; Renin*

OBJECTIVE: To analyze the interrelationship between homocysteine and methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: Homocysteine and MTHFR mutation were tested by fluorescent polarizing immunoassay and PCR-RFLP method, respectively. RESULTS: In patients with homocysteine level less than 5 mmol/L, there was no case of normal group but there were four cases of heterozygosity and one case of homozygosity. In patients with homocysteine level 5~10 mmol/L, the number of normal, heterozygosity and homozygosity group were eleven, eighteen and eight, respectively. In patients with homocysteine level 10~15 mmol/L, the number of normal, heterozygosity and homozygosity group were four, one and one, respectively. In patients with homocysteine level more than 15 mmol/L, there was no case of normal and heterozygosity group but there were two cases of homozygosity. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. And there was a significant relationship between homocysteine and MTHFR mutation.
Abortion, Spontaneous* ; Female ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

PURPOSE: The corneal change induced by refractive procedures influence both the postoperative refractive status and the ocular spherical aberration (SA). We evaluated changes in corneal SA after three types of surface ablation: phototherapeutic keratectomy (PTK), myopic photorefractive keratectomy (PRK), and myopic wavefront-guided laser epithelial keratomileusis (LASEK). METHODS: Twenty-six eyes (25 patients) were subjected to PTK 26 eyes (14 patients) to PRK, and 34 eyes (17 patients) to wavefront-guided LASEK. Corneal SA was measured with the iTrace in all patients both preoperatively and 6 months postoperatively. RESULTS: Six months after surgery, mean corneal SA was -0.173 +/- 0.171 micrometer in the PTK group, 0.672 +/- 0.200 micrometer in the PRK group, and 0.143 +/- 0.136 micrometer in the wavefront-guided LASEK group. The mean difference between the preoperative and postoperative corneal SA (DeltaSA) was -0.475 micrometer in the PTK group, 0.402 micrometer in the PRK group, and -0.143 micrometer in the wavefront-guided LASEK group. CONCLUSIONS: Surgically induced changes in corneal SA vary with procedure. The prediction of the pattern of SA change induced by various surface ablation procedures may be helpful for developing future surgical procedures.
Adult ; Aged ; Corneal Dystrophies, Hereditary/*surgery ; Corneal Wavefront Aberration/*surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Male ; Middle Aged ; Myopia/*surgery ; Photorefractive Keratectomy/*methods ; Prospective Studies ; Treatment Outcome

PURPOSE: The corneal change induced by refractive procedures influence both the postoperative refractive status and the ocular spherical aberration (SA). We evaluated changes in corneal SA after three types of surface ablation: phototherapeutic keratectomy (PTK), myopic photorefractive keratectomy (PRK), and myopic wavefront-guided laser epithelial keratomileusis (LASEK). METHODS: Twenty-six eyes (25 patients) were subjected to PTK 26 eyes (14 patients) to PRK, and 34 eyes (17 patients) to wavefront-guided LASEK. Corneal SA was measured with the iTrace in all patients both preoperatively and 6 months postoperatively. RESULTS: Six months after surgery, mean corneal SA was -0.173 +/- 0.171 micrometer in the PTK group, 0.672 +/- 0.200 micrometer in the PRK group, and 0.143 +/- 0.136 micrometer in the wavefront-guided LASEK group. The mean difference between the preoperative and postoperative corneal SA (DeltaSA) was -0.475 micrometer in the PTK group, 0.402 micrometer in the PRK group, and -0.143 micrometer in the wavefront-guided LASEK group. CONCLUSIONS: Surgically induced changes in corneal SA vary with procedure. The prediction of the pattern of SA change induced by various surface ablation procedures may be helpful for developing future surgical procedures.
Adult ; Aged ; Corneal Dystrophies, Hereditary/*surgery ; Corneal Wavefront Aberration/*surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Male ; Middle Aged ; Myopia/*surgery ; Photorefractive Keratectomy/*methods ; Prospective Studies ; Treatment Outcome

The effect of betaxolol and dipivefrin on microcirculation of peripapil lary reina and optic disc in normal tension glaucoma was assessed. Betaxolol, selective beta-1 blocker, was known to improve the blood flow of retrobulbar arteries, and dipivefrin was known to decrease the flow of ciliary body. Total subjects were 29 normal tension glaucoma patients; 18 subjects with no previous IOP reducing eye drops during 4 weeks were assigned for betaxolol group, and 11 subjects with using timolol for dipivefrin group. The intraocular pressure was significantly reduced after instillation in betaxolol group(p<0.01), and in dipivefrin group(p<0.05). But systemic blood pressure and pulse rate were not changed after instillations in both groups. Blood flow, volume, velocity of optic disc and peripapillary retina of betaxolol group and dipivafrin group were not significantly changed. From the above results, we concluded that betaxolol and dipiverin with timolol did not influenced the microcirculation of peripapillary retina and opit disc.
Arteries ; Betaxolol* ; Blood Pressure ; Ciliary Body ; Heart Rate ; Humans ; Intraocular Pressure ; Low Tension Glaucoma* ; Microcirculation ; Ophthalmic Solutions ; Optic Disk* ; Optic Nerve* ; Retina ; Retinaldehyde* ; Timolol

PURPOSE: Goggles are frequently worn in the sport of swimming and are designed to form a seal around the periorbital tissue orbit. The resultant pressure on the eye may have the potential to affect intraocular pressure and blood flow of the optic nerve head. This study evaluates the influence of wearing swimming goggles on intraocular pressure (IOP) and blood flow of the ocular nerve head (ONH) in normal subjects. MATERIALS AND METHODS: Thirty healthy participants took part in this study. The IOP of each participant was measured using a Goldmann tonometer. Measurements were taken immediately before putting on swimming goggles, at 5, 10, 30, and 60 minutes after putting on swimming goggles, and then immediately after taking off the goggles. Blood flow of the ONH was measured using the Heidelberg retinal flowmeter. RESULTS: The average IOP before, during and after wearing the swimming goggles were 11.88 +/- 2.82mmHg, 14.20 +/- 2.81 mmHg and 11.78 +/- 2.89mmHg, respectively. The IOP increased immediately after putting on the goggles (p < 0.05) and then returned to normal values immediately after removal (p > 0.05). Blood flow of the ONH was 336.60 +/- 89.07 Arbitrary Units (AU) before and 319.18 +/- 96.02 AU after the goggles were worn (p < 0.05). CONCLUSION: A small but significant IOP elevation was observed immediately after the swimming goggles were put on. This elevated IOP was maintained while the goggles were kept on, and then returned to normal levels as soon as they were taken off. Blood flow of the ONH did not change significantly throughout the experiment. These facts should be considered for safety concerns, especially in advanced glaucoma patients.
Adult ; Eye Protective Devices/*adverse effects ; Female ; Humans ; *Intraocular Pressure ; Male ; Optic Disk/*blood supply ; Regional Blood Flow ; *Swimming ; Time Factors

Purpose: A video-urodynamic study is known as the most accurate test to differentiate between benign prostatic hyperplasia (BPH) with overactive bladder and detrusor instability but requires expensive equipment and an expert technique, so is not commonly available. We performed a video- urodynamic study and ice-water test which is easily performed for the diagnosis of a neurogenic bladder in the patients with symptomatic BPH associated with overactive bladder and compared the results. Materials and Methods: The video-urodynamic study using a 10-Fr triple lumen urodynamic catheter was performed in 36 patients with symptomatic BPH associated with overactive bladder that had frequency, weak stream, nocturia, urgency, urge incontinence, dysuria and no clinical neurogenic defect. After the video-urodynamic study, the ice-water test was performed by instilling 4degreesC sterilized water through a catheter at 200ml/ min in the supine position. The volume instilled was about 30% of the bladder capacity. The ice-water test was positive if there was an efflux of water around the catheter during or after water instillation. Results: Thirty two of the 36 symptomatic BPH patients with an overactive bladder were negative on the ice-water test. All 32 patients who had a negative ice-water test were BPH with overactive bladder on the video- urodynamic study. Four of the 36 symptomatic BPH patients with an overactive bladder were positive on the ice-water test. Two of the 4 patients who had a positive ice-water test were BPH with overactive bladder and the other two were detrusor instability on the video-urodynamic study. Conclusions: Therefore, in case of a positive ice water test, a video-urodynamic study is needed to differentiate between BPH with overactive bladder and detrusor instability in patients with symptomatic BPH associated with overactive bladder.
Catheters ; Diagnosis ; Dysuria ; Humans ; Ice ; Nocturia ; Prostatic Hyperplasia* ; Rivers ; Supine Position ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Bladder, Overactive* ; Urinary Incontinence, Urge ; Urodynamics ; Water

OBJECTIVE: To report the prevalence of lupus anticoagulants and anticardiolipin antibodies in patients with recurrent spontaneous abortion and infertility. MATERIAL AND METHOD: Lupus anticoagulants and anticardiolipin antibodies were analyzed by Diluted Russell's Viper Venom Test (DRVVT) and solid phase enzyme immunoassay, respectively. RESULTS: In 200 patients with infertility, there were 6 cases (3%) with positive lupus anticoagulants or anticardiolipin antibodies. Of these, 3 patients (1.5%) showed positive lupus anticoagulants and anticardiolipin antibodies, respectively. In 120 patients with recurrent spontaneous abortion, there were 13 cases (10.8%) of positive lupus anticoagulants or anticardiolipin antibodies. Of these, one patient (1%) showed lupus anticoagulants and 12 patients (10%) showed anticardiolipin antibodies. But in two groups, there was no cases with positive lupus anticoagulants and anticardiolipin antibodies. CONCLUSION: Lupus anticoagulants and anticardiolipin antibodies are definite cause of recurrent spontaneous abortion. There has been a speculation that they might be associated with infertility and repeated IVF failures. But it was found that the role of lupus anticoagulants and anticardiolipin antibodies in these cases are not clear.
Abortion, Spontaneous* ; Antibodies, Anticardiolipin* ; Anticoagulants* ; Female ; Humans ; Immunoenzyme Techniques ; Infertility* ; Pregnancy ; Prevalence ; Russell's Viper ; Venoms