PURPOSE: To compare the macular choroidal thickness, ganglion cell complex thickness, peripapillary choroidal thickness and retinal nerve fiber layer thickness among normal, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients using RTVue (Fourier-domain optical coherence tomography; Optovue, Fremont, CA, USA). METHODS: A retrospective analysis of 32 normal controls, 32 POAG and 52 NTG patients was performed. Choroidal thickness, ganglion cell complex thickness and retinal nerve fiber layer thickness were compared among normal controls, POAG and NTG subjects. Additionally, the factors influencing choroidal thickness (age, axial length, spherical equivalent, central corneal thickness, mean deviation, nocturnal dip, blood pressure variability) were analyzed. RESULTS: A total of 32 normal controls, 32 POAG and 52 NTG patients were enrolled in this study. Macular and peripapillary choroidal thicknesses were significantly thinner in the NTG patients. In NTG subjects, the significant influencing factors associated with macular and peripapillary choroidal thicknesses were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant influencing factors associated with macular and peripapillary choroidal thicknesses were age and axial length. CONCLUSIONS: Choroidal thickness was significantly thinner in NTG patients compared with normal controls and POAG patients. Factors influencing choroidal thickness in NTG patients were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant factors influencing choroidal thickness were age and axial length.
Blood Pressure ; Choroid* ; Ganglion Cysts ; Glaucoma, Open-Angle* ; Humans ; Low Tension Glaucoma ; Nerve Fibers ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To compare the macular choroidal thickness, ganglion cell complex thickness, peripapillary choroidal thickness and retinal nerve fiber layer thickness among normal, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients using RTVue (Fourier-domain optical coherence tomography; Optovue, Fremont, CA, USA). METHODS: A retrospective analysis of 32 normal controls, 32 POAG and 52 NTG patients was performed. Choroidal thickness, ganglion cell complex thickness and retinal nerve fiber layer thickness were compared among normal controls, POAG and NTG subjects. Additionally, the factors influencing choroidal thickness (age, axial length, spherical equivalent, central corneal thickness, mean deviation, nocturnal dip, blood pressure variability) were analyzed. RESULTS: A total of 32 normal controls, 32 POAG and 52 NTG patients were enrolled in this study. Macular and peripapillary choroidal thicknesses were significantly thinner in the NTG patients. In NTG subjects, the significant influencing factors associated with macular and peripapillary choroidal thicknesses were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant influencing factors associated with macular and peripapillary choroidal thicknesses were age and axial length. CONCLUSIONS: Choroidal thickness was significantly thinner in NTG patients compared with normal controls and POAG patients. Factors influencing choroidal thickness in NTG patients were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant factors influencing choroidal thickness were age and axial length.
Blood Pressure ; Choroid* ; Ganglion Cysts ; Glaucoma, Open-Angle* ; Humans ; Low Tension Glaucoma ; Nerve Fibers ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence

No abstract available.
Basal Ganglia* ; Pseudohypoparathyroidism*

The purpose of this study is to evaluate the effects of 2% dorzolamide(Trusopt(R)) on the ocular blood flow and retinal microcirculation. To creat an experimental glaucoma model in rabbits and to study the effects of elevated intraocular pressure(IOP), ocular blood flow, retinal effects of elevated intraocular pressure(IOp), ocular blood flow, retinal microcirculation on rabbits eyes, we treated trabecular meshwork of 6 adult pigmented rabbits with Q-switched Nd;YAG laser. And then we investigated the IOP lowering effect, ocular blood flow, and the microcirculation on retina of 2% dorzolamide(Trusopt(R)) in experimental glaucoma model. The IOP, ocular blood flow and the microcirculation were measured with applanation pneumotonography(Alcon, Texas), pneumotonometric probe linked to Langham ocular blood foow system(OBF, Blue mountain) and Heidelberg Retina Flowmeter(HRF). During sustained IOP elevation, 2% dorzolamide(Trusopt(R)) was instilled in one eye and normal saline in the fellow eye. The IOP and ocular blood flow were measured 1, 2, 4 and 8 hours after instillation. The retinal microcirculation was measured 2 and 8 hours after instillation. The retinal microcirculation was measured 2 and 8 hours after instillation at 200micrometer apart from the superior optic disc margin. There were statistically significant reductions in IOP in both 2% dorzolamide(Trusopt(R)) and normal saline-treated eyes(P<0.05). Maximal reduction of IOP was observed 2 hours after single-drop of 2% dorzolamide(Trusopt(R)), with significant reduction of IOP up to 4 hours duration(P<0.05) There was no statistically significant incrsment in ocular blood for even though incrsment was observed 2 hours after single-drop of 2% dorzolamide(Trusopt). There were no change in volume, flow and velocity of blood flow in the peripapillary retina after single-drop of 2% dorzolamide(Trusopt(R))(P>0/1). From the above results, we concluded that 2% dorzolamide(Trusopt(R)) reduced the IOP but did not alter ocular blood flow and peripapillary retinal microcirculation.
Adult ; Glaucoma* ; Humans ; Intraocular Pressure ; Microcirculation ; Rabbits* ; Retina ; Retinaldehyde ; Trabecular Meshwork

We observed the changes of IOP after contact transscleral cyclophotocoagualtion with Diode laser which emit 810mm beam and we tride to investigatethe suitable level and range of energy when Diode laser was applied to the refractory glaucoma patients. Fifteen eyes underwent contact transscleral cyclophotocoagulation with energy 3J(Group A, 6eyes), 4J(Group B, 9eyes) separately and intraocular pressure(IOP) was measured at 1 day, 1 week, 1 month, 2 month, 3 month, 4month, 5month, 6month, postoperatively. The intraocular pressure(IOP) decreasing rate was 83.02% in A group and 64.72% in B group. The success rate was 50% in A group and 66.7% in B group at 6 month postoperatively. It is suggested that contact transscleral cyclophotocoagulation with Diode laser si useful in lowering IOP in refractory glaucoma patients.
Glaucoma* ; Humans ; Lasers, Semiconductor*

We investigated the outcome of needling revision with adjunctive subconjunctival 5-fluorouracil(5-FU) injection performed on 20 eyes of 20 consecutive glaucoma patients with failed filtering blebs. Follow-up time was 44.5+/-53.9 weeks from the first needling revision and 31.8+/-43.5 weeks from the last needling procedures. We divided the patients into the success group and the failed group depending on the change of the intraocular pressure(IOP) after needling, and analysed the multi-factors which influenced the success rate of needling by logistic regression analysis. Thirteen(65%) of the eyes were classified treatment success after 1.6+/-0.8 needling revision, with a mean intraocular presure(IOP) of 19.8+/-1.9mmHg on 1.1+/-0.9 medications, significantly lower mean IOP and number of medications than before the procedure(28.1+/-15.7mmHg [P<0.01, paired t-test]). Needling revision with adjunctive 5-FU appears to be a safe and effective means of reestablished filtration.
Blister* ; Filtration ; Fluorouracil ; Follow-Up Studies ; Glaucoma ; Humans ; Logistic Models ; Trabeculectomy*

Neurologic complications after open-heart surgery are not only relatively common but also often fatal. In order to know the clinical characteristics and causative risk factors, we carried out the retrospective study on 655 patients who had been admitted and undergone OHS at Seoul National University Children's Hospital during 2-year period from July 1990 to June 1992. The results were as follows; 1) The incidence of neurologic complications after OHS was 4.7% (31 cases) of the total 655 cases. 2) In the viewpoint of the pre-op diagnosis, neurologic complications developed in 20 cases (7.8%) among cyanotic congenital heart disease and in 11 cases (2.9%J among acyanotic CHD. 3) In the viewpoint of the type of operation, the incidence of neurologic complications was 33.3% in Jatene procedure and 12.1% in Fontan procedure. 4) Compared with the group who didn't develp neurologic complications (624 cases), cardiopulmonary bypass time, aorta cross clamp time, and total arrest time were longer and the degree of hypothermia was lower in the group who had neurologic complications (31 cases), which are statistically significant each other(p<0.01). 5) In 25 cases (80.6%), neurologic complications occurred within 72 hours after OHS. 6) Clinical manifestations of neurologic complications were seizures (26 cases, 84%), consciousness change (13 cases, 42%), hemiplegia (1 case), and decreased muscle tone (1 case). 7) Of the 31 cases, 16 cases showed more than one abnormal finding among EEG, Brain CT, or Brain MRI. 8) The possible etiologies of neurologic complications were diffuse hypoxic ischemic encephalopathy (16 cases, 51.6%), focal or multiple ischemic stoke that was thought to be due to microembolisms (3 cases, 9.7%), electrolyte or acid-base imbalance (8 cases, 25.8%), and the remainders were unknown (4 cases. 12.9%) 9) In the course of neurologic complications, 11 cases (35.5%) expired, 14 cases(45.2%) recovered at discharge, 3 cases (9.7%) were controlled at discharge, and 2 cases (6.5%) had long-term sequela(one spastic quadriplegia and one hemiparesis). 10) The cause of death among mortality cases were mainly due to brain damage (7 cases), while 4 cases had other direct causes such as heart failure, respiratory failure, or sepsis.
Acid-Base Imbalance ; Aorta ; Brain ; Cardiopulmonary Bypass ; Cause of Death ; Child* ; Consciousness ; Diagnosis ; Electroencephalography ; Fontan Procedure ; Heart Defects, Congenital ; Heart Failure ; Hemiplegia ; Humans ; Hypothermia ; Hypoxia-Ischemia, Brain ; Incidence ; Magnetic Resonance Imaging ; Mortality ; Muscle Hypotonia ; Quadriplegia ; Respiratory Insufficiency ; Retrospective Studies ; Risk Factors ; Seizures ; Seoul ; Sepsis

Using 3D ultrasound, bilateral chylothorax was diagnosed antenatally in the second trimester. Apparently stable, bilateral pleural effusion progressed rapidly to severe hydrops with facial edema during observation, and then we decided bilateral pleural-amniotic shunt operation. Here we present a case where drainage of pleural effusion by a double reverse pig tail stent made by ourself was achieved, although placement of the thoracoamniotic shunt resulted in near complete drainage of bilateral pleural effusion with normalization of intrathoracic anatomic relationships, subsequent resolution of fetal hydrops, but the ultimate outcome was unsuccessful due to the internalization of one catheter and unknown sudden death. We think that ongoing research is required to further evaluation about complications associated with this procedure, specifically failure of function due to obstruction, migration of the catheter,
Catheters ; Chylothorax* ; Death, Sudden ; Drainage ; Edema ; Female ; Humans ; Hydrops Fetalis ; Pleural Effusion ; Pregnancy ; Pregnancy Trimester, Second ; Stents ; Tail ; Ultrasonography

Dural arteriovenous fistulas (AVFs) are uncommon, representing only 10% to 15% of all intracranial AVFs. Here we present the case of a patient with cerebral infarction who experienced a dural AVF after craniotomy for superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery. A 48-year-old man presented with dysarthria and right side hemiparesis. A brain magnetic resonance imaging scan revealed multiple acute infarctions and severe stenosis of the left MCA. Therefore, STA-MCA bypass surgery was performed. A follow-up angiography performed 2 weeks after the surgery showed an abnormal vascular channel from the left middle meningeal artery (MMA) to the middle meningeal vein (MMV) just anterior to the border of the craniotomy margin. This fistula originated from a screw used for cranial fixation. The screw injured the MMA and MMV, and this resulted in the formation of a fistula. The fistula was successfully treated with transarterial embolization. Surgeons should be careful when fixing bones with screws and plates as fistulas can develop if vessels are injured.
Angiography ; Brain ; Central Nervous System Vascular Malformations* ; Cerebral Infarction ; Cerebral Revascularization ; Constriction, Pathologic ; Craniotomy ; Dysarthria ; Fistula ; Follow-Up Studies ; Humans ; Infarction ; Magnetic Resonance Imaging ; Meningeal Arteries ; Middle Aged ; Middle Cerebral Artery* ; Paresis ; Temporal Arteries* ; Veins

OBJECTIVE: The ovine fetus responds to hemorrhage with a 10-20 fold increase in plasma erythropoietin (EPO) concentration at 24 hr and a return toward normal at 48 hr after the hemorrhage. The objective of the present study was more accurately to compare the magnitude and time course of the plasma EPO response after fetal hemorrhage. METHODS: Chronically catheterized, 12 of late gestation ovine fetus were gradually hemorrhaged 40% of their blood volume over 2 hr (1ml/min). Plasma was sampled for EPO concentration at 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24, 30, 36 hr after initiating the hemorrhage were collected at these times. Radioimmunoassay was used to measure plasma EPO concentrations. Analysis of variance was used for statistical analysis. RESULT: After a slow hemorrhage in the ovine fetus (1ml/min over 2hr), plasma EPO concentration increased significantly at 4hr (2.3 times basal values), reached a maximum at 16 hr (33.3 times basal values), and declined thereafter. CONCLUSION: We studied change in time course of the fetal plasma EPO after slow hemorrhage and recent studies have shown that the fetal kidney, liver and placenta express EPO mRNA. These observation suggest that plasma EPO increase may be mediated by a tissue specific up-regulation of EPO transcription in the fetal kidney, liver and placenta. We have studied change in Epo mRNA expression in various fetal tissue after slow haemorrhage.
Blood Volume ; Catheters ; Erythropoietin* ; Fetus ; Hemorrhage* ; Kidney ; Liver ; Placenta ; Plasma* ; Pregnancy ; Radioimmunoassay ; RNA, Messenger ; Sheep ; Up-Regulation