PURPOSE: The authors sought to determine the neuroprotective effect of melatonin in a model of ischemic injury in rabbit retina. METHODS: Ischemia was induced by high intraocualr pressure. A dose of 100 microgram of melatonin or dimethyl sulfoxide(DMSO) alone was injected intravitreally just after the induction of ischemia. After 7 and 14 days, the neuroprotective effect of melatonin on ischemic retina was examined with light microscope and transmission electron microscope. RESULTS: The authors found reduction of cytoplasm of retinal ganglion cell(RGC), vacuole formation, chromatin condensation and rupture of nuclear membrane in ischemia-injured eyes treated with DMSO alone. But in melatonin treated eyes, we found that RGC layer's thickness and number of RGC reduced and destruction of cytoplasmic organells and nuclear damage were minimal. The partial recovery of wave is noted in melatonin-treated eyes after ischemia induction. CONCLUSIONS: The melatonin(100 microgram) protected the rabbit retina from high intraocular pressure-induced ischemic injury when administered intravitreally. Melatonin may be useful to decrease neuronal damage in the retina as a result of ischemic injury. But further investigations are neccesary to decide effective concentration, route and time of administration.
Chromatin ; Cytoplasm ; Dimethyl Sulfoxide ; Ganglion Cysts ; Ischemia* ; Melatonin* ; Neurons ; Neuroprotective Agents* ; Nuclear Envelope ; Retina ; Retinaldehyde* ; Rupture ; Vacuoles

BACKGROUND: The past. studies on prediction formulas of pulmonary function parameters in healthy nonsmoking Korean adults have been performed in relatively small number of subjects and the reported results were restricted on a few parameters. Also there was no systematic investigation into the effect of smoking on pulmonary function parameters in smokers who have no respiratory symptoms. Therefore we attempted to establish prediction formulas of pulmonary function parameters and examined the effect of smoking on pulmonary function parameters. METHODS: We analyzed the result of parameters derived from the forced expiratory spirogram in 1,067 nonsmoking subjects from June in 1990 to December in 1991. They consisted of 306 males and 761 females and had neither respiratory symptoms nor history of respiratory disease. We derived prediction formulas by multiple linear regression method from their age, heights, and weights in each sex. To examine the effect of smoking on pulmonary function parameters, we classified 383 smoking men into three groups according to the past amount of smoking as follows : i.e. group of smokers who have smoked below 10 pack-years, 10-20 pack-years and above 20 pack-years. Regarding each group of past smoking as an independent dummy variable, we analyzed pulmonary function parameters including nonsmoking men as a baseline by multiple linear regression. We evaluated the smoking effect on pulmonary function parameters according to estimated p-value. RESULT: 1) Prediction formulas for pulmonary function parameters in each sex were derived. 2) The past smoking less than 10 pack-years does not give any effect on pulmonary function parameters. The past smoking of 10~20 pack-years showed significant negative correlation with FEV1/FVC and FEF 25~75%, and the smoking above 20 pack years showed negative correlation with FEV1 and FEV1/FVC. CONCLUSION: We have got prediction formulas of pulmonary function parameters which is driven from forced expiratory spirogram in nonsmoking Korean adults by multiple linear regression from age, heights and weights of subjects. The past smoking more than 10 pack-years showed negative correlation with some pulmonary function parameters of airflow obstruction.
Adult* ; Female ; Humans ; Linear Models ; Male ; Smoke* ; Smoking* ; Weights and Measures

PURPOSE: To evaluate the differences between IOLMaster(R) and A-scans in changes in axial length after vitrectomy in patients with macular disease. METHODS: Using IOLMaster(R) and A-scans, we measured preoperative and postoperative axial length in 12 eyes with epiretinal membranes (ERM) and in 8 eyes with macular holes (MH). The relationship between the absolute error in axial length after vitrectomy and both methods was assessed using Mann-Whitney U test. The correlation to central macular thickness was evaluated by Spearman's correlation coefficient. RESULTS: In eyes with ERM and MH, preoperative and postoperative axial lengths obtained with both methods had no significant difference (p>0.05). The absolute error in axial length after vitrectomy was not significant using IOLMaster(R) (ERM: 0.07+/-0.05 mm, MH: 0.04+/-0.02 mm, p>0.05) but was significant using A-scan (ERM: 0.20+/-0.11 mm, MH: 0.30+/-0.07 mm, p<0.05). The correlation between the change of axial length after vitrectomy and the central macular thickness was poor (IOLMaster(R): ERM; correlation coefficient = -0.182, p>0.05, MH; correlation coefficient = -0.054, p>0.05, A-scan: ERM; correlation coefficient = -0.210, p>0.05, MH; correlation coefficient = -0.156, p>0.05). CONCLUSIONS: The IOLMaster(R) is more useful than the A-scan when measuring axial length without refractive errors after vitrectomy in eyes with macular disease.
Epiretinal Membrane ; Eye ; Humans ; Refractive Errors ; Retinal Perforations ; Vitrectomy

PURPOSE: To evaluate the differences between IOLMaster(R) and A-scans in changes in axial length after vitrectomy in patients with macular disease. METHODS: Using IOLMaster(R) and A-scans, we measured preoperative and postoperative axial length in 12 eyes with epiretinal membranes (ERM) and in 8 eyes with macular holes (MH). The relationship between the absolute error in axial length after vitrectomy and both methods was assessed using Mann-Whitney U test. The correlation to central macular thickness was evaluated by Spearman's correlation coefficient. RESULTS: In eyes with ERM and MH, preoperative and postoperative axial lengths obtained with both methods had no significant difference (p>0.05). The absolute error in axial length after vitrectomy was not significant using IOLMaster(R) (ERM: 0.07+/-0.05 mm, MH: 0.04+/-0.02 mm, p>0.05) but was significant using A-scan (ERM: 0.20+/-0.11 mm, MH: 0.30+/-0.07 mm, p<0.05). The correlation between the change of axial length after vitrectomy and the central macular thickness was poor (IOLMaster(R): ERM; correlation coefficient = -0.182, p>0.05, MH; correlation coefficient = -0.054, p>0.05, A-scan: ERM; correlation coefficient = -0.210, p>0.05, MH; correlation coefficient = -0.156, p>0.05). CONCLUSIONS: The IOLMaster(R) is more useful than the A-scan when measuring axial length without refractive errors after vitrectomy in eyes with macular disease.
Epiretinal Membrane ; Eye ; Humans ; Refractive Errors ; Retinal Perforations ; Vitrectomy

Schwannoma is a benign encapsulated nerve sheath tumor and is histologically characterized by a mixture of Antoni type A and B tissue. A preoperative diagnosis of schwannoma by fine needle aspiration cytology or by any other means is important to preserve clinically important nerves. Therefore, it is necessary to make a specific cytological diagnosis of nerve sheath tumor. However, there are a few reports regarding cytological features of schwannoma in Korea. We experienced seven cases of solitary schwannoma and here we report their characteristic cytological features with a review of literatures. The characteristic features of schwannoma on cytology were the presence of both Antoni type A and B tissue. The cytologic findings common to all cases of schwannoma generally corresponded to the histologic findings of Antoni type A tissue, consisting of fragments of tightly cohesive fascicles with variable cellularity. Dense fibrillary substances were found, along with palisading nuclei and Verocay bodies. Individual tumor cells consisted of cohesive cells having spindle or oval nuclei, with pointed ends and indistinct cell borders. Variation in nuclear size and shape was also present. The Antoni type B consisted of scattered wavy or short spindle cells and some histiocytes and lymphocytes in the abundant myxoid background with formation of microcysts. Immunohistochemistry for S-100 protein revealed a uniformly strong positive reaction and was helpful to make more accurate diagnosis of schwannoma.
Hemangioma

PURPOSE: To evaluate the long-term results of intravitreal bevacizumab injection for macular edema (ME) due to retinal vein obstruction (RVO) and diabetic retinopathy (DR). METHODS: The objects of study were patients with decreased visual acuity due to ME with RVO and DR for whom intravitreal injections of 1.25 mg (0.05 ml) bevacizumab were repeated three times with an interval of six weeks and who were available for a follow-up period of more than 12 months. The patients underwent additional bevacizumab injections if ME increased as assessed by optical coherence tomography (OCT). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and follow-up visits. RESULTS: There were 16 patients with RVO and 18 patients with DR. In the RVO group, the mean length of follow-up was 12.4+/-1.1 months, the mean baseline BCVA was 0.75+/-0.32 and the final BCVA was 0.42+/-0.25, a difference that was statistically significant (p<0.05). The mean CMT at baseline was 588.5+/-301.0 microm and this decreased to a mean of 191.8+/-112.0 microm at the end of the follow-up period (p<0.05). In the DR group, the mean length of follow-up was 15.4+/-3.2 months, the mean baseline BCVA was 0.63+/-0.33 and the final BCVA was 0.61+/-0.37, a difference that was not statistically significant (p>0.05). The mean CMT at baseline was 462.0+/-195.0 microm and decreased to a mean of 282.2+/-177.3 microm at the end of the follow-up period (p<0.05). CONCLUSIONS: In RVO and DR, three injections of intravitreal bevacizumab with an interval of six weeks and additional injections as indicated were effective in reducing ME and showed especially good results in improvement of visual acuity for ME due to RVO.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Bevacizumab

No abstract available.
Lasers, Solid-State* ; Papilloma*

OBJECTIVES: The stress response involves the activation of the hypothalamic-pituitary-adrenal(HPA) axis and the sympathetic nervous system. Corticosteroids have been clearly demonstrated to cause anti-inflammatory and/or immnosuppressive effects in man including granulocytosis in part by decreasing migration into tissue, especially damaged tissues(myocardium), and circulating relative lymphocytopenia. To test whether automated measurements of the the increased serum cortisol-induced hematologic changes in the leukocyte differential significance or not in the initial differential diagnosis of acute myocardial infarction in acute chest pain syndromes. METHODS: 101 consecutive patients with myocardial infarction or myocardial ischemia presenting to the emergency room of Seoul Adventist Hospital with acute chest pain from January 1993 to August 1995(Retrospective group) and from December 1995 to March patients compatible with exclusion criteria in myocardial infarction were excluded. We measured automated leukocyte differential and serial CK-MB level in both groups, and the intial serum cortisol levels in prospective infarction group. RESULTS: 1) Total leukocyte and granulocyte counts were increased in acute myocardial infarction(p<0.01). 2) In acute myocardial infarction group, lymphocyte counts were slightly increased(p<0.05), but relative lymphocytes percentage more significantly decreased(p<0.01). 3) Serum cortisol levels are significantly raised early in the course of the acute myocardial infarction and prior to the elevation of the specific cardiac enzymes on the basis of analytic results of prospective infarction group. 4) Cortisol-induced changes in leukocyte differential were noted with time passes into reverse approximately 4 days later in our study. 5) The leukocyte differential does not shows significant changes in the retrospective myocardial ischemia group, so we arrive in careful conclusion that serum cortisol level seems does not increase. 6) No sexual differences were noted in leukocyte differential. CONCLUSIONS: The serum cortisol level and cortisol-induced leukocyte differential are helpful for initial differential diagnosis of acute myocardial infarction in acute chest pain sysdrome.
Adrenal Cortex Hormones ; Axis, Cervical Vertebra ; Chest Pain* ; Diagnosis, Differential* ; Emergency Service, Hospital ; Granulocytes ; Humans ; Hydrocortisone* ; Infarction ; Leukocytes* ; Lymphocyte Count ; Lymphocytes ; Lymphopenia ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Retrospective Studies ; Seoul ; Sympathetic Nervous System ; Thorax*

Genitourinary gangrene is an uncommon, potentially lethal disorder characterized by the abrupt onset of a rapidly progressive necrotizing soft tissue infection caused by the synergistic action of various organisms that spread along fascial planes, causing subfascial soft tissue necrosis and destruction. Many factors, debilitating condition such as carcinoma, diabetes and alcoholism, contribute to the development and perpetuate the course of Fournier's gangrene. In our two cases , predisposing causes were as follow ; chronic liver disease, diabetes mellitus, chronic alcoholism, perianal abscess. The patients were hemodynamically unstable and extensive necrosis was noted. After aggressive debridement of the wound and triple antibiotic therapy, general condition became improved and then we performed split thickness skin grafts and the results of reconstructive surgery were satisfactory.
Abscess ; Alcoholism ; Debridement ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Humans ; Liver Diseases ; Necrosis ; Skin ; Soft Tissue Infections ; Transplants ; Wounds and Injuries

This report describes a case of diffuse neurofibroma(DNF) that presented with spontaneous intratumoral hemorrhage. A 31-year-old man with cutaneous manifestations typical of neurofibromatosis type 1(NF1) was referred to hospital with a progressively expanding scalp swelling. Magnetic resonance imaging(MRI) showed an acute hematoma surrounded by a dense mass on the parietooccipital scalp. Plain skull radiographs and a computed tomography(CT) scan revealed bony defects in the occipital bone around the lambdoid suture and the skull base, including the sphenoid and petrous bones. The tumor extended to the upper cervical region and infiltrated through the fascia of the musculature. The tumor and adjacent soft tissue were highly vascular, which made surgical resection difficult. We describe the clinical, radiological and pathological features of this patient and discuss the surgical methods used to avoid a life-threatening hemorrhage during surgery.
Adult ; Fascia ; Hematoma ; Hemorrhage* ; Humans ; Neurofibroma* ; Neurofibromatoses ; Occipital Bone ; Petrous Bone ; Scalp ; Skull ; Skull Base ; Sutures