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*

No abstract available.
Aspergillosis*

BACKGROUND: Cardiovascular injury is a potentially fatal complication of blunt chest trauma. The diagnosis of cardiovascular injury in blunt chest trauma is not easy because of concomittent injuries of thoracic cage or lungs and early death from cardiovascular injury. Diagnostic tools such as electrocardiography or cardiac enzyme studies are not specific to cardiovascular injury. Two-demensional echocardiography can visualize anatomic and functional disturbances from cardiovascular injuries in patients with blunt chest trauma. Purpose: This study was designed to evaluate the usefulness of echocardiography in detecting cardiovascular injury of patients with blunt chest trauma. METHODS: We performed echocardiography for detecting cardiovascular injury in 151 patients with significant blunt chest trauma including sternal fracture, multiple rib fractures or pulmonary contusion. Echocardiography was performed within 6 hours since patient arrived emergency department. Electrocardiography was traced on arrival and 24 hours after admission. Serial determinations of cardiac enzymes including MB fraction of creatinine phosphokinase were also performed every 8 hours after admission. RESULTS: 37(25%) patients had echocardiographic evidences of cardiovascular injury. Abnormal echocardiographic findings were 10 pericardial effusion, 9 regional wall motion abnormality(RWMA) outright ventricle, 5 aortic injuries, 4 reduced left ventricular ejection fraction, 3 RWMA of left ventricle, 2 right ventricular dilatation, 2 valve injuries, and 2 other cardiovascular injuries. Electrocardiographic abnormalities were associated with echocardiographic findings. However, CK-MB/CK ratio was not associated with echocardiographic findings. Significant proportion(65%) of patients with abnormal echocardiographic findings needed cardiovascular management during hospital stay. CONCLUSION: Two-dimensional echocardiography is useful for detecting cardiovascular injury. Echocardiographic abnormality in blunt chest trauma is associated with high probability of need of cardiovascular management.
Contusions ; Creatinine ; Diagnosis* ; Dilatation ; Echocardiography* ; Electrocardiography ; Emergency Service, Hospital ; Heart Ventricles ; Humans ; Length of Stay ; Lung ; Pericardial Effusion ; Rib Fractures ; Stroke Volume ; Thorax*

We perfomed pars plana vitrectomy together with soft tipped extrusion needle and 23 gauge bent needle. After vitrectomy in 14 eyes of 11 patients of macular cyst, we observed visual acuity and progression of macular cyst to macular hole during follow-up period(average 27.4 months). In 10 out of 14 eyes(71%) visual acuity was improved, in 4 eyes(29%) visual acuity revealed no change. However in all 14 eyes decreaced vision after surgery was not observed. None of 14 eyes have progressed to macular hole during the follow-up period.
Follow-Up Studies ; Humans ; Needles ; Retinal Perforations ; Visual Acuity ; Vitrectomy*

No abstract available.
Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic*

Heat disorders are not uncommon in the military society due to supposedly hard training to overcome the environmental conditions. Twenty-two soldiers with heat disorders were admitted to Chin Hae Naval Hospital June 1969 through July 1970. Hoping that our clinical studies on them contribute to a renewed understanding, the results are reported in summary as follows: 1) Heat disorders occurred with an overall incidence of 3.1 per cent during running in early summer. 2) Of the twenty-two patients, eight (37 per cent) had heat cramps, six (27 per cent) heat exhaustion, five(23 per cent) heat stroke, and three(13 per cent) had undetermined disorder. 3) Ten patients(45 per cent) were comatous, and this occurred most frequently(80 per cent) among those with heat stroke. 4) All patients were grouped into four according to their physical status on admission. Those with heat exhaustion mostly belonged to group I (good) or group II (fair). Those with heat stroke and heat cramps eomprised most of group III (poor) and group IV (grave). 5) Group I and II patients recovered within 12 hours; group III, within 12~24 hours; and group IV, required more than 24 hours of care. 6) One patient with heat stroke, graded V, expired with sudden hypothermia 15 hours following admission. Overall mortality of heat disorders was 4.5 per cent, and that of heat stroke 20 per cent. 7) The rest recovered uneventfully within 19 hours of average.
Chin ; Emergencies* ; Heat Exhaustion ; Heat Stress Disorders ; Heat Stroke ; Hope ; Hot Temperature* ; Humans ; Hypothermia ; Incidence ; Military Personnel ; Mortality ; Running

BACKGROUND AND PURPOSE: The purpose of this study is to compare two clinical predictive rules, the pre-arrestmorbidity(PAM) index and the prognosis-after-resuscitation(PAR) score, which predict failure to survive following in-hospital cardiopulmonary resuscitation(CPR). METHOD: The study population consisted of 162 consecutive adult patients who underwent CPR at Wonju Christian Hospital over a year period. The PAM index and PAR score were calculated from the most recent data available for each variable prior to cardiac arrest. Each predictive tool was compared between the group of discharge alive and the group of in-hospital mortality. Performance of the predictive scores was also compared by receiver-operating characteristic(ROC) curves where appropriate. RESULTS: PAM index of study population was 4.39+/-2.69 and PAR score was 2.99+/-3.36. PAM index in the group of discharge alive was 1.87+/-2.79, and PAM index in the group of ih-hospital mortality was 4.51+/-2.62. PAR score in the group of discharge alive was 0.75+/-1.75, and PAR score in the group of in-hospital mortality was 3.1+/-3.4. The PAM index identified 15 patients with a score>8, while the PAR score identified 39 patients with a score>4, none of whom survived. The sensitivity of the PAR score for the prediction of failure to survive was 25%, while that of the PAM index was 10%; neither index incorrectly identified a patient as a non-survivor who eventually survived. Both of predictive methods were not significantly different in the ROC curve. CONCLUSION: Although further confirmation is necessary, PAM index and PAR score may provide useful prognostic information to physicians and patients involved with decisions about do-no- resuscitate orders.
Adult ; Cardiopulmonary Resuscitation* ; Gangwon-do ; Heart Arrest ; Hospital Mortality ; Humans ; Mortality ; ROC Curve

The classification, size and activity of choroidal neovascularization (CNV) by optical coherence tomography (OCT) were compared with those obtained by fluorescein angiography (FA) and Indocyanine green angiography (ICG). This study included 32 patients (32 eyes) diagnosed as having CNV. The etiology of CNV was found to be age-related macular degeneration (AMD) or non-AMD. Patients were studied retrospectively by FA, ICG, and OCT. Of the 13 eyes with AMD, the boundary of the lesion could not be defined using FA in 7 patients. Among the 7 poorly defined CNV cases by FA, the identification of the boundary was possible in one case by OCT. The mean diameter of the classic well-defined lesions was 3500 +/- 421 micrometer by FA, 2624 +/- 1044 micrometer by ICG, and 1927 +/- 1272 micrometer by OCT. The size of the CNV by OCT was always smaller than by FA or ICG. Of the 19 eyes with Non-AMD, the boundary of the lesion could not be defined by FA in 5 patients. Among the 5 poorly defined cases by FA, the identification of the boundary was possible in 3 cases by OCT. The mean diameter of the well-defined CNV lesions was 2153 +/- 759 micrometer by FA, 1929 +/- 673 micrometer by ICG, and 1322 +/- 566 micrometer by OCT. Retinal thickness, which represents retinal edema, was found to be proportional to lesion size, although the relationship was not statistically significant. Regardless of CNV type, FA, ICG and OCT used in combination increase the specificity of diagnosis if their findings are compared.
Adult ; Aged ; Choroidal Neovascularization/*diagnosis/pathology ; Female ; Fluorescein Angiography ; Human ; Indocyanine Green/diagnostic use ; Male ; Middle Aged ; Retrospective Studies ; *Tomography, Optical Coherence

BACKGROUND: Septic shock is characterized by an abnormal vascular tone that has been related to various factors. Myocardial depression can also occur in septic shock. Various experimental studies have indicated that the myocardial depression could be present early in the course of septic shock. This study aimed to assess hemodynamic characteristics according to outcome of septic shock in emergency department. METHOD: The study population comprised 20 patients admitted to our emergency department for septic shock. All patients with septic shock(prolonged hypotension, signs of tissue hypoperfusion, signs of sepsis, suspected source of infection, or documented bacteremia) had conventional serial hemodynamic evaluations in emergency department to identify early hemodynamic variables that predicted outcome. All patients were monitored with a pulmonary artery catheter and an arterial catheter. Hemodynamic measurements and oxygen profile were obtained. RESULTS: There were 9(53%) survivors and 8(47%) nonsurvivors. There were no significant differences in systolic pressure, pulse rate, mean pulmonary artery pressure, pulmonary capillary wedge pressure, systemic vascular resistance index, and pulmonary vascular resistance index between survivors and nonsurvivors at initial hemodynamic value. However, significant differences were found in cardiac index(4.3+/-0.5 vs. 2.74+/-0.7 L/min/m2), stroke volume index(44+/-10 vs. 23+/-5 ml/beat/m2), left ventricular stroke work index(39+/-11 vs. 15+/-6 gm m/m2), and right ventricular stroke work index(8.1+/-3.0 vs. 5.2+/-2.9 gm m/m2) between survivors and nonsurvivors at initial hemodynamic value. CONCLUSION: Survivors had better myocardial function than nonsurvivors during the early phase of septic shock. This results suggest that myocardial depression during septic shock develops in the early course of septic shock, which is associated with outcome.
Blood Pressure ; Catheters ; Depression ; Emergencies* ; Emergency Service, Hospital* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Oxygen ; Prognosis* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Sepsis ; Shock, Septic* ; Stroke ; Stroke Volume ; Survivors ; Vascular Resistance

STATEMENT OF PROBLEM: Higher incidence of prosthetic complications such as screw loosening, screw fracture has been reported for posterior single tooth implant. So, there is ongoing research regarding stability of implant-abutment interface. One of those research is increasing the implant diameter and prosthetic table width to improve joint stability. In another part of this research, internal conical type implant-abutment interface was developed and reported joint strength is higher than traditional external hex interface. Purpose. The purpose of this study is to compare stress distribution in single molar implant between external hex butt joint implant and internal conical joint implant when increasing the implant diameter and prosthetic table width : 4mm diameter, 5mm diameter, 5mm diameter/6mm prosthetic table width. MATERIAL AND METHOD: Non-linear finite element models were created and the 3-dimensional finite element analysis was performed to see the distribution of stress when 300N static loading was applied to model at 0., 15., 30.off-axis angle. RESULTS: The following results were obtained: 1. Internal conical joint showed lower tensile stress value than that of external hex butt joint. 2. When off-axis loading was applied, internal conical joint showed more effective stress distribution than external hex butt joint. 3. External hex butt joint showed lower tensile stress value when the implant diameter was increased. 4. Internal conical joint showed lower tensile stress value than external hex butt joint when the implant diameter was increased. 5. Both of these joint mechanism showed lower tensile stress value when the prosthetic table width was increased. CONCLUSION: Internal conical joint showed more effective stress distribution than external hex joint. Increasing implant diameter showed more effective stress distribution than increasing prosthetic table width.
Incidence