PURPOSE: There were many studies on the distributions of the retinal ganglion cells(RGC) in the experimental model of the retinal ischemia. RGC was known to be more sensitive to the ischemic injury than the other types of the retinal cells. So, we would identify the changes of the retinal ganglion cell morphologies and distribution after the iatrogenic retinal ischemia induced by intraocular pressure(IOP) elevation. METHODS: Eight pigmented and six white rabbits were used and retinal ischemia was induced by increasing IOP higher than 120 mmHg for 60 minutes. Electroretinogram were recorded at 6 days or 13 days, and histologic findings were observed at 7 or 14 days. RESULTS: After 7 days, RGC densities decreased, cytoplasmic staining disappeared, and the intranuclear hyperpigmentation was noted. RGC densities decreased significantly at 14 days. In the vertical retinal section, some flattening of retinal ganglion cell layer and inner plexiform layer was observed. Changes in the cellular morphologies were prominent. CONCLUSIONS: It may be more appropriate to examine both the retinal whole-mount and the vertical tissue section for the estimatation of the changes of retinal ganglion cell layer in the pressure-induced retinal ischemia.
Cytoplasm ; Ganglion Cysts* ; Hyperpigmentation ; Ischemia ; Models, Theoretical ; Rabbits ; Retina* ; Retinal Ganglion Cells ; Retinaldehyde*

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

Placental site nodules and plaques have been recently described to designated single or multiple, well-circumscribed, rounded lesions at the placental site, composed of viable or degenerating intermediate trophoblastic cells and extensive hyalinization between the cells. We described clinicopathologic findings of 14 cases of placental site nodules and plaques. The age of 14 patients ranged from 25 to 39(average 33) years and all of them had been pregnant in the past. Ten of them presented with vaginal spotting, which was preceded by recent pregnancy in only 3 cases. Three patients presented with secondary infertility and one with secondary infertility and vaginal spotting. Urine pregnancy tests were negative in all 14 cases at the time of presentation. Ultrasonographic examination disclosed abnormalities in only 3 cases and the remaining cases were normal. Hysterosalpingography was performed in 3 patients who presented with 2 degrees infertility and revealed moderate to severe intrauterine adhesions. Microscopically, chronic endometritis of varying degrees evidenced by plasma cells and eosinophiles were present in all cases and these were more prominent in the vicinity of the lesions. It is presumed that the placental site nodules and plaques are not sloughed at the time of menstruation and it may cause chronic endometritis or intrauterine adhesions at any time after previous delivery.
Pregnancy ; Female ; Humans

PURPOSE: We examined the ability of alpha-phenyl-tert-butyl-nitrone (PBN), an electron spin trapper, to determine the neuroprotective effect in the argon laser induced ischemic rat retina model. METHODS: After ischemic condition of rat retina was induced by argon green laser, PBN was given intraperitoneally at 50 or 100 mg/kg and normal saline was injected to control group. After 24 hours, 48 hours, and 7 days, the neuroprotective effect of PBN was examined by electroretinogram (ERG) and after 7 days, the enucleation of eyes was performed and histologic findings were compared by light microscopy and transmission electron microscopy. RESULTS: We found relatively reduced amplitude of ERG wave in the PBN injected group but not so greatly reduced as in normal saline control group. The retinal ganglion cell (RGC) layer and the number of RGCs were affected by acute ischemic changes but in the group of PBN treatment, the cell membrane was well preserved and vecuoles formation, cytoplasmic destructions, nuclear chromatin condensation were reduced. CONCLUSIONS: Systemic administration of PBN can ameliorate an argon laser induced retinal ischemia. Further investigations are necessary to decide effective dose without toxicity and to find more convenient methods of administrations.
Animals ; Argon* ; Cell Membrane ; Chromatin ; Cytoplasm ; Ischemia* ; Microscopy ; Microscopy, Electron, Transmission ; Neuroprotective Agents* ; Rats ; Retina ; Retinal Ganglion Cells ; Retinaldehyde*

A 42-year-old male was hospitalized with abdominal pain, dyspnea, and turbid peritoneal fluid. He was diagnosed with hypertension, diabetes and started continuous ambulatory peritoneal dialysis (CAPD) 11 months ago. He was treated with intraperitoneal cefazolin and ceftazidime, and then white blood cell counts of dialysate decreased. Incidentally, liver abscess was found in chest CT performed for the evaluation of dyspnea, and patient was febrile persistently. So percutaneous abscess drainage was done by pigtail catheter. We changed the antibiotics to ceftriaxone and metronidazole, and hemodialysis was started. Klebsiella pneumoniae was cultured from peritoneal fluid and blood simultaneously. We concluded that liver abscess is a primary cause of CAPD peritonitis.
Abdominal Pain ; Abscess ; Adult ; Anti-Bacterial Agents ; Ascitic Fluid ; Catheters ; Cefazolin ; Ceftazidime ; Ceftriaxone ; Drainage ; Dyspnea ; Humans ; Hypertension ; Klebsiella ; Klebsiella pneumoniae ; Leukocyte Count ; Liver ; Liver Abscess ; Male ; Metronidazole ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis ; Thorax

Endoscopic sympathicotomy is the choice of the treatment for hyperhidrosis. There are some recognized risks such as Honer's syndrome and Hemopneumothorax; however, Chylothorax has very rarely been reported after thoracic sympathicotomy. We recently encountered a case of chylothorax. Early diagnosis and prompt treatment is noteworthy.
Chylothorax* ; Early Diagnosis ; Hemopneumothorax ; Hyperhidrosis

No abstract available.
Pancytopenia*

PURPOSE: Epiretinal membrane in proliferative vitreoretinopathy (PVR) may cause tractional retinal detachment after vitreoretinal surgery. It has been thought that the proliferative membrane is mainly composed of choroidal fibroblasts and retinal pigment epithelial cells. Inspite of the technical advances, the treatment of PVR is still difficult. Therefore, the need for phamarcologic treatment of proliferative vitreoretinopathy is increasing. METHODS: In vitro models of proliferative vitreoretinopathy allow to identify the factors which may inhibit proliferation and contraction of collagen matrix by choroidal fibroblast and retinal pigment epithelial cells. Cultured choroidal fibroblasts and the RPE cells were plated to the collagen matrix and antiproliferative drugs was tested. RESULTS: Each antiproliferative drug showed the inhibition of collagen matrix contraction at following concentration: colchicine(0.1 microgram/ml), puromycin(1~10 microgram/ml), cytochalasin B(0.05 microgram/ml). Transmission electron micrograph of collagen matrices showed dense collagen fibers surrounding choroidal fibroblast and fine collagen fibers surrounding RPE cell. Scanning electron micrograph of collagen matrices contaning colchicine, puromycin, or cytochalasin B showed that collagen fibers were well preserved without distortion. All collagen matrices containing RPE cells showed more fine collagen fibers than those containing choroidal fibroblasts. CONCLUSION: Colchicine, puromycin, cytochalasin B showed inhibitory effect on cell mediated contraction in addition to potent antiproliferative effect. Retinal pigment epithelial cell played less significant role in causing PVR than choroidal fibroblast.
Choroid* ; Colchicine ; Collagen* ; Cytochalasin B ; Epiretinal Membrane ; Epithelial Cells* ; Fibroblasts* ; Membranes ; Puromycin ; Retinal Detachment ; Retinaldehyde* ; Traction ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

There is still lack of a convinient system that connect referring physicians to the information system of referral hospitals, We proposed to develop the laboratory-information-accessing system(LISA) for physicians referred to AMC referral center with Web-based internet technology. We constructed the menu of AMC Referral Center as a part of Asan Medical Center(AMC) homepage. The information of the referred patients wee collected in the separate internal server and then transferred to the external network sever by a batch. Referring physicians was able to connect to AMC Referral Center via AMC homepage and then browse the list of their patients by putting their identification number and password. At the next, the physicians chose the patients and the test item to be displayed. In order that the referral system is established tin the medical part, the LISA world be more needed, in the society, which internet is getting popular. This LISA was introduced successfully now, and it could be a model of national standard for hospital information system.
Chungcheongnam-do ; Clinical Laboratory Information Systems ; Hospital Information Systems ; Humans ; Information Systems ; Internet ; Referral and Consultation ; Tin

BACKGROUND/AIMS: The number of elderly individuals continues to increase, as does the incidence of acute kidney injury (AKI). There are few data concerning the clinical features and prognosis in AKI in the elderly in Korea. METHODS: Patients over 80 years old admitted to our hospital with a diagnosis of AKI between January 2004 and December 2005 were evaluated. Etiology, clinical, and prognostic variables were analyzed. RESULTS: The mean age was 82.6+/-2.2 years. The cause of AKI was dehydration (37.1%), infection (33.9%), bleeding (8.1%), contrast material (4.8%), drugs (4.8%), obstruction (3.2%), cardiogenic shock (3.2%), renal infarction (1.6%), rhabdomyolysis (1.6%), and hepatorenal syndrome (1.6%). The mortality rate was 29.0% and the major cause of death was pneumonia (50.0%). Based on the univariate analyses, albumin, serum sodium, number of failing organs, ventilatory support, need for a vasopressor, ICU care, sepsis, and infection were all significant factors discriminating between survivors and non-survivors (p<0.05). CONCLUSIONS: AKI in the elderly is not a different entity from that encountered in other age groups and age alone should never be a drawback to appropriate therapy.
Acute Kidney Injury ; Aged ; Aged, 80 and over ; Cause of Death ; Dehydration ; Hemorrhage ; Hepatorenal Syndrome ; Humans ; Incidence ; Infarction ; Korea ; Pneumonia ; Prognosis ; Rhabdomyolysis ; Sepsis ; Serum Albumin ; Shock, Cardiogenic ; Sodium ; Survivors