PURPOSE: To evaluate the long-term changes in cornea endothelial cell density (ECD) after pars plana vitrectomy (PPV) with fragmentation. METHODS: Twenty patients (20 eyes) who underwent PPV with fragmentation and who were followed up for 2 years were enrolled in this retrospective study. The cornea ECD, coefficient of variation (CV), and hexagonality (HA) were calculated using a specular microscopy at 1, 3, 6, 12 months, and 2 years after surgery. RESULTS: The preoperative mean ECD was 1,782 ± 623 cells/mm², and the postoperative mean ECD did not significantly change at 1, 3, 6, and 12 months. Additionally, there were no significant changes in CV or HA. At 2 years after surgery, the mean ECD was 1,722 ± 532 cells/mm², the mean CV was 35.50 ± 3.03%, and the mean HA was 53.00 ± 4.91%. There were no significant changes in ECD, CV, or HA preoperatively and postoperatively at 1, 3, 6, and 12 months. CONCLUSIONS: In this study, the mean ECD did not significantly decrease after PPV with fragmentation at 2 years after surgery. A PPV with fragmentation was an appropriate surgical procedure for patients with low cornea endothelial cell density.
Cornea ; Endothelial Cells* ; Humans ; Microscopy ; Retrospective Studies ; Vitrectomy*

The authors experienced a case of traumatic infarction of cerebellum and brain stem. The victim was 48-year-old woman and died after violence including head trauma. On admission, being unconscious, clinical diagnosis was cerebellar infarction of unknown cause. Autopsy showed severe subscalp hemorrhage and avulsion, cerebral edema, infarction of cerebellum and brain stem, and we also noted cervical spine fracture(C4) and Rt. vertebral artery occlusion by thrombus and dissection. There was no signs of trauma on the surface of the neck. We will describe the autopsy findings and clinical course of death.
Autopsy ; Brain Edema ; Brain Stem ; Cerebellum ; Craniocerebral Trauma ; Diagnosis ; Female ; Hemorrhage ; Humans ; Infarction* ; Middle Aged ; Neck ; Spine* ; Thrombosis ; Vertebral Artery* ; Violence

Herein, we report a case of tumorous endobronchial tuberculosis with successful recovery of atelectasis without any significant bronchial stricture, after repeated expectorations of nodular tissues. A 24-year-old male patient was presented with persistent cough. The patient was diagnosed to be suffering from tuberculous lymphadenitis on right axillar and mediastinum of lung, and was subsequently treated with antituberculosis agents. After two months, clinical deteriorations and atelectasis were observed on right upper lobe of lung. Multiple endobronchial tumorous lesions, which obstructed the right main bronchus, were revealed on bronchoscopy, and based on the endobronchial biopsy findings we confirmed that the patient was suffering from endobronchial tuberculosis. We decided to administer antituberculosis agents without any additional procedure. After few weeks, the patient spontaneously expectorated nodular tissues with vigorous coughing. Later on, the symptoms and atelectasis disappeared and the patient was completely recovered. This case shows that in patients suffering from tumorous endobronchial tuberculosis, endobronchial mass can be expectorated spontaneously without sequelae of significant bronchial stenosis.
Biopsy ; Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Cough ; Humans ; Lung ; Male ; Mediastinum ; Pulmonary Atelectasis ; Tuberculosis* ; Tuberculosis, Lymph Node ; Young Adult

BACKGROUND/AIMS: Eosinophilic gastroenteritis (EG) is an uncommon disease with various gastrointestinal symptoms characterized by eosinophilic infiltration. Its incidence increases recently. We investigated the clinicopathologic features of the patients with EG. METHODS: Between January 1970 and July 2003, a total of 28 cases of EG have been reported. By adding 3 cases diagnosed in the Eulji Hospital, we evaluated the 31 cases of EG for the symptoms, laboratory findings, histologic findings, method of treatment, and allergic history. RESULTS: The incidence increased during 1990s. The predominant site of the eosinophilic infiltration was mucosa in 10 cases, muscularis in 5 cases, and subserosa in 5 cases. The remaining 11 patients had the EG in two sites. The most frequently affected organ was small intestine (12 patients), but there were 12 cases which more than two organs involved. Melena and hematochezia were dominant findings in the patients whose infiltration occurred in mucosa. On the other hand, ascites was a dominant finding in the cases that infiltration occurred in subserosa or involving over 2 layers. There was no difference in eosinophilia, clinical symptoms, and duration between two groups according to the symptom duration for less or more than 30 days. Additionally, seven patients had allergc histories. Peripheral eosinophilia was found in 24 cases. There was no recurrence of EG after the treatment. CONCLUSIONS: Our retrospective studies about EG reported in Korea could not clarify whether EG is related to allergy. Recently, the occurrence of EG is increasing and it is frequently involved in young men. The most apparent finding include peripheral eosinophilia. There is no significant clinical feature which is consistent with Klein's classification, though blood loss was more common in mucosal type and ascites was more common in serosal type and in case above two layers.
Adolescent ; Adult ; Aged ; English Abstract ; Eosinophilia/complications/*diagnosis ; Female ; Gastroenteritis/complications/*diagnosis ; Humans ; Male ; Middle Aged

Pulmonary aspergilloma usually results from the ingrowths of the colonized Aspergillus in the damaged bronchial tree, pulmonary cyst or cavities of patients with underlying lung diseases. We experienced a case of endobronchial aspergilloma developed in a healthy female patient with asymptomatic collapse of right middle lobe (RML). She visited our clinic with intermittent hemoptysis for one year. The chest X-ray and HRCT showed severe collapse of the RML and multiple calcifications of peribronchial nodes around the proximal part of RML bronchus. Bronchoscopy revealed an aspergilloma in theorifice of the lateral segmental bronchus of RML. Patient had undergone RML and right lower lobe resection because of recurrent hemoptysis in spite of medical therapy. After surgery patient's symptoms were relieved. We present this unusual case with a review of the literature.
Aspergillosis ; Aspergillus ; Bronchi ; Bronchoscopy ; Colon ; Female ; Hemoptysis ; Humans ; Immunocompetence ; Lung Diseases ; Thorax

The most effective ways to salvage ischemic myocardium threatened by infarction is to restore tissue perfusion as rapidly as possible. These are best accomplished by restoration of coronary flow(reperfusion) by thrombolysis, percutaneous transluminal conronary angioplasty(PTCA), coronary arterial bypass graft (CABG), or cardiac transplantation. Reperfusion of an ischemic area may result however, in paradoxical cardiomyocytes dysfunction, a phenomenon termed" reperfusion injury". Reperfusion injury has been observed in each of above situations. The myocardium can tolerate brief periods (up to 15 minutes) of severe and even total myocardial ischemia without resultant myocardial death. With increasing duration and severity of ischemia, greater cardiomyocytes damage develop with spectrum of reperfusionassociated pathologies, collectively called reperfusion injury. Here, we report a case of a sixty two-yearold female woman who was suffered cardiac surgery(bivalvular replacement and CABG) and died soon after. Post-mortem examination have revealed typical cardiac reperfusion injury in the background of diffuse myocardial infarction. So, authors report this case with literatures reviews, because we think that this is very good case of cardiac reperfusion injury, confirmed histologically by post-mortem examination.
Autopsy ; Coronary Artery Bypass* ; Coronary Vessels* ; Female ; Heart ; Heart Transplantation ; Heart Valves* ; Humans ; Infarction ; Ischemia ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Reperfusion Injury* ; Myocardial Reperfusion* ; Myocardium ; Myocytes, Cardiac ; Pathology ; Perfusion ; Reperfusion ; Reperfusion Injury ; Transplants

BACKGROUND AND OBJECTIVES: Experimental protocols for remote ischemic conditioning (RIC) utilize models in which a tourniquet is placed around the hindlimb or effluent is collected from an isolated heart. In analyzing the humoral factors that act as signal transducers in these models, sampled blood can be influenced by systemic responses, while the effluent from an isolated heart might differ from that of the hindlimb. Thus, we designed a new isolated hindlimb model for RIC and tested whether the effluent from this model could affect ischemia/reperfusion (IR) injury and if the reperfusion injury salvage kinase (RISK) and survivor activating factor enhancement (SAFE) pathways are involved in RIC. MATERIALS AND METHODS: After positioning needles into the right iliac artery and vein of rats, Krebs-Henseleit buffer was perfused using a Langendorff apparatus, and effluent was collected. The RIC protocol consisted of 3 cycles of IR for 5 minutes. In the RIC effluent group, collected effluent was perfused in an isolated heart for 10 minutes before initiating IR injury. RESULTS: Compared with the control group, the infarct area in the RIC effluent group was significantly smaller (31.2%±3.8% vs. 20.6%±1.8%, p<0.050), while phosphorylation of signal transducer and activation of transcription-3 (STAT-3) was significantly increased. However, there was a trend of increased phosphorylation of extracellular signal-regulated kinase (ERK) 1/2 in this group. CONCLUSION: This is the first study to investigate the effect of effluent from a new isolated hindlimb model after RIC on IR injury in an isolated heart model. The RIC effluent was effective in reducing the IR injury, and the cardioprotective effect was associated with activation of the SAFE pathway.
Animals ; Heart* ; Hindlimb* ; Humans ; Iliac Artery ; Models, Animal ; Needles ; Phosphorylation ; Phosphotransferases ; Rats ; Reperfusion Injury ; Survivors ; Tourniquets ; Transducers ; Veins

BACKGROUND/AIMS: Acute intestinal obstruction is an urgent disease to be diagnosed and treated promptly. In elderly, fecal impaction may be an important and preventable cause of colonic obstruction. We investigated the clinical features of patients presenting with denical features of intestinal obstruction transiently due to fecal impaction. METHODS: From February 2001 to March 2004, nineteen patients were diagnosed as transient intestinal obstruction due to fecal impaction. We evaluated clinical characteristics, radiologic findings, sigmoidoscopic or colonoscopic findings and managements. RESULTS: Male and female ratio was 1:1.1. Mean age was 79.3 years. All 19 patients had abdominal pain and distension. On digital rectal examination, the hard feces was palpable in only 8 patients (42%) while others showed empty rectum. The abnormal laboratory findings included leukocytosis in 5 patients (26%), anemia in 10 patients (53%) and electrolyte abnormalities in 7 patients (37%). Simple abdominal X-rays showed diffuse small and/or large bowel dilatations. In only 3 patients (16%) air-fluid levels were definite, but most patients showed abundant feces in the rectum and colon. During emergency sigmoidoscopy, abdominal pain and distension were relieved and there were Bristol type 1 hard stool in the recto-sigmoid junction in 7 patients (37%) and multiple rectal ulcers in 1 patient. On colonoscopy, there were no mass or pathologic obstruction in all patients. Patients were discharged after the adequate medication and toilet training. CONCLUSIONS: In elderly patients, fecal impaction is odd and preventable cause of intestinal obstruction. It is often significant to differentiate fecal impaction from other pathologic conditions in patients with chronic constipation.
Aged ; Aged, 80 and over ; Fecal Impaction/*complications/diagnosis/therapy ; Female ; Humans ; Intestinal Obstruction/diagnosis/*etiology/therapy ; Male

BACKGROUNDS: The exacerbations of asthma and chronic obstructive pulmonary disease (COPD) have been suggested to be associated with respiratory tract viral infections (RTVIs). However, the rates of virus detection in previous studies have been quite variable, with lower rates for the exacerbation of COPD. Therefore, the virus detection of patients with exacerbation of asthma and COPD were investigated. METHODS: 20 and 24 patients with exacerbation of asthma and COPD, respectively, were enrolled. Nasal and sputum samples were taken, and polymerase chain reaction (PCR) for rhinovirus and coronavirus and virus culture for influenza A, B, RSV and parainfluenza virus performed. RESULTS: The mean FEV1/FVC in the exacerbation of asthma and COPD patients were 1.9/2.9 L (65.5%) and 1.1/2.6 L (42.3%), respectively. Respiratory virus was detected in 13 (65%) patients with exacerbation of asthma and rhinovirus was detected in 9. Coronavirus, influenza A, RSV and parainfluenza virus were detected in 2, 2, 1 and 1 patients with asthma. Among patients with exacerbation of COPD, a virus was detected in 14 (58.3%) patients, with rhinovirus, coronavirus and influenza A detected in 10, 3 and 4, respectively. CONCLUSIONS: This study suggested that RTVIs may have a role in the exacerbation of COPD as well as asthma.
Asthma* ; Coronavirus ; Humans ; Influenza, Human ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Pulmonary Disease, Chronic Obstructive* ; Respiratory System ; Rhinovirus ; Sputum

BACKGROUND AND OBJECTIVES: Chronic impairment of beta-adrenergic receptor signaling increases cardiac apoptosis, hypertrophy and fibrosis. The aim of this study was to investigate whether isoproterenol (ISO), an agonist of the adrenergic receptor, can enhance tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis in human embryonic kidney (HEK) 293 cells. MATERIALS AND METHODS: HEK 293 cells were treated with ISO and/or TRAIL for 24 hours. Cell viability was evaluated by microscopy and an established viability assay, and apoptotic cell death was analyzed by staining with fluorescein isothiocynate-annexin-V/propidium iodide (PI) and caspase activation. To confirm the mechanism of cell death induced by co-treatment with ISO and TRAIL, expression of TRAIL receptor 2 (death receptor 5, DR5) was evaluated by immunoblotting. RESULTS: Although ISO or TRAIL treatment decreased HEK 293 cell viability by 13% and 17%, respectively, co-treatment with ISO and TRAIL resulted in a markedly higher death rate of 35% after 24 hours. Increases were evident in early apoptotic cells (i.e., annexin-V positive/PI negative; 19.4%), late apoptotic cells (i.e., annexin-V positive/PI positive; 6.3%) and dead cells (i.e., annexin-V negative/PI positive; 1.1%) when cells were co-treated with ISO and TRAIL, compared to cells treated with either ISO or TRAIL. In addition, marked increases of cleaved cas-3, cleaved poly (adenosine diphosphate-ribose) polymerase and DR5 were observed in HEK 293 cells co-treated with ISO and TRAIL. CONCLUSION: Treatments combining ISO with TRAIL may be responsible for death of HEK 293 cells through DR5 up-regulation. Activation of adrenergic receptors is responsible for the synergistic cell death observed with TRAIL.
Apoptosis* ; Cell Death ; Cell Survival ; Fibrosis ; Fluorescein ; HEK293 Cells ; Humans* ; Hypertrophy ; Immunoblotting ; Isoproterenol* ; Kidney* ; Microscopy ; Mortality ; Necrosis* ; Receptors, Adrenergic ; Receptors, TNF-Related Apoptosis-Inducing Ligand* ; TNF-Related Apoptosis-Inducing Ligand ; Up-Regulation*