Normal C3WHeN strain mice exposed to topical 8inethoxypsomlen plus long wave ultraviolet (PUVA) showed a reduction in contact hypersensitivity, (CH) which was localized to the skin in the area of PUVA treatment (local suppression), whereas systemic PUVA treatment caused diffuse suppression of CH reaction, regardless of the application site of 2,4-dinitro-1-fluorobenzene (DNFB). There seem to be two different mechanisms responsible for CH reduction by PUVA. Local suppression by topical PUVA treatment was thought to be a result of blocking the afferent phase of immune response, it was associated with a lack of CH effector cells in the peripheral lymph nodes and could not be reversed by indomethacin treatment. Diffuse suppression induced by systemic PUVA treatment seemed to be associated with blocking of egress of effector cells from the regional lymph nodes, this depressed CH response was prevented when indomethacin was administered before PUVA treatment.
Animals ; Dermatitis, Contact* ; Indomethacin ; Lymph Nodes ; Mice ; Skin

The pathological changes of the gastric rumen produced by rocking stress in 38 young male albino rats fed on low protein diet for a short period and in 20 young male albino rats fed on low protein diet only as the control rats, were investigated macroscopically and histologically. The ulcerative lesions of the gastric rumen were observed in 17 out of 38 experimental rats accompanied with hyperplasia and cornification of the ruminal epithelial layer and more or less edematous changes of the tunica propria near the ulcer site. The authors, finding of the ruminal ulcer in albino rats produced by rocking stress associated with feeding on a low protein diet for a short period were compared with the results of others. The authors discussed other opinions concerning of the gastric ruminal ulcer of the albino rats produced in various ways.
Animal ; Male ; Protein Deficiency/complications* ; Rats ; Rumen* ; Stomach Ulcer/etiology* ; Stomach Ulcer/pathology ; Stress*

Since the first report by Tansini in 1896, the latissimus dorsi muscle free flap has been widely used for various types of soft tissue defect due to reliable anatomy with a sufficient diameter of neurovascular pedicle and a sizable muscle. However, for relatively small soft tissue defect, latissimus dorsi free flap offers several distinct disadvantages of donor site including loss of the posterior axillary fold and flattening of the posterolateral chest wall, weakness of upper arm strength in extension, adduction and internal rotation. We treated three patients having various types of soft tissue defect using segmental latissimus dorsi muscular free flap depending on its descending branch of thoracodorsal neurovascular pedicles. There were no serious complications during 18 months of mean follow-up. We concluded that this method has some advantages such as no weakness of strength of the upper arm including walking on crutches, preserving the posterior axillary fold, preventing winging of the scapula and increased chance of using a flow-through technique. Here we present our cases of reconstruction of soft tissue defect using segmental latissimus dorsi free flap with a review of the literature.
Arm ; Crutches ; Follow-Up Studies ; Free Tissue Flaps* ; Humans ; Scapula ; Superficial Back Muscles* ; Thoracic Wall ; Tissue Donors ; Walking

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.
Adult ; Arteries ; Arteriovenous Fistula* ; Cardiomegaly ; Dyspnea ; Edema ; Fistula ; Heart Failure ; Heart Sounds ; Humans ; Lower Extremity ; Pleural Effusion ; Rare Diseases ; Ribs* ; Subclavian Artery* ; Thorax

PURPOSE: To investigate the relationship between optical coherence tomography (OCT) and scanning laser polarimetry (SLP) in measuring peripapillary retinal nerve fiber layer (RNFL) thickness in glaucomatous eyes. METHODS: Fifty glaucomatous eyes were evaluated in this study. Evaluations were analyzed two ways. First, parameters of the Stratus OCT (average thickness, superior/ inferior average) and GDx VCC (TSNIT average, nerve fiber indicator (NFI), superior/ inferior average) were correlated using the Pearson's correlation coefficient (r). Secondly, comparison (r) of these parameters was completed using the mean deviation (MD) of visual field defect. RESULTS: The following parameters were found to be significantly correlated (P<0.005). TSNIT average/average thickness (r=0.673), NFI/average thickness (r=-0.742), superior average (r=0.841), and inferior average (r=0.736). In the correlation analysis using the severity of visual field defect, all these parameters had statistically meaningful correlations (P<0.005). CONCLUSIONS: GDx VCC and Stratus OCT are highly correlated in glaucomatous eyes. Therefore, peripapillary RNFL thickness measured by Stratus OCT and GDx VCC may be equally helpful in the diagnosis of glaucoma.
Tomography, Optical Coherence/*methods ; Severity of Illness Index ; Retina/*pathology ; Reproducibility of Results ; Middle Aged ; Male ; Laser Scanning Cytometry/*methods ; Humans ; Glaucoma/*pathology ; Female ; Aged, 80 and over ; Aged ; Adult

PURPOSE: The use of pre- and intraoperative vitreous bevacizumab injection and combined lens extraction with vitrectomy in patients with proliferative diabetic retinopathy (PDR) is increasing. In this study we analyzed the incidence and risk factors of neovascular glaucoma (NVG) after vitrectomy for PDR. METHODS: Patients who underwent vitrectomy for PDR from January 2004 to June 2011 were retrospectively reviewed. The minimum follow-up was 12 months. The cumulative incidence of NVG was calculated using the Kaplan-Meier survival analysis. The patients were divided into 4 groups according to lens status (preoperative pseudophakic group, simultaneous cataract surgery group, sequential cataract surgery group, non-cataract surgery group). The differences in incidence between the groups were determined by the Chi-square test. Finally, to analyze the risk factors associated with the occurrence of NVG, the Cox's regression model was used. RESULTS: Of the 614 eyes (402 patients), 284 were males and 330 were females. The mean age was 55.8 +/- 10.46 years (range 30-81 years) and the mean follow-up period was 36.6 months (range 1-93 months). Thirty-four of 614 patients (5.5%) developed postoperative NVG after vitrectomy. The probability of NVG occurrence at 6 and 12 months after vitrectomy was 0.7% and 2.5%, respectively. The incidence between the 4 groups did not show a statistically significant difference. The risk factors for postoperative NVG were male gender (RR = 3.01 p = 0.004), preoperative intravitreal bevacizumab injection (RR = 7.20, p < 0.001), and reoperation (RR = 3.18, p = 0.0037). CONCLUSIONS: The frequency of NVG after vitrectomy in patients with PDR was 5.5%. Lens status was not associated with NVG occurrence. The risk factors related to NVG were male gender, preoperative intravitreal bevacizumab injection, and reoperation.
Cataract ; Diabetic Retinopathy* ; Female ; Follow-Up Studies ; Glaucoma, Neovascular* ; Humans ; Incidence ; Male ; Phacoemulsification ; Reoperation ; Retrospective Studies ; Risk Factors* ; Vitrectomy* ; Bevacizumab

PURPOSE: To report a case of supratarsal injection of triamcinolone for the management of chronic, steroid-dependent Thygeson's superficial punctate keratitis. CASE SUMMARY: A 37-years-old woman complained of redness, photophobia, and tearing in both eyes, which lasted for 6 years. The slit lamp examination revealed multiple intraepithelial and subepithelial, punctated corneal lesions which were elevated and scattered diffusely upon staining with fluorescein dye in both eyes. The patient was diagnosed with Thygeson's superficial punctate keratitis and treated with 0.1% fluorometholone, 0.05% cyclosporin, and 0.15% ganciclovir in both eyes. After 10 months of follow-up, recurrences were reported twice in the right eye, and 7 times in the left eye. The patient was treated with a supratarsal injection of triamcilonone in both eyes and after injection, the patient was treated only with artificial tears. Four months later, the patient did not complain of any symptoms and her cornea was clear. CONCLUSIONS: A supratarsal injection of triamcinolone may be an effective method to prevent recurrence of chronic, steroid-dependent Thygeson's superficial punctate keratitis.
Cornea ; Cyclosporine ; Eye ; Female ; Fluorescein ; Fluorometholone ; Follow-Up Studies ; Ganciclovir ; Humans ; Keratitis ; Ophthalmic Solutions ; Photophobia ; Recurrence ; Tears ; Triamcinolone

PURPOSE: To evaluate the diagnostic outcomes of patients suspicious for glaucoma referred from the company health screening. METHODS: In this prospective study, 147 (87 male, 60 female) patients for glaucoma suspicious referred from the company health screening were enrolled. They underwent slit-lamp examination, Goldmann applanation tonometry, gonioscopy, optic disc examination, visual field examination and peripapillary retinal nerve fiber layer (RNFL) thickness measurement using optical coherence tomography (StratusOCT) and scanning laser polarimetry (GDx VCC). We analyzed their diagnostic outcomes. RESULTS: The mean age of patients was 43.8 9.6 years. Reasons for glaucoma suspicion and the number of referred patients were 111 (75.5%) high cup/disc ratio, 23 (15.6%) high intraocular pressure and 13 (8.8%) both of these. The diagnostic outcome was as follows: glaucoma, 26 (17.7%); glaucoma suspect, 4 (2.7%); ocular hypertension (OHT), 14 (9.5%); no glaucoma and no ocular hypertension, 89 (60.5%); and normal, 18 (12.2%). CONCLUSIONS: Glaucoma, glaucoma suspect and ocular hypertension were confirmed in 27.2% of patients suspicious for glaucoma referred from the company health screening. Thus, the company health screening appears to be relatively sensitive to detecting glaucoma patients.
Glaucoma* ; Gonioscopy ; Humans ; Intraocular Pressure ; Male ; Manometry ; Mass Screening* ; Nerve Fibers ; Ocular Hypertension ; Prospective Studies ; Referral and Consultation ; Retinaldehyde ; Scanning Laser Polarimetry ; Tomography, Optical Coherence ; Visual Fields

Vascular injuries in lumbar disc surgery are serious complications which may be overlooked due to a broad range of clinical manifestations. It is important to be aware of the perioperative implications of this rare occurrence to lower mortality risk. A 20-yr-old man with a right L4-5 lumbar disc protrusion was operated on routinely under a surgical microscope. A bloody surgical field was noted temporarily during a discectomy along with a decreased blood pressure. After fluid resuscitation with an ephedrine injection, the bleeding soon stopped spontaneously and his vital signs were stabilized. Fifty hours after the operation, the patient showed signs of hypovolemic hypotension with abdominal distension. The right femoral artery pulsation was absent on palpation. An enhanced CT angiography revealed a retroperitoneal hematoma and obstruction of the left common iliac artery. An urgent laparotomy was done to repair the injured vessel by excision and interposition of a graft. The patient had an uneventful recovery.The subacute course of deterioration might have been due to intermittent blood leakage from the lacerated common iliac artery, which was sealed spontaneously. It is very important to pay close attention to post-surgical clinical manifestations to avoid a potentially fatal outcome in lumbar disc surgery.
Angiography ; Diskectomy/*adverse effects ; Hematoma/etiology ; Humans ; Iliac Artery/*injuries ; Intervertebral Disc ; Lacerations/*etiology ; Lumbar Vertebrae/*surgery ; Male ; Tomography, X-Ray Computed ; Young Adult

Down syndrome is perhaps the most common genetic condition associated with mental retardation. In cytogenetic examination, trisomy 21 is in 95% of Down syndrome, and the others are mosaicism, translocation or deletion. There are many associated diseases with Down syndrome such as, thyroid function abnormality, congenital heart disease, intestinal blockage, and so on. Hypothyroidism appeared in 15% before adolescent in Down syndrome patients. In Korea, there were several reports of Down syndrome with hypothyroidism in childhood but not in adulthood. And we had three cases of hypothyroidism with Down syndrome in adulthood. Cytogenetic examination revealed trisomy 21 in the 2 cases and 1 case of mosaicism. Antithyroid antibody was positive in one case. None of these cases was admitted due to symptoms of hypothyroidism. It is very difficult to make the diagnosis of hypothyroidism in Down syndrome because of similarity in symptoms between Down syndrome and hypothyroidism. Thus, periodic thyroid function test should be made in Down syndrome, and this could be a part of improving quality of life in Down syndrome.
Adolescent ; Adult* ; Congenital Abnormalities ; Cytogenetics ; Diagnosis ; Down Syndrome* ; Heart Diseases ; Humans ; Hypothyroidism* ; Intellectual Disability ; Korea ; Mosaicism ; Quality of Life ; Thyroid Function Tests ; Thyroid Gland