Morphologic Changes of the Inferior Turbinate after Total Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The cessation of airflow in nasal cavity after total laryngectomy could influence the function and morphology of the nasal mucosa. The effect on human nasal mucosa after total laryngectomy was investigated with endoscopic photographs and biopsies. SUBJECTS AND METHOD: Twenty-two laryngectomees were studied and compared with 15 normal controls. Inferior turbinate was checked with 0 degree endoscopic photographs, and the RGB (Red, Green, Blue) scale was analysed by a histogram of adobe photoshop 6.0. In thirteen patients, inferior turbinate mucosa was taken for microscopic examination. RESULTS: The difference of RGB scale between laryngectomees and normal control was statistically significant with the exception of the Red. Furthermore, the anterior part of the inferior turbinate was found to consist of ciliated columnar epitheliums which contained goblet cells. CONCLUSION: This study implicates that the stimulation of nasal airflow affects the function and morphology of the human nasal mucosa.

Adhesion and Morphologic Change of Lens Epithelial Cell According to Materials of Intraocular Lens

PURPOSE: We investigated the adhesion rate and morphologic change of lens epithelial cell (LEC) according to materials of intraocular lens (IOL). With the results, we estimated the appearance and characteristics of posterior capsular opacity after cataract extraction. METHODS: LECs were prepared from fresh bovine lens. Hydrophobic acylic IOLs such as Acrysof(R) and Sensar(R) and hydrophilic acrylic IOLs such as Corneal(R) were tested. On the days 2, 9 and 12 of LEC culture, we calculated the adhesion rate and observed the cellular morphologic changes. Immunostaining with alpha smooth muscle actin (SMA) was performed. RESULTS: Adhesion rate was higher in hydrophilic lens on the days 2 and 9 (p-value=0.029). Acrysof(R) had the lowest adhesion rate. LEC in hydrophobic IOL showed differentiation to myofibroblast that was strong positive for SMA. LEC in hydrophilic IOL preserved natural cellular morphology until the day 12. Immunostaining with SMA was nearly negative. CONCLUSIONS: Hydrophobic acrylate induced much differentiation from LEC into myofibroblast, but had low adhesion rate. Hydrophilic acrylate does not induce the differentiation, but has high adhesion rate.

Systemic Risk Factors for Postoperative Vitreous Hemorrhage Following Diabetic Vitrectomy

PURPOSE: To determine the incidence of and the systemic risk factors for postoperative vitreous hemor-rhage(PVH). METHOD: The records of 503 consecutive diabetic vitrectomy cases were reviewed. RESULT: Eighty-seven eyes(17.3%) had at least one episode of PVH. Sixty-five eyes(12.9%) had PVH within 3 months after vitrectomy, and the mean onset time of the first episode of PVH was about 13 weeks after vitrectomy. The mean follow-up period was 17.2 months in non-hemorrhage group, and 21.9 months in hemorrhage group. While 34 eyes(29.6%) had spontaneous absorption of blood, 42 eyes(36.5%) required air(or gas)-fluid exchange and 39 eyes(33.9%) vitreous cavity lavage. Using univariate analysis, the factors associated with increased incidence of PVH include type 1 diabetes mellitus(p=0.01), method of glycemia control(p=0.02), anemia(p=0.04), and hypercholesterolemia(p=0.005). Multivariate analysis revealed diabetic nephropathy(p=0.02) and hypercholesterolemia(p=0.01) were the risk factors. Five eyes(1.0%) lost light perception, 7 eyes(1.4%) had rhegmatogenous retinal detachment, and 11 eyes(2.2%) had neovascular glaucoma. CONCLUSION: Vitreous hemorrhage after diabetic vitrectomy occurred in the 17.3%, three quarters of them within 3 months. About one third had spontaneous clearing, and two-thirds required reoperation. Diabetic nephropathy and hypercholesterolemia were the systemic risk factors of vitreous hemorrhage after diabetic vitrectomy.

Penet rating Keratoplasty Results in 275 Cases

In this study we evaluated the risk factors that affect the survival rate of penetrating keratoplasty(PKP). Retrospectively we reviewed medical records of 275 cases which had taken PKP for 9 years between 1989 and 1997 in AMC. Mean age of patients was 39. 9 years and mean follow up period was 32.6 months. Only PKP was performed in 182 eyes(66%)and combined procedure with cataract extraction, silicon oil removal or glaucoma surgery in 93 eyes(34%). PKP was combined with cataract extraction and IOL insertion in 56 eyes. We analyzed the survival rate with Kaplan-Meier survival function. The survival rate was 94%for 3 months, 87%for 6 months, 78%for 1 year, 69%for 2 years, 62%for 5 years. According to the success rate based on etiology, keratoconus was highly successful in 82.6%and the survival rate of regraft or bullous keratopathy was significantly lower than that of keratoconus(p<0.01). Major cause of graft failure was rejection(68%)and rejection was occurred within 12 months following PKP in 65.2%. Rejection was reversed in 40.7%with medical treatment. So the factor that significantly affected the survival of graft was causative disease and this study suggested that the effort to prevent rejection was most important in graft survival.

IOP & Corneal Diameter in Premature Infants

Premature infants may have underdevelopment of multiple organs including ocular structures.Sixty one premature infants of thirty seven weeks-old or younger were examed to note the correlation of intraocular pressure andcorneal diameter with gestational age and birth weight. Following topical anesthesia, intraocular pressure was measured with Tonopen II tonometer and the corneal diameter with caliper.The fundus was examed for the presence of risk factors for retinopathy of prematurity. Average gestational age of the subjects was 30.2 weeks (26~37 weeks), and birth weight was 1419 g (677~3691 g).Thirty five subjects had experienced oxygen therapy, and eleven patients were found to have any stage of retinopathy of prematurity. Average intraocular pressure was 10.8 +/-2.3 mmHg (mean +/-standard deviation), corneal diameter was 8.8 +/-0.5 mm.No significant correlation was found between intraocular pressure or corneal diameter and gestational age or birth weight.The presence of retinopathy of prematurity did not seem to influence the intraocular pressure and corneal diameter. Our results suggested that the growth in uterus did not seem to affect intraocular pressure or corneal diameter in gestational age of 26 to 37 weeks. These normative values may aid ophthalmologists in assesing intraocular pressure and corneal diameter in premature infants.

The Effect of Magnesium Depletion on the Electrocardiogram and Plasma Electrolytes in Liver Cirrhosis

Plsama and urinary Mg were measured in relation to EKG change in 24 patients with liver cirrhosis, and summarized as below. 1. Plasma albumin and Ca were below normal, however Na, K, and Mg level were in the lower limit of normal. 2. Abnormal EKG findings were QT prolongation, ST elevation, peaked T, low T, ST depression and U wave in the order of frequency. 3. Coefficient of correlation between plasma Mg and QT prolongation was -0.5 compared with that of Ca-0.28. 4. Mg depletion was moderately correlated with plasma albumin (r=0.59). 5. Marked urinary Mg excretion in the presence of normal plasma Mg suggest that plasma Mg level poorly reflect total Mg depletion.

A Case of Calyceal Diverticlum Treated by Partial Nephrectomy / 대한비뇨기과학회지

Authors present here in a calyceal diverticulum complicated by chronic pyelonephritis, which was diagnosed on urinalysis, IVP, RGP and symptoms. Partial nephrectomy was done and confirmation was made by specimen gross findings and biopsy. The microscopic findings are as follows: The lining epithelium of the inner surface of the cystically dilated calyx is made up of transitional epithelial cells. The epithelium in the areas is eroded. The subepithelial interstitial tissue is fibrotic and infilterated with large numbers of chronic inflammatory cells, which also invade the underlying renal parenchyma.