Potassium Depletion Upregulates Expression of Nrf2 Transcription Factor in Rat Kidney / 대한신장학회지

PURPOSE: The purpose of this study was to analyze the expression and localization of Nrf2 mRNA in rats according to the changes of K-diet. METHODS: Nrf2 gene was isolated using DNA chip microassay. Northern and Western blot analysis and in situ hybridization (ISH) were performed. RESULTS: Northern analysis of normal rat demonstrated that Nrf2 mRNA was abundantly expressed in stomach, moderately in testis, kidney, distal colon, duodenum, and adrenal gland, and weakly in brain, heart, spleen, salivary gland, liver, and lung. In the kidney of K-restricted groups, Nrf2 mRNA and protein expressions were gradually increased in K-restricted kidney. By ISH, hybridization signal for Nrf2 gene of normal group was prominent in the S3 segment of proximal tubule, distal tubule, and cortical collecting duct, and weak in outer and inner medullary collecting duct. In K-restricted groups, the localization of hybridization signal was the same as in normal group. Signal intensity of K-restricted groups was markedly increased in outer and inner medullary collecting ducts compared with normal group. But, that of the distal tubule and cortical collecting duct was decreased. mRNA for Nrf2 gene of normal group was detected in the cells of the basal portion of intestinal gland of distal colon and stomach, spermatogonia and spermatocytes of seminiferous tubule of testis, small lymphocytes of germinal center of spleen, and adrenal medulla cells of adrenal gland. CONCLUSION: These results suggest that expression of Nrf2 is different in various tissues and increased expression of Nrf2 gene in outer and inner medullary collecting ducts of hypokalemic kidney could regulate the ion transporter genes by these segments.

Vitrectomy in Severe Giant Retinal Tear

PURPOSE: To determine the results of pars plana vitrectomy (PPV) for the treatment of severe giant retinal tear. METHODS: We analyzed the clinical records of patients who had 150degrees or greater of giant retinal tear and underwent PPV. RESULTS: Of all 10 patients (10 eyes), 7 were male patients and mean age was 29.8 years. Giant retinal tear was idiopathic in 6 eyes and traumatic in 1 eye, and occurred after vitrectomy in 3 eyes. Primary operations were scleral buckle in 1 eye, PPV with intraocular gas injection in 2 eyes and with silicone oil (SO) injection in 7 eyes. In 3 eyes without SO injection, secondary operations were PPV with intraocular gas injection in 1 eye and with SO injection in 2 eyes. In 1 eye with PPV and intraocular gas injection, tertiary operation was PPV with SO injection. Removal of SO was done in all 10 eyes and SO was re-injected due to proliferative vitreoretinopathy in 2 eyes. Visual acuity was counting fingers or worse in 8 eyes before the primary operation and, on the final visit, 0.1 or better in 6 eyes and 0.3 or better in 3 eyes. CONCLUSIONS: These results suggest that PPV with SO injection might be better for the treatment of severe giant retinal tear than with intraocular gas injection.

Acrysof(R) and Polymethylmethacrylate Intraocular Lens Implantation in Diabetic Patients

OBJECTIVE: To determine the efficacy of Acrysof(R) intraocular lens (IOL) compared to PMMA IOL about visual acuity & postoperative complications (eg. posterior capsular opacification) in diabetic patients. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 18 patients (21 eyes) which underwent cataract extraction with Acrysof (R) IOL implantation and 58 patients (65 eyes) with PMMA (polymethylmethacrylate) IOL implantation from January 1996 to December 1999 at Chonnam National University Hospital. RESULTS: Postoperative best corrected visual acuity of above or equal to 0.5 was seem in 66.7% in acrysof (R) group, and in 73.9% in PMMA group at 6 months follow-up. Postoperative posterior capsular opacification was 33.3% and 49.2% respectively, and there was statistically significant difference in both group(p=0.021). CONCLUSIONS: Acrysof(R) intraocular lens can be used safely and reduce the rate of posterior capsular opacification in diabetic patients, which can make the positive effect on the treatment of the diabetic retinopathy after cataract surgery.

Pars Plana Vitrectomy for Macular Hole Retinal Detachment

PURPOSE: To evaluate the clinical characteristics and surgical results of retinal detachment due to macular hole. METHODS: We analyzed the record of the patient undergoing pars plana vitrectomy(PPV) for thetreatment of macular hole retinal detachment (MHRD). RESULTS: Of all 13 eyes, the follow-up period was 25.7 months on average and 10 eyes were highly myopic. Mean preoperative axial length was 26.58 mm (29.15 mm in high myopia group). In terms of visual acuity, 11 eyes showed less than 0.04 before the operation and on the final examination, 10 eyes 0.04 or more and 11 eyes improved 2 lines or more. Silicone oil was injected in a recurrent case. Finally there was the complete retinal attachment in all 13 eyes and sealed macular hole in 12 eyes. CONCLUSIONS: PPV seems to be an effective method for the treatment of MHRD.

Fetal vesico-amniotic shunting procedure (VASP) for posterior urethral valve syndrome at 19weeks' gestation / 대한산부인과학회잡지

An ultrasonographic examination revealed increased fetal bladder size and decreased AFI as well as fetal bilateral hydronephrosis at 173weeks' gestation. Diagnosis of the fetal posterior urethral valve syndrome was made. Percutaneous fetal bladder puncture with aspiration and amniocentesis was performed. The fetus was normal male karyotype and with a predicted good renal function(sodium concentration, chloride concentration, and osmolarity at 74 mEq/L, 60 mEq/L, and 148 mOsm, respectively). So, the fetus underwent amnioinfusion and vesico-amniotic shunting procedure (VASP) using a double-basket catheter at 194weeks' gestation in order to prevent development of dysplastic kidneys and hypoplastic lungs. The healthy male baby was delivered at 384weeks' gestation and had normally functioning kidney. Cutaneous vesicostomy was performed for the newborn since the urethral orifice was small. The one year old infant is now well and waiting for urethroscopic valve ablation procedure.