Short-term Efficacy of Intravitreal Ranibizumab for Myopic Choroidal Neovascularization

PURPOSE: To evaluate the effects of intravitreal ranibizumab in myopic choroidal neovascularization (CNV). METHODS: Patients who underwent intravitreal ranibizumab injection for myopic CNV, and were followed up more than 6 months, and their records were retrospectively investigated. The best corrected visual acuity, central macular thickness, and leak in fluorescein angiography were compared at baseline, and at 1, 3, and 6 months after injection. RESULTS: Twenty-one eyes of 18 patients were evaluated. The mean best corrected visual acuity (logMAR) was 1.23+/-0.65, 0.96+/- 0.40, 0.95+/-0.67, and 0.83+/-0.58 at baseline, 1, 3, and 6 months, respectively (p<0.001, p=0.006, p=0.001). The mean central macular thickness was 233.42+/-65.55 microm, 204.14+/-65.29 micrometer, and 157.76+/-71.45 microm at baseline, 3, and 6 months, respectively (p<0.001). In fluorescein angiography at 6 months after injection, regression was observed in 12 eyes, and fibrosis in 9 eyes. CONCLUSIONS: Intravitreal ranibizumab injection for myopic CNV in Korean patients appeared to be effective, resulting in regression of lesion and improvement of visual acuity.

A Comparison of Sugar Tong Splint and Radial Gutter Short Arm Splint after Closed Reduction of Distal Radius Fracture

PURPOSE: Various methods of immobilization exist in the nonsurgical treatment of the distal radius fracture, among which sugar tong splint is the most commonly used. In this study, we observed the results after treating the distal radius fracture with radial gutter short arm splint without elbow immobilization. MATERIALS AND METHODS: Among the fracture of distal radius who have been under conservative treatment after closed reduction, 48 patients (from January to December of 2005) were treated with sugar tong splint, and 57 patients (from January to December of 2007) were treated with radial gutter short arm splint. The loss of reduction after closed reduction of the two groups was compared. The types of fractures were determined as either stable or unstable based on the fracture segment. Follow up examination of the stability was performed 8 weeks later. RESULTS: There were 105 patients (male, 52; female, 53) with mean age of 50.2. Of the 57 patients with the sugar tong splint, loss of reduction was shown in 11 cases out of the 31 unstable fractures and none in 17 stable fractures. In the radial gutter short arm splint group, 12 cases out of 33 unstable fractures showed loss of reduction. Only one case in 24 stable fractures treated by the radial gutter splint has failed. There was no statistically significant difference in the reduction loss rate between the two immobilizing methods (p-value=0.37), as well as the type of reduction loss (p-value>0.05). CONCLUSION: Sugar tong splint and radial gutter short arm splint had no difference in maintaining reduction. Sugar tong splint has been considered as the most effective method of maintaining reduction by preventing rotation of the forearm and flexion-extension of the elbow. Furthermore, radial gutter short arm splint can minimize limitation of the elbow motion and daily life activity. Based on our results, radial gutter short arm splint, which only immobilize the wrist joint, had a good results as well.

Surgical Treatment of Posterosuperior Hip Dislocation in A Patient with Hereditary Sensory Autonomic Neuropathy Type IV: A Case Report

A 4-year old female patient with a diagnosis of hereditary sensory autonomic neuropathy type IV (congenital insensitivity to pain with anhidrosis) since the age of 1 year, sustained a posterior hip dislocation. During her initial stay at the hospital, an attempt at manual reduction failed. Open reduction, capsulorrhaphy, and Salter operation were done at 36 days after the index dislocation. After the operation there was a 23-degree acetabular index, and there were several abnormal round whitish gray fibrous nodules. There was also severe wound discharge, skin abrasion, and erythema on the patient's back and buttocks due to loss of protective sensation. After conservatively treating the wound and skin problems with prone positioning, we achieved a final acetabular index of 26 degrees. The patient did not have protective sensation in her hip joint. We were able to check for increasing instability after the index operation.

Anatomic Analysis of Rectus Femoris Functional Flap in Korean

purpose of this article to evaluate the availability of the rectus femoris flap in Korean subjects. Material and Methods is that Cadaveric dissections were done on 51 femoral triangles of 26 cadevers. We measured the length of the direct head of rectus femoris from anterior superior iliac spine to patella upper pole, ASIS to lateral border of femoral nerve, and entry point of femoral nerve and vessel branches to rectus. Usually, there were three terminal branches to rectus femoris from the femoral nerve. The entry point of the first branch was at the proximal 17.5~31.4% portion of the rectus femoris. The second and the third branch entered at the proximal 22.5~40.7% and 26.3~42.3%, respectively. The vessel entry was at 20.2~37.3%. The length from ASIS to femoral nerve was 3.5~8.5 cm. Among the 51 rectus femoris muscles, 44 had one nutrient artery, and 7 had 2 nutrient arteries. The nutrient artery originated from the descending branch of the lateral femoral circumflex artery in 18(40.9%) cases, directly from the lateral femoral circumflex artery in 8(18.0%) cases, and from proximal(6 cases, 13.6%) and distal(12 cases, 27.3%) portion of the deep femoral artery. The average length of the nutrient artery was 29.8 mm and the width was 2.14 mm. The point where it meets the main feeding artery of the rectus femoris was 9.0~15.0 cm from the ASIS. In all cases, the main artery's entrance was proximal to the first nerve branch. Conclusion is that rectus femoris has available data for functional flap

The Morphologic Study of the Calcar Femorale and the Femoral Stem in Korean Population

PURPOSE: The aim of this study was to examine morphological data of the calcar femorale using high resolution CT and to determine its relationship with the morphology of femoral stems commonly used in Korea. MATERIALS AND METHODS: CT scans of the bilateral proximal femurs were randomly obtained from 54 Korean subjects(31 males and 23 females). The mean age was 49 years. The length, vertical height and thickness of the calacr femorale were measured. The medial dimension of the proximal portion of the femoral stems was investigated and matched with the distance between the anterior cortex of the proximal femur and the midpoint of the calcar femorale. RESULTS: The calcar femorale was visible in 53 CT scans(98%). The length, vertical height and thickness of the calacr femorale was 11.4+/-3.0 mm, 35.1+/- 5.96 mm and 2.4+/-0.7 mm, respectively, and there were no significant changes with age. The dimensions of the femoral stems were compatible with the morphology around the calcar femorale. CONCLUSION: The calcar femorale is a constant cortical structure that can provide consistent rotational stability for the proposed cementless stems. It is strongly recommended that the calcar femorale be preserved during the femoral preparation.

Influence of Obesity on Left ventricular filling patterns in Hypertensives / 대한내과학회지

BACKGROUND: Left ventricular (LV) diastolic dysfunction has often been described in arterial hypertension in either the presence or the absence of LV hypertrophy. Impairment of LV relaxation have been recently described in obese normotensive individuals, and the prevalence of overweight to frank obesity in hypertensive populations is very high, obesity might well be an important confounder for the evaluation of LV diastolic dysfunction in the patients with hypertension. Accordingly, we designed this study to assess the effect of obesity on LV relaxation and filling in arterial hypertension. METHODS: We assessed the relations of left ventricular filling to load and geometry by Doppler echocardiography in 73 normotensive subjects (40 normal-weight [50 +/- 11 years, 22 women] and 33 obese [57 +/- 11 years, 27 women]) and 81 hypertensive subjects without silent coronary heart disease (23 normal-weight [59 +/- 7 years, 13 women] and 58 obese [54 +/- 13 years, 30 women]). RESULTS: Isovolumic relaxation time (IVRT) was prolonged in hypertensive subjects and normotensive obese subjects compared with normotensive normal-weight subjects (all p<0.01). After controlling for age, height, blood pressure, LV mass index, body mass index, between-group differences in IVRT, peak early transmitral flow velocity, the deceleration time (DT) of early filling velocity, and the ratio of early to late left ventricular filling were disappeared. CONCLUSION: Isovolumic relaxation time (IVRT) is prolonged in both arterial hypertension and obesity, and the presence of obesity does not significantly increase isovolumic relaxation time in hypertension, and abnormalities of left ventricular filling in arterial hypertension are offset after controlling for left ventricular mass.

The Effect of Oxytocin on Subcellular Localization of Aquaporin-2 in Rat Kidney: an Ultrastructural Immunocytochemical Study / 대한신장학회잡지

BACKGROUND: The aquaporin-2 (AQP2) water channel is mainly located in the apical plasma membrane of epithelial cells in the connecting tubule and collecting ducts, but there has been some evidence of a moderate amount of basolateral localization of AQP2 in these nephron segments. Previous in vitro microperfusion studies showed that oxytocin has an antidiuretic action most likely mediated by the vasopressin V2 receptor (V2R) in rat inner medullary collecting duct. METHODS: By using ultrastructural preembedding immunocytochemistry with 1 nm immunogold in male Sprague-Dawley rat kidneys, we investigated the acute (60 min) effect of oxytocin (10 U) on the subcellular localization of AQP2 and tested whether the effect of oxytocin is prevented by a V2R antagonist, OPC-31260 (OPC). RESULTS: In control rat kidneys, AQP2 was mainly expressed in the apical plasma membrane and subapical vesicles in the connecting tubule (CNT) cells, principal cells of cortical (CCD), outer medullary collecting duct (OMCD) and initial part of inner medullary collecting duct (IMCD), and IMCD cells of terminal part of IMCD. Basolateral AQP2 labeling was observed in the CNT cells and IMCD cells. In contrast, there was little basolateral AQP2 labeling in the CCD and OMCD principal cells. Oxytocin treatment induced apical immunolabeling of AQP2 and caused an increase of AQP2 immunolabeling in the basal part including basolateral plasma membrane in the CNT cells, principal cells of CCD, OMCD and initial part of IMCD, and IMCD cells of terminal part of IMCD. Pretreatment of rats with a V2R antagonist OPC before oxytocin treatment caused translocation of AQP2 from the apical plasma membrane to the subapical vesicles. However, AQP2 labeling of basolateral plasma membrane was unchanged or slightly increased. CONCLUSION: Oxytocin induces an increase of AQP2 expression not only in the apical plasma membrane but also in the basolateral plasma membrane. Pretreatment with a V2R antagonist blocked redistribution of apical AQP2 immunolabeling, but did not cause retrieval of AQP2 from the basolateral plasma membrane. These results suggest that apical and basal targeting of AQP2 are regulated by different mechanisms.

Ureteroscopic Stone Removal: Efficacy, Safety and Skilled Experience of the Surgeon / 대한비뇨기과학회지

PURPOSE: We retrospectively reviewed the cases of ureteroscopic stone removal at our hospital and defined the efficacy, safety and the skilled experience of the surgeon. MATERIALS AND METHODS: Ureteroscopic stone removal was done in 510 cases. Sixty eight stones were located in the upper ureter, 114 stones in the mid ureter, and 328 stones in the lower ureter. The stone size was less than 5mm in 210 cases, from 5 to 10mm in 241 cases and more than 10mm in 59 cases. The objective cases were categorized into three groups according to the experience of the surgeon, and then compared to each group. RESULTS: The overall success rate was 94.5%. The success rates of upper, mid and lower ureteral stones were 86.7, 90, and 96.9%. The success rate was 95.7% in stones less than 5mm, 94.1% in 5 to 10mm and 91.5% in more than 10mm. The operation results were improved and stabilized after 50 cases. There were 48 cases (9.4%) of complications which were treated successfully with conservative treatment except for 2 cases. CONCLUSIONS: Our study suggests that the ureteroscopic stone removal technique of the surgeon is improving by accumulating operation experience, and stabilized skillful technique will be achieved after experience of more than 50 cases.

Expression and Distribution of Aquaporin-2, -3 and -4 in Developing Rat Kidney / 대한비뇨기과학회지

PURPOSE: The aquaporins (AQPs) are transmembrane water channel proteins. It is well known that AQP2, -3 and -4 contribute to the urinary concentration in collecting duct (CD) and also reported the presence of these three AQPs in the connecting tubule (CNT). Newborn rats are not capable of producing a concentrated urine. Rats develop the ability to concentrate urine after birth. The purpose of this study was to establish the time of the expression and the distribution of AQP2, -3 and -4 in the developing rat kidney. MATERIALS AND METHODS: Sprague-Dawley rats were used in all experiments. Kidneys were obtained from 16, 18 and 20-day-old fetuses and 1, 4, 7, 14 and 21-day-old pups and preserved and processed for immunohistochemical studies using a preembedding immunoperoxidase procedure. AQP2, -3 and -4 immunoreactivity was detected using rabbit polyclonal antibody and donkey anti-rabbit IgG. RESULTS: AQP2, -3 and -4 appeared first in 16-day-old fetuses in the CD and in 18-day-old fetuses in the CNT. Immunoreactivity for AQP2, -3 and -4 was markedly increased after birth and gradually increased during development. In CNT cells and principal cells, AQP2, -3 and -4 were not distinctly demonstrated on the apical, lateral and basal plasma membrane respectively until 21 days after birth. Distinct polarity of these AQPs both in CNTcells and principal cells were observed at 21 days after birth. CONCLUSIONS: AQP2 -3, and -4 were expressed not only in CD but also in CNT before developing of urine concentrating ability during development and it is concluded that their expression and distribution in CNT may play a role in the development of urine concentration abilities in rat kidney.