Evaluation of Eye Injury Cases in a Single Emergency Department

PURPOSE: After cataracts, eye injuries are the second leading cause of visual impairment worldwide. But most eye injuries are preventable simply by wearing appropriate eye protection. In this study we evaluate factors leading to eye injury in a sample of emergency department (ED) patients. METHODS: This study was conducted with 424 isolated eye injury patients who visited our ED from January to December of 2008. The following data were reviewed; date of visit, characteristics of subjects, existing use of eyewear, relationship of injury to work, causative activity, location where the injury occurred, type of injury, disposition at ED discharge, length of hospital stay, and the existence of sequelae. Severe eye injuries were classified based on the type of injury, disposition at ED, remaining visual loss, and sequelae. RESULTS: Among the total 424 isolated eye injury patients, 411 cases were analyzed. Eye injuries occurred most frequently at home (22.6%), in a factory workplace (21.2%), or an outdoor agricultural workplace (18.2%). The incidence of eye injuries peaked in the fifth decade of life. Among the 306 (74.5%) cases that were workplace unrelated, the main causative activities were assault (18.0%), injury associated with play (14.1%), sports (11.1%), and lawn mowing (9.2%). CONCLUSION: The most common location where the eye injury occurred was at home. Eye injuries prevention in the workplace is well promoted, but in fact, eye injuries were more common at home and during non-occupational activities. We suggest that public education programs which highlight non-occupational eye injury risk and prevention measures should be instituted to reduce preventable eye injuries.

The Relationship between Early Hyperglycemia and Prognosis in Trauma Patients

PURPOSE: Recent randomized prospective data suggest that early hyperglycemia is associated with high mortality in critically ill patients and that tight glucose control leads to an improved outcome. This concept has not been carefully examined in trauma patients. The purpose of this study was to determine the relationship of different levels of early hyperglycemia to the clinical outcomes in trauma patients. METHODS: A retrospective study of 309 cases of trauma victims who visited the Emergency Department of Daegu Catholic University Hospital from March 2003 to February 2004 was made. Patients younger than 15 years of age and patients having diabetes mellitus were excluded. The records of all of these patients were reviewed for age, the Injury Severity Score (ISS), Glasgow Coma Scale (GCS) score, blood glucose, lengths of ICU and hospital stays, infection morbidity, and mortality. They were divided into three groups by their glucose level (> or = 110 mg/dl and or = 140 mg/dl and or = 200 mg/dl and or = 110 mg/dl, > or = 140 mg/dl, > or = 200 mg/dl) showed higher mortality compared to the corresponding non-hyperglycemic groups ( or = 110 mg/dl, > or =140 mg/dl, > or = 200 mg/dl) with mortality. A multivariate logistic regression analysis addressing the effects of age, ISS, and GCS score showed a significant relationship among age (p or = 140 mg/dl (0.042), and death. In the univariate logistic regression analysis of these variables to infection, we observed a significant correlation between all examined variables and infection, except for glucose > or = 110 mg/dl. Glucose > or = 200 mg/dl (p= 0.007), age (p=0.014), and ISS (p or = 200 mg/dl was an independent predictor of increased infection rate in trauma patients. Also, early hyperglycemia defined as glucose > or = 140 mg/dl showed a significant independent relationship to death.

Expression of Met Protein in Colorectal Carcinoma

Met protein is a transmembrane 190 kD heterodimer with tyrosine kinase activity, encoded by c-Met oncogene. It serves as a high affinity receptor for hepatocyte growth factor (HGF)/scatter factor (SF), a cytokine which stimulates cell proliferation, motility, and invasion. In this study, we immunohistochemically evaluated the expression of Met/hepatocyte growth factor receptor in colorectal cancers. Met protein was expressed in 31 of 72 patients (43.1%). The staining pattern was cytoplasmic in nature, present throughout the tumor, and showed variable intensity from case to case. The relationship between the expression rate and intensity, and age and sex of patients, tumor size (p=0.645), tumor site (p=0.902) and tumor differentiation (p=0.844) was not statistically significant. The expression rate and intensity were significantly correlated with lymphovascular invasion (p=0.001), lymph node metastasis (p=0.010), depth of invasion (0.019), and stage (p=0.023). Cytoplasmic accumulation of Met protein was not associated with enhanced PCNA index of tumor cells (p=0.052). These results suggest that Met protein may play an important role in the invasion and metastasis of colorectal cancer cells.

Effect of the Viscoelastic Substance on Surgery of the Extraocular Muscles in Rabbit: 1. Histopathologic Study by a Light Microscope

We evaluated histopathologically the effect of the viscoelastic substance on surgery of the extraocular muscle in the 26 rabbits with 1. 6-2. 5kg of weight. The viscoelastic substances were 1% sodium hyaluronate(Healon) and 2% hydroxypropyl methylcellulose(Methocel), which were introduced between the extraocular muscle and its adjacent tissue on surgery. The rabbits were categorized by group 1(the rabbits with Healon), group 2(with Methocel), and group 3(with normal saline as control). These rabbits were enuclated at 3rd, 7th, 14th, 28th and 56th day following operations, and the eyes were fixed in 2.5% glutaraldehyde solution. The tissue was stained with hematoxylin-eosin and Masson's trichrome, and examined under a light microscope. The results were as follows: 1. In the first group(Healon), the tissue adhesion and degeneration of the muscle were milder than those of control(saline) group. 2. The changes in second group(Methocel) was milder than in the first group and more severe than in control group. 3. It is concluded that 2% Methocel can be used clinically in the surgery of the extraocular muscle.