Effect of Basic Fibroblast Growth Factor on Fibrovascular Ingrowth into Porous Polyethylene Anophthalmic Socket Implants

To investigate the effect of basic Fibroblast Growth Factor (bFGF) on fibrovascular ingrowth into porous polyethylene orbital implants (Medpor (R) ) and to investigate any differences according to the method of administration. For the treated groups, after evisceration and Medpor (R) implantation, bFGF was administered by soaking Medpor (R) in the bFGF solution, and/or by injecting bFGF into the Medpor (R) 1 week after the operation. Implants were removed 4 weeks after the operation and examined for the degrees of fibrovascular ingrowth by light microscopy. The percentages of the cross-sectional area of the implant occupied by fibrovascular ingrowth and the numbers of proliferated vessels were significantly higher in the bFGF-treated groups (Mann Whitney test, p 0.05). bFGF promoted fibrovascular ingrowth into porous polyethylene orbital implants regardless of the route of administration. Therefore, bFGF might be helpful to prevent complications such as implant exposure.

Clinical Analysis of Intermediate Uveitis

PURPOSE: To evaluate the clinical characteristics, recurrence rate and visual prognosis of intermediate uveitis in terms of cryotherapy and pars plana vitrectomy. METHODS: Medical records of 124 eyes in 110 patients who were diagnosed to have intermediate uveitis from Jan. 1988 to Dec. 2000 were retrospectively reviewed. Clinical features, fluorescein angiographic findings in intermediate uveitis, and therapeutic results of vitrectomy and cryotherapy were analyzed. RESULTS: The mean age of the patients was 39.1 years and the mean follow-up period was 3.6 years (2 months ~ 11 years). Of those patients, 12.7% were bilateral and average recurrence rate was 2.9 per year. And 81.5% of the snowbank was located inferiorly. Fluorescein angiography (FAG) was done in 91 eyes. Cystoid macular edema (CME) was observed in 81.3% (74 eyes), focal leakage in 77.6% (69 eyes), and diffuse leakage in 22.5% (20 eyes). In 11 eyes which had undergone pars plana vitrectomy, the recurrence rate decreased from 2.2 a year to 0.6 a year. In 9 eyes which had undergone cryotherapy, it decreased from 3.6 a year to 0.7, which was statistically significant (p<0.05). The visual acuity improved in 34.7% (43 eyes), did not change in 44.4% (55 eyes), and worsened in 21.0% (26 eyes) at the final follow-up. CONCLUSIONS: This demonstrates the overall favorable visual prognosis in patients with intermediate uveitis. Pars plana vitrectomy and cryotherapy may contribute to reducing the recurrence rate of intermediate uveitis.

Clinical Features of Anterior Ischemic Optic Neuropathy

PURPOSE: To analyze the clinical features of anterior ischemic optic neuropathy (AION) and to evaluate the visual prognosis METHODS: Medical records of 52 eyes in 47 patients who were diagnosed with AION from January 1991 to December 2000 were retrospectively reviewed. The clinical features, associated systemic disease, visual fields findings, and fundus findings in the patients were analyzed. RESULTS: The mean age of the patients was 55.9 years (20~81 years). Twenty-six were men (55.3%) and 21 were women (44.7%). The initial visual acuity of less than 0.1 was 24 eyes (46.2%), that of 0.1 to 0.5 was 23 eyes (44.2%), and more than 0.5 was 5 eyes (9.6%). In seasonal onset, frequency of AION during the winter was 18 eyes (37.5%). As the associated systemic diseases, 15 had diabetes mellitus (31.9%), and 27 had hypertension (57.4%). In laboratory examination, erythrocyte sedimentation rate (ESR) was elevated in 4 patients (8.5%). In fundus examination, the optic disc swelling was found in 16 eyes (30.8%), and optic disc atrophy was found in 36 eyes (69.2%). In Goldmann perimetry, the altitudinal field defect was found in 23 eyes (44.2%), most commonly. The mean follow-up period was 1.7 years (2 months ~ 9 years), and the visual acuity improved in 13 eyes (25.0%), worsened in 6 eyes (11.5%), and did not change in 33 eyes (63.5%) at the final follow-up. CONCLUSIONS: In conclusion, patients with AION showed various clinical features and overall visual prognosis is poor. Because AION is frequentely associated with systemic diseases, careful evaluation on the systemic disease is mandatory.

Clear lens Extraction and Epikeratophakic Lenticule Removal in Complicated Epikeratophakic Patients

PURPOSE: To assess clinical outcome of clear lens extraction in high myopia after epikeratophakic (EKP) lenticule removal and to evaluate the change of cornea in EKP. METHODS: The retrospective study reports 5 eyes of 3 patients who underwent clear lens extraction (CLE) after EKP lenticule removal to treat myopia. The changes in best corrected and uncorrected visual acuity, spherical equivalent and corneal refractivity were evaluated before and after EKP, EKP lenticule removal and CLE. RESULTS: The cornea was clear, but the refractive power and astigmatism of cornea increased after EKP lenticule removal. The degree of change of the cornea seemed to be associated with the period between the EKP lenticule removal and the CLE. The BCVA in 3 of 5 eyes returned to the pre-EKP level after CLE. The eye that underwent CLE without EKP lenticule removal revealed severe overcorrected hyperopia and was corrected after CLE. The eye that had CLE without the EKP lenticule removal showed the overcorrection postoperatively but it was corrected after the EKP lenticule removal. CONCLUSIONS: The CLE following EKP lenticule removal can be an effective refractive surgery in complicated EKP patients. To obtain the accurate refractive estimate postoperatively, it is better to perform EKP lenticule removal preceding CLE.

Histologic Changes, Hsp 70 and bcl-2 Expression and Apoptosis Following Piezoelectric Extracorporeal Shock Wave Treatment on Immature Rat Testis / 대한비뇨기과학회지

PURPOSE: The aim of this study is to evaluate the sequential histologic changes and spermatogenesis of the testis after extracorporeal shock wave treatment (ESWT). MATERIALS AND METHODS: ESWT to right testis was applied on total 48 immature, 5-week-old Sprague Dawley rats. The rats were sacrficed immediately, at 1 day, 3 days, 1 week, 2 weeks and 4 weeks after ESWT, and each group consisted of 8 rats including 2 rats as control (without ESWT). Histologic changes of both testes were examined, and serial three or more parafin sections were obtained, and immunohistochemical stains for bcl-2 and Hsp 70 and TUNEL method for apoptosis were performed. RESULTS: Hemorrhage and destruction of seminiferous tubules which appeared immediately after ESWT were maximal at 1 day after ESWT and were seen absorption and atrophy at 1 week after ESWT. Even regenerating tubules were found at 2 weeks after ESWT, no significant histologic difference between both testes experimental and control groups were seen except for some regenerating tubules. The right testicular tissues, remote from the ESWT-targeted area, showed preserved spermatogenesis since the age of 5 weeks 3 days, and was presented no significant difference between experimental and control groups. Hsp 70 and bcl-2 expression and apoptosis were maximal at 1 day after ESWT and persisted to 3 day after ESWT. Weak and focal expression were noted at 1 week after ESWT, and mostly disappeared at 2 weeks after. CONCLUSIONS: Spermatogenesis of right testis except the targeted area was not diffrent compared with that of left testis and control group. Hsp-70 expressin, which limits tissue destruction after injury, was immediately appeared for defense mechanism, and hemorrhage and tissue destruction following ESWT seemed to be due to apoptosis controlled by bcl-2 expression.

Squamous Cell Carcinoma Occurred Concomitantly in the Female Urethra and Vulva / 대한비뇨기과학회지

Urethral carcinomas represent a rare and challenging subset of genitourinary malignancies. Treatments are variable from a radical operation to only radiotherapy, depending upon the size, extent and location of the lesion. Despite of the various treatments, the prognosis for urethral carcinoma is poor. We report a case of a 41-year-old woman with squamous cell carcinoma which occurred concomitantly in the urethra and vulva.

A Case of Intracavernous Needle Breakage during Intracavernous Self-injection of Prostaglandin E1 ( Caverject? ) / 대한비뇨기과학회지

Intracavernous self-injection of vasoactive agents for the treatment of erectile dysfunction has been used widespread in recent years. Complications of intracavernous self-injection include priapism, burning sensation, fibrosis, penile nodule and urethral injection. We report a case of intracavernous needle breakage associated with the Prostaglandin E1 self-injection therapy.