Therapeutic Efficacy of Spironolactone for Central Serous Chorioretinopathy

Purpose@#To evaluate the therapeutic effects and safety of oral spironolactone (SPRL) in patients with central serous chorioretinopathy (CSC). @*Materials and Methods@#The medical records and imaging data of patients diagnosed with CSC and treated with SPRL were retrospectively reviewed. Central macular thickness (CMT), subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and best-corrected visual acuity (BCVA) at baseline, at 1, 3, and 6 months, and at the last visit after the treatment were analyzed. @*Results@#In total, 103 patients with 107 eyes were included. The mean age of the patients was 51.5±9.3 years, and 77 (72.0%) were male. The mean follow-up duration was 48.6±40.2 weeks. The mean duration of oral SPRL therapy was 15.5±13.4 weeks. CMT, SRF height, and SFCT improved significantly at 1, 3, and 6 months after SPRL therapy and at the last follow-up. BCVA, however, showed no significant change at any time point. The rate of complete resolution of SRF at 1 month was higher in those with chronic CSC than in those with acute CSC (21.1% vs. 6.0%, respectively). Recurrence occurred in 14 (13.1%) eyes after the complete resolution of SRF. Older age (p=0.001), a greater number of previous intravitreal bevacizumab injections (p=0.006), and poor initial visual acuity (p=0.048) were associated with recurrence. No permanent adverse effects were observed. @*Conclusion@#Oral SPRL showed therapeutic benefits in patients with CSC in terms of SRF resolution, but relatively frequent recurrence was observed, especially in older patients.

Short-Term Result of Triple Procedure in Pterygium Surgery

PURPOSE: To evaluate the success and complication rates of triple procedure, including pterygium excision, marginal amniotic membrane insertion beneath the conjunctiva, and limbal-conjunctival autograft in pterygium surgery. METHODS: We conducted a retrospective study on 45 eyes of 45 patients who underwent pterygium surgery between August 2011 and October 2012. After pterygium excision, amniotic membrane was placed beneath the conjunctiva along the margin of the exposed sclera followed by a limbal conjunctival autograft. Success rates, intraoperative and postoperative complications were evaluated. RESULTS: Forty-three eyes with primary pterygium and 2 eyes with recurrent pterygium were enrolled in the present study. The mean age of the patients was 59.87 +/- 14.30 years with a mean follow-up of 12.9 +/- 4.6 months. There were no complications during surgery. Early postoperative complications included partial wound dehiscence in 1 eye and a simple conjunctival cyst on the autografted conjunctiva in the another eye. No clinically significant recurrence (G2, G3) was noted during the observational periods. Thirty-nine (86.7%) and 6 (13.3%) eyes were graded as G0 and G1, respectively. CONCLUSIONS: Our surgical technique not only has the benefits of the limbal conjunctival autograft acting as a barrier against fibrovascular invasion of the cornea and supplying stem cells to the corneal epithelium but also has antiangiogenic effects of amniotic membrane with minimal use. In addition, this technique is a safe surgical method in primary and recurrent pterygium.

Bilateral Eyelid Contact Dermatitis and Toxic Conjunctivitis due to Acrylate-Containing Glue

No abstract available.

Acute Ocular Manifestations after an Accidental Hydrofluoric Acid Release

PURPOSE: To report the ocular health of a community after an accidental release of hydrofluoric acid (HF). METHODS: The hospital records of 327 patients that were exposed to HF between Sep 9, 2012 and Oct 31, 2012 were reviewed. Demographic characteristics, subjective ocular symptoms, and the ophthalmologic examination results of the patients were analyzed retrospectively. RESULTS: Among the 327 patients, 203 patients (62.1%) were exposed to hydrofluoric acid (HF) within 1,000 m of the site of the accident. A total of 131 patients (40.1%) were exposed to HF over 3 days. The most frequently reported ocular symptoms after HF exposure were ocular pain (49.5%) and conjunctival hyperemia (37.9%). Conjunctival hyperemia (43.4%), corneal erosion (23.9%), conjunctiva papilla, and follicles (24.2% and 14.4%, respectively) were noted during ophthalmologic examinations, but 46.2% of patients were normal on examination. None of the patients had vision-threatening damages. CONCLUSIONS: In this study, severe ocular surface changes, which can affect vision, were not identified. This result could be explained by the low atmospheric HF concentration after the accident.

Effects of Transfection of Keratinocyte Growth Factor Gene derived from Dendritic Epidermal T Cell on Keratinocyte Proliferation and Differentiation / 대한피부과학회지

BACKGROUND: Dendritic epidermal T cell(DETC) resident in the mouse epidermis is gammadelta-T lymphocytes. Most of them express Vgamma5/Vdelta1 T cell receptor. Compared with alphabeta-T lymphocytes, physiologic and/or pathologic role of DETC are not fully understood. Keratinocytes under the conditions such as irradiation, viral and bacterial infection, and exposure to carcinogen may express keratinocyte self-antigen. DETC may have the ability to recognize stressed and malignant keratinocytes. Moreover, specific chemokines released from DETC may contribute to inflammatory response, which maintain skin integrity and homeostasis. OBJECTIVE: The purpose of this study was to investigate the effects of transfection of keratinocyte, growth factor(KGF) gene derived from DETC on the keratinocyte proliferation and differentiation in cell culture. METHODS: RT-PCR using KGF primer to confirm the KGF mRNA in DETC and Keratinocyte MTT assay to evaluate the effect of keratinocyte proliferation and immunohistochemical staining using anti keratin(K)14 mAb, anti K1,10 mAb and anti involucrin mAb as a marker to elucidate the effect of keratinocyte differentiation were done. RESULTS: 1.The KGF specific PCR product was demonstrated in DETC, normal positive control of cultured fibroblast and KGF gene transfected cultured keratinocytes, but it was not observed in normal cultured keratinocytes by RT-PCR using KGF-specific primer. 2.Numbers of keratinocytes in normal control group were (2.5+/-0.5)X10(4), (8.8+/-1.5)X10(4), (8+/-0.5)X10(4), (10.5+/-0.7)X10(4) after 1st, 2nd, 3rd and 4th days, respectively. Numbers of keratinocytes with KGF gene transfected group were (1.5+/-1.0)X10(4), (9.5+/-0.2)X10(4), (9.8+/-0.5)X10(4), (13+/-2.0) X10(4) after 1st, 2nd, 3rd and 4th days, respectively. In comparison to the control, the numbers of keratinocytes were increased in the KGF gene transfected group from the 3rd and 4th day(p<0.05). On the MTT assay, compared with the control, the numbers of keratinocytes were also increased in the KGF gene transfected group at 3rd day(p<0.05). 3.In the immunohistochemical staining with mAb to K1,10 and involucrin, to evaluate the degree of differentiatin of kerationcyte reveals that KGF gene transfected cells with Ca++(0.5mM) were stained weaker than the degree of differentiation of Ca++(0.5mM) treated group. Immunohistochemical staining with mAb to K14 reveals that KGF gene transfected cells with Ca++(0.5mM) were stained stronger than the degree of differentiation of Ca++(0.5mM) treated group. CONCLUSION: The above results strongly suggest that KGF, which produced by activated DETC, have a role in stimulating the proliferation and suppressing the differentiation of keratinocytes in the skin. In conclusion, DETC may involved in the control of proliferating activity of neighboring kerationcytes through KGF communication, which play an important role in the maintenance of epithelial integrity.

Transcription Factors / 대한내분비학회지

No abstract available.

Dermatomyositis Associated with Stomach Cancer / 대한피부과학회지

A 62 year old man had skin eruptions, general weakness, swallowing difficulty, and fever for 3 months. Diagnosis of dermatomyositis was established on the bases of clinical manifestations, muscle enzyrne study, electromyogram and histopathological findings of skin and muscle. Borrman type g stomach cancer was found by gastroendoscopy and computed tomography. He refused surgical operation for stomach cancer and died 2 months later.

Antitumor Effect of Methotrexate in SCID Mice with Human Leukemia CCRF-CEM Cell Line / 대한암학회지

No abstract available

A Clinical and Histopathological Study of Dermatofibromas / 대한피부과학회지

BACKGROUND: Dermatofihromas are relatively common benign tumors which occur in the skin. However, clinical and histopathological studies have been rarely reported in Korea. OBJECTIVE: This study was taken to evaluate the clinical and histopathological features of dermatofibromas in Korea. METHODS: Fifty cases of dermatofibromas were selected from 10 years of laboratory files for during the period January 1985 to December 1994 at Chung Ang University Hospitals. RESULTS: 1. The age range was from 18 to 61 and the average age at diagnosis was 38.7(male;37.6, female;39.4). The ratio of male to female was 1.0: 16(19:31). 2. The diameter of the dermatofibromas : 1) 5-20mm;32 cases(64.0%), 2) 5mm>;8 cases(16.0 %), 3) 20mm<;7 cases(14.0%), 4) unrecorded;3 cases(6.0%). 3. The most common color was brown(14 cases, 28.0% ), and other common colors were skin-color(7 cases, 14.0%), red(4 cases, 8.0%), black(3 cases, 6.0%), violaceous(2 cases, 4.0%), unknown(20 cases, 40.0%). 4. Thirty seven cases(74.0%) had solitary lesions, and thirteen cases(26.0%) had multiple lesions. 5. The lower extremeties(39 cases, 50.6%) were the most common sites followed by the back (10 cases, 13.0%), upper extremities(9 cases, 11.7%), shoulders(8 cases, 10.4%), abdomen(4 cases, 5.2%), hands(2cases, 2.6%), face(2 cases, 2.6%), neck(2 cases, 2.6%), breast(1 case, 1.3%). 6 Histopathologically, fibrous types were seen in 40 cases(80.0%), cellular types in 3 cases(6.0 %), mixed types in 5 cases(10.0%), and sclerosing hemangiomas in 2 cases(4.0%). CONCLUSION: The 50 cases of dermatofibromas, which were confirmed at Chung Ang University Hospitals from January 1985 to December 1994, were reviewed clinically and histopathologically.

A Case of Microcystic Adnexal Carcinoma / 대한피부과학회지

Microcystic adnexal carcinoma(MAC) is an unusual carcinoma of eccrine glands, composed of pilar and sweat duct structures. We report here a 64-year-old man with MAC on his left cutaneous upper lip. Microscopically, the tumor consisted of nests and gland-like structures within desmoplastic stroma, and it stained positively for carcinoembryonic antigen. The clinical appearance and histopathologic findings of the tumor may be mistaken for other benign and malignant entities. The patient was treated with excision and skin flap, and no recurrence over a 31-month follow up period.

The Effect of Non-Ionic Contrast Media on Q-T Interval and ST-T Wave of ECG during Coronary Angiography

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.

Complications for implanted cardiac permanent pacemaker / 대한내과학회지

No abstract available.

A Clinical Study on the Antihypertensive Effect of Nipradilol

beta-receptor antagonist as antihypertensive agent has adverse effect such as vasoconstriction, bronchoconstriction and aggravation of atherosclerosis. So beta-receptor antagonist with alpha-receptor blocking property has been studied for avoidance of adverse effects of beta-receptor antagonist. Nipradilol, a new beta-receptor antagonist with alpha-receptor blocking property was administrated in 30 essential hypertensive patients for 10 week in order to evaluate the antihypertensive effects and adverse effects. The results were as follows: 1) Nipradilol was effective in 20 patients(67%) on systolic blood pressure 22 patients (73%) on diastolic blood pressure at the end of 10 weeks treatment. 2)Before medication, mean systolic and diastolic blood pressure in sitting position were 160+/-14mmHg and 102+/-18mmHg,and after 10 weeks of medication, mean systolic and diastolic blood pressure were significantly declined to 143+/-22mmHg and 89+/-12mmHg(p<0.001). 3) There was no significant change in pulse rate, from 78+/-12 beats per minute the beginning of the treatment to 75+/-11 beats per minute after 10 week of treatment. 4) There was no significant changes in sodium, potassium, GOT, GPT, bilirubin, alkalin ephosphatase, BUN, creatinine, LDH, CPK and lipid. 5) The adverse effects of nipradilol were bradycardia(7%), dyspnea(3%), chest discomfort(3%) and headache(3%). In summary, nipradilol seemed to be effective antihyertensive drug in treating mild to moderate hypertension.

Differential Diagnosis between Dilated Cardiomyopathy and Ischemic Heart Failure with Post-Exercise Echocardiography

BACKGROUND: Ischemic cardiomyopathy and dilated cardiomyopathy may be clinically indistinguishable and cardiac catheterization is often required to differentiate between them. And many nonivasive methods including myocardial Thallium scan have showed nonspecific results in differentiating between them. METHODS: We studied the change of echocardiographic ejection fraction after exercise in 8 patients with ischemic heart failure and 9 patients with dilated cardiomyopathy and have assessed the usefulness of this noninvasive technique in distinguishing between the two groups. RESULTS: All patients with ischemic cardiomyopathy displayed the significant decrease of ejection fraction at 5 minutes after exercise(p28.75+/-7.89%-->34.38+/-8.50%). Respectively, all patients with dilated cardiomyopathy showed the significant increment of ejection fraction at 5 minutes(p46.33+/-11.93%-->35.00+/-5.68%). CONCLUSION: Our results suggest that echocardiographic ejection fraction at post-exercise 5 minutes, will be the adjunctive method to differentiate between ischemic cardiomyopathy and dilated cardiomyopathy.

A Case of Viral Myocarditis Presenting as Acute Extensive Myocardial Infarction

Viral myocarditis is a inflammatory process of the heart caused by virus. Its manifestation ranges from asymptom to acute fulminent congestive heart failure and often mimics acute myocardial infarction. A 22 year old man was admitted to the hospital because of prolonged anterior chest pain. 15 days before entry, anterior chest pain with cough and fever brought him to the another hospital. At that time, the LDH level was 1160U/L, the CPK level was 659.7U/L and MB band was 16.1%. The ECG revealed acute inferior wall infarction. And 3 days later, extensive anterior wall infarction findings appeared. 2D-Echo findings showed proximal septal hypokinesia. On admission time to this hospital, physical examination was negative. The ECG showed no interval change. 2D-Echo findings showed increased echogenicity of anterior and inferior wall. Treadmill test did not evoked chest pain or change of ECG. The LDH, CPK levels returned to normal range. The antibody titers of Coxsackievirus type A-16 was positive. Coronary angiography showed normal findings. 3 months later, antibody's titer of Coxsackievirus A-16 was increased. A diagnosis of acute viral myocarditis was made.

An analysis of contributing factors to financial status of regional health insurance / 예방의학회지

Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women, premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.

The Comparison of Renal Handling of Sodium and Potassium According to Salt Intake between Control and Hypertensive Group

The salt-sensitivity has been generally accepted as a mechnism of high blood pressure in elderly hypertensive patients, and so it may result in a difference of renal handling of sodium and potassium between normal healthy control and elderly hypertensive patient. So to evaluate an lbove difference, the amount of 24 hours' urinary excretion of Na+ & K+ were measured in healthy normotensive control (10 case) and elderly hypertensive group(10 case) according to normal diet (12-15gm of NaCl) for first 3 days and low salt diet (3~5)gm of NaCi) for next 3 days, also blood rewwure was mintored. The results were followed : 1) 24 hours' urinary excretion of NA+ was increased in hypertensive group more than control group at first day of normal diet and low salt diet significantly. 2) After a replacement of normal diet to low salt diet, a maximal decrement of 24 hours' urinary excretion of Na+ was 25% at first day in control but 40% at second day in hypertensive group only. 3) There was a similar pattern of urinary excretion of K+ as Na+ in hypertensive group, but it was not stastically significant. 4) There was no significant changes of blood pressure, serum electrolyte and BUN/creatinine according to salt intake in both group. From above findings. We can conclude that a urinary excretion of sodium is delayed in elderly hypertensive group, and it is suggested that a delayed excretion of sodium. is associated with retention of sodium in body. So a persistent restriction of sodium is recommended in elderly hypertensive patient.

An Analysis of the Factors Affection Anemia in the Female Industrial Workers / 예방의학회지

In this study an attempt was made to determine the factors affecting anemia in female industrial workers. The population was identified through the records of screening examinations given by Kosin Medical Center to the industrial workers in Sasang Industrial Complex during the period from March 1987 to October 1988. One hundred twenty eight cases were selected from the records screening examination of 155 anemic patients. A case-control study was carried out using matched 128 anemic cases and 128 non-anemic workers who were selected by simple random sampling. Age was matched, and their occupational history, general characteristics, physical characteristics and health status were analyzed. The results were; 1. In the anemic group, educational level was lower, and the frequencies of irregular menstruation and poor appetite were higher than in the control group but these differences were statistically not significant. 2. The percentage of working with organic solvents, working hours and years of service (total years exposed to organic solvents) were significantly higher in the anemic group than those in the control group. 3. A career exposed to organic solvents was more influential factor affecting anemia in the female industrial workers rather than menstruation amount of other factors, and it was statistically significant.

A Case of Wilson's Disease

No abstract available.

A Case of Relapsing Polychondritis

No abstract available.