Regulations of Bicarbonate Ions in Pregnant Rat Kidney / 대한해부학회지

The marked hemodynamic and hormonal changes of normal pregnancy are associated with striking alterations in renal physiology involving structure, dynamics, tubular function, and volume homeostasis. A number of acid-base or electrolyte disorders are associated with decreased or increased HCO3-reabsorption in the renal tubules. The present study was to examine the alterations of expression and distribution of Na+/HCO3-cotransporter (NBC), Na+/H+ exchanger-3 (NHE-3), and carbonic anhydrase I and II (CA I, II) proteins in the kidneys of non-pregnant (NP) and pregnant rats using Western blot analysis and immunohistochemistry. Sprague-Dawley female rats were studied on days 10 (P 10), 12 (P 12), 14 (P 14), 17 (P 17), and 19 (P 19) of pregnancy. Western blot analysis demonstrated that the expression of NBC, ~110 kDa at molecular mass, was increased in pregnant rats, particularly P 12, compared with NP rat. The expression of NHE-3, ~83 kDa at molecular mass, was increased in pregnant rats, particularly P 12 and P 14. The expression of CA I, ~30 kDa at molecular mass, was decreased in pregnant rats, particularly P 14, but, CA II protein, ~30 kDa at molecular mass, was similar NP rat. In immunohistochemistry, strong immunoreactivity of NBC of NP rat was exclusively detected in the basolateral membranes of S1 and S2 segment of proximal tubules whereas not in S3 segment. In pregnant rats, the pattern of cellular labeling of NBC was identical to that of NP rat, but signal intensity was increased, particularly P 12. In NHE-3, strong immunoreactivity was detected in apical membranes and brush borders of S3 segments and moderate in S1 and S2 segments. In pregnant rats, the pattern of cellular labeling was identical to that of NP rat, but the signal intensity was increased, particularly P 12 and P 14. Expression of CA I and II proteins was detected in entire collecting duct. Signal intensity was prominent in type A intercalated cells and moderate in type B intercalated cells. In pregnant rats, the pattern of cellular labeling of CA I and II proteins was identical to that of non-pregnant rat, but the signal intensity of CA I was decreased in cortical collecting duct, particularly P 14 and CA II was identical to that of NP rat. These results suggest that the regulation of NBC and NHE-3 expressions in the proximal tubules and CA I expression in cortical collecting duct may maintain HCO3-concentration during the pregnancy.

Comparison of Surgical Results between Bilateral and Unilateral Lateral Rectus Recession in 20~25 Prism Diopters Intermittent Exotropia

PURPOSE: To compare the postoperative results of unilateral lateral rectus recession with bilateral lateral rectus recession between 20 prism diopters (PD) and 25 PD intermittent exotropia for basic type. METHODS: We analyzed retrospectively the data of 27 patients underwent unilateral lateral rectus recession and 38 patients underwent bilateral lateral rectus recession with 20 PD and 25 PD intermittent exotropia for basic type from June 1996 to May 2000 at the Department of Ophthalmology of Chonnam National University Hospital. RESULTS: There were 10 cases (37.0%) in unilateral group and 8 cases (21.1%) in bilateral group showing undercorrection in the amount of deviation more than 10 PD and 2 cases (5.3%) in bilateral group showing overcorrection in the amount of deviation more than 10 PD, and there was no overcorrection in unilateral group. There was a tendency of recurrence of exotropia during the first postoperative month, but the alignment after 1 month postoperative was not much different from the alignment at the last follow-up. The mean amount of correction after surgery was 13.78+/-7.65 PD (Mean+/-SD) in unilateral group and 20.32+/-8.37 PD (Mean+/-SD) in bilateral group (P=0.002). Success rate was 73.6% in bilateral group, better than 63.0% in unilateral group although there was no statistically significant difference (p>0.05). CONCLUSIONS: The undercorrection rate of bilateral lateral rectus recession is less than that of unilateral lateral rectus recession and more satisfactory surgical outcome was obtained in bilateral lateral rectus recession; therefore bilateral lateral rectus recession can lead to good result in 20~25 PD intermittent exotropia for basic type.

Strabismus and Refractive Errors in Cerebral Palsy Patients

OBJECTIVE: The purpose of this study was to compare the patients in the rehabilitation center with the patients who had visited the Department of Ophthalmology of Chonnam University Hospital to investigate incidence and type of ocular abnormalities in cerebral palsy patients. METHODS: We compared the seventy patients who had visited the Department of Ophthalmology of Chonnam University Hospital from January 1990 to July 2000 with one hundred and six patients in the rehabilitation center, and analyzed the incidence and type of ocular abnormalities between the two groups of cerebral palsy patients. RESULTS: In rehabilitation center group, spastic type was 51 patients among 90 patients (56.7%). In outpatient group, spastic type was 48 patients among 52 patients (92.3%). In rehabilitation center group, strabismus was detected in 35 patients among 106 patients (33.0%). In outpatient group, strabismus was detected in 31 patients among 70 patients (44.3%). In rehabilitation center group, refractive errors were detected in 27 patients among 85 patients (31.8%). In outpatient group, refractive errors were detected in 28 patients among 60 patients (46.7%). CONCLUSION: We concluded that because of the high incidence of ocular abnormalities in both rehabilitation center and outpatient groups, early detection through routine screening and early treatment for the ocular abnormalities of the cerebral palsy patients would be needed.

Neovascular Glaucoma with Diabetic Retinopathy: Trabeculectomy and Nd:YAG Cyclophotocoagulation

PURPOSE: We carried out to determine the effectiveness of trabeculectomy and neodymium:YAG (Nd: YAG) cyclophotocoagulation in eyes with neovascular glaucoma from diabetic retinopathy. METHODS: We retrospectively reviewed medical records of patients who had undergone trabeculectomy or Nd:YAG cyclophotocoagulation from May 1992 to August 1997. RESULTS: The average drop in IOP was 24.6 mmHg in the trabeculectomy group and 17.3 mmHg in the transscleral cyclophotocoagulation group. Success rate was 69.2% in the trabeculectomy group and 21.4% in the transscleral cyclophotocoagulation group. Most common postoperative complication was hyphema (38.4%) in the trabeculectomy group and phthisis bulbi (21.4%) in the transscleral cyclophotocoagulation group. CONCLUSIONS: Trabeculectomy had higher success rate and less serious complications than transscleral cyclophotocoagulation. Transcleral cyclophotocoagulation may be considered as a treatment of neovascular glaucoma in the patients who have severe pain or poor general condition.

Surgical Correction of Congenital Epiblepharon: Lower Eyelid Crease Reforming Technique

Epiblepharon is a commonly encountered congenital anomaly in Asian infants and children. It causes symptoms of ocular irritation and inferior punctate corneal epithelial erosion. Surgical correction may be needed if ocular irritation symptom and corneal pathology persist with age. A series of 185 lower eyelid epiblepharon in 98 Korean children underwent lower eyelid crease reforming technique. Surgical treatment included excision of redundant skin and pretarsal orbicularis muscle with lid everting suture by anastomosis of the subcutaneous tissue and inferior tarsal border including capsulopalpebral fascia. With a minimum follow-up of 12 months, a total of 37 [20%]eyelids developed recurrence of cilia touch, and then 9 [4.8%]eye-lids needed further surgery.

The Study of Chronic Dacryocystitis: Identification of Pathogenic Organism and Histopathological Findings

The study of chronic dacryocystitis: Identification of pathogenic organism and histopathological findings. Primary acquired nasolacrimal duct obstruction is a clinical syndrome of unknown cause, and the histopathology of the nasolacrimal duct has not been substantially studied. The intent of this study was to determine what organisms grow in the lacrimal sac of patients ewquirirng dacryocystorhinostomy. It was also investigated whether or not there was a correlation between organisms cultured from the sac and from the conjunctiva. The tissue fo lacrimal sac was examined histopathologically. A total of 32 patients who had received dacryyocystorhinostomy from January 1998 to July 1998 were included. The result of the study indicate thath there is not a clinically significant correlation of pathogenic organism between conjunctiva and lacrimal sac. Most patients had histopathologic findings consisted of inflammation or fibrosis of the lacrimal sac. The incidence of significant pathology of the lacrimal sac is low. However, one case was identified as an adenocarcinoma by routine biopsy of the lacrimal sac during dacryocystorhinostomy.

Retinopathy of Prematurity and Perinatal Risk Factors

PURPOSE: The incidence of retinopathy of prematurity(ROP) which is one of the most common cause of childhood blindness has not decreased despite the restricted use of oxygen. There may be other factors responsible for ROP which could not be explained solely by improved survival of very low birth weight infants. We tried to clarify perinatal risk factors that are nrelated to the occurrence of ROP. METHODS: We enrolled 239 infants with gestational ages less than 33 wks or with birth weight less than 1,800 gm who had received ophthalrnologic examination between Jan. 1995 and Dec. 1997. The patients were categorized into two groups,' "No ROP" group as control(n=185) and ROP group as study population(n=54), and we compared the perinatal risk factors between the two. RESULTS: 54(22.6%) out of 239 infants were diagnosed as having ROP. The annual incidence of ROP decreased but the incidence of treated ROP increased. The incidence of ROP decreased with longer gestation and higher birth weight. Mean gestational age was 30.3 weeks in the study group vs 31.0 weeks in the control group, and mean birth weight was 1,390 gm and 1,586 gm, respectively. Significant factors contributing to increased incidence of ROP included: duration of oxygen therapy, ventilator therapy, total parenteral nutrition and hospitalization, frequency of hyperoxia, hypercarbia, and transfusion and respiratory distress syndrome, umbilical artery catheterization, intraventricular hemorrhage, sepsis, bronchopulmonary dysplasia, use of dexamethasone and aminophylline, pneumonia, air leak syndrome, and hyperglycemia. The incidence of ROP and treated ROP was not influenced by the mode of surfactant treatment(prophylactic vs rescue) in RDS patients and the mode of dexamethasone treatment(short vs long) in BPD patients. CONCLUSION: The risk factors for retinopathy of prematurity included gestational age, birth weight and duration of oxygen, as well as other aforementioned perinatal factors. The occurrence of ROP can be decreased by preventing preterm birth, minimizing the use of oxygen, and further morbidity can be prevented by performing proper ophthalmologic examination and doing an appropriate follow-up.

Macular Hole Surgery with Scraping the Retinal Pigment Epithelium: A Pilot Study

We performed vitreous surgery for stage 3 or 4 idiopathic macular holes and assessed the efficacy of basal retinal pigment epithelial scraping in postoperative healing of macular holes. Twelve eyes of 12 patients were included. Mean duration of symptom was 12.75 months and mean age was 65.7 years. 9 patients(75%) were female and three eyes(25%) had macular holes larger than 1/3 disc diameter. The preoperative visual acuity was 0.1 or worse in eleven eyes(92%). Postoperatively, hole closed in ten eyes(83%) and the visual acuity improved two line or more in all eyes(100%) with mean follow-up time of 12.8 months. In 5 eyes(42%), the visual acuity improved 0.3 or better. Anatomical success seemed to be related to the preoperative hole size, which statistically had no significant relationship(p=0.0593). Retinal pigment epithelial alteration was notified in three eyes(25%). This result suggests retinal pigment epithelial scraping may become adjunctive therapy in macular hole surgery and, however, care has to be taken to prevent from inducing retinal pigment epithelial alteration.