A mathematical model for the deficiency-excess mechanism of yin-yang in five viscera / 中国结合医学杂志

To raise traditional medicine to a higher level of scientific research, a mathematical model has been proposed using symbolic notations and operators to describe several disease symptoms generally recognized in traditional medicine. Even though this model to a certain degree offers a mathematical approach to identify the relationships between yin-yang and the five viscera, it is not an efficient means of explaining the pathology in traditional medicine due to its use of superfluous notations and definitions. In this paper, we introduce two concise operators, a self-development operator and an action operator: the former describes the effect of a viscus in the unbalanced state on other viscera: the latter explains the engendering and restraining relationships between the two viscera. These tools are useful to elucidate the interactions among the states of the five viscera based on yin-yang and the five elements theory. Our mathematical model with these two operators facilitates description for the scheme of deficiency-excess of yin-yang in the five viscera. Accordingly, we have mathematically refined the existing results and shown clinical applications as well.

Percutaneous Anterolateral Vertebroplasty for a Myelomatous Pathologic Fracture of the Subaxial Cervical Spine: A Case Report

The authors describe a patient with multiple myeloma who was treated for an acute cervical vertebra body fracture by percutaneous vertebroplasty. A 48-year-old female patient presented a severe neck pain without neurologic deficit. A myelomatous pathologic fracture of C4 was diagnosed, and percutaneous vertebroplasty was performed successfully through a left anterolateral approach. Her posterior neck pain was immediately relieved with vertebroplasty and no instability was observed over 18 months of follow-up.

Occurrence of diabetic ketoacidosis and autoimmune thyroiditis in a patient treated with pegylated interferon-alpha 2b and ribavirin for chronic hepatitis C / 대한간학회지

Combined pegylated interferon and ribavirin therapy for chronic hepatitis C infection cause a wide range of side effects, including flu-like syndrome, hematological abnormalities, cardiovascular symptoms, gastrointestinal symptoms, pulmonary dysfunction, depression, and retinopathy. Interferon-alpha has been shown to be related to the development of various autoimmune diseases, including systemic lupus erythematosus, rheumatoid arthritis, autoimmune thyroid disease, and type 1 diabetes mellitus (DM). Type 1 DM and thyroid disease respectively develop in 0.08~2.61% and 10~15% of patients treated with combined interferon-alpha and ribavirin for chronic hepatitis C. The coexistence of type 1 DM and autoimmune thyroiditis was rarely reported. We report a case of a 33-year-old female patient with chronic hepatitis C who simultaneously developed diabetic ketoacidosis and autoimmune thyroiditis after treatment with pegylated interferon-alpha 2b and ribavirin.

The effect of hyaluronic acid on anti-inflammatory action in mouse

PURPOSE: The purpose of this study was not only to evaluate the relative mRNA expression of interleukin-1beta(IL-1beta), cyclooxygenase2 (COX-2) and prostaglandin E2 (PGE2) by RT-PCR analysis but to observe pattern of edema by light microscopic and electron microscope after topical apply of hyaluronic acid in inflammation-guided mouse. MATERIAL AND METHODS: Mice of this study were devided into 4 groups: Control group (no inflammation guided), Positive control (inflammation guided + vaselin apply), Protopic group (inflammation guided + protopic apply), Hyaluronic group (inflammation guided + hyaluronic acid apply). RESULTS: Hyaluronic group showed less expressions of IL-1beta, COX-2, PGE2 than those of positive control & protopic group. Hyaluronic group revealed a decreased inflammation than positive control & protopic group in Light Microscope. Hyaluronic group appeared decreased edema of ear compare to positive control & protopic group in Elecron Microscope. CONCLUSION: It was considered that hyaluronic acid has an antiinflammatory effect for intercepting the gene expression of cytokines related to inflammation.

Atypical Acute Syphilitic Posterior Placoid Chorioretinitis

A 48-year-old man presented with visual dimness in the right eye that had developed 2 weeks previously. Dilated fundus examination showed few vitreous cells and numerous yellow, placoid lesions in both eyes. His right eye had more severe serous retinal detachment involving the macula. Fluorescein angiography demonstrated early irregular hypofluorescence with late staining in the areas of the yellow placoid lesions. He started a regimen of 60 mg of oral prednisone daily. Two weeks later, a serologic fluorescent treponemal antigen absorption test was positive for Ig G and Ig M. He was referred to an infectious disease specialist for antibiotic therapy. A week later, he returned, having stayed on prednisone only and not having taken the internist's antibiotic prescription. Meanwhile, the chorioretinitis in his right eye, which had initially been at a more advanced stage, was resolved with the use of steroids. The chorioretinitis in his left eye, which was aggravated at an earlier stage, ultimately recovered. Our case had atypical courses such that one eye improved and the other worsened during the same steroid treatment period. This result was inconsistent with that of previous reports showing that oral steroid influences the clinical course of acute syphilitic posterior placoid chorioretinitis.

The Clinical Features and the Clinical Outcome of Duodenal Brunner's Gland Adenoma

PURPOSE: The aim of this study was to characterize the clinical presentation and outcome of a series of patients with Brunner's gland adenoma. METHODS: Between 1996 and 2007, 15 patients who underwent surgical resection and 9 patients who underwent endoscopic polypectomy for pathologically confirmed Brunner's gland adenoma were identified. We reviewed the clinico-pathological features of these patients. RESULTS: The mean age of the total patients was 56 years and the male to female ratio was 1.4 to 1. There were no significant differences in age, gender and the polyp size between the surgical resection group and the endoscopic polypectomy group. Among the 15 patients of the surgery group, all 15 patients (100%) were symptomatic (p=0.031). The hospital stay in the endoscopic polypectomy group was significantly shorter than that in the surgery group (p=0.001). CONCLUSION: Brunner's gland adenoma is a rare duodenal tumor that occurs in middle age people and the patients with this tumor present with either gastrointestinal hemorrhage, obstructive symptoms or other incidental findings. Surgical or endoscopic excision for treating this tumor is uncomplicated, and the long-term outcome is favorable.

Long-term Results of Endoscopic Histoacryl(R) (N-butyl-2-cyanoacrylate) Injection for Treatment of Gastric Varices : A 10-year Experience / 대한소화기학회지

BACKGROUND/AIMS: Gastric variceal bleeding is an infrequent but serious complication of portal hypertension. Endoscopic injection of Histoacryl(R) (N-butyl-2-cyanoacrylate) has been approved as an effective treatment for gastric variceal bleeding. The aim of this study was to evaluate the long-term efficacy and safety of the endoscopic injection of Histoacryl(R) for the treatment of gastric varices. METHODS: Between January 1994 and January 2005, eighty-five patients with gastric varices received endoscopic injections of Histoacryl(R) . Among these 85 patients, 65 received the procedure within 1 week after gastric variceal bleeding, and 13 received as a prophylactic procedure. According to the Sarin classification, 32 patients were GOV1 and 53 were GOV2. Most of the varices were large (F2 or F3, 75 patients). The average volume of Histoacryl(R) per each session was 1.43 ml. Among 85 patients, 72 patients were followed-up and the median duration was 24.5 months. RESULTS: The rate of initial hemostasis was 98.6% and recurrent bleeding occurred in 29.2% (21 of 72). When rebleeding occurred, 76.2% was within 1 year after the initial injection. Treatment failure-related mortality rate was 1.4% (1 of 85). Twenty-seven patients died, mostly due to hepatocelluar carcinoma or liver failure. Two patients experienced pulmonary embolism and one experienced splenic infarction. They recovered without specific treatment. Rebleeding rate had a tendency to increase in patients with hepatocelluar carcinoma (p=0.051) and GOV2 (p=0.061). CONCLUSIONS: Histoacryl(R) injection therapy is a effective treatment method for gastric varices with high initial hemostasis rate and low major complications.

The Study on Healing of the Corneal Epithelial Cells in Laser Assisted Subepithelial Keratectomy (LASEK) on Rabbits

PURPOSE: To investigate the difference in healing of the corneal epithelial cells between in LASEK and in PRK and the factor to induce the difference. METHODS: The rate of corneal epithelial recovery was measured after mechanical removal of corneal epithelium (PRK) or after removal with alcohol (LASEK) in rabbits. PCNA (proliferating cell nuclear antigen) staining was performed to compare the degree of cellular proliferation. Immunocytochemical staining was also carried out to examine the expressions of fibronectin and EGFR (epidermal growth factor receptor), which were known as the factors participating in corneal epithelial regeneration. In cultured porcine corneal epithelial cells, the degree of epithelial proliferation was compared between the control group (group I without alcohol treatment) and alcohol treated groups with various alcohol concentrations (groups II, III, IV and V) after cell culture for 2 weeks. RESULTS: The rate of epithelial healing was faster in LASEK group than in PRK group. These epithelial cells recovered to normal cells faster in LASEK group than in PRK group according to light and electron microscopic findings. PCNA expression and fibronectin expression were higher in LASEK group than in PRK group, whereas no difference was seen in the expression of EGFR. Although the proliferation of corneal epithelial cells increased, it was not proportional to the amount of added alcohol-treated epithelial cells. CONCLUSIONS: We showed that the corneal epithelia recovered to normal shape faster in LASEK than in PRK group when alcohol treated corneal epithelial cells were treated to the site of the wound. Higher expression of fibronectin in LASEK group suggest that fibronectin could be a factor promoting corneal epithelial cell regeneration.

Ocular deviation after unilateral laser in situ keratomileusis

Laser keratomileusis and excimer laser photorefractive keratectomy in situ are widely used therapies for treating myopia. The corrections of refractive error by glasses or contact lens result in a relatively equal refractive correction on both eyes. However, refractive surgery on a single eye can cause a focus disparity between both eyes and may result in the impairment of fusion leading to strabismus. This article aims to report a case where diplopia and esotropia occurred 1 month after laser keratomileusis (LASIK) in situ for the correction of myopia.

The Study for the Outflow Of Aqueous Humor after Injection of Dye into the Anterior Chamber

The aqueous bumor makes an important role to maintain intraocular pressure. The production and outflow of aqueous humor controls the intraocular pressure. The accurate understanding of the pathway of aqueous outflow and the rate of outflow is essential to the study of glaucoma. The purpose of this study is to investigate the pathway of aqueous outflow after injection of dye into the anterior chamber, the duration of staining and the degree of delay of aqueous outflow after the use of viscoelastics. Three dyes. Gentian Violet, Methylene Blue and Viscoelastics mixed with Gentian Violer were injected into the anterior chambers of 20 eyes of 10 rabbits. The eyes were enucleated at 1 hour, 2 hour, 3 hour, 4 hour after injection of Gentian Violer and Methylene Blue. After injiection of viscoelastics mixed with Gentian violet, the eyes were enucleated at 2 hour, 4 hour, 6 hour, 8 hour, and 9 hour. The enucleated eyes were performed for frozen section and the fragments were observed by light microscopee. Gentian violet and Merhylene Blue were stained in the pathway of the pectinate ligaments, trabecular meshwork, intrascleral plexus and the pathway of the capillary network of iris and suprachoroidal space. The disappearance of injected dye was ended between 3 hour and 4 hour. And the viscoelastics mixed with dye was removed between 8 hour and 9 hour. This means that viscoelastics make the outflow of aqueous delay.

The Electrolyte Changes of Pig`s Lens in Experimentally Induced Cataract

Protein accounts for over one third of the human lens, the remaining two thirds being water. The other constotuents of the lens including lipids, amino acids, electrolytes and a variety of peptides and carbohydrates, account for about 1% of the lens wet weight. Since transparency of the lens is so highly dependent on protein order and structural integrity, it is not surprising that relatively small changes in any of these parameters might lead to the development of opacification resulting in a cataract.We have analyzed electrolytic differences between normal lens and lens of experimentally induced cataract to find the important factor in including cataract after we had extracted one hundred eight pig lenses. We divided these experimentally induced cataract into a group of normal lens capsule and another group of lenses which we performed with a 26 gauge needle. The sodium level was decreased in 15% mannitol solution and increased in normal saline. In every solution the potassium level was decreased. The chloride level was decreased in the 15% mannitol solution and increased in the normal saline solution. The calcium level also was decreased in mannitol and distilled water.Our results indicate that the potassium level of the experimentally induced cataracts decreased in any conditions and may be an important factor in inducing cataract.

Neuro-Behcet's disease presenting with isolated unilateral lateral rectus muscle palsy

The authors present the clinical findings of a 30-year-old female and a 29-year-old male who both had isolated unilateral lateral rectus muscle palsy in neuro-Behcet's disease. The clinical feature related to isolated abduscens nerve palsy was identified by CT, systemic assessment and extraocular examination. These patients' constellation of findings appear to be unique: it does not follow any previously reported pattern of ocular manifestations of neuro-Behcet's disease.

The effects of diffusion blur on Snellen and grating acuity and foveal function in amblyopia

In order to verify that the effects of diffusion blur on Snellen and grating acuity in amblyopic eyes resemble those obtained from the peripheral or central retina in normal controls, we conducted the following experiment using a liquid crystal window (Edmund Scientific Co.) to produce diffusion blur on Snellen and grating acuity. Spatial frequencies used for a Snellen chart and Teller acuity card were 3.2, 6.5, 13.0, 26.0 cyc/cm at a working distance of 55 cm. The values of diffusive blur on central and peripheral visual acuity obtained from 20 normal healthy control eyes were compared with those values of central visual acuity in 26 amblyopic eyes. The diffusion blur had a strong negative effect on both Snellen and grating acuity in amblyopic eyes, but it had more potent effects on grating acuity (p 0.05). Snellen acuity obtained from diffusion blur overestimated grating acuity in the normal central acuity group and amblyopic central acuity group. The result of this investigation demonstrated that the liquid crystal diffusion blur had a strong negative effect on both Snellen and grating acuity and suggested that the visual function of an amblyopic retina resembled that of a normal central retina.

Surgical Experiences of Congenital Aural Atresia Analysis of 53 Cases / 대한이비인후과학회지

Congenital aural atresia requires reconstructive surgery because of its negative effect against hearing and cosmetic problem. Two surgical methods, anterior and transmastoid approaches, have been designed for the surgery and many surgeons have advocated any techniques depending on their surgical experiences and advantages of each method. We analyzed retrospectively 53 cases of congenital aural atresia operated with the use of one of both approaches, and got the clinical, audiological and surgical results as follows. 1) Postoperative dressing period was shorter in the anterior approach(34.5 days) than in the posterior one(44.2 days). 2) Hearing results are better in the anterior approach. 3) Postoperative complications include granulation tissue formation, drum lateralization, external auditory canal stenosis and temporary facial nerve weakness. And it happened more frequently in the anterior approach than the posterior one. 4) Facial nerve anormaly was noted in 16 cases(30.2%) and cholesteatoma in 5 cases(9.4%).

The Usefulness of Sutureless Strabismus Surgery with Tissue Adhesives in Rabbit

Inadvertent perforation of the globe is the most severe complication of strabismus surgery using 6-0 vicryl. Previous studies have reported that the incidence of this complication occurs in 1% to 12.1%. In animal experiments using adhesives(Tisseel, Beriplast-P), the tissue adhesives were considered to be good materials for replacement of sutures in strabismus surgery. In clinical application, the bond strength of the immediate postoperative period is the most important factor for the success of the operation. Therefore we performed sutureless strabismus surgery with Tisseel and Beriplast-P in 10 albino rabbits to evaluate the bond strength of the immediate postoperative period. Superior and inferior rectus muscles were ercessed in 2mm length. In 5 rabbits, Tisseel was used, and those rabbits were divided into 5 groups according to the postoperative period : 10 min, 30 min, 60 min, 1 day, and 1 week after operation. The eyes were enucleated to examine the tensile strength. In the other group of 5 rabbits, Beriplast-P was used and the same experiment was performed. The mean adhesion powers in the Tisseel group were 13.13, 20.24, 22.20, 51.25, and 188.76g. gravity at 10, 30, 60 min, 1 day, and 1 week, respectively. In the Beriplast-P group they were 18.28, 22.07, 36.46, 40.73, and 181.14g. gravity. The use of tissue adhesives for sutureless strabismus surgery is considered to be impractical due to inadequate bond strength of the immediate postoperative period. Tissue adhesives with strong tensile strength in the early postoperative period could be useful in strabismus surgery.

The Effects of Diffusive Blur on Snellen and Grating Acuity in Amblyopia

Amblyopia is a disturbance of spatial or form vision that develops early in life, usually in association with strabismus, anisometropia, high refractive errors and so on. It was reported that the visual functions obtained from the foveal region of an amblyopic eye resembled those obtained from the peripheral retina rather than central retina of a normal eye. We designed this experiment which examines the effects of diffusion blur on grating and Snellen acuity in normal and amblyopic eyes, using a liquid crystal window. We obtained the value of diffusion blur in 26 amblyopic eyes and then compared the result with that of normal eyes. The diffusion blur had a strong negative effect on both the Snellen and grating acuity but it had a more potent effect on grating acuity. Because there is a significant difference in the diffusion blur produced by an amblyopic eye and a normal eye at the same vision, there is a difference between visual function of amblyopic eyes and that of normal central retina.

Orbital Malignant Melanoma Diagnosed after Evisceration for Neovascular Glaucoma

Malignant melanoma is the most common intraocular tumor in adults. Extrascleral extension has been reported to occur in 10% to 28% of patients with choroidal melanoma, and the mortality rate is much higher than that for patients without extrascleral extension. Many ophthalmologist are familiar with the difficulties that may occur in the clinical diagnosis of malignant melanoma. Especially it is very difficult if there are glaucoma, cataract, and retinal detachment. In this situation the evisceration procedure probably did permit the development of an orbital recurrence of malignant melanoma. A 50-year-old woman developed orbital mass 2 month after evisceration at the right eye for neovascular glaucoma and the patient was managed by orbital excenteration and radiotheraphy. If there are glaucoma, cataract, and retinal detachment of unknown causes, the ultrasonography and other radiologic study should be done for unsuspected malignant tumor.