Spontaneous Anterior Lens Capsular Dehiscence Causing Lens Particle Glaucoma

To report acute onset lens particle glaucoma associated with a spontaneous anterior capsular dehiscence. A 66-year-old man presented with spontaneous anterior lens capsule dehiscence with an acute onset of right eye pain that was associated with white particles in the anterior chamber angle and intraocular pressure (IOP) of 55 mmHg. No trauma or other inflammatory antecedents were reported. A hypermature cataract was observed at slit lamp exam. After medical treatment without IOP control, we performed extracapsular cataract extraction and anterior vitrectomy. Anterior chamber aspirate confirmed the presence of macrophages. The postoperative IOP at one month was 16 mmHg OD without medication. Spontaneous dehiscence of the anterior lens capsule in a patient with a hypermature cataract may release lens cortical material, resulting in lens particle glaucoma. Prompt surgical removal of the lens material usually controls the high IOP, and the need for additional glaucoma surgery is not common.

A Case of Comamonas Acidovorans Corneal Ulcer

PURPOSE: To report a case of a Comamonas acidovarans corneal ulcer treated with antibiotics in Korea. Comamonas acidovarans corneal ulcer has not been previously reported to our knowledge. METHODS: A 70-year-old woman visited our clinic complaining of left ocular pain and decreased visual acuity for six days. We performed a smear and culture on the corneal lesion and treated it with topical and systemic antibiotics. RESULTS: Comamonas acidovorans was cultured from ulcer lesion. Corneal ulcer improved with the administration of ciprofloxacin and tobramycin.

Clinical Study on Anterior Chamber Intraocular Lens Implantation in Completely Vitrectomized Eyes

PURPOSE: We studied the result and clinical significance of anterior chamber lens implantation in completely vitrectomized eyes without capsular support. METHODS: We evaluated 15 aphakic eyes of 15 patients. According to the cause of pars plana vitrectomy, there were 6 eyes for lens dislocation, 5 for intraocular foreign body, and 4 for rhegmatogenous retinal detachment. RESULTS: The final available postoperative best-corrected visual acuity was 0.5 or better in 9 eyes (60%). No statistically significant difference was noted in preoperative and postoperative IOP. The average of postoperative astigmatism was 1.14 +/- 0.79D. The most common early complication was temporary increase in IOP, but we could control IOP within normal limit with transient treatment. The postoperative late complications were glaucoma, IOL decentration and cystoid macular edema, but serious postoperative complications such as bullous keratopathy and retinal detachment were not found. CONCLUSIONS: The anterior chamber IOL implantation appears to be well tolerated and represents a simple alternative to transscleral fixation of a posterior chamber IOL in completely vitrectomized aphakic eyes.

Clinical Results of Black-Diaphragm Intraocular Lens Implantation

PURPOSE: We studied the clinical products of sulcus fixation of Black-diaphragm intraocular lens and transscleral fixation of Black-diaphragm intraocular lens in congenital and acquired aniridia patients. METHODS: We retrospectively analyzed the records of 12 aniridic eyes in 20 patients who underwent Black-diaphragm intraocular lens implantation from December 2001 to December 2003 at our hospital. We divided the aniridia eyes into sulcus fixation (group 1, 3 eyes of 3 patients) and transscleral fixation (group 2, 8 eyes of 8 patients) groups, and congenital aniridia (group A, 3 eyes of 3 patients) and acquired anirida (group B, 9 eyes of 9 patients) groups. We compared results between groups 1 and 2, and between groups A and B. RESULTS: The differences (in diopter) between preoperatively expected refractive error and postoperative refractive error were -1.27 +/- 1.06 in group 1 and -1.06 +/- 1.06 in group 2, and this difference between groups 1 and 2 was not significant. Postoperative visual acuity results in group A (0.18 +/- 0.03) were significantly better than those in group B (0.61 +/- 0.29). CONCLUSIONS: In Black-diaphragm intraocular lens implantation of aniridia patients, the differences between preoperatively expected refractive error and postoperative refractive error were not different between sulcus fixation and transscleral fixation. Better postoperative visual acuity results are anticipated in acquired aniridia patients than in congenital aniridia patients.

A Case of Anterior Chamber Irrigation with Distilled Water During Cataract Operation

PURPOSE: To report a case of anterior chamber irrigation with distilled water during cataract operation. METHODS: During the cataract operation of 56 year-old male patient, corneal edema and anterior chamber hazziness were noted after anterior chamber irrigation with distilled water for a minute. Distilled water was replaced rapidly balanced salt solution (BSS) as irrigation solution and operation was completed. At postoperative one day, corneal edema and anterior chamber exudative membrane were formed. After topical 5% NaCl, 1% prednisolone treatment, corneal edema and exudative membrane disappeared at postoperative sixth week. BCVA was 0.6. At postoperative ninth week, the patient complained of decreased visual acuity. On fundus exmination and flourescein angiography, cystoid macular edema (CME) was detected. RESULTS: After prednisolone oral administration and diclofenac eyedrop instillation, CME improved. At postoperative 24th month, BCVA was 0.8 and CME disappeared. CONCLUSIONS: From our experience of a case of anterior chamber irrigation with distilled water during cataract operation, if balanced salt solution replaces hypotonic solution rapidly as irrigation solution, corneal and other complications are managed properly, long term visual acuity appears good.

A Clinical Study on Transscleral Fixation of Posterior Chamber Intraocular Lens in Complete Vitrectomized Eyes

PURPOSE: We studied the result and cilincal significance of transscleral fixation of posterior chamber lens in complete vitrectomized eyes without capsular support. METHODS: We evaluated 30 aphakic eyes of 30 patients and according to the cause of pars plana vitrectomy, there were 9 eyes for intraocular foreign body, 8 eyes for lens dislocation, 8 eyes for retinal detachment, 3 eyes for vitreous hemorrhage, 2 eyes for endophthalmitis. RESULTS: The postoperative best-corrected visual acuity group was intraocular foreign body group and the group of lens dislocation, vitreous hemorrhage, retinal detachment, and endophthalmitis were in the descending order of visual acuity. The most common postoperative early complication was temporary hypotony and the others were hyphema, and temporary increased IOP. The most common postoperative late complication was exposed scleral fixation suture and the others were vitreous hemorrhage, cystoid macular edema, subluxation of intraocular lenses, retinal detachment. CONCLUSIONS: We experienced many postoperative temporary hypotony patients, but all cases were improved in short term period. The complication related to scleral fixation in vitrectomized eyes was imposed to smaller than the scleral fixation in vitreous support. But, in fact the development of retinal detachment or vitreous incarceration complication in the vitrectomized eye was not different from the eyes having vitreous support.

A Case of Chandler's Syndrome Associated with Anterior Uveitis

PURPOSE: To report a case of Chandler's syndrome associated with anterior uveitis. METHODS: We encountered a 39-year-old woman who complained of decreased visual acuity in the left eye with anterior uveitis and increased intraocular pressure. On examination, we found corectopia, endothelial pleomorphism and peripheral anterior synechiae, leading to the diagnosis of Chandler's syndrome with anterior uveitis. RESULTS: The anterior uveitis and increased intraocular pressure in Chandler's syndrome were well controlled with the use of Beta-blocker, Latanoprost and topical corticosteroids. We report this case with a review of the literatures.

A Case of Chandler's Syndrome Associated with Anterior Uveitis

PURPOSE: To report a case of Chandler's syndrome associated with anterior uveitis. METHODS: We encountered a 39-year-old woman who complained of decreased visual acuity in the left eye with anterior uveitis and increased intraocular pressure. On examination, we found corectopia, endothelial pleomorphism and peripheral anterior synechiae, leading to the diagnosis of Chandler's syndrome with anterior uveitis. RESULTS: The anterior uveitis and increased intraocular pressure in Chandler's syndrome were well controlled with the use of Beta-blocker, Latanoprost and topical corticosteroids. We report this case with a review of the literatures.

Expression of TGF-alpha, beta1, beta2 in Pterygial Mast cell

PURPOSE: To evaluate whether TGF-alpha, beta1, beta2 are expressed in pterygial mast cell and the difference between each growth factor exists. METHODS: We prepared 10 pieces each of excised normal conjunctiva, primary pterygium, recurrent pterygium from human eyes and then fixed those in 4% paraformaldehyde solution. The tissues were embedded in paraffin and slide samples taken from those. After that, we observed mast cells stained by immunohistochemistry against each of TGF-alpha,beta1 ,beta2 and compared the staining features between them, and we also confirmed metachromatic staining of the mast cell with toluidine blue. RESULTS: As compared with normal conjunctiva, in primary and recurrent pterygia, those counts of mast cells expressing TGF-alpha, beta1, beta2 were increased respectively with statistical significance and especially, those counts for TGF-beta1 in primary pterygium were 9 times as high as in normal conjunctiva. CONCLUSIONS: Pterygial mast cells are considered to play an important role in fibrovascular proliferation of pterygium by synthesizing and secretion of TGF-alpha, beta1, beta2 . Especially, TGF-beta1 is thought to play a more important role than TGF-alphaandbeta2 in primary pterygium.

The Effect of 5HT(3) Receptor Agonist on Intraocular Pressure and Pupil Diameter in Rabbits

PURPOSE: The effects of 5HT3 receptor agonist and antagonist on rabbit intraocular pressure (IOP) and pupil size were evaluated. METHODS: A 5HT3 receptor agonist, I-Phenylbiguanide (PBG, 1%) and a 5HT3 receptor antagonist, 3-Tropanyl-indole-carboxylate methiodide (ICS-205,930) were applied topically to the rabbit eye, and intraocular pressure and pupil diameter were checked with a Tono-PenTM XL and a ruler. RESULTS: Topical application of 1% PBG significantly increased IOP by 4.6+/-1.2 mmHg (p<0.001) over a period of up to 2 hours, the IOP maximum reached at 1 hour and caused pupil dilatation by 3.3+/-0.3mm (p<0.001) over a period of up to 5 hours, the dilation maximum reached at 2 hour. Topical preadministration of 1% ICS-205,930 prevented a rise in IOP but did not counteract on the pupil dilatation brought about by 5HT3 receptor agonist. CONCLUSIONS: These findings indicate that topically applied 5HT3 receptor agonist could raise IOP and dilate pupil.

The Efficacy of Nonpenetrating Deep Sclerectomy with 0.02% Mitomycin C

PURPOSE: To investigate the efficacy and postoperative complications of nonpenetrating deep sclerectomy(NDS) with 0.02% Mitomycin C(MMC) in primary open-angle glaucoma(POAG). METHODS: After 5 x 5 mm scleral flap was made externally, 0.02% MMC was applied under and above the scleral flap for 2 to 5 minutes. A rectangular internal scleral flap was dissected down to remove Schlemm's canal and juxtacanalicular trabecula. RESULTS: Eleven patients(16 eyes) with POAG underwent the filtering surgery of NDS. The mean follow-up was 10.7(range 6 to 12) months. The mean preoperative intraocular pressure(IOP) was 25.6+/-1.7mmHg(SEM, standard error of mean). The mean postoperative IOP was 12.3+/-1.4, 15.8+/-1.8, 15.5+/-0.9, 16.3+/-1.3, and 18.3+/-1.7 mmHg(SEM) at 1, 3, 6, 9, and 12 months, respectively. Success rate defined as an IOP lower than 21 mmHg without medication was 93.8%, 87.5% and 80.8% at 3, 6 and 12 months, respectively. Complications included two shallow anterior chambers, three wound leakages, two hypotonies and two iris adhesions to sclerectomy site. CONCLUSION: Deep sclerectomy with 0.02% MMC may contribute to a satisfactory result of effect of IOP reduction with fewer complication in management of POAG but has tendency to increase the IOP gradually as time elapsed.

Sequential Argon and Nd : YAG Laser Iridotomies in Angle Closure Glaucoma

A retrospective clinical study to evaluate the use of the argon and Nd: YAG laser in sequential combination for iridotomy was carried out on 29 eyes of 19 patients with angle closure glaucoma. The argon laser settings were standardized at 0.01-0.02 second duration and 50 micrometerspot size. The total mean energies for the argon and Nd: YAG stages were 2.7 +/-1.49J and 9.0 +/-5.83 mJ respectively. Mean postoperative decrease of intraocular pressure(IOP)was 26.4 +/-20.14 mmHg. Postoperative complications were bleeding at iridotomy site (3 eyes),transient increse in IOP (2 eyes),and posterior synechia (1 eye),but there was no lenticularopacity,and no closure of the iridotomy site. The laser iridotomy using sequential argon and Nd: YAG laser is an effective method in dark irides, lowering the mean total energy delivered per eye by the argon and YAG laser repectively, combining the advantages of both laser procedures while avoiding most of the disadvantages. We think that it is the more safe and effective method with the decreased mean total energy of argon laser at 0.01-0.02 second duration, 50 micrometerspot size followed by YAG laser.

Expression and Distribution of Beta 2 Adrenergic Receptor mRNA in the Rat eye

Beta adrenergic receptors(beta-ARs) were detected in retina, trabecular meshwork, iris and ciliary body in eye of human, cat, rabbit, and bovine using in vitro autoradiography and majority of the beta-ARs found in eye are the beta2 subtype. Recently, the beta2-AR gene has been cloned from hamster, human, rat and monkey using molecular biological methods. Expression of beta2-AR mRNA were demonstrated in smooth muscle, kidney, ovary, brain, adipose tissue, heart, epithelial cells, thymus, lung and liver. However, studies about expression and distribution of beta2-AR mRNA in the eye have not been done yet. Author have characterized the expression of beta2-AR mRNA in rat eye using in situ hybridization with 35S-UTP riboprobe. beta2-AR mRNA was expressed in corneal epithelium and stroma, ciliary epithelium, vessels of ciliary body, choroidal vessel, and retina. In contrast it was not expressed in iris and sclera in the rat eyes. These results support the hypothesis that beta2-AR mRNA may be synthesized in the various ocular tissue and its characterized distribution suggests partially that beta2-ARs are related with aqueous production and blood supply of the eye.

Toxicity of Ciprofloxacin in Vitreous Infusion Fluid on Rabbit Retina

To investigate the retinal toxicity of ciprofloxacin on retina, 23 New Zealand white rabbits received vitrectomy with intravitreal infusion that contain of 1 g/ml, 2 g/ml, 5 g/ml, 10 g/ml, and 25 g/ml of ciprofloxacin(20 eyes) or balanced salt solution(BSS) only(3 eyes). In transmission elctron microscope, no disintegration of all retinal layers and slightly irregular pattern of disc of outer segment of rod were observed in 1, 2 and 5 g/ml of ciprofloxacin groups at 14 days postinfusion. In concentration of 10 g/ml or greater, retina showed destroyed inner and outer segment of the photoreceptor cells, pyknotic nuclei in the outer nuclear layer, lucent vacoules and pigment granules in apical cytoplasm of the retinal pigment epithelium(RPE), loss of photoreceptor outer segment-RPE integration. This study suggest that infusion with 5 g/ml or less of ciprofloxacin may be safe when used in the treatment of bacterial endophthalmitis.

Introduction to Problem Based Learning / 한국의학교육

Problem-based learning(PBL) is defined as a process of acquiring understanding, knowledge, skills and attitudes in the context of an unfamiliar situation, and applying such learning to that situation. PBL is a way of enabling students thinking more efficiently than they can do in the traditional methods of largely rote learning. Because mordern medical knowledge is growing at an enormous rate, PBL is though as a mean to cope with the rapidly increasing, rapidly changing information base of medicine. The definition, goals, practice, strength, and problems of PBL in medical education are discussed. The curriculum and educational philosophy of McMaster Medical School, where PBL in small group tutorials predominates the programme, are also introduced. Hinderences from implementing PBL in our medical education are discussed.

Electron microscopic study on pseudorabies virus as a neurotracer / 대한해부학회지

No abstract available.

Study on neural axis of rat uterus using pseudorabies virus / 대한해부학회지

No abstract available.

Ontogeny of tryosine hydroxylase in rat fetus by immunohistochemistry / 대한해부학회지

No abstract available.