Analysis of Adverse Reactions Associated with Parenteral Nutrition Use in Korea

PURPOSE: To evaluate the clinical manifestations of adverse drug reactions (ADRs) of parenteral nutrition (PN) use in Korea. METHODS: The Korean Adverse Event Reporting System (KAERS) database records in 2015 on PN-treated patients were used. ADRs classified as “certain,”“probable,” and “possible” based on the WHO-Uppsala Monitoring Centre criteria were analyzed. RESULTS: In total, 21,436 ADRs from 2,346 patients were included for analysis. The mean patient age was 57.1 years and the mean number of ADRs per patient was 9.1. ADRs were reported frequently with amino acids solutions (682 events, 40.8%), followed by combinations products (519 events, 31.1%), and fat emulsions (363 events, 21.7%). The frequent ADRs were gastrointestinal (507 events, 30.3%), skin (343 events, 20.5%), general disorders (239 events, 14.3%), and central/peripheral nervous system disorders (165 events, 9.9%). The common clinical symptoms were nausea (321 events, 19.2%), vomiting (105 events, 6.3%), and vein pain (102 events, 6.1%). Serious ADRs accounted for 220 patients (9.4%) and dyspnea was the most frequent clinical manifestation. CONCLUSION: This study analyzed the KAERS data in 2015 from patients treated with PN and revealed gastrointestinal and skin disorders to be the leading ADRs.

Clinical Characteristics of Sclerosing Pseudotumor of the Orbit

Sclerosing pseudotumor of the orbit is a unique clinico-pathological entity which is characterized by an insidious, chronic and progressive fibrosing process damaging orbital structures.As this entity forms immunologically mediated fibrosis even in early phase and frequently involves orbital apex and adjacent intracranial structures, it can cause severe ocular symptoms, visual impairments and even can threaten the life. We report clinical characteristics of nine biopsy-proven cases of sclerosing pseudotumor of the orbit.Five cases out of them have shown clinical improvement with combined therapeutic approach of surgical debulking, systemic steroids therapy, radiation therapy, and immunosuppressive therapy. We believe that prompt diagnosis through biopsy, early introduction of radiation therapy and immunosuppressive therapy are the most rational, currently available treatment for sclerosing pseudotumor of the orbit.

A Case of Human Amniotic Membrane Transplantation for the Treatment of Overhanging Bleb

Overhanging bleb after trabeculectomy is a late complication which can cause visual disturbance, ocular pain and even be a risk factor of late endophthalmitis. When it fails to be managed with conservative and less invasive treatment, the bleb is to be excised surgically. In this case, the shortage of conjunctiva in the course of partial excision of the bleb was successfully managed by human amniotic membrane transplantation. Amniotic membrane is avascular tissue with thick basement membrane and rich stroma, and it can supply the conjunctiva with basement membrane and growth factors. We report the usefulness of amniotic membrane transplantation as a temporary substitute of conjunctiva and a source of stroma for its growth in the excision of overhanging bleb.

Treatment of Late Bleb Leak with Human Amniotic Membrane Transplantation

Late bleb leak after trabeculectomy is a serious and intractable complication and its frequency is increasing as antimetabolites are used in the surgery. Various modalities have been challenged in the treatment of late bleb leak but the results have not been satisfactory.Amniotic membrane is avascular tissue with thick basement membrane and rich stroma, and it can modulate wound.As it does not express HLA, it doesn t induce graft rejection. With the use of these characteristics of amniotic membrane, we report a case in which late bleb leak after trabeculectomy with MMC was successfully treated with amniotic membrane transplantation maintaining bleb function.