Changes in Eye Movement Amplitude after Conjunctivo-Limbal Autograft in Patients with Recurrent Pterygium, Ocular Motility Restriction

Purpose@#To investigate changes in eye movement amplitude after conjunctival recession and conjunctivo-limbal autograft for treating recurrent pterygium with ocular motility restriction. @*Methods@#We retrospectively analyzed 18 eyes of 16 patients who had recurrent pterygium with ocular motility restriction, who had received conjuntivo-limbal autografts from January 2011 to December 2019 and who had been followed-up for more than 6 months. We evaluated changes in eye movement amplitude, best corrected visual acuity, uncorrected visual acuity, corneal astigmatism and keratometry, and recurrence and complication rates before and after surgery. @*Results@#The mean age of the patients was 63.9 ± 9.7 years. Eye movement amplitude increased significantly from 5.80 ± 1.70 mm preoperatively to 7.02 ± 1.37 mm postoperatively (p < 0.001). The mean UCVA increased from 0.67 ± 0.46 preoperatively to 0.36 ± 0.35 postoperatively (p < 0.001). The mean corneal astigmatism decreased from 3.51 diopters (D) preoperatively to 1.22 D postoperatively (p = 0.001). According to the power vector analysis, M and B were significantly reduced after the surgery, but the changes in J0 and J45 were not significant. No recurrence of pterygium was observed. @*Conclusions@#Eye movement amplitude for severe recurrent pterygium with symblepharon or ocular motility restriction quantitatively measured the range of ocular movement clinically and was applied to determine the severity of recurrent pterygium and predict the surgical outcome. Conjunctivo-limbal autograft for severe recurrent pterygium is thought to be a safe and effective surgical method because it solves the ocular motility restriction caused by adhesions and has low recurrence rates, although it requires the skilled experience and techniques of the operator and a long operation time.

Infectious Crystalline Keratopathy Caused by Alternaria

PURPOSE: To report a case of infectious crystalline keratopathy caused by Alternaria in the corneal center. CASE SUMMARY: A 66-year-old male visited our clinic with right ocular pain and visual loss after corneal trauma caused by a foreign body hitting his right eye while performing farm work 1 month prior to his visit. The patient had no history of corneal surgery and long-term use of topical corticosteroid. A corneal epithelial defect and whitish snowflake margin infiltration around the corneal stroma were observed in the corneal center, but there was an absence of conjunctival injection and anterior segment inflammation. Cultures and a biopsy of the corneal scrapings revealed Alternaria species fungus. The patient was treated with 1% topical voriconazole and 0.5% moxifloxacin, together with oral voriconazole (400 mg/day). After 2 months of treatment, the disease was completely cured, with a minute corneal opacity. CONCLUSIONS: We successfully treated a rare case of infectious crystalline keratopathy caused by Alternaria, which has not been previously reported in the Republic of Korea.

A Case of Isolated Traumatic Aniridia in a Pseudophakic Eye

PURPOSE: We report a rare case of isolated traumatic aniridia in a pseudophakic eye. CASE SUMMARY: A 69-year-old female came to our emergency department complaining of right eye pain and visual disturbance after trauma due to fall on the stairs. Five years earlier she had undergone an uncomplicated right sutureless phacoemulsification cataract extraction through a 2.2 mm temporal clear corneal incision, followed by insertion of a folding intracapsular intraocular lens. Total iris expulsion occurred through the cataract incision without extension of the wound or disruption of the posterior capsule or intraocular lens. CONCLUSIONS: We report a rare case of isolated traumatic aniridia in a pseudophakic eye, which has not been reported in the Republic of Korea.

Fast Cardiac CINE MRI by Iterative Truncation of Small Transformed Coefficients

PURPOSE: A new compressed sensing technique by iterative truncation of small transformed coefficients (ITSC) is proposed for fast cardiac CINE MRI. MATERIALS AND METHODS: The proposed reconstruction is composed of two processes: truncation of the small transformed coefficients in the r-f domain, and restoration of the measured data in the k-t domain. The two processes are sequentially applied iteratively until the reconstructed images converge, with the assumption that the cardiac CINE images are inherently sparse in the r-f domain. A novel sampling strategy to reduce the normalized mean square error of the reconstructed images is proposed. RESULTS: The technique shows the least normalized mean square error among the four methods under comparison (zero filling, view sharing, k-t FOCUSS, and ITSC). Application of ITSC for multi-slice cardiac CINE imaging was tested with the number of slices of 2 to 8 in a single breath-hold, to demonstrate the clinical usefulness of the technique. CONCLUSIONS: Reconstructed images with the compression factors of 3-4 appear very close to the images without compression. Furthermore the proposed algorithm is computationally efficient and is stable without using matrix inversion during the reconstruction.

Anti-inflammatory Activity of Carpinus tschonoskii Leaves Extract in R848-stimulated Bone Marrow-derived Macrophages and Dendritic Cells

The present study aims to evaluate the anti-inflammatory effect of methanol extract from leaves of Carpinus tschonoskii (CE) on R848-stimulated primary bone marrow-derived macrophages (BMDMs) and dendritic cells (BMDCs). Primary BMDMs and BMDCs were used for pro-inflammatory cytokine production. Human embryonic kidney cell line 293T (HEK293T) was used to access NF-kappaB activity. In all cases, R848 was used to stimulate the cells. The CE (0~150 microg/ml) was treated to BMDMs, BMDCs, and HEK293T cells. CE pre-treatment in R848-stimulated BMDMs and BMDCs showed a dose-dependent inhibitory effect on pro-inflammatory cytokine (e.g., IL-12 p40, IL-6, and TNF-alpha) production as compared to non-treated controls. In NF-kappaB reporter gene assay, the CE pre-treatment inhibited NF-kappaB-dependent luciferase activity in a dose-dependent manner. Overall, our findings suggest that CE has significant inhibitory effect on pro-inflammatory cytokine production and deserve further studies concerning potentials of CE for medicinal uses.

Abdominal Wall Endometriosis after Cesarean Section: A Report of Two Cases / 대한산부인과학회지

Extrapelvic endometriosis remains quite rare phenomenon. The majority of extrapelvic endometriosis involve scar tissue following obstetric/gynecologic procedures. Endometriosis involving a cesarean section scar may be more common than previously recongnized. The classic symptom is a painful scar that became swollen and more tender during menstruation. The cause of surgical scar endometriosis is believed to be iatrogenic transplantation of endometrial tissue to the surgical wound. The surgical excision remains the treatment of choice for expected cures and presents the most appropriate diagnostic and therapeutic intervention. We present two cases of endometriosis appearing on the abdominal wall scar of cesarean section with a brief review of the concerned literatures.

A Case of Pelvic and Abdominal Actinomycosis Associated with Wearing an Intrauterine Device / 대한산부인과학회잡지

Actinomycosis, a rare disease entity in the upper genital tract, and caused by anaerobic bacteria, Actinomyces israelii, presents some difficulties in establishing a correct preoperative diagnosis. Pelvic actinomycosis has been reported more frequently in women with intrauterine device (IUD). Actinomycosis may be confused with malignancy and other inflammatory diseases due to its infiltrative nature and tendency to invade normal anatomic barriers. So, cervicovaginal smear is recommended for all women wearing IUDs, and actinomyosis should be suspected in such patients suffering pelvic infections. We experienced a case of pelvic and abdominal actionomycosis complicated by tuboovarian abscess in a 52 year-old woman wearing IUD and report it with a brief review of related literatures.

A study on the relationship of leptin concentrations in the maternal plasma and cord blood to fetal weight in term normal-pregnant and preeclampsia women / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.

A study on the relationship of leptin concentrations in the maternal plasma and cord blood to fetal weight in term normal-pregnant and preeclampsia women / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.

A study of the effects of epidural analgesia on the course of labor and delivery mode / 대한산부인과학회잡지

OBJECTIVE: This study was designed to evaluate the effect of epidural analgesia on the course of labor and delivery mode. METHOD: Three hundred eighteen term pregnant women with singleton fetus in vertex presentation were admitted for vaginal delivery at the Department of Obstetrics and Gynecology, medical center Chung-ju hospital from January 1, 1998 to December 31, 1998. They were divided into two groups: epidural analgesia group and non-epidural analgesia group. Epidural analgesia group was 106 women (79 primiparas and 27 multiparas). Non-epidural analgesia group was 212 women (138 primiparas and 74 multiparas). Course of labor and delivery mode were compared between the two groups. RESULTS: 1. The duration of the first stage of labor was not significantly different between two groups (primiparas: 672+/-110 min vs 625+/-134 min, multiparas: 458+/-152 min vs 422+/-184 min), and that of the second stage of labor in the primiparas was significantly longer in epidural analgesia group than non-epidural analgesia group (62+/-25 min vs 42+/-20 min, p=0.03), but did not differ significantly in the multiparas groups (36+/-12 min vs 31+/-20 min).2. Cesarean delivery rates were not significantly different between two groups (19.8% vs 15.1%).3. Cesarean delivery rates due to failure to progress were not significantly different between two groups (85.7% vs 78.1%).4. Oxytocin augmentation rates were significantly higher in epidural analgesia group than in non-epidural analgesia group (primiparas: 42.3% vs 20.1%, p=0.008, multiparas: 38.5% vs 19.7%, p=0.01).5. The newborn birthweight, Apgar score and the incidence of meconium-stained amnionic fluid were not significantly different between two groups.6. The complication of the epidural analgesia were back pain (10.4%), shivering (7.5%), nausea and vomiting (1.3%), hypotension (0.9%), and voiding difficulty (0.9%). CONCLUSION: Though epidural analgesia prolonged second stage of labor in the primiparas and increased oxytocin augmentation rates but did not increased the cesarean delivery rates. So intrapartum epidural analgesia provided safe and effective pain control without undesirable effects on labor outcomes.

A Case of Pelvic and Abdominal Actinomycosis Associated with wearing an Intrauterine Device / 대한산부인과학회잡지

Actinomycosis, rare in pelvic localization and a severe condition not well known to gynecologists, is an uncommon entity caused by anaerobic bacteria, Actinomycosis israelii. After trauma, surgery, or other infections that alter the host's mucosal barriers, these organisms advance to invade surrounding tissue and organs. The pelvic loculation of the disease generally presents as a pseudoneoplastic formation, so it is very difficult to make an accurate diagnosis initially. We experienced a pelvic and abdominal actinomycosis confirmed by pathology in a woman who had been wearing an IUD and complained fever, chill, headache for one month, and lower abdominal pain and palpable mass. This case illustrates the importance of considering the possibility of actinomycosis when we met a vague abdominal mass.