Comparison of Ocular Biometric Measurements Using New Swept-source Optical-coherence Tomography, Low-coherence Reflectometry, A-Scan Biometry, and Autokeratometry

Purpose@#We compared optical biometric measurements made using new swept-source optical-coherence tomography, low-coherence reflectometry, autokeratometry, and A-scan biometry. @*Methods@#In total, 86 eyes of 47 patients were included. Axial length, lens thickness, central corneal thickness, anterior chamber depth, and corneal curvature were measured using the Anterion® (Heidelberg Engineering, inc., Heidelberg, Germany) and Lenstar LS 900® (Haag-Streit AG, Koeniz, Switzerland) platforms. Corneal curvature and axial length were measured using the Essilor AKR 750® (Essilor instruments, France, Charenton-le-Pont) and PacScan 300A® (Sonomed Inc., Chicago, IL, USA) platforms, respectively. The evaluated biometric parameters were compared and verified; intraclass correlation coefficients and Bland-Altman plots were used to analyze statistical agreement. @*Results@#The differences between the Anterion® and Lenstar LS 900® platforms in terms of axial length, lens thickness, central corneal thickness, anterior chamber depth, and white-to-white diameter were -0.02 ± 0.08, 0.08 ± 0.13, -2.66 ± 11.12, 0.05 ± 0.12, and 0.08 ± 0.26, respectively. All values were statistically significant. The mean corneal curvature between Anterion® and Lenstar LS 900® had a statistically significant difference of -0.08 ± 0.47, while the difference between the Anterion® and AKR 750® platforms was not significant. Biometric parameters measured using an Anterion® and other devices showed a strong positive correlation when assessed using Pearson’s correlation analysis; there was good agreement between the results when analyzed using intraclass correlation coefficients and Bland-Altman plots. @*Conclusions@#Optical biometric measurements made using the Anterion® platform were not significantly different from those obtained using other devices, but there were significant differences compared to the Lenstar LS 900® platform. Since these significant differences could influence decision making during intraocular lens selection for cataract surgery, the values are clinically useful for reference.

Efficacy and Safety of a Fixed Combination of Bimatoprost (0.03% w/v) and Timolol (0.5% w/v) for Patients with Open-angle Glaucoma

Purpose@#We investigated the efficacy and safety of a fixed combination of bimatoprost (0.03% w/v) and timolol (0.5% w/v) (Ganfort® , Allergan Inc., Irvine, CA, USA; fixed combination of bimatoprost-timolol, BTFC) for open-angle glaucoma patients. @*Methods@#We included 25 right eyes with open-angle glaucoma treated with eye drops. The drops were changed to the BTFC without a wash-out period. The therapeutic and adverse effects were evaluated by comparing the intraocular pressure (IOP) before the change to that at 1, 4, 7, and 10 months thereafter. @*Results@#The mean IOP before the instillation of eyedrop and the mean reduction of IOP at each time was 18.66 ± 8.22 mmHg (n = 21) and 2.47 ± 3.19 mmHg (13.24%) at 1 month, 19.05 ± 8.54 mmHg (n = 18) and 3.68 ± 5.55 mmHg (19.32%) at 4 months, 16.68 ± 2.52 mmHg (n = 16) and 2.13 ± 2.87 mmHg (12.77%) at 7 months, and 20.07 ± 9.91 mmHg (n = 14) and 2.79 ± 4.48 mmHg (13.90%) at 10 months (p < 0.05). Side effects included soreness (two eyes, 7.7%), red eye and allergic symptoms (three patients, 11.5%), and discomfort (three patients, 11.5%); there were no severe adverse events such as permanent vision loss or systemic side effects. @*Conclusions@#BTFC reduced the IOP of open-angle glaucoma patients without causing permanent vision loss or any other serious side effects.

Is the critical pathway effective for the treatment of gastric cancer? / 대한외과학회지

PURPOSE: The present study was conducted to investigate the low compliance rate of the critical pathway (CP) and whether CP is effective for treatment of gastric cancer in radical gastrectomy. METHODS: The medical records of 631 patients who had undergone radical gastrectomy with D2 lymph node dissection were reviewed. This study compared data from patients in early gastric cancer (EGC) and advanced gastric cancer (AGC) groups, which were further subdivided into general care (non-CP) and CP groups. RESULTS: The mean length of preoperative hospital stays were significantly different between the EGC and AGC patients (P 0.05). The postoperative and total cost of hospitalization was not statistically different between either of the groups (P > 0.05); however, the mean preoperative costs were significantly different (P < 0.05). CONCLUSION: We conclude that use of the CP following gastrectomy is unnecessary. To decrease the length of hospital stay and associated costs, preoperative examination and consultation should be performed before admission.

Impact of Malnutrition Risk Determined by Nutrition Screening Index on Operative Morbidity after Gastric Cancer Surgery

PURPOSE: Nutrition status is regarded as an important factor for postoperative morbidity in cancer surgery. The aim of this study was to evaluate the impact of the malnutrition risk, determined by Seoul National University Hospital-Nutrition Screening Index (SNUH-NSI), on operative morbidity after gastrectomy for gastric cancer. METHODS: This study enrolled 246 patients who had undergone gastrectomy for gastric cancer at Seoul National University Hospital from March 2009 to February 2010. We collected general patient information, SNUH-NSI at administration and related parameters (serum albumin, cholesterol, total lymphocyte counts, hemoglobin and body mass index), operative method, hospital stay and operative morbidity. RESULTS: The patients' mean age was 59.6+/-11.3 years, and 9.4% (n=23) of patients were rated as severe malnutrition risk. There was no difference in operative morbidity by age or sex. The patients with high risk of malnutrition by SNUH-NSI or with advanced gastric cancer showed higher operative morbidity (P<0.01). There were no relationships between biochemical parameters and operative morbidity. On multivariate analysis, the significant independent risk factors were severe malnutrition by SNUH-NSI (OR 2.627, 95% CI 1.033~6.679; P<0.05) and advanced gastric cancer (OR 2.023, 95% CI 1.074~3.811; P<0.05). CONCLUSION: Overall nutritional status, rather than single data, is more related to operative morbidity in gastrectomized patients. Especially severe malnutrition as determined by SNUH-NSI, is an independent risk factor for operative morbidity. Nutritional support to severely malnourished patient by SNUH-NSI is expected to be an effective approach in preventing complications after gastrectomy.

Seroepidemiological Studies of Aino Virus Infection in Korean Cattle

Aino virus infection is characterized by abortion, stillbirth, and congenital abnormalities such as arthropgryposis-hydranencephaly syndrome in calves. In Korea, Aino virus infection was first reported in 1997 by researchers who were investigating the cause of newborn calf deformities. Given the incidence of Aino-related deformities, the need for a study of the Aino virus infection status in Korea was recognized. In this study, we investigated the nationwide seroepidemiological status of Aino virus infection. A total of 9,921 serum samples collected between 1993 and 2001, and 23,760 serum samples between 2002 and 2007 were tested using a virus neutralization assay. The seroprevalence of Aino virus was 73.1, 63.8, 44.9, 56.0, 38.5, 28.4 18.3, 19.6, and 23.2%, respectively, between 1993 and 2001, and 43.8, 42.9, 50.7, 55.3, 31.4, and 25.4%, respectively, between 2002 and 2007. Aino virus infection does not pose a major threat to the bovine industry in Korea till now. The future prospects for Aino virus infection in cattle, however, may change with the global warming phenomena. The results of this study may serve as a basis for future epidemiological studies on Aino virus infection.

Management of an Intra-abdominal Fluid Collection after Gastric Cancer Surgery

PURPOSE: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. MATERIALS AND METHODS: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. RESULTS: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, kg/m2) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. CONCLUSION: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.

Efficacy and Safety of Intraveous Iron Sucrose in the Perioperatively Anemic Patients of Gastrectomy

PURPOSE: This study was aimed to evaluate the efficacy and safety of of intravenous iron sucrose (Venoferrum(R)) for treating the perioperative anemic gastrectomy patients. MATERIALS AND METHODS: From September 2006 to February 2007 at Seoul National University Hospital, the gastrectomy patients who displayed perioperative anemia (7.0 g/dl or = 1 month after gastrectomy) patients without evidence of acute bleeding were included into Group 1. The immediate postoperative (< 1 month after gastrectomy) patients with stable vital signs were included into Group 2. The age, gender, diagnosis, Hb, hematocrit (Hct), mean corpuscular volume (MCV), serum ferritin (SF), total iron binding capacity (TIBC), serum iron and reticulocyte counts (RC) were evaluated before and after intravenous iron sucrose administration. The adverse effects of drugs were investigated. RESULTS: The number of patients of group 1 and group 2 was 79 and 46, respectively. In group 1, there was a statistically significant difference in the Hb, Hct, MCV, SF, RC and TIBC with each mean change of 1.3 g/dl, 4.1%, 3.1fl, 195 ng/ml, 0.2% and -86.4 ug/dl, respectively. In group 2, there was a statistically significant difference in the Hb, Hct, MCV, SF and RC with each mean change of 1.8 g/dl, 6.1%, 3.4fl, 260 ng/ml and 0.3%, respectively. Two patients (1.6%) suffered local thrombophlebitis as an adverse effect. CONCLUSION: Intravenous iron sucrose for the perioperative anemia of gastrectomy patients was efficacious in the short period without significant adverse effects.

Safety and Efficacy of Postoperative Total Parenteral Nutrition (TPN) in Patients after Gastrectomy

PURPOSE: Total parenteral nutrition (TPN) has been widely used in malnourished, critically ill or surgical patients since the 1970's. However, short-term application of TPN after elective gastrointestinal surgery has rarely been studied. The purpose of this study was to evaluate the safety and efficacy of postoperative TPN in patients after gastrectomy. METHODS: Forty seven patients who underwent elective gastrectomy from October 2005 to December 2005 were enrolled in this trial. Twenty two patients (TPN group) received multivitamin-containing TPN (Fulcaliq(R), Terumo, Japan) and 25 patients (control group) received the usual 10% dextrose solution for five days after surgery. Vital signs, body weight and nutritional support-related complications were evaluated on a daily basis. In addition, CBC, LFT, electrolyte, and trace elements were measured four times (preoperatively, POD1, POD 3 and POD 6). RESULTS: Nutritional support-related complications did not develop in the groups studied. Body weight and serum albumin levels were not different in comparisons between the two groups. However, in the TPN group, the total protein level on POD 6 had a tendency to be higher than in the control group. On POD 6, AST and ALT levels were significantly higher in the TPN group, but the total bilirubin and cholesterol levels were significantly higher in the control group. CONCLUSION: Multivitamin-containing TPN appears to be safe and effective for patients, in the short term, after gastric surgery.