Effect of Hormone Replacement Therapy on Dry Eye Syndrome in Postmenopausal Women: A Prospective Study

PURPOSE: To evaluate the effects of conjugated hormone replacement therapy (HRT) on dry eye syndrome in postmenopausal women. METHODS: Thirty-six healthy postmenopausal women (72 eyes) were included in this three-month prospective study. Schirmer test, tear film break-up time (BUT), fluorescein staining score and symptom score were performed on all patients at the time of enrollment, one month and three months after initiation of HRT. All patients received HRT consisting of conjugated estrogen and progesterone taken orally in a continuous combined regimen. RESULTS: Symptom score significantly decreased from 2.10+/-0.79 before HRT to 1.32+/-0.84 after one month and to 0.88+/-0.67 after three months (p<0.001). In addition, tear film BUT measurements significantly increased from 6.04+/-2.54 seconds to 7.99+/-2.43 seconds after one month and to 8.93+/-2.20 after three months (p<0.001). The fluorescein staining score was 0.94+/-0.71 before HRT and decreased to 0.42+/-0.60 after one month and to 0.22+/-0.42 after three months (p<0.001). CONCLUSIONS: Hormone replacement therapy consisting of conjugated estrogen and progesterone significantly improved the symptoms and signs of dry eye syndrome in postmenopausal women.

Effect of Intradermal Injection of Placenta Hydrolysate to Postburn Hyperpigmented Skin

PURPOSE: The skin hyperpigmentation or hypermelanosis caused by burns results in social withdrawal due to cosmetic problem and depression as a psychiatric aspect. The treatment of the skin hyperpigmentation includes sunscreen, whitening material, skin massage, laser therapy and plastic surgery. Placenta extract can be used to reduce and inactivate the synthesis of the important enzyme (tyrosinase) that compose melanin. This study was performed to estimate the effect of intradermal injection of placenta extract (placenta hydrolysate) for the postburn hyperpigmentation. METHODS: Total 10 subjects who have postburn hyperpigmentation were selected. Two sites of skin area from each subject were randomly selected as possible as symmetrical body area, the one site was to be 'treated site' with placenta extract, the other site was untreated 'control site'. The injection was performed weekly for about 4 weeks only to the 'treated site', not to the control site. The both site were measured by pigment index using Mexameter. The index was also converted to the percentage that indicate a change of after-injection to before-injection. RESULTS: The pigment index of 'treated site' was 399.5+/-63.9 before treatment, and then it had decreased to 333.6+/-59.5 after 4 weeks of injection. The change after injection compared to before injection was significant statistically (p0.05). CONCLUSION: As a result, in the posttburn hyperpigmentation scar, the intradermal injection of placenta extract may be helpful in the management of hyperpigmentation or rehabilitation process of the hypertrophic scar.

Burn Injury in Stroke Patients

PURPOSE: To provide epidemiologic data of the burn injuries in stroke patients and to determine the most effective prevention and education methods. METHODS: We retrospectively reviewed the medical records of patients who had been admitted to the burn center at the Hangang Sacred Heart Hospital between January 2002 and June 2008. Burn cause, size, depth, duration of hospital stay, rate of operation performed, outcomes and time from stroke onset to burn were reviewed and compared. RESULTS: We reviewed the charts of total 87 patients (57 men and 30 women with a mean age of 61.95+/-14.48 years). Places of burn were divided into two groups (at home: n=52, outside: n=25) and patients injured at home were more than twice than who were outside. According to etiology of infarction, patients group was divided into ischemic (n=49) and hemorrhagic (n=38) group. Most of the patients were injured from flame burn. The rate of operation for ischemic group was significantly higher than hemorrhagic group. The etiology of infarction and cause of burn were not significant to prognosis. Chronic group (defined as burn occurred 6 months after the onset of stroke) had the higher incidence of burn injuries. But, there was no significant relationship between the time from stroke onset to burn and burn cause, prognosis, rate of operation, total body surface area burned. Non-survivor group had a higher operation rate than survivor group, although there was no difference in total burn surface area. CONCLUSION: Functional recovery of stroke was not associated with burn injury in our study. Flame burn took the highest percentage of burn causes. We believe that studies pooling different center's results are need to improve significance of conclusion drawn from these data.

2006 Survey for KSCRS Members: Current Trends in Cataract Surgery in Korea

PURPOSE: To investigate the current situation and future trends in the field of cataract surgery in Korea. METHODS: Since 1995, the members of the Korean Society of Cataract and Refractive Surgery (KSCRS) have conducted annual surveys on cataract and refractive surgery. The 2006 annual survey, consisting of 89 multiple-choice questions, was mailed in February 2007 to 289 KSCRS members. Sixty (20.7%) members answered the questions. Current data were compared with data of previous annual surveys and with data of surveys in the United States and Europe. RESULTS: Fifty-one percent of the respondents were in their fifties. The duration of hospital stays has decreased annually, and the use of topical anesthesia (53%) has not changed. Self-sealing wound construction was the main wound closure technique in phacoemulsification (52%). The implantation of phakic intraocular lenses (IOL) was performed on 50% of the respondents, and the preferred IOLs for small incision cataract surgery were acrylic (87%). Interest in the added value of IOL has increased annually. CONCLUSIONS: This survey summarized current trends and changes in cataract surgery in Korea.

A Case of Transient Toxic Response with Accidental Intravascular Administration of Benoxinate

A 20-year-old male was admitted to our hospital due to a cosmetic problem of gynecomastia. He received a surgical resection of subcutaneous fat through an incision in the periareolar area under general anesthesia. On the postoperative fifth day, he complained of intraoral pain due to an oral ulcer. He was prescribed benoxinate at 4 mL (12 mg) for use by gargling, but instead he injected it intravenously by himself. He experienced severe tremors in the extremities, chest discomfort, and palpitation immediately after injection, and sinus tachycardia was noted on the electrocardiogram. We managed his symptoms by hydration with normal saline and oxygen supplementation. Seven hours later, his symptoms had subsided, and no further complications were observed.

Changes in Plasma Concentration of Catechloamine during Sodium Nitroprusside-induced Hypotension / 대한마취과학회지

Sodium nitroprusside is used to induce hypotension to decrease bleeding in operation site, Sodium nitroprusside decrease vascular resistance by directly relax arteriolar and venous smooth muscle, to a lesser extent. Hypotension stimulate baroreceptors and increase sympatho-adrenal activity. The function of sympatho-adrenal mdullary system may be monitored by the changes of plasma cancentrations of epinephrine and norepinephrine. To study the relationship between induced hypotension and the catecholamine release, the plasma epinephrine and norepinephrine concentration were measured before, during and after infusion of aodium nitropruaside to rabbits The results were as follows: 1) The mean arterial blood pressure decreased significantly after SNP infusion (5.0 ug/kg/minute) from the control value of 98.1+/-11.9 mmHg to 66.3+/-16.2, 57.9+/-17.9 mmHg in 10 and 20 minutes after SNP infusion (P<0.01) and 78.8+/-12.5 mmHg after discontinuation of SNP infusion. 2) The heart rate increased significantly after SNP infusion from the control value of 149.8+/-12.8 beat/minute to 166.5+/-10.8, 190.4+/-17.6 beats/minute in 10 and 20 minutes after SNP infusion (P<0.05, P<0.01) and the heart rate increased after discontinuation of SNP infusion. 3) The plasma epinephrine concentration increased significantly after SNP infusion from the control value of 181.2+/-91.9 pg/ml to 547.5+/-163.2, 837.5+/-253.6 pg/ml in 10 and 20 minutes after SNP infusion and continued to increase of epinephrine after discontinuation of SNP infusion. 4) The plasma norepinephrine concentration increased significantly after SNP infusion from the control value of 566.2+/-92.6 pg/ml to 1131.3+/-424.7, 1432.5+/-479.2 pg/ml 10 and 20 minutes after SNP infusion and continued to increase after discontinuation of SNP infusion. There was a highly significant correlation between decrease in mean arterial pressure and increase in plasma epinephrine and norepinephrine concentrations.