Clinical safety and effectiveness of the Genoss drug-eluting stent in real-world clinical practice

Background/Aims@#The Genoss DES™ is a novel, biodegradable, polymer-coated, sirolimus-eluting stent with a cobalt- chromium stent platform and thin strut. Although the safety and effectiveness of this stent have been previously investigated, real-world clinical outcomes data are lacking. Therefore, the aim of this prospective, multicenter trial was to evaluate the clinical safety and effectiveness of the Genoss DES™ in all-comer patients undergoing percutaneous coronary intervention. @*Methods@#The Genoss DES registry is a prospective, single-arm, observational trial for evaluation of clinical outcomes after Genoss DES™ implantation in all-comer patients undergoing percutaneous coronary intervention from 17 sites in South Korea. The primary endpoint was a device-oriented composite outcome of cardiac death, target vessel-related myocardial infarction (MI), and clinically driven target lesion revascularization (TLR) at 12 months. @*Results@#A total of 1,999 patients (66.4 ± 11.1 years of age; 72.8% male) were analyzed. At baseline, 62.8% and 36.7% of patients had hypertension and diabetes, respectively. The implanted stent number, diameter, and length per patient were 1.5 ± 0.8, 3.1 ± 0.5 mm, and 37.0 ± 25.0 mm, respectively. The primary endpoint occurred in 1.8% patients, with a cardiac death rate of 1.1%, target vessel-related MI rate of 0.2%, and clinically driven TLR rate of 0.8%. @*Conclusions@#In this real-world registry, the Genoss DES™ demonstrated excellent safety and effectiveness at 12 months among all-comer patients undergoing percutaneous coronary intervention. These findings suggest that the Genoss DES™ may be a viable treatment option for patients with coronary artery disease.

Comparison of Surgical Outcomes after Phacoemulsification between Trabeculectomized Eyes and Ahmed Valve-implanted Eyes

Purpose@#We compared the outcomes of cataract surgery in patients who underwent trabeculectomy and Ahmed glaucoma valve implantation. @*Methods@#Twenty-nine trabeculectomized eyes of 29 patients (group 1) and 20 Ahmed glaucoma valve-implanted eyes of 20 patients (group 2) were enrolled consecutively. All subjects underwent thorough ophthalmic examinations, including slit-lamp microscopy and Goldmann applanation tonometry preoperatively, on postoperative days 1 and 7, and at postoperative months 1, 3, and 6. The surgical outcomes including intraocular pressure (IOP) and the required number of IOP-lowering medications were compared between the two groups. @*Results@#The mean preoperative IOP in groups 1 and 2 was 15.34 ± 4.34 and 16.35 ± 3.44 mmHg, respectively (p = 0.265). In group 1, the IOP on postoperative day 1 increased significantly (by 3.86 ± 9.69 mmHg, p = 0.038), and the number of IOP-lowering medications rose at both 3 months (0.28 ± 0.70, p = 0.046) and 6 months (0.34 ± 0.94, p = 0.047) postoperatively. Group 2 exhibited no change in the IOP postoperatively or the number of IOP-lowering medications required in the postoperative period. Subconjunctival 5-fluorouracil injections for IOP control were required by two group 1 patients within 1 month postoperatively. @*Conclusions@#In patients with a trabeculectomized eye, the IOP increased immediately after cataract surgery; additional IOP-lowering procedures were required by some patients. The number of IOP-lowering medications increased after 3 months postoperatively. As cataract surgery may compromise filtering bleb function to a greater extent in trabeculectomized than in Ahmed glaucoma valve-implanted eyes, the former eyes require closer observation during the early postoperative period.

Comparison of Surgical Outcomes after Phacoemulsification between Trabeculectomized Eyes and Ahmed Valve-implanted Eyes

Purpose@#We compared the outcomes of cataract surgery in patients who underwent trabeculectomy and Ahmed glaucoma valve implantation. @*Methods@#Twenty-nine trabeculectomized eyes of 29 patients (group 1) and 20 Ahmed glaucoma valve-implanted eyes of 20 patients (group 2) were enrolled consecutively. All subjects underwent thorough ophthalmic examinations, including slit-lamp microscopy and Goldmann applanation tonometry preoperatively, on postoperative days 1 and 7, and at postoperative months 1, 3, and 6. The surgical outcomes including intraocular pressure (IOP) and the required number of IOP-lowering medications were compared between the two groups. @*Results@#The mean preoperative IOP in groups 1 and 2 was 15.34 ± 4.34 and 16.35 ± 3.44 mmHg, respectively (p = 0.265). In group 1, the IOP on postoperative day 1 increased significantly (by 3.86 ± 9.69 mmHg, p = 0.038), and the number of IOP-lowering medications rose at both 3 months (0.28 ± 0.70, p = 0.046) and 6 months (0.34 ± 0.94, p = 0.047) postoperatively. Group 2 exhibited no change in the IOP postoperatively or the number of IOP-lowering medications required in the postoperative period. Subconjunctival 5-fluorouracil injections for IOP control were required by two group 1 patients within 1 month postoperatively. @*Conclusions@#In patients with a trabeculectomized eye, the IOP increased immediately after cataract surgery; additional IOP-lowering procedures were required by some patients. The number of IOP-lowering medications increased after 3 months postoperatively. As cataract surgery may compromise filtering bleb function to a greater extent in trabeculectomized than in Ahmed glaucoma valve-implanted eyes, the former eyes require closer observation during the early postoperative period.

Safety and Efficacy of a New Ultrathin Sirolimus-Eluting Stent with Abluminal Biodegradable Polymer in Real-World Practice

BACKGROUND AND OBJECTIVES@#Recently, Genoss drug-eluting stent (DES)™ stent comprising cobalt-chromium platform with an ultrathin strut thickness, sirolimus, and an abluminal biodegradable polymer was developed. Owing to the lack of substantial evidence for the safety and efficacy of this stent, we report 12-month results of the Genoss DES™ stent.@*METHODS@#We analyzed subjects who were eligible for a 12-month follow-up from the ongoing Genoss DES™ registry, which is a prospective, single-arm, observational, multicenter trial to investigate the clinical outcomes after the successful Genoss DES™ stent implantation among all-comers. The primary endpoint was a device-oriented composite outcome, defined as cardiac death, target vessel-related myocardial infarction, and target lesion revascularization at 12-month follow-up.@*RESULTS@#Among 622 subjects, the mean age of subjects was 66.5±10.4 years, 70.6% were males, 67.5% had hypertension, and 38.3% had diabetes. The implanted stent number, diameter, and length per patient were 1.5±0.8, 3.1±0.4 mm, and 36.0±23.3 mm, respectively. At 12-month clinical follow-up, the primary endpoint occurred only in 4 (0.6%) subjects.@*CONCLUSIONS@#The novel Genoss DES™ stent exhibited excellent safety and efficacy in real-world practice.

Safety and Efficacy of a New Ultrathin Sirolimus-Eluting Stent with Abluminal Biodegradable Polymer in Real-World Practice

BACKGROUND AND OBJECTIVES: Recently, Genoss drug-eluting stent (DES)™ stent comprising cobalt-chromium platform with an ultrathin strut thickness, sirolimus, and an abluminal biodegradable polymer was developed. Owing to the lack of substantial evidence for the safety and efficacy of this stent, we report 12-month results of the Genoss DES™ stent.METHODS: We analyzed subjects who were eligible for a 12-month follow-up from the ongoing Genoss DES™ registry, which is a prospective, single-arm, observational, multicenter trial to investigate the clinical outcomes after the successful Genoss DES™ stent implantation among all-comers. The primary endpoint was a device-oriented composite outcome, defined as cardiac death, target vessel-related myocardial infarction, and target lesion revascularization at 12-month follow-up.RESULTS: Among 622 subjects, the mean age of subjects was 66.5±10.4 years, 70.6% were males, 67.5% had hypertension, and 38.3% had diabetes. The implanted stent number, diameter, and length per patient were 1.5±0.8, 3.1±0.4 mm, and 36.0±23.3 mm, respectively. At 12-month clinical follow-up, the primary endpoint occurred only in 4 (0.6%) subjects.CONCLUSIONS: The novel Genoss DES™ stent exhibited excellent safety and efficacy in real-world practice.

Diphlorethohydroxycarmalol Suppresses Ultraviolet B-Induced Matrix Metalloproteinases via Inhibition of JNK and ERK Signaling in Human Keratinocytes

Skin aging is the most readily observable process involved in human aging. Ultraviolet B (UVB) radiation causes photo-oxidation via generation of reactive oxygen species (ROS), thereby damaging the nucleus and cytoplasm of skin cells and ultimately leading to cell death. Recent studies have shown that high levels of solar UVB irradiation induce the synthesis of matrix metalloproteinases (MMPs) in skin fibroblasts, causing photo-aging and tumor progression. The MMP family is involved in the breakdown of extracellular matrix in normal physiological processes such as embryonic development, reproduction, and tissue remodeling, as well as in disease processes such as arthritis and metastasis. We investigated the effect of diphlorethohydroxycarmalol (DPHC) against damage induced by UVB radiation in human skin keratinocytes. In UVB-irradiated cells, DPHC significantly reduced expression of MMP mRNA and protein, as well as activation of MMPs. Furthermore, DPHC reduced phosphorylation of ERK and JNK, which act upstream of c-Fos and c-Jun, respectively; consequently, DPHC inhibited the expression of c-Fos and c-Jun, which are key components of activator protein-1 (AP-1, up-regulator of MMPs). Additionally, DPHC abolished the DNA-binding activity of AP-1, and thereby prevented AP-1-mediated transcriptional activation. These data demonstrate that by inactivating ERK and JNK, DPHC inhibits induction of MMPs triggered by UVB radiation.

Dieckol, a Component of Ecklonia cava, Suppresses the Production of MDC/CCL22 via Down-Regulating STAT1 Pathway in Interferon-gamma Stimulated HaCaT Human Keratinocytes

Macrophage-derived chemokine, C-C motif chemokine 22 (MDC/CCL22), is one of the inflammatory chemokines that controls the movement of monocytes, monocyte-derived dendritic cells, and natural killer cells. Serum and skin MDC/CCL22 levels are elevated in atopic dermatitis, which suggests that the chemokines produced from keratinocytes are responsible for attracting inflammatory lymphocytes to the skin. A major signaling pathway in the interferon-gamma (IFN-gamma)-stimulated inflammation response involves the signal transducers and activators of transcription 1 (STAT1). In the present study, we investigated the anti-inflammatory effect of dieckol and its possible action mechanisms in the category of skin inflammation including atopic dermatitis. Dieckol inhibited MDC/CCL22 production induced by IFN-gamma (10 ng/mL) in a dose dependent manner. Dieckol (5 and 10 muM) suppressed the phosphorylation and the nuclear translocation of STAT1. These results suggest that dieckol exhibits anti-inflammatory effect via the down-regulation of STAT1 activation.

Jeju seaweeds suppress lipopolysaccharide-stimulated proinflammatory response in RAW 264.7 murine macrophages

Objective: To investigate the anti-inflammatory effects of Jeju seaweeds on macrophage RAW 264.7 cells under lipopolysaccharide (LPS) stimulation. Methods: Ethyl acetate fractions were prepared from five different types of Jeju seaweeds, Dictyopteris divaricata (D. divaricata), Dictyopteris prolifera (D. prolifera), Prionitis cornea (P. cornea), Grateloupia lanceolata (G. lanceolata), and Grateloupia filicina (G. filicina). They were screened for inhibitory effects on proinflammatory mediators and cytokines such as nitric oxide (NO), prostaglandin E

Jeju seaweeds suppress lipopolysaccharide-stimulated proinflammatory response in RAW 264.7 murine macrophages

<p><b>OBJECTIVE</b>To investigate the anti-inflammatory effects of Jeju seaweeds on macrophage RAW 264.7 cells under lipopolysaccharide (LPS) stimulation.</p><p><b>METHODS</b>Ethyl acetate fractions were prepared from five different types of Jeju seaweeds, Dictyopteris divaricata (D. divaricata), Dictyopteris prolifera (D. prolifera), Prionitis cornea (P. cornea), Grateloupia lanceolata (G. lanceolata), and Grateloupia filicina (G. filicina). They were screened for inhibitory effects on proinflammatory mediators and cytokines such as nitric oxide (NO), prostaglandin E2, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6).</p><p><b>RESULTS</b>Our results revealed that D. divaricata, D. prolifera, P. cornea, G. lanceolata, and G. filicina potently inhibited LPS-stimulated NO production (IC50 values were 18.0, 38.36, 38.43, 32.81 and 37.14 µg/mL, respectively). Consistent with these findings, D. divaricata, D. prolifera, P. cornea, and G. filicina also reduced the LPS-induced and prostaglandin E2 production in a concentration-dependent manner. Expectedly, they suppressed the expression of inducible NO synthase and cyclooxygenase-2 at the protein level in a dose-dependent manner in the RAW 264.7 cells, as determined by western blotting. In addition, the levels of TNF-α and IL-6, released into the medium, were also reduced by D. divaricata, D. prolifera, P. cornea, G. lanceolata, and G. filicina in a dose-dependent manner (IC50 values for TNF-α were 16.11, 28.21, 84.27, 45.52 and 74.75 µg/mL, respectively; IC50 values for IL-6 were 37.35, 80.08, 103.28, 62.53 and 84.28 µg/mL, respectively). The total phlorotannin content was measured by the Folin-Ciocalteu method and expressed as phloroglucinol equivalents. The content was 92.0 µg/mg for D. divaricata, 151.8 µg/mg for D. prolifera, 57.2 µg/mg for P. cornea, 53.0 µg/mg for G. lanceolata, and 40.2 µg/mg for G. filicina.</p><p><b>CONCLUSIONS</b>Thus, these findings suggest that Jeju seaweed extracts have potential therapeutic applications for inflammatory responses.</p>

Fucodiphlorethol G Purified from Ecklonia cava Suppresses Ultraviolet B Radiation-Induced Oxidative Stress and Cellular Damage

Fucodiphlorethol G (6'-[2,4-dihydroxy-6-(2,4,6-trihydroxyphenoxy)phenoxy]biphenyl-2,2',4,4',6-pentol) is a compound purified from Ecklonia cava, a brown alga that is widely distributed offshore of Jeju Island. This study investigated the protective effects of fucodiphlorethol G against oxidative damage-mediated apoptosis induced by ultraviolet B (UVB) irradiation. Fucodiphlorethol G attenuated the generation of 2, 2-diphenyl-1-picrylhydrazyl radicals and intracellular reactive oxygen species in response to UVB irradiation. Fucodiphlorethol G suppressed the inhibition of human keratinocyte growth by UVB irradiation. Additionally, the wavelength of light absorbed by fucodiphlorethol G was close to the UVB spectrum. Fucodiphlorethol G reduced UVB radiation-induced 8-isoprostane generation and DNA fragmentation in human keratinocytes. Moreover, fucodiphlorethol G reduced UVB radiation-induced loss of mitochondrial membrane potential, generation of apoptotic cells, and active caspase-9 expression. Taken together, fucodiphlorethol G protected human keratinocytes against UVB radiation-induced cell damage and apoptosis by absorbing UVB radiation and scavenging reactive oxygen species.

Reversible Symptomatic Myocarditis Induced by All-Trans Retinoic Acid Administration during Induction Treatment of Acute Promyelocytic Leukemia: Rare Cardiac Manifestation as a Retinoic Acid Syndrome

Treatment by All-trans retinoic acid (ATRA) followed by anthracycline-AraC chemotherapy has improved the outcome of acute promyelocytic leukemia. ATRA is usually well tolerated, but a few major side effects can be observed. Retinoic acid syndrome (RAS) often occurs during the induction chemotherapy of acute promyelocytic leukemia. A pericardial effusion is a common cardiac manifestation but myocarditis has been rarely documented. Here we reports a very rare case of fully recovered myocarditis as a result of RAS related to ATRA administration during induction treatment of acute promyelocytic leukemia which documented by echocardiographic evidence.

Comparison of bony changes between panoramic radiograph and cone beam computed tomographic images in patients with temporomandibular joint disorders / 대한치과교정학회지

OBJECTIVE: This study was designed to assess the diagnostic validity of digital panoramic radiographs compared to cone beam computed tomography (CBCT) in patients with temporomandibular joint disorders. METHODS: Panoramic radiograph and CBCT were taken from a total of 212 joints from 106 subjects. The joints were examined by two dentists and divided into the following six groups: normal, flattening, osteophyte formation, erosion, sclerosis, and unclassified. The sensitivity and specificity of each observer and inter-observer reliability were statistically analyzed. RESULTS: The results showed relatively high intra-observer reliability in the diagnosis of both panoramic and CBCT images and the weighted Kappa indices of panoramic and CBCT images were 0.714 and 0.727, respectively. The sensitivities of panoramic images of observer A and B to CBCT images was 82.35% and 84.30%, respectively, while the specificity of observer A and B was 58.06% and 61.54%, respectively. However, guided diagnosis from panoramic and CBCT images were statistically different (p < 0.05). CONCLUSIONS: The present study suggests that the panoramic radiograph could be used as a primary diagnostic device to detect bony changes of temporomandibular joints in clinical orthodontics, because panoramic images showed relatively high sensitivity compared to CBCT images. However, CBCT images may be one of the best choices when a more accurate diagnosis is necessary.

Comparison of Safety and Efficacy Between Silicone and Polypropylene Ahmed Glaucoma Valves

PURPOSE: To compare the safety and efficacy of polypropylene and silicone Ahmed glaucoma valves (AGVs). METHODS: The medical records of 62 consecutive refractory glaucoma patients who had undergone AGV implantion from March 2003 to December 2005 were reviewed retrospectively. Among the 62 patients, 32 patients underwent polypropylene AGV implantation (group P) and the other 30 patients underwent silicone AGV implantation (group S). Postoperative IOP, the complication rate, and the success rate were compared between the two groups. RESULTS: The life-table success rates for the group P were 81.3% at 6 months and 71.2% at 12 months, and the success rates for the group S were 89.9% at 6 months and 78.6% at 12 months, showing no significant difference between the two groups. Complications, including non-tube-related complications, were observed more frequently in the group S, but there was no significant difference between the two groups. CONCLUSIONS: The silicone AGV can reduce IOP effectively but may be associated with non-tube-related complications.

Radiologic Findings in Hydrated Hydrogel Buckles

Hydrogel buckles, which are used in scleral buckling surgery for retinal detachment, have been associated with late complications after successful retinal reattachment surgery, including strabismus, extraocular motility restriction, extrusion through the eyelid or conjunctiva, intraocular erosion, and scleral erosion. Hydrogel buckles sometimes appear as well-marginated, circumferential, lobulating, contoured cystic masses mimicking orbital cysts on orbital CT or MRI. We report the radiologic findings in 5 patients whose hydrogel buckles needed to be differentiated from orbital cysts.

The radioprotective effects of the hexane and ethyl acetate extracts of Callophyllis japonica in mice that undergo whole body irradiation

The radioprotective activity of extracts from the red seaweed Callophyllis (C.) japonica was investigated in mice that underwent whole-body exposure to gamma radiation. A methanol extract of C. japonica and its fractions [hexane, ethyl acetate (EtOAc), butanol and the remaining H(2)O] were used. Each fraction (100 mg/kg body weight) was administered intraperitoneally (i.p.) 2 times into the BALB/c mice, once at 1 and once at 24 h before exposure to 9 Gray (Gy) of gamma radiation. Pre-irradiation administration of the hexane and EtOAc fractions saved the mice, with their survival rates being greater than 80% at 30 days post-irradiation; the mice that were pretreated with the other fractions showed survival rates lower than 20% over the same time period. To examine the effect of each C. japonica fraction on the survival of intestinal and bone marrow stem cells, the number of intestinal crypts and bone marrow cells in the gamma-irradiated mice were examined. Pre-treatment of mice (i.p., 100 mg/kg body weight at 1 and 24 h before irradiation) with the hexane or EtOAc fraction prior to 6-Gy irradiation significantly protected the number of jejunal crypts and bone marrow cells at 9 days after irradiation. These findings suggest that certain extracts from C. japonica, when they are administered prior to irradiation, play an important role in the survival of irradiated mice, and this is possibly due to the extracts protecting the hematopoietic cells and intestinal stem cells against gamma irradiation.

Difference in 24-Hour Ambulatory Blood Pressure in Normal Tension Glaucoma and Primary Open-Angle Glaucoma

PURPOSE: To evaluate the variation of 24-hours blood pressure in patients with normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG). METHODS: Thirty patients with NTG, 30 patients with POAG, and 30 normal controls were enrolled in this study. Each subjects underwent 24-hours ambulatory blood pressure monitoring. The variation of each parameter and difference among NTG, POAG, and control groups were compared. RESULTS: The lowest diastolic blood pressure (DBP) and the lowest mean arterial blood pressure (MAP) were significantly lower in the NTG group(51.9+/-11.3 mmHg and 66.9+/-13.1 mmHg) than in the POAG group(60.0+/-11.4 mmHg and 77.8+/-16.8 mmHg, p=0.048 and 0.024) and the control group(60.1+/-10.5 mmHg and 77.4+/-13.3 mmHg, p=0.047 and 0.031) during nighttime. More patients showed a lowest MAP less than 60 mmHg in the NTG group(8 patients, 27%) than in the POAG group(2 patients, 7%) and the control group(2 subjects, 7%, p=0.038 each). In addition, a decrease of more than 15% in DBP was more frequent in NTG group(17 patients, 57%) than in the POAG group(9 patients, 30%) and the control group(9 subjects, 30%, p=0.037 each). CONCLUSIONS: Nocturnal reduction in blood pressure may play an important role in the pathogenesis of NTG in some patients. Therefore, nighttime blood pressure should be considered as an important reference factor in diagnosis and treatment of NTG.

Central Corneal Thickness and Visual Field Progression in Primary Open-Angle Glaucoma

PURPOSE: To find difference in the rate of visual field defect progression among primary open angle glaucoma (POAG) patients grouped according to central corneal thickness (CCT). METHODS: The medical records of 87 eyes of 87 POAG patients who received were on regular treatment and had a minimum of 5 years of longitudinal Humphrey automated visual field follow-up were reviewed retrospectively. The patients were divided into 4 quartile groups by CCT, and the correlations among clinical factors, such as intraocular pressure (IOP), and change in mean deviation (MD), were analyzed. RESULTS: The thinner cornea group showed a significant trend foward higher average, maximal, and yearly maximal IOP when the IOP was corrected by CCT (p<0.01), The rate of change in MD is significantly different; -0.33+/-0.6dB, -0.28+/-0.4dB, -0.09+/-0.2dB ,-0.02+/-0.2dB starting with the thinnest cornea group (p=0.036). Correlation analysis revealed a significant correlation between CCT and the rate of change in MD (r=0.351, p=0.001). CONCLUSIONS: In POAG patients who were on regular treatment at a tertiary referral hospital, patients with thinner cornea showed faster visual field defect progression.

Late Complications after Successful Scleral Buckling Surgery Using Hydrogel Buckles

PURPOSE: To report late complications of hydrogel buckles (MIRAgel explant, MIRA, Waltham, U.S.A.) from use in scleral buckling surgery for retinal detachment. METHODS: The clinical records of 10 patients who underwent MIRAgel removal between January 1993 and March 2005 were reviewed. Preoperative computerized tomography (CT) scans were examined in three patients with suspected orbital mass. The unused and removed MIRAgel were examined by scanning electron microscopy (SEM). RESULTS: The average interval to MIRAgel removal was 9.4 years. Patients presented with complaints of restricted gaze (6 cases), exposed buckle (6 cases), palpebral mass (5 cases), and periorbital swelling (3 cases). Initially, 4 patients were misdiagnosed with orbital tumor or cellulitis. MIRAgel were removed by transconjunctival or skin incision, (totally in 7 eyes and partially in 3 eyes). CT scans showed circumferential soft tissue mass surrounding the globe with a peripherally-enhancing rim. SEM showed that unused samples had a smooth surface and uniformly sized micropores. The surfaces of the removed MIRAgel were uneven, with micropores that were distorted in shape and irregular in size. CONCLUSIONS: Because late complications with MIRAgel have various clinical aspects, complete history taking and ophthalmic examination are essential in making an accurate diagnosis and choosing proper treatment. Patients with MIRAgel should be followed up periodically, and its timely removal should be considered.

Late Complications after Successful Scleral Buckling Surgery Using Hydrogel Buckles

PURPOSE: To report late complications of hydrogel buckles (MIRAgel explant, MIRA, Waltham, U.S.A.) from use in scleral buckling surgery for retinal detachment. METHODS: The clinical records of 10 patients who underwent MIRAgel removal between January 1993 and March 2005 were reviewed. Preoperative computerized tomography (CT) scans were examined in three patients with suspected orbital mass. The unused and removed MIRAgel were examined by scanning electron microscopy (SEM). RESULTS: The average interval to MIRAgel removal was 9.4 years. Patients presented with complaints of restricted gaze (6 cases), exposed buckle (6 cases), palpebral mass (5 cases), and periorbital swelling (3 cases). Initially, 4 patients were misdiagnosed with orbital tumor or cellulitis. MIRAgel were removed by transconjunctival or skin incision, (totally in 7 eyes and partially in 3 eyes). CT scans showed circumferential soft tissue mass surrounding the globe with a peripherally-enhancing rim. SEM showed that unused samples had a smooth surface and uniformly sized micropores. The surfaces of the removed MIRAgel were uneven, with micropores that were distorted in shape and irregular in size. CONCLUSIONS: Because late complications with MIRAgel have various clinical aspects, complete history taking and ophthalmic examination are essential in making an accurate diagnosis and choosing proper treatment. Patients with MIRAgel should be followed up periodically, and its timely removal should be considered.

Investigation of Hemodynamic Changes in the Ophthalmic Artery using Color Doppler Imaging after Strabismus Surgery

PURPOSE: We investigated hemodynamic changes in the ophthalmic artery (OA) using color Doppler imaging (CDI) after two horizontal rectus muscles surgery. METHODS: Eyes of the surgical group (n=18) underwent surgery on two horizontal rectus muscles, and the control group was the contralateral eyes. CDI of the OA was performed before operation and on postoperative days (POD) 1, 7 and 30. Peak systolic (Vmax), end diastolic (Vmin), and mean (Vmean) blood flow velocities were measured, and resistivity index (RI) and pulsatility index (PI) were calculated. RESULTS: Vmax, Vmin and Vmean were significantly higher, and RI and PI were significantly lower in the surgical group than in the control group on POD 1 (p< 0.05). In the surgical group, Vmax, Vmin and Vmean were significantly higher, and RI and PI were significantly lower, on POD 1 than those mesured on other days (p< 0.05). CONCLUSIONS: We showed that surgery on the two horizontal rectus muscles increased OA blood flow during the early postoperative period.