ABSTRACT
PURPOSE: To determine the effect of intraocular pressure (IOP) reduction of selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and the factors associated with the treatment result. METHODS: Forty-seven eyes of 47 OAG patients were enrolled for 180° SLT or 360° SLT, all under maximal tolerated medical therapy and with IOP above their target pressure. All patients were followed-up for at least 1 year after the procedure. Treatment success was defined as IOP reduction ≥20% from baseline at 12 months after SLT treatment without additional anti-glaucomatous intervention. RESULTS: The treatment success rate was 65.96%. Baseline IOP was 23.84 ± 4.52 mmHg in the success group and 21.44 ± 2.97 mmHg in the failure group (p = 0.035). Significant mean IOP reduction was observed at 6, 9, and 12 month follow-ups (p = 0.001 at 6 months; 0.041 at 9 months, and <0.001 at 12 months). The success rate did not vary significantly by sex (p = 0.362), age (p = 0.081), history of cataract surgery (p = 0.470), number of medications (p = 0.857), duration of medication (p = 0.613), or angular degree of SLT treatment (180° vs. 360°) (p = 0.137). There was a positive correlation between mean baseline IOP and mean reduction of IOP from baseline in the success group (p < 0.001, r = 0.861), while there was no such correlation in the failure group (p = 0.272, r = −2.921). CONCLUSIONS: SLT was an effective treatment for IOP reduction until 12 months in medically uncontrolled OAG patients. A greater amount of IOP reduction is expected in patients with higher baseline IOP in the success group.
Subject(s)
Humans , Cataract , Follow-Up Studies , Glaucoma, Open-Angle , Intraocular Pressure , TrabeculectomyABSTRACT
PURPOSE: To evaluate the accuracy of intraocular lens (IOL) power estimation and the factors associated with outcome in eyes undergoing combined phacovitrectomy for proliferative diabetic retinopathy. METHODS: We performed a retrospective case review of 39 consecutive patients (44 eyes) that underwent phacovitrectomy for proliferative diabetic retinopathy. Axial lengths were measured using ultrasound (A-scan) and/or optical biometry (IOL Master). Achieved and predicted refractions were compared to calculate the mean postoperative refractive prediction error (ME) and the mean absolute prediction error (MAE). Systemic conditions of patients and several preoperative and postoperative factors related to the postoperative refraction were analyzed. RESULTS: The ME of 44 eyes were -0.23 +/- 0.52 diopters (D) and -0.23 +/- 0.47 D after 3 and 6 months, respectively (range, -1.40~+0.79 D). There was no statistically significant difference in the refractive outcomes between the refractive errors (p = 0.959). The MAEs were 0.45 +/- 0.35 D and 0.40 +/- 0.33 D after 3 and 6 months, respectively with no statistical significant difference between the results (p = 0.196). When comparing ME in the 20 eyes that achieved both results, ultrasound was more accurate than optical biometry (p = 0.002, 0.002). The factors associated with more inaccurate ME and MAE after phacovitrectomy were diabetic nephropathy and neovascular glaucoma. CONCLUSIONS: Combined phacovitrectomy in proliferative diabetic retinopathy showed small biometric errors within the tolerable range in most cases. Patients with neovascular glaucoma and diabetic nephropathy had more inaccurate postoperative refractive power. Both optical biometry and ultrasound should be used to estimate axial lengths for improving the accuracy of IOL power calculation.
Subject(s)
Humans , Biometry , Diabetic Nephropathies , Diabetic Retinopathy , Glaucoma, Neovascular , Lenses, Intraocular , Refractive Errors , Retrospective Studies , UltrasonographyABSTRACT
PURPOSE: To report a case of idiopathic orbital inflammation presenting with isolated myositis of the superior oblique muscle. CASE SUMMARY: A 57-year-old male presented with pain in his left eye and diplopia for three months. His past history was unremarkable except surgery for a thyroid nodule six months prior. At initial presentation, his corrected vision and intraocular pressure were normal. Biomicroscopy and fundus examination were unremarkable. Nasal side swelling of the left upper eyelid was observed, and 1.5-mm proptosis of the left eye was revealed on exophthalmometry. Two and four prism diopter right hypertropia were noted at up and right-up gaze, respectively. Axial and coronal orbital computed tomography (CT) showed enhancement of isolated superior oblique muscle hypertrophy in the left eye. Systemic work-up was negative for any inflammatory disease. A presumptive diagnosis of isolated myositis of superior oblique muscle was made, and the patient was started on 30 mg of oral prednisolone daily. Pain and diplopia disappeared and proptosis of the left eye decreased to 0.5 mm after one week of treatment. Orbital CT images obtained one month after treatment showed a significant decrease in size of the left superior oblique muscle. The steroid was tapered for two months, and the patient has shown no signs of recurrence for four months after cessation of treatment. CONCLUSIONS: Idiopathic orbital inflammation presenting with isolated myositis of the superior oblique muscle is very rare and has not been previously reported in Korea. A patient presenting with pain and diplopia was diagnosed as having isolated myositis of the superior oblique muscle based on CT scan, and good results were achieved with oral steroid therapy.
Subject(s)
Humans , Male , Middle Aged , Diagnosis , Diplopia , Exophthalmos , Eyelids , Hypertrophy , Inflammation , Intraocular Pressure , Korea , Myositis , Orbit , Prednisolone , Recurrence , Strabismus , Thyroid Nodule , Tomography, X-Ray Computed , Withholding TreatmentABSTRACT
A rare case of vaginal tuberculosis is reported. A 42-year-old woman referred to our hospital for surgical treatment of a cystocele presented with vaginal mass for 2 months. Pelvic examination revealed a cystic mass at anterior vagianl wall. Her initial diagnosis was urethral diverticulum. Surgical excision was performed and pathological analysis of the specimen revealed tuberculosis. She was treated with antituberculous drugs. We emphasize the need to maintain a high index of suspicion and to biopsy any suspicious vaginal lesion in the diagnosis of vaginal tuberculosis.
Subject(s)
Adult , Female , Humans , Biopsy , Cystocele , Diagnosis , Diverticulum , Gynecological Examination , TuberculosisABSTRACT
A 29-year-old phenotypic female with 46,XY genotype presented with primary amenorrhea, no breast development, no axillary hair, no pubic hair, and clitomegaly. The vagina was blind pouch. The vagina and urethra shared same outlet. Plasma follicle-stimulating hormone (FSH) was in the normal range for female subject. Plasma luteinizing-hormone (LH) and testosterone were elevated. Plasma estradiol (E2) level was markedly low. At laparoscopy, no uterus, only vestigial remnants of fallopian tube was seen and very small streak gonad was found. According to the pathologic report, they were remnant of Mullerian duct and salpinx ("right adnexa") and streak gonad with vas deference ("left adnexa"). On the basis of the clinical, genotypic, and endocrine feature, the patient was diagnosed as testicular regression syndrome. We present it with brief review of literature.
Subject(s)
Adult , Female , Humans , Amenorrhea , Breast , Estradiol , Fallopian Tubes , Follicle Stimulating Hormone , Genotype , Gonads , Hair , Laparoscopy , Plasma , Reference Values , Testosterone , Urethra , Uterus , VaginaABSTRACT
Primary extrapulmonary small cell carcinoma(SCC) is appearing with increased frequency in the literature. These tumors have been described in the esophagus, stomach, pancreas, larynx, hypopharynx, salivary gland, nasal cavity & paranasal sinus, thymus, small & large bowel, uterine cervix, endometrium, breast, prostate, urinary bladder and skin. Small cell carcinoma of the stomach is extremely rare and a total 9 cases have been reported in the English literature. Like SCC in the lung, SCC in the alimentary tract has a aggresive behavior and prognosis of the patient is poor. We are reported a case of advanced gastric cancer diagnosed as small cell type by endoscopic biopsy. Grossly, the lesion of small cell carcinoma of the stomach, located in the upper body and gastric angle, is ulcerated with irregular margin and dirty surface covered with blodd clots and exudates.
Subject(s)
Female , Humans , Biopsy , Breast , Carcinoma, Small Cell , Cervix Uteri , Endometrium , Endoscopy , Esophagus , Exudates and Transudates , Hypopharynx , Larynx , Lung , Nasal Cavity , Pancreas , Prognosis , Prostate , Salivary Glands , Skin , Stomach Neoplasms , Stomach , Thymus Gland , Ulcer , Urinary BladderABSTRACT
Autonomously functioning thyroid nodules(AFTNs) are so named because they presumably are independent of TSH for growth and function. In general, surgery and radioactive iodine are effective therapies but reluctant to use because of complications such as hypothyroidism or cosmetic problems.Percutaneous ethanol injection therapy(PEIT) under sonographic guidance has recently been introduced as alternative therapy. But its adverse effects such as severe local pain, subcutaneous hematoma or palsy of the recurrent nerve are not negligible, therefore sufficient skill is required.In this case, the levothyroxine therapy in reducing the size of colloid thyroid nodules was not apparent within three months. Therefore we selected another sclerosing therapeutic method such as percutaneous tetracycline injection(PTI) and followed up thyroid function test, thyroid scan, ultrasonographical size and volume of nodule. The results were as follows: 1) With 0.5-0.8 cc tetracycline injection for three times, the volume of nodule was reduced after PTI; About 2.3 X 1.7 X 0.7 cm sized nodule was reduced to about 1.3 X 1.0 X 0.5 cm sized nodule. 2) There were significant improvements of TFT(subclinical hyperthyroidism to euthyroidism) and thyroid scan(solitary hot nodule to completely ablated AFTN) during 9 months follow-up after PTI as compared with the base line study. In conclusion, we experienced good results in a 22-year-old woman suffered from AFTN treated with PTI and think that PTI could be the effective, safe, simple, well tolerable procedure in the treatment of AFTN.
Subject(s)
Female , Humans , Young Adult , Colloids , Ethanol , Follow-Up Studies , Hematoma , Hyperthyroidism , Hypothyroidism , Iodine , Methods , Paralysis , Tetracycline , Thyroid Function Tests , Thyroid Gland , Thyroid Nodule , Thyroxine , UltrasonographyABSTRACT
No abstract available.
ABSTRACT
The distribution of exogenous C(14)-succinic acid by Clonorchis sinensis incubated in Tyrode medium was studied by using autoradiographic techniques. A comparison was made between macro and microautoradiographs of this worm showed that black grains derived from labeled substance were distinctly observed in parenchymal tissue, oral sucker, ventral sucker, ovary, testes, and uterine tubules with eggs. In pharynx and intestine, a low density was monitored while negligible activity was found in seminal receptacle and vitelline follicles. In studying the further details, microautoradiography was utilized. The most radioactive regions were the reticular tissue and subcuticular musculature of this fluke, closely compatible with the finding of macroautoradiography. Apparent black grains of radioactivity were also found in oral sucker, ventral sucker, pharynx, uterine tubules, eggs in uterus, and intestinal ceca. Structures showing the least radioactivity included ovary, seminal receptacle and vitelline folliciles.