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1.
Article in Korean | WPRIM | ID: wpr-901127

ABSTRACT

Purpose@#To analyze the therapeutic effects, prognostic factors, and complications that occurred after iStent® or iStent inject® implantation in South Korean glaucoma patients. @*Methods@#We retrospectively analyzed 42 eyes of South Korean glaucoma patients, who were followed-up for more than 6 months after iStent® or iStent inject® implantation alone or combined with cataract surgery. Surgical success was defined as an intraocular pressure (IOP) ≤21 mmHg and an IOP reduction ≥20% from preoperative IOP levels. @*Results@#The cumulative success rate at 6 months after surgery was 45.3 ± 8.1% for iStent inject® alone (group A), 28.6 ± 13.1% for iStent® alone (group B), 81.2 ± 6.8% for iStent inject® combined with cataract surgery (group A-1), and 27.3 ± 21.8% for iStent® combined with cataract surgery (group B-1). Group A-1 showed a higher success rate than group B-1 (p = 0.007); the difference in success rates between groups A and B was not statistically significant (p = 0.579). When the success prognostic factors were analyzed by Cox regression analysis, the results showed that a higher preoperative IOP was associated with a higher surgical success rate (hazard ratio 0.80, p = 0.02). @*Conclusions@#In our patient group, iStent inject® was more effective than iStent® in combination with cataract surgery. The higher the preoperative IOP, the higher the surgical success rate; the results were significant.

2.
Article in Korean | WPRIM | ID: wpr-893423

ABSTRACT

Purpose@#To analyze the therapeutic effects, prognostic factors, and complications that occurred after iStent® or iStent inject® implantation in South Korean glaucoma patients. @*Methods@#We retrospectively analyzed 42 eyes of South Korean glaucoma patients, who were followed-up for more than 6 months after iStent® or iStent inject® implantation alone or combined with cataract surgery. Surgical success was defined as an intraocular pressure (IOP) ≤21 mmHg and an IOP reduction ≥20% from preoperative IOP levels. @*Results@#The cumulative success rate at 6 months after surgery was 45.3 ± 8.1% for iStent inject® alone (group A), 28.6 ± 13.1% for iStent® alone (group B), 81.2 ± 6.8% for iStent inject® combined with cataract surgery (group A-1), and 27.3 ± 21.8% for iStent® combined with cataract surgery (group B-1). Group A-1 showed a higher success rate than group B-1 (p = 0.007); the difference in success rates between groups A and B was not statistically significant (p = 0.579). When the success prognostic factors were analyzed by Cox regression analysis, the results showed that a higher preoperative IOP was associated with a higher surgical success rate (hazard ratio 0.80, p = 0.02). @*Conclusions@#In our patient group, iStent inject® was more effective than iStent® in combination with cataract surgery. The higher the preoperative IOP, the higher the surgical success rate; the results were significant.

3.
Yonsei Medical Journal ; : 705-711, 2020.
Article | WPRIM | ID: wpr-833321

ABSTRACT

Purpose@#In the recent antiretroviral therapy (ART) era, a large proportion of Korean patients with human immunodeficiency virus (HIV) infection were shown to have low CD4 cell counts at diagnosis and during ART initiation. We investigated the survival trends in patients living with HIV/acquired immunodeficiency syndrome (AIDS) in Korea who started ART in the 2000s, and evaluated the risk factors for mortality to elucidate the association between survival and low CD4 cell counts at ART initiation. @*Materials and Methods@#Patients with HIV infection who were aged >18 years and had started ART between 2001 and 2015 in the Korean HIV/AIDS cohort study were enrolled. We compared the clinical characteristics, mortality, and causes of death among the enrolled subjects based on the time of ART initiation. Cox regression analysis was used to estimate the adjusted hazard ratios of mortality based on the time of ART initiation. @*Results@#Among the 2474 patients enrolled, 105 (4.24%) died during the follow-up period of 9568 patient-years. Although CD4 cell counts at the time of ART initiation significantly increased from 161 [interquartile range (IQR), 73.5–303] in 2001–2003 to 273 (IQR, 108–399) in 2013–2015 (p40 years [adjusted hazard ratio, 3.71; 95% confidence interval (CI), 2.35–5.84] and low CD4 counts (<100 cells/mm3: adjusted hazard ratio, 2.99; 95% CI, 1.44–6.23) were significant risk factors for mortality. @*Conclusion@#Despite excellent HIV care available in the recent ART era, the survival of patients with HIV/AIDS undergoing ART did not improve between 2001 and 2015 in Korea.

4.
Korean Journal of Medicine ; : 237-245, 2019.
Article in Korean | WPRIM | ID: wpr-759940

ABSTRACT

Measles is a highly contagious infectious disease characterized by fever, rash, cough, coryza, and conjunctivitis. The causative organism is the measles virus transmitted via the respiratory route. Before the introduction of an effective vaccine, measles was one of most prevalent diseases worldwide. Mortality may occur in patients with complications, including pneumonia, which is the most common cause of measles-associated death. The diagnosis of measles is based on clinical symptoms and laboratory tests, including the detection of measles virus-specific antibodies or measles virus ribonucleic acid and cultured viruses. The treatment for measles is primarily supportive care. In Korea, availability of the measles vaccine has substantially reduced the incidence and mortality of the disease. The World Health Organization verified the elimination of measles in March 2014; however, small outbreaks continue to be reported. Although a large proportion of measles cases occur in infants less than 1 year old, the disease has been reported in young adults with a history of measles vaccination. Here, we review the current literature on measles and discuss the importance of measles prevention in Korean adults.


Subject(s)
Adult , Antibodies , Communicable Diseases , Conjunctivitis , Cough , Diagnosis , Disease Outbreaks , Exanthema , Fever , Humans , Incidence , Infant , Korea , Measles Vaccine , Measles virus , Measles , Mortality , Pneumonia , RNA , Vaccination , World Health Organization , Young Adult
5.
Article in English | WPRIM | ID: wpr-765378

ABSTRACT

OBJECTIVE: Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection. METHODS: Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5–10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed. RESULTS: Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05). CONCLUSION: Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.


Subject(s)
Animals , Braces , Follow-Up Studies , Humans , Joint Deformities, Acquired , Kyphosis , Lordosis , Male , Mental Health , Osteotomy , Pseudarthrosis , Scoliosis , Spine
6.
Article in Korean | WPRIM | ID: wpr-770037

ABSTRACT

Globally, the elderly population is increasing rapidly, which means that the number of deformity correction operations for elderly spine deformity patient has increased. On the other hand, for aged patients with deformity correction operation, preoperative considerations to reduce the complications and predict a good clinical outcome are not completely understood. First, medical comorbidity needs to be evaluated preoperatively with the Cumulative Illness Rating Scale for Geriatrics or the Charlson Comorbidity Index scores. Medical comorbidities are associated with the postoperative complication rate. Managing these comorbidities preoperatively decreases the complications after a spine deformity correction operation. Second, bone densitometry need to be checked for osteoporosis. Many surgical techniques have been introduced to prevent the complications associated with posterior instrumentation for osteoporosis patients. The preoperative use of an osteogenesis inducing agent


Subject(s)
Aged , Comorbidity , Compensation and Redress , Congenital Abnormalities , Densitometry , Geriatrics , Hand , Humans , Lower Extremity , Osteogenesis , Osteoporosis , Pelvis , Postoperative Complications , Posture , Spine , Teriparatide
7.
Article in English | WPRIM | ID: wpr-788805

ABSTRACT

OBJECTIVE: Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection.METHODS: Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5–10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed.RESULTS: Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05).CONCLUSION: Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.


Subject(s)
Animals , Braces , Follow-Up Studies , Humans , Joint Deformities, Acquired , Kyphosis , Lordosis , Male , Mental Health , Osteotomy , Pseudarthrosis , Scoliosis , Spine
8.
Infection and Chemotherapy ; : 149-152, 2018.
Article in English | WPRIM | ID: wpr-721994

ABSTRACT

Brucellosis is a zoonotic infection that is usually transmitted from cattle to humans through ingestion of animal milk, direct contact with animal parts, or inhalation of aerosolized particles. In Korea, brucellosis seem to be transmitted through close contact with blood, fetus, urine, and placenta of domestic cow that has been infected by Brucella abortus, or inhalation of B. arbortus while examining or slaughtering cow. Brucella melitensis infection is rare in Korea and there have been no reported cases of B. melitensis originating from other countries until now. This report details a case of complicated brucellosis with infective spondylitis in a 48-year-old male construction worker recently returned from Iraq. Infection with B. melitensis was confirmed using 16s rRNA sequencing and omp31 gene analysis. The patient was successfully treated using a combination of rifampin, doxycycline, and streptomycin, in accordance with WHO guidelines. This is the first reported case of complicated brucellosis with infective spondylitis in Korea caused by B. melitensis originating from Iraq.


Subject(s)
Animals , Brucella abortus , Brucella melitensis , Brucella , Brucellosis , Cattle , Doxycycline , Eating , Fetus , Humans , Inhalation , Iraq , Korea , Male , Middle Aged , Middle East , Milk , Placenta , Rifampin , Spondylitis , Streptomycin , Zoonoses
9.
Infection and Chemotherapy ; : 149-152, 2018.
Article in English | WPRIM | ID: wpr-721489

ABSTRACT

Brucellosis is a zoonotic infection that is usually transmitted from cattle to humans through ingestion of animal milk, direct contact with animal parts, or inhalation of aerosolized particles. In Korea, brucellosis seem to be transmitted through close contact with blood, fetus, urine, and placenta of domestic cow that has been infected by Brucella abortus, or inhalation of B. arbortus while examining or slaughtering cow. Brucella melitensis infection is rare in Korea and there have been no reported cases of B. melitensis originating from other countries until now. This report details a case of complicated brucellosis with infective spondylitis in a 48-year-old male construction worker recently returned from Iraq. Infection with B. melitensis was confirmed using 16s rRNA sequencing and omp31 gene analysis. The patient was successfully treated using a combination of rifampin, doxycycline, and streptomycin, in accordance with WHO guidelines. This is the first reported case of complicated brucellosis with infective spondylitis in Korea caused by B. melitensis originating from Iraq.


Subject(s)
Animals , Brucella abortus , Brucella melitensis , Brucella , Brucellosis , Cattle , Doxycycline , Eating , Fetus , Humans , Inhalation , Iraq , Korea , Male , Middle Aged , Middle East , Milk , Placenta , Rifampin , Spondylitis , Streptomycin , Zoonoses
10.
Infection and Chemotherapy ; : 268-274, 2017.
Article in English | WPRIM | ID: wpr-102697

ABSTRACT

BACKGROUND: Despite declines in mortality and morbidity rates of patients with human immunodeficiency virus (HIV) infection as the result of highly active antiretroviral therapy, liver diseases due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a leading cause of death among HIV-infected patients. However, HIV and HBV or HCV coinfection is still poorly documented, and more information is needed to better understand the characteristics of HIV-infected patients in Korea. MATERIALS AND METHODS: A cross-sectional study was performed to investigate clinical characteristics and prevalence of HBV and HCV infection in HIV patients enrolled in the Korea HIV/acquired immune deficiency syndrome (AIDS) cohort study from 17 institutions between December 2006 and July 2013. RESULTS: Among the 1,218 HIV-infected participants, 541 were included in this study. The prevalence of HBV-HIV and HCV-HIV coinfection was 5.0% (27/541) and 1.7% (9/541), respectively. There was no patient who was positive for both HBs antigen and HCV antibody. In multivariate logistic regression analysis, HBV unvaccinated status was a significant risk factor for HBV-HIV coinfection (odds ratio = 4.95, 95% confidence interval = 1.43–17.13). CONCLUSIONS: HBV and HCV infection was more common in HIV-infected persons enrolled in the Korean HIV/AIDS cohort, than in the general population in Korea.


Subject(s)
Antiretroviral Therapy, Highly Active , Cause of Death , Cohort Studies , Coinfection , Cross-Sectional Studies , Hepacivirus , Hepatitis B virus , Hepatitis B, Chronic , Hepatitis Viruses , Hepatitis , HIV Infections , HIV , Humans , Korea , Liver Diseases , Logistic Models , Mortality , Prevalence , Risk Factors
11.
Article in Korean | WPRIM | ID: wpr-177527

ABSTRACT

STUDY DESIGN: Case report OBJECTIVES: This study introduces an interesting case of adolescent cervical myelopathy with atypical cervical magnetic resonance imaging (MRI) findings. A differential diagnosis was made, followed by successful surgical treatment. SUMMARY OF LITERATURE REVIEW: A careful differential diagnosis of high signal intensity on T2-weighted cervical MRI is necessary if there is no evidence of cervical stenosis. Recent reports have suggested that the differential diagnosis should be based on a comprehensive analysis of data, including brain MRI, a cerebrospinal fluid examination, and empirical steroid treatment. MATERIALS AND METHODS: A 17-year-old male patient complained of upper extremity weakness, gait disturbance, and decreased sensation in the upper extremity. Cervical spine MRI findings suggested C3/4 disc herniation, moderate cervical stenosis, and high signal intensity in the spinal cord. A differential diagnosis was made between cervical myelopathy and myelitis. RESULTS: Decompression and posterolateral fusion of C3/4 were performed in a 17-year-old patient with cervical myelopathy without significant cervical stenosis. Postoperatively, upper extremity sensation and weakness and gait disturbance showed improvement, and the Japanese Orthopedic Association score improved to 17 points at 6 months after surgery. CONCLUSIONS: In patients with cervical myelopathy showing high signal intensity on T2-weighted imaging without evident spinal stenosis, a differential diagnosis should be made between cervical myelopathy and myelitis; surgical decompression can be an effective treatment choice upon the diagnosis of cervical myelopathy.


Subject(s)
Adolescent , Asian Continental Ancestry Group , Brain , Cerebrospinal Fluid , Constriction, Pathologic , Decompression , Decompression, Surgical , Diagnosis , Diagnosis, Differential , Gait , Humans , Magnetic Resonance Imaging , Male , Myelitis , Orthopedics , Sensation , Spinal Cord , Spinal Cord Diseases , Spinal Stenosis , Spine , Upper Extremity
12.
Infection and Chemotherapy ; : 199-208, 2016.
Article in English | WPRIM | ID: wpr-28870

ABSTRACT

BACKGROUND: Septic shock remains a leading cause of death, despite advances in critical care management. The Surviving Sepsis Campaign (SSC) has reduced morbidity and mortality. This study evaluated risk factors for mortality in patients with septic shock who received treatment following the SSC bundles. MATERIALS AND METHODS: This retrospective cohort study included patients with septic shock who received treatments following SSC bundles in an urban emergency department between November 2007 and November 2011. Primary and secondary endpoints were all-cause 7- and 28-day mortality. RESULTS: Among 436 patients, 7- and 28-day mortality rates were 7.11% (31/436) and 14% (61/436), respectively. In multivariate analysis, high lactate level (odds ratio [OR], 1.286; 95% confidence interval [CI], 1.016–1.627; P=0.036) and low estimated glomerular filtration rate (OR, 0.953; 95% CI, 0.913–0.996; P=0.032) were independent risk factors for 7-day mortality. Risk factors for 28-day mortality were high lactate level (OR, 1.346; 95% CI, 1.083–1.673; P=0.008) and high Acute Physiology and Chronic Health Evaluation II score (OR, 1.153; 95% CI, 1.029–1.293; P=0.014). CONCLUSION: The risk of mortality of septic shock patients remains high in patients with high lactate levels and acute kidney injury.


Subject(s)
Acute Kidney Injury , APACHE , Cause of Death , Cohort Studies , Critical Care , Emergency Service, Hospital , Glomerular Filtration Rate , Humans , Lactic Acid , Mortality , Multivariate Analysis , Retrospective Studies , Risk Factors , Sepsis , Shock, Septic
14.
Asian Spine Journal ; : 728-733, 2016.
Article in English | WPRIM | ID: wpr-148223

ABSTRACT

STUDY DESIGN: Retrospective study. PURPOSE: To identify the prevalence of severe headache occurring after cervical posterior surgical fixation (PSF) and to evaluate the clinical and radiological findings associated with severe headache after surgery. OVERVIEW OF LITERATURE: Several studies have reported on the axial pain after cervical surgery. However, to our knowledge, the incidence of severe headache after cervical PSF has not been elucidated. METHODS: The medical records and radiological assessment of patients who underwent surgical treatment from August 2002 to May 2012 were reviewed to identify the prevalence and risk factors for severe headaches occurring following PSF from C2 distally. Neck disability index scores (NDI) (the item for neck pain), the type of C2 screw, number of cervical fused levels (1–6), and smoking habit were calculated preoperatively and postoperatively. In addition, radiological parameters (T1 slope angle, C1/2 angle, C2–7 Cobb angle, C2–7 sagittal vertical axis and C1-implant distance) were assessed for all patients. Severe headache was defined as a high NDI headache score (>4 out of 5). RESULTS: Eighty-two patients met the inclusion criteria. The mean age was 59.2 years (range, 21–78 years), and the mean number of fused levels was 5.1. The mean follow-up period was 2.9 years (range, 1–10.9 years). While only one severe headache occurred de novo postoperatively in a patient in the C3 or C4 distally group (total 30 patients, average age of 50.2 years), 11 patients in the C2 distally group (p=0.04) had severe headache occur postoperatively. The radiological parameters were not significantly different between the postoperative milder headache and severe headache (SH) groups. The SH group had a significantly higher preoperative NDI score (neck pain) (p<0.01). CONCLUSIONS: Newly occurring severe headaches can occur in 18% of patients after PSF from C2 distally. The patients with newly occurring severe headaches had significantly higher preoperative NDI score (neck pain).


Subject(s)
Follow-Up Studies , Headache , Humans , Incidence , Medical Records , Neck , Prevalence , Retrospective Studies , Risk Factors , Smoke , Smoking
15.
Article in Korean | WPRIM | ID: wpr-66374

ABSTRACT

STUDY DESIGN: Literature review. OBJECTIVES: To present updated information on the relationship of the pelvis and lumbar degenerative disease (LDD) patients and to emphasize the importance of the pelvis in sagittal alignment of LDD patients. SUMMARY OF LITERATURE REVIEW: Although the relationship of the pelvis and sagittal alignment of LDD patients is controversial, many authors have reported a significant impact of the pelvis on LDD sagittal alignment. MATERIALS AND METHODS: The authors identified references through a literature search on the pelvis and LDD and continuous monitoring of the literature during the past 30 years. RESULTS: The pelvis and lumbar levels were related to whole-body sagittal alignment. The pelvis is also closely related to sagittal alignment of LDD patients. Therefore, the entire area should be regarded as a lumbopelvic complex. CONCLUSIONS: We need to consider the concept of a lumbopelvic joint and lumbopelvic lordosis, not a lumbosacral joint and lumbar lordosis. We must also evaluate the lumbopelvic complex to assess whole-body sagittal alignment and dynamic balance.


Subject(s)
Animals , Humans , Joints , Lordosis , Pelvis
16.
Article in English | WPRIM | ID: wpr-143640

ABSTRACT

How the news media cover cancer may have profound significance for cancer prevention and control; however, little is known about the actual content of cancer news coverage in Korea. This research thus aimed to examine news portrayal of specific cancer types with respect to threat and efficacy, and to investigate whether news portrayal corresponds to actual cancer statistics. A content analysis of 1,138 cancer news stories was conducted, using a representative sample from 23 news outlets (television, newspapers, and other news media) in Korea over a 5-year period from 2008 to 2012. Cancer incidence and mortality rates were obtained from the Korean Statistical Information Service. Results suggest that threat was most prominent in news stories on pancreatic cancer (with 87% of the articles containing threat information with specific details), followed by liver (80%) and lung cancers (70%), and least in stomach cancer (41%). Efficacy information with details was conveyed most often in articles on colorectal (54%), skin (54%), and liver (50%) cancers, and least in thyroid cancer (17%). In terms of discrepancies between news portrayal and actual statistics, the threat of pancreatic and liver cancers was overreported, whereas the threat of stomach and prostate cancers was underreported. Efficacy information regarding cervical and colorectal cancers was overrepresented in the news relative to cancer statistics; efficacy of lung and thyroid cancers was underreported. Findings provide important implications for medical professionals to understand news information about particular cancers as a basis for public (mis)perception, and to communicate effectively about cancer risk with the public and patients.


Subject(s)
Communication , Humans , Incidence , Internet/statistics & numerical data , Liver Neoplasms/epidemiology , Male , Mass Media/statistics & numerical data , Neoplasms/epidemiology , Pancreatic Neoplasms/epidemiology , Prostatic Neoplasms/epidemiology , Republic of Korea/epidemiology , Retrospective Studies , Stomach Neoplasms/epidemiology
17.
Article in English | WPRIM | ID: wpr-143629

ABSTRACT

How the news media cover cancer may have profound significance for cancer prevention and control; however, little is known about the actual content of cancer news coverage in Korea. This research thus aimed to examine news portrayal of specific cancer types with respect to threat and efficacy, and to investigate whether news portrayal corresponds to actual cancer statistics. A content analysis of 1,138 cancer news stories was conducted, using a representative sample from 23 news outlets (television, newspapers, and other news media) in Korea over a 5-year period from 2008 to 2012. Cancer incidence and mortality rates were obtained from the Korean Statistical Information Service. Results suggest that threat was most prominent in news stories on pancreatic cancer (with 87% of the articles containing threat information with specific details), followed by liver (80%) and lung cancers (70%), and least in stomach cancer (41%). Efficacy information with details was conveyed most often in articles on colorectal (54%), skin (54%), and liver (50%) cancers, and least in thyroid cancer (17%). In terms of discrepancies between news portrayal and actual statistics, the threat of pancreatic and liver cancers was overreported, whereas the threat of stomach and prostate cancers was underreported. Efficacy information regarding cervical and colorectal cancers was overrepresented in the news relative to cancer statistics; efficacy of lung and thyroid cancers was underreported. Findings provide important implications for medical professionals to understand news information about particular cancers as a basis for public (mis)perception, and to communicate effectively about cancer risk with the public and patients.


Subject(s)
Communication , Humans , Incidence , Internet/statistics & numerical data , Liver Neoplasms/epidemiology , Male , Mass Media/statistics & numerical data , Neoplasms/epidemiology , Pancreatic Neoplasms/epidemiology , Prostatic Neoplasms/epidemiology , Republic of Korea/epidemiology , Retrospective Studies , Stomach Neoplasms/epidemiology
18.
Article in Korean | WPRIM | ID: wpr-86209

ABSTRACT

PURPOSE: To evaluate the clinical efficacy and shortcomings of neodymium-doped yttrium aluminum garnet (Nd-YAG) laser membranotomy in inadvertently retained host membrane. METHODS: Among 742 patients who underwent penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) surgery at Seoul St. Mary's Hospital between January 2007 and May 2013 by a single surgeon, 10 patients had a thin, opaque membrane in the anterior chamber observed under slit lamp examination and both a subjective decrease in visual acuity and decrease i best corrected visual acuity. A single surgeon performed membranotomy using the Nd-YAG laser at 4.9 months after graft surgery. In this study we compared the differences in visual acuity, endothelial cell count and correlations between distance from donor endothelium and retained host membrane and endothelial loss before and after the graft surgery. RESULTS: Patients who had Nd-YAG laser membranotomy performed on the retained host membrane showed significant improvements in visual acuity (p = 0.039). Donor endothelial cell count was significantly reduced 1 month after Nd-YAG laser. The average distance between donor endothelium and retained host membrane was 712.0 +/- 217.5 microm. The distance and the decreased donor endothelial cell count were not statistically correlated (R2 = 0.39, p = 0.072). There were no significant complications after the laser membranotomy. CONCLUSIONS: Inadvertently retained host membrane forms close to the donor endothelium as identified on optical coherence tomography (OCT) images. Nd-YAG laser membranotomy significantly affected clear vision but endothelial cell count loss was also observed.


Subject(s)
Aluminum , Anterior Chamber , Corneal Transplantation , Endothelial Cells , Endothelium , Humans , Keratoplasty, Penetrating , Lasers, Solid-State , Membranes , Seoul , Tissue Donors , Tomography, Optical Coherence , Transplants , Visual Acuity , Yttrium
19.
Article in Korean | WPRIM | ID: wpr-45184

ABSTRACT

PURPOSE: To seek for mechanisms to prevent fixed dilated pupil including Urrets-Zavalia syndrome after intraocular surgery by analyzing and classifying the causes of such cases. METHODS: Medical records and anterior segment photographic images of patients with fixed dilated pupil who underwent penetrating keratoplasty, lamellar keratoplasty, or cataract surgery were analyzed in a retrospective manner from April, 1984 to February, 2014. RESULTS: Among 15 cases of postoperative fixed dilated pupil, 8 eyes of keratoconus eyes had received penetrating keratoplasty done and 7 eyes with ocular disorders other than keratoconus underwent intraocular surgeries. In cases 1 and case 2, which received penetrating keratoplasty for keratoconus, dilated pupil with regular pupil border, iris atrophy, and secondary glaucoma occurred; these cases were classified as group 1 and diagnosed as Urrets-Zavalia syndrome. Cases from 3 to 8 which also received penetrating keratoplasties due to keratoconus, irregularly dilated pupil, severe iris atrophy, posterior synechiae after moderate to severe inflammation in the anterior chamber, and fibrotic membrane on the anterior capsule occurred; these cases were classified as group 2. Finally, cases 9 to 15, which had mild inflammation, no fibrotic membrane, and regularly fixed dilated pupil after receiving other intraocular surgeries were classified as group 3. CONCLUSIONS: Differences exist between definite Urrets-Zavalia syndrome and postoperative fixed dilated pupil with regards to regularity of pupillary margin, degree of iris atrophy, posterior synechiae, fibrotic membrane, and posterior subcapsular opacity. Therefore, a new classification of fixed dilated pupil after intraocular surgery which addresses these characteristics is required and various trials to prevent the adverse postoperative complications of fixed dilated pupil should be performed. Preventive measures may include careful control of intraocular pressure, restricting atropine use, completely removing of viscoelastics, and minimal air or gas injection.


Subject(s)
Anterior Chamber , Atrophy , Atropine , Cataract , Classification , Corneal Transplantation , Glaucoma , Humans , Inflammation , Intraocular Pressure , Iris , Keratoconus , Keratoplasty, Penetrating , Medical Records , Membranes , Postoperative Complications , Pupil , Retrospective Studies
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