Treatment of Branch Retinal Artery Occlusion With Transluminal Nd:YAG Laser Embolysis

The purpose of this paper was to report a successful treatment of transluminal Nd:YAG laser embolysis (NYE) for branch retinal artery occlusion (BRAO) with visible emboli. Two patients with acute, severe vision loss secondary to a branch retinal artery occlusion with visible emboli in one eye underwent NYE. A complete ocular examination was performed which included biomicroscopy of the posterior pole of the retina, intraocular pressure measurement, fundus color photographs, and fluorescein angiography (FA). After the NYE, the two patients showed dramatic improvements in best-corrected visual acuity, as well as, immediate and dramatic restorations in flow past the obstructed arteriole in FA. NYE is a treatment modality to be considered in patients with BRAO who present acutely with severe vision loss and a visible embolus.

Lid Reconstruction Using the Porous Polyethylene (Medpor(R)) Sheet

PURPOSE: To assess the efficacy of porous polyethylene (Medpor(R)) sheet as a substitute material for tarsus in lid reconstruction of rabbits. METHODS: A nonrandomized animal study was conducted in 12 rabbits. The Medpor(R) sheet which has a 0.85 mm thickness with barrier surface was implanted in 6 rabbits, and the Medpor(R) sheet without barrier surface was implanted in the others. The full-thickeness eyelid defect which was one third size of eyelid were made in the center of eyelids, and then the Medpor(R) sheet substituted for tarsal plate was sutured with conjuctiva, muscle and skin. At 1, 2 and 4 weeks after implantation, the status of eyelid defect coverage and corneal injury were evaluated. RESULTS: At 1 and 2 weeks after implantation, the shape of eyelid was well maintained, but at 4 weeks, implanted Medpor(R) was exposed and dislocated. However, there was no injury of cornea. CONCLUSIONS: In this study, Medpor(R) sheet which has a 0.85mm thickness was not useful as a substitute for tarsal plate because of incomplete fibrovascularization. The further study for the development of variable size, thickness and shape of Medpor(R) sheet is aquired.

A Case of Chemotherapy of Neuroblastoma Diagnosed by Proptosis

PURPOSE: A case of proptosis due to orbital metastasis of neuroblstoma and review of the current literature on neuroblastoma METHODS: A 8-month-old female presented with proptosis due to neuroblastoma involving skull and bone marrow. RESULTS: Proptosis was improved following chemotherapy. CONCLUSIONS: In case of infant who has a proptosis and periorbital ecchymosis without a primary lesion or a specific history, neuroblastoma may be considered as a differential diagnosis.

A Case of Acute Myocardial Infarction In Man Treated with Chemotherapy containing Doxorubicin for Non-Hodgkin Lymphoma

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.

A Case of Acute Myocardial Infarction In Man Treated with Chemotherapy containing Doxorubicin for Non-Hodgkin Lymphoma

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.

A Case of Idiopathic Orbital Myositis Involving All Extraocular Muscles of Both Eyes

PURPOSE: To report a case of idiopathic orbital myositis involving all extraocular muscles bilaterally after trauma and to review current literatures on the orbital myositis. METHODS: The idiopathic orbital myositis primarily involving the extraocular muscles is a subtype of nonspecific orbital inflammation. Pathophysiology of orbital myositis, although unknown, is likely to be an immune-mediated mechanism. A 17-year-old male presented with the orbital myositis involving all extraocular muscle after blunt head trauma. RESULTS: Treatment of the idiopathic orbital myositis with oral corticosteroid and radiotherapy has been reported to be ineffective in cases involving 4 extraocular muscles. We herein report an experience of treating a case of orbital myositis involving all extraocular muscles with intravenous corticosteroid and radiotherapy.

Clinical Usefulness of Systolic Time Intervals and QT-QS2 Value as Complication Predictors in Myocardial Infarction

Over the physiologic range of heart rate, the duration of electrical systole(QT) is shorter than that of electromechanical systole(QS2), which reflects direct physiologic link between electrical repolarization and mechanical events of the cardiac cycle. The present study designed to test usefulness of systolic time intervals and QT-QS2(QT minus QS2) value as complication predictors, which may predict prognostic status of myocardial infarction. The studied subjects were consisted of 33 healthy adults as control(22 men, 11 women) and 35 patients with myocardial infarction. And studied patients were divided into 3 groups; group I of 14 patients with or without complication in acute stage, group II of 11 uncomplicated patients under recovery of chronic status, group III of 10 complicated patients under recovery or chronic status. The observation periods were 3 to 13 days in group I, 5 to 96 weeks in group II and III after their onset. The results were follows; 1) The normal ranges were defined as mean+/-2 standard deviations of the measured values of control, that of QTc were shorter than 431ms of man and 458ms of woman, that of QS2 I were longer than 503ms of man and 514ms of woman, that of PEP/LVET ratio was less than 0.40, that of QT-QS2 value was less than 0 ms respectively. 2) QTc of all patient groups were significantly prolonged compared with that of control, and that of group III was significantly longer than that of group II(481+/-25 vs 432+/-32, pQS2 in group I and III. and QTQS2 had positive predictive value of 82% for predicting probability of previous complicated status. We concluded that QT-QS2 value, including PEP/LVET ratio and QTc, could be used as complication predictors. But it is necessary to examine these indicators prospectively to confirm its clinical applicability.

A Clinical Study on Coenzyme Q10(Neuquinon(R)) in the Treatment of Congestive Heart Failure

Coenzyme Q is concentrated in Golgi apparatus membranes and mitochondria, but not in other membranes. Although it is difficult to prove the metabolic action of coenzyme Q administered exogenously in clinical cases, the effect of this substance can be evaluated by criteria based on clinical findings. In an attempt to evaluate the effect of coenzyme Q for the treatment of 67 patients(male 26 cases, female 41 cases) of congestive heart failure, we administered Coenzyme Q1030mg daily for 4 to 8 weeks. Most of them were valvular heart disease(74.6%) and hypertension (14.9%). Clinical effects were evaluated at least 4 weeks later by the criteria using a scoring method of severity of congestive heart failure which was devised by Ishiyama, etc. In summary, a definite effect was found in 13 cases(19%) and a mild effect was observed in 46 cases(69%). During treatment there were no significant side effects, and also no significant changes in heart rate and blood pressure.

A Study on Plasma Renin Activity in Normal and Essential Hypertension in Korea

Plasma renin activity (ORA) was determined by radioimmunoassay in 55 normal controls and 121 hypertensive patients in basal state and after double stimulation with furosemide administration and upright posture of 4 hrs. The results were obtained as follows, 1) Mean value of PRA of normal control was 2.2+/-1.41ng/ml/hr in basal state and 2.9+/-1.39ng/ml/hr after double stimulation, respectively. The latter was elevated significantly as compaired to the former. 2) PRA in males was significantly higher than in females, and PRA tend to be decreased as age become old. 3) Normal value of PRA after double stimulation was ranged from 1.0 to 5.0 ng/ml/hr. Of total 121 hypertensive patients(55 males and 66 females), PRA was low in 33 cases(27.3%), normal in 77 cases (63.6%), and high in 11 cases(9.1%). 4) Of 55 male hypertensive patients, PRA was low in 13 cases(23.6%), normal in 35 cases (63.7%), and high in 7 cases(12.7%). Of 66 female hypertensive patients,, PRA was low in 20 cases (30.3%), normal in 42 cases(63.6%), and high in 4 cases(6.1%). High renin group was observed more frequently in male hypertensive patients than in female hypertensive patients, while low renin group more frequently in famale than in male patients. 5) Low renin group was observed more frequently in older age group than in younger age group, while high renin group more frequently in younger age than in older age group.