The Effect of Telmisartan on Endothelial Function and Arterial Stiffness in Patients With Essential Hypertension

BACKGROUND AND OBJECTIVES: Several studies have shown that angiotensin II receptor blockers (ARBs) improve endothelial function and arterial stiffness. Telmisartan is a highly selective ARB that activates peroxisome proliferator-activated receptor gamma (PPARgamma). The purpose of this study was to evaluate the effects of telmisartan, such as endothelial function, arterial stiffness, and insulin sensitivity, in patients with essential hypertension. SUBJECTS AND METHODS: Thirty-nine patients with essential hypertension were administered telmisartan (80 mg once daily) using an open-labeled and prospective protocol. The patients were examined before and 8 weeks after treatment to assess changes in flow mediated-vasodilation (FMD), pulse wave velocity (PWV), quantitative insulin-sensitivity check index (QUICKI), homeostasis model assessment (HOMA), and adiponection. RESULTS: The systolic and diastolic blood pressure (BP) decreased from 153+/-15 mmHg and 90+/-13 mmHg to 137+/-16 mmHg and 84+/-10 mmHg after telmisartan treatment, respectively (p<0.01). Telmisartan therapy increased the FMD from 7.6+/-3.5 to 9.0+/-2.8% (p<0.01). The following parameters of arterial stiffness were significantly improved after telmisartan therapy: brachial-ankle pulse wave velocity (baPWV), from 17.2+/-3.1 to 15.9+/-2.6 m/sec; heart-carotid PWV (hcPWV), from 9.7+/-1.8 to 9.0+/-1.9 m/sec; and heart-femoral PWV (hfPWV), from 11.3+/-1.9 to 10.7+/-1.9 m/sec (p<0.01). There were no changes in QUICKI, the HOMA level, and plasma adiponectin (p=NS). CONCLUSION:These results suggest that telmisartan is effective in improving endothelial function and arterial stiffness in patients with essential hypertension.

Anomalous Origin of the Right Coronary Artery From the Main Pulmonary Artery Presenting as Angina Pectoris in an Adult

The anomalous origin of the right coronary artery from the main pulmonary artery has been rarely reported. We report a 63-year-old male with angina pectoris who was shown to have an anomalous origin of the right coronary artery from the main pulmonary artery. The abnormal origin was identified by conventional coronary angiography, but the abnormal course of the artery was precisely delineated by high resolution multi-slice computerized tomography. The patient underwent successful surgical correction of the anomalous vessel with complete resolution of symptoms.

Adrenal Crisis after Off-pump Coronary Artery Bypass Surgery / 대한흉부외과학회지

Addisonian crisis, also commonly referred to as adrenal crisis, occurs when the cortisol produced by the adrenal gland is insufficient to meet the body's needs. Pituitary apoplexy usually occurs as hemorrhagic and ischemic necrosis in the presence of a pre-existing pituitary adenoma, and is a rare sequela of cardiovascular surgery. Most pituitary apoplexy that happens in cardiovascular surgery has been known to be related to harmful effects of the cardiopulmonary bypass. The case presented herein illustrates occult pituitary apoplexy that occurred after off-pump coronary artery bypass grafting. In this patient, the initial signs of addisonian crisis was similar to those of septic shock, and were overlooked. However, once recognized, they were reduced dramatically with standard stress-dose cortisone.

Early and Mid-term Results of Operation for Infective Endocarditis on Mitral Valve / 대한흉부외과학회지

BACKGROUND: Infective endocarditis shows higher operative morbidity and mortality rates than other cardiac diseases. The vast majority of studies on infective endocarditis have been made on aortic endocarditis, with little attention having been paid to infective endocarditis on the mitral valve. This study attempts to investigate the clinical aspects and operative results of infective endocarditis on the mitral valve. METERIAL AND METHOD: The subjects of this study consist of 23 patients who underwent operations for infective endocariditis on the mitral valve from June 1995 to May 2003. Among them, 2 patients suffered from prosthetic valvular endocarditis and the other 21 from native valvular endocarditis. The subjects were evenly distributed age-wise with an average age of 44.8+/-15.7 (11~66) years. Emergency operations were performed on seventeen patients (73.9%) due to large vegetation or instable hemodynamic status. In preoperative examinations, twelve patients exhibited congestive heart failure, four patients renal failure, two patients spleen and renal infarction, and two patients temporary neurological defects, while one patient had a brain abscess. Based on the NYHA functional classification, seven patients were determined to be at Grade II, 9 patients at Grade III, and 6 patients at Grade IV. Vegetations were detected in 20 patients while mitral regurgitation was dominant in 19 patients with 4 patients showing up as mitral stenosis dominant on the preoperative echocardiogram. Blood cultures for causative organisms were performed on all patients, and positive results were obtained from ten patients, with five cases of Streptococcus viridance, two cases of methicillin-sensitive Staphylococcus aureus, and one case each of Corynebacterium, Haemophillis, and Gernella. Operations were decided according to the AA/AHA guidelines (1988). The mean follow-up period was 27.6+/-23.3 (1~97) months. RESULT: Mitral valve replacements were performed on 13 patients, with mechanical valves being used on 9 patients and tissue valves on the other 4. Several kinds of mitral valve repair or mitral valvuloplasty were carried out on the remaining 10 patients. Associated procedures included six aortic valve replacements, two tricuspid annuloplasty, one modified Maze operation, and one direct closure of a ventricular septal defect. Postoperative complications included two cases of bleeding and one case each of mediastinitis, low cardiac output syndrome, and pneumonia. There were no cases of early deaths, or death within 30 days following the operation. No patient died in the hospital or experienced valve related complications. One patient, however, underwent mitral valvuloplasty 3 months after the operation. Another patient died from intra-cranial hemorrhage in the 31st month after the operation. Therefore, the valve-related death rate was 4.3%, and the valve-related complication rate 8.6% on mid-term follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, 3-, and 5-year survival rates were 100%, 88.8%, and 88.8%, respectively. CONCLUSION: The findings suggest that a complete removal of infected tissues is essential in the operative treatment of infectious endocarditis of the mitral valve. It is also suggested that when infected tissues are completely removed, neither type of material nor method of operation has a significant effect on the operation result. The postoperative results also suggest the need for a close follow-up observation of the patients suspected of having brain damage, which is caused by preoperative blood contamination or emboli from vegetation, for a possible cerebral vascular injury such as mycotic aneurysm.

Total Arterial Revascularization Using Y-composite Graft for Isolated Left Main Coronary Artery Disease / 대한흉부외과학회지

BACKGROUND: For the treatment of isolated left main coronary artery disease, twelve arterial revascularizations with Y-composite grafts using left internal thoracic artery and radial artery or right gastroepiploic artery were performed. This study was performed to investigate whether Y-composite graft can satisfy the blood flow required to make myocardium act properly or not. Borderline stenotic lesions on the left main coronary artery, which are very prone to remodel the bypassed vessels due to competitive flows, were also considered. MATERIAL AND METHOD: Among 247 patients who underwent coronary artery bypass grafting from March 2000 to April 2003, 12 patients (4.7%) who had received total arterial revascularizations for the isolated left main coronary artery disease were studied retrospectively. RESULT: Left anterior descending arteries were bypassed with left internal thoracic artery by off-pump technique in all patients, however, 2 cases of left obtuse marginal branches were bypassed under on-pump beating heart. Except for one patient, who did not have an obtuse marginal branch more than 1 mm in diameter, 11 patients had gone through complete arterial revascularizaions by use of the Y shape arterial graft. Among five patients who had less than 75% stenosis, one patient showed string sign on left internal thoracic artery grafted to left anterior descending artery. However, two grafts to obtuse marginal branches were completely obstructed and one showed slender sign. There were no graft-dominant flow in patients with stenotic lesion less than 75%. On the contrary to the result of patients with stenotic lesions less than 75%, all the patients with stenotic lesions more than 90% showed graft-dominant blood flow. CONCLUSION: In conclusion, it is assumed that, when stenotic lesions are over 90%, coronary artery bypass grafting with an Y shape arterial graft could possibly give enough help to the obstructed coronary arteries in blood supplying to myocardium, which needs massive quantity of blood to act well. However, when patients have borderline stenoses, through scrupulous examinations, more prudent and flexible decisions are required in choosing the treatment methods, such as, direct anastomosis of vein or artery to aorta, or adding supplementary treatment methods like percutaneous coronary intervention, rather than choosing a fixed treatment methods.

A Case of Pulmonary Endometriosis Causing Catamenial Hemoptysis / 대한흉부외과학회지

Pulmonary endometriosis is a rare disorder. We report a case of a 38-year-old woman with a 10-year history of catamenial hemoptysis due to pulmonary endometriosis which was diagnosed by CT during menstruation and treated successfully by wedge-resection of the right middle lobe. Medical therapy with hormones was not performed. There is no evidence of recurrence 5 months after the operation.

A Case of Pulmonary Inflammatory Myofibroblastic Tumor / 대한흉부외과학회지

Inflammatory myofibroblastoma is a solid tumor, occurring mainly to children and young adults, and occupying 0.7% of total isolated pulmonary nodules. Since 1973, several cases about inflammatory myofibroblastoma have been reported. Firstly, this tumor was found in lungs. Then, tumors have been founded and reported in mesentery or cardioesophageal region. Histologically, this tumor can be classified as a benign tumor. However, since this tumor has two characteristics showing malignancy, that is, local invasion and recurrence, malignancy can not be completely excluded. Recently, a patient with pulmonary inflammatory myofibroblastoma underwent surgical resection without any signs or symptoms of recurrence.

The changes of fibronectin in the cultured porcine lens epithelial cells

PURPOSE: to investigate change of fibronectin as a relating factor of cellular migration in the cultured lens epithelial cells. METHODS: We attempted to observe the fibronectin from cornea, crystalline lens and cultured lens epithelial cells by immunocytochemistry. We also compared the expression of fibronectin from normal porcine crystalline lens epithelial cells and cultured lens epithelial cells that received bFGF with western blot method. RESULTS: Fibronectin was detected in the extracellular matrix of normal corneal epithelium by immunocytochemistry, but not in the normal lens epithelial cells. However, fibronectin was detected in the cytoplasm of the cultured lens epithelial cells and treated with bFGF by immunocytochemistry. CONCLUSIONS: lens epithelial cells in normal condition may not produce fibronectin, but lens epithelial cells without lens nucleus after cataract surgery produce fibronectin.

Early Clinical Experience in Aortic Valve Replacement Using On-X(R) Prosthetic Heart Valve / 대한흉부외과학회지

BACKGROUND: Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. MATERIAL AND METHOD: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50+/-13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32 (61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6+/-10.5 months (1~39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. RESULT: Mean cardiopulmonary bypass time was 191+/-94.7 minutes with an aortic cross-clamp time of 142+/-51.7 minutes. There was no early and late mortality. Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6+/-6%; bleeding events, 90.2+/-4%; paravalvular leakage 92.3+/-4%; and overall valve-related morbidity at 1 year was 76.6+/-3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7+/-9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8+/-15.9%, p=0.006). Left ventricular mass index was 247.3+/-122.3 g/m2 on preoperative echocardiographic study, but regressed to 155.5+/-58.2 g/m2 at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5+/-38.0 mmHg on preoperative assessment, 18.2+/-6.8 mmHg at immediate postoperative period (p<0.0001), 7.6+/-5.09 mmHg (p<0.0001) at 6 month, 18.0+/-10.8 mmHg (p<0.0001) at 1 year. CONCLUSION: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

Prospective Study on the Development of Glaucoma after Interferon alfa Therapy for Chronic Hepatitis B / 대한소아소화기영양학회지

PURPOSE: Previously reported ocular complications of interferon alfa administration are extremely rare. We experienced a 15-year-old boy with chronic hepatitis B who developed glaucoma after interferon alfa therapy. The purpose of this prospective study was to evaluate the possible development of glaucoma after interferon alfa therapy for chronic hepatitis B. METHODS: Nine patients with chronic hepatitis B who visited Inha university hospital between February 1998 and July 1999 received interferon alfa therapy. We measured visual acuity, intraocular pressure, C/D ratio, and visual field examination at pre-interferon therapy, three and six months after therapy, respectively. RESULTS: The total number of patients was 9 (4 boys and 5 girls). Mean age was 11.7±4.1 years. The duration of therapy was 6 months and mean dosage of interferon was 5 million units. Compared with visual acuity, intraocular pressure, and C/D ratio at pre-therapy, those parameters at 3 months and 6 months after therapy showed no significant differences and none showed visual field defect after therapy. CONCLUSION: Our prospective study showed no evidence of development of glaucoma after interferon therapy. However, it is necessary to be concerned about the possibility of developing glaucoma or other ophthalmologic diseases after interferon therapy in chronic hepatitis B.

Partial Mastoid Obliteration Using Inferior Based Musculoperiosteal Flap and Autogenous Conchal Cartilage Chips / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recently, canal down mastoidectomy tends to be more frequently selected for complete eradication of the lesion and prevention of recurrence. Therefore, the problems attendant to the open mastoid continue to be of concern. Although various techniques have been used to solve the cavity problems, no single procedure has yet been devised that entirely accomplished this purpose. We evaluated the effects of partial mastoid obliteration using inferior based musculoperiosteal flap and autogenous conchal cartilage chips. MATERIALS AND METHODS: Twenty four cases were performed with mastoid obliteration using inferior based musculoperiosteal flap and autogenous conchal cartilage chips obtained from meatoplasty. There were 11 cases for control which were performed with canal down mastoidectomy without obliteration. We compared these two groups in the duration of epithelialization, accumulation of debris, presence or absence of drainage, shape of remodeled canal and caloric response and evaluated survival or atrophy of flap and absorption of cartilage chips. RESULTS: Obliteration group showed more rapid healing and epithelialization and less accumulated epithelial debris. Atrophy of flap or absorption of cartilage was not observed. There was no draining ear but vertigo with nystagmus on caloric stimulation developed in both groups. CONCLUSION: This partial mastoid obliteration technique used easy and quick application instead of complete restoration of canal wall, and it may be also valuable in providing rapid epithelialization and reducing mastoid bowl volume with relatively round canal shape. Furthermore, epitympanic obliteration using cartilage chips may be an effective method to prevent formation of attic retraction pocket.

Ultrastructure of the Experimentally Induced Cataract in Porcine Crystalline Lens

One of the purposes of this experiment is to observe the structure of crystalline lens with cataract, which is formed artificially, using the light microscope and electron microscope. The other is to observe the differences of structural variations in the cataract developed inside body. Twelve eyes of six pigs were used for this experiment. Two of them are normal crystalline lens, five are cystalline lens in distilled water, and the rest are in balanced salt solution through intact or ruptured capsule. We examined the time of cataract formation and compared the ultrastructural changes. Ruptured capsule and high osmotic pressure difference induced more rapid opacity. In case of distilled water, the capsule is maintained but it is very difficult to distinguish between epithelium and lens fibers. Also, there is a severe crack in the lens fibers. In electron microscopic, as the cataract progresses, the osmotic swelling becomes more prominent. One of the striking changes was a marked intercellular cyst formation. Lens cells became irregular in size and density and were extensively vacuolated. The swelling of the lens cells continuously induced large intracellular vacuoles and liquefied the cytoplasmic protein. In conclusion, the structural change of cataract, which was seen by an electron microscope, resulted from change in osmolarity from previously announced in vivo experiment and structural change resulted from this experiment are similar.

A Case of Zygomatic Osteomyelitis Complicating Preseptal and Postseptal Abscess / 대한이비인후과학회지

The most common cause of orbital in/fection is a sinusitis, and if this orbital complication is not provided with appropriate and intensive treatments, serious status such as visual loss or life-threatening may occur. Osteomyelitis rarely results from sinusitis, and in cases where it happens, the frontal sinus is the most frequently involved site. However, zygomatic osteomyelitis has not been reported so far. We present a case of maxillary sinusitis which was initiated by oroantral fistula, and developed to preseptal and postseptal abscess, penetrating into the orbital septum. The case was complicated by zygomatic osteomyelitis. This case was successfully treated by draining pus by endonasal endoscopic sinus surgery, infraorbital incision, and was followed by antibiotic therapy for about 8 weeks.

Comparison of corneal centering in photorefractive keratectomy

The present study compares three centering methods for excimer laser photorefractive keratectomy (PRK. VISX 20/20) by analyzing the corneal topography. The subjects were grouped according to three different centering methods used in the procedure: an ablation using a light reflex from the patient's cornea pursued by both eyes of the surgeon (Group 1, n = 49); an ablation using a red light reflex from the patient's cornea pursued by the surgeon's left eye only while the right eye remained closed (Group 2, n = 27); an ablation using the patient's center of the pupil pursued by the surgeon's left eye only while the right eye remained closed (Group 3, n = 21). The mean distance from the center of ablation zone to the center of the pupil were; 0.69 +/- 0.45 mm for Group 1, 1.05 +/- 0.48 mm for Group 2 and 0.63 +/- 0.28 mm for Group 3. The degree of deviation in Group 2 was significantly greater than in Group 1 or Group 3. The deviation was greater in the right eyes than the left eyes in Group 2 only. The decentration of the right eye in Group 2 was due to angle Kappa with misalignment of the fixation light and viewing tube containing reticule.

The Effects and Complications of Mitomycin-C for Prevention of Recurrence after Pterygium Operation

The most common problem in pterygium operation is the recurrence. Therefore radiation therapy or instillation of mitomycin-C after pterygium operation have used to prevent the recurrence of pterygium. We evaluated recurrence rate and complication rate with mitomycin-C and without mitomycin-C after the operation of pterygium in 113 eyes. The 112 patients(113 eyes) underwent simple surgical excision, whose mean age was 50.7 tears, and whose follow-up period was 6 to 12 months. 0.04% solution of mitomycin-C was instilled to 61 eyes and not to 52 eyes. Recurrence was noticed in 12 out of 61 eyes(19.6%) among the group not using mitomycin-D and in 2 out of 52 eyes(3.8%) among the group using mitomycin-C after pterygium operation. One eye in patients using mitomycin-C showed severe corneal edema due to endothelial decompensation by the toxicity of mitomycin-C. It is concluded that mitomycin-C ws effective to prevent recurrence after pterygium operation, but we should be aware of the severe complications by the toxicity of mitomycin-C.

Estimaionof Intraocular Lens Power in Penetration Keratoplasty Combined with Intraocular Lens Implantation

The corneal triple procedure is that penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber intraocular lens implantation are performed simultaneously and preoperative prediction of intraocular lens implant power is necessary to achieve the desired postoperative refractive status in eyes undergoing the triple procedure. Therefore we evaluated the important factors in determining intraocular implant power patients undergoing the triple procedure. A retrospective study was done on 12 eyes of 11 patients who underwent triple procedure between March 1993 and April 1997. Mean age was 52.9 years and mean follow-up period was 26.3 month(range, 4 to 53 months). The Mean postoperative spherical equivalent was -0.98+/-4.05D. Forty-two percents of patients were within +/-2.00D of emmetropia. The important factors in determining intraocular lens power of patients undergoing the triple procedure are axial length, corneal curvature, refractive status of the fellow eye, and donor/recipient size. If these values are unreliable, it is desirable for the corneal srurgeon to use mean axial length and mean corneal curvature to determine the intraocular implant power. The important factors in determining intraocular lens power of patients undergoing the triple procedure are axial length, corneal curvature, refractive status of the fellow eye, and donor/recipient size. If these values are unreliable, it is desirable for the corneal surgeon to use mean axial length and mean corneal curvature to determine the intraocular implant power.

Therapeutic Effect of Recurrent Corneal Erosion by Nd: YAG Anterior Stromal Puncture

Many conventional treatments of recurrent corneal erosion have been reported to yield varying degrees of effect. Epithelial basement menmbranectomy, microdiathermy or needle anterior stromal puncture, and excimer laser phototherapeutic keratectomy have recently been proposed as new treatments for recalcitrant cases of recurrent corneal erosion. We used the Nd:YAG laser to perform anterior stromal puncture of evaluation of therapeutic effects and several advantages effects over conventional treatments. For this purpose, we performed retrospective review of medical records of 7 patients who had been confirmed to have recurrent corneal erosion and given a trial of the Nd:YAG laser anterior stromal puncture due to two or more recurrences in spite of conventional treatments from January 1996 to December 1997. The mean recurrence rate of erosion before anterior stromal puncture and the mean trial number were 1 time(ranging from 1 to 2 times) per month and 4.7 times(ranging from 1 to 10 times), respectively. There were no recurrences after the laser trial in all 7 patients. Compared with various conventional treatments, this study showed the Nd:YAG laser anterior stromal puncture may obtain more permanent healing in mild to moderate epithelial basement membrane dystrophy and traumatic recurrent corneal erosion.

Therapeutic Effect of Recurrent Corneal Erosion by Nd: YAG Anterior Stromal Puncture

Many conventional treatments of recurrent corneal erosion have been reported to yield varying degrees of effect. Epithelial basement menmbranectomy, microdiathermy or needle anterior stromal puncture, and excimer laser phototherapeutic keratectomy have recently been proposed as new treatments for recalcitrant cases of recurrent corneal erosion. We used the Nd:YAG laser to perform anterior stromal puncture of evaluation of therapeutic effects and several advantages effects over conventional treatments. For this purpose, we performed retrospective review of medical records of 7 patients who had been confirmed to have recurrent corneal erosion and given a trial of the Nd:YAG laser anterior stromal puncture due to two or more recurrences in spite of conventional treatments from January 1996 to December 1997. The mean recurrence rate of erosion before anterior stromal puncture and the mean trial number were 1 time(ranging from 1 to 2 times) per month and 4.7 times(ranging from 1 to 10 times), respectively. There were no recurrences after the laser trial in all 7 patients. Compared with various conventional treatments, this study showed the Nd:YAG laser anterior stromal puncture may obtain more permanent healing in mild to moderate epithelial basement membrane dystrophy and traumatic recurrent corneal erosion.

Treatment of Chronic Corneal Ulcer with Nd-YAG Laser

The marginal epithelium of corneal ulcer is occasionally edernatous and detached from corneal stroma in chronic corneal ulcer. This leads to retard healing of corneal epithelium because the migration and adhesion of corneal epithelium are prevented. We performed Nd-YAG laser in chronic corneal ulcer, 6 eyes of 6 patients from July 1996 to December 1996. It was used to improve the healing of corneal epithelium. The patiente were treated with Nd-YAG laser using 0.8 to 1. 2mJ per pulse applied to the region of Bowman`s membrane in the margin of corneal ulcer. The mean number of laser spots in one procedure was 22 and the rnean frequency of Nd-YAG laser use in each patient was 2. 3 times. The Nd-YAG laser induced adhesion of corneal epithelium in all patients and improved the healing of corneal epithelium. Therefore, the treatment of Nd-YAG laser can become 8 useful procedure for chronic corneal ulcer accompanied with corneal epithelial detachment.

The Therapeutic Effect of Levocabastine Eye Drops on Allergic Conjunctivitis: A Multicenter Study

The efficacy nd tolerance of topical administration of levocabastine(0.5mg/ml)were evaluated in patients with allergic conjunctivitis. A total of 166 patients who had a typical history of atopy and a positive skin test were recruited in this study. Five clinicl symptoms(itch, tearing, chemosis, lid edema and conjunctival injection) were assessed according to a four point scale before the treatment and at 1 and 2 weeks post-therapy. Total symptom severity score before the therapy, 6.68, was remarkably decreased to 2.86 at 1 week and 2.08 at 2 weeks after the treatment. The investigators rated the treatment as globally good or excellent in 68.1% of patients checked at 1 week and 72.5% at 2 weejs after treatment. And the patients evaluated that the therapy ws good to excellent in 66.9% at 1 week and 73.1% at 2 weeks after treatment. Levocabastine eye drops has a fast onet of action with 55.4% of the patients feeling symptom relief within 15 minutes after the first administration. The adverse effect was experienced in 44 patients. Ocular irritation sign, such as foreign body sensation or soreness, was the most frequently reported complaint. These results suggest that levocabastine eye drops is an effective and safe topical alternative for treatment of allergic conjunctivitis.