Relationship between anthropometric parameters and open angle glaucoma: The Korea National Health and Nutrition Examination Survey.

AIMS: To evaluate the relationships between open-angle glaucoma (OAG) and various anthropometric measurements. DESIGN: Korea National Health and Nutrition Examination Survey (KNHANES), a population-based cross-sectional study using a complex, stratified, multistage, probability-cluster survey. METHODS: A total of 5,255 participants including 247 glaucoma patients, aged ≥ 19 years were included from the KNHANES V database. Glaucoma diagnosis was based on International Society of Geographical and Epidemiological Ophthalmology criteria. Various anthropometric data regarding obesity were analyzed including body mass index (BMI), total body fat mass, total body muscle mass (lean body mass, non-bone lean body mass, and appendicular skeletal muscle (ASM) mass), and waist circumference (WC). The differences in OAG prevalence with respect to anthropometric parameter quartiles were examined. RESULTS: In males, the multivariate general linear model adjusted for age, alcohol, smoking, exercise, systemic hypertension, diabetes, and intraocular pressure (IOP) showed the quartiles for the anthropometric parameters BMI, fat mass/weight ratio and fat mass/muscle mass ratio were negatively associated with OAG. However, muscle mass parameter/BMI ratio was significantly positively associated with OAG (P for trend<0.05). In females, height and fat mass/BMI showed a significant relationship with the risk of OAG. (P value<0.05). CONCLUSIONS: In the present study, high fat mass was associated with low OAG risk. Body composition seemed to affect the prevalence of OAG, but further evaluation is needed.

White blood cell counts, insulin resistance, vitamin D levels and sarcopenia in Korean elderly men.

Sarcopenia is a major determinant of frailty, disability and mortality in the elderly. Whether low-grade inflammation, insulin resistance and vitamin D are independently associated with sarcopenia remains unclear. In our study, sarcopenia was defined as an appendicular skeletal muscle mass divided by height squared (ASM/Ht2) that was <2 SD below the normal means for young adults. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR) index [(insulin (IU/mL) × fasting glucose (mg/dL)/18)/22.5]. Data of white blood cell counts and serum 25-hydroxyvitamin D (25-(OH)D) levels were collected in the second and third year (2008-2009) of Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). The results showed that the prevalence of sarcopenia in Korean elderly men aged more than 65 years was 11.2%. ASM/Ht2 were positively associated with vitamin D levels, but negatively associated with white blood cell counts and HOMA-IR by multiple regression analysis. After adjustment for covariables, sarcopenia was associated with the highest quartile of WBC counts (OR = 2.93, 95% CI = 1.21-7.14) and the highest quartile of serum vitamin D levels (OR = 0.38, 95% CI = 0.15-0.95). In conclusion, the study findings suggest that higher WBC counts and lower vitamin D levels are independently associated with the presence of sarcopenia in community-dwelling elderly men. They also provide a basis for further studies of the complex immune-endocrine network in sarcopenia.

Relationship between Plasma Homocysteine Level and Glaucomatous Retinal Nerve Fiber Layer Defect.

AIMS: To investigate the association between plasma homocysteine levels and glaucomatous retinal nerve fiber layer (RNFL) defect in South Korean population. MATERIALS AND METHODS: This retrospective cross-sectional study included subjects who underwent screening at Kangbuk Samsung Hospital Health Screening Center between August 2012 and July 2013. Subjects underwent physical examination and provided samples for laboratory analysis of homocysteine. Subjects were divided equally into four quartiles (Qs) based on plasma homocysteine level. Digital fundus photographs of both eyes were obtained. Determination of glaucomatous disc appearance was based on criteria set forth by the International Society of Geographical and Epidemiological Ophthalmology and based on the appearance of the RNFL and optic disc. Multivariate logistic regression models were used to define elevated glaucoma risk with P < 0.2 on univariate analysis. RESULTS: A total of 78,049 subjects were included; 76,093 subjects were male, and 1956 subjects were female. When analyzed by gender, the mean homocysteine level in the male group with glaucomatous RNFL defects (11.05 ± 3.80 µmol/L) was higher than those without RNFL defects (10.81 ± 4.12 µmol/L (P = 0.000, χ2 test). Upon multifactorial logistic regression analysis adjusted for age, gender, creatinine, diabetes mellitus, hypertension, and hyperlipidemia, glaucomatous RNFL defects had a significant correlation with plasma homocysteine level. Based on the Q2 level, the odds ratio (OR) of Q3 was 1.267, while the OR of Q4 was 1.285 (95% CI = 1.067-1.505, 1.081-1.529, respectively, P for trend = 0.001). CONCLUSION: Our results suggest that homocysteine level is associated with the presence of glaucomatous RNFL defects.

Relationships Between Anthropometric Measurements and Intraocular Pressure: The Korea National Health and Nutrition Examination Survey.

PURPOSE: To evaluate the relationship between intraocular pressure (IOP) and various anthropometric measures. DESIGN: A population-based cross-sectional study. METHODS: A total of 5008 participants, 2080 men and 2928 women ≥19 years of age were included from the Korea National Health and Nutrition Examination Survey V database, focusing on the years 2010 and 2011. We selected IOP in the right eye of a normal healthy population as the outcome variable of our study. We analyzed the relationship between IOP and anthropometric parameters using dual-energy X-ray absorptiometry by sex. Lean body mass was calculated as total body mass minus fat mass. We used general linear models and logistic regression analysis to evaluate risk factors of high IOP. Our main outcome measure was correlation between anthropometric data and IOP. RESULTS: In multivariate general linear models, greater body mass index (BMI) and waist circumference were correlated with higher IOP for both men (BMI, ß = 0.053, P = .026; waist circumference, ß = 0.016, P = .067) and women (BMI, ß = 0.074, P < .001; waist circumference, ß = 0.028, P < .001). Greater fat mass (ß = 0.027, P = .037) and fat mass/lean body mass (ß = 1.170, P = .06) were correlated with higher IOP, while greater lean body mass/weight (ß = -3.188, P = .025), lean body mass/BMI (ß = -1.379, P = .002), appendicular skeletal muscle mass/BMI (ß = -2.270, P = .022), and bone mineral content/BMI (ß = -11.653, P = .031) were correlated with lower IOP in women, but not in men (P > .10). CONCLUSIONS: In healthy women, greater fat mass was associated with higher IOP, and greater muscle mass was associated with lower IOP after adjusting for weight and BMI. Fat and muscle influenced IOP in women independently.

Hemangiopericytomas in the Central Nervous System: A Multicenter Study of Korean Cases with Validation of the Usage of STAT6 Immunohistochemistry for Diagnosis of Disease.

BACKGROUND: Hemangiopericytoma (HPC) in the central nervous system (CNS) is a rare disease with distinctive biological/clinical characteristics compared with meningioma. METHODS: Cases of HPCs of the CNS were collected, and clinicopathological records were retrospectively reviewed and analyzed. Immunohistochemistry (IHC) for proliferative markers (Ki-67, PHH3) and STAT6 were performed. RESULTS: A total of 140 cases were collected, with mean follow-up of 77 months (median 58.8 months; range 0.53-540.5 months). 1-, 5-, 10-, and 20-year survival rates were 99.1, 94.0, 74.4, and 61.9 %, respectively. Thirty-nine patients (27.9 %) had recurrent disease. Mean and median times to recurrence were 62.9 and 47.3 months with 1-, 5-, 10-, and 20-year recurrence-free survival rates of 98.3, 78.3, 50.1, and 11.0 %, respectively. Thirteen patients (9.3 %) developed extracranial metastases. No adjuvant radiation therapy, higher histologic grades, failure of gross-total resection, and cases with gamma-knife surgery (GKS) were factors associated with shorter disease-free survival (log-rank test, p = 0.02, 0.00, 0.02, 0.00), among which high histologic grade and cases with GKS were significant in multivariable analysis. Strong nuclear STAT6 expression was noted in HPCs in 62 cases of HPCs (60/62, 96.8 %), whereas diffuse weak positivity was demonstrated in all meningioma cases. CONCLUSIONS: The survival rate in patients with HPC of the CNS is comparable to that of previously reported series. Recurrence remains a critical clinical issue of the disease. Identification of NAB2-STAT6 fusion transcript with surrogate IHC marker is a valuable diagnostic tool in the differential diagnosis of the disease.

A case of inadvertent anterior chamber and corneal stromal injection with antibiotics during cataract operation.

PURPOSE: To report a case of inadvertent anterior chamber and cornea stromal injection with high dose antibiotics and steroids during cataract operation. METHODS: During cataract operation on a 78 year-old female patient, high dose gentamicin (20 mg/0.5 ml) and dexamethasone (2 mg/0.5 ml) were inadvertently injected into the anterior chamber and cornea stroma when making cornea edema for sealing of the incision sites. Anterior chamber irrigation with balanced salt solution (BSS) was immediately administered. On postoperative day one, extensive cornea edema was noted, and best-corrected visual acuity was 0.2. Descemet's membrane folds were observed around the corneal incision sites. Topical 5% NaCl and 1% prednisolone were started. RESULTS: Four weeks postoperatively, corneal edema began to reduce significantly. At four months postoperatively, corneal edema fully resolved, and best-corrected visual acuity was 0.8. However, some Descemet's membrane folds still remained, and a decrease in the number of endothelial cells was noted by specular microscope. CONCLUSIONS: In this case involving anterior chamber and cornea stromal injection with high dose antibiotics and steroids, immediate anterior chamber irrigation with balanced salt solution seemed an appropriate management, and the patient's long-term visual acuity appears good. To prevent such mistakes, precise labeling of all solutions and use of different syringe needles should be considered.