PURPOSE: To report a case of suction loss during small incision lenticule extraction (SMILE) and a good visual outcome after switching to femtosecond laser-assisted in-situ keratomileusis (LASIK). CASE SUMMARY: A 20-year-old female was admitted to receive refractive surgery. During SMILE in the left eye, suction loss occurred at 65% of posterior cut completion. We switched to LASIK and SMILE was performed in the right eye as planned. The uncorrected distance visual acuity was 1.2 with a manifest refraction of +0.25 Dsph with 0 Dcyl. The patient had no complications at 3 months postoperatively. CONCLUSIONS: Suction loss during SMILE is a rare complication. Good visual outcome was achieved by switching to LASIK.
Female ; Humans ; Keratomileusis, Laser In Situ* ; Refractive Surgical Procedures ; Suction* ; Visual Acuity ; Young Adult

PURPOSE: To evaluate the clinical outcomes of a combined procedure of astigmatic keratotomy (AK) and laser in situ keratomileusis (LASIK) for the correction of high astigmatism. METHODS: Thirty-five eyes of 19 patients who had astigmatic keratotomy were studied. The patients had a secondary procedure, LASIK, to correct the residual refractive error. Follow-up visits were at 1 week, 1 month, 3 months, and 6 months. The outcome measures included uncorrected distance visual acuity, refractive error, efficacy, safety, and predictability. We compared preoperative and post-AK expected corneal ablation depth using an Amaris Ablation depth table. RESULTS: After astigmatic keratotomy, astigmatism was reduced by 61.43 ± 14.62%, and after LASIK, astigmatism was reduced by 91.65 ± 8.68%. Expected corneal ablation depth was reduced by 18.72 ± 11.77% after astigmatic keratotomy. The proportion of eyes with spherical equivalent 0.5 D or less was 85.71% at 6 months after the combined procedure of astigmatic keratotomy and LASIK. No intraoperative or postoperative complications were observed. CONCLUSIONS: This study showed the combined procedure of astigmatic keratotomy and LASIK is effective for visual acuity, refraction, and reduction in corneal ablation depth.
Astigmatism ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Outcome Assessment (Health Care) ; Postoperative Complications ; Refractive Errors ; Visual Acuity

PURPOSE: To evaluate the beveled, full thickness astigmatic keratotomy. METHODS: This study included 185 eyes of 112 patients treated with beveled, full thickness astigmatic keratotomy. Treated eyes were divided into 3 groups: beveled, full thickness astigmatic keratotomy after implantable collamer lens (ICL) implantation (group A), beveled, full thickness astigmatic keratotomy after cataract surgery (group B) and beveled, full thickness astigmatic keratotomy alone (group C). Follow-up visits were at 1 week, 1 month, 3 months and 6 months. The outcome measures included uncorrected distance visual acuity, astigmatism, efficacy, safety and predictability. RESULTS: At 6 months postoperatively, astigmatism was significantly reduced: 68.9 +/- 18.24% in total, 69.24 +/- 20.76%, in the group A, 67.84 +/- 17.56% in the group B and 67.82 +/- 13.97% in the group C. The proportion of eyes with astigmatism 1.0 or less was 88.65% in total, 91.49% in the group A, 87.5% in the group B and 70.0% in the group C. Mean improvement in corrected distance visual acuity (CDVA) was 0.56 lines; no eyes lost 2 lines of CDVA after 6 months postoperatively. Postoperative complications were not observed. CONCLUSIONS: This study showed the beveled, full thickness astigmatic keratotomy is effective and safe for correcting astigmatism alone as well as correcting astigmatism after ICL implantation or cataract surgery.
Astigmatism ; Cataract ; Follow-Up Studies ; Humans ; Outcome Assessment (Health Care) ; Postoperative Complications ; Visual Acuity

BACKGROUND AND OBJECTIVES: Sinonasal sarcomas are relatively rare tumors, accounting for only about 1 percent of all sinonasal malignancies. The purpose of this study is to analyze the clinical features, treatment modalities and outcomes, survival and prognostic factors of sinonasal sarcomas. SUBJECTS AND METHOD: We retrospectively reviewed the medical records of 20 patients who were diagnosed and treated for sinonasal sarcomas between July 1993 and June 2006. Potential prognostic factors including age, tumor size, histology and adjuvant treatment were evaluated. RESULTS: According to histologic subtype, twenty cases consisted of 7 rhabdomyosarcomas, each 2 cases of spindle cell sarcoma, Ewing's sarcoma, angiosarcoma, and each 1 case of fibrosarcoma, leiomyosarcoma, hemangiopericytoma, peripheral neuroectodermal tumor, myxoid sarcoma, osteosarcoma, chondrosarcoma. The mean follow-up period was 61 months. Fourteen patients (65%) had undergone surgical approach with adjuvant chemotherapy or radiotherapy. Four patients (20%) had undergone surgical treatment only. Two patients (15%) had undergone chemotherapy or radiotherapy. At 5 years, the overall survival rates of sinonasal sarcomas were 65%. The survival rates according to the treatment modality were 100% (surgery only), 66% (surgery with adjuvant chemotherapy or radiotherapy), and 33% (chemotherapy or radiotherapy), respectively. The overall recurrence rates of the sinonasal sarcomas were 25%. The univariate analysis showed that the treatment modality and surgical margin are important prognostic factors for survival. CONCLUSION: The 5-year survival rate of sinonasal sarcomas was 65%. Early diagnosis and wide excision with safe resection margin are important for the treatment of sinonasal sarcomas.
Accounting ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Early Diagnosis ; Fibrosarcoma ; Follow-Up Studies ; Hemangiopericytoma ; Hemangiosarcoma ; Humans ; Leiomyosarcoma ; Medical Records ; Neuroectodermal Tumors, Primitive, Peripheral ; Osteosarcoma ; Recurrence ; Retrospective Studies ; Rhabdomyosarcoma ; Sarcoma ; Sarcoma, Ewing ; Survival Rate

5-fluorouracil (5-FU) is a chemotherapeutic agent commonly used for treatment of solid tumors, including colorectal cancer. However, chemoresistance against 5-fluorouracil (5-FU) often limits its success for chemotherapy and, therefore, finding out appropriate adjuvant(s) that might overcome chemoresistance against 5-FU bears a significant importance. In the present study, we have found that α-mangostin can sensitize 5-FU-resistant SNUC5/5-FUR colon cancer cells to apoptosis. Exposure of α-mangostin induced significant DNA damages and increased the intracellular 8-hydroxyguanosine (8-OH-G) and 4-hydroxynonenal (4-HNE) levels in SNUC5 and SNUC5/5-FUR cells. Western blot analysis illustrated that α-mangostin-induced apoptosis was mediated by the activation of the extrinsic and intrinsic pathways in SNUC5/5-FUR cells. In particular, we observed that Fas receptor (FasR) level was lower in SNUC5/5-FUR cells, compared with SNUC5 cells and that silencing FasR attenuated α-mangostin-mediated apoptosis in SNUC5/5-FUR cells. Together, our study illustrates that α-mangostin might be an efficient apoptosis sensitizer that can overcome chemoresistance against 5-FU by activating apoptosis pathway.
Antigens, CD95 ; Apoptosis* ; Blotting, Western ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; DNA Damage ; Drug Therapy ; Fluorouracil

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy

BACKGROUND: Obesity is a risk factor for developing hyperlipidemia and cardiovascular diseases. Various diagnostic methods and criteria of obesity have been developed. The predictive values of health risk factors(hyperlipidemia, hypertension, diabetes mellitus, and body fatness) were different for cardiovascular diseases. We reviewed the medical records to assess the relation of health risk factors to waist-hip ratio(WHR) and body mass index (BMI). METHODS: We gathered 5100 cases who have taken medical examination from March 1995 to February 1996 at Ajou University Hospital and measured BMI, WHR, body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar etc.. Except 1350 abnormal cases on current illness and laboratory study, 3750 healthy cases were analysed. First we divided the healthy cases into obese and non-obese group according to BMI 25kg/m2 in men and women. And then, the obese and non-obese group was divided into central and non-central obese type by WHR 0.8 in women and 0.9 in men. RESULTS: Except only diastolic blood pressure in male, other lab data such as body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar in male and female were significantly different between the two groups divided by WHR in BMI<25kg/m2. But in BMI)25kg/m2, men had higher(P<0.01) triglyceride at WHR>_0.9. Women had higher(P<0.05) triglyceride, systolic and diastolic blood pressure at WHR>_0.8. CONCLUSIONS: We thought that the increase of WHR was risk factor for hyperlipidemia, hypertension, diabetes mellitus in men and women when BMI was less than 25kg/m2. In obese group(BMI>_225kg/m2), increase of WHR was risk factor for hyperlipidemia in men and hyperlipidemia and hypertension in women.
Adipose Tissue* ; Blood Glucose ; Blood Pressure* ; Body Mass Index* ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diabetes Mellitus ; Fasting ; Female ; Glucose* ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Medical Records ; Obesity ; Risk Factors ; Triglycerides ; Waist-Hip Ratio*

BACKGROUND AND OBJECTIVES: Intratympanic gentamicin injection is used as one of the treatment modalities for medically intractable Meniere's disease. But the ideal dosage and concentration of gentamicin were not established in consideration of therapeutic efficacy and the risk of postoperative hearing loss. We analyzed the clinical outcome of low-concentration intratympanic gentamicin injection in patients with Meniere's disease. And we also tried to find factors anticipating for the response to treatment. SUBJECTS AND METHOD: A retrospective review was conducted on 45 subjects who had been diagnosed as 'definite' Meniere's disease (AAO-HNS, 1995) and had no response to medical treatment over 3 months in our clinic. The concentration of gentamicin was 7 mg/cc, which was very low compared with previous studies. We reviewed postoperative changes on vertigo, tinnitus and hearing by questionnaire and pure tone audiometry. We also analyzed preoperative patients' characteristics for acquisition of predictive factors of treatment response. RESULTS: Vertigo was completely disappeared in 37 (82%) patients and there was no vertigo improvement in 8 (18%) patients despite multiple injections. Tinnitus was controlled in 11 (24%) patients, and aggravated in 4 (8%) patients. A significant postoperative hearing loss over 10 dB occurred in only 6 (13%) patients. Preoperative patients' hearing threshold, frequency of vertigo, functional level and finding in electrical test, such as electrocochleogram, were not different regarding treatment response. CONCLUSION: Low-concentration gentamicin was enough to control vertigo and could reduce the risk of postoperative hearing loss in patients with Meniere's disease.
Audiometry ; Gentamicins ; Hearing ; Hearing Loss ; Humans ; Meniere Disease ; Surveys and Questionnaires ; Retrospective Studies ; Tinnitus ; Vertigo

OBJECTIVES: With the rapid increase in the prevalence of diabetes, the age groups of diabetic patients are becoming diversified. This study will examine the degree of obesity, insulin resistance, and insulin secretion ability among patients first diagnosed with diabetes according to age and gender. METHODS: The subjects of this study included 616 patients who were first diagnosed with diabetes during a routine physical examination. This sample was obtained from a total of 28,075 adults aged 19 years and older who received the examination among 33,829 participants in the Korea National Health & Nutrition Examination Survey (KNHANES) from 2007–2010. The subjects were categorized by age into young age (age: 19 – 39 years), middle age (age: 40 – 59 years), and old age (age: 60 years and older). The degree of obesity was categorized according to body mass index (BMI) into normal weight (BMI: 18.5 ~ 22.9), overweight (BMI: 23 ~ 24.9), and obesity (BMI: 25 or above). Insulin resistance was evaluated by homeostatic model assessment of insulin resistance (HOMA-IR). RESULTS: It was found that 14.1% (n = 87) of a total of 616 subjects (324 men, 292 women) were in the young age group, 43.8% (n = 270) were in the middle age group, and 42.1% (n = 259) were in the old age group. In addition, 83.3% of men that were overweight or obesity were in the young age group, while 79.2% and 60.5% were in the middle age and old age groups, respectively. A total of 82.2% of women that were overweight or obesity were in the young age group, while 79.5% and 77% were in the middle age and old age groups, respectively. For men, the more obesity they were in all age groups, the higher their HOMA-IR. For women, the more obesity they were in the young age and middle age groups, the higher their HOMA-IR; however, women in the old age group showed the highest HOMA-IR when they were of normal weight. CONCLUSION: Among diabetic patients first diagnosed with the disease in Korea, the youth population had the highest obesity rate. Insulin resistance increases as an individual's weight increases among those patients who are first diagnosed with diabetes; the only exception noted is for elderly women.
Adolescent ; Adult ; Aged ; Bodily Secretions ; Body Mass Index ; Female ; Humans ; Insulin Resistance* ; Insulin* ; Korea* ; Male ; Middle Aged ; Obesity* ; Overweight ; Physical Examination ; Prevalence