PURPOSE: To evaluate the parameters affecting vaulting and correlation between preoperative crystalline lens rise and vaulting after implantable collamer lense (ICL) implantation. METHODS: A total of 53 eyes of 34 patients who underwent ICL implantation were examined retrospectively. White-to-white (WTW) and anterior chamber depth (ACD) were obtained from scanning topography (ORB scan) before surgery. Preoperative crystalline lens rise (CLR) and vaulting at 6 months after ICL implantation were measured using anterior segment optic coherence tomography (AS-OCT). Multiple regression analysis was performed to evaluate the factors affecting central vaulting. RESULTS: The mean preoperative crystalline lens rise was -120 +/- 219 microm, and mean central vaulting 6 months after surgery was 544 +/- 175 microm. Preoperative SE, WTW, ACD, and CLR were significantly correlated with vaulting at 6 months after surgery. With the use of meaningful variables, multiple regression analysis showed that CLR, WTW, ACD and SE, in that order of influence, had significant effects on vaulting and the multiple regression equation was obtained as follows: Vaulting (microm) = (160.913 x ACD (mm)) + (170.134 x WTW (mm)) + (-0.338 x CLR (microm)) + (-23.783 x SE (D)) - 2250.184. CONCLUSIONS: CLR had a stronger influence on vaulting after ICL implantation than the previously proven parameters: WTW, ACD, and SE. In addition to WTW, ACD and SE, CLR should also be considered a new criterion for estimating vaulting after ICL implantation.
Anterior Chamber ; Crystallins ; Eye ; Humans ; Lens, Crystalline ; Lenses, Intraocular ; Retrospective Studies

No abstract available.
Blood Flow Velocity*

Tuberculous pseudoaneurysm of the abdominal aorta (TBAA) is an exceedingly rare, but fatal complication of the tuberculosis, especially in the condition of the disseminated tuberculosis. We reported a case of TBAA treated successfully by surgical and medical therapy. A 65-year-old woman admitted to our hospital complaining of sudden abdominal pain, nausea and vomiting for 3 days. She underwent 4 times operation of orthopedic surgery for tuberculous spondylitis at the level of the L4-5, T5-7, tuberculous epidural abscess, both psoas abscess, and had been receiving antituberculous medications for disseminated miliary tuberculosis at the both lung fields. Soon after this, she developed aggravated abdominal pain and we examined contrast enhanced abdominal CT scan and revealed saccular, thrombosed aneurysmal dilatation on the level of the aortic bifurcation. We performed elective operation for direct closure of the small rent at the anterior wall of the abdominal aorta after confirming no active inflammatory reaction on the frozen biopsy. Currently, the patient is an antituberculous medications without any surgical complication for 12 months after operation.
Abdominal Pain ; Aged ; Aneurysm ; Aneurysm, False* ; Aorta ; Aorta, Abdominal* ; Biopsy ; Dilatation ; Epidural Abscess ; Female ; Humans ; Lung ; Nausea ; Orthopedics ; Psoas Abscess ; Spondylitis ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Miliary ; Vomiting

BACKGROUND: Cat scratch disease (CSD) manifests as a self-limiting, regional lymphadenopathy, fever and constitutional symptoms following a cat scratch or close contact with cats. Bartonella henselae is a causative agent of CSD that is globally distributed. In Korea there are no case report of CSD and no reports on the seroprevalence of Bartonella henselae in patients with suspected CSD. In this study the prevalence of antibodies to Bartonella in patients with lymphadenopathies was evaluated. METHODS: We evaluated serological responses of 31 patients (8 male, 23 female) with regional lymphadenopathies. The age of the patients ranged from 6 to 76 years old (mean+/-S.D., 30.6+/-14.3 years). Final diagnoses on the lymphadenopathies were tuberculous lymphadenopathy, Kikuchi's disease, Kawasaki's disease, and viral infection, but considerable cases remained undiagnosed. All sera were examined using MRL Diagnostics Bartonella IgG indirect immunofluorescent antibody (IFA) test kits (MRL Diagnostics, Cypress, California, USA) according to the manufac-turer's instructions. RESULTS: Of the 31 patients, 21 (67.7%) patients showed positive titers of immunoglobulin G (IgG) to B. henselae (1 : 64 or higher). Twelve (38.7%) had IgG titers of 1 : 128 and four (12.9%) had titers of 1 : 256. Among these patients, three patients had a history of close contact with a cat or cat scratch. Twenty patients (64.5%) showed positive reactions against B. quintana. CONCLUSION: This study revealed possible patients with cat scratch disease, but, unlike other countries, Bartonella seropositivity was not closely associated with cat contact. The further studies should be performed in a large number of patients including a control group and be accompanied with culture or polymerase chain reaction of extirpated lymph node.
Aged ; Animals ; Antibodies* ; Bartonella henselae* ; Bartonella quintana* ; Bartonella* ; California ; Cat-Scratch Disease ; Cats ; Cupressus ; Diagnosis ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Immunoglobulin G ; Korea ; Lymph Nodes ; Lymphatic Diseases* ; Male ; Polymerase Chain Reaction ; Prevalence* ; Seroepidemiologic Studies

Lymphadenitis is a common manifestation in tuberculous diseases. However, papulonecrotic tuberculid is an uncommon cutaneous manifestation, and is considered an allergic reaction against tuberculous bacilli in tuberculous lesions other than the lymph nodes. A wide great variety of cutaneous manifestations arise over a period of a few weeks - i.e., papules, necrosis, crusted and atrophic scars. We described a 27-year-old woman with right cervical tuberculous lymphadenitis and skin lesions involving her arms, legs and both fingers. Histopathologically, a leukocytoclastic vasculitis with V-shaped epidermal necrosis was observed in the upper and deep dermis, including the good response to anti-tuberculosis therapy support the diagnosis of papulonecrotic tuberculid.
Adult ; Arm ; Cicatrix ; Dermis ; Diagnosis ; Female ; Fingers ; Humans ; Hypersensitivity ; Leg ; Lymph Nodes ; Lymphadenitis ; Necrosis ; Skin ; Tuberculosis, Cutaneous* ; Tuberculosis, Lymph Node* ; Vasculitis

Granulocyte macrophage-colony stimulating factor (GM-CSF) has immuno-stimulatory effects. We hypothesized that GM-CSF plays an important role both in lipopolysaccharide (LPS)- and hemorrhage-induced acute lung injury (ALI). We also postulated that GM-CSF augments LPS-induced inflammation by priming neutrophils. ALI was induced in GM-CSF-/- or control C57BL mice either by LPS injection or by hemorrhage. Lung inflammation (by lung expression for tumor necrosis factor-alpha (TNF-alpha), macrophage inflammatory protein-2 (MIP-2), interleukin-1beta (IL-1beta), interleukin- 6 (IL-6), and keratinocyte-derived chemokine) and lung injury (by myeloperoxidase and evans blue dye assay) were evaluated after ALI. Incremental doses of LPS (0, 1, 10, and 100 ng/mL) and GM-CSF (0, 1, 10, and 100 ng/mL) were added to bone marrow neutrophils. The expression of TNF-alpha, MIP-2, and IL-1beta was evaluated with enzyme linked immunosorbent assay. The mRNA expression of three cytokines, and the nuclear translocation of nuclear factor kappa B (NF kappa-B) were evaluated by reverse transcriptase-polymerase chain reaction and electropnoretic mobility shift assay, respectively. GM-CSF -/- mice showed decreased neutrophil infiltration, less leakage, and lower expression of cytokines in the lung after LPS or hemorrhage. GM-CSF augmented LPS-induced protein and mRNA expression of TNF-alpha, MIP-2 and IL-1beta, which was mediated by increased intra-nuclear translocation of NF-kappa B. GM-CSF plays an important role in high-dose LPS and hemorrhage-induced ALI, which appears to be mediated by its priming effect on neutrophils.
Animals ; Bone Marrow Cells/cytology ; Chemokine CXCL2/metabolism ; Granulocyte-Macrophage Colony-Stimulating Factor/metabolism/*physiology ; Interleukin-1beta/metabolism ; Lipopolysaccharides/metabolism ; Lung/metabolism/pathology ; *Lung Injury ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Transgenic ; Neutrophils/*cytology/metabolism ; Peroxidase/metabolism ; Tumor Necrosis Factor-alpha/metabolism

BACKGROUND: Recently, trak - C (Total HCV core antigen test; Ortho Clinical Diagnostics, Raritan, NJ, USA) that is based on the enzyme- linked immnunosorbent assay was developed. So, we tried to compare the performance of the Hepatitis C virus (HCV) total core antigen test (HCVAg) with the qualitative in-house reverse transcription (RT) - polymerase chain reaction (PCR) assay and HCV- RNA Quantitation assay (HCVQn, Amplicor HCV monitor test version 2.0; Roche Diagnostics System, Basel, Switzerland). METHODS: Dilution test was performed to evaluate the reproducibility and detection sensitivity of the methods. 87 sera of 70 Hepatitis C virus antibody (Ab) positive patients were tested to evaluate the diagnostic sensitivity and concordance of three methods, and to discover the quantity relationship of HCVAg and HCVQn. We also contained the results of 100 negative control specimens by HCV Ag to evaluate the specificity. RESULTS: In the dilution test, the coefficient variation values of HCVAg were 41%, 29%, and 21% and HCVQn were 17%, 11%, and 150% of diluted sera respectively at 50, 5(-1), and 5(-2) dilution factor for four days running. The qualitative in - house HCV RT-PCR (5(-5) dilution factor) and HCVQn (5(-5) dilution factor) were more sensitive than the HCVAg (5(-2) dilution factor). And the diagnostic sensitivity was high in order on the qualitative in - house HCV RT-PCR; 97%, HCVQn; 91%, and HCVAg; 85%. The concordance rate between the three methods was 83.9%. The quantity of HCVAg and HCVQn showed a significant correlation (R =0.8, P<0.0001). CONCLUSIONS: HCVAg showed reliable results and a significant correlation with the quantitative RNA level. HCVQn showed a quantitative result but less sensitivity than the qualitative in-house HCV RT-PCR. Even though the HCVAg has slightly lower sensitivity than the two methods, methodologically, it is the most cost-effective, is simple, and gives high throughput. So it should be a simple economic surrogate marker for viremia detection and viral load monitoring.
Biomarkers ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Polymerase Chain Reaction ; Reverse Transcription ; RNA* ; Running ; Sensitivity and Specificity ; Viral Load ; Viremia

Endometriosis is estrogen dependent disease in reproductive age. Endometriosis is a chronic inflammatory gynecologic disease. Problems associated with endometriosis include dysmenorrhea, dyspareunia, and infertility. Postmenopausal endometriosis is rare. Also, malignant transformation in endometriosis is rare. There is no report in Korea about serous adenocarcinoma arising from endometriosis after menopause. The authors present a case of serous adenocarcinoma arising from endometriosis after menopause with brief review of the literature.
Adenocarcinoma ; Dysmenorrhea ; Dyspareunia ; Endometriosis ; Estrogens ; Female ; Genital Diseases, Female ; Infertility ; Korea ; Menopause

PURPOSE: This clinical study evaluated the feasibility of needlescopic appendectomy (NA) in young patients with acute appendicitis, and we compare the outcome of this new technique with that of conventional laparoscopic appendectomy (LA). METHODS: Two groups of young patients who underwent laparoscopic appendectomy at Sanggye Paik Hospital between January 2009 and December 2009 were studied. In the first group, a 2-mm instrument appendectomy was performed in 13 patients. These patients were compared with the second group, which were 21 patients who underwent conventional laparoscopic appendectomy. Statistical significance was set at p values<0.05. RESULTS: The patient demographics and operative findings were similar in both groups. There was no conversion to open appendectomy in either group. Postoperative ileus was occurred in 3 patients who underwent LA, but there was no statistical difference between the both groups (p=0.154). The needlescopic group had a shorter mean operative time (p=0.65), but there was no statistically significance. The mean hospital stay was significantly shorter (p=0.026) in the needlescopic group than that in the conventional laparoscopic group. CONCLUSION: According to our experience, needlescopic laparoscopic appendectomy is a safe and feasible procedure as compared with that of conventional laparoscopic appendectomy in young patients.
Appendectomy ; Appendicitis ; Child ; Demography ; Humans ; Ileus ; Length of Stay ; Operative Time

We report a case of intraocular gnathostomiasis diagnosed by western blot assay in a patient with subretinal tracks. A 15-year-old male patient complained of blurred vision in the right eye, lasting for 2 weeks. Eight months earlier, he had traveled to Vietnam for 1 week and ate raw wild boar meat and lobster. His best-corrected visual acuity was 20/20 in both eyes and anterior chamber examination revealed no abnormalities. Fundus examination showed subretinal tracks in the right eye. Fluorescein angiography and indocyanine green angiography showed linear hyperfluorescence of the subretinal lesion observed on fundus in the right eye. Ultrasound examination revealed no abnormalities. Blood tests indicated mild eosinophilia (7.5%), and there was no abnormality found by systemic examinations. Two years later, the patient visited our department again for ophthalmologic evaluation. Visual acuity remained 20/20 in both eyes and the subretinal tracks in the right eye had not changed since the previous examination. Serologic examination was performed to provide a more accurate diagnosis, and the patient's serum reacted strongly to the Gnathostoma nipponicum antigen by western blot assay, which led to a diagnosis of intraocular gnathostomiasis. This is the first reported case of intraocular gnathostomiasis with subretinal tracks confirmed serologically using western blot in Korea.
Adolescent ; Animals ; Blotting, Western ; Fundus Oculi ; Gnathostoma/*isolation & purification ; Gnathostomiasis/*diagnosis/parasitology ; Humans ; Male ; Retinal Diseases/*diagnosis/parasitology ; Travel ; Vietnam