No abstract available.
Epinephrine* ; Injections, Subcutaneous* ; Lidocaine* ; Ophthalmic Artery*

Systemic infections that are caused by various types of pathogenic organisms can be spread to the eyes as well as to other solid organs. Bacteria, parasites, and viruses can invade the eyes via the bloodstream. Despite advances in the diagnosis and treatment of systemic infections, many patients still suffer from endogenous ocular infections; this is particularly due to an increase in the number of immunosuppressed patients such as those with human immunodeficiency virus infection, those who have had organ transplantations, and those being administered systemic chemotherapeutic and immunomodulating agents, which may increase the chance of ocular involvement. In this review, we clinically evaluated posterior segment manifestations in the eye caused by hematogenous penetration of systemic infections. We focused on the conditions that ophthalmologists encounter most often and that require cooperation with other medical specialists. Posterior segment manifestations and clinical characteristics of cytomegalovirus retinitis, endogenous endophthalmitis, toxoplasmosis, toxocariasis, and ocular syphilis are included in this brief review.
Bacteria ; Cytomegalovirus Retinitis ; Diagnosis ; Endophthalmitis ; Eye Infections ; HIV ; Humans ; Inflammation* ; Organ Transplantation ; Parasites ; Specialization ; Syphilis ; Toxocariasis ; Toxoplasmosis ; Toxoplasmosis, Ocular ; Transplants

For the purpose of investigation to identify the quantities of heavy metals contained in the tissues of the Korean people, a series of analyses was conducted with atomic absorption spectrophotometry to measure the amount of lead, cadmium and copper distributed in various tissues, such as brain, liver, kidney, heart, lung, spleen, large intestine, hair, muscle, fat, stomach, costal cartilage, blood and urine, obtained from 30 cadaverous bodies who were believed not exposed to the said heavy metals during their life time either occupationally or therapeutically. 1. Lead content: Inter-individual difference was noted in lead contents in each tissue, vis., the average content of lead in hair was the highest with 14.90+/-9.74 ppm. The next was in costal cartilage that contained 5.06+/-3.86 ppm. The average contents of lead in liver, kidney and muscle were the lowest in value, showing 1.11+/-0.92 ppm, 0.73+/-0.48 ppm and 0.06+/-0.06 ppm, respectively. The lead contents in tissues of children under the age of 10 were significantly lower than those of adults, and the higher values were shown in finales than in females in general. The lead contents in most of the tissues such as hair, costal cartilage, kidney, lung, fat, stomach, large intestine, heart, muscle and urine were well correlated with age. 2. Cadmium content: The average content of cadmium in kidney appeared to be the highest, of ether tissues showing 20.7+/-29.82 ppm, and liver came nest with the value of 1.17+/-0.99 ppm. It was estimated that 83.9% of the total cadmium absorbed into the body was stored in kidney, 4.7% in liver, and the remaining 11.4% was distributed in the rest of the tissues. Cadmium contents in tissues showed difference between both sexes showing higher values in the females than in the males, which was quite contrary to the lead content. Cadmium contents in tissues steadily increased in amount with age, showing a significant correlation with age in all tissues. 3. Copper content: The average content of copper in hair was the highest with 10.36+/-2.21 ppm, and liver came next with 6.31+/-1.24 ppm. The copper that was absorbed into the body w4s distributed in each tissue: 29.9.% in hair, 18.2% in liver, 5~11% in brain, heart and kidney, and 3.0~3.5% in stomach, blood, and lung. The copper contents in tissues of children under the age of 10 showed significantly higher values in liver, kidney, heart and large intestine than those of the adults. The copper contents in brain, costal cartilage and fat were well correlated with age showing the highest correlation coefficient of 0.870 (p<0.01) in brain tissue. There was no difference in copper contents in tissues between both sexes, and the values were, in general, lower than those for Japanese.
Adult ; Asian Continental Ancestry Group ; Brain ; Cadaver ; Cadmium ; Cartilage ; Child ; Copper ; Ether ; Female ; Hair ; Heart ; Humans ; Intestine, Large ; Kidney ; Liver ; Lung ; Male ; Metals, Heavy* ; Occupations ; Spectrophotometry, Atomic ; Spleen ; Stomach

PURPOSE: To evaluate clinical characteristics and the macular gradient in myopic posterior staphyloma with time domain (TD) optical coherence tomography (OCT). METHODS: Sixty-four staphyloma eyes of 40 patients were examined. Macular gradient (tangent theta) and the location of staphyloma were assessed with OCT imaging. The macular gradient was measured at points 1 mm and 2 mm distant from the fovea. The relationships of the macular gradient with age, axial length, and spherical equivalent were analyzed. RESULTS: In 8 eyes (12.5%), the bottoms of the staphylomas were in the fovea, and there was no macular gradient. However, in the other 56 eyes (87.5%), the bottoms of the staphylomas were not in the foveal area, and macular gradients existed. Staphylomas were commonly located in the infero-nasal retinal area. The mean macular gradient (tangent theta) was 0.26 +/- 0.08 at 1 mm distance from the fovea and 0.28 +/- 0.10 at 2 mm. No significant relationships were observed between macular gradient and axial length, patient age, or spherical equivalent. CONCLUSIONS: TD OCT reveals staphyloma location. If the location is outside of the fovea, a macular gradient exists and can be measured by OCT. Axial length measurement error may occur in eyes with poor visual fixation and steep macular gradients.
Disease Progression ; Female ; Follow-Up Studies ; Humans ; Macula Lutea/*pathology ; Male ; Middle Aged ; Myopia, Degenerative/complications/*pathology ; Retrospective Studies ; Scleral Diseases/complications/*pathology ; Severity of Illness Index ; Tomography, Optical Coherence/*methods

No abstract available.
Craniocerebral Trauma* ; Head* ; Protons*

PURPOSE: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. MATERIALS AND METHODS: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MRI, and US at 1 day, 3 day, and 1 week after operation. RESULTS: US was superior to MRI or spiral CT in diagnosis of diaphragmatic rupture(P<0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitively of MRI and spiral CT increased as the size of laceration were larger, but no statistical significant was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase. US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spinal CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05) In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). CONCLUSION: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.
Animals ; Delayed Diagnosis ; Diagnosis* ; Diaphragm ; Hemothorax ; Hernia ; Humans ; Lacerations ; Magnetic Resonance Imaging ; Models, Animal ; Mortality ; Pleural Effusion ; Rabbits ; Rupture* ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Ultrasonography* ; Viscera

PURPOSE: To characterize the features of peripapillary atrophy (PPA), as imaged by spectral-domain optical coherence tomography (SD-OCT). METHODS: SD-OCT imaging of the optic disc was performed on healthy eyes, eyes suspected of having glaucoma, and eyes diagnosed with glaucoma. From the peripheral beta-zone, the retinal nerve fiber layer (RNFL), the junction of the inner and outer segments (IS/OS) of the photoreceptor layer, and the Bruch's membrane/retinal pigment epithelium complex layer (BRL) were visualized. RESULTS: Nineteen consecutive eyes of 10 subjects were imaged. The RNFL was observed in the PPA beta-zone of all eyes, and no eye showed an IS/OS complex in the beta-zone. The BRL was absent in the beta-zone of two eyes. The BRL was incomplete or showed posterior bowing in the beta-zone of five eyes. CONCLUSIONS: The common findings in the PPA beta-zone were that the RNFL was present, but the photoreceptor layer was absent. Presence of the BRL was variable in the beta-zone areas.
Adult ; Aged ; Bruch Membrane/pathology ; Female ; Glaucoma/*complications ; Humans ; Male ; Middle Aged ; Nerve Fibers/pathology ; Optic Atrophy/*diagnosis/*etiology ; Optic Disk/*pathology ; Photoreceptor Cells, Vertebrate/pathology ; Retina/pathology ; Retinal Pigment Epithelium/pathology ; Tomography, Optical Coherence/*methods

PURPOSE: To report the results of the 2015 questionnaire survey of current trends and practice patterns in the treatment of vitreoretinal diseases, which was conducted by the Korean Retina Society (KRS). METHODS: In October 2015, members of the KRS participated in a survey of current trends and practice patterns in the treatment of vitreoretinal diseases. This survey was comprised of 68 multiple choice and dichotomy questions. RESULTS: One hundred eleven (41%) members participated in this survey. Most respondents (42%) had begun their vitreoretinal subspecialty ≤7 years previously, 32% had practiced for 8-15 years, and 26% for 16 years or more. The preferred primary treatment for newly diagnosed wet-type age-related macular degeneration was ranibizumab or aflibercept, and most clinicians (68%) favored a pro re nata regimen. Seventy percent of respondents treated injection-related endophthalmitis using a combination of immediate vitrectomy and intravitreal antibiotic injection. Bevacizumab was the most commonly (78-87%) preferred first-line therapy for macular edema (ME) secondary to central retinal vein occlusion or branch retinal vein occlusion. When ME did not respond to anti-vascular endothelial growth factor treatment, most respondents (91%) switched patients to dexamethasone implant or triamcinolone acetonide. Eighty-four percent of the respondents performed scleral buckling during retinal detachment surgery in fewer than 40% of cases. Also, most respondents (96%) prescribed an antibiotic eye drop after, or before and after intravitreal drug injection. CONCLUSIONS: This survey reflected the recent trends and practice patterns in the treatment of vitreoretinal diseases in Korea.
Bevacizumab ; Dexamethasone ; Endophthalmitis ; Endothelial Growth Factors ; Humans ; Korea ; Macular Degeneration ; Macular Edema ; Ranibizumab ; Retina* ; Retinal Detachment ; Retinal Vein ; Retinal Vein Occlusion ; Scleral Buckling ; Surveys and Questionnaires ; Triamcinolone Acetonide ; Vitrectomy

Fluoroscopy guidance is useful to confirm anatomical landmark and needle location for spine intervention; however, it can lead to radiation exposure in patients, physicians, and medical staff. Physicians who used fluoroscopy should be cognizant of radiation exposure and intend to minimize radiation dose. We retrospectively reviewed three lumbar spine intervention procedures (nerve root block, medial branch block, and facet joint block) at our institution between June and December, 2014. We performed 268 procedures on 220 patients and found significant difference in radiation dose between two groups classified by performing physicians. The physician who controlled the fluoroscopy unit directly used significantly shorter fluoroscopy (6 seconds) that resulted in a smaller radiation dose (dose area product [DAP] 0.59 Gy.cm2) than the physician supervising the radiographer controlling the fluoroscopy unit (72 seconds, DAP 5.31 Gy.cm2, P < 0.001). The analysis indicates that the difference in fluoroscopy time depends on whether a physician or a radiographer controls the fluoroscopy unit.
Adult ; Aged ; Aged, 80 and over ; Female ; Fluoroscopy ; Health Personnel/psychology ; Humans ; Lumbar Vertebrae/*diagnostic imaging ; Male ; Middle Aged ; Pain Management ; Physicians/psychology ; Radiation Dosage ; *Radiation Exposure ; Retrospective Studies

PURPOSE: To report the outcome of scleral buckling using a non-contact wide-angle viewing system with a 25-gauge chandelier endoilluminator. METHODS: Retrospective analyses of medical records were performed for 17 eyes of 16 patients with primary rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy who had undergone conventional scleral buckling with cryoretinopexy using the combination of a non-contact wide-angle viewing system and chandelier endoillumination. RESULTS: The patients were eight males and five females with a mean age of 26.8 ± 10.2 (range, 11 to 47) years. The mean follow-up period was 7.3 ± 3.1 months. Baseline best-corrected visual acuity was 0.23 ± 0.28 logarithm of the minimum angle of resolution units. Best-corrected visual acuity at the final visit showed improvement (0.20 ± 0.25 logarithm of the minimum angle of resolution units), but the improvement was not statistically significant (p = 0.722). As a surgery-related complication, there was vitreous loss at the end of surgery in one eye. As a postoperative complication, increased intraocular pressure (four cases) and herpes simplex epithelial keratitis (one case) were controlled postoperatively with eye drops. One case of persistent RRD after primary surgery needed additional vitrectomy, and the retina was postoperatively attached. CONCLUSIONS: Scleral buckling with chandelier illumination as a surgical technique for RRD has the advantages of relieving the surgeon's neck pain from prolonged use of the indirect ophthalmoscope and sharing the surgical procedure with another surgical team member. In addition, fine retinal breaks that are hard to identify using an indirect ophthalmoscope can be easily found under the microscope by direct endoillumination.
Female ; Follow-Up Studies ; Herpes Simplex ; Humans ; Intraocular Pressure ; Keratitis ; Lighting ; Male ; Medical Records ; Neck Pain ; Ophthalmic Solutions ; Ophthalmoscopes ; Postoperative Complications ; Retina ; Retinal Detachment ; Retinal Perforations ; Retrospective Studies ; Scleral Buckling* ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative