Since surgically induced corneal astigmatism was one of important complications after cataract extraction the authors analyzed corneal astigmatism for 3 months after sutureless cataract surgery. Among the patients who were treated with phacoemulsification and PCL implantation by one surgeon (L. E. H.), 40 patients had sutureless cataract surgery by 5mm incision and 51 patients had 10-0 nylon shoelace suture by 7mm incision. Corneal astigmatism was analyzed by algebraic and vector method. Visual acuity was analyzed in patients who were below 60 years age and without posterior segment disorders, whose predictive refractive errors were -0.75D according to SRK/T formula. 0.19D with-the-rule astigmatism induced at 1 day after 5mm sutureless cataract surgery was nearly unchanged until 3 months postoperatively and induced with-the-rule astigmat ism at 1 day after operation was not changed into against-the-rule astigmatism, visual rehabilitation was faster and corrected visual acuity was better.
Astigmatism* ; Cataract Extraction ; Cataract* ; Humans ; Nylons ; Phacoemulsification ; Refractive Errors ; Rehabilitation ; Sutures ; Visual Acuity

We rotated the nucleus up to 270 degree and dislocated it into anterior chamber through the diameter of capsulorhexis after hydrodissection by using the planned extracapsular cataract extraction. And later on we delivered the nucleus with hydroexpression using the irrigating Vectis or with rotation using a lens spatuala. As a result of this procedure, the nucleus was safely delivered in all cases without zonular rupture and vitreous prolapse.
Anterior Chamber ; Capsulorhexis* ; Cataract Extraction* ; Cataract* ; Prolapse ; Rupture

One case of unilaterally developed acute retinal necrosis syndrome was studied with retina and vitreous from biopsy during operation through electronmicroscope pathologically and virolo gically. In photoreceptor cells, generalized necrosis was found: loss of outer segments, fragmentation of inner segments, and decrease of mitochondria in ellipsoids. Bipolar cells and axons were well preserved. Internal limiting membrane was intact, and covered by an unidentified cell. Degenerated retinal proper had various sized vacuoles. Around the intraretinal vessels, neutrophils and lymphocytes were infiltrated considering vasculitis. In ganglion cells, swelling of mitochondrias were seen, and their cell organelles were decreased, No virus particle was detected in all layers of the retina with electronmicroscope.
Axons ; Biopsy ; Ganglion Cysts ; Lymphocytes ; Membranes ; Mitochondria ; Necrosis ; Neutrophils ; Organelles ; Photoreceptor Cells ; Retina ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde ; Vacuoles ; Vasculitis ; Virion

For the purpose of correction of high myopia, we had implanted Worst-Fechner Biconcave Lens (Ophtec B.V., Groningen, Holland) in the 10 phakic eyes which were more myopic than -8.0 D. We examined postoperative visual acuity and complications. Postoperative uncorrected visual acuity was from 0.3 to 1.0. Cataract, glaucoma, chronic iridocyclitis and macular edema or retinal detachment did not occur and during the iris fluorescein angiography of 4 eyes there was no leakage of dye at the fixation site of iris by haptic of the lens. But all patients complained of glare. In the 3 eyes which were followed up for 12 months, corneal endothelial cell loss occurred continuously and the endothelial cell loss was 17.2% at the central cornea and 19.5% at the paracentral cornea. Therefore, long term follow up is necessary.
Cataract ; Cornea ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Fluorescein Angiography ; Follow-Up Studies ; Glare ; Glaucoma ; Humans ; Iridocyclitis ; Iris ; Macular Edema ; Myopia* ; Retinal Detachment ; Visual Acuity

We evaluated pseudophakia in high myopic patients whose an axial lenght were 26mm and over. Cataract surgery was performed with ECCE and posterior chamber intraocular lens implantations from May 1986 to May 1991 on 69 patients (80 eyes). The results were as follows; 1. Most myopic patients were good candidates for posterior chamber intraocular lens implantation regardless of axial length. 2. Posterior chamber intraocular lens implantations in high myopia were a good refractive surgery. 3. The theoretical formula had better predictabilized than the empirical formula in apredictive accuracy.
Cataract ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Myopia* ; Pseudophakia ; Refractive Surgical Procedures

BACKGROUND AND OBJECTIVES: The causes of vasospastic angina are not well known. We attempted to elucidate the risk profiles of Korean patients with vasospastic angina. SUBJECTS AND METHODS: The risk profiles were analyzed in 181 patients with vasospastic angina (VA), 1533 patients with obstructive coronary artery disease (CAD) who underwent coronary angiography at Samsung Seoul Hospital, and 455 normal control subjects, sex and age matched to the VA group and selected from the Health Promotion Center of Samsung Seoul Hospital. The male to female ratio was significantly higher in the VA group (4.6:1) than the obstructive CAD group (2.7:1). The mean age of the VA group (52.2+/-10.7 years) was significantly younger than the mean age of the obstructive CAD group (59.0+/-10.6 years) (p<0.01). Additionally, the smoking rate was significantly higher in the VA group (49.2%) as compared with the obstructive CAD group (43.1%) (p<0.01). Other major risk factors such as hyperlipidemia, hypertension and diabetes mellitus were significantly more prevalent in the obstructive CAD group than the VA group. Among the obstructive CAD group, a subgroup of Q-wave myocardial infarction (MI) showed a significantly higher smoking rate (59.3%) as compared with VA group (49.2%) (p<0.01). CONCLUSION: The VA group showed a higher prevalence in males and younger subjects as compared with the obstructive CAD group, and smoking appeared to be the most important risk factor for VA.
Angina Pectoris, Variant ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Coronary Vasospasm ; Diabetes Mellitus ; Female ; Health Promotion ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Myocardial Infarction ; Prevalence ; Risk Factors* ; Seoul ; Smoke ; Smoking

Neurocardiogenic syncope is a relatively common cause of syncope and is diagnosed by head-up tilt test. A wide variety of medical treatment has been proposed, such as beta-blocker, vasoconstrictor, fludrocortisone, and serotonin re-uptake inhibitors. But there are some cases in which these therapies have failed to prevent syncope. Recent report has shown that tilt training is a very effective therapy for recurrent neurocardiogenic syncope. Thus, to determine whether tilt training could prevent symptoms in the patients with recurrent neurocardiogenic syncope, the following study was taken. Five patients diagnosed with neurocardiogenic syncope by head-up tilt test were included. After hospital admission, they were tilted daily until negative response occurred. Negative response was noted in four patients. But tilt training was stopped in one patient because of no response of tilt training. After hospital discharge, the four patients performed tilt training at home by leaning against wall. They were interviewed on the phone eight to eleven months later. They have not experienced any symptoms during the follow-up period. This is the first domestic report of tilt training in patients with neurocardiogenic syncope.
Fludrocortisone ; Follow-Up Studies ; Humans ; Serotonin ; Syncope ; Syncope, Vasovagal*

The aim of this study was to investigate the efficacy of simvastatin to improved lipid profiles in hypercholesterolemic Korean patients. METHODS: From 25 hospitals in Korea, 478 hypercholesterolemic patients were enrolled from November 1996 to April 1998. The inclusion criteria was hypercholesterolemia over 240 mg/dl after diet therapy for 1 month or hypercholesterolemia over 220 mg/dl in patients with definite evidence of ischemic heart disease. Simvastatin 10mg was started and doubled up to 40mg if total cholesterol level remained higher than 200 mg/dl at monthly check. Of 478 subjects, 344 patients in whom study protocol was not violated were analyzed. RESULTS: Male to female ratio was 27:73 and 47% of the subjects were in 6th decade. Hypertension, coronary artery disease, and diabetes mellitus were present in 30, 10, and 4% of the subjects. Baseline lipid profile (mean of total cholesterol-LDL-HDL-triglyceride mg/dl) was 274-185-52-188. The dose of simvastatin for 3 months was 10/10/10mg in 61% of subjects, 10/20/20mg in 21%, 10/10/20mg in 7%, and 10/20/40mg in 12%. The change of total cholesterol level(before-4wk-8wk-12wk-withdrawal 4wk) was 274-209- 205-198-250, and the maximal reduction rate was 27%. The change of LDL-cholesterol was 185-123-116-110-159, with maximal reduction rate 39%. The change of HDL-cholesterol was 52-54-56-55-54, with maximal increase rate 9%. The change of tryglyceride was 188-161- 164-162-189, with maximal reduction rate 15%. The value before/after treatment of ApoA1, ApoB, and Lp(a) was 129/129, 138/83, and 9.3/10.7, respectively. The level of LDL-cholesterol at the end of treatment was below 100mg/dl in 36% of subjects, 100-130 in 45%, 130-160 in 16%, and over 160mg/dl in 4%. The reduction rate of LDL-cholesterol was different between subjects whose LDL decreased below 100 and those whose LDL did not decrease below 130mg/dl, which suggests the existence of the individual difference of responsiveness to simvastatin. There were only 3 subjects (0.9%) who showed increase of liver enzyme over 3 times as the upper normal limit. Conclusion: Simvastatin is effective in improving lipid profiles in hypercholesterolemic Korean patients without serious side effects.
Apolipoproteins B ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Individuality ; Korea ; Liver ; Male ; Myocardial Ischemia ; Simvastatin*

The aim of this study was to investigate the efficacy of simvastatin to improved lipid profiles in hypercholesterolemic Korean patients. METHODS: From 25 hospitals in Korea, 478 hypercholesterolemic patients were enrolled from November 1996 to April 1998. The inclusion criteria was hypercholesterolemia over 240 mg/dl after diet therapy for 1 month or hypercholesterolemia over 220 mg/dl in patients with definite evidence of ischemic heart disease. Simvastatin 10mg was started and doubled up to 40mg if total cholesterol level remained higher than 200 mg/dl at monthly check. Of 478 subjects, 344 patients in whom study protocol was not violated were analyzed. RESULTS: Male to female ratio was 27:73 and 47% of the subjects were in 6th decade. Hypertension, coronary artery disease, and diabetes mellitus were present in 30, 10, and 4% of the subjects. Baseline lipid profile (mean of total cholesterol-LDL-HDL-triglyceride mg/dl) was 274-185-52-188. The dose of simvastatin for 3 months was 10/10/10mg in 61% of subjects, 10/20/20mg in 21%, 10/10/20mg in 7%, and 10/20/40mg in 12%. The change of total cholesterol level(before-4wk-8wk-12wk-withdrawal 4wk) was 274-209- 205-198-250, and the maximal reduction rate was 27%. The change of LDL-cholesterol was 185-123-116-110-159, with maximal reduction rate 39%. The change of HDL-cholesterol was 52-54-56-55-54, with maximal increase rate 9%. The change of tryglyceride was 188-161- 164-162-189, with maximal reduction rate 15%. The value before/after treatment of ApoA1, ApoB, and Lp(a) was 129/129, 138/83, and 9.3/10.7, respectively. The level of LDL-cholesterol at the end of treatment was below 100mg/dl in 36% of subjects, 100-130 in 45%, 130-160 in 16%, and over 160mg/dl in 4%. The reduction rate of LDL-cholesterol was different between subjects whose LDL decreased below 100 and those whose LDL did not decrease below 130mg/dl, which suggests the existence of the individual difference of responsiveness to simvastatin. There were only 3 subjects (0.9%) who showed increase of liver enzyme over 3 times as the upper normal limit. Conclusion: Simvastatin is effective in improving lipid profiles in hypercholesterolemic Korean patients without serious side effects.
Apolipoproteins B ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Individuality ; Korea ; Liver ; Male ; Myocardial Ischemia ; Simvastatin*