Background: To compare open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) in the management of renal tumors larger than 4 cm. Methods: Clinical records of 220 patients who underwent OPN or RAPN for a single renal tumor ≥ 4.0 cm with a normal contralateral kidney were reviewed. After determining the propensity score, surgical parameters, functional outcomes, and oncological outcomes were compared between OPN (n = 67) and RAPN (n = 67) groups of patients. Results: The RAPN group had longer operation time (149.0 min vs. 173.3 min, P = 0.030) and longer ischemic time (20.3 min vs. 29.4 min, P = 0.001), but shorter hospital stay (8.2 days vs 6.0 days, P = 0.001) than the OPN group. Estimated blood loss (P = 0.053), pain visual analog score at 1 day postoperatively (P = 0.194), and complications of grade III or higher (P = 0.403) were similar between OPN and RAPN groups. There was no radical conversion or positive surgical margin in either group. Mean change in 6-month estimated glomerular filtration rate was significantly better in the RAPN group (−8.2 vs. −3.1, P = 0.027). There was no statistical difference in recurrence-free survival (P = 0.970) or cancer-specific survival (P = 0.345) between the two groups. Conclusion RAPN is a safe and feasible surgical modality comparable to OPN for managing renal tumors larger than 4 cm in terms of surgical, functional, and oncological outcomes.

Background: To compare open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) in the management of renal tumors larger than 4 cm. Methods: Clinical records of 220 patients who underwent OPN or RAPN for a single renal tumor ≥ 4.0 cm with a normal contralateral kidney were reviewed. After determining the propensity score, surgical parameters, functional outcomes, and oncological outcomes were compared between OPN (n = 67) and RAPN (n = 67) groups of patients. Results: The RAPN group had longer operation time (149.0 min vs. 173.3 min, P = 0.030) and longer ischemic time (20.3 min vs. 29.4 min, P = 0.001), but shorter hospital stay (8.2 days vs 6.0 days, P = 0.001) than the OPN group. Estimated blood loss (P = 0.053), pain visual analog score at 1 day postoperatively (P = 0.194), and complications of grade III or higher (P = 0.403) were similar between OPN and RAPN groups. There was no radical conversion or positive surgical margin in either group. Mean change in 6-month estimated glomerular filtration rate was significantly better in the RAPN group (−8.2 vs. −3.1, P = 0.027). There was no statistical difference in recurrence-free survival (P = 0.970) or cancer-specific survival (P = 0.345) between the two groups. Conclusion RAPN is a safe and feasible surgical modality comparable to OPN for managing renal tumors larger than 4 cm in terms of surgical, functional, and oncological outcomes.

PURPOSE: It is important to know the accurate refractive error of the patients before LASIK because the amount of ablation is determined by that. We analyzed whether there are differences among the preoperative and postoperative results of cycloplegic retinoscopy (CR), module setting value, and autorefraction with and without cycloplegia (ACR, AMR). METHODS: The manifest and cycloplegic refractions of 104 eyes of 104 patients who underwent LASIK from February 2001 to July 2001 were reviewed. The preoperative and postoperative cycloplegic refraction, autorefraction by Canon RK-5, and module setting value were analyzed. RESULTS: In comparison of the preoperative values, AMR showed myopic shift compared to CR, module setting, and ACR (p<.001). ACR showed hyperopic shift compared to CR (p<0.001). The module setting showed myopic shift compared to CR, but it was not statistically significant. Postoperative mean spherical equivalent was 0.04 +/- 0.67D(range: -1.75 ~ +1.5). In comparison of the postoperative results, ACR showed hyperopic shift compared to CR (p<0.001) and AMR showed myopic shift compared to CR (p<0.001). CONCLUSIONS: As there is a difference between autorefraction and cycloplegic refraction, it is inappropriate to decide the amount of ablation only by one method. Hence when LASIK or LASIK retreatment is planned, cycloplegic refraction as well as autorefraction is necessary.
Humans ; Keratomileusis, Laser In Situ* ; Refractive Errors ; Retinoscopy ; Retreatment

PURPOSE: This project was designed to study the effectiveness and safety of Dream lens(TM) (OK B+ series lenses, Contex, USA) in correcting myopia in a population of school children, under 13 years old. METHODS: Twenty-three school children aged 7 to 13 years followed over a 3-month period were fitted with lenses in the Vision Eye Center from September 2002 to March 2003. Slit lamp examination, uncorrected visual acuity, autorefraction and autokeratometry by Canon RK-5 and topography were measured at baseline and at 1week, 1 month, and 3 months after the lenses were worn. RESULTS: The mean baseline autorefraction was -2.54 +/- 1.00 diopters (range: -0.63~-4.00) and baseline uncorrected visual acuity over 0.5 was 11.1% and over 0.8 was 0%. Vision correction of over 0.8 was found in 80% of the cases in the first 1 week, 78% at 1 month, 91% at 3 months with the most rapid improvement occurring during the first 1 week. Superficial punctate keratitis occurred in 4 of 45 eyes, but there was no other pathologic problem. CONCLUSIONS: Dream lens is an effective and safe means of temporarily reducing myopia in a certain range of myopic patients; however, further studies are needed to determine the long-term effects on the eye health.
Adolescent ; Child* ; Humans ; Keratitis ; Myopia ; Visual Acuity

OBJECTIVE: The present study has examined whether subjective age would be associated with cognitive functioning in older adults. METHODS: Data from the third wave of Korean Social Life, Health, and Aging Project were used. This study was conducted with 152 older adults aged 60–89 years (mean=72.26, standard deviation=6.41) who completed measures of subjective age, Mini-Mental State Examination for Dementia Screening, Elderly Verbal Learning Test, Digit Span Test, Korean-Color Word Stroop Test, Trail Making Test, Verbal Fluency Test, Korean Boston Naming Test-Short form. The association of subjective age and cognitive functioning was analyzed using hierarchical regression analysis. Sex, depression, and chronological age were included as control variables. RESULTS: Hierarchical regression analysis revealed that a younger subjective age was associated with better processing speed, immediate memory, and executive function respectively. Even after controlling for chronological age, depression, and sex, the subjective age was associated with cognitive functioning in old age. CONCLUSION: Beyond chronological age, the subjective experience of age was associated with cognitive aging.
Adult ; Aged ; Aging ; Cognition ; Cognitive Aging ; Dementia ; Depression ; Executive Function ; Humans ; Mass Screening ; Memory, Short-Term ; Stroop Test ; Trail Making Test ; Verbal Learning

Chronic constipation is a common disease that can impair the quality of life, with a prevalence of 14% globally and 16.5% in South Korea. Straining, hard stools, the sensation of incomplete evacuation, the sensation of anorectal blockage, and manual maneuvers to facilitate defecation are the related symptoms of chronic constipation. On the other hand, medications commonly referred to as laxatives are the essentials of treatment for constipation compared to non-pharmacological treatment, such as lifestyle modifications, biofeedback, or surgery. Unfortunately, there is still an unmet need to determine if pharmacological treatment for constipation is being administered appropriately. Therefore, there are many disadvantages as to whether the indications and side effects of laxatives are adequately considered and prescribed as the primary treatment modality for constipation in a real clinical situation in Korea. Laxatives are generally recommended as the next step for patients in whom organic causes have been excluded and have not responded to initial non-pharmacologic therapies such as dietary fiber intake and exercise. Laxatives can be classified as bulk-forming laxatives, osmotic laxatives, stimulant laxatives, and other novel laxatives. On the other hand, there are distinct mechanisms underlying constipation, and appropriate administration is the most decisive. Therefore, the present investigators prepared this review to discuss appropriate pharmacological strategies for chronic constipation in Korea. Moreover, this paper also includes suggestions for appropriate pharmacological treatment options for special patient populations.

Broussonetia kazinoki Siebold. (B. kazinoki) has long been used in the manufacture of paper in Asian countries. Although B. kazinoki leaves (BK) have been employed in dermatological therapy, use of BK has not been tested in patients with atopic dermatitis (AD). Using Nc/Nga mice, which are genetically predisposed to develop AD-like skin lesions, we confirmed the efficacy of BK in AD treatment. BK extract was applied topically to Dermatophagoides farinae-induced AD-like lesions in Nc/Nga mice, and the effects were assessed both clinically and by measuring skin thickness on the back and ears. We measured the effects of BK extract on plasma levels of IgE and IL-4. We also measured the ability of BK extract to inhibit the secretion of hTARC in HaCaT cells after stimulation by TNF-alpha and IFN-gamma. We found that BK extract significantly reduced ear and dorsal skin thickness and the clinical signs of AD, as well as significantly down-regulating the plasma levels of IgE and IL-4 (p<0.01 for each comparison). Moreover, 500 mug/mL of BK extract inhibited hTARC secretion in HaCaT cells by activated TNF-alpha/IFN-gamma by about 87%. These findings suggest that topical application of BK extract has excellent potential in the treatment of AD.
Animals ; Asian Continental Ancestry Group ; Broussonetia* ; Dermatitis, Atopic ; Ear ; Humans ; Immunoglobulin E ; Interleukin-4 ; Mice* ; Mites* ; Plasma ; Pyroglyphidae ; Skin ; Tumor Necrosis Factor-alpha

PURPOSE: The aim of this study is evaluating the accuracy of preoperative magnetic resonance imaging (MRI) in patients who underwent pelvic lymph node dissection (PLND). MATERIALS AND METHODS: The medical records of 1,528 patients who underwent radical prostatectomy and PLND from 2003 to 2017 in Seoul National University Bundang Hospital were retrospectively reviewed. We evaluated the various clinicopathologic variables including preoperative MRI findings and pathologic lymph node (LN) metastasis. The prediction model for pathologic LN metastasis was assessed using univariate and multivariable logistic regression analyses and areas under receiver operating characteristic (ROC) curves. RESULTS: The mean age of our cohort was 66.4±6.7 years. Positive LN finding of preoperative MRI finding was observed in 9.4% (145 of 1,528) of patients. 5.3% (81 of 1,528) of patients had confirmed final pathologic LN metastases. Sensitivity and specificity of preoperative MRI were 30.8% and 91.7%, respectively. Multivariable analysis showed that preoperative MRI findings, clinical stage and biopsy Gleason score were independent significant predictors for pathologic LN metastasis (p < 0.001, p=0.002, and p < 0.001, respectively). Prediction model using preoperative MRI findings and National Comprehensive Control Network risk stratification showed fair accuracy using ROC analysis. CONCLUSIONS: Preoperative MRI findings for pathologic LN metastasis showed limited prediction value. A large-scale, multicenter, prospective study is needed to fully evaluate the clinical significance of preoperative MRI.
Biopsy ; Cohort Studies ; Humans ; Logistic Models ; Lymph Node Excision* ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Medical Records ; Neoplasm Grading ; Neoplasm Metastasis* ; Prospective Studies ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Seoul

PURPOSE: To report two cases of toxic corneal reaction induced by infusion of distilled water into anterior chamber during cataract surgery. CASE SUMMARY: The first case was a 60-year-old female who was inadvertently infused with distilled water for 20 minutes during phacoemulsification in place of balanced salt solution (BSS). The second case was a 70-year-old male who received anterior chamber irrigation with distilled water for approximately 1 minute then and then immediately irrigated with BSS as soon as the mistake was identified. In both cases, topical 1% prednisolone acetate and 5% NaCl solution was immediately administered every hour as well as oral prednisolone at 1 mg/kg for one week after which the dose was slowly tapered. The first case completely returned to normal after 3 months, whereas the second case only requied 1 month to return to pre-surgery conditions. CONCLUSIONS: Patients who were exposed to distilled water within the anterior chamber resulted in corneal endothelial damage and corneal edema proportionate to the amount irrigated. However, The corneal edema gradually healed with treatment and eventually regained translucency without complications, completely.
Aged ; Anterior Chamber ; Cataract ; Corneal Edema ; Female ; Humans ; Hypogonadism ; Male ; Middle Aged ; Mitochondrial Diseases ; Ophthalmoplegia ; Phacoemulsification ; Prednisolone ; Water

We report on a case of cholesterosis bulbi concurrent with secondary glaucoma. A 36-year-old man, with a history of long-standing retinal detachment in his right eye after the irrigation and aspiration of a congenital cataract, presented with a clinical picture of elevated intraocular pressure and ocular pain. Upon slit-lamp examination, we found a ciliary injection and a pseudohypopyon of polychromatic crystals. Gonioscopic examination revealed a large amount of crystals deposited on the trabecular meshwork and mild rubeosis iridis, but the neovascularization of the angle could not be clearly confirmed due to the presence of so many crystals. Pars plana vitrectomy was performed to remove clusters of crystals and bevacizumab was injected intravitreally to treat iris neovascularization. Aqueous aspirate was examined by light microscopy and the typical highly refringent cholesterol crystals were identified. Intraocular pressure returned to a normal level after the bevacizumab injection, although severe cholesterosis was still evident in the anterior chamber. To our knowledge, this would be the first Korean case of cholesterosis bulbi combined with chronic retinal detachment and presumed neovascular glaucoma, which was treated by pars plana vitrectomy and intravitreal bevacizumab injection.
Adult ; Angiogenesis Inhibitors/therapeutic use ; Anterior Chamber/*metabolism ; Antibodies, Monoclonal, Humanized/*therapeutic use ; *Cholesterol ; Eye Diseases/complications/metabolism ; Follow-Up Studies ; Glaucoma/surgery ; Glaucoma, Neovascular/drug therapy/*etiology/surgery ; Humans ; Intraocular Pressure ; Male ; Vitrectomy/*methods