PURPOSE: To evaluate the efficacy and safety of laser photocoagulation and intravitreal injection of bevacizumab in zone I ROP (retinopathy of prematurity) accompanied with plus signs. METHODS: We performed a retrospective analysis of the records of 12 eyes of 7 premature infants with zone I ROP accompanied with plus signs, treated with diode laser photocoagulation and intravitreal injection of bevacizumab that were followed-up for at least 12 months. RESULTS: Mean gestational age was 30 + 2 weeks, mean birth weight was 1437 +/- 478 g, mean follow-up period was 14.7 +/- 2.0 months and mean age of diagnosis was 36 + 3 weeks. Plus signs were disappeared after an average of 10.1 +/- 2.4 postoperative days in all 12 eyes. The outcome was favorable in 11 (91.7%) of 12 treated eyes after a minimum of 12 months of follow-up. No local or systemic complications were observed. CONCLUSIONS: Laser photocoagulation and intravitreal injection of bevacizumab are effective and safe for treatment of zone I ROP accompanied with plus signs and require long-term follow-up.
Antibodies, Monoclonal, Humanized ; Birth Weight ; Diterpenes ; Eye ; Follow-Up Studies ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Intravitreal Injections ; Lasers, Semiconductor ; Light Coagulation ; Retinopathy of Prematurity ; Retrospective Studies ; Bevacizumab

PURPOSE: To study the treatment outcomes in patients who were administered multiple intravitreal ganciclovir injections more than 10 times alone without systemic anti-cytomegalovirus therapy for cytomegalovirus retinitis. CASE SUMMARY: A 64-year-old man who underwent immunosuppressive therapy after thymectomy due to an invasive thymoma and pure red-cell aplasia, a 60-year-old woman who underwent chemotherapy after diagnosis of diffuse large B-cell lymphoma, a 49-year-old man with a history of bone marrow transplantation due to acute myeloid leukemia, a 29-year-old woman with dermatomyositis treated with oral steroids and cyclosporine, and a 47-year-old woman who received intravitreal dexamethasone implant injections, intravitreal and subtenon steroid injections due to Behcet's disease were diagnosed with cytomegalovirus retinitis. All patients showed systemic complications such as pancytopenia after systemic anti-cytomegalovirus therapy, and therefore, they were administered multiple intravitreal ganciclovir injections alone. Best-corrected visual acuities improved in all patients, except in one case, where viral lesions were observed in the fovea. Retinal hemorrhaging and infiltrative lesions decreased in all patients. No severe complication was observed during the injection and in the follow-up period. CONCLUSIONS: Multiple intravitreal ganciclovir injections alone can be used as a treatment modality for cytomegalovirus retinitis to avoid the systemic side effects of systemic anti-cytomegalovirus therapy.
Adult ; Bone Marrow Transplantation ; Cyclosporine ; Cytomegalovirus Retinitis* ; Cytomegalovirus* ; Dermatomyositis ; Dexamethasone ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Ganciclovir* ; Humans ; Intravitreal Injections ; Leukemia, Myeloid, Acute ; Lymphoma, B-Cell ; Middle Aged ; Pancytopenia ; Red-Cell Aplasia, Pure ; Retinaldehyde ; Steroids ; Thymectomy ; Thymoma ; Visual Acuity

A mixture of tegafur and uracil (TEGASIL) is a common antineoplastic agent. Tegafur is a fluoropyrimidine structurally similar to 5-fluorouracil (5-FU); uracil slows the degradation of 5-FU by dihydropyrimidine dehydrogenase, which results in higher 5-FU concentrations in tumors. Mucocutaneous side effects induced by this agent are rare and include photosensitivity of lichenoid and eczematous types, acral erythema, hyperpigmentation and palmoplantar keratoderma. However, there have been no reports of fixed drug eruption associated with TEGASIL. We report here on a case of fixed drug eruption due to oral TEGASIL.
Dihydrouracil Dehydrogenase (NADP) ; Drug Eruptions ; Erythema ; Fluorouracil ; Hyperpigmentation ; Keratoderma, Palmoplantar ; Tegafur ; Uracil

A retrospective analysis of 122 consecutive of rhegmatogenous retinal detatchment cases which obtained successful surgical results was performed. All the cases were followed for longer than 1 year postoperatively. 15 eyes (12.3%) developed macular pucker. There was no significant difference in sex distribution and mean age was 43.7 years. The mean lapse time between surgery and the development of macular pucker was 7.2 months. Significant factors for developing macular pucker were multiple operation, preoperative macular detachment, and duration of retinal detachment (longer than 1 month). Other factors such as subretirial fluid drainage and myopia were not significant. 9 of 15 eyes with macular pucker were treated with vitrectomy and visual acuity improved in 66.7% of surgically treated eyes. These results suggest that success with single surgical procedure, operation before macular detachment, and early treatment of retinal detachment are important for preventing postsurgical macular pucker.
Drainage ; Myopia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Sex Distribution ; Visual Acuity ; Vitrectomy

BACKGROUND: Infectious complications frequently occur after cardiac arrest and may be even more frequent after therapeutic hypothermia. Pneumonia is the most common infectious complication associated with therapeutic hypothermia, and it is unclear whether prophylactic antibiotics administered during this intervention can decrease the development of early-onset pneumonia. We investigated the effect of antibiotic prophylaxis on the development of pneumonia in cardiac arrest patients treated with therapeutic hypothermia. METHODS: We retrospectively reviewed the medical records of patients who were admitted for therapeutic hypothermia after resuscitation for out-of-hospital cardiac arrest between January 2010 and July 2015. Patients who died within the first 72 hours or presented with pneumonia at the time of admission were excluded. Early-onset pneumonia was defined as pneumonia that developed within 5 days of admission. Prophylactic antibiotic therapy was defined as the administration of any parenteral antibiotics within the first 24 hours without any evidence of infection. RESULTS: Of the 128 patients admitted after cardiac arrest, 68 were analyzed and 48 (70.6%) were treated with prophylactic antibiotics within 24 hours. The frequency of early-onset pneumonia was not significantly different between the prophylactic antibiotic group and the control group (29.2% vs 30.0%, respectively, p = 0.945). The most commonly used antibiotic was third-generation cephalosporin, and the class of prophylactic antibiotics did not influence early-onset pneumonia. CONCLUSION: Antibiotic prophylaxis in cardiac arrest patients treated with therapeutic hypothermia did not reduce the frequency of pneumonia.
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Heart Arrest* ; Humans ; Hypothermia* ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Pneumonia* ; Resuscitation ; Retrospective Studies

PURPOSE: To evaluate the usefulness of imaging diagnosis in patients with atypical oculomotor abnormalities and paralytic strabismus. METHODS: The magnetic resonance imaging (MRI) or computed tomography (CT) of 3 patients with atypical Y pattern vertical incomitance and medial rectus (MR) paresis after MR impingement reduction and A pattern vertical incomitance were analyzed. High-resolution, surface coil MRI was used to obtain sets of contiguous, 2-mm thick quasi-coronal images in 9-cardinal gaze directions. Digital image analysis was used to evaluate the results. RESULTS: MRI revealed lateral displacement of the superior rectus (SR) and inferior displacement of the lateral rectus (LR) during upper temporal gaze and inferior displacement of the LR during lateral gaze in patients with Y pattern vertical incomitance. In patients with MR paresis, the maximal surface area of MR cross section is in the image plane 10 mm posterior from the orbital center at primary gaze. The maximal surface area of MR cross section is in the image plane 22 mm posterior from the orbital center during medial gaze. Quasi-coronal images show that contraction tends to cause the plane of maximum cross-section to move posteriorly. Surgical treatment was avoided and observational treatment maintained. There is incyclotorsion of both extraocular muscles in patients with A pattern vertical incomitance and upslanted palpebral fissure. CONCLUSIONS: Imaging diagnosis of pulley position and rectus muscle contractility is helpful for determining accurate diagnosis and treatment methods at atypical oculomotor abnormalities and paralytic strabismus.
Contracts ; Displacement (Psychology) ; Humans ; Magnetic Resonance Imaging ; Muscles ; Orbit ; Paresis ; Strabismus

This study was performed to investigate mistletoe extract-induced apoptosis in oral squamous cell carcinoma. In vivo study, HN22 cells were xenografted in nude mice. After tumor was experimentally induced, mistletoe extract was directly injected on the tumor mass. The specimens were evaluated using light and transmission electron microscopes. In vitro study, HN22 cells were cultured and exposed to mistletoe extract. The cells were evaluated using transmissin electron microscope. To evaluate apoptotic cells, flow cytometric analysis was done. The results were obtained as follows: 1. Light microscopic view of tumor mass showed necrosis at 2-4 weeks. 2. Transmission electron micrographs of tumor mass showed apoptosis and necrosis. 3. In TEM view of cell lines, necrosis and apoptosis were shown with mistletoe extract at 300microgram/ml, apoptosis was shown with mistletoe extract at 100microgram/ml. 4. In flow cytometric analysis, early and late apoptosis was shown when using caspase-3Ab and annexin-V, but no significant change was noted when using mebstain and Apo2.7 Ab. In this study, mistletoe extract induced necrosis and apoptosis in the tumor mass was induced by HN22 cells, early and late apoptosis in vitro study. Mistletoe extract was likely to induce cell death in oral squamous cell carcinoma through apoptosis.
Animals ; Apoptosis* ; Carcinoma, Squamous Cell* ; Cell Death ; Cell Line ; Heterografts ; Mice ; Mice, Nude ; Mistletoe* ; Necrosis

PURPOSE: To compare the postoperative results of inferior oblique muscle operation in congenital superior oblique palsy (CSOP) according to the preoperative vertical deviation. METHODS: This study reviewed medical records of 26 patients who were diagnosed as CSOP with the largest vertical deviation at adducted position and incomitant vertical strabismus from May 2003 to April 2004 at hospital. The patients were divided into two groups, the group 1 (18 patients) shows less than 20 prism diopter (PD) vertical deviation at the primary position, the group 2 (10 patients) shows no less than 20 PD vertical deviation at the primary position preoperatively. We performed operation of the inferior oblique muscle (IOM) for both group. We evaluated the surgical effect at the primary position and both lateral gaze after 3 months. and performed reoperation as needed. RESULTS: Mean correction amount of vertical deviation at primary position of two groups were 11.6+/-2.7 PD in the group 1 and 7.4+/-3.5 PD in the group 2. Postoperative vertical deviation was decreased compared to preoperative value and it was statistically significant. But there were statistically significant differences in the corrected amount after inferior oblique muscle operation between two groups at all gazes. Surgical result of group 1 was successful (100%), but in group 2, all failed (100%) and needed reoperation. CONCLUSIONS: This study showed that corrected amount with IOM operation was smaller in CSOP with no less than 20 PD vertical deviation at primary position and incomitant vertical strabismus. It may be taken into consideration when operation for rectus and oblique musle were performed simultaneously in CSOP.
Humans ; Medical Records ; Paralysis* ; Reoperation ; Strabismus

BACKGROUND: This study was conducted to analyze the height and width of the pedicle of the upper and lower levels on the concave and the convex sides. In addition, we checked for the appropriate pedicle screw size which could be screwed in without complications. MATERIALS AND METHODS: Taking a simple AP radiography in a standing position, 99 vertebrae on the major curve with the possibility of 3-D reconstruction were analyzed after checking the CT in a supine position of 22 idiopathic scoliosis. We measured Cobb's angle from a simple radiograph, and measured the size of the isthmus by the Inner Space 3-D Editor after 3-D reconstruction with the Inner Space 3-D program in the DICOM file transformed from CT image. We then analyzed the size of pedicles of the upper and lower levels on the concave and the convex sides by measuring the height and width of the pedicle. RESULTS: All pedicles on the concave side were smaller than those on the convex side. Their size increased as the measurement moved from the upper to lower vertebra, except for the upper thoracic vertebra. When the width of the pedicle through 3-D reconstruction was compared with the narrowest width of the pedicle measured by using CT, the width of the pedicles through 3-D reconstruction was statistically smaller (P< 0.01). Most of the pedicles were tear-drop or kidney shaped rather than cylindrical. CONCLUSION: These results suggest that the use of the coronal plane through 3-D reconstruction would be necessary for an accurate measurement of the size of the pedicle. It is important to pay careful attention to the screw size and the screwing method considering the pedicle shape through 3-D reconstruction.
Kidney ; Radiography ; Scoliosis* ; Spine ; Supine Position

The development of optical coherence tomography (OCT) has changed the clinical management of ophthalmic diseases by furthering the understanding of pathogenesis, as well as improving the monitoring of their progression and assisting in quantifying the response to treatment modalities in ophthalmic diseases. Initially, the two-dimensional configuration of the optic nerve head (ONH) and the thickness of the retinal nerve fiber layer (RNFL) were the main OCT structural parameters used in clinical management of optic nerve diseases. Now, with higher resolution power and faster acquisition times, the details of ONH and the retina including the macular area can be measured using spectral domain OCT (SD-OCT) with high reproducibility and increased diagnostic ability. OCT can provide structural information to improve the understanding and management of optic nerve diseases. In this review, we will briefly summarize the clinical applications of SD-OCT in glaucoma and nonarteritic anterior ischemic optic neuropathy, which are two representative optic nerve diseases.
Glaucoma ; Nerve Fibers ; Optic Disk ; Optic Nerve Diseases ; Optic Neuropathy, Ischemic ; Retina ; Retinaldehyde ; Tomography, Optical Coherence