After extracapsular cataract extraction and posterior chamber intraocular lens implantation on 62 high myopic patients(79 eyes) whose axial lengths were more than 26.0mm, the authors investigated the differences between the calcualted, predicted, peroperative values and measured postoperative values retrospectively. The patients were divided into 2 groups according to their axial lengths; Group C is 35 patients (44 eyes) with 26.0-28.4mm. Group D is 27 patients(35 eyes) with more than 28.4mm. Group A, as control group, is 70 patients(81 eyes) with 22.0-24.4mm and group B, as control group, is 37 patients(44 eyes) with 24.5-25.9mm. Autorefractive examination and manifest refraction was done at 1week, 1month, 3 months postoperatively. Preoperative intraocular lens diopter was calculated by SRK-II and SRK/T formula. After the scleral incision, continuous circumlinear capsulorhexis, and phacoemulsification, one-piece PMMA lens was implanted in the bag. At postoperative 3 months, all patients had the tendency of myopic shift and the shift calculated by SRK-II was much more than that by SRK/T. The difference was statistically significant. In conclusion, it is better to apply SRK/T formula when axial length is more than 26.0mm, in order to acheive goal diopter postoperatively.
Capsulorhexis ; Cataract Extraction ; Cataract* ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Retrospective Studies

PURPOSE: To evaluate the clinical results of a AMO Array mutifocal lens. METHOD: we performed a prospective clinical trial of 20 bilateral cataract patients for at least 6 months. RESULT: Mean monocular uncorrected distance acuity(Snellen) was 0.75, which increased to 0.9 with best correction. Mean biocular uncorrected distance acuity was 0.85,which increased to 1.0 with best correction. Mean monocular near acuity was 0.62, which reached 0.88 with best correction. Mean biocular near acuity was 0.71, which reached 1.00 with best correction. Mean contrast sensitivities were within normal range for all spacial frequencies. In glare discomfort, 10 patients had no complaint, 7 patients had no idea, and only 3 patients had some problem. Reading newspaper without glasses was achieved by 28 of 40 eyes(70%) and 15 of 20 patients(75%). CONCLUSION: AMO Array lens can be used as a method of treatment of presbyopia, when combined with correct biometry.
Biometry ; Cataract ; Eyeglasses ; Glare ; Glass ; Humans ; Lenses, Intraocular* ; Periodicals ; Presbyopia ; Prospective Studies ; Reference Values

A 44-year-old man, who had a history of myocardial infarction (MI) due to thrombotic occlusion of right coronary artery (RCA) aneurysm, visited emergency department presenting with ST-segment elevation myocardial infarction (STEMI). The patient had been on oral anticoagulant therapy (warfarin) from the first thrombotic event, but the medication had been recently changed to aspirin 4 months before the second event. Emergent coronary angiography revealed thrombotic total occlusion of RCA with heavy thrombotic burden from middle RCA to the ostium of the posterior descending branch. Combination pharmacotherapy was performed with anticoagulants (heparin), fibrinolytics (urokinase), and Glycoprotein IIb/IIIa antagonists (abciximab), in addition to mechanical thrombosuction. However, on hospital day 2, the patient complained recurrent chest pain and again underwent coronary angiography, which revealed distal embolization of large thrombus to the posterior lateral branch. Coronary flow was recovered after repeated mechanical thrombosuction was performed. This case has shown the importance of aggressive combination drug therapy, accompanied by mechanical thrombosuction in patient with myocardial infarction due to thrombotic occlusion of coronary artery aneurysm and the importance of unceasing life-long anticoagulant therapy in those particular patients.
Adult ; Aneurysm* ; Anticoagulants ; Aspirin ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Occlusion* ; Coronary Vessels* ; Drug Therapy ; Drug Therapy, Combination ; Emergency Service, Hospital ; Glycoproteins ; Humans ; Myocardial Infarction* ; Thrombectomy ; Thrombosis ; Warfarin*

PURPOSE: To evaluate the factors useful for predicting the surgical outcome of endonasal dacryocystorhinostomy. METHODS: This retrospective observational study included 117 eyes of 94 patients with nasolacrimal duct obstruction who underwent endonasal dacryocystorhinostomy and were followed up for more than 6 months. Factors associated with successful surgery were analyzed based on the preoperative and intraoperative factors and postoperative clinical features. Preoperative factors such as age, gender, laterality, presence or absence of hypertension, and diabetes were analyzed. Intraoperative factors such as use of triamcinolone, removal of uncinate process or middle turbinate during surgery, and location of the sac were analyzed. The postoperative clinical features including high tear meniscus, no intranasal silicone tube movement, and no air reflux feeling were each given a score of 1. Based on aggregate score, the patients were divided into 2 groups, the high score and low score groups and analyzed accordingly. RESULTS: The success rate was 91.5%. Patients with diabetes showed a significantly low success rate (73.3%, p = 0.007). In patients with high tear meniscus at 3, 6, and 9 weeks after surgery, the success rate was significantly low (76.9%, 81.8% and 75.0%; p = 0.003, p = 0.029 and p = 0.002, respectively). The low score group at 3 and 6 weeks after surgery showed a significantly high success rate (100% and 95.9%; p < 0.001 and p = 0.023, respectively). CONCLUSIONS: Besides preoperative and intraoperative factors, the early postoperative clinical features are important for predicting the success of the surgery. If tear meniscus is high and there is no intranasal silicone tube movement and air reflux from the punctum in the early stages after surgery, more active management from the initial treatment is needed.
Dacryocystorhinostomy* ; Humans ; Hypertension ; Nasolacrimal Duct ; Observational Study ; Retrospective Studies ; Silicones ; Tears ; Triamcinolone ; Turbinates

PURPOSE: Currently the most widely used method of measuring IgG concentration is the method employing ELISA. This method has an advantage to detect smaller quantities than other standard methods, but in certain cases, consistent results cannot be obtained, thus impairing reliable data analysis. In this study, we attempt to determine the advantages in data analysis offered by the new method developed by Binding Site Ltd. (England) that employs a nephelometry. METHODS: 20 healthy subjects were studied from each of the following age groups : neonates, 1-4 months old, 5-10 months old, 11-24 months old, and 2-5 years old children. Serum IgG and IgG subclass concentrations were measured by nephelometry (Gehring Nephelometer Analyzer II, Germany) using Human IgG subclass, Liquid reagents BNII kit (Binding Site Ltd., England). RESULTS: 1) The r values for the standard curves of IgG, IgG1, IgG2, IgG3, IgG4 concentrations were 0.991, 0.997, 0.980, 0.973, 0.997, respectively. 2) IgG, IgG3, and IgG4 concentrations were lowest at the age of 5-10 months and increased to normal adult levels at 2-5 years of age. 3) IgG1 and IgG2 were lowest at the age of 1-4 months and increased to normal adult levels at 2-5 years of age. CONCLUSION: The method employing nephelometry for measuring serum IgG & IgG subclasses concentration is not as sensitive as ELISA in detecting the lower concentrations. However, our studies indicate that it presents the advantage of better quality control in measuring values in the average range.
Adult ; Binding Sites ; Child* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin G* ; Indicators and Reagents ; Infant, Newborn ; Nephelometry and Turbidimetry ; Quality Control ; Reference Values* ; Statistics as Topic

PURPOSE: To report a case involving an eyelid mass that was diagnosed as apocrine carcinoma. CASE SUMMARY: A 52-year-old man visited our hospital with a recurrent mass on his right upper eyelid, which had developed 4 years prior. Initially, he received laser therapy at a dermatologic clinic to remove the mass. Two years later, the mass recurred and was excised at another clinic. At the time the patient visited our institution, the lesion had developed into multiple erythematous nodules at the margin of the right upper eyelid. The results of excisional biopsy performed under local anesthesia revealed hidradenoma papilliferum. One month after excision, recurred multiple elevated nodules were found at the margin of the excision, and thus total excision of the mass and reconstruction of the upper eyelid was performed. Biopsy confirmed that the mass was apocrine adenocarcinoma. Five months have passed since the excision and no evidence of recurrence has been observed. CONCLUSIONS: Apocrine adenocarcinoma is a malignant tumor of the sweat gland and is rarely found on the eyelid. Apocrine adenocarcinoma should be considered in the differential diagnosis of recurrent eyelid mass at the eyelid margin.
Acrospiroma ; Adenocarcinoma* ; Anesthesia, Local ; Biopsy ; Diagnosis, Differential ; Eyelids* ; Humans ; Laser Therapy ; Middle Aged ; Recurrence ; Sweat Glands

BACKGROUND: The development of new drugs or alternative therapies effective against methicillin-resistant Staphylococcus aureus (MRSA) is of great importance, and various natural anti-MRSA products are good candidates for combination therapies. We evaluated the antibacterial activities of a Phellinus baumii ethyl acetate extract (PBEAE) and its synergistic effects with beta-lactams against MRSA. METHODS: The broth microdilution method was used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of the PBEAE. The PBEAE synergistic effects were determined by evaluating the MICs of anti-staphylococcal antibiotic mixtures, with or without PBEAE. Anti-MRSA synergistic bactericidal effects of the PBEAE and beta-lactams were assessed by time-killing assay. An ELISA was used to determine the effect of the PBEAE on penicillin binding protein (PBP)2a production. RESULTS: The MICs and MBCs of PBEAE against MRSA were 256-512 and 1,024-2,048 microg/mL, respectively. The PBEAE significantly reduced MICs of all beta-lactams tested, including oxacillin, cefazolin, cefepime, and penicillin. However, the PBEAE had little or no effect on the activity of non-beta-lactams. Time-killing assays showed that the synergistic effects of two beta-lactams (oxacillin and cefazolin) with the PBEAE were bactericidal in nature (Deltalog10 colony forming unit/mL at 24 hr: 2.34-2.87 and 2.10-3.04, respectively). The PBEAE induced a dose-dependent decrease in PBP2a production by MRSA, suggesting that the inhibition of PBP2a production was a major synergistic mechanism between the beta-lactams and the PBEAE. CONCLUSIONS: PBEAE can enhance the efficacy of beta-lactams for combined therapy in patients infected with MRSA.
Acetates/chemistry ; Agaricales/*chemistry/metabolism ; Anti-Infective Agents/chemistry/*pharmacology ; Drug Synergism ; Enzyme-Linked Immunosorbent Assay ; Methicillin-Resistant Staphylococcus aureus/*drug effects/metabolism ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins/analysis/metabolism ; Plant Extracts/chemistry/*pharmacology ; beta-Lactams/*pharmacology

The purpose of this study was to evaluate the effect of diode laser & desensitizing agents to overcome hypersensitizing root surfaces problem after periodontal treatment. 20 patients(60 teeth) presented were volunteered in this study. Diode laser & MS coat was respectively applied on hypersensitizing root surfaces after periodontal treatments. Following application, they were evaluated immediately. The results were as follows: 1. The frequency and degree of root surface hypersensitivity levels were measured by the sequence of tactile and air stream. 2. Reduction of root surfaces hypersensitivity by tactile were for Diode laser and Ms coat application respectively 3.0294+/-2.0224 and 3.2692+/-1.6139. 3. Reduction of root surfaces hypersensitivity by air stream were for Diode laser and Ms coat application respectively 3.0294+/-2.0224 and 3.2692+/-1.6139. 4. It could be said that Diode Laser and Ms coat application were significantly effective in reducing dentin hypersensitivity as far as concerned effect, Ms coat applicatio showed more effective than Diode laser. In conclusion, both methods were significantly effective in reducing dentinal hypersensitivity. Therefore, it was recommended that Diode laser and desensitizing agents could be used routinely for patients dentinal hypersensitivity following periodontal treatment.
Dentin Sensitivity ; Dentin* ; Humans ; Hypersensitivity* ; Lasers, Semiconductor* ; Rivers

PURPOSE: To elucidate the learning curve for endoscopic endonasal dacryocystorhinostomy (EE-DCR) based on the results of EE-DCR performed by three surgeons at three different tertiary hospitals. METHODS: A retrospective review of the medical records of 386 eyes of 337 patients who had undergone EE-DCR by three surgeons at three tertiary hospitals and who were available for a >6-month postoperative observation period was conducted. The success of a given surgery was determined based on the results of a test performed during the patient's last outpatient visit to the hospital. The learning curve was identified by dividing the patients into four groups (20, 30, 40, and 50 eyes in each respective group) and comparing their success rates. RESULTS: The overall success rate of the entire study population was 86.3%. The success rates for each of three surgeons was 83.3%, 85.6%, and 88.1%, respectively. After dividing the patients into groups of 30 eyes each, all three surgeons showed a significant increase in surgery success rates after their first group of 30 eyes (p < 0.05). The overall success rate excluding the first 30 eyes was 92.9%, and all three surgeons exhibited a significantly improved success rate of >90% (A, 94.4%; B, 90.8%; C, 95.4%). CONCLUSIONS: A surgeon should be required to perform at least 30 EE-DCR procedures to obtain stable surgical skill for this procedure.
Dacryocystorhinostomy* ; Humans ; Lacrimal Duct Obstruction ; Learning Curve* ; Learning* ; Medical Records ; Outpatients ; Retrospective Studies ; Surgeons ; Tertiary Care Centers

Retrograde transpapillary cholangioscopy can be safely performed by use of a mother-baby-scope system after endoscopic sphincterotomy. Improved endoscopes are now available and may lead to a better acceptance of this technique. Cholangioscopy is complementary to cholangiography for differential diagnosis of various types of bile duct lesions. From march 1992 to September 1994, we performed 15 cases of peroral cholangioscopy for evaluation of bile duct lesions. Indications of peroral cholangioscopy were 6 cases of benign biliary diseases and 9 cases of malignant biliary diseases. In benign diseases, two cases of extrahepatic bile duct stones, 1 case of intrahepatic duct stone with stricture, 2 cases of benign elevated lesions of bile duct and 1 case of occluded expandable metallic stent were involved. In malignant diseases, 7 cases of primary bile duct cancer, 2 cases of hepatocellular carcinoma with bile duct invasion were involved. By use of peroral cholangioscopy with biopsy, differential diagnosis of bile duct lesion was possible. As a complication, severe abdominal pain and hypotension was developed in one case during the procedure and in another case, cholangitis was developed after the procedure. In conclusion, peroral cholangioscopy is a safe and useful procedure in various types of biliary diseases especially in the differential diagnosis of malignancy.
Abdominal Pain ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Constriction, Pathologic ; Diagnosis, Differential ; Endoscopes ; Hypotension ; Sphincterotomy, Endoscopic ; Stents