PURPOSE: To compare the aqueous concentrations of cytokines in glaucomatous eyes with those of normal controls and to characterize the clinical factors associated with aqueous cytokine concentration. METHODS: In this cross-sectional study, aqueous humor samples were collected from 54 eyes of 54 patients (34 medically treated primary open angle glaucoma and 20 normal controls) during cataract surgery from January 2014 to January 2015. Glaucoma patients were divided into two groups: patients using prostaglandin analogue for more than 6 months (prostaglandin F2α analogue [PGA] user) and patients with no experience of PGA use (PGA non-user). The levels of cytokines (matrix metalloproteinase [MMP]1, MMP9, MMP3, vascular endothelial growth factor, interleukin [IL]-1, IL-8, tumor necrosis factor [TNF]-α) in the aqueous of glaucoma and control subjects were quantified using a multiplex cytokine analysis. RESULTS: Aqueous humor collected from the glaucoma patients exhibited significantly increased concentrations of MMP1 (p = 0.002) and MMP9 (p = 0.026). Among glaucoma patients, PGA users showed significantly higher level of MMP 9 compared with PGA non-users (p = 0.003). In the univariate and multivariate linear regression analyses, PGA use (β = 0.351, p = 0.027) and vertical cup-to disc ratio (β = -0.401, p = 0.013) were the significant risk factors associated with the level of MMP9. CONCLUSIONS: Primary open-angle glaucoma showed increased aqueous levels of MMP1 and MMP9. Especially, PGA use for longer than 6 months was associated with increased level of MMP9.
Aqueous Humor* ; Cataract ; Cross-Sectional Studies ; Cytokines ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Interleukin-8 ; Interleukins ; Linear Models ; Risk Factors ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

PURPOSE: To compare the aqueous concentrations of cytokines in glaucomatous eyes with those of normal controls and to characterize the clinical factors associated with aqueous cytokine concentration. METHODS: In this cross-sectional study, aqueous humor samples were collected from 54 eyes of 54 patients (34 medically treated primary open angle glaucoma and 20 normal controls) during cataract surgery from January 2014 to January 2015. Glaucoma patients were divided into two groups: patients using prostaglandin analogue for more than 6 months (prostaglandin F2α analogue [PGA] user) and patients with no experience of PGA use (PGA non-user). The levels of cytokines (matrix metalloproteinase [MMP]1, MMP9, MMP3, vascular endothelial growth factor, interleukin [IL]-1, IL-8, tumor necrosis factor [TNF]-α) in the aqueous of glaucoma and control subjects were quantified using a multiplex cytokine analysis. RESULTS: Aqueous humor collected from the glaucoma patients exhibited significantly increased concentrations of MMP1 (p = 0.002) and MMP9 (p = 0.026). Among glaucoma patients, PGA users showed significantly higher level of MMP 9 compared with PGA non-users (p = 0.003). In the univariate and multivariate linear regression analyses, PGA use (β = 0.351, p = 0.027) and vertical cup-to disc ratio (β = -0.401, p = 0.013) were the significant risk factors associated with the level of MMP9. CONCLUSIONS: Primary open-angle glaucoma showed increased aqueous levels of MMP1 and MMP9. Especially, PGA use for longer than 6 months was associated with increased level of MMP9.
Aqueous Humor* ; Cataract ; Cross-Sectional Studies ; Cytokines ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Interleukin-8 ; Interleukins ; Linear Models ; Risk Factors ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

PURPOSE: To evaluate the effect of orbital wall reconstruction with absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide by assessment of the orbital volume via orbital computed tomography. METHODS: 24 patients who followed up at least 6 months after orbital wall reconstruction with unsintered hydroxyapatite/poly L-lactide were included. Retrospective clinical chart reviews for clinical manifestations and complications were performed, and orbital volume measurements were taken using the Eclipse Treatment Planning System (ver.13.0, Varian Medical System Inc., Palo Alto, CA, USA) through orbital computed tomography, which were taken before operation, right after operation, and at last follow up. RESULTS: Fourteen patients (58.3%) showed diplopia and extraocular muscle movement limitation preoperatively. Diplopia was resolved at last follow up and extraocular muscle movement limitation was improved at postoperative 6 months for all cases. The mean volumes of the fractured orbit and the unaffected orbit before operation were 23.62 ± 0.45 cm3 and 21.95 ± 1.01 cm3, respectively (p = 0.003). The mean volumes of the fractured orbit and the unaffected orbit right after operation were 21.65 ± 0.91 cm3 and 21.78 ± 0.83 cm3, respectively (p = 0.542). The mean volumes of the fractured orbit and the unaffected orbit at last follow up were 21.84 ± 0.93 cm3 and 21.81 ± 0.91 cm3, respectively (p = 0.889). CONCLUSIONS: Absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide was effective for clinical improvement and orbital volume assessment in cases of orbital wall reconstruction and it can be used safely without definite implant related complications.
Absorbable Implants ; Diplopia ; Follow-Up Studies ; Humans ; Orbit* ; Retrospective Studies

PURPOSE: To evaluate the effect of orbital wall reconstruction with absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide by assessment of the orbital volume via orbital computed tomography. METHODS: 24 patients who followed up at least 6 months after orbital wall reconstruction with unsintered hydroxyapatite/poly L-lactide were included. Retrospective clinical chart reviews for clinical manifestations and complications were performed, and orbital volume measurements were taken using the Eclipse Treatment Planning System (ver.13.0, Varian Medical System Inc., Palo Alto, CA, USA) through orbital computed tomography, which were taken before operation, right after operation, and at last follow up. RESULTS: Fourteen patients (58.3%) showed diplopia and extraocular muscle movement limitation preoperatively. Diplopia was resolved at last follow up and extraocular muscle movement limitation was improved at postoperative 6 months for all cases. The mean volumes of the fractured orbit and the unaffected orbit before operation were 23.62 ± 0.45 cm3 and 21.95 ± 1.01 cm3, respectively (p = 0.003). The mean volumes of the fractured orbit and the unaffected orbit right after operation were 21.65 ± 0.91 cm3 and 21.78 ± 0.83 cm3, respectively (p = 0.542). The mean volumes of the fractured orbit and the unaffected orbit at last follow up were 21.84 ± 0.93 cm3 and 21.81 ± 0.91 cm3, respectively (p = 0.889). CONCLUSIONS: Absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide was effective for clinical improvement and orbital volume assessment in cases of orbital wall reconstruction and it can be used safely without definite implant related complications.
Absorbable Implants ; Diplopia ; Follow-Up Studies ; Humans ; Orbit* ; Retrospective Studies

PURPOSE: To investigate the long-term outcome of lateral rectus (LR) advancement for consecutive esotropia following bilateral LR recession for intermittent exotropia. METHODS: Medical records of 25 patients who underwent LR advancement for consecutive esotropia after bilateral LR recession and who were followed up for more than 24 months postoperatively were reviewed. Patients were divided into two groups: bilateral lateral rectus recession (BLR) group included 16 patients with consecutive esotropia greater than or the same magnitude as the initial exotropia and who underwent bilateral LR advancement; Unilateral lateral rectus recession (ULR) group included nine patients with consecutive esotropia less than the initial exotropia and who underwent unilateral LR advancement. Main outcome measurements were motor and sensory outcomes and the dose-effect relationship calculated from observed overall and group changes in the angle of deviation per millimeter. Motor success was defined as alignment from orthotropia to exodeviation less than 10 PD at distance. Sensory outcome was described by comparing the Titmus stereoacuity test before and after LR advancement. Sensory successvwas defined at 100 seconds of arc. RESULTS: Eighteen patients (72.0%) showed satisfactory long-term motor and sensory outcomes. Seventeen (77.3%) of 22 patients showed favorable stereopsis of 100 seconds of arc or more at final observation. The long-term motor success rate of the ULR group was better than that of the BLR group (p = 0.025). The average observed change in the angle of deviation was 3.6 PD/mm at the final visit in all patients. A greater dose-effect relationship was observed in the ULR group than in the BLR group at the final visit (p = 0.043). CONCLUSIONS: LR advancement showed favorable motor and sensory outcomes in the majority of patients. The surgical outcome was not favorable in patients in the BLR group with consecutive esotropia of the same magnitude as the initial exotropia. These results require further investigation for verification.
Depth Perception ; Esotropia* ; Exotropia* ; Humans ; Medical Records

PURPOSE: This study investigated the current trends and changes in the field of cataract surgery in Korea. METHODS: The members of the Korean Society of Cataract and Refractive Surgery (KSCRS) and the members of the Korean Ophthalmological Society (KOS) participated in a survey on cataract surgery in 2012, the 16th survey, consisting of 108 multiple-choice questions, mailed in July 2013 to 301 KSCRS and KOS members. Sixty two (20.6%) members answered the questions. Current data were compared with previous surveys performed in 2006 and 2009. RESULTS: Most of the respondents (46%) were in the fourth decade, 43% in the fifth decade and 10% in the sixth decade of life. The duration of hospital stay had decreased annually and the use of topical anesthesia (69%) was the most preferred. Self-sealing wound construction was the main wound closure technique in phacoemulsification (72%). The most preferred intraocular lens (IOL) for cataract surgery was hydrophobic acrylic (76%) which showed an increasing trend. The implantation of phakic IOL was performed by 41% of the respondents and interest in the value added IOLs such as presbyopia IOL and toric IOL had increased annually. In addition, to minimize astigmatism following cataract surgery, several methods were performed according to the degree of astigmatism. However, there was little interest in new cataract surgery techniques such as femtosecond laser and many respondents were skeptical whether to adopt the femtosecond laser cataract surgery system. CONCLUSIONS: This survey summarized current trends and changes in the field of cataract surgery in Korea.
Anesthesia ; Astigmatism ; Cataract* ; Surveys and Questionnaires ; Korea* ; Length of Stay ; Lenses, Intraocular ; Phacoemulsification ; Postal Service ; Presbyopia ; Refractive Surgical Procedures ; Wound Closure Techniques ; Wounds and Injuries

BACKGROUND: Atrial fibrillation(AF) is the common and importand arrhythmia in the eldery. Because the distribution of cardiovascular disease changes according to age group and era, the distribution of underlying diseases in patients with AF also tends to change. The purpose of this study is to identify the difference between the eldery(> or = 65yr) and the young adult(<65yr) patients with AF in distribution of underlying disease. METHODS: 218 patients with AF diagnosed by routine EKG and Holter minitoring from Jan. 1996 to Dec 1998 in National Medical Center was evaluated. Their medical records were reviewed retrospectively in aspect of age, sex, developmental form & underlying disease of AF. In detail. last two subjects were investigated in two separate age group and at the same time, relation between them studied. RESULTS: The majority of age group with AF was 65~74yr(40.4%) and the eldery patient was 59.7%. Acute paroxysmal form and chronic persistent form was 21.1% and 78.9% respectively. There was no significant difference in development form of AF between the eldery and young adult group(chi2=1.45, p=0.227) The common underlying disease were hypertension(33.4%), congestive heart failure(32.1%), rheumatic valvular heart diseas(20.2%). ischemic heart disease(14.2%), hyperthyroidism(6.9%), COPD(4.1%), and lone AF(10.1%). In the eldery patients. hypertension is the most common underlying disease(42.3%) and congestive heart failure, ischemic heart disease, rheumatic valvular heart disease, and COPD were 36.2%, 21.5%, 10.8%, 6.9% respectively. In the young adult group-, rheumatic valvular heart disease was the most common(34%), and congestive heart failure, hypertension, ischemic heart disease, and hyperthyroidism were 26.1%, 20,5%, 3.4%, 10.2% respectively(chi2 = 62.71, p = 0.000). wheares ischemic heart disease, COPD, hyperthyroidism, stress, trauma, acute alcohol intoxication and lone AF were more common in acute paroxysmal AF, but hypertension, congestive heart failure, reumatic valvular heart disease were more common in chronic persistent AF(chi2 = 93.75, p = 0.000). CONCLUSION: Among underlying disease of AF. hypertension, congestive heart failure, ischemic heart disease were markedly increased and rheumatic valvular heart disease was decreased than previous reports in Korea. Hypertension, congestive heart failure, ischemic heart disease, COPD were more common in the eldely and as to rheumatic valvular heart disease, hyperthyroidism, and lone AF were in the young adult. Thus it showed significant difference in underlying desease between the eldery & the young adult as well as acute paroxysmal & chronic persistent form.
Aged* ; Arrhythmias, Cardiac ; Cardiovascular Diseases ; Electrocardiography ; Estrogens, Conjugated (USP) ; Heart ; Heart Failure ; Heart Valve Diseases ; Humans ; Hypertension ; Hyperthyroidism ; Korea ; Medical Records ; Myocardial Ischemia ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Young Adult

Although extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) has emerged as a significant community-acquired pathogen, there is little epidemiological information regarding community-onset bacteremia due to ESBL-EC. A retrospective observational study from 2006 through 2011 was performed to evaluate the epidemiology of community-onset bacteremia caused by ESBL-EC. In a six-year period, the proportion of ESBL-EC responsible for causing community-onset bacteremia had increased significantly, from 3.6% in 2006 to 14.3%, in 2011. Of the 97 clinically evaluable cases with ESBL-EC bacteremia, 32 (33.0%) were further classified as healthcare-associated infections. The most common site of infection was urinary tract infection (n=35, 36.1%), followed by biliary tract infections (n=29, 29.9%). Of the 103 ESBL-EC isolates, 43 (41.7%) produced CTX-M-14 and 36 (35.0%) produced CTX-M-15. In the multilocus sequence typing (MLST) analysis of 76 isolates with CTX-M-14 or -15 type ESBLs, the most prevalent sequence type (ST) was ST131 (n=15, 19.7%), followed by ST405 (n=12, 15.8%) and ST648 (n=8, 10.5%). No significant differences in clinical features were found in the ST131 group versus the other group. These findings suggest that epidemic ESBL-EC clones such as CTX-M-14 or -15 type ESBLs and ST131 have disseminated in community-onset infections, even in bloodstream infections, which are the most serious type of infection.
Aging ; Bacteremia/drug therapy/*epidemiology ; Biliary Tract Diseases/epidemiology/microbiology ; Cephalosporin Resistance/genetics ; Cephalosporins/therapeutic use ; Community-Acquired Infections/*epidemiology/microbiology ; Escherichia coli/isolation & purification/metabolism ; Escherichia coli Infections/drug therapy/*epidemiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Multilocus Sequence Typing ; Prevalence ; Retrospective Studies ; Urinary Tract Infections/epidemiology/microbiology ; beta-Lactamases/*metabolism

Despite a high mortality rate, no specific treatment for severe fever with thrombocytopenia syndrome (SFTS) has been established. This study compared the clinical outcomes of SFTS patients treated with plasma exchange (PE group) with those who were not treated (non-PE group) at nine Korean hospitals between May 2013 and August 2015. A total of 53 SFTS patients were included: 24 (45.3%) PE cases and 29 (54.7%) non-PE cases. The overall in-hospital mortality rate was 32.1% (17/53). The in-hospital mortality rate of the PE group did not differ from that of the non-PE group (29.3% vs. 34.5%, p=0.680). Of the 24 PE cases, 16 (66.7%) were treated with PE within 7 days of symptom onset (early PE group). The early PE group survived longer than the non-PE group (mean 28.4 days vs. 22.6 days, p=0.044). Multivariate analysis showed an inverse association between early PE implementation and 30-day mortality (adjusted hazard ratio 0.052, 95% confidence interval 0.004–0.678, p=0.024). The results of this study suggest that early PE implementation may have a beneficial effect on the clinical outcome of SFTS patients.
Fever* ; Hospital Mortality ; Humans ; Mortality ; Multivariate Analysis ; Phlebovirus ; Plasma Exchange* ; Plasma* ; Thrombocytopenia*

Rhomboid family member 2 gene (Rhbdf2) is an inactive homologue lacking essential catalytic residues of rhomboid intramembrane serine proteases. The protein is necessary for maturation of tumor necrosis factor-alpha (TNF-α) converting enzyme, which is the molecule responsible for the release of TNF-α. In this study, Rhbdf2 knockout (KO) mice were produced by CRISPR/CAS9. To see the effects of the failure of TNF-α release induced by Rhbdf2 gene KO, collagen-induced arthritis (CIA), which is the representative TNF-α related disease, was induced in the Rhbdf2 mutant mouse using chicken collagen type II. The severity of the CIA was measured by traditional clinical scores and histopathological analysis of hind limb joints. A rota-rod test and grip strength test were employed to evaluate the severity of CIA based on losses of physical functions. The results indicated that Rhbdf2 mutant mice showed clear alleviation of the clinical severity of CIA as demonstrated by the significantly lower severity indexes. Moreover, a grip strength test was shown to be useful for the evaluation of physical functional losses by CIA. Overall, the results showed that the Rhbdf2 gene has a significant effect on the induction of CIA, which is related to TNF-α.
Animals ; Arthritis, Experimental* ; Chickens ; Collagen Type II ; Extremities ; Hand Strength ; Humans ; Joints ; Mice ; Mice, Knockout* ; Serine Proteases ; Tumor Necrosis Factor-alpha