PURPOSE: To report three cases of unexpected intraocular foreign bodies which were detected during silicone oil removal procedure following pars planar vitrectomy and silicone oil injection due to the severe vitreoretinal proliferations. METHODS: The medical records of three male patients, aged 61, 40, and 38 years, were reviewed retrospectively. We performed pars planar vitrectomy and silicone oil injection due to submacular hemorrhage with vitreous hemorrhage, tractional retinal detachment with proliferative diabetic retinopathy, and proliferative vitreoretinopathy, respectively. After the retinas were stabilized, we performed silicone oil removal at postoperative 1, 6, and 5 months, respectively. During the silicone oil removal procedure, intraocular foreign bodies were detected and removed with the vitreoretinal forceps. RESULTS: The intraocular foreign bodies were approximately 6 mm x 1 mm in size, transparent, rod-shaped, solid materials. Histopathologic findings didn't show any cellular or intraocular tissue components in and around the foreign bodies. Using electron spectroscopy for chemical analysis, the elemental compositions of the intraocular foreign bodies were determined to be the same as that of the silicone oil that had been previously injected in the eye. We therefore confirmed that those foreign bodies that were removed from the eyes were crystallized remnants of the silicone oil. CONCLUSIONS: Silicone oil can be crystallized after intraocular injection. Therefore, meticulous fundus examination including peripheral fundus is mandatory at the end of the silicone oil removal procedure to prevent any solid silicone foreign bodies from remaining in the eyes. Further investigations are needed to reveal the mechanisms of intraocular crystallization of the silicone oil.
Crystallization* ; Diabetic Retinopathy ; Foreign Bodies ; Hemorrhage ; Humans ; Injections, Intraocular ; Male ; Medical Records ; Photoelectron Spectroscopy ; Retina ; Retinal Detachment ; Retrospective Studies ; Silicone Oils* ; Surgical Instruments ; Traction ; Vitrectomy* ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage

BACKGROUND: Coronary artery disease is an important cause of death in adults and stent insertion is one of the treatment modalities. The most severe adverse effect of a stent insertion is the formation of a thrombus; therefore, antiplatelet agents are used. The addition of cilostazol to low-dose aspirin and clopidogrel results in a better antiplatelet effect. However, laboratory tests to monitor the effect of cilostazol are insufficient. METHODS: We tested the inhibitory effect of cilostazol using maximal platelet aggregation in 20 healthy volunteers. Conditions for incubation and concentrations of cilostazol and prostaglandin E1 (PGE1) were established and aggregation was induced by 5'-adenosine diphosphate (ADP) and measured with light transmission aggregometry (LTA). Blood samples were incubated with 1 µM and 2 µM cilostazol for 10 minutes at room temperature, and 80 nM PGE1 was added and incubated for an additional 10 minutes. Aggregation was induced by ADP and reactivity was evaluated. RESULTS: The average maximum aggregation (MA) was 58.1% at 1 µM cilostazol and 22.0% when PGE1 was added. The average MA was 42.8% when cilostazol concentration was increased to 2 µM and 21.2% when PGE1 was added. Average inhibition of aggregation at 1 µM cilostazol was not statistically significant (P=0.085), but was significant (P=0.004) at 2 µM cilostazol. Aggregation was not inhibited even with 2 µM cilostazol and PGE1 in 2 volunteers, which suggests possible resistance to cilostazol. CONCLUSIONS: We designed a method to monitor the effect of cilostazol using in vitro incubation with PGE1.
Adenosine Diphosphate ; Adult ; Alprostadil ; Aspirin ; Cause of Death ; Coronary Artery Disease ; Healthy Volunteers ; Humans ; In Vitro Techniques ; Methods ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; Stents ; Thrombosis ; Volunteers

STUDY DESIGN: Retrospective case-control study OBJECTIVE: To use MRI to assess intervertebral disc degeneration at adjacent levels after spinal fusion and after discectomy. SUMMARY OF LITERATURE REVIEW: Degeneration of adjacent intervertebral discs following lumbar spinal fusion is one of the principal reasons for considering motion preservation techniques, such as placement of an artificial disc. Much attention has recently been directed toward disc morphometric studies using MRI. MATERIALS AND METHODS: Fifty-six patients who underwent spinal surgery for lumbar degenerative disease and who underwent a minimum of 2 years of follow-up MRIs were included in this study. Thirty-four patients were included in the lumbar fusion study group, and 22 patients were included in the discectomy control group. The MRI Thompson classification was used to grade both upper and lower adjacent disc degeneration preoperatively and at the time of last follow-up. RESULTS: There were significant changes in Thompson degenerative grade in the upper adjacent levels for both the fusion group patients and in the discectomy group patients. However, there was no statistically significant difference between the two groups with regard to either the upper or lower adjacent levels (p=0.146 and 0.350, respectively). CONCLUSIONS: In this short-term study comparing MRI outcomes in spinal fusion and discectomy patients, no significant difference in adjacent disc degeneration was observed between the two group.
Case-Control Studies ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Retrospective Studies ; Spinal Fusion

STUDY DESIGN: Retrospective radiologic assessment OBJECTIVES: To assess the clinical importance of MRI for the diagnosis of posterior spinal ligament complex injuries in thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Evaluation of spinal instability is important in thoracolumbar fractures. When simple radiography and CT alone are performed, spinal instability may be missed, especially that involving the posterior spinal ligament complex. MATERIALS AND METHODS: Eighty-seven patients who were evaluated using simple radiography, computed tomography (CT), and magnetic resonance imaging (MRI) between March 1994 and March 2003 were included in the study. The local kyphotic angle was measured on lateral radiography, and it was then compared to the fracture pattern on MRI. Statistical analysis was performed using ANOVA. RESULTS: There was no correlation between the local kyphotic angle on radiography and fracture involvement on MRI (p=0.106). In 41 patients who were found to have involvement of the anterior column on CT, 25 had anterior column involvement, 4 had middle column involvement, and 12 had posterior column involvement on MRI. In 36 patients who were found to have involvement of the middle column on CT, 17 had involvement of the middle column and 19 had involvement of the posterior column on MRI. The fractures of the ten patients who were found to have posterior column involvement on CT were all seen on MRI. The coincidence of fracture patterns between CT and MRI, which was evaluated using Cohen's Kappa analysis, was 0.434. The sensitivity of CT compared with MRI was 0.741 in the middle column and 0.243 in the posterior column. CONCLUSIONS: Many thoracolumbar fractures are missed on both simple radiography and CT. MRI is essential for accurate diagnosis of posterior spinal ligament complex injuries, especially when there is involvement above the middle column, or when canal encroachment is seen on CT.
Humans ; Ligaments ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Fractures

STUDY DESIGN: A prospective radiological assessment was performed using computerized tomography measurements. OBJECTIVES: The aim of this study was to assess the changes in the dimensions of the neural foramen after anterior interbody fusion with posterior fixation in spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Anterior lumbar interbody fusion distracts the height and width of the neural foramen. MATERIALS AND METHODS: Anterior interboody fusion with posterior fixation was performed in twenty-five patients. The sagittal parameters were the height and area of the neural foramen. The fused lumbar segments was imaged in the direct sagittal projections in a CT (SOMATOM Senstaion; SIMENS, Germany) and 1-mm slice thickness before surgery and after solid fusion. Computer digitation was used for the measurements independently by three different observers. Statistical analysis was performed using a Wilcoxon signed test and a paired T-test to determine the correlation between the measurements, and Pearson correlation to determine the level of interobserver and intraobserver agreement. RESULTS: After anterior interbody fusion and posterior fixation, the height and the area of the neural foramen had increased significantly by 15.5+/-14.0%(p.0.001) and 23.2+/-17.7%(p.0.001). There was a significant confidence in interobserver (0.9466~0.9996) and intraobserver(0.8896~0.9991) agreement. CONCLUSIONS: Anterior interbody fusion significantly increased the changes in the dimensions of the neural foramen. Anterior distraction and decompression with anterior interbody fusion increased the area of the neural foramen This study shows that anterior interbody fusion can be used to decompress the neural foramen in the spondylolisthesis.
Decompression ; Humans ; Prospective Studies ; Spondylolisthesis*

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). Results: A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). Conclusions Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). Results: A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). Conclusions Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

No abstract available.
Lymphoma ; Lymphoma, Large-Cell, Anaplastic

Brimonidine Tartrate ; Disease Management ; Drug Combinations ; Drug-Related Side Effects and Adverse Reactions ; Glaucoma, Open-Angle ; Humans ; Incidence ; Intraocular Pressure ; Retrospective Studies

Purpose: To investigate the prevalence ratio of primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in the Asian population. Methods: Systematic searches of PubMed, Embase, and Cochrane databases for population-based studies in Asia published until August 5, 2022. We conducted a meta-analysis for PACG to POAG prevalence ratio using inverse variance–weighted random-effects meta-analyses so as to combine the study-specific measures of association. Between-study outcome variation (i.e., heterogeneity) was quantified with the I2 statistic. The multiple meta-regression analyses were performed in order to further account for the reasons for heterogeneity. Results: Twenty studies, with a total study population of 52,522 individuals, had been conducted in 13 countries. The pooled PACG to POAG prevalence ratio was 2.204 (95% confidence interval, 1.617–3.004) with high heterogeneity (p < 0.001). In multiple meta-regression model, prevalence of POAG is the most important predictor for heterogeneity (model importance, 0.954), followed continent (0.508), and publication year (0.222). For every additional elevation of POAG prevalence (i.e., increase of 1.0%), the PACG to POAG prevalence ratio is expected to rise by 0.471. Conclusions We estimated the pooled PACG to POAG prevalence ratio in the Asian population. The POAG prevalence is the most important factor to determine the PACG to POAG prevalence ratio.