No abstract available.
Humans

PURPOSE: The residual intrahepatic stones with biliary strictures are difficult to remove percutaneously via T-tube tract after surgery in patients with recurrent pyogenic cholangitis. We evaluated the effectiveness of percutaneous balloon dilatation of benign biliary strictures. MATERIALS AND METHODS: The balloon dilatations with 6-12mm angioplasty balloon catheter and stone extractions were performed via a T-tube tract after surgical treatment in 15 patients with recurrent pyogenic cholangitis. The balloons were inflated for 3-4minutes under 5 atm. until disappearance of waist of the stricture site, from one to seven session. After balloon dilatation, residual stones were extracted with saline irrigation or stone basket. RESULTS: Among total 42 strictures, the balloon dilatation was succesful in 27 strictures(64.3%), partially successful in 12 strictures(28.6%), and failed in three strictures(7.1%). Single or central biliary strictures were dilated easily rather than multiple ductal strictures. Of 26 sites with residual intrahepatic stones, stone extraction was complete in 17 sites(65.4%), incomplete in seven sites(26.9%) due to impacted or large stone and acute ductal angulation, and failed in two sites(7.7%). CONCLUSION: Percutaneous balloon dilatation of benign biliary strictures is an effective procedure for extraction of residual intrahepatic stones associated with recurrent pyogenic cholangitis.
Angioplasty ; Catheters ; Cholangitis ; Constriction, Pathologic* ; Dilatation* ; Humans

Purpose: To compare the accuracy of standard and total keratometry data obtained using the Barrett Universal II and Barrett Toric Calculator. Methods: In total, 111 eyes of 111 patients who visited our hospital for cataract surgery from February 2019 to September 2019 were included in this study. Total keratometry and standard keratometry data were obtained using the Barrett Universal II and the Barrett Toric Calculator; mean absolute errors were derived by using preoperative IOL Master 700® (Carl Zeiss Meditech AG, Jena, Germany) data and 2-month postoperative manifest refraction data. The mean absolute errors of the two methods were compared in terms of a posterior corneal astigmatism greater than 0.3 diopter (D) in patients fitted with Toric intraocular lenses. Results: Using the Barrett Universal II formula, the mean absolute error spherical equivalent difference between total keratometry and standard keratometry was 0.021 ± 0.102 D (p = 0.65) when the Barrett Toric Calculator was used. The mean absolute error differences between the two methods were 0.015 ± 0.121 D for the spherical equivalent (p = 0.80) and 0.005 ± 0.870 D for the cylinder measurement (p = 0.94). In terms of a posterior corneal astigmatism greater than 0.3 D, the mean absolute error spherical equivalent and cylinder measurement differences were -0.020 ± 0.107 D (p = 0.70) and -0.023 ± 0.055 D (p = 0.50) in patients fitted with Toric intraocular lenses. Conclusions The total keratometry method, which directly measures posterior corneal curvature, yields data comparable to those of the standard keratometry method. When the posterior corneal astigmatism was greater than 0.3 D, we found no significant difference between the total keratometry and standard keratometry data of patients fitted with Toric intraocular lenses.

Purpose: To compare the accuracy of standard and total keratometry data obtained using the Barrett Universal II and Barrett Toric Calculator. Methods: In total, 111 eyes of 111 patients who visited our hospital for cataract surgery from February 2019 to September 2019 were included in this study. Total keratometry and standard keratometry data were obtained using the Barrett Universal II and the Barrett Toric Calculator; mean absolute errors were derived by using preoperative IOL Master 700® (Carl Zeiss Meditech AG, Jena, Germany) data and 2-month postoperative manifest refraction data. The mean absolute errors of the two methods were compared in terms of a posterior corneal astigmatism greater than 0.3 diopter (D) in patients fitted with Toric intraocular lenses. Results: Using the Barrett Universal II formula, the mean absolute error spherical equivalent difference between total keratometry and standard keratometry was 0.021 ± 0.102 D (p = 0.65) when the Barrett Toric Calculator was used. The mean absolute error differences between the two methods were 0.015 ± 0.121 D for the spherical equivalent (p = 0.80) and 0.005 ± 0.870 D for the cylinder measurement (p = 0.94). In terms of a posterior corneal astigmatism greater than 0.3 D, the mean absolute error spherical equivalent and cylinder measurement differences were -0.020 ± 0.107 D (p = 0.70) and -0.023 ± 0.055 D (p = 0.50) in patients fitted with Toric intraocular lenses. Conclusions The total keratometry method, which directly measures posterior corneal curvature, yields data comparable to those of the standard keratometry method. When the posterior corneal astigmatism was greater than 0.3 D, we found no significant difference between the total keratometry and standard keratometry data of patients fitted with Toric intraocular lenses.

Purpose: To calculate the intraocular lens (IOL) power using the Shammas-PL formula after laser in-situ keratomileusis (LASIK). Methods: Forty-one eyes of 29 patients that had undergone cataract surgery from September 2018 to September 2019 after LASIK were enrolled in this study. A preoperative AL-Scan® (Nidek Co., Gamagori, Japan) was used to measure the axial length, anterior chamber depth, and corneal curvature. An IOL power calculation was performed using the Shammas-PL (post LASIK) formula. Mean absolute error (MAE) and mean arithmetic error (MARE) were calculated using preoperative manifest refraction and postoperative manifest refraction. Results: Of the 41 eyes, 15 eyes (36.6%) were relatively hyperopic-shifted after surgery compared to the predicted refractive error before surgery, 25 eyes (61%) showed a relative myopic shift, and one eye (2.4%) showed no change with respect to the previous refractive predicted error. Refractive errors before cataract surgery were not related to myopic, emmetropic, or hyperopic shifting after surgery (p > 0.05). Conclusions When cataract surgery using the Shammas-PL formula was performed after LASIK, myopic shifting was more common than hyperopic shifting. The MAE was greater in myopic-shifted cases than that of hyperopic-shifted cases. Thus, it is better to determine IOL power toward the hyperopic side than the target refractive prediction.

PURPOSE: The purpose of this study was to evaluate the utility of two-phase dynamic CT, early and equilibrium pahse, in the preoperative staging of rectal cancers. MATERIALS AND METHODS: We performed incremental dynamic CT after rectal infusion of water in 34 patients with pathologically proved rectal cancers. Two-phase dynamic CT findings were prospectively analyzed and correlated with surgical and histopathologic findings. A total of 150ml of nonionic contrast medium was intravenously administered with a power injector at a flow rate of 5ml/sec for 30 sec, and two-phase images were obtained at 30 sec(early phase) and 2 min (equilibrium phase) after bolus injection. Local tumor staging and regional lymph node were classified by TNM staging. RESULTS: All 34 rectal cancers showed a moderate to marked enhancement in the early phase and a homogeneous and prolonged enhancement of the entire lesion in the equilibrium phase. T-staging of primary tumors were 85.3%(29/34) in early phase and 70.6%(24/34) in equilibrium phase. The accuracy in determining the perirectal fat invasion of rectal cancer was 92%(23/25) in early phase, and 72%(18/25) in equilibrium phase. The sensitivity & specificity of the regional lymph node metastasis were 63.6% and 79.1% in early phase, and 54.5% and 65.2% in equilibrium phase, respectively. CONCLUSION: Early phase dynamic CT was more accurate for the preoperative staging of rectal cancer than that at equilibrium phase.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms* ; Sensitivity and Specificity ; Water

PURPOSE: To report a case of corneal and lenticular pigmentation after prolonged clozapine therapy. CASE SUMMARY: A 56-year-old male visited our hospital with a progressive decline in vision that affected both eyes. He had a history of schizophrenia. He was being treated with 200 mg clozapine and 1 mg lorazepam daily, and had been treated with clozapine for 5 years. At the first visit, his best-corrected-visual acuity was 20/32 in both eyes. Slit lamp examination of the corneas showed bright, fine, grayish-brown deposits on the endothelium, and on dilation, bilateral central stellate opacity of the anterior portion of the lens capsule was revealed. CONCLUSIONS: Clozapine may induce corneal and lenticular pigmentation and thus may lead to a decline in vision. Patients on long-term clozapine therapy should be considered for regular ophthalmic review.
Clozapine ; Cornea ; Endothelium ; Humans ; Lorazepam ; Male ; Middle Aged ; Pigmentation ; Schizophrenia ; Slit Lamp

Purpose: The Eyelike K-flex Aspheric® (Koryoeyetech, Seoul, Korea) is manufactured in 0.25-diopter (D) intervals, which allows the target refractive error after surgery to be achieved. We here evaluate the refractive power outcomes. Methods: We retrospectively studied 95 eyes of 72 patients who underwent cataract surgery with implantation of the Eyelike K-flex Aspheric®. Refractive error was measured at 1 and 2 months postoperatively (33 eyes of 27 patients) and compared to that of patients fitted with 0.50-D-interval lenses (62 eyes of 49 patients). Results: At 1 month postoperatively, the mean absolute error between the spherical equivalent and planned value was 0.33 ± 0.28 and 0.41 ± 0.39 D in the 0.25- and 0.50 D-interval lens groups, respectively (p = 0.318). At 2 months postoperatively, the respective values were 0.21 ± 0.15 and 0.34 ± 0.29 D (p = 0.009). Conclusions The Eyelike K-flex Aspheric® shows excellent refractive predictability; use of 0.25-D-interval intraocular lenses close to the target refractive power allows the desired spherical equivalent to be achieved.

Purpose: To seek Pearson correlations of tear film osmolarity measured by the I-PEN® (I-MED Pharma Inc., Dollard-des-Ormeaux, Canada) with Schirmer test result, tear break-up time, and Ocular Surface Disease Index score in patients with mild dry eye syndrome. Methods: Patients with mild dry eye syndrome were divided into two groups according to Ocular Staining Score: group 1 (50 patients; 67 eyes) and group 2 (59 patients; 91 eyes), 90 patients and 158 eyes in total. The above mentioned correlations were derived. Results: No significant correlations were observed between tear film osmolarity and Schirmer test result (r < -0.01, p = 0.97), tear break-up time (r = 0.05, p = 0.54), or Ocular Surface Disease Index score (r = 0.03, p = 0.76). When the two groups were compared, the Ocular Surface Disease Index score significantly differed between groups (p < 0.01), whereas the Schirmer test result (p = 0.31), tear break-up time (p = 0.11), and tear film osmolarity (p = 0.12) did not. Conclusions No significant correlations were found between tear film osmolarity and other dry eye indicators in patients with mild dry eye syndrome. The diagnostic utility of tear film osmolarity in patients with moderate dry eye syndrome is should be evaluated.

Purpose: The Eyelike K-flex Aspheric® (Koryoeyetech, Seoul, Korea) is manufactured in 0.25-diopter (D) intervals, which allows the target refractive error after surgery to be achieved. We here evaluate the refractive power outcomes. Methods: We retrospectively studied 95 eyes of 72 patients who underwent cataract surgery with implantation of the Eyelike K-flex Aspheric®. Refractive error was measured at 1 and 2 months postoperatively (33 eyes of 27 patients) and compared to that of patients fitted with 0.50-D-interval lenses (62 eyes of 49 patients). Results: At 1 month postoperatively, the mean absolute error between the spherical equivalent and planned value was 0.33 ± 0.28 and 0.41 ± 0.39 D in the 0.25- and 0.50 D-interval lens groups, respectively (p = 0.318). At 2 months postoperatively, the respective values were 0.21 ± 0.15 and 0.34 ± 0.29 D (p = 0.009). Conclusions The Eyelike K-flex Aspheric® shows excellent refractive predictability; use of 0.25-D-interval intraocular lenses close to the target refractive power allows the desired spherical equivalent to be achieved.