PURPOSE: To evaluate the effectiveness of 0.1% topical bromfenac as an adjunctive treatment with intravitreal bevacizumab (IVB) injection for branch retinal vein occlusion (BRVO) patients.METHODS: We retrospectively evaluated 68 eyes of 68 patients with macular edema (ME) secondary to BRVO who were treated with IVB injection and followed up for at least 12 months. Of the 68 eyes, 38 were treated with IVB combined with 0.1% topical bromfenac and 30 were treated with IVB alone. IVB reinjection was performed in cases of recurrence. The primary outcome measurement was the number of IVB injections. Changes in the best-corrected visual acuity (BCVA) and central foveal thickness (CFT) during the 12-month follow-up were compared.RESULTS: There was no significant difference in the BCVA or CFT between the two groups at the initial and final examinations. However, the number of IVB injections was significantly lower in the 0.1% bromfenac-treated eyes (p < 0.01) than in the control eyes (4.1 ± 0.7 vs. 5.0 ± 0.6 times).CONCLUSIONS: Compared to IVB monotherapy, topical bromfenac as an adjunctive treatment with IVB injection of eyes with ME secondary to BRVO did not affect visual outcomes, but it reduced the number of IVB injections.
Bevacizumab ; Follow-Up Studies ; Humans ; Macular Edema ; Recurrence ; Retinal Vein Occlusion ; Retinal Vein ; Retinaldehyde ; Retrospective Studies ; Visual Acuity

PURPOSE: To report a case of infectious crystalline keratopathy caused by Alternaria in the corneal center. CASE SUMMARY: A 66-year-old male visited our clinic with right ocular pain and visual loss after corneal trauma caused by a foreign body hitting his right eye while performing farm work 1 month prior to his visit. The patient had no history of corneal surgery and long-term use of topical corticosteroid. A corneal epithelial defect and whitish snowflake margin infiltration around the corneal stroma were observed in the corneal center, but there was an absence of conjunctival injection and anterior segment inflammation. Cultures and a biopsy of the corneal scrapings revealed Alternaria species fungus. The patient was treated with 1% topical voriconazole and 0.5% moxifloxacin, together with oral voriconazole (400 mg/day). After 2 months of treatment, the disease was completely cured, with a minute corneal opacity. CONCLUSIONS: We successfully treated a rare case of infectious crystalline keratopathy caused by Alternaria, which has not been previously reported in the Republic of Korea.
Aged ; Agriculture ; Alternaria ; Biopsy ; Corneal Injuries ; Corneal Opacity ; Corneal Stroma ; Crystallins ; Foreign Bodies ; Fungi ; Humans ; Inflammation ; Male ; Republic of Korea ; Voriconazole

BACKGROUND: We evaluated the Vitros 950 (Johnson & Johnson Clinical Diagnostics, Inc., NY, USA) in the measurement of digoxin and theophylline levels and compared its results to those of the TDxFLx II (Abbott Laboratories, IL, USA) used for therapeutic drug monitoring (TDM) world-widely in order to assess the utility of the Vitros 950 as a TDM instrument. METHODS: From June 1997 to August 1997, 125 and 135 candidates for TDM were randomly chosen to measure digoxin and theophylline, respectively, using the Vitros 950 and TDxFLx II. The relationship between its results and those of TDxFLx II were determined. The within-run and between-run precisions of the Vitros 950 were determined using two controls (Vitros Performance Verifier I and II; J & J Clinical Diagnostics, Inc., NY, USA). The high-concentration control (Vitros Performance Verifier II) was diluted in Vitros 7% BSA to 5 dilutions. And linearity for quantitative analysis of digoxin and theophylline were determined. RESULTS: The coefficients of variation (CV) for the within-run of the Vitro 950 were 0.8% - 4.4%. And the CV for between-run precision of the Vitro 950 were 1.7% - 12.3%. The linearity of digoxin and theophylline were relatively good. The correlations (r) of digoxin and theophylline levels with those determined by the Abbott TDxFLx II were 0.95 and 0.93, respectively (P <0.001). CONCLUSIONS: The recently developed dry slide method of the Vitros 950 proves to good precision and linearity for quantitative analysis of digoxin and theophylline. Its results correlate well with those of the TDxFLx II. The Vitros 950 does not require an elaborate preparatory protocol for the sample, and is easy to use and maintain.So it is considered a highly feasible instrument for stat test.
Digoxin* ; Drug Monitoring ; Theophylline*

Jejunogastric intussusception (JGI) is a rare complication of gastric surgery, with most cases occurring in the form of long-term complications following gastric surgeries. We present a case of JGI in a 74-year-old man who presented with progressive abdominal pain and distention, and was admitted to our hospital. The patient had undergone a totally laparoscopic distal gastrectomy with a Billroth II gastrojejunostomy 9 days previously. Computed tomography and endoscopic findings revealed the presence of a small bowel loop within the gastric lumen, which we failed to reduce in size. We performed an emergency laparoscopic exploration and immediate reduction of the JGI. The efferent and afferent loops were then fixed to the mesentery and the stomach. The postoperative course was uneventful and the patient remained asymptomatic during the 1-year follow-up period.

It is unusual that an unexpected mass is encountered within a hernia sac. This report describes a patient diagnosed with Langerhans cell histiocytosis (LCH) after surgery for an inguinal hernia. A 64-year-old male patient presented with inguinal mass over a 1-year period. Direct inguinal hernias were found in both sides, and enlarged lymph nodes were found in both hernia sacs. Laparoscopic totally extraperitoneal repair was done, and one enlarged lymph node within inguinal hernia sac was excised for diagnostic purposes.Microscopic findings showed the distinctive cytologic features of Langerhans cells and immunohisto chemical staining are positive for CD1a and S-100. LCH is a rare disorder, and the involvement of the lymph nodes with no other sites of disease is uncommon. To the best of our knowledge, this is the first report of LCH within an inguinal hernia sac. Multidisciplinary approach should be considered to provide better detection and treatment.

BACKGROUND/AIMS: The study proposed to evaluate the efficacy of anticancer drugs of intraarterial chemoinfusion and investigate prognostic factors influencing survival. METHODS: A total of 127 patients diagnosed as having advanced hepatocellular carcinoma(HCC) of same stage (TNM stage IVa) from 1996 to 1998 were examined. Two intraarterial infusion chemotherapeutic regimens were employed: Adriamycin(Group I) and Cisplatin(Group II). RESULTS: Overall survival was significantly diffrent(10.0 vs 5.7months) and favored Group I. By the univariate analysis, significant prognostic factors included: age, portal vein thrombosis(PVT), size(>5cm) and type of tumor, response rate (size & -fetoprotein) at 3 months after therapy, level of albumin, alkaline phosphatase, and total bilirubin. After repeated therapy, Group I showed better survival (14.0 vs 7.9 months), but there was no statistical difference in survival rate between two groups in the case of large size, PVT, and diffuse type. CONCLUSION: Group I showed better survival than Group II in advanced HCC of TNM stage IVa. But, considering prognostic factors, there was no significant difference in survival rate between two groups except small size or nodular type of HCC. TNM classification of stage IVa should be reconsidered to include prognostic factors influencing survival rate such as PVT, size and type of HCC.
Alkaline Phosphatase ; Bilirubin ; Carcinoma, Hepatocellular* ; Classification ; Humans ; Infusions, Intra-Arterial ; Neoplasm Staging ; Portal Vein ; Psychotherapy, Group ; Survival Rate ; Treatment Outcome*

PURPOSE: Phenylacetate has potent antiproliferative effects in many malignant tumors. However, the exact mechanism as to how phenylacetate induces cell growth arrest remains unclear and very little is known about its effects on human osteosarcoma cells. In this study, we investigated whether phenylacetate is effective against two osteosarcoma cell lines (HOS and U-2 OS) in vitro. MATERIALS AND METHODS: The viability of phenylacetate- treated cell lines was assessed by trypan blue exclusion assay, and the cell cycle distribution was measured by flow cytometry. To measure cell apoptosis, poly (ADP- ribose) polymerase cleavage assay and flow cytometry were employed. The expressions of cell cycle-regulatory proteins and the apoptosis-related genes were evaluated by western blot analysis. RESULTS: Phenylacetate was found to inhibit the growth of osteosarcoma cells, induce cell cycle arrest in the G1 phase, and induce apoptosis. A significant decrease in Bcl-2 expression and a mild up-regulation of Bax were also observed in both phenylacetate-treated cell lines. Reduced phosphorylation of the pRb and the increased expression of p21Cip1 were observed subsequent to treatment with phenylacetate. CONCLUSION: These findings support the idea that pheny lacetate may be an effective chemotherapeutic agent to be employed in the future against osteosarcoma, because phenylacetate acts to inhibit the growth of osteosarcoma cells through cell cycle arrest and apoptosis.
Apoptosis* ; Blotting, Western ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line ; Flow Cytometry ; G1 Phase ; Humans* ; Osteosarcoma* ; Phosphorylation ; Trypan Blue ; Up-Regulation

BACKGROUND: To investigate the changes of cross sectional area (CSA) in paraspinal muscles upon magnetic resonance imaging (MRI) and bone mineral density (BMD) in postmenopausal osteoporotic spinal compression fractures. METHODS: We reviewed 81 postmenopausal women with osteoporosis, who had underwent MRI examination. The patients were divided into 51 patients who had osteoporotic spinal compression fractures (group I), and 30 patients who without fractures (group II). Group I were subdivided into IA and IB, based on whether they were younger (IA) of older (IB) than 70 years of age. We additionally measured body mass index and BMD. The CSA of multifidus, erector spinae, paraspinal muscles, psoas major (PT), and intervertebral (IV) discs were measured. The degree of fatty atrophy was estimated using three grades. RESULTS: The BMD and T-score of group I were significantly lower than those of group II. The CSA of erector spinae, paraspinal muscles, and PT in the group I was significantly smaller than that of group II. The CSA of paraspinal muscles in group IB were significantly smaller than those of group IA. The CSA of erector spinae, mutifidus, and PT in group IB were smaller than those of group IA, but the difference was not statistically significant. Group 1 exhibited greater fat infiltration in the paraspinal muscle than group II. CONCLUSIONS: Postmenopausal osteoporotic spinal compression fracture is associated with profound changes of the lumbar paraspinal muscle, reduction of CSA, increased CSA of IV disc, and increased intramuscular fat infiltration.
Atrophy ; Body Mass Index ; Bone Density ; Female ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging* ; Magnetics* ; Magnets* ; Muscles* ; Osteoporosis ; Postmenopause ; Psoas Muscles

A sesamoid bone can occasionally be found under the interphalangeal joint of the hallux. These had anatomical variants and usually remain asymptomatic, it is uncommon for symptomatic cases of painful plantar keratoses or irreducible dislocation of interphalangeal joint of the hallux with incarcerated sesamoid. While the latter has a few cases, the former has not reported in Korea. We experienced a rare case of intractable plantar keratoses due to interphalangeal sesamoid bone of the hallux which may reqire excision.
Dislocations ; Hallux ; Joints ; Keratosis ; Korea ; Sesamoid Bones

Tracheotomy and end-to-end anastomosis is a relatively rare operation, but it is one of the most challenging for anesthesiologists. During surgery, the principal anesthetic consideration is to maintain the ventilation and oxygenation throughout the procedure. We experienced anesthetic management of a 49-year-old man with upper tracheal stenosis after long-term intubation and ventilation care. The stenotic lesion was located at 2 cm below the vocal cords, and the length of the stenotic segment was about 2 cm. The anesthesia was induced and maintained with intravenous propofol and alfentanil. The airway was managed with LMA and distal tracheal intubation on the surgical field and we were able to maintain adequate ventilation and oxygenation throughout the operational period.
Alfentanil ; Anesthesia ; Humans ; Intubation ; Laryngeal Masks* ; Middle Aged ; Oxygen ; Propofol ; Tracheal Stenosis* ; Tracheotomy* ; Ventilation ; Vocal Cords