No abstract available.
Accidents, Traffic*

PURPOSE: To present differences in visual acuity and macular structure before and after surgery in patients with idiopathic epiretinal membrane (ERM) according to the presence of retinoschisis. METHODS: This retrospective observational study included 324 eyes with idiopathic ERM, that underwent pars plana vitrectomy with ERM and internal limiting membrane peeling, and were followed for more than 6 months. Subjects were classified into two groups according to the presence of retinoschisis using preoperative optical coherence tomography (OCT; group 1, ERM with retinoschisis; group 2, ERM without retinoschisis). Preoperative and postoperative macular structure changes and surgical outcomes were compared. RESULTS: Group 1 included 61 eyes, and group 2 included 263 eyes. Group 1 had a significantly higher preoperative and final postoperative best-corrected visual acuity compared with group 2 (p = 0.01, p = 0.02). Preoperative disorganization of retinal inner layers (DRIL) was significantly less in group 1 than group 2 (p = 0.01). Preoperative central macular thickness was not significantly different between the two groups. However, postoperative central macular thickness was significantly lower in group 1 than group 2 (p = 0.02, p = 0.01, p < 0.01). The ratio of the inner or outer layer in the total retinal thickness before surgery was significantly smaller in group 1 than in group 2 (p = 0.02, p = 0.04). CONCLUSIONS: Preoperative visual acuity was better and the occurrence of DRIL was less in idiopathic ERM with retinoschisis than without retinoschisis. Postoperative visual and structural outcome was better in idiopathic ERM with retinoschisis than without retinoschisis. Retinoschisis may have played a role in reducing the tractional force given to the inner and outer retina.
Epiretinal Membrane ; Humans ; Membranes ; Observational Study ; Retina ; Retinaldehyde ; Retinoschisis ; Retrospective Studies ; Tomography, Optical Coherence ; Traction ; Visual Acuity ; Vitrectomy

Purpose: To observe results in drusen patients with epiretinal membrane after a vitrectomy and membrane peeling. Methods: This retrospective, observational study included drusen patients diagnosed with epiretinal membrane after vitrectomy with membrane peeling. Twenty eyes had epiretinal membrane with drusen (group 1) and 112 eyes had epiretinal membrane without drusen (group 2). At the 6 month follow-up, central foveal thickness and changes in best-corrected visual acuity (BCVA) were evaluated. In Group I, the results with drusen size <65 μm and size >65 μm were compared. The largest drusen size change was measured and compared according to the existence of preoperative intraretinal cysts or ellipsoid zone disruption. Results: Preoperatively and at 6 months postoperatively, the average size of the largest drusen was 198.23 ± 27.34 and 192.23 ± 26.12 μm, respectively, and there was no significant change during the follow-up period. Group I patients with intraretinal cysts and ellipsoid zone disruption experienced low BCVA during the preoperative period; the BCVA had improved postoperatively at 6 months, but with limitations. Conclusions Postoperatively at 6 months, no significant change was observed in the largest drusen size after vitrectomy and membrane peeling. Thus, drusen patients with epiretinal membrane, as well as intraretinal cysts or ellipsoid zone disruption can expect an extended recovery period and slow BCVA improvement.

Purpose: To observe results in drusen patients with epiretinal membrane after a vitrectomy and membrane peeling. Methods: This retrospective, observational study included drusen patients diagnosed with epiretinal membrane after vitrectomy with membrane peeling. Twenty eyes had epiretinal membrane with drusen (group 1) and 112 eyes had epiretinal membrane without drusen (group 2). At the 6 month follow-up, central foveal thickness and changes in best-corrected visual acuity (BCVA) were evaluated. In Group I, the results with drusen size <65 μm and size >65 μm were compared. The largest drusen size change was measured and compared according to the existence of preoperative intraretinal cysts or ellipsoid zone disruption. Results: Preoperatively and at 6 months postoperatively, the average size of the largest drusen was 198.23 ± 27.34 and 192.23 ± 26.12 μm, respectively, and there was no significant change during the follow-up period. Group I patients with intraretinal cysts and ellipsoid zone disruption experienced low BCVA during the preoperative period; the BCVA had improved postoperatively at 6 months, but with limitations. Conclusions Postoperatively at 6 months, no significant change was observed in the largest drusen size after vitrectomy and membrane peeling. Thus, drusen patients with epiretinal membrane, as well as intraretinal cysts or ellipsoid zone disruption can expect an extended recovery period and slow BCVA improvement.

It is important to follow strict indications for surgery and recognize prognostic factors in order to get good results in the surgical treatment of herniated nucleus pulposus. 55 patients with herniated nucleus pulposus were studied who had had laminectomy and discectomy and were followed up for more than 1 year in order to analyze the correlation between various factors including history, physical examination and radiologic finding and surgical results. Age, sex, symptom duration, location of the herniation, smoking, occupation, physical examination, disc height change, MRI findings, operation time and bleeding volume were evaluated as prognostic factors that seemed to influence surgical result. The results are as follow 1. Female had significantly better surgical results than male (P<0.05). 2. Non-smokers had significantly better surgical result than smokers (P<0.01). 3. In MRI finding, protruded disc had significantly better surgical result when it had involved spinal canal posterolaterally than centrally (P<0.01). 4. The less bleeding volume, the better surgical result (P<0.05).
Diskectomy ; Female ; Hemorrhage ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Occupations ; Physical Examination ; Smoke ; Smoking ; Spinal Canal

PURPOSE: To analyze healing changes of corneal wounds of different corneal incision sizes with or without stromal hydration in cataract surgery using anterior segment optical coherence tomography. METHODS: Cataract surgeries were performed by a single surgeon and 2.2- and 2.8-mm corneal incisions were made using a diamond blade (ME-759; Meyco, Biel-Bienne, Swiss). Patients were divided into four groups according to incision size (2.2 and 2.8 mm), and with/without stromal hydration. Fifteen eyes were assigned to each group and incision wounds were measured using anterior segment optical coherence tomography at 2 hours, 1 day, 1 week, 1 month, and 3 months postoperatively. Corneal thickness, incision length and incision angle were measured and existence of epithelial, endothelial gaping and Descemet's membrane detachment was evaluated. RESULTS: Incision thickness was greater in the group with stromal hydration than in the group without on operation day (p < 0.05). Stromal hydration exerted greater influence in the 2.2-mm incision group than in the 2.8-mm incision group. Corneal thickness decreased more rapidly in the stromal hydration group than in the group with no hydration (p = 0.022). Endothelial gaping was greater in the 2.2-mm incision group than in the 2.8-mm incision group 1 day, 1 month, and 3 months after surgery (p = 0.035, p = 0.009, and p = 0.008, respectively). No other statistical significance was observed between the two groups (2.2 and 2.8 mm) during follow-up regarding corneal thickness, epithelial gaping and Descemet's membrane detachment. CONCLUSIONS: Corneal wounds with a smaller incision could be more vulnerable to external stimuli such as stromal hydration and are less stable than those with a larger incision.
Aged ; Anterior Eye Segment ; Cataract Extraction/*methods ; Corneal Stroma/pathology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Surgical Wound Dehiscence/diagnosis/*prevention & control ; Tomography, Optical Coherence/*methods ; *Wound Healing

BACKGROUND/AIMS: Appropriate interval for performing follow-up endoscopy among dyspeptic patients without abnormal findings on previous endoscopy is unclear. We analyzed the multicenter-collected data from the Korean Society of Neurogastroenterology and Motility. METHODS: We collected clinical data of the patients who visited the gastroenterology department and underwent 2 or more sessions of upper endoscopy during 2012–2017 at 6 university hospitals in Korea. Patients with endoscopic interval between 90 days and 760 days were included. For those with multiple endoscopic sessions, only the first 2 were analyzed. Positive outcome was defined as adenoma or cancer in the upper gastrointestinal tract. To identify the point of change and estimate the properties of the stochastic process before and after the change, we used Bayesian regression with Metropolis-Hastings algorithm. RESULTS: There were 1595 patients. Mean age was 58.8 years (standard deviation, 12.8). Median interval of endoscopy was 437 days (standard deviation, 153). On follow-up endoscopy, there were 12 patients (0.75%) who had neoplasia (4 with gastric cancer and 8 with gastric adnoma). As with the prior hypothesis, we presumed the change point (CP) of increase in frequency of organic lesion as 360 days. After random-walk Metropolis-Hastings sampling with Markov-Chain Monte Carlo iterations of 5000, the CP was 560 days (95% credible interval, 139–724). Estimated average of frequency of dysplastic lesions increased by a factor of 4.4 after the estimated CP. CONCLUSION: To rule out dysplastic lesions among dyspeptic patients who had previously normal endoscopy, a 2-year interval could be offered as follow-up interval for repeat upper endoscopy.
Adenoma ; Bayes Theorem ; Dyspepsia ; Endoscopy ; Follow-Up Studies ; Gastroenterology ; Gastroscopy ; Hospitals, University ; Humans ; Korea ; Stomach Neoplasms ; Upper Gastrointestinal Tract

Takayasu's arteritis is an inflammatory vasculitis that primarily affects the aorta and its major branches. Involvement of the thoracic and abdominal aortas, although rare, causes marked hypertension and may lead to severe heart failure. We report the improvement of cardiac function after axillofemoral bypass grafting in a 59-year-old woman who had this condition.
Aorta ; Aorta, Abdominal ; Female ; Heart ; Heart Failure ; Humans ; Hypertension ; Middle Aged ; Takayasu Arteritis ; Transplants ; Vasculitis

PURPOSE: The favorable types of the breast cancer - medullary, mucinous, papillary and tubular carcinoma are uncommon subtypes and their incidences in different series ranges between 2.0% and 8.0%, 1% and 2%, 0.3% and 3%, less than 2% of all breast cancers, respectively. In westem countries these subtypes have been reported to have good prognosis and slow growth rate. Clinically, these tumors have lower frequency of axillary nodal involvement and better 5-year or 10-year surviral rate than the other common types of breast cancer. MATERIALS AND METHODS: To determine the clinical characteristics and to evaluate the correlation between the progrostic factors and survival rate of these tumors, the medical records of 83 women with medullary, mucinous, papillary and tubular carcinoma treated at Korea Cancer Center Hospital between Jan. 1987 and Dec. 1997 were reviewed retrospectively. RESULTS: The incidences of medullary, mucinous, papillary and tubular carcinoma were 0.51%, 1.45%, 0.71% and 0.14% of all breast cancer, respectively. There were 1 case of local recurrence and 5 cases of systemic relapse during the follow-up (median follow-up peroid of 56 months). Overall 5-year survival and 10-year survival rate were 98.5% and 94.2%, respectively. No significant difference in overall survival rate was detected according to histologic types of these tumors but disease-free survival was significantly lower in papillary carcinoma than the other types of these tumors (p=0.042). Standard prognostic factors of breast cancer such as tumor size, lymph node status, age of the patient and ER status did not affect the prognosis of these tumors. CONCLUSION: Medullary, mucinous, papillary and tubular carcinoma revealed very excellent prognosis in this study regardless of tumor size, lymph node status, age of the patients and ER status.
Adenocarcinoma* ; Breast Neoplasms* ; Breast* ; Carcinoma, Papillary ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lymph Nodes ; Medical Records ; Mucins* ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms revealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardio- pulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.
Aged ; Aneurysm ; Aneurysm, Dissecting ; Aortic Aneurysm, Thoracic* ; Cardiopulmonary Bypass ; Cerebral Infarction ; Constriction ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Diaphragm ; Heart ; Humans ; Hypoxia, Brain ; Rupture ; Saphenous Vein ; Shock ; Subclavian Artery ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed ; Transplants