PURPOSE: To evaluate the postoperative corneal topographic changes after 23-gauge transconjunctival vitrectomy. METHODS: Twenty eyes of 20 consecutive patients who required vitrectomy were included in the present study. The 23-gauge transconjunctival vitrectomy was performed by a single surgeon from September 2007 through November 2007. Videokeratography system (TMS-4, Tomey Co., Japan) was obtained preoperatively and at 1 day, 2 weeks, and 1 month postoperatively. The date changes of Fourier indices including spherical power, regular astigmatism, asymmetry, and higher-order irregularity were analyzed at the central 3- and 6-mm zone of the cornea. RESULTS: Twenty eyes, including eyes with proliferative diabetic retinopathy (n = 9), vitreous hemorrhage and opacity (n = 7), and epiretinal membrane (n = 4), underwent the operation. None of the Fourier indices significantly changed throughout the observation period (p < 0.05, Wilcoxon-signed-ranks test). CONCLUSIONS: A 23-gauge transconjunctival vitrectomy does not induce significant changes in corneal topography even in the central 6-mm zone, as well as the 3-mm zone of the cornea.
Astigmatism ; Cornea ; Corneal Topography ; Diabetic Retinopathy ; Epiretinal Membrane ; Eye ; Humans ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate the postoperative corneal topographic changes after 23-gauge transconjunctival vitrectomy. METHODS: Twenty eyes of 20 consecutive patients who required vitrectomy were included in the present study. The 23-gauge transconjunctival vitrectomy was performed by a single surgeon from September 2007 through November 2007. Videokeratography system (TMS-4, Tomey Co., Japan) was obtained preoperatively and at 1 day, 2 weeks, and 1 month postoperatively. The date changes of Fourier indices including spherical power, regular astigmatism, asymmetry, and higher-order irregularity were analyzed at the central 3- and 6-mm zone of the cornea. RESULTS: Twenty eyes, including eyes with proliferative diabetic retinopathy (n = 9), vitreous hemorrhage and opacity (n = 7), and epiretinal membrane (n = 4), underwent the operation. None of the Fourier indices significantly changed throughout the observation period (p < 0.05, Wilcoxon-signed-ranks test). CONCLUSIONS: A 23-gauge transconjunctival vitrectomy does not induce significant changes in corneal topography even in the central 6-mm zone, as well as the 3-mm zone of the cornea.
Astigmatism ; Cornea ; Corneal Topography ; Diabetic Retinopathy ; Epiretinal Membrane ; Eye ; Humans ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To report a case of IgG4-related sclerosing dacryoadenitis masquerading for a long period as a. CASE SUMMARY: A 59-year-old man with visual acuity loss and proptosis in the left eye was referred to our hospital. Ten years prior, the patient was diagnosed with lymphoma and underwent chemotherapy at another hospital. However, the patient spontaneously stopped treatment and took steroids for the relief of periorbital swelling. Magnetic resonance imaging revealed diffuse infiltrative lesions involving both optic nerves and extraocular muscles. Incisional biopsies of the lacrimal gland's posterior side and the lateral rectus muscle's lateral side were performed. Staining for IgG4 via immunochemistry showed infiltration of IgG4-positive lymphoplasmacytic cells. Under the diagnosis of IgG4-related sclerosing disease, the patient underwent high-dose steroid pulse therapy.
Biopsy ; Dacryocystitis ; Exophthalmos ; Eye ; Humans ; Immunochemistry ; Immunoglobulin G ; Lymphoma ; Magnetic Resonance Imaging ; Middle Aged ; Mikulicz' Disease ; Muscles ; Optic Nerve ; Steroids ; Visual Acuity

PURPOSE: To report a case of IgG4-related sclerosing dacryoadenitis masquerading for a long period as a. CASE SUMMARY: A 59-year-old man with visual acuity loss and proptosis in the left eye was referred to our hospital. Ten years prior, the patient was diagnosed with lymphoma and underwent chemotherapy at another hospital. However, the patient spontaneously stopped treatment and took steroids for the relief of periorbital swelling. Magnetic resonance imaging revealed diffuse infiltrative lesions involving both optic nerves and extraocular muscles. Incisional biopsies of the lacrimal gland's posterior side and the lateral rectus muscle's lateral side were performed. Staining for IgG4 via immunochemistry showed infiltration of IgG4-positive lymphoplasmacytic cells. Under the diagnosis of IgG4-related sclerosing disease, the patient underwent high-dose steroid pulse therapy.
Biopsy ; Dacryocystitis ; Exophthalmos ; Eye ; Humans ; Immunochemistry ; Immunoglobulin G ; Lymphoma ; Magnetic Resonance Imaging ; Middle Aged ; Mikulicz' Disease ; Muscles ; Optic Nerve ; Steroids ; Visual Acuity

PURPOSE: To describe the rate of surgical intervention to the intranasal structures for making a sufficient bony ostium in endonasal dacryocystorhinostomy. METHODS: Video records of 52 Korean patients (66 eyes) who underwent endonasal dacryocystorhinostomy between January 2010 and December 2010 for primary nasolacrimal duct obstruction were reviewed. To locate the internal common punctum in the lateral nasal wall, a transcanalicular illumination device consisting of disposable vitrectomy light pipe was introduced horizontally through the canaliculus. The relative position of the internal common punctum to the operculum of the middle turbinate was divided into 4 types and analyzed according to the intranasal surgical procedures necessary. RESULTS: Internal common punctum was located posterior-superior to the operculum of the middle turbinate in 37 cases (56%), anterior-superior in 16 cases (24%), posterior-inferior in 11 cases (17%) and anterior-inferior in 2 cases (3%). To expose the bony ostium, partial removal of the operculum of the middle turbinate was required in 63 cases (95%), anterior middle turbinectomy in 43 cases (65%), uncinectomy in 62 cases (94%) and opening of the agger nasi cell in 45 cases (68%). CONCLUSIONS: In a majority of patients, partial removal of the middle turbinate, uncinate process and agger nasi cell were necessary to create a sufficient bony ostium. The transcanalicular illumination device is useful to locate the lacrimal sac and can be helpful in understanding the intranasal structures which need to be removed during surgery.
Dacryocystorhinostomy ; Humans ; Light ; Lighting ; Nasolacrimal Duct ; Turbinates ; Vitrectomy

Purpose: We aimed to survey current status of preparedness for neonatal resuscitation in delivery rooms in Korea. Methods: We analyzed data regarding preparedness for the resuscitation in terms of personnel, equipment, and education using a questionnaire, which was developed by the Korean Association of Cardiopulmonary Resuscitation. From August 2020 through January 2021, the questionnaires were sent to hospitals affiliated with the Korean Association of Maternity Hospitals or the Korean Neonatal Network (KNN) operated by the Korean Society of Neonatology. As per the affiliated society, the hospitals were grouped as the maternity hospitals or the KNN hospitals. The questionnaires were delivered in 3 steps: mailout, electronic mail, and phone calls. Results: Response rate was 21.3% (115 of 541) and 65.3% (49 of 75) in the maternity and KNN hospitals, respectively. The maternity hospitals showed a higher mean number of delivery and fewer pediatricians. In the KNN hospitals, pediatricians played a leading role during the resuscitation, but in the maternity hospitals, their role as a leader was less conspicuous. The KNN hospitals were better equipped with masks of variable sizes, oxygen blender, T-piece resuscitator, and electrocardiographic monitor (all Ps < 0.001). In the maternity hospitals, the preparedness of oxygen blender or T-piece resuscitator was positively associated with the number of pediatricians (P = 0.005). Although bag-mask ventilation was mostly feasible in both groups, endotracheal intubation was less feasible in the maternity hospitals (P = 0.007). The annual participation in resuscitation training for providers was higher in the KNN hospitals (P < 0.001). In the maternity hospitals, the annual participation was positively associated with the numbers of deliveries, obstetricians, and pediatricians. Conclusion This preliminary survey indicates the need for further improvement in preparing in personnel, equipment, and education, particularly in maternity hospitals.

PURPOSE: To describe femtosecond laser-assisted corneal biopsy and its use in assessing the causative organism in a case of fungal keratitis that occurred 8 months after penetrating keratoplasty. CASE SUMMARY: A 27-year-old man who had undergone penetrating keratoplasty 8 months prior showed atypical diffuse corneal haze and erosion. Diagnostic corneal biopsy using a femtosecond laser was performed because of repeated negative test results for an infectious organism and a lack of improvement, despite steroid and empirical antibiotic therapy. A corneal flap 200 micrometer in depth and 3 mm in diameter was obtained. The biopsy showed pseudohyphae, which led to a diagnosis of Candidal keratitis. No complications occurred during the procedure. CONCLUSIONS: Femtosecond laser-assisted corneal biopsy enabled identification of the infectious pathogen. This technique is easy, safe, and rapid, and it yields a biopsy specimen with a uniform depth and precise size. Femtosecond laser-assisted corneal biopsy can be used as an accurate diagnostic method in uncertain cases of corneal ulcers.
Adult ; Biopsy ; Humans ; Keratitis ; Keratoplasty, Penetrating

PURPOSE: To compare ocular higher order aberrations measured by two different aberrometers in a sample of normal eyes. METHODS: We included 41 normal eyes of Koreans in this study. Ocular aberration data were obtained through three measurements per eye using Zywave and OPD-Scan devices. Spherical equivalent and higher order aberrations calculated in the central 6 mm zone and expressed as root mean square (RMS) values were analyzed. RESULTS: A comparison of measurements between the Zywave and OPD-Scan devices demonstrated no statistically significant differences in the RMS values of total higher order aberration (p=0.11), but significant differences were detected in the RMS values of total spherical aberration, total coma and total trefoil (p<0.01). CONCLUSIONS: The two different aberrometers that we tested are suitable for taking repeated measurements and are internally consistent, but not interchangeable.
Coma ; Eye ; Lotus

Escherichia coli heat-labile enterotoxin (LT), which causes a characteristic diarrhea in humans and animals, is a strong mucosal immunogen and has powerful mucosal adjuvant activity towards coadministered unrelated antigens. Here we report the different mucosal adjuvanticity of nontoxic LT derivatives, LTS63Y and LTdelta110/112, generated by immunizing through two different mucosal routes. Intragastric (IG) immunization with Helicobacter pylori urease alone resulted in poor systemic IgG and IgA responses and no detectable local secretory IgA, but IG co-immunization with urease and LTdelta110/112 induced high titers of urease-specific local secretory IgA and systemic IgG and IgA, comparable to those induced by wild-type LT. LTS63Y showed far lower adjuvant activity towards urease than LTdelta110/112 in IG immunization, but was more active than LTdelta110/112 in inducing immune responses to urease by intranasal (IN) immunization. LTdelta110/112 predominantly enhanced the induction of urease-specific IgG1 levels following IG immunization, whereas LTS63Y induced high levels of IgG1, IgG2a and IgG2b following IN immunization. In addition, quantitative H. pylori culture of stomach tissue following challenge with H. pylori demonstrated a 90-95% reduction (p < 0.0002) in bacterial burden in mice immunized intranasally with urease using either mutant LT as an adjuvant. These results indicate that the mechanism(s) underlying the adjuvant activities of mutant LTs towards coadmnistered H. pylori urease may differ between the IN and IG mucosal immunization routes.
Adjuvants, Immunologic/administration & dosage* ; Administration, Intranasal ; Animal ; Bacterial Toxins/immunology* ; Bacterial Toxins/genetics ; Bacterial Toxins/administration & dosage ; Enterotoxins/immunology* ; Enterotoxins/genetics ; Enterotoxins/administration & dosage ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli* ; Feces ; Female ; Gastric Mucosa/microbiology ; Gastric Mucosa/immunology* ; Helicobacter pylori ; Human ; IgA, Secretory/immunology* ; IgG/immunology ; Mice ; Mice, Inbred BALB C ; Mutagenesis, Site-Directed ; NAD+ ADP-Ribosyltransferase/immunology ; NAD+ ADP-Ribosyltransferase/genetics ; Nasal Mucosa/immunology* ; Point Mutation ; Urease/immunology* ; Urease/administration & dosage ; Vaccination*

Escherichia coli heat-labile enterotoxin (LT) is composed of catalytic A and non-catalytic homo-pentameric B subunits and causes diarrheal disease in human and animals. In order to produce a nontoxic LT for vaccine and adjuvant development, two novel derivatives of LT were constructed by a site-directed mutagenesis of A subunit; Ser63 to Tyr63 in LTS63Y and Glu110, Glu112 were deleted in LT delta 110/112. The purified mutant LTs (mLTs) showed a similar molecular structural complex as AB5 to that of wild LT. In contrast to wild-type LT, mLTs failed to induce either elongation activity, ADP-ribosyltransferase activity, cAMP synthesis in CHO cells or fluid accumulation in mouse small intestine in vivo. Mice immunized with mLTs either intragastrically or intranasally elicited high titers of LT-specific serum and mucosal antibodies comparable to those induced by wild-type LT. These results indicate that substitution of Ser63 to Tyr63 or deletion of Glu110 and Glu112 eliminate the toxicity of LT without a change of AB5 conformation, and both mutants are immunogenic to LT itself. Therefore, both mLTs may be used to develop novel anti-diarrheal vaccines against enterotoxigenic E. coli.
Amino Acid Substitution ; Animal ; Bacterial Toxins/toxicity* ; Bacterial Toxins/metabolism ; Bacterial Toxins/immunology* ; Bacterial Toxins/genetics ; CHO Cells ; Cyclic AMP/metabolism ; Enterotoxins/toxicity* ; Enterotoxins/metabolism ; Enterotoxins/immunology* ; Enterotoxins/genetics ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli*/metabolism ; Escherichia coli*/genetics ; Female ; Hamsters ; IgA, Secretory/blood ; Ileum/metabolism ; Immunity, Mucosal ; Mice ; Mice, Inbred BALB C ; Mutagenesis, Site-Directed ; NAD+ ADP-Ribosyltransferase/metabolism ; Recombinant Proteins/toxicity ; Recombinant Proteins/metabolism ; Recombinant Proteins/immunology ; Recombinant Proteins/chemistry