PURPOSE: To compare the clinical effectiveness of 1% Prednisolone acetate ophthalmic solution and 0.1% Bromfenac sodium hydrate ophthalmic solution on prevention of cystoid macular edema after cataract surgery. METHODS: A retrospective chart review of 349 patients who received phacoemulsification with intraocular lens implantation in Severance Hospital from July 2013 to January 2016 was performed. In these patients, 192 eyes received 1% Prednisolone acetate ophthalmic solution, and 157 eyes were treated with topical 0.1% Bromfenac sodium hydrate ophthalmic solution. The incidence and severity of cystoid macular edema (CME) were evaluated by retinal foveal thickness on optical coherence tomography for patients who showed best corrected visual acuity (BCVA) less than 0.5 (log MAR ≥ 0.3). RESULTS: There was no significant difference between the two groups in age (p = 0.708), sex (p = 0.977), or the side of operated eye (p = 0.443). The two groups showed BCVA 0.04 ± 0.09 (Steroid group) and 0.03 ± 0.07 (nonsteroidal anti-inflammatory drug [NSAID] group) at 1 month after the surgery and the difference was not significant (p = 0.947). One eye in the topical steroid group had cystoid macular edema, and 3 eyes in the steroid group showed elevated intraocular pressure (IOP) over 30 mm Hg. There were no IOP elevations or macular edema in the NSAID group. CONCLUSIONS: The results showed that 0.1% Bromfenac sodium hydrate ophthalmic solution had a similar effect to 1% Prednisolone acetate ophthalmic solution on preventing CME after cataract surgery. This indicates that topical NSAID can be considered along with topical steroids in order to prevent CME after cataract surgery.
Cataract* ; Humans ; Incidence ; Intraocular Pressure ; Lens Implantation, Intraocular ; Macular Edema* ; Phacoemulsification ; Prednisolone* ; Retinaldehyde ; Retrospective Studies ; Sodium ; Steroids ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity

No abstract available.
Heart* ; Thoracic Surgery* ; Thyroid Gland*

PURPOSE: This case is the first report of optic neuritis following acute disseminated encephalomyelitis in Korean literature and we report this case with a successful result of conservative treatment. METHODS: We examined a 7-year and-7-month-old female patient who visited our ophthalmology clinic complaining of a headache and visual disturbance in both eyes. At the time of visit, light perception was negative in both eyes, response to light reflex was nil in the right eye and weak in the left eye. Relative afferent papillary defect (RAPD) was noted in both eyes, and the disc swelling was found in both eyes on fundus examination. MRI brain scans revealed asymmetrical multifocal lesions involving the cortex and subcortex in the bilateral brain hemispheres, and contrast enhanced in T2-weighted images. Cerebrospinal fluid (CSF) examination showed results of 45 WBC, 10 polynuclear lymphocyte, and 88 monocyte cells/mm3. RESULTS: As patient was diagnosed with acute disseminated encephalomyelitis, she was prescribed intravenous steroid pulse therapy with methylprednisolone sodium succinate (Solu-medrol(R), Pharmacia, U.S.A), and immunoglobulin (Liv gamma(R), Green Cross, Korea). Seven days of steroid therapy was followed by tapering with oral steroid. Uncorrected vision was 0.9 in the right eye and 0.9 in the left. RAPD was resolved in both eyes. Visual evoked potentials showed both eyes being normal.
Brain ; Cerebrospinal Fluid ; Encephalomyelitis, Acute Disseminated* ; Evoked Potentials, Visual ; Female ; Headache ; Humans ; Immunoglobulins ; Lymphocytes ; Magnetic Resonance Imaging ; Methylprednisolone Hemisuccinate ; Monocytes ; Multiple Sclerosis ; Ophthalmology ; Optic Neuritis* ; Reflex

No abstract available.
Humans ; Lung Neoplasms* ; Lung*

The changes of higher-order aberrations (HOAs) after bilateral lateral rectus muscle recession were evaluated. Forty eyes of 20 children were enrolled and their wavefront information was assessed until postoperative 3 months. Even though the root mean square (RMS) of total aberration was not changed, the RMS of HOA was transiently increased at postoperative 1 week and returned to baseline level after 1 month. Among individual Zernike coefficient, secondary astigmatism, quadrafoil, secondary coma, secondary trefoil, and pentafoil showed similar tendency with the RMS of HOA. However, coma, trefoil, and spherical aberration were not changed. Regarding recession amount, it did not correlate with any Zernike coefficient. In summary, our data imply that the HOAs are transiently increased after lateral rectus recession surgery. These results are in collusion with previous reports that strabismus surgery induced transient corneal astigmatism.
Adolescent ; Astigmatism/*etiology ; Child ; Child, Preschool ; Exotropia/*surgery ; Female ; Humans ; Male ; Postoperative Care ; *Postoperative Complications/epidemiology/pathology ; Vision Tests

PURPOSE: To compare changes in human central corneal thickness after instillation of proparacaine with those after oxybuprocaine instillation, over a period of 10 minutes. METHODS: Eighteen healthy young participants were recruited. Baseline central corneal thicknesses were measured every 30 seconds for 10 minutes using a noncontact specular microscope. Changes in central corneal thickness were measured every 20 seconds for 10 minutes after the administration of one drop of 0.5% proparacaine into the right eye, and one drop of 0.4% oxybuprocaine into the left eye. RESULTS: Mean baseline central corneal thickness was 531 +/- 45 micrometer in the right eye and 531 +/- 42 micrometer in the left. The central corneal thickness after proparacaine instillation increased to 8.6 micrometer (4.5-12.6 micrometer, 95% CI) and then returned to baseline within 80 seconds. Central corneal thickness after oxybuprocaine instillation increased to 7.7 micrometer (3.6-11.2 micrometer, 95% CI) and then returned to baseline within 80 seconds. There was a second transient increase about 5 minute after proparacaine instillation but no additional transient increase after oxybuprocaine instillation. CONCLUSIONS: The severity of oxybuprocaine's effect on central corneal thickness is similar to that of proparacaine. Central corneal thickness instability may occur for 5 minutes after proparacaine administration. Therefore, changes in central corneal thickness after topical anesthetics instillation should be considered when measuring central corneal thickness.
Anesthetics* ; Humans

The surgical outcome of excimer laser photorefractive keratectomy(PRK) depends on the accuracy of ablation and the smoothness of the surface ablated. The purpose of this study was to investigate the clinical usefulness of a new eyeball fixation device(EK fixation device). First, the PRK was done on the cornea of New Zealand white rabbit (-8 D, 5.5 mm). The surface with the device was smoother compared to that without. Second, The PRK (-4 D, 6 mm)was done on the surface of the contact lens over the cornea of human volunteers. The ablation surface with the device was smoother than that without(0.20+/-0.04 micrometer vs. 0.34 +/-0.14 micrometer, p=0.028). The epithelial healing experiment in New Zealand white rabbit after myopic PRK (-8 D, 5.5 mm)showed more rapid wound healing in the fixation group (66.49+/-0.03 micrometer/hr vs 47.93+/-1.80 micrometer/hr, p=0.0001). In conclusion, the EK fixation device during the PRK procedures creates a smoother ablation surface and enhances corneal epithelial healing, thus may be a useful clinical device.
Cornea ; Healthy Volunteers ; Lasers, Excimer ; New Zealand ; Wound Healing

We experienced a case of unusual complication following esophageal reconstruction. In 1969, accidentally the patient swallowed lye and was developed benign esophageal stricture one year later. In 1972, esophageal reconstruction with right colon was done but pus was drained out of the abdominal wound. After then wound disruption and healing were repeated. In 1996, stenosis of colonic graft was found and resection of stenotic area and end to end anastomosis was done. We concluded that it was developed inflammatory change of graft by intraoperative infection.
Abscess* ; Colon ; Constriction, Pathologic* ; Esophageal Stenosis ; Humans ; Lye ; Postoperative Complications ; Suppuration ; Transplants ; Wounds and Injuries

BACKGROUND: Perfusion scintigraphy with dipyridamole have been reported to be useful for diagnosis of coronary artery disease and the assessment of the presence and extent of myocardium at ischemic risk, especially in patients who can not undergo dynamic exercise testing. Dipyridamole, pharmacologic coronary vasodilator, also induces fall in blood pressure and rise in heart rate. The purpose of this study was to answer the question if dipyridamole induced peripheral hemodynamic responses were related to chest pain, ST changes on EKG, scintigraphic defect or extent of coronary stenosis. METHODS: Dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 43 subjects who were suspected to have coronary artery disease. The peripheral hemodynamic response was graded as absent(group 0) if there was a < or =10mm fall in systolic blood pressure (SBP) and/or < or =10 beats/min rise in geart rate(HR) ; moderate(group 1) if there was >10 but < or =20mm fall in SBP and/or >10 but < or =20 beats/min rise in HR ; and marked (group 2) if there was >20mm fall in SBP and/or >20 beats/min rise in HR. RESULTS: The overall diagnostic sensitivity and specificity for coronary artery disease of dipyridamole perfusion scintigraphy were 68%, 83% while per vessel sensitivity and specificity for coronary artery disease were 66%, 97%. The numbers of induced chest pain and ischemic ST changes among hemodynamic subgroups, were 40%, 40% in group 0, 33%, 27% in group 1 and 50%, 40% in group 2 without significant difference in each hemodynamic subgroups. Either the numbers of diseased coronary arteries or the numbers of patients demonstrationg reversible scintigraphic defects were not statically different among each subgroups. CONCLUSION: Although the peripheral hemodynamic response dose not always correlate with its central coronary effect but dipyridamlole 99mTc-MIBI myocardial perfusion scintigraphy is an useful test for diagnosis of coronary artery disease.
Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Electrocardiography ; Exercise Test ; Heart Rate ; Hemodynamics* ; Humans ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion Imaging ; Sensitivity and Specificity

The clinical complex of ARDS includes hypoxemia, hypercapnia, diffuse pulmonary infiltrates on chest radiograph, and depressed pulmonary compliance. Even with improved intensive care, the onset of severe disease with ARDS is associated with high mortality rate of 55% to 85% in an adult population. The etiology of ARDS remains uncertain, although increasing experimental evidence suggests that high inflation pressures may be involved in the pulmonary injury that is associated with ARDS. The use of low volume, pressure limited mechanical ventilation with permissive hypercapnia has been proposed to reduce the mortality rates associated with severe ARDS. Pressure-controlled ventilation has been proposed to recruit closed alveolar units and improve oxygenation through changing the inspiratory flow pattern from a square wave as used with volume-controlled ventilation to a rapidly exponentially decaying curve and through maintaining airway pressure at a constant level throughout the inspiratory phase. We present the case of a severe ARDS patient in whom a specific ventilatory management strategy of low peak inflation pressures and permissive hypercapnia appears to have favorably influenced survival and warrants further clinical evaluation.
Adult* ; Anoxia ; Compliance ; Humans ; Hypercapnia* ; Inflation, Economic ; Critical Care ; Lung Injury ; Mortality ; Oxygen ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Ventilation*