1.Clinical Outcomes of Trabeculectomy with Amniotic Membrane Transplantation and Mitomycin C in Primary Open-Angle Glaucoma
Journal of the Korean Ophthalmological Society 2020;61(8):929-939
Purpose:
To evaluate the short-term clinical outcomes of trabeculectomy with amniotic membrane transplantation (AMT) and mitomycinC (MMC) in patients with primary open-angle glaucoma (POAG).
Methods:
This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patientswith POAG who underwent trabeculectomy with AMT and MMC and compared the surgical outcomes according to AMTwith Kaplan-Meier survival analysis. All patients had follow-up of ≥6 months. Surgical success was defined as an intraocularpressure (IOP) ≤18 mmHg and IOP reduction ≥20% without medication. We evaluated the frequency of complications and blebmorphology according to AMT.
Results:
A total of 95 eyes of 79 patients were included; 52 eyes of 46 patients with AMT (AMT group) and 43 eyes of 33 patientswithout AMT (control group). The cumulative probability of success after trabeculectomy was 94.2% and 85.8% after one year forthe AMT and control groups, respectively (p= 0.121). Mean IOP decreased from 30.2 ± 9.8 mmHg preoperatively to 11.6 ± 4.2mmHg at the final visit in the AMT group (p< 0.001). Mean IOP decreased from 29.7 ± 7.4 mmHg preoperatively to 12.2 ± 4.5mmHg at the final visit in the control group (p< 0.001). Preoperative and final IOP were not significantly different between the twogroups. Complications were comparable between the groups. However, avascular cystic bleb was more frequent in the controlgroup (18.6%) than in the AMT group (0%) (p= 0.002).
Conclusions
Trabeculectomy with AMT and MMC appears to be a safe and effective procedure for IOP reduction in patientswith POAG, without development of avascular cystic bleb or bleb-related infection.
2.One-Year Outcomes of Ab Externo XEN45 Gel Stent Implantation with an Open Conjunctiva Approach in Patients with Open-Angle Glaucoma
Kwangeon HAN ; Jiwoong LEE ; Sangwoo MOON
Korean Journal of Ophthalmology 2023;37(5):353-364
Purpose:
This study aimed to evaluate the 1-year surgical outcomes of XEN45 gel stent implantation with an open conjunctiva approach in patients with open-angle glaucoma (OAG).
Methods:
This retrospective cohort study included 19 eyes of 19 patients who underwent XEN45 gel stent implantation with an open conjunctival approach. Surgical success was defined by intraocular pressure (IOP) ≤18 mmHg and one of the following: IOP reduction ≥30% or reduction of two glaucoma medications with final IOP if baseline IOP ≤18 mmHg. The cumulative probability of success rate was analyzed using Kaplan-Meier survival analysis. Cox proportional hazard regression analysis was used to assess prognostic factors for surgical failure.
Results:
IOP reduced from 32.37 ± 12.08 mmHg preoperatively to 15.14 ± 2.25 mmHg at 1 year (p = 0.001). The number of glaucoma medication reduced from 3.89 ± 0.32 preoperatively to 0.86 ± 1.35 at 1 year (p = 0.001). The success rates were 78.9% at 6 months and 73.7% at 1 year. Eyes with bleb horizontal extent ≥2 clock hours at 1 month postoperatively had a significantly higher success rate (log-rank test, p < 0.001). Greater bleb horizontal extent at 2 weeks and 1 month postoperatively was associated with a lower surgical failure rate (2 weeks: hazard ratio, 0.119; p = 0.024; 1 month: hazard ratio, 0.046; p = 0.007). Bleb needling and additional glaucoma surgeries were necessary in 10 (52.6%) and five eyes (26.3%), respectively.
Conclusions
XEN45 gel stent implantation with the open conjunctiva approach is effective in reducing IOP and glaucoma medication for over 1 year in patients with OAG.
3.The Evolving Policy Debate on Border Closure in Korea
SuJin KANG ; Jihyun MOON ; Heewon KANG ; Heekyoung NAM ; Sangwoo TAK ; Sung-Il CHO
Journal of Preventive Medicine and Public Health 2020;53(5):302-306
Objectives:
In this paper, we aimed to investigate the evolving debate over border closure in Korea during the coronavirus disease 2019 (COVID-19) pandemic, to address the main themes associated with border closure, and to discuss the factors that need to be considered when making such decisions.
Methods:
We collated and reviewed previously conducted review studies on border closures during infectious disease outbreaks to derive relevant themes and factors.
Results:
According to our systematic review on border closures and travel restrictions, the effects of such containment efforts are limited. We suggest considering the following factors when determining whether to impose border closure measures: (1) disease characteristics, (2) timeliness of implementation, (3) transmission delay and the basic reproduction number, (4) globalization and pandemics, and (5) social and economic costs.
Conclusions
Our assessment indicates that the effects of border closures are at best temporary and limited. Alternative measures must be contemplated and implemented to suppress the spread of COVID-19 in particular and infectious diseases more broadly.
4.Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey.
Yeonhee PARK ; Jong Joon AHN ; Byung Ju KANG ; Young Seok LEE ; Sang Ook HA ; Jin Soo MIN ; Woo Hyun CHO ; Se Hee NA ; Dong Hyun LEE ; Seung Yong PARK ; Goo Hyeon HONG ; Hyun Jung KIM ; Sangwoo SHIM ; Jung Hyun KIM ; Seok Jeong LEE ; So Young PARK ; Jae Young MOON
Korean Journal of Critical Care Medicine 2017;32(3):231-239
BACKGROUND: Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals. METHODS: This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present. RESULTS: Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001). CONCLUSIONS: RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.
Adult
;
Cardiopulmonary Resuscitation
;
Heart Arrest*
;
Hospitals, High-Volume
;
Humans
;
Incidence
;
Motivation*
;
Patient Safety
;
Patients' Rooms
;
Pilot Projects*
;
Quality of Health Care
;
Retrospective Studies
;
Tertiary Care Centers
5.Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey
Yeonhee PARK ; Jong Joon AHN ; Byung Ju KANG ; Young Seok LEE ; Sang Ook HA ; Jin Soo MIN ; Woo Hyun CHO ; Se Hee NA ; Dong Hyun LEE ; Seung Yong PARK ; Goo Hyeon HONG ; Hyun Jung KIM ; Sangwoo SHIM ; Jung Hyun KIM ; Seok Jeong LEE ; So Young PARK ; Jae Young MOON
The Korean Journal of Critical Care Medicine 2017;32(3):231-239
BACKGROUND: Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals. METHODS: This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present. RESULTS: Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001). CONCLUSIONS: RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.
Adult
;
Cardiopulmonary Resuscitation
;
Heart Arrest
;
Hospitals, High-Volume
;
Humans
;
Incidence
;
Motivation
;
Patient Safety
;
Patients' Rooms
;
Pilot Projects
;
Quality of Health Care
;
Retrospective Studies
;
Tertiary Care Centers