Purpose: To evaluate risk factors predisposing to intraocular lens (IOL) dislocation after cataract surgery. Methods: The medical and surgical records of patients diagnosed with IOL dislocation between January 2011 and December 2021 after undergoing extracapsular cataract extraction, phacoemulsification, and phacoemulsification with pars plana vitrectomy at Hallym University Sacred Heart Hospital were reviewed retrospectively. Preoperative factors (ocular parameters and demographics) and intra-operative factors (surgery time, surgeon, and intra-operative complications) were compared according to early, late, and bilateral dislocation. Results: In 68 patents and 71 eyes, the average age at the diagnosis of dislocation was 63.3 years, and there were more males (77.5%) than females. Possible major factors predisposing to IOL dislocation were high myopia (9 eyes), retinal detachment (8 eyes), neodymium-doped yttrium aluminum garnet capsulotomy (6 eyes), and normal tension glaucoma (6 eyes). The rate of out-of-the bag dislocation was higher in early dislocation than in late. Early dislocation had a significantly older age, longer surgery time, and higher intraoperative complication rate during cataract surgery than did late dislocation. There was no difference in surgery time for late dislocated eyes compared to non-dislocated eyes. There was no difference in the incidence of dislocation between phacoemulsification and phacoemulsification with pars plana vitrectomy; there were seven eyes with prior vitrectomy only, with late dislocation. Of the seven patients with bilateral IOL dislocation, one had retinitis pigmentosa, two had retinal detachment, and one had high myopia. Bilateral dislocation patients were significantly younger at the time of cataract surgery, compared to unilateral dislocation patients. Conclusions Early dislocation was associated with long surgery time and intraoperative complications, while late dislocation had no significant correlation with surgery-related factors. A history of vitrectomy and combined vitrectomy with cataract surgery seemed to be associated with late dislocation, but this association was not significant.

PURPOSE: To introduce a novel adjuvant technique to locate cyclodialysis cleft using a laser pointer in a gonioscopic view. CASE SUMMARY: A 36-year-old man complaining of blurred vision in his left eye after blunt trauma 2 weeks prior was referred to our hospital. Gonioscopy showed a cyclodialysis cleft from 3 to 4 o'clock and fundus revealed hypotonic maculopathy. After the failure of medical treatment, we tried various interventions such as injection of viscoelastic agent into the anterior chamber and intravitreal gas tamponade with transconjunctival cryotherapy. Since those were not successful, we decided to treat the patient with direct cyclopexy. For the preoperative localization of the cleft, we tried a new technique that uses a laser pointer. On gonioscopic examination, an assistant shot the laser toward the limbal area where the suspicious cleft was located. We were able to precisely locate the cyclodialysis cleft if the laser pointer light was seen through the cleft in the gonioscopic view. With the aid of a laser a pointer, the cleft was successfully closed. CONCLUSIONS: Localization with a laser pointer is simple, safe, rapid, and helpful for planning surgical repair of a cyclodialysis cleft without expensive equipment.
Adult ; Anterior Chamber ; Cryotherapy ; Gonioscopy ; Humans ; Methods*

BACKGROUND: We investigated how cataract surgery might influence long-term intraocular pressure (IOP) change in both healthy subjects and glaucoma patients. METHODS: A retrospective analysis of patients who had had clear corneal phacoemulsification with a minimum of 12 months of follow up was performed. Glaucoma patients with medically controlled open-angle glaucoma and healthy subjects with no glaucoma were included in the analysis. The change of IOP after phacoemulsification and factors associated with postoperative IOP change were investigated. RESULTS: In total, 754 eyes of 754 patients, specifically 106 patients with glaucoma and 648 patients with no glaucoma (i.e., healthy subjects) were enrolled. The phacoemulsification effected a reduction of IOP: 1.03 ± 3.72 mmHg in healthy subjects and 1.08 ± 3.79 mmHg in glaucoma patients at postoperative 1 year (P = 0.656). There were negative coefficients of IOP until 1 year of follow up (all P < 0.001), but the IOP change gradually showed a less steeply decreasing slope (correlation coefficient: −0.993), compared with those for 1 week and 1 month of follow up (correlation coefficients: −1.893 and −1.540, respectively). In the multivariate analysis, age and preoperative IOP showed significant associations with postoperative IOP change (regression coefficients: −0.034 and 0.419 respectively, all P < 0.001). CONCLUSION: Phacoemulsification resulted in IOP reduction, which effect regressed in healthy subjects and glaucoma patients over the course of long-term follow up. Therefore, long-term monitoring of IOP change is needed. In cases of higher preoperative IOP and young patients, phacoemulsification alone is a reliable option for IOP control.
Cataract ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle ; Healthy Volunteers ; Humans ; Intraocular Pressure ; Multivariate Analysis ; Phacoemulsification ; Retrospective Studies

Background: Conventional right ventricular apex (RVa) pacing increases the risk of pacing-induced cardiomyopathy (PICM), especially in elderly patients with a higher ventricular pacing burden. Left bundle branch area pacing (LBBAP) has been suggested as an alternative to conventional RVa pacing. However, there is a lack of evidence that LBBAP may reverse PICM. We report a case of a reversal of PICM after LBBAP.Case presentation An 81-year-old woman with a history of complete atrioventricular block and baseline QRS dura‑ tion of 142 ms received permanent pacemaker implantation with dual pacing. The ventricular lead was placed at the apical direction and paced QRS duration was 146 ms. After 8 months, the patient visited with acute heart failure. The patient’s ventricular pacing burden was > 99%, and echocardiography found severe depression of left ventricular ejec‑ tion fraction (LVEF, 30%), left ventricular dyssynchrony, and global hypokinesia. Despite 3 months of optimal medical management of heart failure, there was minimal improvement in LVEF (35%) and ventricular dyssynchrony persisted.The patient’s presentation was consistent with PICM. LBBAP was performed with a stylet-driven lead and a delivery sheath (Biotronik Selectra 3D, Biotronik, Berlin, Germany). The lead was placed at the area of the left bundle branch trunk and non-selective LBBAP was achieved with a left ventricular activation time of 71 ms, paced QRS duration of 110 ms, and bipolar stimulation to QRS end of 136 ms. After a month, echocardiography found improved LVEF (53%) and N-terminal Pro-B-Type natriuretic peptide was decreased from 1011 to 645 pg/mL. The patient was relieved from dyspnea. Conclusions We report a case that PICM was resolved after LBBAP. LBBAP could be a rescue therapy for PICM induced by conventional RVa pacing.

Background: To analyze the relationship between interocular difference of retinal thickness and motor asymmetry in Parkinson's disease (PD). Methods: Prospective case-control series analyzed 62 eyes of 31 patients with PD and 62 eyes of 31 age- and sex-matched control. Ophthalmologic examinations including optical coherence tomography (OCT) scans were performed in both groups, and in the patients with PD, motor function was evaluated on the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) to determine the clinically more affected side. Peripapillary retinal nerve fiber layer thickness (pRNFLT) and macular retinal thickness (mRT) were measured in both eyes, after which the interocular asymmetry of the OCT parameters was determined. Additionally, the more and less affected sides of the UPDRS-III were evaluated using Symmetric index. Results: The average and quadrant pRNFLT and mRT values between the two groups were not different, but the interocular asymmetry of the average mRT and asymmetry index of retinal thickness (AIRT) of temporal mRT were significantly higher in the PD patients than in the controls (P = 0.026 and 0.044). The sum of UPDRS-III showed a discrepancy between the more and less affected sides (P = 0.002); the calculated Symmetric index was 0.21 ± 0.19, which suggested asymmetric motor symptoms. The Symmetric index of UPDRS-III showed significant relations for interocular asymmetry of superior mRT and AIRT of average mRT (P = 0.001 and 0.008). Conclusion In the PD patients, the interocular asymmetry of mRT was larger than in the controls, and the motor symptoms were asymmetric. Additionally, the interocular asymmetry of mRT showed a significant correlation with motor-symptom laterality.

Background: To analyze the relationship between interocular difference of retinal thickness and motor asymmetry in Parkinson's disease (PD). Methods: Prospective case-control series analyzed 62 eyes of 31 patients with PD and 62 eyes of 31 age- and sex-matched control. Ophthalmologic examinations including optical coherence tomography (OCT) scans were performed in both groups, and in the patients with PD, motor function was evaluated on the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) to determine the clinically more affected side. Peripapillary retinal nerve fiber layer thickness (pRNFLT) and macular retinal thickness (mRT) were measured in both eyes, after which the interocular asymmetry of the OCT parameters was determined. Additionally, the more and less affected sides of the UPDRS-III were evaluated using Symmetric index. Results: The average and quadrant pRNFLT and mRT values between the two groups were not different, but the interocular asymmetry of the average mRT and asymmetry index of retinal thickness (AIRT) of temporal mRT were significantly higher in the PD patients than in the controls (P = 0.026 and 0.044). The sum of UPDRS-III showed a discrepancy between the more and less affected sides (P = 0.002); the calculated Symmetric index was 0.21 ± 0.19, which suggested asymmetric motor symptoms. The Symmetric index of UPDRS-III showed significant relations for interocular asymmetry of superior mRT and AIRT of average mRT (P = 0.001 and 0.008). Conclusion In the PD patients, the interocular asymmetry of mRT was larger than in the controls, and the motor symptoms were asymmetric. Additionally, the interocular asymmetry of mRT showed a significant correlation with motor-symptom laterality.

In this study, we examined the therapeutic effects of an immune-stimulating peptide, WKYMVm, in ulcerative colitis. The administration of WKYMVm to dextran sodium sulfate (DSS)-treated mice reversed decreases in body weight, bleeding score and stool score in addition to reversing DSS-induced mucosa destruction and shortened colon. The WKYMVm-induced therapeutic effect against ulcerative colitis was strongly inhibited by a formyl peptide receptor (FPR) 2 antagonist, WRWWWW, indicating the crucial role of FPR2 in this effect. Mechanistically, WKYMVm effectively decreases intestinal permeability by stimulating colon epithelial cell proliferation. WKYMVm also strongly decreases interleukin-23 and transforming growth factor-beta production in the colon of DSS-treated mice. We suggest that the potent immune-modulating peptide WKYMVm and its receptor FPR2 may be useful in the development of efficient therapeutic agents against chronic intestinal inflammatory diseases.
Adjuvants, Immunologic/pharmacology/*therapeutic use ; Animals ; Caco-2 Cells ; Cell Proliferation ; Colitis, Ulcerative/*drug therapy/metabolism ; Colon/pathology ; Humans ; Interleukin-23/genetics/metabolism ; Intestinal Mucosa/drug effects/metabolism/pathology ; Mice ; Mice, Inbred C57BL ; Oligopeptides/pharmacology/*therapeutic use ; Permeability ; Receptors, Formyl Peptide/antagonists & inhibitors ; Transforming Growth Factor beta/genetics/metabolism

No abstract available.
Cardiomyopathy, Hypertrophic ; Fabry Disease

Background and Objectives: Antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF) has changed in recent years with new data from large randomized trials and updates to clinical guidelines. This study aimed to investigate the trends in periprocedural antithrombotic regimens in Korean patients with AF undergoing PCI with non-vitamin K antagonist oral anticoagulants (NOACs). Methods: Using the claims database of the Health Insurance Review and Assessment during 2013–2018, 27,594 patients with AF undergoing PCI were identified. The annual prevalence of PCI and prescriptions of each antithrombotic agent, including antiplatelet agents and oral anticoagulants, within 30 days after PCI were investigated. Results: During 2013–2018, the number of patients with AF undergoing PCI increased up to 1.3-fold (from 3,913 to 5,075 patients per year). After the introduction of NOACs, the proportion of dual antiplatelet therapy (DAPT) decreased from 71.9% to 49.8% but still occupied the largest proportion among antithrombotic regimens. Triple antithrombotic therapy (TAT) use increased from 25.4% to 46.0%, and NOAC has rapidly replaced warfarin as the oral anticoagulant of choice. TAT was preferred to DAPT for patients with CHA2 DS2 -VASc score ≥2. Among various factors, prior intracranial hemorrhage was the most powerful predictor of favoring DAPT use over TAT. Conclusion Since the introduction of NOACs, the patterns of periprocedural antithrombotic regimens have changed rapidly toward more use of TAT, specifically with NOAC-based regimen. Appropriate stroke prevention with oral anticoagulants is still underutilized in patients with AF undergoing PCI in Korea.