This prospective observational case series study included 6 eyes of 6 consecutive glaucomatous patients. Each patient underwent trabeculectomy with mitomycin C, and received a 1.25 mg of subconjunctival bevacizumab injection at completion of the trabeculectomy. Study eyes included two with neovascular glaucoma, three with uveitic glaucoma, and one with secondary glaucoma following vitrectomy. All eyes had undergone failed glaucoma laser/surgical treatment or an intraocular surgical procedure. Intraocular pressure (IOP) at the following postoperative visits: preoperative, 1 week, 1 month, 2 months, 3 months, and 6 months, was measured. We also evaluated postoperative bleb findings and complications. IOP measured at each visit was 37.5+/-14.4 mmHg, 6.2+/-3.4 mmHg, 8.3+/-7.2 mmHg, 12.0+/-4.4 mmHg, 10.8+/-3.1 mmHg, and 12.2+/-3.3 mmHg, respectively, for each visit. All eyes had functioning blebs with normal IOP at postoperative 6 months with no additional IOP-lowering medication.
Adult ; Aged ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Conjunctiva ; Female ; Glaucoma/*drug therapy/etiology/*surgery ; Glaucoma, Neovascular/drug therapy/surgery ; Humans ; Injections, Intraocular ; Male ; Middle Aged ; Prospective Studies ; Trabeculectomy/*methods ; Uveitis/complications ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors ; Vitrectomy/adverse effects

PURPOSE: To analysis the epidemiology, distribution of age, and social welfare statue of low vision patients. METHODS: A retrospective analysis of age, visual acuity, underlying ocular disease, and optical aids of 102 patients who visited our clinic from March 2004 to March 2006. We had an interview with patients about their educational background, jobs and registration of legal blindness. RESULTS: The mean age was 40.87+/-22.72 years old and the patients in their forties were most common. The most frequent cause of low vision included optic atrophy (16.7%), macular degeneration (15.7%), retinitis pigmentosa (11.8%), congenital cataract (10.8%), glaucoma (6.9%), amblyopia (6.9%). 42 patients had already got the registration for legal blindness but, 41 patients were newly registered during this study. Under 20 years old, there were 17 general school students, 4 special school students, and 1 preschool child. Over 20 years old, there were only 14 patients who got regular job and all patients have educational attainment under high school graduate except 10 patients. CONCLUSIONS: The epidemiology of low vision has been changed to the aging society. And the registration of legal blindness criteria and understanding of low vision need to be changed. Moreover, understanding how low vision impacts lives is important to be able to provide better social services in the future.
Aging ; Amblyopia ; Blindness ; Cataract ; Child, Preschool ; Epidemiology ; Glaucoma ; Humans ; Macular Degeneration ; Optic Atrophy ; Retinitis Pigmentosa ; Retrospective Studies ; Social Welfare* ; Social Work ; Vision, Low* ; Visual Acuity ; Young Adult

PURPOSE: To evaluate the refractive outcomes using 5 different IOL power calculation formulas (SRK II, Holladay I, Hoffer Q, SRK T, Binkhorst II) in pediatric cataract patients. METHODS: A retrospective analysis of biometric and refractive data was performed on 63 eyes of 44 pediatric patients, who successfully underwent primary and secondary IOL implantation. For analysis, the eyes were divided into three groups: those with axial length <22.0 mm (group S); > or =22 mm but <24.5 mm (group M); and > or =24.5 (group L). And also divided into another three groups: those with mean keratomery value <42.5D (group I); > or =42.5D but <44.5D (group II); and > or =44.5D (group III). The postoperative refractive outcome was taken as a spherical equivalent of the refraction at 1 week and 2 to 3 months after surgery. The 'predictive error' was defined as absolute error between the target and actual postoperative refraction. RESULTS: SRK II had a best predictive error but there was no statically significant in short eye group and medium eye group at 1 week and 2 to 3 months after the surgery. And SRK II also had a best predictive error but there was no statically significant in group I, II, and III at 1 week and 2 to 3 months. CONCLUSIONS: In our study, theoretical formulas did not outperform the regression formula in pediatric IOL implantation. This may be related to the variability of the relationship between axial length and corneal curvature in pediatric eyes and to dependent variables inherited in the formulas.
Cataract ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Models, Theoretical ; Retrospective Studies

PURPOSE: A diagnosis of wooden intraorbital foreign bodies is common and their removal is often necessitated after complications become manifested. In case of operation, it is difficult to find and remove wooden foreign bodies completely. We have experienced a case of retained multiple intraorbital foreign bodies removed by the secondary operation. We report this case with a literature review. METHODS: A 39-year-old man visited our clinic complaining of diplopia, exophthalmos, and limitation of eyeball movement. He had fallen down and had a lacerated wound. Right after primary closure, he experienced strabismus, orbital cellulitis, and abscess. Several months later, he had a soft mass in the operated lower lid, and two wooden intraorbital foreign bodies were found. MRI detected granuloma and cellulitis near the cavernous sinus. RESULTS: More than ten intraorbital wooden foreign bodies were surgically removed. After the surgery exophthalmos and diplopia were improved, and limitation of eyeball movement disappeared. The MRI findings were also improved. CONCLUSIONS: Intraorbital wooden foreign bodies should be diagnosed with a thorough history taking and radiologic exam, due to a number of potential complications, such as orbital cellulitis, abscess, and diplopia. Furthermore, they should be removed in consideration that they can move spontaneously into the deep interior of the orbit.
Abscess ; Adult ; Cavernous Sinus ; Cellulitis ; Diagnosis ; Diplopia ; Exophthalmos ; Foreign Bodies* ; Granuloma ; Humans ; Magnetic Resonance Imaging ; Orbit ; Orbital Cellulitis ; Strabismus ; Wounds and Injuries

BACKGROUND: Several investigations have studied hypoxic pulmonary vasoconstriction (HPV) during endotoxemia and there is an increase in nitric oxide (NO) in pulmonary vessels. However, these studies yielded conflicting or at times contradictory results, since reference has been made to both enhancement and inhibition of HPV. Our objective was to determine the changes of hypoxic pulmonary vasoconstriction on the isolated blood-perfused lung of endotoxemic rats. METHODS: Pulmonary arterial pressure (PAP) was measured in a blood-perfused lung preparation from Sprague-Dawley rats in normoxia (21% O2, 5% CO2, balanced N2) and hypoxia (5% O2, 5% CO2, balanced N2). We studied the effect of normoxia and hypoxia in a control group, Escherichia coli lipopolysaccharide group (LPS) and LPS with N omega-nitro-L-arginine methyl ester group (L-NAME). RESULTS: The Baseline PAP was higher in LPS (15.0+/-4.0 mmHg) compared with control group (10.9+/-2.9 mmHg) and L-NAME (11.1+/-3.6 mmHg). In hypoxia, HPV was higher in L-NAME (109.6+/-100.2%) compared with control group (59.9+/-31.6%) and LPS (58.8+/-33.8%)(P<0.05). CONCLUSIONS: We conclude that NO is an important factor to impair HPV during endotoxemia.
Animals ; Anoxia ; Arterial Pressure ; Endotoxemia ; Escherichia coli ; Lung* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Rats* ; Rats, Sprague-Dawley ; Vasoconstriction*

To check expert opinion about the investigation system of medicine-related death, model for "Death Investigation Center" was suggested and related questionnaire were requested. Between 15 December 2009 and 5 April 2010, we sent e-mails of the questionnaire which asked the opinion for the new postmortem investigation system. We sent the questionnaire to 3,289 lawyers and 4,523 doctors (total 7812), and received 100 replies out of the total. All the lawyers and doctors interviewed knew the importance of the postmortem investigation system. Most of them (87%) agreed to the introduction of the new postmortem investigation system. Some of them thought that protector's agreement was necessary for the postmortem investigation (21%), and more doctors were likely to participate with legal protocol (23%). If the postmortem investigation could not be performed due to the protector's disagreement, another specialized medical investigation should be needed to figure out the cause of death (85%). The new postmortem investigation system should be performed by the specific institution, and supported by the government (44%). In many expert's opinion, nonmedical experts such as lawyers and priests should be included for the institution of investigation for objectivity and neutrality (72%). This sample study finds that the postmortem investigation performed by specialized institution is necessary to determine the cause of death in the hospital. For the operation of the system, neutrality and the operating core would be the most important.
Cause of Death ; Electronic Mail ; Expert Testimony ; Humans ; Lawyers ; Surveys and Questionnaires

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

PURPOSE: The effect of 0.2% cyclosporin A (CsA) as an adjuvant therapy after glaucoma-filtering surgery was the focus of this study. METHODS: A posterior lip sclerotomy was performed in 16 eyes of 8 rabbits, and 0.2% CsA was administered into the right eyes. The left eyes served as controls. The intraocular pressure (IOP) was measured 1, 3, 5, 7, 14, and 28 days after surgery. Hematoxylin-eosin (HE) and anti-bromodeoxyuridine (BrdU) immunocytochemical staining were performed at 1, 2, 4, and 8 weeks. RESULTS: The IOP at 7 and 14 days after surgery was lower in the 0.2% CsA group and statistically significant (P=0.047, P=0.48; respectively). HE staining did not show any difference between experimental and control eyes, but anti-BrdU staining showed a lower number of positive cells in the experimental eyes at 1 week. The fibroblast proliferation rate was significantly lower 1 week after surgery in the 0.2% CsA group (P=0.003). CONCLUSIONS: An effect of 0.2% CsA on early wound healing was observed. The data suggest that a low concentration of CsA can be useful when employed as adjuvant therapy in glaucoma filtering surgery.
Cyclosporine ; Eye ; Fibroblasts ; Filtering Surgery ; Glaucoma ; Intraocular Pressure ; Lip ; Pilot Projects ; Rabbits ; Wound Healing

BACKGROUND: The major risk factors such as hypercholesterolemia, hypertension, diabetes melitus and cigarrete smoking have not been studied in an attempt to provide a composition of major risk factors in Korea. Also we have met with some patients without major risk factors. METHODS: A Retrospective Study was done on 160 patients of acute myocardial infarction who had been admitted to National Medical Center within 48 hours from onset, from January 1948 to December 1992 and studied on major risk factors of acute myocardial infarction. RESULTS: 1) Among major risk factors, smoking was found in 50%, hypertension in 49%, diabetes in 25% and hypercholesterolemia in 21%. 2) The percentage of patients without major risk factors was 19%. 3) Among major risk factors, hypertension, hypercholesterolemia and diabetes were increasing tendencies, recentely. CONCLUSION: Some patients with acute myocardial infarction don't have any major risk factors. Also hypertension, hypercholesterolemia and diabetes were increasing tendencies. So further study for other risk factors is needed and preventive management should require a commitment to behavior modification and alteration in life-style.
Behavior Therapy ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking

PURPOSE: To compare conventional laser peripheral iridotomy (LPI) and LPI combined with laser peripheral iridoplasty in eyes with primary angle closure suspect (PACS) by assessment of anterior chamber dimensional changes using a Pentacam. METHODS: Forty-eight eyes of 24 subjects with bilateral PACS were recruited consecutively. Each eye was randomly allocated to treatment with conventional LPI, argon LPI only, or LPI plus iridoplasty, which consisted of simultaneous argon LPI and peripheral iridoplasty. Anterior chamber measurements were performed on each eye using a Pentacam, both before and after treatment. Mean anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle were measured, and topographic ACD analysis was performed. Results were compared between the two treatment groups. RESULTS: After treatment with either conventional LPI or LPI plus iridoplasty, the mean ACD and ACV increased significantly. Topographic ACD analysis revealed that the mid-to-peripheral ACD increase was significantly greater in the LPI plus iridoplasty group than in eyes treated with conventional LPI. Intraocular pressure changes and post-LPI complications did not differ between the groups. CONCLUSIONS: Compared with conventional LPI, our study showed that LPI plus iridoplasty improved the mid-to-peripheral ACD increase. This procedure may have a role as an adjunct for reducing angle closure by simultaneously eliminating pupillary and non-pupillary block components.
Adult ; Aged ; Anterior Chamber/*pathology/surgery ; Diagnostic Techniques, Ophthalmological/*instrumentation ; Equipment Design ; Female ; Follow-Up Studies ; Glaucoma, Angle-Closure/pathology/physiopathology/*surgery ; Gonioscopy ; Humans ; Intraocular Pressure ; Iridectomy/*methods ; Iris/pathology/*surgery ; Laser Therapy/*methods ; Lasers, Solid-State ; Male ; Middle Aged ; Prospective Studies ; Tonometry, Ocular