BACKGROUND: This study was conducted to compare the accuracy of computered tomography(CT) and sonography(US) in diagnosing acute appendicitis and to analyze the radiologic factors which influence the result. METHODS: We retrospectively studied the cases of 53 patients who were suspected of having appendicitis and who were examined by CT and US covered a three-year period. The final diagnosis was determined from the surgico-pathologic diagnosis and clinical follow-up for two months, as well as from the discharge diagnosis. RESULTS: Thirty-eight(38) patients had acute appendicitis; 15 patients did not. In the analysis, CT and US, respectively, revealed sensitivities of 89.5% and 73.7%, specificities of 93.3% and 60.0%, positive predictive values of 97.1% and 82.4%, negative predictive values of 77.8% and 47.4%. Among patients diagnosed with acute appendicitis, 10 patients were discordant in the US and the CT examinations; CT findings were correct in 8 and US findings in 2. Among non-appendicitis patients, 5 patients were discordant in the US and the CT examinations; CT was correct in 5 and US in 0. Nighteen(19) patients had complications such as an abscess or a perforation. Among these patients, the degree and the extent of the complication were accurately evaluated by CT in 15 patients and by US in 5 patients. CONCLUSION: CT is more accurate than US in diagnosing and excluding acute appendicitis. The use of CT will substantially decrease unnecessary laparotomies and post-operation complications.
Abscess ; Appendicitis* ; Diagnosis ; Follow-Up Studies ; Humans ; Laparotomy ; Retrospective Studies

PURPOSE: The present study investigates the patterns of internal optical aberrations in eyes with different types of cataract. METHODS: Eighty eyes of 70 cataract patients were included in the present study. Internal optical aberrations were measured with a KR-1W wavefront aberrometer before cataract operation. Types of cataract were classified into three groups; cortical, nuclear and posterior subcapsular cataracts. The differences in the results of the wavefront data of 6-mm pupil diameter zones were compared among three groups. The Kruskal-Wallis test and Mann-Whitney U test were used for comparing data. RESULTS: A total of 80 eyes consisting of 30 cortical cataracts, 30 nuclear cataracts and 20 posterior subcapsular cataracts were found. In the 6-mm pupil diameter zone, the average internal spherical aberrations by original value were 0.042 microm of cortical cataracts, -0.092 microm of nuclear cataracts and -0.109 microm of posterior subcapsular cataracts. The average internal spherical aberrations by absolute value were 0.122 microm of cortical cataracts, 0.533 microm of nuclear cataracts and 0.202 microm of posterior subcapsular cataracts. The internal spherical aberrations by original value were not statistically significantly different, but by absolute value were statistically significantly different (p = 0.003, Kruskal-Wallis test). Nuclear cataracts have a much higher positive or negative value than other cataract groups in the distribution of internal spherical aberrations by original value for each type of cataract. Other than this difference, the internal astigmatism and internal high order aberrations were not statistically significantly different. CONCLUSIONS: The change in internal spherical aberrations of nuclear cataract from the original value was larger than cortical and posterior subcapsular cataract. Therefore, nuclear cataracts have much higher positive or negative values than other cataract groups.
Astigmatism ; Cataract* ; Humans ; Pupil

PURPOSE: To introduce 2 cases of trichomegaly associated with the use of systemic epidermal growth factor receptor (EGFR) inhibitors for the treatment of lung cancer. CASE SUMMARY: An 82-year-old female visited our clinic for ocular pain in both eyes. She was suffering from metastatic lung cancer and was under daily treatment with gefitinib (Iressa(R), AstraZeneca, London, UK) for 6 months. On ophthalmologic examination, she presented with abnormally elongated eyelashes, hyperemic conjunctiva and dense corneal erosion. A 52-year-old male who was diagnosed with non-small cell lung cancer 7 months before and treated with erlotinib (Tarceva(R) OSI Pharmaceuticals, Inc., Melville, NY, USA) was referred to our clinic for injection and foreign body sensation in both eyes. Although there were no remarkable changes in eyelashes at the initial visit, long, curly, uneven eyelashes were observed after 3 months. CONCLUSIONS: Due to the increased use of EGFR inhibitors in anti-cancer treatment, ophthalmologists should be aware of these chemotherapeutics' adverse effects.
Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; Conjunctiva ; Eyelashes* ; Female ; Foreign Bodies ; Humans ; Lung Neoplasms ; Male ; Middle Aged ; Receptor, Epidermal Growth Factor ; Sensation ; Erlotinib Hydrochloride

PURPOSE: To evaluate the immediate effects of 3% diquafosol ophthalmic solution on tear MUC5AC concentration and corneal wetting property in rabbit eyes. METHODS: Six New Zealand white rabbits were used in the present study. Fifteen minutes after instilling 50 microL of 3% diquafosol into the right eye of each rabbit and 50 microL of saline into the left eye, corneal wetting property, tear MUC5AC concentrations and the area of periodic acid-Schiff (PAS)-stained conjunctival goblet cells were evaluated under general anesthesia using conjunctival impression cytology. Corneal wetting property was evaluated by measuring the duration from when the image of the microscopic light beam was clear on the corneal surface immediately after blinking to when the image began to blur. RESULTS: The mean time of corneal wetting property was 86.40 (+/- 17.90) seconds in the diquafosol group and 49.00 (+/- 6.35) seconds in the control group. There was a significant difference between the two groups (p = 0.043). The mean concentration of tear MUC5AC was significantly higher in the diquafosol group (18.21 +/- 1.52 ng/mL) than the control group (12.75 +/- 1.82 ng/mL; p = 0.028). Conjunctival impression cytology showed the area of PAS-stained conjunctival goblet cells was significantly lower in the diquafosol group (23.17 +/- 0.05%) than the control group (32.49 +/- 0.08%; p = 0.028). CONCLUSIONS: Immediately after instilling 3% diquafosol, corneal wetting property improved significantly. Also tear MUC5AC concentration, which was released from conjunctival goblet cells increased compared to saline.
Anesthesia, General ; Blinking ; Goblet Cells ; Rabbits* ; Tears

PURPOSE: To assess the changes in mean corneal refractive power (DeltaK) following pterygium surgery and to predict DeltaK in cases of combined cataract and pterygium surgery. METHODS: Thirty-seven eyes of unilateral pterygium patients who underwent pterygium surgery were analyzed retrospectively with at least more than 1 month of follow-up. Preoperative and postoperative 1 month corneal refractive power was measured using auto-keratometer (RK-F1, Canon, Tokyo, Japan). Pterygium horizontal extension, width, and area were measured and correlation with DeltaK before and after surgery analyzed. We also compared DeltaK of the contralateral normal eye. RESULTS: The mean corneal refractive (Km) power measured before and 1 month after surgery was 43.30 +/- 1.66 D and 44.07 +/- 1.42 D, respectively. The Km significantly increased at 4 weeks after surgery (p < 0.001). However, postoperative Km was not significantly different when compared with the contralateral normal eye (43.86 +/- 1.34 D; p = 0.59). All parameters of pterygium size including horizontal extension, width, and area were positively correlated with the mean DeltaK. Among parameters, horizontal extension was best correlated with mean DeltaK (p < 0.001). The mean DeltaK with horizontal extension was predicted using linear regression (2.5 mm to 1 D, 4.0 mm to 1.8 D). CONCLUSIONS: We recommend contralateral corneal refractive power or prediction of corneal refractive power using linear regression with pterygium horizontal extension for determining intraocular lens power in cases of combined cataract and pterygium surgery.
Cataract ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Linear Models ; Pterygium* ; Retrospective Studies

PURPOSE: To evaluate the objective amplitude of accommodation in various age groups using an autorefractometer and to compare the results with subjective assessments on accommodation. Objective accommodative amplitude of artificial lenses in post-operative cataract patients was also measured. METHODS: In this study, 41 patients who visited Korea University Guro Hospital from July through August 2014 were categorized into 6 different age groups. Accommodative amplitude was measured using long-distance refraction at 5 m and short-distance refraction at 20 cm. In 20 patients, subjective amplitude of accommodation was measured using the minus lens technique and was compared with the measured objective accommodative amplitude. Accommodative amplitude was also measured in 8 patients who received cataract surgery. RESULTS: The mean accommodative ability in normal people was 2.38 D. The age groups of 10-19, 20-29, 30-39, 40-49, 50-59, and over 60 years showed accommodative amplitudes of 3.31 +/- 0.99 D, 3.25 +/- 0.34 D, 3.78 +/- 0.68 D, 1.00 +/- 0.60 D, 0.22 +/- 0.23 D, 0.00 +/- 0.00 D, respectively. The results showed a rapid decrease in accommodative ability of patients older than 40 years and demonstrated a correlation between objective and subjective amplitude of accommodation (Pearson's correlation coefficient 0.838). There was a significant difference between objective and subjective accommodative amplitudes in artificial lenses (p = 0.015), with average objective and subjective measures of 0.10 +/- 0.23 D and 0.59 +/- 0.35 D, respectively. CONCLUSIONS: Measuring amplitude of accommodation using an autorefractometer can be useful in assessing results of presbyopia treatment.
Cataract ; Humans ; Korea ; Presbyopia

PURPOSE: To analyze the improvement of symptoms and signs of dry eye after surgical punctual occlusion and to evaluate the effects of secondary systemic disease in dry eye patients. METHODS: From March 2011 to July 2014, 15 eyes of 8 dry eye patients with a history of punctal plug insertion underwent surgical punctal occlusion. Schirmer test was measured based on mean 2.9 mm. The patients consisted of 4 dry eye patients with Sjogren's disease, 1 with rheumatoid arthritis, 1 with graft-versus-host disease (GVHD), and 2 with no secondary systemic disease. Preoperative and postoperative ophthalmic examinations of log MAR visual acuity, subjective symptoms, corneal staining (National Eye Institute [NEI] score), and tear break-up time (BUT) were performed and the effects of secondary systemic disease in dry eye patients were evaluated. The results of surgical punctual occlusion were analyzed. RESULTS: All patients showed a statistically significant improvement of log MAR visual acuity, subjective symptoms, corneal staining (NEI score), and tear BUT. The patients with rheumatoid-related diseases showed improved symptoms after surgery, but the patient with GVHD showed no significant improvement after surgery. Among the study patients, 80.0% showed completely closed punctum and 20.0% showed partial recanalization. CONCLUSIONS: Surgical punctal occlusion is an effective alternative in patients with severe aqueous deficient dry eye who show recurrent punctal plug loss or complications associated with punctal plugs.
Arthritis, Rheumatoid ; Graft vs Host Disease ; Humans ; Sjogren's Syndrome ; Tears ; Visual Acuity

PURPOSE: We estimated scattered radiation doses to the patients and medical practitioneer and revealed risk factors associated with increasing radiation doses during extracorporeal shock wave lithotripsy(ESWL). MATERIALS AND METHODS: At first, we measured radiation doses 2 times using thermoluminescence dosimeter to simulative patients and medical practitioneer without any shield during 10 minutes of ESWL and determined mean radiation dose/minute. From June to August 2007 at our institution, we prospectively measured radiation exposured time during respective ESWL for treatment of urinary stones. Thereafter, we calculated practical radiation doses to patients and medical practitioneer from respective mean radiation dose/minute. We also analyzed which factors were associated with increasing radiation doses. RESULTS: A total of 50 ESWL were analyzed from 38 patients. Mean radiation dose/minute to simulative patients and medical practitioneer was 16.20, 0.006mSv respectively. At 1 time ESWL, median radiation exposured time was 360 seconds(130-980), therefore, median radiation dose to patients and medical practitioneer was calculated as 97.20mSv(35.10-264.60), and 0.04mSv(0.01-0.08) respectively. Larger stone size had a correlation with increasing radiation dose and additional pain control group had higher radiation dose than otherwise. CONCLUSIONS: During ESWL, patients were relatively exposed to high radiation which were roughly corresponded to that of 3 times of computed tomography. But the radiation dose to medical practitioneer was insignificant consider international guideline. Medical practitioneer should be aware of radiation hazard and try to minimize radiation dose to the patients at the time of ESWL.
Humans ; Lithotripsy ; Prospective Studies ; Risk Factors ; Shock ; Urinary Calculi

PURPOSE: Warm compression using a commercial heat pad was used to evaluate the effects of temperature on the eyelids and tear film lipid layer thickness. METHODS: Targeting 13 patients (26 eyes) with non-specific eye disease such as dry eye syndrome or Meibomian gland dysfunction, we measured the average thickness of the tear film lipid layer in both eyes with the LipiView 2® System (Tearscience®, Morrisville, NY, USA). We performed warm compression on the right eye only in order to evaluate the effectiveness of massage and measured the temperature of the right eye lid immediately, 3 minutes, and 5 minutes after compression in order to compare with the untreated left eye. After warm compression for 5 minutes, we measured tear film lipid layer thickness of both eyes and analyzed the effectiveness of warm compression. RESULTS: The average tear film lipid layer thickness was 55.1 ± 21.0 nm in the right eyes and 53.9 ± 13.9 nm in the left eyes (p = 0.474). Before performing the warm compression, the temperature of the right eye lid was 53.9 ± 13.9 nm, and that of the left was 35.9 ± 0.2℃. The eye lid temperature of the right eye immediately, 3 minutes, and 5 minutes after warm compression was 40.3 ± 1.3℃, 40.3 ± 1.3℃, and 40.3 ± 1.9℃, respectively, and these temperatures were relatively constant during the massage. Tear film lipid layer thickness after warm compression in the right eye was 83.5 ± 18.8 nm, which was increased compared to the original temperature (p = 0.001) and showed significant difference compared with the 65.5 ± 27.1 nm in the left eye (p = 0.005). CONCLUSIONS: Warm compression increased the tear film lipid layer thickness and showed a relatively constant increased temperature of 40.3℃ over 5 minutes. This technique will be helpful for maintaining tear film lipid layer thickness in patients with Meibomian gland dysfunction.
Dry Eye Syndromes ; Eye Diseases ; Eyelids* ; Hot Temperature ; Humans ; Massage ; Meibomian Glands ; Tears*

PURPOSE: Warm compression using a commercial heat pad was used to evaluate the effects of temperature on the eyelids and tear film lipid layer thickness. METHODS: Targeting 13 patients (26 eyes) with non-specific eye disease such as dry eye syndrome or Meibomian gland dysfunction, we measured the average thickness of the tear film lipid layer in both eyes with the LipiView 2® System (Tearscience®, Morrisville, NY, USA). We performed warm compression on the right eye only in order to evaluate the effectiveness of massage and measured the temperature of the right eye lid immediately, 3 minutes, and 5 minutes after compression in order to compare with the untreated left eye. After warm compression for 5 minutes, we measured tear film lipid layer thickness of both eyes and analyzed the effectiveness of warm compression. RESULTS: The average tear film lipid layer thickness was 55.1 ± 21.0 nm in the right eyes and 53.9 ± 13.9 nm in the left eyes (p = 0.474). Before performing the warm compression, the temperature of the right eye lid was 53.9 ± 13.9 nm, and that of the left was 35.9 ± 0.2℃. The eye lid temperature of the right eye immediately, 3 minutes, and 5 minutes after warm compression was 40.3 ± 1.3℃, 40.3 ± 1.3℃, and 40.3 ± 1.9℃, respectively, and these temperatures were relatively constant during the massage. Tear film lipid layer thickness after warm compression in the right eye was 83.5 ± 18.8 nm, which was increased compared to the original temperature (p = 0.001) and showed significant difference compared with the 65.5 ± 27.1 nm in the left eye (p = 0.005). CONCLUSIONS: Warm compression increased the tear film lipid layer thickness and showed a relatively constant increased temperature of 40.3℃ over 5 minutes. This technique will be helpful for maintaining tear film lipid layer thickness in patients with Meibomian gland dysfunction.
Dry Eye Syndromes ; Eye Diseases ; Eyelids* ; Hot Temperature ; Humans ; Massage ; Meibomian Glands ; Tears*