The aim of this study was to examine the effect of phase I cardiac rehabilitation program (CRP) on physical capacity in patients with coronary artery bypass graft (CABG). Eighty seven patients who underwent CABG in our hospital were enrolled on the study. Among them, excluding 17 during the study, the results of 70 patients were included in the final data. Subjects were classified into two groups according to the participation in the phase I CRP; participation group (n=35) and non-participation group (n=35). The CR was executed for the participation group until patients' discharge. The variables including resting heart rate (RHR), oxygen saturation, walking distance in 6 minutes, and forced expiration amount were measured at initial phase, discharge and follow-up at 1 month after discharge. From the data, descriptive statistics (mean, standard deviation) were calculated, and differences in each variable before, during, after the treatment and between groups were tested using repeated measure analysis of variance using SPSS ver. 18.0 statistics program for Window. For the effects and results with a statistical significance, post-hoc test was made using t-test. There was statistically significant difference (p<0.05) in the RHR and the walking distance in 6 minutes. While there was no significant difference in the oxygen saturation and the maximum expiration amount. As conclusion, the Phase I CRP after CABG showed a effect on the significant improvement of physical capacity by decreasing the RHR and increasing the walking distance in 6 minutes, exerting a positive influence on the recovery after the CABG operation.
Coronary Artery Bypass ; Coronary Vessels ; Follow-Up Studies ; Heart ; Heart Rate ; Humans ; Oxygen ; Transplants ; Walking

PURPOSE: To report a case of epidemic keratoconjunctivitis complicated by Alcaligenes xylosoxidans. METHODS: A 37-year-old man suffered epidemic keratoconjunctivitis in both eyes. Eleven days later, he developed a corneal ulcer in his left eye. Bacterial staining, culture, and antibiotics sensitivity test were performed from a corneal scrape. RESULTS: The cultures revealed a growth of Alcaligenes xylosoxidans, and the patient was treated with ceftazidime and levofloxacin, based on the sensitivity test results. After 21 days of treatment, the infection was resolved with mild scaring and final vision in the left eye of 20/20. CONCLUSIONS: Alcaligenes xylosoxidans should be considered a rare but potential pathogen able to produce corneal ulcer complication in epidemic keratoconjunctivitis.
Male ; Keratoconjunctivitis/*complications/pathology ; Humans ; Gram-Negative Bacterial Infections/*complications/pathology ; Corneal Ulcer/*microbiology/pathology ; Adult ; *Achromobacter denitrificans

PURPOSE: To evaluate the intraocular pressure (IOP) -lowering efficacy of latanoprost in normal-tension glaucoma (NTG). METHODS: One-hundred and seventeen eyes of 63 NTG patients treated with 0.005% latanoprost once a day were enrolled in this study. Of these, 85 eyes of 47 patients were treated for 12 months. Mean IOPs were analyzed, and the mean IOP reductions from the untreated baseline were assessed after two weeks and after 1, 3, 6, 9, and 12 months of treatment. RESULTS: The mean untreated baseline IOP was 15.0+/-2.7 mmHg. After two weeks of latanoprost treatment, the mean IOP reduction from the baseline value was 2.6+/-0.2 mmHg (17.3%, p< 0.05), and after 6 and 12 months, the reduction was 2.4+/-0.2 mmHg (16.0%, p< 0.05) and 2.4+/-0.2 mmHg (16.0%, p< 0.05), respectively. Patients with a baseline IOP of > or=15 mmHg achieved significantly higher IOP reductions than those with a baseline IOP of < 15 mmHg at all follow-ups (p< 0.05). CONCLUSIONS: Latanoprost was found to be well tolerated and to significantly reduce IOP in NTG patients.
Treatment Outcome ; Time Factors ; Retrospective Studies ; Prostaglandins F, Synthetic/administration & dosage/*therapeutic use ; Middle Aged ; Male ; Intraocular Pressure/*drug effects/physiology ; Humans ; Glaucoma, Open-Angle/*drug therapy/physiopathology ; Follow-Up Studies ; Female ; Dose-Response Relationship, Drug ; Antihypertensive Agents/administration & dosage/*therapeutic use ; Aged, 80 and over ; Aged ; Adult

PURPOSE: To present a case of inflammatory myofibroblastic tumor which was manifested as an idiopathic subretinal mass without underlying pathology. METHODS: The subretinal mass was surgically excised and evaluated histopathologically. Fluorescein angiography and optical coherence tomography were performed pre- and post-operatively. RESULTS: The mass was histologically composed of lymphoplasma cell infiltration and fibrous proliferation without microorganisms or malignant cells. Immunohistochemistry for smooth muscle actin revealed myofibroblasts as a major cellular component. Preoperative optical coherent tomography showed that the lesion was contiguous to the retina while inducing foveal detachment. Postoperatively, the fovea was attached with visual recovery, and the subretinal lesion did not recur during the follow up. CONCLUSIONS: Inflammatory myofibroblastic tumors may be included in the differential diagnoses of subretinal masses.
Tomography, Optical Coherence ; Retina/pathology ; Neoplasms, Muscle Tissue/diagnosis/*pathology ; Male ; Inflammation/pathology ; Humans ; Fundus Oculi ; Fluorescence ; Eye Neoplasms/*pathology ; Choroid/pathology ; Atrophy ; Angiography ; Adult

PURPOSE: To analysis the chronological changes of surgical strategy for early gastric cancer (EGC) in our hospital over a 10-year period. METHODS: From November 1993 to August 2003, we experienced 201 patients with EGC at Ewha Womans University Mokdong Hospital. The medical and pathologic records of these patients were reviewed retrospectively. The patients were categorized into three groups in chronological order: P1 (1993~1996), P2 (1997~2000), and P3 (2001~2003). The clinicopathological characteristics and treatment modalities among these three groups were compared. RESULTS: Of the 683 gastric cancer patients, 201 patients (29.7%) were pathologically confirmed to have EGC. The proportion of EGC gradually increased in chronological order: 19.2% in P1, 33.2% in P2 and 32.9% in P3. There were no significant differences in clinicopathological characteristics among three groups, including age, sex, location, size, gross type, histology, depth of invasion, and lymph node metastasis. Open surgery was performed in 134 patients, laparoscopic surgery in 52 and endoscopic mucosal resection (EMR) in 15. The proportion of minimally invasive surgery such as EMR, laparoscopic wedge resection, laparoscopy- assisted distal gastrectomy (LADG), and hand-assisted laparoscopic surgery (HALS) increased in chronological order: 0% in P1, 22.4% in P2 and 58.5% in P3. The postoperative mortality was 1.49% (3/201): 2 cases after open surgery, and 1 case after laparoscopic wedge resection. One case after open conventional surgery recurred. There were no significant difference in postoperative complication, postoperative mortality and survival rate among the three groups. Overall 5-year survival rate was 95.4%. CONCLUSION: The proportion of minimally invasive surgery increased during a 10-year period in our hospital. However, there were no significant differences in postoperative complication, postoperative mortality, recurrence rate, and survival rate among three chronological groups.
Female ; Gastrectomy ; Hand-Assisted Laparoscopy ; Humans ; Laparoscopy ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Surgical Procedures, Minimally Invasive ; Survival Rate

BACKGROUND: Myocardial contrast two-dimensional echocardiography(MC-2DE) has been known to have the real time capabilities for repeat in vivo assessment of ischemic risk areas and for evaluation of the myocardial perfusion. The aims of this investigation are (1) to evaluate the feasibility of MC-2DE for the delineation and quantitation of the area at risk. (2) to determine the relationship between the extent of the echocontrast defect area(EDA) during reperfusion and the size of myocardial infarction as determined by post-mortem tissue examination, and (3) to observe serial changes in the time echo-intensity characteristics of MC-2DE during coronary occlusion and reperfusion. METHODS: Myocardial contrast echocardiographic images were made by injecting bolus 5mL of two-syringe-agitated mixture of sodium meglumine ioxaglate(Hexabrix(R)) and normal saline(2 : 3 by volume) into the aortic root before and during coronary occlusion of the left anterior descending coronary artery, distal to the first diagonal branch and during reperfusion on eight open-chest dogs. Two-dimensional echocardiographic short axis views were obtained at four anatomic levels : the apex, the low papillary muscle, the high papillary muscle and the mitral valve. The changes in EDA and echo-intensity with its wash-out half time(WHT) at the high papillary muscle level during coronary occlusion and reperfusion were measured every 15 minutes. The total EDA was measured by planimetry at 3 minutes after coronary occlusion and at 60 minutes after reperfusion. Evans blue or methylene blue were used for the measurement of the anatomic area at risk and triphenyl-tetrazolium chloride(TTC) for the measurement of the infarct area. RESULTS: The EDA measured 30 minutes after coronary occlusion(19.6%) was smaller than that at 3 minutes after coronary occlusion(24.0%, p<0.01). Then EDA at 3 minutes occlusion was strongly predictive of the anatomic extent of area at risk(EDA=0.48 Area at risk+16.95, r=0.84, p<0.05). The EDA at 60 minutes after reperfusion, which showed an irregular margin and was located within the subendocardium of the area at risk, also correlated well with the infarct area(IA)(EDA=0.78 IA+3.32, r=0.82, p=0.09). The peak echo-intensity in the ischemic area during coronary occlusion was significantly low(14.2+/-6.5 vs 73.8+/-31.7 in the non-ischemic area, p<0.01) and the WHT was delayed more in the ischemic area than in the non-ischemic area(23.2+/-2.8 sec vs 8.1+/-3.3sec, p<0.01). During the period of reperfusion, WHT in the previously ischemic area was markedly delayed compared to that in the non-ischemic area (p<0.01), although the peak echo-intensity in the ischemic area at 3 minutes after reperfusion increased modestly compared to that in the non-ischemic area(80.9+/-22.8 vs 72.7+/-8.4), suggesting the impairment in the transit of microbubbles is probably due to microvascular damage after reperfusion. There were no adverse hemodynamic or electrocardiographic effects after injection of the contrast agent. CONCLUSIONS: These findings suggest that myocardial contrast echocardiography was useful as a non-invasive technique, first, to delineate the area at risk in vivo during coronary occlusion and, after reperfusion, the infarct area, and secondly, to evaluate indirectly the state of myocardial perfusion during coronary occlusion and reperfusion.
Animals ; Axis, Cervical Vertebra ; Coronary Occlusion* ; Coronary Vessels ; Dogs ; Echocardiography* ; Electrocardiography ; Evans Blue ; Hemodynamics ; Meglumine ; Methylene Blue ; Microbubbles ; Mitral Valve ; Myocardial Infarction ; Papillary Muscles ; Perfusion* ; Reperfusion* ; Sodium

PURPOSE: To evaluate corneal biomechanical properties in eyes that had previously undergone penetrating keratoplasty (PK) using the ocular response analyzer (ORA). METHODS: We recruited 26 patients who had received unilateral PK. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and cornea-compensated intraocular pressure (IOPcc) were measured with the ORA and were compared to the measurements from the contralateral eyes that did not undergo PK. RESULTS: The CH was 8.95+/-2.59 mmHg in eyes that underwent PK and 9.78+/-1.45 mmHg in the contralateral eyes that did not undergo PK (p=0.077). The CRF was 10.26+/-2.64 mmHg in post-PK eyes and 9.75+/-1.45 mmHg in the contralateral eyes (p=0.509), and the CH-CRF was significantly smaller in post-PK eyes (-1.31+/-2.32 mmHg in post-PK eyes vs. 0.03+/-0.88 mmHg in fellow eyes, p=0.016). The IOPg and IOPcc were significantly higher in the PK group than they were in the control group. The IOPcc's were 20.81+/-7.81 mmHg and 16.27+/-2.49 mmHg in post-PK and control eyes, respectively (p=0.011); and the IOPg's were 19.22+/-7.34 mmHg and 15.07+/-3.03 mmHg in post-PK and control eyes, respectively (p=0.019). The IOPcc-g's were 1.59+/-2.81 mmHg and 1.21+/-1.30 mmHg in post-PK and control eyes, respectively (p=0.412), and the central corneal thickness (CCT)'s were 489.11+/-90.60 microm and 556.24+/-42.84 microm in post-PK and control eyes, respectively (p=0.068). CONCLUSIONS: Following PK, CH tended to decrease while CRF tended to increase, significantly decreasing CH-CRF. A significantly higher intraocular pressure and a thinner CCT following PK may have contributed to the observed changes in these corneal biomechanical parameters.
Adolescent ; Adult ; Aged ; Cornea/*physiopathology ; *Diagnostic Techniques, Ophthalmological ; Elasticity ; Female ; Humans ; Intraocular Pressure ; *Keratoplasty, Penetrating ; Male ; Middle Aged ; Postoperative Period ; Young Adult

PURPOSE: To evaluate the clinical features, associated factors, and treatment outcomes of scleritis in the Korean population. METHODS: Medical records were retrospectively reviewed for 94 eyes of 76 patients with scleritis. Clinical features of scleritis, including systemic disease, presence of microorganisms, serologic markers, history of previous ocular surgery, and use of immunosuppressants were investigated and compared amongst the subtypes of scleritis. Treatment outcomes were evaluated using best corrected visual acuity (BCVA) and time to scleritis remission. RESULTS: Nodular scleritis was the most common form observed, followed by necrotizing scleritis with inflammation, diffuse scleritis, and necrotizing scleritis without inflammation, respectively. A total of 16 of 76 patients (21.1%) had connective tissue diseases. Eleven cases (14.5%) had infectious scleritis, of which bacteria (54.5%) and fungi (45.5%) were the causative microorganisms. Thirty-three patients (43.4%) had previous ocular surgery, mostly pterygium excision. Notably, a history of pterygium excision was significantly associated with development of necrotizing and infectious scleritis (odds ratio [OR], 399 and 10.1; p < 0.001 and 0.002, respectively). In addition, patients with necrotizing scleritis were more likely to have infectious scleritis (OR, 11.7; p = 0.001). BCVA after treatment and time to remission also showed significant differences among the different scleritis subtypes. Systemic immunosuppression was required in addition to steroids for treating diffuse and necrotizing scleritis. CONCLUSIONS: Careful taking of patient history including previous pterygium excision should be performed, especially in patients with necrotizing and infectious scleritis. In addition, evaluation of microbiological infection can be crucial for patients with necrotizing scleritis and history of pterygium excision.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; *Asian Continental Ancestry Group ; Bacterial Infections ; Child ; Eyeglasses ; Female ; Humans ; Male ; Medical Records ; Middle Aged ; Mycoses ; Postoperative Period ; Pterygium/surgery ; Retrospective Studies ; Scleritis/classification/ethnology/*etiology/*surgery ; Treatment Outcome ; Visual Acuity ; Young Adult

PURPOSE: To report three cases of corneal power estimation for intraocular lens power calculation using Orbscan II videokeratography in eyes with previous corneal refractive surgeries. CASE SUMMARY: In three eyes of three patients with previous corneal refractive surgeries, corneal power values were respectively measured at three, four, five, six mm-diameter zones of total mean, axial, tangential, and optical maps using Orbscan II videokeratography. Then, intraocular lens power values were calculated via the SRK/T formula. After cataract surgeries, back-calculated corneal power (BCK) values were estimated from post-phacoemulsification refraction data, and compared with those measured at three, four, five, six mm-diameter zones of each map in Orbscan II videokeratography. The postoperative refractive values after cataract surgeries were achieved within 1.5D of the target refraction in all eyes by using five mm total axial power and four mm total optical power for intraocular lens power calculation. Orbscan II parameters including three mm, four mm total axial power, and three mm total optical power were the least different from the BCK (0.69+/-0.49D, 1.08+/-0.54D, and 1.10+/-0.44D, respectively). CONCLUSIONS: If historical data are not available, Orbscan II videokeratography can be useful for estimating corneal power for intraocular lens power calculations in patients with previous corneal refractive surgeries.
Cataract ; Corneal Topography ; Eye ; Humans ; Lenses, Intraocular ; Refractive Surgical Procedures

PURPOSE: To evaluate the results of frontalis sling operation using silicone rod in congenital ptosis patients. METHODS: The authors retrospectively investigated the surgical results of congenital ptosis patients who underwent frontalis sling operation using silicone rod and were followed up for at least 12 months postoperatively. We compared their results with those of congenital ptosis patients who underwent frontalis sling operation using preserved fascia lata. RESULTS: Twenty nine patients were included in the silicone rod group and 81 in the preserved fascia lata group. The average age at operation was 70.5 months in the silicone rod group, and 62.2 months in the preserved fascia lata group. At 12-month follow-up, good lid height was achieved in 9 patients (31.0%), fair in 17 (58.6%), and poor in 3 (10.4%) among the 29 patients of the silicone rod group. Of the 81 patients with preserved fascia lata, 22 (27.2%) were good, 44 (54.3%) were fair, and 15 (18.5%) were poor at postoperative 12 months. Chronic exposure keratopathy occurred postoperatively in one patient of the preserved fascia lata group and early recurrence due to spontaneous break of silicone rod developed in one patient of the silicone rod group. CONCLUSIONS: At 12-month follow-up, frontalis sling operation using silicone rod showed equal or better results compared with the operation using preserved fascia lata. However, longer follow-up is required to confirm the long-term results of frontalis sling operation using silicone rod.
Blepharoptosis* ; Fascia Lata ; Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Silicones*