No abstract available.
Graves Disease* ; Humans ; Thyroid Gland*

PURPOSE: To assess the usefulness of two spectral domain optical coherence tomography (SD-OCT) instruments (Cirrus(R), Spectralis(R)) for evaluating optic nerve head and peripapillary structures. METHODS: Images of optic nerve complex were obtained from 136 eyes of 136 patients using enhanced depth imaging technique of 2 SD-OCT instruments. Optic nerve head and peripapillary structures were investigated for their visibility and morphological features in total eyes and glaucomatous eyes. Effect factors for laminar thickness measurement were evaluated and the reproducibility of the lamina cribrosa thickness measured by the 2 OCT instruments was analyzed. RESULTS: Lamina cribrosa thickness was better identified using Spectralis(R) OCT in total and glaucomatous eyes. Short posterior ciliary artery (in total eyes) and peripapillary choroid (in total and glaucomatous eyes) were also better identified using Spectralis(R) OCT (p < 0.001). A cup-disc ratio < or = 0.6 was the significant effect factor for laminar thickness measurement (p < 0.05). Interobserver reproducibility was excellent using both OCT instruments. Intraobserver reproducibility was excellent using Spectralis(R) OCT and moderate using Cirrus(R) OCT. CONCLUSIONS: Spectralis(R) OCT was better for visualizing optic nerve head and peripapillary structures and showed better reproducibility than Cirrus(R) OCT. Thus, the Spectralis(R) may be helpful for detecting and understanding features of the optic nerve complex.
Choroid ; Ciliary Arteries ; Glaucoma ; Humans ; Optic Disk ; Optic Nerve* ; Tomography, Optical Coherence*

PURPOSE: The present study investigates the seasonal variations of acute angle-closure glaucoma in patients visiting the hospital. METHODS: Eighty-seven patients (94 eyes) who underwent laser iridotomy were retrospectively analyzed over 5 years. Monthly and seasonal variations were investigated and the difference in seasonal variations according to sex, age, and inhabited area were inspected. RESULTS: When evaluating monthly variations, acute angle-closure glaucoma occurred mostly in January (13.8%). Incidence of glaucoma was the highest in winter (29.9%), decreased in spring and summer (26.4%) and was lowest in autumn (17.2%). In big cities, the incidence trend was highest in spring (31.8%), lowest in autumn (19.7%) and slightly elevated in winter (27.3%). However, in small cities and rural areas, the incidence was highest in summer (42.9%) and winter (38.1%). There were significant differences between inhabited areas. CONCLUSIONS: Among the patients, seasonal incidence of acute angle-closure glaucoma was the highest in winter and decreased as autumn approached. There were differences of incidence between inhabited areas.
Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Incidence ; Retrospective Studies ; Seasons

OBJECTIVE: Cognitive dysfunction is an important factor on functional recovery after stroke. This study investigated the relationship between functional outcome and cognitive status during rehabilitation after stroke. METHOD: This retrospective study included 80 patients with rehabilitation program after first-ever stroke. The independent variables were mini-mental status examination (MMSE) and computerized neurocognitive function test (CNT). The dependent variables were modified Barthel index (MBI), Berg balance scale (BBS), National Institute of Health Stroke Scale (NIHSS) and discharge destination. The correlation analysis was applied. RESULTS: Mean interval from onset to rehabilitation program was 29.5 days and duration of inpatient rehabilitation program was 31.1 days. Mean score of initial MMSE was 20.5 and CNT showed abnormal performance in at least one of the domain specific tests in all patients. The scores of MMSE, MBI, NIHSS and BBS were improved after rehabilitation program (p<0.05). Cognitive improvement contributing to the functional recovery were significant in the early participants in rehabilitation and in older patients (p<0.05). The home-discharge group demonstrated higher scores in executive function tests (p<0.001). Visual attention, visual working memory and reasoning revealed significant correlation with the MBI score at discharge. CONCLUSION: The results of present study suggest that cognitive function, especially attention and working memory, is a predictor of functional outcome after stroke rehabilitation.
Cognition ; Executive Function ; Humans ; Inpatients ; Memory, Short-Term ; Recovery of Function ; Retrospective Studies ; Stroke

Objective: A retrospective study was performed to evaluate the usefulness of the delta neutrophil index as a prognosticfactor for mortality in intensive care unit patients admitted via the emergency department. Methods: Patients, who presented to the emergency department and were admitted to the intensive care unit fromJanuary 2018 to August 2018, were reviewed retrospectively. The clinical features, inflammatory marker levels, such asC-reactive protein, lactate, simplified acute physiology score 3, length of stay, and in-hospital mortality were obtainedfrom the medical records. Patients, who visited the emergency department because of trauma or suicidal attempts,arrived after out-hospital cardiac arrest, or were diagnosed with cerebrovascular disease, were excluded. Results: Of the 310 patients included, 65 died during their admission, and 245 patients were discharged after treatment.The receiver operating characteristic curve showed that the delta neutrophil index (area under curve [AUC], 0.72), Creactiveprotein (AUC, 0.70), lactate (AUC, 0.64), and simplified acute physiology score 3 (AUC, 0.79) indicated a lowpredictive power for in-hospital mortality. Whole patients were divided into four subgroups (infectious diseases, cardiovasculardiseases, gastrointestinal bleeding diseases, and others). The receiver operating curve of delta neutrophil indexrevealed infectious diseases (AUC, 0.65), in cardiovascular diseases (AUC, 0.70), and gastrointestinal bleeding diseases(AUC, 0.79). Conclusion The role of the delta neutrophil index for predicting the prognosis of in-hospital mortality showed equally lowpredictive power for critically ill patients with the C-reactive protein and lactate.

Objective: This study examined the predictive factors to decide the surgical treatment for clinically suspected pediatric acute appendicitis with equivocal imaging findings. Methods: This study was conducted retrospectively on children who visited local emergency medical centers and outpatients from January 2018 to February 2021. The electronic medical records were reviewed from 811 pediatric patients younger than 16 years of age with the chief complaint of abdominal pain and who underwent an imaging test for the clinical suspicion of appendicitis. Ninety-two patients who showed ambiguous findings on imaging tests but were still suspected of having appendicitis were analyzed. Recursive partitioning analysis and multivariable logistic regression were used to identify the variables associated with appendicitis. Results: Of the 92 enrolled patients, 23 patients were confirmed to have appendicitis, and 69 did not. Patients with the clinical suspicion who had an elevated white blood cell (WBC) count, polymorphonuclear leukocyte differential count (PMN), absolute neutrophil count (ANC), and leukocytosis were more likely to have appendicitis. The PMN (odds ratio=1.175; 95% confidence interval, 1.092-1.265) and ANC (odds ratio=1.00050; 95% confidence interval, 1.00025-1.00075) remained significant after multivariable logistic analysis. Conclusion Elevated PMN and ANC are clinical predictors of pediatric appendicitis when the imaging findings are nondiagnostic, and the clinical suspicion is continuous.

There has been no standard therapy for patients with metastatic colorectal cancer who have failed to first-line fluorouracil-based treatment. The present study was designed to assess the efficacy and toxicities of a combination of oxaliplatin, 5-fluorouracil (5-FU) and leucovorin in fluoropyrimidine-pretreated patients with metastatic colorectal cancer. Chemotherapy consisted of oxaliplatin 85 mg/m2 on day 1, followed by leucovorin 20 mg/m2 and 5-FU 1,200 mg/m2 on days 1 and 2. Treatment courses were repeated every two weeks. Thirty-nine patients were enrolled in this study. All patients previously received fluoropyrimidine-based chemotherapy. Thirty-one patients were assessable for response and 33 for treatment toxicity. Six patients required dose reduction of 5-FU due to grade III/IV cytopenia. Nausea/vomiting and peripheral neuropathy were common non-hematologic toxicities. Overall response rate was 42.0% including 3 complete response and 10 partial response. The median response duration was 91 days (range, 28-224+). The median duration of progression-free survival was 132 days (range, 40-308). A combination of oxaliplatin, 5-FU, and leucovorin showed high response rate in fluoropyrimidine-pretreated patients with metastatic colorectal cancer, but the duration of response was relatively short. It may be worthwhile to explore its therapeutic potential in the first-line treatment setting.
Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use* ; Antineoplastic Agents, Combined/adverse effects ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/drug therapy* ; Disease-Free Survival ; Female ; Fluorouracil/administration & dosage ; Human ; Leucovorin/administration & dosage ; Male ; Middle Age ; Organoplatinum Compounds/administration & dosage