Central neurogenic hyperventilation (CNH) is a rare condition that characterized by an increase in the rate and depth of respiration to an extent that produces advanced respiratory alkalosis due to various central nervous disorder. The mechanism of CNH remains unclear. We reported a case of CNH in patients with progressive ischemic stroke in pons, including parabrachial nucleus, which is thought to have disrupted inhibitory impulses to the medullary respiratory center.

In stroke patients, upper extremity deep vein thrombosis (UEDVT) is uncommon compared with lower extremity. Unlike the blood stasis in lower extremity, UEDVT has been developed by secondary cause. We reported a case of stroke patient with repeated UEDVT, presenting superficial venous congestion, who was finally diagnosed with pulmonary adenocarcinoma. The cause of stroke was non-bacterial thromboembolism formed at the mitral valve. Our case shows that unexpected UEDVT should be closely evaluated for higher coagulable status such as a malignancy.

Purpose: To compare the effect on changes in anterior chamber depth (ACD) and refractive error between subjects after combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe and control subjects after combined phacovitrectomy without posterior capsulotomy. Methods: A total of 20 eyes of 20 subjects who underwent combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe were compared with 20 eyes of 20 control subjects who underwent only phacovitrectomy without posterior capsulotomy. The ACD was measured with Scheimpflug imaging (Pentacam ® ; OCULUS Optikgeräte GmbH, Wetzlar, Germany) before and after surgery. Also the preoperative desired refraction and postoperative refraction were compared using an auto keratorefractometor. Results: The preoperative ACD of subjects with posterior capsulotomy was 2.56 ± 0.233 mm. The ACD was 3.54 ± 0.366 mm and 3.71 ± 0.424 mm at one and three months after surgery in subjects with posterior capsulotomy. The preoperative ACD of subjects without posterior capsulotomy was 2.53 ± 0.204 mm. The ACD was 3.09 ± 0.197 mm and 2.95 ± 0.295 mm at one and three months after surgery in subjects without posterior capsulotomy. There was no significant difference between the two groups in preoperative ACD, but ACD at one and three months after surgery was significantly different between the two groups.The desired refractory error was -0.32 ± 0.124 D in subjects with posterior capsulotomy, and -0.33 ± 0.142 D in the control group.The postoperative refraction was -0.62 ± 0.132 D in patients who underwent phacovitrectomy with posterior capsulotomy, and -0.91 ± 0.292 D in the control group. There was a significant difference in refraction three months after the surgery. Conclusions Combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe may be a useful way to prevent myopic change caused by anterior migration of an intraocular lens compared with control subjects, without posterior capsulotomy, for three months after surgery.

Purpose: To evaluate the correlation between visual acuity (VA) and the disorganization of retinal inner layers (DRIL) after use of an intravitreal dexamethasone implant to treat diabetic macular edema (DME). Methods: The clinical records of 25 patients with DME treated with an intravitreal dexamethasone implant were reviewed. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography data were analyzed from each visit. Results: The BCVAs at 1 month and 3 months after treatment were statistically significant with respect to the baseline BCVA of DME patients (p = 0.021, p < 0.001, respectively); however no statistically significant change was evident at the 6 months follow-up (p = 0.062). Also, the DRIL degree at 1 month and 3 months after treatment was statistically significant with respect to baseline DRIL (p = 0.034, p < 0.001); however, there was no statistically significant change at 6 months after treatment (p = 0.052). The BCVA at 6 months after treatment was positively and significantly correlated with the baseline BCVA (p < 0.001, R2 = 0.705), CRT (p = 0.032, R2 = 0.308), and DRIL extent (p = 0.024, R2 = 0.201). Conclusions The BCVA in patients after treatment with an intravitreal dexamethasone implant for DME was related to the change in the CRT after treatment. The baseline BCVA and change in the DRIL may be important indicators for predicting VA improvement in DME.

Purpose: To evaluate the correlation between visual acuity (VA) and the disorganization of retinal inner layers (DRIL) after use of an intravitreal dexamethasone implant to treat diabetic macular edema (DME). Methods: The clinical records of 25 patients with DME treated with an intravitreal dexamethasone implant were reviewed. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography data were analyzed from each visit. Results: The BCVAs at 1 month and 3 months after treatment were statistically significant with respect to the baseline BCVA of DME patients (p = 0.021, p < 0.001, respectively); however no statistically significant change was evident at the 6 months follow-up (p = 0.062). Also, the DRIL degree at 1 month and 3 months after treatment was statistically significant with respect to baseline DRIL (p = 0.034, p < 0.001); however, there was no statistically significant change at 6 months after treatment (p = 0.052). The BCVA at 6 months after treatment was positively and significantly correlated with the baseline BCVA (p < 0.001, R2 = 0.705), CRT (p = 0.032, R2 = 0.308), and DRIL extent (p = 0.024, R2 = 0.201). Conclusions The BCVA in patients after treatment with an intravitreal dexamethasone implant for DME was related to the change in the CRT after treatment. The baseline BCVA and change in the DRIL may be important indicators for predicting VA improvement in DME.

OBJECTIVES: The aim of this study was to develop a new prognostic classification for epithelial ovarian cancer (EOC) patients using gradient boosting (GB) and to compare the accuracy of the prognostic model with the conventional statistical method. METHODS: Information of EOC patients from Samsung Medical Center (training cohort, n=1,128) was analyzed to optimize the prognostic model using GB. The performance of the final model was externally validated with patient information from Asan Medical Center (validation cohort, n=229). The area under the curve (AUC) by the GB model was compared to that of the conventional Cox proportional hazard regression analysis (CoxPHR) model. RESULTS: In the training cohort, the AUC of the GB model for predicting second year overall survival (OS), with the highest target value, was 0.830 (95% confidence interval [CI]=0.802–0.853). In the validation cohort, the GB model also showed high AUC of 0.843 (95% CI=0.833–0.853). In comparison, the conventional CoxPHR method showed lower AUC (0.668 (95% CI=0.617–0.719) for the training cohort and 0.597 (95% CI=0.474–0.719) for the validation cohort) compared to GB. New classification according to survival probability scores of the GB model identified four distinct prognostic subgroups that showed more discriminately classified prediction than the International Federation of Gynecology and Obstetrics staging system. CONCLUSION: Our novel GB-guided classification accurately identified the prognostic subgroups of patients with EOC and showed higher accuracy than the conventional method. This approach would be useful for accurate estimation of individual outcomes of EOC patients.
Area Under Curve ; CA-125 Antigen ; Chungcheongnam-do ; Classification ; Cohort Studies ; Gynecology ; Humans ; Machine Learning ; Methods ; Obstetrics ; Ovarian Neoplasms ; Prognosis