PURPOSE: To evaluate clinical effects of intracameral voriconazole injection in fungal keratitis refractory to conventional therapy. METHODS: Thirty-eight eyes of 38 patients with fungal keratitis were included in this study. The patients were divided into 3 groups: 13 patients with intracameral voriconazole injection (50 microg/0.1 ml; group A), 11 patients with intracameral amphotericin B injection (10 microg/0.1 ml; group B), and 14 patients with conventional therapy only (group C). Clinical factors including treatment success rate and time to successful treatment were evaluated. RESULTS: Treatment success was accomplished in 12 eyes in group A (92.3%), 10 eyes in group B (90.9%), and 12 eyes in group C (85.7%). Time to treatment success in group A, B, and C was 36.1 +/- 10.4 days (p = 0.04), 34.2 +/- 7.8 days (p = 0.03), and 49.5 +/- 16.7 days, respectively. Patients who had received intracameral voriconazole injection or amphotericin B showed faster fungal keratitis improvement than patients who received conventional treatment. Time to re-epithelialization and time to disappearance of hypopyon showed a similar clinical course. CONCLUSIONS: Intracameral voriconazole injection, which has a similar therapeutic effect as intracameral amphotericin B injection in the management of fungal keratitis, can be helpful in the treatment of intractable fungal keratitis.
Amphotericin B ; Eye ; Humans ; Keratitis ; Pyrimidines ; Re-Epithelialization ; Time-to-Treatment ; Triazoles

PURPOSE: To report a case of herpes simplex keratitis after descemet stripping automated endothelial keratoplasty (DSAEK). CASE SUMMARY: A 66-year-old male underwent DSAEK in his right eye due to bullous keratopathy after cataract surgery. The corneal epithelium which was removed during surgery was healed, but the patient was experiencing pain and decreased visual acuity in his right eye 1 month after surgery. Increasing corneal epithelial defects and corneal edema were observed on slit-lamp examination. Therapeutic soft contact lenses and artificial tears were used for treatment but were not effective, thus amniotic membrane transplantation was performed. Three months after transplantation, the epithelial defect appeared as a geographic ulcer suspecting to be herpes simplex keratitis; therefore, ganciclovir ophthalmic ointment and oral acyclovir were administered. Six months after antiviral therapy, the epithelial lesion of herpes simplex keratitis completely disappeared, leaving only mild corneal opacity. CONCLUSIONS: If corneal epithelial defects are persistent after DSAEK in patients even with no past history of herpes simplex keratitis, herpes simplex keratitis should be considered in the differential diagnosis.
Acyclovir ; Aged ; Amnion ; Cataract ; Contact Lenses, Hydrophilic ; Corneal Edema ; Corneal Transplantation ; Diagnosis, Differential ; Epithelium, Corneal ; Eye ; Ganciclovir ; Herpes Simplex ; Humans ; Keratitis, Herpetic ; Male ; Methylmethacrylates ; Ophthalmic Solutions ; Polystyrenes ; Transplants ; Ulcer ; Visual Acuity

PURPOSE: The present study investigated the therapeutic effects of periocular triamcinolone acetonide injections to treat inflammatory signs in patients with severe acute thyroid-associated ophthalmopathy. METHODS: Twenty-two patients with symptoms of severe acute thyroid ophthalmopathy were enrolled in the present study. The patients received four doses of 20 mg of triamcinolone acetonide via periocular injection into the inferotemporal orbital quadrant every 2 weeks. The changes in visual acuity, intraocular pressure, eye ball motility, exophthalmos, thickness of extraocular muscles, clinical activity score and NOSPECS score were measured. RESULTS: Eighteen of 22 patients (81.8%) showed improvement in soft tissue swelling, ten patients (45.5%) showed improvement in conjunctival hyperemia and one patient showed improvement of ocular motility. Clinical activity score and NOSPECS score had significant improvements. No patient had changes in visual acuity, intraocular pressure, diplopia, proptosis or thickness of extraocular muscles. An ocular adverse effect was found in one patient, who had subcutaneous fat atrophy at the injection site. CONCLUSIONS: In patients with severe acute thyroid ophthalmopathy, periocular triamcinolone acetonide injection can be effective to improve acute inflammatory symptoms, without significant adverse effects.
Atrophy ; Diplopia ; Exophthalmos ; Eye ; Graves Ophthalmopathy ; Humans ; Hyperemia ; Injections, Intraocular ; Intraocular Pressure ; Muscles ; Orbit ; Subcutaneous Fat ; Thyroid Gland ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity

BACKGROUND: ABO antibody titration is useful for the evaluation of ABO-incompatible bone marrow or solid organ transplantations, yet the results quite vary between different test methods used. We compared the results of microcolumn agglutination and tube methods. METHODS: Anti-A and anti-B isoagglutionin titers were determined in 63 healthy individuals (23 O, 20 A, and 20 B blood groups) using 4 different methods: immediate spin tube (tube), microcolumn agglutination without anti-human globulin (AHG) (CAT), tube with AHG (tube-AHG) and microcolumn agglutination with AHG (CAT-AHG). RESULTS: The median (range) titers of anti-A and anti-B in group O individuals by tube, CAT, tube-AHG, and CAT-AHG methods were 64 (8-512), 64 (8-512), 128 (8-2,048), and 128 (16-2,048); 64 (16-128), 128 (16-256), 128 (16-512), and 256 (16-512), respectively. The median (range) titers of anti-A in group B and anti-B in group A individuals by the four methods were 64 (16-128), 128 (8-128), 128 (8-256), and 256 (8-256); 64 (8-128), 64 (8-128), 32 (8-128), and 64 (8-256), respectively. The isoagglutinin titer measured by CAT-AHGmethod was the highest. The titers measured by CAT and CAT-AHG methods were 0-1 titer higher than those by tube and tube-AHG methods, respectively. Whatever method was used, the isoagglutinin titers were higher in women than in men. CONCLUSIONS: CAT-AHG was the most sensitive method among the four methods tested. Since AHG titer values are critical for the clinical management and CAT has less manual procedures than tube method, CAT-AHG method could be used for the standardization of ABO antibody titration in different institutions.
Agglutination ; Animals ; Bone Marrow ; Cats ; Female ; Humans ; Organ Transplantation ; Transplants

BACKGROUND: The use of automated techniques reduces the impact of human errors in blood banking and it improves the standardization and the quality of the achieved results. Erythrocyte Magnetized Technology (EMT) is now being widely used due to its simplicity and efficiency for detecting alloantibody. We evaluated the antibody screening test of the QWALYS-3 (DIAGAST, Loos Cedex, France). METHODS: The evaluation focused on antibody screening using the QWALYS-3 as compared to the standard manual tube method and the Ortho BioVue system in clinical samples (n=100) and frozen stored samples (n=64), which had RBC alloantibody. RESULTS: Using the manual tube method, the sensitivity of antibody screening was 100% by the QWALYS-3 and 42.8% by the Ortho BioVue in the clinical samples (n=7) and 2 results were discrepant by the QWALYS-3 for negative samples. For the known antibodies from the frozen stored samples (n=64) this correspondence rate amounted to 93.7% (n=60). CONCLUSION: The QWALYS-3 system displayed a good match rate with the Ortho BioVue system (92%). It also showed reliable results for the general accuracy when compared to the manual method (concordance rate: 98%). The QWALYS-3 system will facilitate the automation of routine antibody screening with high reliability, sensitivity and specificity compared to the standard manual methods.
Antibodies ; Automation ; Blood Banks ; Cephalosporins ; Erythrocytes ; Humans ; Magnets ; Mass Screening ; Sensitivity and Specificity

PURPOSE: The present study was performed to evaluate the changes in tear film and ocular surface parameters after using sodium hyaluronate (SH) 0.1% alone or in combination with cyclosporine A (CsA) 0.05% in patients with thyroid-associated ophthalmopathy accompanied by dry eye. METHODS: A total of 72 eyes from 36 patients were divided into two groups; 36 eyes of 18 patients were treated with 0.1% SH alone (group 1), and 36 eyes of 18 patients were treated with SH 0.1% and CsA 0.05% (group 2). Tear break-up time (BUT), basal tear secretion test (BST), tear clearance rate (TCR), fluorescein staining (FS) and corneal sensitivity test (CST) were evaluated at pre-treatment and one, three and six months post-treatment. Conjunctival impression cytology was performed and tear CXCL11 (Chemokine (C-X-C motif) ligand) levels were measured pre-treatment and three months post-treatment. RESULTS: BUT, BST, TCR, KEP and CST were significantly improved at six months in group 1 (p < 0.05) and at three months in group 2 (p < 0.05). The degree of conjunctival squamous cell metaplasia, goblet cell density and tear CXCL11 levels were significantly changed at three months in group 2 (p < 0.05). However, there were no significant changes in group 1 after 3 months. CONCLUSIONS: Combined use of topical 0.1% SH and 0.05% CsA can result in early improvement in tear films and ocular surface parameters in patients with thyroid-associated ophthalmopathy accompanied by dry eye.
Cyclosporine ; Dry Eye Syndromes ; Eye ; Fluorescein ; Goblet Cells ; Graves Ophthalmopathy ; Humans ; Hyaluronic Acid ; Metaplasia ; Tears ; Thyroid Gland

Since an exact ABO blood type match is essential for transfusion therapy, any ABO discrepancies should be resolved prior to the issuing of blood. The authors confirmed the ABO blood group of a 50-year-old male using genotyping. On a routine blood group test, the cell type was A+; however, anti-B was undetected in his serum. To determine the cause of this ABO discrepancy, an adsorption elution test and saliva test were performed. The presence of a weak B substance was suspected despite no evidence of the B antigen on red blood cells. Polymerase-chain-reaction restriction-fragment-length-polymorphism (PCR-RFLP) and sequencing analysis of exons 6 and 7 demonstrated that his blood type was A1Bweak (the A allele tested as the A105 subtype, while the B allele was most similar to the B302 subtype). Again, using genotyping, we subsequently confirmed the A1Bweak blood type in a leukemic patient who was in complete remission.
Adsorption ; Alleles ; Erythrocytes ; Exons ; Humans ; Leukemia ; Male ; Middle Aged ; Saliva

Lung cancer is one of the most prevalent cancers and it has the highest mortality of all forms of cancers. Although surgery, chemotherapy and radiotherapy are routinely used for the treatment of lung cancer treatment, little progress has been made in the treatment of this condition over the past 20 years. The histological subtype of squamous cell carcinoma (SCC) accounts for approximately 30% of all lung cancer patients. Spontaneous regression of non-small-cell lung cancer (NSCL) is an extremely rare phenomenon. Spontaneous regression of cancer (SR) is defined as a complete or partial, temporary or permanent disappearance of all or at least some the relevant parameters of soundly diagnosed malignant disease without any medical treatment or with treatment that is considered inadequate to produce the resulting regression.
Carcinoma, Squamous Cell ; Humans ; Lung ; Lung Neoplasms

BACKGROUND: The reference values of laboratory should review regularly to maintain good quality of practice. This is the second report of studies on reference values of Korea Association of Health Promotion (KAHP). The first one was reported in 2002 in Journal of Laboratory Medicine and Quality Assurance in Korea. The aim of this study is to know the changes of reference values for the past five years. METHODS: The way to analyze the data this time was essentially the same as the previous one (Indirect Method). The data from January to December, 2007 were collected. They totalled 5,133,327 test results from approximately 140 thousands individuals who visited for health checkup. The data were statistically analyzed with Minitab version 15.1.20.0 for Gaussian distribution using Anderson-Darling test. The trimming process repeated for the outliers, the results lying outside of +/-3SD, and as much as four times in certain test items, though, none of the tests showed Gaussian distribution. Subsequently, the reference values of most tests were defined in the ranges from the point of lowest 2.5% to the point of highest 97.5% and others were those, below 95 percentiles according to CLSI C28-A3 guideline. RESULTS: The reference ranges of 56 test items were either set as before or adjusted with new values, and compared. CONCLUSIONS: Comparing to the previous reference values (2002), the tests for liver function showed the lower upper values and the tests for diabetes and lipids showed higher upper values. Others were changed minimally with no significance.
Deception ; Health Promotion ; Korea ; Liver ; Normal Distribution ; Reference Values

The aim of this study was to investigate the relationship between obesity, insulin resistance and atherosclerosis in type 2 diabetes mellitus (T2DM) patients. Total 530 patients with T2DM were included. To evaluate the severity of atherosclerosis, we measured the coronary artery calcification (CAC) score, intima-media thickness (IMT) of the common carotid artery, and the ankle-brachial pressure index (ABPI). Subjects were classified according to body mass index (BMI), a marker of general obesity, and waist-to-hip ratio (WHR), a marker of regional obesity. The insulin sensitivity index (ISI) was measured by the short insulin tolerance test. All subjects were classified into four groups, according to BMI: the under-weight group, the normal-weight (NW) group, the over-weight (OW) group, and the obese (OB) group. WHR and systolic blood pressure, triglycerides (TG), HDL-cholesterol (HDLC), free fatty acids (FFA), fibrinogen, and fasting c-peptide levels were significantly different between BMI groups. TG, HDL-C, FFA, fibrinogen and ISI were significantly different between patients with and without abdominal obesity. In the OW group as well as in the NW group, carotid IMT, ABPI and CAC score were significantly different between patients with and without abdominal obesity. This study indicates that abdominal obesity was associated with atherosclerosis in T2DM patients.
Aged ; Atherosclerosis/complications ; Blood Pressure ; Coronary Vessels/pathology ; Diabetes Complications ; Diabetes Mellitus, Type 2/*genetics ; Female ; Humans ; Insulin Resistance ; Korea ; Male ; Middle Aged ; Obesity/*complications/*genetics ; Triglycerides/metabolism ; Tunica Intima/pathology ; Tunica Media/pathology