摘要
Purpose@#To evaluate the safety and efficacy of preservative-free (PF) latanoprost in glaucoma patients. @*Methods@#In this prospective, open-label, observational study, a total of 27 primary open-angle glaucoma patients who used benzalkonium chloride-preserved prostaglandin analogues for at least 6 months were enrolled. After changing the eye drops to PF lataprost, the intraocular pressure (IOP) and ocular surface symptoms and signs were evaluated in all patients on days 0 (first visit, D0), 45 (D45), and 90 (D90). @*Results@#Mean IOP remained stable during the study period (14.0 ± 2.4 mmHg at D0, 13.9 ± 2.0 mmHg at D45, 13.7 ± 2.2 mmHg at D90; p = 0.603). Mean deviation, pattern standard deviation, and best-corrected visual acuity were similar before and after eye drops replacement. Bulbar conjunctival hyperemia, corneal staining, and conjunctival staining were significantly decreased over 90 days (p = 0.025, p < 0.001, p = 0.020, respectively). The ocular surface disease index score showed a statistically significant improvement from 26.4 ± 18.5 at D0 to 19.8 ± 17.0 at D45 and 15.7 ± 15.6 at D90 (p < 0.001). In the evaluation of ocular tolerability, burning symptoms and dryness were significantly decreased (p = 0.001, p = 0.040). @*Conclusions@#The effects of PF latanoprost on reducing IOP were comparable with those of benzalkonium chloride-preserved prostaglandin analogues, but side effects on the ocular surface were much less pronounced when PF latanoprost was used. With this efficacy, PF latanoprost could slow the progression of glaucoma by increasing patient compliance.
摘要
Purpose@#To evaluate the safety and efficacy of preservative-free (PF) latanoprost in glaucoma patients. @*Methods@#In this prospective, open-label, observational study, a total of 27 primary open-angle glaucoma patients who used benzalkonium chloride-preserved prostaglandin analogues for at least 6 months were enrolled. After changing the eye drops to PF lataprost, the intraocular pressure (IOP) and ocular surface symptoms and signs were evaluated in all patients on days 0 (first visit, D0), 45 (D45), and 90 (D90). @*Results@#Mean IOP remained stable during the study period (14.0 ± 2.4 mmHg at D0, 13.9 ± 2.0 mmHg at D45, 13.7 ± 2.2 mmHg at D90; p = 0.603). Mean deviation, pattern standard deviation, and best-corrected visual acuity were similar before and after eye drops replacement. Bulbar conjunctival hyperemia, corneal staining, and conjunctival staining were significantly decreased over 90 days (p = 0.025, p < 0.001, p = 0.020, respectively). The ocular surface disease index score showed a statistically significant improvement from 26.4 ± 18.5 at D0 to 19.8 ± 17.0 at D45 and 15.7 ± 15.6 at D90 (p < 0.001). In the evaluation of ocular tolerability, burning symptoms and dryness were significantly decreased (p = 0.001, p = 0.040). @*Conclusions@#The effects of PF latanoprost on reducing IOP were comparable with those of benzalkonium chloride-preserved prostaglandin analogues, but side effects on the ocular surface were much less pronounced when PF latanoprost was used. With this efficacy, PF latanoprost could slow the progression of glaucoma by increasing patient compliance.
摘要
Purpose@#To report incidence rates of primary congenital glaucoma in Korea and evaluate comorbidity and mortality from 2001 to 2015. @*Methods@#This study is a nationwide and retrospective population-based study. We used claims data from the Korean National Health Insurance Service database between 2001 and 2015. Data for all patients diagnosed with primary congenital glaucoma were retrieved using the Korean Electronic Data Interchange and Korean Standard Classification of Diseases-6 codes. @*Results@#The number of patients with primary congenital glaucoma between 2001 and 2015 was 776, of which 437 were male (56.31%) and 339 were female (43.69%). The annual prevalence demonstrated a general decreasing trend since 2011, but this was not significant. Over the total survey period, the incidence rate was 11.0 per 100,000 births, with 12.0 cases among males and 10.0 among females. The incidence according to age was 518 (68.78%) patients at age 0, 112 (13.66%) at 1year, 70 (8.39%) at 2 years, and 76 (9.17%) at 3 years. Of the 776 patients diagnosed with primary congenital glaucoma in the study population, 27 died. The observed mortality per 100,000 people is about 10 times higher than that of the general infant and child population under the age of 4 years. Visual impairment was the most common accompanying disability, followed by brain lesion. @*Conclusions@#Our study’s estimates of the nationwide population-based incidence of primary congenital glaucoma in a Korean population will expand our understanding of the disease and allow healthcare systems to plan for primary congenital glaucoma.
摘要
PURPOSE: The objective of this case report was to present tube erosion of Ahmed valve implantation using a synthetic dura substitute (Neuro-Patch®, B. Braun, Boulogne, France). CASE SUMMARY: Tube erosion was caused by dissolution of the conjunctiva and partial-thickness scleral tunnel in 5 patients who received Ahmed valve implantation using a synthetic dura substitute for glaucoma treatment 2 to 4 months after the operation. Furthermore, the patients required re-operation for preventing secondary complications such as endophthalmitis. CONCLUSIONS: This case series using a synthetic dura substitute in Ahmed valve implantation demonstrated the risk of tube erosion with scleral tunnel melting and following secondary complications even with a partial-thickness scleral tunnel method.
Subject(s)
Humans , Conjunctiva , Endophthalmitis , Freezing , Glaucoma , Methods摘要
PURPOSE: To determine the effect of intraocular pressure (IOP) reduction of selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and the factors associated with the treatment result. METHODS: Forty-seven eyes of 47 OAG patients were enrolled for 180° SLT or 360° SLT, all under maximal tolerated medical therapy and with IOP above their target pressure. All patients were followed-up for at least 1 year after the procedure. Treatment success was defined as IOP reduction ≥20% from baseline at 12 months after SLT treatment without additional anti-glaucomatous intervention. RESULTS: The treatment success rate was 65.96%. Baseline IOP was 23.84 ± 4.52 mmHg in the success group and 21.44 ± 2.97 mmHg in the failure group (p = 0.035). Significant mean IOP reduction was observed at 6, 9, and 12 month follow-ups (p = 0.001 at 6 months; 0.041 at 9 months, and <0.001 at 12 months). The success rate did not vary significantly by sex (p = 0.362), age (p = 0.081), history of cataract surgery (p = 0.470), number of medications (p = 0.857), duration of medication (p = 0.613), or angular degree of SLT treatment (180° vs. 360°) (p = 0.137). There was a positive correlation between mean baseline IOP and mean reduction of IOP from baseline in the success group (p < 0.001, r = 0.861), while there was no such correlation in the failure group (p = 0.272, r = −2.921). CONCLUSIONS: SLT was an effective treatment for IOP reduction until 12 months in medically uncontrolled OAG patients. A greater amount of IOP reduction is expected in patients with higher baseline IOP in the success group.
Subject(s)
Humans , Cataract , Follow-Up Studies , Glaucoma, Open-Angle , Intraocular Pressure , Trabeculectomy摘要
Dry eye syndrome (DES) is recognized as a public health concern. One of the pathophysiologies in the development of DES is inflammation, and metabolic syndrome (MetS), which is highly prevalent in the general population, is a well-known chronic and systemic inflammatory condition. Despite the increasing interest regarding a relationship between DES and MetS, information is lacking on the association between DES and MetS and its individual components. We investigated the association between DES symptoms and MetS and its components among adults aged ≥ 19 years using population-based data from the Korea National Health and Nutrition Examination Survey V. A sample group of 15,294 adults (42.67% men and 57.33% women) completed household interviews in which they provided blood (for high-density lipoprotein cholesterol, triglyceride, and glucose) and anthropometric measurements (including waist circumference, weight, and height) to define MetS. We also collected information regarding sociodemographic and behavioral risk factors. The survey results showed that 11.50% of men and 22.35% of women experienced DES and 5.30% of patients had both DES and diagnosis of MetS, including 204 men and 606 women. Thus, no significant difference was observed between DES and the diagnosis of MetS according to sex (P = 0.4008 in men; P = 0.0804 in women); however, a significant association was observed between DES and hypertriglyceridemia in women (OR, 1.13; 95% CI, 1.01-1.29). Therefore, hypertriglyceridemia might be an important factor in the association between DES and MetS. Further longitudinal research is needed to evaluate this relationship.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Blood Glucose/analysis , Body Height , Body Weight , Cholesterol, HDL/blood , Cross-Sectional Studies , Dry Eye Syndromes/complications , Hypertriglyceridemia/complications , Interviews as Topic , Metabolic Syndrome/complications , Nutrition Surveys , Prevalence , Republic of Korea/epidemiology , Risk Factors , Sex Factors , Triglycerides/blood , Waist Circumference摘要
PURPOSE: To compare the efficacy of selective laser trabeculoplasty (SLT) in phakic and pseudophakic eyes in primary open-angle glaucoma. METHODS: Charts of 55 phakic eyes and 24 pseudophakic eyes that underwent 360-degree SLT were retrospectively reviewed. Intraocular pressure (IOP) was measured before SLT and 1 week, 1, 3, 6, 9, 12, 18 and 24 months after SLT. Treatment success was defined as IOP reduction > or = 20% without additional medications, laser or glaucoma surgery. Mean IOP change, mean percentage of IOP reduction and success rates of phakic and pseudophakic eyes were compared. RESULTS: Mean percentage of IOP reduction after SLT at 1 week and 1, 3, 6, 9, 12, 18, and 24 months were 18.8%, 23.9%, 24.6%, 23.3%, 24.0%, 22.1%, 20.8%, and 17.9%, respectively, in the phakic group and 15.7%, 22.3%, 23.7%, 25.3%, 25.6%, 25.2%, 21.9%, and 19.3%, respectively, in the pseudophakic group. Success rates were 57.6 +/- 11.9% in the phakic group and 61.3 +/- 10.4% in the pseudophakic group. No statistically significant differences in IOP change, percentage of IOP reduction, and success rates were observed between the groups at each time point after SLT (p > 0.05). CONCLUSIONS: Application of 360-degree SLT appears an efficient treatment option for the management of phakic and pseudophakic open-angle glaucoma. Evaluating the success of SLT 1 month postoperatively may be premature.
Subject(s)
Cataract , Glaucoma , Glaucoma, Open-Angle , Intraocular Pressure , Retrospective Studies , Trabeculectomy摘要
PURPOSE: To report a case of central serous chorioretinopathy development after glaucoma filtering surgery and spontaneous resolution in a patient with a history of central serous chorioretinopathy in the contralateral eye. CASE SUMMARY: A 46-year-old male with a history of chronic uveitis in both eyes presented with uncontrolled intraocular pressure (IOP) in his left eye. Initial IOP was 34 mm Hg in his left eye. On preoperative evaluation, central serous chorioretinopathy, which was diagnosed in another clinic 1 month prior, was observed in his right eye. Slightly pale optic disc and retinal nerve fiber layer defects were noted in the left eye. However, macular abnormalities were not observed in the left eye. Trabeculectomy and peripheral iridectomy using mitomycin C were performed in the left eye. The patient was prescribed triamcinolone 8 mg daily for 4 days to reduce the post-surgical inflammation. On postoperative day 4, IOP in the left eye was 7 mm Hg and newly developed central serous chorioretinopathy was noted. On follow-up, IOP was maintained at 7-10 mm Hg and central serous chorioretinopathy disappeared 7 months postoperatively. CONCLUSIONS: When clinicians consider performing an ophthalmological procedure in a patient with a history of central serous chorioretinopathy in the contralateral eye, careful observation of central serous chorioretinopathy development is recommended.
Subject(s)
Humans , Male , Middle Aged , Central Serous Chorioretinopathy , Filtering Surgery , Follow-Up Studies , Glaucoma , Inflammation , Intraocular Pressure , Iridectomy , Mitomycin , Nerve Fibers , Retinaldehyde , Trabeculectomy , Triamcinolone , Uveitis摘要
PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.
Subject(s)
Aged , Female , Humans , Male , Double-Blind Method , Ginkgo biloba , Laser-Doppler Flowmetry , Low Tension Glaucoma/drug therapy , Optic Disk/blood supply , Phytotherapy/methods , Plant Extracts/therapeutic use , Regional Blood Flow/drug effects , Retina/physiopathology , Retrospective Studies , Time Factors , Visual Fields摘要
PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.
Subject(s)
Aged , Female , Humans , Male , Double-Blind Method , Ginkgo biloba , Laser-Doppler Flowmetry , Low Tension Glaucoma/drug therapy , Optic Disk/blood supply , Phytotherapy/methods , Plant Extracts/therapeutic use , Regional Blood Flow/drug effects , Retina/physiopathology , Retrospective Studies , Time Factors , Visual Fields摘要
A 60-year-old male was referred to the ophthalmologic clinic with aggravated anterior uveitis and corneal edema despite the use of topical and systemic steroids. He had undergone cataract surgery in both eyes 15 years previous. Slit lamp examinations revealed a retained lens fragment in the inferior angle of the anterior chamber, with severe corneal edema and mild anterior uveitis. The corneal edema and uveitis subsided following surgical extraction of the lens fragment. That a retained lens fragment caused symptomatic anterior uveitis with corneal edema 15 years after an uneventful cataract surgery is unique. A retained lens fragment should be considered as one of the causes of anterior uveitis in a pseudophakic patient.
Subject(s)
Humans , Male , Middle Aged , Cataract Extraction/adverse effects , Corneal Edema/etiology , Lens, Crystalline/pathology , Postoperative Complications/pathology , Pseudophakia/pathology , Reoperation , Severity of Illness Index , Uveitis, Anterior/etiology摘要
PURPOSE: To determine the effect of cataract extraction on visual field damage in glaucoma patients with cataracts. METHODS: Sixty-two eyes of fifty glaucoma patients (primary open-angle glaucoma, angle-closure glaucoma, and normal-tension glaucoma) were divided into three groups according to the MD (mean deviation) value from the Humphrey automatic visual field test. The PSD (pattern standard deviation) values were analyzed before and after the cataract surgery. Additionally, the visual acuity, intraocular pressure and the number of antiglaucomatous agents were compared. RESULTS: All of the three groups, showed significant improvement in visual acuity. However, there was only a significant decrease in intraocular pressure at three months postoperatively. When comparing the mean MD values of each group, there was a statistically significant difference between the mild defect group and the severe defect group, but no statistically significant difference in the moderate defect group. There was also no statistically significant difference in PSD values in the any of the groups before and after cataract surgeries. CONCLUSIONS: In glaucoma patients with cataracts, there were no significant differences in PSD values before and after cataract surgery. Additionally, to perform an adequate cataract operation in advanced glaucoma patients without the progression of visual field damage, lowering intraocular pressure and improving visual acuity is helpful.
Subject(s)
Humans , Cataract , Cataract Extraction , Eye , Glaucoma , Glaucoma, Angle-Closure , Glaucoma, Open-Angle , Intraocular Pressure , Visual Acuity , Visual Field Tests , Visual Fields摘要
PURPOSE: Malignant glaucoma is a rare complication of anterior segment surgery. The authors present a case of a malignant glaucoma-like phenomenon during cataract surgery in a primary open-angle glaucoma (POAG) patient. CASE SUMMARY: A 74-year-old man with POAG underwent a cataract surgery in his left eye. After phacoemulsificiation, sodium hyaluronate was used to form the capsular bag for intraocular lens implantation. Following this procedure, the capsular bag space and anterior chamber became shallow. Intraocular pressure (IOP) elevated, and the shallowing of the anterior chamber and capsular bag space continued to a dangerous level. The surgical procedure was stopped and postponed for two days. After two days, IOL was successfully implanted in the posterior bag. CONCLUSIONS: Although the preoperative ophthalmologic examination failed to reveal a zonular problem, there was a possibility for a small area of zonular defect. A malignant glaucoma-like phenomenon was suspected to have occurred due to leakage of sodium hyaluronate or balanced salt solution into the vitreous through a small area of zonular dialysis. If a similar condition, occurs delayed surgery for IOL implantation would be more effective than vitrectomy or laser treatment.
Subject(s)
Aged , Humans , Anterior Chamber , Cataract , Dialysis , Eye , Glaucoma , Glaucoma, Open-Angle , Hyaluronic Acid , Intraocular Pressure , Lens Implantation, Intraocular , Vitrectomy摘要
PURPOSE: To report a case of an anterior fibrovascular membrane following cataract extraction and intraocular lens implantation in a patient with congenital aniridia. CASE SUMMARY: A 13-year-old girl presented with congenital aniridia and cataracts in both eyes. She underwent cataract extraction by phacoemulcification with intraocular lens implantation. Six months after cataract surgery, a progressive anterior chamber fibrovascular membrane was noted in both intraocular lens and rudimentary iris. Surgical excision of the fibrovascular membrane was performed, but there was recurrence after five weeks in both eyes. Subsequent surgical intervention on both eyes involved intraocular lens explantation combined with membranectomy to prevent recurrence and phthisis. Surgical findings indicated that the fibrovascular membrane involved the retrolenticular space, and histopathological evidence indicated that the extensive fibrotic tissue originated from the root of the rudimentary iris. CONCLUSIONS: Patients with congenital aniridia should be monitored carefully for the development of intraocular fibrosis after intraocular lens implantation. If a fibrovascular membrane is noted, early surgical intervention is recommended, and the explantation of the intraocular lens should be considered during surgical intervention to prevent recurrence and complications.
Subject(s)
Adolescent , Humans , Aniridia , Anterior Chamber , Cataract , Cataract Extraction , Eye , Fibrosis , Iris , Lens Implantation, Intraocular , Lenses, Intraocular , Membranes , Recurrence摘要
PURPOSE: To report a case of very limited primary sebaceous carcinoma of the lacrimal gland that soon recurred and rapidly progressed after excision and radiotherapy. METHODS: A 67-year-old man presented to our clinic with a history of proptosis in his right eye for 1 month. On physical examination, 4mm exophthalmos and a palpable mass at the superotemporal area of the lacrimal gland without tenderness were noted in his right eye. The eyelid was entirely normal on examination. A CT scan was taken which showed a heterogenous mass in the lacrimal gland area. We performed surgical excision and biopsy of the mass through lateral orbitotomy. RESULTS: Primary sebaceous carcinoma of the lacrimal gland was diagnosed pathologically. A 63-Gy electron beam was irradiated for 6 weeks. Five months after the operation, a large mass was again palpable at the superotemporal orbital area. MRI revealed recurrence of the sebaceous carcinoma and its metastasis to the brain. Systemic metastasis in multiple organs was noted on PET scan. CONCLUSIONS: As primary sebaceous carcinoma of the lacrimal gland has a very poor prognosis, aggressive treatment such as exenteration should be considered, and a CT scan should be taken early on to find any recurrence or metastasis.
Subject(s)
Aged , Humans , Biopsy , Brain , Exophthalmos , Eyelids , Lacrimal Apparatus , Magnetic Resonance Imaging , Neoplasm Metastasis , Orbit , Physical Examination , Positron-Emission Tomography , Prognosis , Radiotherapy , Recurrence , Tomography, X-Ray Computed摘要
PURPOSE: Currently, when injecting botulinum a toxin into the extraocular muscle, EMG (Electromyography) is used for accurate location. In this study, we examined the effects of subtenon botulinum toxin injection without EMG guidance by quantifying the morphological changes of the extraocular muscle fibers in rabbits. METHODS: Using 10 New Zealand white rabbits, 10 units of botulinum a toxin in 0.1 ml of normal saline was injected into the subtenon space of the superior rectus muscles, 5 mm from the muscle insertion in right eyes. As a control, 0.1 ml of normal saline was injected into the subtenon space of the superior rectus muscles in left eyes. At 3 weeks after injections, the bilateral superior rectus muscles of each rabbit were carefully dissected from the globe. Cross-sections of 5 micrometer thickness were obtained at the site, 5 mm from the insertion of each superior rectus muscle. Sections were stained with Masson's trichrome and observed by light microscopy. Using Image-Pro Plus software, the diameter of the orbital layer myofibers was measured and statistical analysis was done using the Kruskal-Wallis test. RESULTS: The average diameter of the orbital layer fiber cells after botulinum toxin injection was 11.5+/-2.26 micrometer at 3 weeks, whereas that of the control was 14.4+/-3.77 micrometer. The difference was statistically significant (p<0.01). CONCLUSIONS: The diameter of myofibers in the orbital layer was reduced after subtenon botulinum a toxin injection. Further studies on the duration of botulium toxin in subtenon space and the change in the size of myofibers depending on the dosage of botulinum toxin will be necessary.
Subject(s)
Rabbits , Botulinum Toxins , Botulinum Toxins, Type A , Microscopy , Muscles , Nerve Block , Orbit摘要
PURPOSE: To determine the levels of antioxidant minerals in serum of normal subjects and patients with cataract. METHODS: Concentrations of antioxidant minerals such as selenium, manganese, copper, zinc were measured with atomic absorption spectrophotometer (AAS) 4110ZL in serum of 45 normal subjects (group 1) and 34 patients (group 2) with cataract, and Cu/Zn ratio was calculated. RESULTS: Serum concentrations of copper were 108.9 +/- 5.48 (male) and 106.9 +/- 5.25 microgram/dl (female) in group 1, 100.9 +/- 5.87 (male), 105.6 +/- 3.68 microgram/dl (female) in group 2, respectively. For zinc they were 105.8 +/- 7.33 (male) and 103.7 +/- 4.24 microgram/dl (female) in group 1, 80.0 +/- 5.78 (male) and 95.1 +/- 6.18 microgram/dl (female) in group 2, respectively. Zn/Cu ratio were 0.98 +/- 0.02 (male) and 1.05 +/- 0.08 (female) in group 1, 1.58 +/- 0.29 (male) and 1.19 +/- 0.09 (female) in group 2, respectively. CONCLUSIONS: Serum zinc concentration in male was significantly lower in cataract patients than in normal subjects (p<0.01). Cu/Zn ratio was lower in cataract patients than in normal subjects in male, but not in female. Further nutrional survey is necessary to determine the relationship between level of antioxidant minerals and development and progression of cataract.
Subject(s)
Female , Humans , Male , Absorption , Cataract , Copper , Manganese , Minerals , Selenium , Zinc摘要
Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries, but the etiology remains unclear. Angiographic characteristics include bilateral stenosis or occlusion of the terminal portions of the intracranial internal carotid arteries and bilateral development of fine collateral vessels at the base of the brain known as 'Moyamoya vessels'. Cardiac surgery using cardiopulmonary bypass due to coronary artery disease and others among patients with moyamoya disease is very rare, and cardiac surgery for such patients has a potential risk of intraoperative and perioperative brain ischemia. We successfully treated a patient who underwent artrial septal defect closure and coronary artery bypass graft using the cardiopulmonary bypass, so we report this case with a brief literature review.
Subject(s)
Humans , Brain , Brain Ischemia , Cardiopulmonary Bypass , Carotid Artery, Internal , Cerebral Arteries , Cerebrovascular Disorders , Constriction, Pathologic , Coronary Artery Bypass , Coronary Artery Disease , Moyamoya Disease , Thoracic Surgery , Transplants摘要
A 68-year-old man with constrictive pericarditis underwent pericardiectomy. The pericardium was dissected with a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH). The harmonic scalpel differs from electrocautery in that there is only a minimal transfer of energy and no transfer of electrical energy to the tissues. A significant decrease in intraoperative and possibly even postoperative heart rhythm disorders is to be expected, as there is no conduction of electricity. This new device has many advantages including no muscular stimulation, low heat, a smokeless field and easy hemostasis. We exprienced a patient who underwent pericardiectomy using the Harmonic scalpel, so we report this case with a brief literature.
Subject(s)
Aged , Humans , Electricity , Electrocoagulation , Heart , Hemostasis , Hot Temperature , Lobeline , Pericardiectomy , Pericarditis, Constrictive , Pericardium摘要
PURPOSE: Behcet's disease is a chronic, recurrent, multisystemic disorder, which visual prognosis is poor. The clinical and epidemiological characteristics of Behcet's disease in Korean were evaluated. METHODS: The clinical records on 3,175 patients with Behcet's disease diagnosed at Behcet's disease clinic in Severance Hospital between November 1983 and December 1999 were reviewed. RESULTS: Among all 3,175 patients, the men/women ratio of Behcet's disease was 1:1.6. The age of disease onset was the highest in the thirties (33.8%). The most frequent major and minor symptom was oral ulcer (97.7%) and arthritis (32.8%) respectively, and the proportion of ocular symptom was 19.3%. The most frequent initial symptom was oral ulcer (77.4%). The ratio of men/women with ocular symptom was 1:0.98. The mean interval between the initial symptom and ocular symptom was 34 months, and the most common ocular symptom was iritis (79.0%). The most frequent systemic drug administered in patients with ocular involvement was colchicines (35%). Visual acuity was worsened in 56% of the eyes followed for over 24 months. CONCLUSIONS: The authors notice the characteristics of Behcet's disease in Korean and suggest that the continuous and nationwide survey is further necessary.