Postoperative occlusion of visual axis with fibrous membrane in the presence of anterior capsular phimosis in a patient with pseudoexfoliation syndrome: a case report

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract Background To report a case of postoperative fibrous membrane formation occluding the visual axis in the presence of anterior capsular phimosis in a patient with pseudoexfoliation syndrome. Case presentation A 79-year-old Asian woman with pseudoexfoliation syndrome underwent uneventful phacoemulsification and implantation of one-piece hydrophilic acrylic square-edged intraocular lens (Cristalens) in the right eye. Two months later, she had blurred vision in the right eye with the best-corrected visual acuity (BCVA) of 20/40. Formation of fibrous membrane occluding the capsulorhexis opening with contraction of anterior capsule was observed, which was confirmed by anterior segment optical coherence tomography. Clear visual axis was achieved by lysis of the membrane using Nd:YAG laser. The BCVA improved to 20/20. Conclusions Occlusion of the visual axis with fibrous membrane can develop in the presence of anterior capsular phimosis in a patient with pseudoexfoliation syndrome

Conjunctival sarcoidosis presenting as limbal conjunctival hypertrophy: a case report

Introduction : To the best of our knowledge, this is the first report of a case of conjunctival sarcoidosis that presented as limbal conjunctival hypertrophy and was controlled with topical cyclosporine. Case presentation : A 70-year-old Asian woman presented with painless limbal conjunctival hypertrophy. An incisional biopsy of the hypertrophic lesion showed noncaseating granulomas that consisted of multinucleated giant cells and epithelioid cells. The results of a systemic evaluation were normal except for a slight increase in serum angiotensin-converting enzyme to 58.9IU/L (normal range, 8 to 55IU/L). Twice-daily 0.05% topical cyclosporine was prescribed for the treatment of remaining lesions. After two months, the lesions had completely resolved and her serum angiotensin-converting enzyme level had normalized. Conclusions : Sarcoidosis should be considered in the differential diagnosis of conjunctival hypertrophy. Topical cyclosporine can be useful in conjunctival sarcoidosis.Peer Reviewe

Cross‐cultural validation of the genetic counseling outcome scale in Korea

The Genetic Counseling Outcome Scale (GCOS‐24) was developed to measure patient‐reported outcomes to evaluate the effectiveness of genetic counseling and testing services. In the current study, the Korean version of GCOS (K‐GCOS) was developed to reflect the sociocultural characteristics of Korea, and its clinical applicability was assessed. Overall, 231 Koreans, including patients with genetic diseases and their family members, participated and completed the K‐GCOS, Hospital Anxiety and Depression Scale (HADS), Multidimensional Health Locus of Control (MHLC) scale, and Satisfaction with Life Scale (SWLS). Validity was examined by assessing the correlations between K‐GCOS scores and other relevant scale scores. Reliability was confirmed using Cronbach's alpha and test–retest scores, measured over 2 weeks. We performed exploratory factor analysis of the five structures of GCOS‐24. For K‐GCOS, four‐factor structures were identified: “cognitive–behavioral control,” “uncertainty about control,” “hope,” and “emotional regulation.” Four original GCOS‐24 items were removed because of low factor loadings and small inter‐item correlations. K‐GCOS‐20 scores were positively correlated with SWLS (r = 0.456) and MHLC‐internal (r = 0.213) scores but negatively correlated with HADS (anxiety r = −0.428, depression r = −0.469) and MHLC‐internal (r = −0.278) scores. These findings demonstrate that K‐GCOS‐20 is a reliable and valid tool for evaluating genetic counseling services in Korea

Positional vertigo afterwards maxillary dental implant surgery with bone regeneration

Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo. It is caused by loose otoconia from the utricle which, in certain positions, displaced the cupula of the posterior semicircular canal. BPPV most often is a result of aging. It also can occur after a blow to the head. Less common causes include a prolonged positioning on the back (supine) during some surgical procedures. Additionally one can include in this ethiopathogenesis the positioning required during the maxillary dental implant surgery with bone regeneration related to a forced head positioning and inner ear trauma induced by dental turbine noise working in the maxillary bone. Two cases of patients who suffered BPPV after undergoing maxillary dental implant with bone regeneration procedures are reported. Diagnosis and treatment are also described

Traumatic neuroma of the right posterior hepatic duct with an anatomic variation masquerading as malignancy: a case report

Traumatic neuroma (TN), also known as amputation neuroma, is a reactive hyperplasia of nerve fibers and connective tissue arising from Schwann cells after trauma or surgery. TN of the bile duct is usually asymptomatic, but rarely can lead to right upper quadrant pain, biliary obstruction, and acute cholangitis. It is very difficult to discriminate TN from malignancy before surgery, although doing so could avoid an unnecessary radical resection of the lesion. In the course of surgery, TN can be caused by unintentional injury of a nerve fiber near the common bile duct (CBD) and heat damage to an artery, complete ligation of an artery, and excessive manipulation of the CBD. Therefore, to prevent TN after cholecystectomy, surgery should be performed carefully with appropriate consideration of anatomic variations, and a cystic duct should not be resected too close to the CBD. The possibility of TN should be considered if a patient who has undergone CBD resection with hepaticojejunostomy or cholecystectomy long ago experiences symptoms of jaundice, cholangitis, or obliteration of the CBD. In this report, we present a case of TN mimicking cholangiocarcinoma that emerged from a cystic duct stump after cholecystectomy

Association of Alcohol Consumption with the Risk of Ocular Trauma

This study was conducted to evaluate the influence of alcohol consumption on the risk of ocular trauma. We retrospectively reviewed the medical records of 1,024 patients who visited emergency department and received ophthalmologic examination from January 1 to December 31, 2009. The patients were divided into 2 groups: those with ocular trauma (n = 494) and those without (n = 530); the influence of alcohol consumption was compared between these 2 groups. In the ocular trauma group, the association of the causes and types of ocular trauma with alcohol consumption was evaluated. One of 530 patients of no trauma group and 117 (23.7%) of 494 patients of trauma group were related with alcohol intake, and the difference was statistically significant (P < 0.001). Concerning the causes, physical assault was significantly more common in alcohol-associated injury (P < 0.001). Regarding the types of injury, orbital wall fracture and hyphema showed a significant association with alcohol consumption (P < 0.001). Older age and nighttime injury were significantly related to the increased risk of alcohol-associated ocular trauma (P = 0.018 and < 0.001, respectively). In conclusion, alcohol consumption significantly increases the risk of ocular trauma

Robot-assisted distal gastrectomy for gastric cancer in a situs inversus totalis patient

A 47-year-old man was referred to Seoul National University Bundang Hospital with an ulcerative lesion in the midbody of the stomach. Computed tomography revealed that he was a situs inversus totalis (SIT) patient. Robot-assisted distal gastrectomy with D1+β lymph node dissection and Billroth II anastomosis were performed. With the aid of robotic surgery, the surgeon didn't need to change his position and could perform the surgery without any confusion resulting from the patient's reversed anatomy. The operation took 300 minutes, with no intraoperative complications. The postoperative course was uneventful, and the patient was discharged on postoperative day 8. The final pathologic report was pT3N3a by American Joint Committee on Cancer 7th tumor-node-metastasis staging. We successfully performed robot-assisted distal gastrectomy for gastric cancer in a SIT patient. We believe that this is the first case of robotic surgery reported in a SIT patient with gastric cancer

Age-related differences in ocular biometry in adult Korean population

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract Background To evaluate the relationship between age, axial length (AL), anterior chamber depth (ACD) and corneal steepness (K) in patients with cataract. Methods In this retrospective study, medical records of 800 patients (800 eyes) who were diagnosed with cataract and received preoperative ophthalmologic examination were reviewed. Data including age, gender and ocular biometric data including AL, ACD and K were collected and analyzed using univariate and multivariate analyses. Results Univariate analysis showed increased age has significant correlation with shorter AL (P < 0.001), shallower ACD (P < 0.001) and steeper K (P < 0.001). K value has a negative correlation with AL (P < 0.001). In multivariate analysis, increasing age has a significant association with shorter AL (P < 0.001) and ACD (P < 0.001), although the association between age and K was not significant (P = 0.398). Negative correlation between AL and K remained significant in multivariate analysis (P < 0.001). Conclusion In patients with cataract, older age had significant association with shorter AL and ACD. AL and K had negative correlation

Sequence Level Analysis of Recently Duplicated Regions in Soybean [Glycine max (L.) Merr.] Genome

A single recessive gene, rxp, on linkage group (LG) D2 controls bacterial leaf-pustule resistance in soybean. We identified two homoeologous contigs (GmA and GmA′) composed of five bacterial artificial chromosomes (BACs) during the selection of BAC clones around Rxp region. With the recombinant inbred line population from the cross of Pureunkong and Jinpumkong 2, single-nucleotide polymorphism and simple sequence repeat marker genotyping were able to locate GmA′ on LG A1. On the basis of information in the Soybean Breeders Toolbox and our results, parts of LG A1 and LG D2 share duplicated regions. Alignment and annotation revealed that many homoeologous regions contained kinases and proteins related to signal transduction pathway. Interestingly, inserted sequences from GmA and GmA′ had homology with transposase and integrase. Estimation of evolutionary events revealed that speciation of soybean from Medicago and the recent divergence of two soybean homoeologous regions occurred at 60 and 12 million years ago, respectively. Distribution of synonymous substitution patterns, Ks, yielded a first secondary peak (mode Ks = 0.10–0.15) followed by two smaller bulges were displayed between soybean homologous regions. Thus, diploidized paleopolyploidy of soybean genome was again supported by our study

Complete Binocular Blindness as the First Manifestation of HIV-Related Cryptococcal Meningitis

Ocular complications of HIV-related cryptococcal meningitis are reasonably common, but complete binocular blindness as the first manifestation of HIV is extremely rare. A 58-year-old man presented with binocular blindness. He experienced blurred vision for 3 days before the blindness. Mild pleocytosis was present in the cerebrospinal fluid, from which Cryptococcus neoformans was cultured. Serology revealed positivity for HIV antibody. He was treated with antifungal and antiretroviral therapy. This case indicates that HIV-related cryptococcal meningitis should be taken into consideration when determining the cause of unexpected sudden binocular blindness