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Busan, South Korea

Kim S.-M.,Maryknoll Medical Center | Cho K.-I.,Kosin University
Cardiovascular Therapeutics | Year: 2013

Summary: Background: Cilostazol, a selective phosphodiesterase three inhibitor, has been proposed to have beneficial effects in the prevention of atherosclerosis. Aims: We aimed to investigate the effects of cilostazol on carotid intima-media thickening (IMT) and total plaque area (TPA) in patients with retinal vascular occlusion. Methods: A total of 63 consecutive vascular occlusive retinopathy patients with carotid atherosclerosis were enrolled. We examined changes in the carotid IMT/TPA and visual acuity/macular thickness before and after 1-year treatment with cilostazol (200 mg/day). Results: The mean IMT of both common carotid arteries (CCAs) and internal carotid arteries (ICAs) were significantly reduced after cilostazol treatment. There was no significant difference in the TPA of both CCAs before and after the treatment (before; 0.61 ± 0.94 vs. after; 0.45 ± 0.79 cm2, P = 0.291); however, significant plaque regression (before; 0.14 ± 0.15 vs. after; 0.25 ± 0.14 cm2, P = 0.004) was observed in selected patients (n = 30) with a TPA <0.5 cm2. The improvement in macular thickness was significantly associated with an improvement in carotid IMT (r = 0.42, P = 0.001) and TPA (r = 0.23, P = 0.04). Conclusion: Cilostazol potently inhibited the progression of carotid IMT and may play a role in the early carotid plaque regression in patients with retinal vascular occlusion. © 2013 John Wiley & Sons Ltd.

Lee J.H.,Maryknoll Medical Center | Im Cho K.,Kosin University
Journal of Cardiology | Year: 2014

The aim of this study is to evaluate the role of arterial stiffness in pulmonary arterial hypertension (PAH) in systemic lupus erythematosus (SLE) patients and its relationship with antiphospholipid antibody (aPL). Methods: Measurement of brachial ankle pulse wave velocity (baPWV), carotid arterial stiffness, and pulmonary vascular resistance (PVR) was performed in 51 patients with SLE. PAH was diagnosed if the pulmonary artery systolic pressure was >40. mmHg. Information concerning SLE duration, medication, and serum autoantibodies was recorded. SLE activity was assessed by the SLE disease activity index (SLEDAI). Results: aPL was present in 10 patients (20%), and PAH was detected in 6 patients (12%). The prevalence of Raynaud's phenomenon, baPWV, positive aPL, and titers of IgG anticardiolipin antibody (aCL) were increased in SLE with PAH; however, no difference was found in inflammatory markers, disease duration, and SLEDAI compared to SLE without PAH. Carotid artery deformation and right ventricular function were reduced in patients with PAH (all p<. 0.05). Carotid artery circumferential strain (r = 0.34, p = 0.021), radial strain (r = -0.30, p = 0.045), and baPWV (r = 0.46, p = 0.001) showed significant correlation between IgG aCL. Univariate and multiple regression analysis revealed that the only significant independent predictors of the presence of PAH were baPWV, carotid artery stiffness, and IgG aCL. Conclusion: Arterial stiffness might contribute to the pathogenesis of PAH related to SLE as well as aPLs. Furthermore, the significant association of aPL with arterial stiffness suggests its important role in PAH with SLE. © 2014 Japanese College of Cardiology.

Kim I.G.,Maryknoll Medical Center
Korean journal of ophthalmology : KJO | Year: 2012

To evaluate factors associated with the direction of horizontal deviation in the sensory strabismus of patients with unilateral organic amblyopia. The medical charts of 53 patients who had been diagnosed with sensory strabismus between 2000 and 2009 were reviewed retrospectively. The underlying ocular disease, time of onset and the duration of vision impairment, refractive error and axial length of the fixing eye, and the direction and angle of deviation were analyzed to determine the distribution of underlying diseases and any factors relevant to determining the direction of the horizontal deviation. Congenital cataracts were the most common underlying disease, found in 33 patients, followed by acquired cataracts, optic nerve disorders, retinal detachment, glaucoma and lens subluxation. Among the 50 patients with horizontal strabismus, 11 had esotropia and 39 had exotropia. The incidence of esotropia was significantly higher when the fixing eye had hyperopia or emmetropia, than when the eye was myopic. Age of onset of vision deterioration and at diagnosis of sensory strabismus, and the axial length of the fixing eye had no relationship to the direction of horizontal deviation. In addition, the duration of visual impairment had no significant relationship with the direction or extent of horizontal deviation. The most common cause of sensory strabismus was congenital cataracts and the most frequent type of strabismus was exotropia. With respect to the direction of horizontal strabismus, esotropia occurred significantly more often when the refractive error of the fixing eye was hyperopia or emmetropia than when the fixing eye was myopic.

Le J.H.,Maryknoll Medical Center | Cho K.I.,Kosin University
Clinical Rheumatology | Year: 2014

Nailfold capillaroscopy (NC) represents the method to analyze microvascular abnormalities in autoimmune rheumatic diseases, but the pathophysiological link between the microvascular derangement which is seen in NC and endothelial function is yet to be discovered. We investigated the association between endothelial function and microvascular derangement in patients with Raynaud’s phenomenon (RP). Postmenopausal women (n = 37) with secondary RP and age-matched healthy controls (n = 25) were evaluated with NC. Microvascular alterations were assessed by microangiopathy evolution score. Endothelial function was examined by brachial artery flow-mediated dilatation (reactive FMD, endothelium-dependent) and response to 40 μg of sublingual nitroglycerine (NTG-induced dilatation, endothelium-independent). There was significant capillary loop dilatation (apical width; 14.1 ± 5.6 vs. 10.4 ± 1.7 μm, p = 0.001 and total width; 40.6 ± 15.1 vs. 31.6 ± 4.6 μm, p = 0.002) and lengthening (316.0 ± 78.5 vs. 270.4 ± 34.7 μm, p = 0.004) in secondary RP compared to controls. Additionally, giant capillaries, loss of capillaries, hemorrhage, and background pallor were much more prevalent in secondary RP as compared to controls (all p’s < 0.05). Although there were no significant differences in NTG-induced dilatation between secondary RP and controls (16.1 ± 5.9 vs. 19.6 ± 9.0 %, p = 0.091), significant decreases in the reactive FMD value (6.1 ± 3.5 vs. 9.0 ± 2.2 %, p = 0.001) were noted. Both FMD and NTG-induced dilatation showed a significant inverse association with microangiopathy evolution score (r = −0.355, p = 0.005 and r = −0.285, p = 0.028). Significantly impaired endothelial function was found in secondary RP, and microvascular derangement was associated with endothelial dysfunction. © 2014, Clinical Rheumatology.

Choroidal osteoma is a benign ossified tumor that is found predominantly in healthy young women during their second and third decades of life. The lesions are white-to-cream or orange in color, are located in the peripapillary and macular areas, and are unilateral in most patients. The symptoms of choroidal osteoma include decreased visual acuity and metamorphopsia or scotoma corresponding to the location of the osteoma, but some patients have no symptoms. Prognosis of vision varies according to tumor location, retinal pigment epithelial and sensory retinal degeneration, subretinal fluid and hemorrhage, and development of a subretinal neovascular membrane.

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