Sunyoung Jang

Cosmetic regional conjunctivectomy with postoperative mitomycin C application with or without bevacizumab injection.

PURPOSE To evaluate the complications of cosmetic wide conjunctivectomy and postoperative topical mitomycin C application with or without bevacizumab injection. DESIGN Cross-sectional cohort study. METHODS Medical records of 1713 consecutive subjects who received cosmetic wide conjunctivectomy plus postoperative topical mitomycin C by a single surgeon at a single center with or without bevacizumab injection from November 2007 to May 2010 were reviewed. A telephone interview was conducted with 557 of the subjects who could be contacted and agreed to participate in the study. Complications, recurrences, and patient satisfaction were the main outcome measures. RESULTS A total of 1713 consecutive patients underwent cosmetic wide conjunctivectomy to treat conjunctival hyperemia. Ocular diagnoses in the medical records at the time of surgery included hyperemia (8.8%), pterygium (14.0%), dry eye (3.5%), pinguecula (1.5%), and conjunctival disorder (23.3%). For the remaining 48.9% of subjects, the diagnosis was not mentioned, or the surgical procedure was for cosmetic purposes. Patients were followed for a mean of 10.9 months (range, 0-30.3 months). The overall complication rate was 82.9%, of which 55.6% were considered severe (fibrovascular conjunctival tissue proliferation, 43.8%; scleral thinning, 4.4%; scleral thinning with calcified plaques, 6.2%; intraocular pressure elevation, 13.1%; diplopia, 3.6%; and recurrence of hyperemic conjunctiva, 28.1%). CONCLUSIONS Cosmetic wide conjunctivectomy plus postoperative topical mitomycin C with or without bevacizumab injection has a high rate of complications and reoperations.

A Systematic Review on the Effectiveness of Detection of M. tuberculosis and Rifampin Resistance Using Xpert MTB/RIF

Background: The purpose of this study was to evaluate the effectiveness of Xpert MTB/RIF (Cepheid, USA) in the detection of Mycobacterium tuberculosis and to determine rifampin resistance. Methods: The literature review covered the period from 16 August 2011 to 1 October 2011, and eight domestic databases and foreign databases including Ovid-Medline, Embase, and Cochrane Library were used. Key words, such as ‘Rifampin, Polymerase Chain Reaction,’ ‘GeneXpert’ and ‘Xpert MTB-RIF’ were used to search a total of 1,385 documents. The SIGN (Scottish Intercollegiate Guidelines Network) tool was used to evaluate the quality of the 20 selected studies. Results: Test accuracy for the detection of M. tuberculosis was assessed on the basis of 20 studies using the M. tuberculosis culture test as the reference standard. The acid-fast bacteria smearing test had a sensitivity in the range of 0.69-1.00, specificity in the range of 0.72-1.00 and test accuracy in the range of 0.75-1.00. Test accuracy regarding rifampin resistance was assessed on the basis of 17 studies. Using an anti-tuberculosis agent sensitivity test as the reference standard, the sensitivity, specificity and test accuracy of real-time, nested PCR were in the ranges of 0.75-1.00, 0.96-1.00 and 0.95-1.00, respectively. Conclusion: Xpert MTB/RIF is a useful test for patients suspected of having rifampin-resistant tuberculosis. (Ann Clin Microbiol 2014;17:42-49)