• Title/Summary/Keyword: 임상 경과

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Safety and Significance of Surgical Lung Biopsy for Interstitial Lung Disease (간질성 폐질환에 대한 수술적 폐생검의 의의 및 안전성)

  • Lee, Yu Jin;Joung, Mi Kyong;Chung, Chae Uk;Park, Ji Won;Shin, Ji Young;Jung, Sun Young;Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.59-66
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    • 2007
  • Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.

Calcium Bioavailability and Antiosteoporotic Effects of Cheonggukjang Containing High Poly-Gamma Glutamate Contents (고함량 폴리감마글루탐산(PGA) 청국장에 대한 칼슘 생체이용률 및 골다공증에 미치는 영향)

  • Lee, Mu-Jin;Jung, Ho-Kyung;Sim, Mi-Ok;Jang, Ji-Hun;Kim, Tae-Mook;Lee, Hyun-Joo;Lee, Ki-Ho;An, Byeong-Kwan;Cho, Jung-Hee;Jang, Min-Cheol;Yong, Ju-Hyun;Kim, Jong-Choon;Cho, Hyun-Woo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.11
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    • pp.1544-1551
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    • 2016
  • Various types of fermented soybean foods are consumed in various Asian countries, including China, Indonesia, Japan, Korea, and Vietnam. Cheonggukjang is a Korean whole soybean paste fermented by Bacillus subtilis and regarded as a healthy food. The objective of this study was to investigate the Ca-bioavailability and anti-osteoporotic effects of cheonggukjang (CGJ) containing high poly-gamma glutamate (PGA) contents in an animal model. Blood samples were collected from the jugular vein at 0, 0.5, 1, 2, 3, 4, and 5 h after a single oral dose in male rats. Ca-bioavailability in CGJ containing high PGA contents was approximately 3~5 times higher than that of natural CGJ. Female rats were either sham-operated (sham; n=5) or surgically ovariectomized (OVX; five animals per group) and then administered to OVX control, raloxifene hydrochloride (RLX) 1 mg/kg/d, or CGJ containing high contents of PGA (20 and 200 mg/kg/d) for 12 weeks. Serum osteocalcin concentration was significantly lower in the CGJ 200 mg/kg/d group compared with the OVX control group. Serum progesterone concentration was significantly higher in the CGJ 200 mg/kg/d group compared with the OVX control group. Reduction grade of the trabecular bone decreased in the RLX 1 and CGJ 200 mg/kg/d group compared with that of the OVX control group. In conclusion, CGJ 200 mg/kg/d may have inhibitory effects on osteoporosis in OVX rats, and Ca-bioavailability was improved in CGJ containing high PGA contents.

Colon Interposition as a Gastric Substitute after Performing Gastrectomy in Patients with Gastric Cancer (위암 환자에서 위 절제술 후 결장 간치술)

  • Lee, Jun-Hyun;Hur, Hoon;Jeon, Hae-Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.217-224
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    • 2008
  • Purpose: For most surgeons, colon interposition after gastrectomy remains an infrequently performed procedure because of its complexity. The aim of this study was to assess its technical feasibility and safety as a post-gastrectomy reconstruction method by reviewing our experience with colon interposition. Materials and Methods: From March 2001 to February 2002, 30 colon interpositions after-gastrectomy were done with using the ileo-ascending or transverse colon. We analyzed the clinicopathologic features and the surgical outcomes. Results: There were 16 males and 14 females in this study with a mean age of 67.5 years (range: 31 to 76 years). Twenty-five ascending colons and 5 transverse colons were used for the interposition, respectively. The mean operation time was 373 minutes (range: 204 to 600 minutes). There were 9 operative morbidities (30%) and 1 operative mortality. The restoration of bowel motility was noted at 3.8 postoperative days; a soft diet was started at 4.9 postoperative days and the duration of the hospital stay was 18.2 days. The percentage of weight loss in the patients with total, proximal and distal gastrectomy was 16.3%, 14.0% and 8.8%, respectively, at 6 months, and thereafter the weight loss gradually recovered as 8.1%, 7.5% and 5.6%, respectively, at 5 years postoperatively. Gastric stasis was the one of the most meaningful long-term complications, and especially in the patients who underwent distal gastrectomy with colon interposition. Conclusion: Colon interposition after gastrectomy was a very complex procedure with a long operating time and many anastomosis sites. The postoperative outcomes failed to achieve satisfactory weight gain and the patients displayed postprandial symptoms. This suggested that this procedure was not an appropriate procedure for conventional reconstruction after gastrectomy.

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Predictive Factors of Renal Scarring in Children with Acute Urinary Tract Infection (급성 요로감염 환아의 신장 반흔 예측요인)

  • Baik, Jun-Hyun;Park, Young-Ha;Hwang, Sung-Su;Jeon, Jung-Su;Kim, Sung-Hoon;Lee, Seong-Yong;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.245-253
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    • 2003
  • Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

The effect of cavity wall property on the shear bond strength test using iris method (Iris 법을 이용한 전단접착강도 측정에서 와동벽의 영향)

  • Kim, Dong-Hwan;Bae, Ji-Hyun;Cho, Byeong-Hoon;Lee, In-Bog;Baek, Seung-Ho;Ryu, Hyun-Mi;Son, Ho-Hyun;Um, Chung-Moon;Kwon, Hyuck-Choon
    • Restorative Dentistry and Endodontics
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    • v.29 no.2
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    • pp.170-176
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    • 2004
  • Objectives : In the unique metal iris method. the developing interfacial gap at the cavity floor resulting from the cavity wall property during polymerizing composite resin might affect the nominal shear bond strength values. The aim of this study is to evaluate that the iris method reduces the cohesive failure in the substrates and the cavity wall property effects on the shear bond strength tests using iris method. Materials and Methods : The occlusal dentin of 64 extracted human molars were randomly divided into 4 groups to simulate two different levels of cavity wall property (metal and dentin iris) and two different materials ($ONE-STEP^{\circledR}$ and $ALL-BOND^{\circledR}$ 2) for each wall property. After positioning the iris on the dentin surface. composite resin was packed and light-cured. After 24 hours the shear bond strength was measured at a crosshead speed of 0.5 mm/min. Fracture analysis was performed using a microscope and SEM. The data was analyzed statistically by a two-way ANOV A and t-test. Results : The shear bond strength with metal iris was significant higher than those with dentin iris (p=0.034). Using $ONE-STEP^{\circledR}$, the shear bond strength with metal iris was significant higher than those with dentin iris (p=0.005), but not in $ALL-BOND^{\circledR}$ 2 (p=0.774). The incidence of cohesive failure was very lower than other shear bond strength tests that did not use iris method. Conclusions:The iris method may significantly reduce the cohesive failures in the substrates. According to the bonding agent systems. the shear bond strength was affected by the cavity wall property.

Acute Renal Failure after On-pump Coronary Artery Bypass Surgery (체외순환하 시행한 관상동맥우회술 후 발생한 급성신부전증)

  • Jin, Ung;Jo, Min-Seop;Park, Chan-Beom;Sa, Young-Jo;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.416-422
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    • 2004
  • Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.

Efficacy of 2 mm Videothoracoscopic Examination and Application of Fibrin Glue in Bullectomy of Primary Spontaneous Pneumothorax (원발성 자연기흉 환자에서 2mm 흉강경 검사와 기포절제술 후 Fibrin Glue 도포의 효용성)

  • 이덕헌;금동윤;박창권
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.438-443
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    • 2004
  • Background : The treatment strategy for urinary spontaneous pneumothorax has progressively changed with the introduction of video-assisted thoracic surgery (VATS). Recently, we modified the strategy of primary spontaneous pneumothorax. If the patient had mild dyspnea and the lung was minimally collapsed, 2 mm thoracoscopic examination was performed. If no blob or bullae was inspected, the intrathoracic air was evacuated through the 2 mm thoracoscopic troca without closed thoracostomy, and if the blob and bullae was noted, the 10 mm thoracoscopic bullecotomy was carried out immediately and also application of fibrin glue was substituted for pleural abrasion. We compared the clinical outcomes of modified treatment strategy with conventional strategy in primary spontaneous pneumothorax. Material and Method: Patients were divided into four groups. Group I (n=21) underwent 2 mm thoracoscopic examination. Group II (n=68) underwent closed thoracostomy. Group III (n=56) underwent VATS and application of fibrin glue. Group IV (n=87) underwent VATS and pleural abrasion. The duration of chest tube drainage, the duration of hospitalization and the recurrence rate were compared between group I and group II and between group III and group IV. Result: Mean age, sex, location of pneumothorax were not different in all groups. In group I, the blob or bullae were existed in 12 patients, In remaining 9 patients, the bleb or bullae was not inspected. The mean duration of hospitalization in 9 patients were 2.4 $\pm$1.0 day and in group II were 3.9$\pm$2.1 day (p=0.014). There was 1 case of recurrence among the 9 patients in group I and 26 recurrences in group II (p=0.149). The mean duration of chest tube drainage were not difference in group III and IV (group III: 2.8$\pm$1.8 day, group IV: 3.0$\pm$2.5 day). The mean duration of hospitalization was shorter in group III than group IV (group III: 5,6$\pm$2.7 day, group IV: 1.3$\pm$3.3 day)(p=0.002). There was no recurrence in group III and 7 recurrences in group IV (p=0.043). Conclusion: Our modified treatment strategy of primary spontaneous peumothorax was effective in short hospital course and low recurrence rate.

The Immunogenicity and Safety Study of 47 Passaged Oka Strain Live Attenuated Varicella Vaccine in Healthy Children (건강한 소아에서의 47계대 Oka주 수두약독화 생백신의 면역원성 및 안전성에 관한 연구)

  • Kang, Jin Han;Kim, Jong Hyun;Suh, Byung Kyu
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.257-264
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    • 1997
  • Purpose: We performed this study to find out short period humoral immunogenicity and safety of 47 passaged Oka strain live attenuated varicella vaccine(1,400PFU) in 12 months to 15 years aged healthy children. Methods: Ninety nine healthy chidren, who have no histories of varicella vaccination, recent chicken pox illness and contact, allergy to other vaccines and underlying severe diseases, were involved in this study from April 1997 to August 1997. 5ml blood were collected before vaccination and after vaccination from all vaccinees to measure varicella membrane antibody by FAMA, and varicella IgG antibody by EIA. And immediate reactions within 30 minutes after vaccination, local and systemic reactions within 3 days after vaccination and vaccine induced systemic illness during 6 weeks postvaccination period were observed in all vaccinees to identify side effects of study vaccine. Results: 1) 49 seronegative and 50 seropositive vaccinees were identified in both prevaccination serologic tests. 2) Serologic responses after vaccination measured by the FAMA in seronegative group showed that the mean GMT level revealed 64.0, and seroconversion rate was 97.9%. And serologic responses after vaccination measured by the FAMA in seropositive group showed that the mean GMT level(242.2) was markedly elevated comparing with the mean GMT level(9.2) of pre vaccination. 3) The results of EIA in seronegative group revealed that postvaccination mean GMT was 435.2(prevaccination GMT; 78.7), and 100% seroconversion rate. Also, the results of EIA in seropositve group showed that the mean GMT level(769.9) of postvaccination was almostly two fold hihger than the mean GMT level(419.7) of prevaccination. 4) Observed local reactions like injection sites redness, pain, hardness and itching sense were mild and disappeared within 3 days, also shorterm systemic reactions like irritability, lethargy, poor appetites and rash were not remarkable. And there were no remarkable side effects due to vaccine during study period in all vaccinees. Conclusion: We confirmed that 47 paasaged Oka strain live attenuated varicella vaccine has high shorterm humoral immunogenicity and safety. However, we need more detail and longterm humoral and cell mediated immunogenicity studies of this vaccine including clinical field trials.

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Comparison of the Diagnostic Performance of $^{14}C$-urea Breath Test According to Counting Method for the Diagnosis of Helicobacter pylori Infection (Helicobacter pylori 감염 진단 시 $^{14}C$-요소호기검사의 계수측정 방법에 따른 진단성능 비교)

  • Kim, Min-Woo;Lim, Seok-Tae;Lee, Seung-Ok;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.21-25
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    • 2005
  • Purpose: $^{14}C$-urea breath test (UBT) is a non-invasive and reliable method for the diagnosis of Helicobacter pylori (HP) infection. In this study, we evaluated the diagnostic performance of a new and rapid $^{14}C$-UBT (Heliprobe method), which was equipped with $Geiger-M\ddot{u}ller$ counter and compared the results with those obtained by using the conventional method. Materials and Methods: Forty-nine patients with dyspepsia underwent gastroduodenoscopy and $^{14}C$-UBT. A 37 KBq $^{14}C$-urea capsule was administered to patients and breath samples were collected. In Heliprobe method, patients exhaled into a Hellprobe BreathCard for 10 min. And then the activities of the BreathCard were countered using Heliprobe analyzer. In the conventional method, results were countered using liquid scintillation counter. During gastroduodenoscopy, 18 of 49 patients were underwent biopsies. According to these histologic results, we evaluated the diagnostic performance of two different methods and compared them. Also we evaluated the concordant and disconcordant rates between them. Results: In all 49 patients, concordant rate of both conventional and Heliprobe methods was 98% (48/49) and the discordant rate was 2% (1/49). Thirteen of 18 patients to whom biopsies were applied, were found to be HP positive on histologic results. And both Heliprobe method and conventional method classified 13 of 13 HP-positive patients and 5 of 5 HP-negative patients correctly (sensitivity 100%, specificity 100%, accuracy 100%). Conclusion: The Heliprobe method demonstrated the same diagnostic performance compared with the conventional method and was a simpler and more rapid technique.

Long-term Outcomes of Conjunctivo-limbal Autograft Alone and Additional Widening of Limbal Incision in Recurrent Pterygia (군날개 재발에 있어서 자가윤부결막이식술 단독 및 추가 윤부절개술의 장기 결과)

  • Chung, In Kwon;Kim, Jin Hyoung;Lee, Jong Hyun;Lee, Do Hyung
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1114-1121
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    • 2018
  • Purpose: We report the clinical outcomes of patients undergoing additional widening of the limbal incision to prevent disease recurrence after conjunctivo-limbal autograft combined with pterygial excision. Methods: We retrospectively compared 95 eyes with primary and 12 eyes with recurrent pterygia randomized to treatment via two surgical methods: conjunctivo-limbal autograft alone and combined with widening of the limbal incision to allow for pterygial removal. We widened the limbal incisions by 1 mm on both the superior and inferior limbal margins and removed the pterygia. The outcomes were compared between 39 eyes undergoing conjunctivo-limbal autograft alone and 68 eyes undergoing conjunctivo-limbal autograft with widening of the limbal incision. Results: The mean overall postoperative follow-up period was $29.6{\pm}10.5months$ and conjunctivo-limbal autograft alone group was $27.4{\pm}11.5months$, combined with widening of the limbal incision group was $30.7{\pm}9.7months$. Six pterygia (15.4%; four primary and two recurrent) developed in those undergoing conjunctivo-limbal autograft alone and two (2.9%; one primary and one recurrent) in those undergoing additional widening of the limbal incision; the recurrence rate differed significantly between the two groups (p < 0.05). In the group treated with conjunctivo-limbal autograft alone, the mean time to development of a new primary pterygium was $6.3{\pm}3.4months$ and that to development of a recurrent pterygium $4.3{\pm}2.5months$; the respective values for the group undergoing additional widening of the limbal incision were $12.1{\pm}2.6$ and $8.4{\pm}4.6months$; the recurrence rates differed significantly (p < 0.05). Conclusions: Conjunctivo-limbal autograft with additional widening of the limbal incision used to treat both new primary and recurrent pterygia was more effective in terms of reducing pterygial recurrence than conjunctivo-limbal aAutograft alone.