Synthesis, crystal structure, and anti-breast cancer activity of a novel metal-porphyrinic complex [YK(TCPP)(OH)2·(solvents)x]

A novel heterometallic metal-porphyrinic framework (MPFs) built from Y and K ions as nods and meso-tetra(4-carboxyphenyl)porphyrin as linkers has been successfully synthesized and characterized. The single crystal X-ray diffraction indicated that this complex 1 exhibited a bilayered architecture of the porphyrins, which is seldom seen in MPFs. In addition, in vitro anticancer activity of complex 1 on three human breast cancer cells (BT474, SKBr-3 and ZR-75-30) was further determined.

TMPYP4 exerted antitumor effects in human cervical cancer cells through activation of p38 mitogen-activated protein kinase

BACKGROUND: The aim of the present study was to investigate the potential effects of the 5,10,15,20-tetrakis (1-methylpyridinium-4-yl) porphyrin (TMPyP4) on the proliferation and apoptosis of human cervical cancer cells and the underlying mechanisms by which TMPyP4 exerted its actions. RESULTS: After human cervical cancer cells were treated with different doses of TMPyP4, cell viability was determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) method, the apoptosis was observed by flow cytometry (FCM), and the expression of p38 mitogen-activated protein kinase (MAPK), phosphated p38 MAPK (p-p38 MAPK), capase-3, MAPKAPK2 (MK-2) and poly ADP-ribose polymerase (PARP) was measured by Western blot analysis. The analysis revealed that TMPyP4 potently suppressed cell viability and induced the apoptosis of human cervical cancer cells in a dose-dependent manner. In addition, the up-regulation of p-p38 MAPK expression levels was detected in TMPyP4-treated human cervical cancer cells. However, followed by the block of p38 MAPK signaling pathway using the inhibitor SB203580, the effects of TMPyP4 on proliferation and apoptosis of human cervical cancer cells were significantly changed. CONCLUSIONS: It was indicated that TMPyP4-inhibited proliferation and -induced apoptosis in human cervical cancer cells was accompanied by activating the p38 MAPK signaling pathway. Taken together, our study demonstrates that TMPyP4 may represent a potential therapeutic method for the treatment of cervical carcinoma.

Metabolismo del hemo: las dos caras de los efectos de la acumulación de precursores y porfirinas / Heme metabolism: the janus nature of precursorsand porphyrins / Metabolismo do hemo: as duas faces dos efeitos da acumulação de precursores e porfirinas

Las porfirias son enfermedades metabólicas consecuencia de fallas en la biosíntesis del hemo, caracterizadas por un patrón específico de acumulación y excreción de intermediarios, responsables de su patofisiología. En las porfirias agudas el exceso de ácido d-aminolevúlico (ALA) produce una sintomatología neuroabdominal asociada al daño oxidativo por formación de especies reactivas de oxígeno (ROS), originadas por autooxidaxión del ALA. En las cutáneas, la sintomatología es producto de la acumulación de porfirinas, que como el ALA, inducen la formación de ROS. Su desencadenamiento se precipita por factores endógenos (ayuno, estrés, hormonas) y/o exógenos (fármacos), en particular algunos anestésicos. Se presenta una revisión de los estudios bioquímicos y genéticos en pacientes con diferentes porfirias obtenidos en el Centro de Investigaciones de Porfirias y Porfirinas (CIPYP), durante los últimos 38 años, que permitieron ampliar el conocimiento sobre las bases moleculares sobre estas patologías. Se describen los logros resultantes del empleo de modelos experimentales de porfiria, inducida farmacológica o genéticamente, que contribuyeron a la clasificación de algunas drogas como prohibidas para pacientes con porfiria. Finalmente, las porfirinas generadoras de ROS, y por ende inductoras de muerte celular, tienen su aplicación para combatir infecciones por organismos hemo-deficientes como Trypanosoma cruzi y también para ser utilizadas como fotosensibilizadores en la terapia fotodinámica (TFD).

Porphyrias comprise a group of metabolic disorders of the heme biosynthesis pathway resulting in a specific accumulation and excretion of intermediates which are responsible for their pathophysiology. Acute porphyrias are characterized by acute neurovisceral symptoms due to the overproduction and accumulation of d-aminolevulinic acid (ALA) which leads to an oxidative damage resulting from the formation of reactive oxygen species (ROS). In cutaneous porphyrias, the symptomatology is a result of porphyrin accumulation which also induces ROS moulding. In both cases, their clinical signs are precipitated by endogenous factors (stress, hormones, low calories intake) and/or exogenous drugs, in particular some anaesthetics. A review of the biochemical and genetic results obtained from patients with different porphyrias, diagnosed at the CIPYP during the last 38 years is presented here, aimed at obtaining additional evidence about the molecular nature of these disorders. The achievements obtained from experimental porphyria models -pharmacologically or genetically induced- are also described, which contributed to the classification of some drugs as prohibited for their use in porphyric patients. Finally, as porphyrins produce ROS and therefore cellular death, they can be used to treat infections by heme-deficient organisms like Trypanosoma cruzi and also as photosensitizers in photodynamic therapy (TFD).

As Porfirias são doenças metabólicas decorrentes de falhas na biossíntese do Hemo, caracterizadas por um padrão específico de acumulação e excreção de intermediários responsáveis de sua patofisiologia. Nas Porfirias Agudas, o excesso de ácido δ-aminolevulínico (ALA) produz uma sintomatologia neuroabdominal associada ao dano oxidativo por formação de espécies reativas de oxigênio (ROS), decorrentes da auto-oxidação do ALA. Nas Cutâneas a sintomatologia é produto da acumulação de porfirinas, que como o ALA, induzem a formação de ROS. Seu desencadeamento precipita-se por fatores endógenos (jejum, estresse, hormônios) e/ou exógenos (fármacos), especialmente alguns anestésicos. Apresenta-se uma revisão dos estudos bioquímicos e genéticos em pacientes com diferentes Porfirias obtidos no Centro de Investigações de Porfirias e Porfirinas (CIPYP), durante os últimos 38 anos, que permitiram ampliar o conhecimento sobre as bases moleculares destas patologias. Descrevem-se as conquistas resultantes do uso de modelos experimentais de Porfiria, induzida farmacológica ou geneticamente, que contribuíram à classificação de algumas drogas como proibidas para pacientes com Porfiria. Afinal, as porfirinas geradoras de ROS e, por conseguinte, indutoras de morte celular têm sua aplicação para combater infecções por organismos hemo-deficientes como Trypanosoma cruzi e também ser utilizadas como fotossensibilizadores na terapia fotodinâmica (TFD).

Production, quality control, biodistribution assessment and preliminary dose evaluation of [177Lu]-tetra phenyl porphyrin complex as a possible therapeutic agent / Produção, controle de qualidade, avaliação de biodistribuição e avaliação da dose preliminar de [177Lu] -tetra complexo fenil porfirina como um possível agente terapêutico

Due to interesting therapeutic properties of ¹⁷⁷Lu and tumor avidity of tetraphenyl porphyrins (TPPs), ¹⁷⁷Lu-tetraphenyl porphyrin was developed as a possible therapeutic compound. ¹⁷⁷Lu of 2.6-3 GBq/mg specific activity was obtained by irradiation of natural Lu₂O₃sample with thermal neutron flux of 4 × 10¹³ n.cm^-2.s^-1. Tetraphenyl porphyrin was synthetized and labeled with ¹⁷⁷Lu. Radiochemical purity of the complex was studied using Instant thin layer chromatography (ITLC) method. Stability of the complex was checked in final formulation and human serum for 48 h. The biodistribution of the labeled compound in vital organs of wild-type rats was studied up to 7 d. The absorbed dose of each human organ was calculated by medical internal radiation dose (MIRD) method. A detailed comparative pharmacokinetic study was performed for ¹⁷⁷Lu cation and [¹⁷⁷Lu]-TPP. The complex was prepared with a radiochemical purity: >97±1% and specific activity: 970-1000 MBq/mmol. Biodistribution data and dosimetric results showed that all tissues receive approximately an insignificant absorbed dose due to rapid excretion of the complex through the urinary tract. [¹⁷⁷Lu]-TPP can be an interesting tumor targeting agent due to low liver uptake and very low absorbed dose of approximately 0.036 to the total body of human...

Devido às propriedades interessantes do ¹⁷⁷Lu e da avidez tumoral das tetrafenil porfirinas (TPP), desenvolveu-se a ¹⁷⁷Lu-tetrafenil porfirina como composto terapêutico potencial. ¹⁷⁷Lu de atividade específica de 2,6-3 GBq/mg foi obtido por irradiação de amostra de Lu₂O₃ com fluxo térmico de nêutrons de 4 × 10¹³ n.cm^-2.s^-1. Sintetizou-se a tetrafenil porfirina e marcou-se com ¹⁷⁷Lu. A pureza radioquímica do complexo foi estudada usando método de Cromatografia Instantânea de Camada Delgada ( ITLC). A estabilidade do complexo foi checada na formulação final e no ser humano por 48 h. A biodistribuição do composto marcado em órgãos vitais de ratos do tipo selvagem foi estudada por mais de 7 dias. A dose absorvida para cada órgão humano foi calculada pelo método da Dose Médica de Radiação Interna (MIRD). Estudo farmacocinético comparativo detalhado foi efetuado para o cátion ¹⁷⁷Lu e para o [¹⁷⁷Lu]-TPP. O complexo foi preparado com pureza radioquímica >97±1% e atividade específica de 970-1000 MBq/mmol. Os dados de biodistribuição e os resultados dosimétricos mostraram que todos os tecidos receberam uma dose absorvida aproximadamente insignificante devido à rápida excreção do complexo pelo trato urinário. O [¹⁷⁷Lu]-TPP pode ser um agente interessante de direcionamento do tumor devido à baixa captação pelo fígado e pela dose bem baixa absorvida, de, aproximadamente, 0,036 do corpo humano total...

Porfiria eritropoyética congénita / Congenital erythropoietic porphyria. Case report

Las porfirias constituyen un grupo de trastornos causados por defectos en la vía de síntesis del grupo hemo. En la porfiria eritropoyética congénita existe deficiencia de la uroporfirinógeno sintetasa, lo que a su vez provoca acumulación de grandes cantidades de uroporfirina I en todos los tejidos; dando lugar a fotosensibilidad con lesiones mutilantes de la piel, eritrodoncia,anemia hemolítica, esplenomegalia, y fragilidad ósea. El diagnóstico definitivo se fundamenta en la demostración de la actividad deficiente de la uroporfirinógeno sintetasa, o la determinación de mutaciones específicas en el gen respectivo. El rasgo histopatológico característico muestra una ampolla subepidérmica y su tratamiento requiere colaboración multidisciplinaria. En el presente artículo se describe un caso de porfiria eritropoyética congénita con la presentación clínica dermatológica clásica...

Structural and Functional Outcomes in Chronic Central Serous Chorioretinopathy Treated with Photodynamic Therapy

PURPOSE: To study the retinal pigment epithelium (RPE) and retinal alterations in chronic central serous chorioretinopathy treated with photodynamic therapy, and its correlation with functional parameters such as best-corrected visual acuity (BCVA) and contrast sensitivity (CS). METHODS: Retrospective, noncomparative, consecutive evaluation by optical coherence tomography and its correlation with BCVA and CS in 31 eyes of 26 patients. RESULTS: In all affected patients, 88.5% were male with a mean age of 42.9 years. The right eye was involved in 64.5% of cases, bilateral in 19% and 73.9% were hyperopic (spherical refraction between 0 and +5.0 diopters). Of these cases, 51.5% had peri-RPE abnormalities, 17.3% hyperreflective substances at RPE, 19.4% RPE atrophy, 55.3% foveolar atrophy, 3.1% pigment epithelial detachment, 5.2% subretinal fluid persistence, 8.3% fibrin deposits, 68.4% photoreceptor inner and outer segment line interruption and 31.1% external limiting membrane interruption. CONCLUSIONS: Time evolution and number of outbreaks were related to the decrease in foveal and chorodial thickness and in those with worse BCVA and CS. RPE abnormalities and atrophy were related to the age of onset of symptoms. Photoreceptor elongation has been correlated with poor BCVA and inner and outer segment line destructuring and interruption with poor CS.

Analysis of porphyrin photosensitizers using HPLC method / 药学学报

Photodynamic therapy (PDT), because of its good targeting, minimal invasion, and safety, is becoming a very active area in cancer prevention and treatment, in which the photosensitizers have proved to be the core element for PDT. We developed a new HPLC method for analyzing porphyrin photosensitizers using Shiseido Capcell PAK C18 (150 mm x 4.6 mm, 5 µm) as the column at 30 °C, methanol-1% aqueous solution of acetic acid as the mobile phase in a flow rate of 1.0 mL · min(-1) in a gradient elution mode, and the detection wavelength at 380 nm. This method, showing good specificity, precision, accuracy and robusty via methodology validations, can be applied to the purity test and assay of porphyrin photosensitizers, and has played a key guide role in the R&D of the new porphyrin photosensitizer--sinoporphyrin sodium.

Pseudoporfiria asociada a hemodialisis / Pseudoporfiria associated with hemodialysis

La pseudoporfiria es una dermatosis ampollar poco frecuente con similares caracter¡sticas cl¡nicas e histopatol¢gicas a las de la porfiria cut nea tarda pero con cifras normales de porfirinas. Se presenta el caso de una paciente con pseudoporfiria asociada a hemodi lisis que fue tratada con N-acetilciste¡na.

The pseudoporphyria is a bullous dermatosis rare with similar clinical and histopathologic features to the ofporphyria cutanea tarda but with normal numbers of porphyrins. The case of a patient is presented with pseudoporphtyria associated with hemodialysis who was treated with N-acetylcysteine.

Determinación del contenido de hierro, saponinas y porfirinas en Cassia grandis L, procedente de Masaya, Chinandega y Jalapa durante el periodo mayo 2013, abril del 2014 / Determination of the content of iron, saponins and porphyrins in Cassia grandis L, from Masaya, Chinandega and Jalapa during the period May 2013, April 2014

El presente trabajo de investigación trata de determinar el contenido de hierro, saponinas y porfirinas en Cassia grandis L. procedente de Masaya, Chinandega y Jalapa¸ asi como, la mejor relación droga solvente y concentración de solvente para el proceso extractivo de las muestras de Cassia grandis L. , señala también, la cuantificación del contenido de saponinas y porfirinas mediante espectrofotometría UV/Visible y la valoración del contenido de hierro, por espectrofotometría de absorción atómica en muestras de Cassia grandis L.

Photothrombosis of corneal neovascularization by photodynamic therapy utilizing verteporfin and diode laser

The aim of the present study was to evaluate the effect of photodynamic therapy in the treatment of experimental corneal neovascularization [NV] with benzoporphyrin derivative [BPD]. One group was considered as control [n=6 eyes] then, corneal NV was induced in 30 New Zealand male rabbits [n=60 eyes] by placing 7.0 silk sutures at midstromal depth approximately 1mm from the limbus. Fifteen rabbits with corneal NV were left without any treatment, and 15 rabbits were subjected to photodynamic therapy [PDT] by intravenous injection with Verteporfin at a dose of 1.5 mg /Kg. Diode laser [660 nm] was applied after 15 minutes for 5 minutes with a power of 50 mW/cm[2]. All rabbits were successively followed up by slit lamp examination for periods of 1 day, 1, 2, 3 and 4 weeks. Three rabbits were selected and sacrificed weekly [n=6 eyes each] and the corneas were isolated for histopathological examination. The results of slit lamp examination indicated the gradual regression of the cornea neovascularization 4 weeks of PDT. Furthermore, regression of corneal neovascularization was documented clinically by decrease number and length of blood vessels and by histopathological examination. PDT with Verteporfin can provide efficacious treatment of corneal neovascularization

Transient increased exudation after photodynamic therapy of intraocular tumors

To report transient increased exudation after photodynamic therapy [PDT] of three different intraocular tumors [retinal hemangioblastoma, retinal astrocytoma, amelanotic choroidal melanoma]. PDT with verteporfin [6 mg/m[2] body surface area] was delivered at a dose of 50 J/cm[2] and intensity of 600 mW/cm[2] over 83 s. All patients experienced decreased vision within a few days following PDT. Optical coherence tomography showed development of subfoveal fluid in all cases and noncystoid intraretinal edema in the eye with juxtapapillary retinal hemangioblastoma. There was complete absorption of retinal/subretinal fluid with improvement of visual acuity to 20/20 in all cases between 3 weeks to 4 months after PDT

Interações moleculares na adesão celular em suportes sólidos e o efeito de fotossensibilizadores porfirínicos / Molecular interactions in cell adhesion on solid substrates and the effect of porphyrinic photosensitizers

A adesão celular está ligada à formação e disseminação de metástases, a principal causa de óbito de pacientes diagnosticados com câncer. O objetivo deste trabalho foi investigar in vitro o efeito de fotossensibilizadores na adesão celular. Foram utilizadas porfirinas comerciais (PpIX, CPpI, TSPP, TMPyP e Zn(II)TMPyP) e um fotossensibilizador sintetizado através da ligação de poli-L-lisina à protoporfirina IX (PLLPpIX). A adesão celular foi estudada por RICM, técnica que permite quantificar a área de contato entre uma célula e um substrato por binarização das imagens digitais utilizando limiares apropriados. A técnica foi padronizada e revelou dois regimes de adesão celular: um limitado e outro não limitado pela quantidade de proteína de adesão adsorvida na superfície. Neste último foi observada lise celular. Todos os fotossensibilizadores estudados foram capazes de aumentar a adesão celular na ausência de irradiação comparados ao controle sem fotossensibilizador, o que não havia sido observado nos ensaios de resistência à tripsinização normalmente utilizados para estudar o efeito de fotossensibilizadores na adesão celular. Quanto maior a anfifilicidade do fotossensibilizador, maior foi o efeito na adesão, o que é explicado pela capacidade das moléculas em se intercalarem na membrana, mudando a sua rigidez. Este aumento da adesão no escuro correlaciona com a diminuição da migração segundo ensaios de ferida. A análise do padrão de expressão de integrinas na superfície celular revela que o aumento da adesão correlaciona com o aumento na expressão de αV. Quando os fotossensibilizadores estão concentrados na região perimembranar (1 minuto de incubação) e as células são irradiadas, há um aumento da adesão em relação ao controle sem fotossensibilizador, mas uma diminuição em relação ao controle tratado com o fotossensibilizador e não irradiado, o que implica que a PDT leva a uma diminuição da adesão celular e não a um aumento como reportado na literatura. Com 3h de incubação, PLLPpIX impede a adesão celular, enquanto PpIX praticamente não muda a adesão comparado ao controle não irradiado. Esta ausência do efeito da irradiação sugere que a PpIX afeta a adesão celular principalmente devido a sua intercalação na membrana e não devido à formação de espécies reativas. Com 3h de incubação os fotossensibilizadores não se encontram na membrana e, portanto, o efeito na adesão celular é indireto e também não está relacionado à diferenças na eficiência de internalização. O comportamento observado deve ter relação com diferenças de citolocalização. Outro processo que pode alterar a adesão celular é a oxidação das proteínas do soro fetal bovino. Como observado nos estudos de fotossensibilização de células, PLLPpIX foi capaz de impedir a adesão celular, diferentemente da PpIX. A maior eficiência da PLLPpIX foi associada a presença do polímero, o qual força por questões estéricas que a interação da PLLPpIX com a albumina, o componente majoritário do soro, fique restrita à superfície da proteína, deixando o fotossensibilizador disponível para interagir com o oxigênio molecular e gerar oxigênio singlete. Assim, a funcionalização com um polímero tornou a PpIX capaz de modular a adesão celular tanto agindo dentro da célula quanto na matriz extracelular

Cell adhesion is associated to the formation and spread of metastasis, the leading cause of death in cancer patients. The aim of this study was to investigate, in vitro, the effect of photosensitizers in cell adhesion. Five commercial porphyrins (PpIX, CPpI, TSPP, TMPyP e Zn(II)TMPyP) and Protoporphyrin IX covalently tethered to poli-L-lysine (PLLPpIX) were used. Cell adhesion was mainly studied by RICM, a technique that allows quantifying the contact area between a cell and a substrate for binarization of digital images using appropriate thresholds. The technique was standardized and disclosed two systems for cell adhesion: a system limited by the amount of adhesion proteina adsorbed on the surface and another one no limited, in which cell lysis was observed. All photosensitizers were able to enhance cell adhesion in the absence of irradiation compared to control without photosensitizer, which had not been observed in the trypsinization resistance tests usually used to study the effect of photosensitizers in cell adhesion. The greater the amphiphilicity of the photosensitizer, the greater was the effect on cell adhesion. This is explained by the ability of molecules to fit in the membrane, changing its tension. This increased adhesion correlates with the decrease in migration according to wound healing assays. Analysis of the integrin expression pattern on cell surface reveals that increased adhesion correlates with increased expression of alpha V. When photosensitizers are concentrated in the perimembranar region (1 minute of incubation) and cells are irradiated, there is an increase in adhesion when compared to control without photosensitizer, but a decrease relative to controls treated with the photosensitizer without irradiation, implying that PDT leads to a reduction of cell adhesion and not to an increase as reported in the literature. With 3h of incubation PLLPpIX prevents cell adhesion, while PpIX practically does not change the adhesion compared to dark control. This lack of effect of irradiation suggests that PpIX affects cell adhesion primarily because of its intercalation into the membrane and not due to the formation of reactive species. With 3h of incubation the photosensitizers are not on the membrane and therefore the effect on cell adhesion is indirect and it is not also related to differences in uptake efficiency. The observed behavior must be related to differences in subcellular localization arising from differences in molecular structure. Another process that can alter the cell adhesion is serum protein oxidation. As noted in the studies with cells, photosensitization of serum with PLLPpIX (but not with PpIX) was capable of preventing cell adhesion. The greater efficiency of PLLPpIX was associated with the presence of the polymer, which, by the steric hindrance, forces that interaction of PLLPpIX with albumin, the major serum component, is restricted to the protein surface, leaving the photosensitizer available to interact with molecular oxygen and generate singlet oxygen. Thus, the functionalization of a polymer has turned PpIX capable of modulating cell adhesion by acting both within and outside (in extracellular matrix) the cell

Malignant Pleural Mesothelioma Diagnosed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration / 결핵및호흡기질환

A 61-year-old woman came to the hospital with dyspnea and pleural effusion on chest radiography. She underwent repeated thoracentesis, transbronchial lung biopsy, bronchoalveolar lavage, and thoracoscopic pleural biopsy with talc pleurodesis, but diagnosis of her was uncertain. Positron emission tomography showed multiple lymphadenopathies, so she underwent endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal lymph nodes. Here, we report a case of malignant pleural mesothelioma that was eventually diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. This is an unusual and first case in Korea.

Full mouth rehabilitation of mandibular edentulous patient using implant hybrid prosthesis / 대한치과보철학회지

Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported-overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

Clinical Outcomes and Quality of Life of Home Health Care Patients

PURPOSE: This study aimed to evaluate the quality of life (QOL) in home health care patients according to change in health status outcomes between the start of care and discharge or 60 days, whichever came first. METHODS: This is a prospective descriptive study. The convenience sample consisted of 100 home health care patients, who started receiving home health care services from a home health care agency in the United States. The World Health Organization Quality of Life Scale-Brief (WHOQOL-BREF) was used for measuring QOL; activities of daily living (ADLs) and instrumental ADLs were collected from the Outcome and Assessment Information Set data via Centers for Medicare and Medicaid Services-required home health agencies. Descriptive statistics, paired t tests, and multiple linear regressions were used for data analysis. RESULTS: ADLs and instrumental ADLs of participants significantly improved between start of care and discharge or 60 days. Overall QOL, general health, and three of four QOL domains (physical, psychological, and environmental, but not social domain) were significantly improved at discharge or 60 days. CONCLUSION: Home health care nurses should maintain and improve the functional ability of patients, as this could improve the QOL of these patients.

Complication of Augmentation Mammoplasty using Polysaccharide Hydrogel Breast implant: Two Cases Report

After the use of silicone-filled breast implant was restricted in 1992, PIP Hydrogel (Poly Implant Prosthesis, France) was temporarily used as an alternative which is an organic polymer of polysaccharide and water. This case report draws attention to an unusual presentation following the insertion of a PIP Hydrogel implant for breast augmentation. The first case is about 43-year-old woman who has undergone breast augmentation using PIP Hydrogel implant was admitted to the hospital because of painful swelling in her right breast. On examination, the right breast was larger than the left. At the operation, it was found that the implant on the right side has a large tear in the shell. And the other case is about 47-year-old woman who had capsular contracture on the outer-lower quadrant of both breasts. She came to our institution to replace bigger implants. We removed existing both breast implants (170cc, subglandular), and replaced cohesive gel implant (300cc, submuscular). From 1992 to 2000, the breast implant filled with a polysaccharide gel had been widely used because of its viscoelastic properties and biodegradability. However, there is no long-term safety data that the filler material as a polysaccharide hydrogel is toxic to humans or not. We wish to highlight its unpredictability and unreliability.

National Evidence-based Collaborating Agency (NECA) Round-table Conference Consensus Statement: multidisciplinary responses to suicide, the first ranked cause of death in adolescents

The National Evidence-based Collaborating Agency (NECA) holds the NECA Round-table Conference that not only disseminates objective and systematic information on topics of social concern in public health care but also organizes discussions on core issues under dispute in the literature through panels composed of multidisciplinary experts. Accordingly, the Round-table Conference was composed of multidisciplinary experts including medical specialists in the areas of psychiatry and preventive medicine, psychiatric and mental health nursing, psychologists, social welfare experts, consultation experts, religious leaders, and government officials from the Ministry of Education, Science and Technology, and Ministry of Health and Welfare. The Round-table Conference, tasked with analysis of the actual status and causes of, and search for solutions for suicide in adolescents, has reached consensus on the current status, trend, risk factors and prevention factors, problems and issues in prevention and coping strategies, effective prevention and coping strategies and areas of research needed for the future. The Round-table Conference commented on the actual status and gravity of suicides in adolescents, and came to the agreement that mental health issues including stress from interpersonal relationships and depression are the key risk factors of suicide. It was further agreed that problems in the measures being implemented for each of the areas include lack of manpower and funding, and inadequate organic association and cooperation among relevant institutions. They also agreed that development of a government-initiated suicide prevention program for adolescents, association among relevant experts, and development, and management of practical guidelines that are of broad and practical use are important. Furthermore, the panels were in agreement that the mass media must comply with the recommended level of coverage in reporting of suicide as adolescents are greatly influenced by provocative mass media reports due to their strong impulsive dispositions.

Spontaneous Reattachment of Descemet's Membrane Detachment at Postoperative Two Months, Which Occurred During Cataract Surgery

PURPOSE: To report a case of spontaneously reattached Descemet's membrane detachment, which first occurred during the cataract surgery, and still remained after injection of 100% air into the chamber. CASE SUMMARY: A 78-year-old woman came to the clinic with decreased visual acuity. She had a brunescent cataract and underwent extracapsular cataract extraction with a posterior chamber lens implantation. During the irrigation and aspiration procedure, the Descemet's membrane was torn and detached. An anterior chamber injection of 100% air was performed prior to the conclusion of surgery. Descemet's membrane detachment remained at the center of the cornea and was naturally reattached without any surgical procedure. At 2 months after the surgery, a well-reattached Descemet's membrane and a clear central cornea were observed. CONCLUSIONS: Descemet's membrane detachment is a rare but potentially serious complication of intraocular surgery. The authors report a case of naturally reattached Descemet's membrane detachment which remained after injection of 100% air into the chamber.

Correlation Between Optical Coherence Tomography and Visual-Acuity in Chronic Central Serous Chorioretinopathy Treated with Half Dose Photodynamic Therapy

PURPOSE: To evaluate the results of half-dose photodynamic therapy (PDT) and determine the correlation between morphological changes measured by spectral-domain optical coherence tomography (SD-OCT) and visual acuity in patients with chronic central serous chorioretinopathy (CSC). METHODS: Twenty-five eyes of 25 patients with chronic CSC who had received half-dose verteporfin PDT were enrolled in the present study. The best-corrected visual acuity (BCVA), outer nuclear layer (ONL) thickness, and the integrity of the photoreceptor inner and outer segment junction (IS/OS) using SD-OCT were evaluated at baseline and at 3 and 6 months after treatment. RESULTS: The neurosensory retinal detachment disappeared in all eyes 6 months after treatment. The BCVA improved significantly from 0.50 +/- 0.32 to 0.31 +/- 0.29 log MAR at 6 months (p < 0.001). The average ONL thickness at the central fovea was 88.76 +/- 19.95 microm at 6 months and the ONL thickness was well correlated with the BCVA (gamma = -0.64; p = 0.001). There was no significant correlation between the status of IS/OS and the BCVA. CONCLUSIONS: Half-dose PDT is effective in treating chronic CSC resulting in visual improvement and complete resolution of neurosensory retinal detachment. The ONL thickness which was positively correlated with the BCVA could be an indicator for visual prognosis of chronic CSC.