Aldosterone Immunoassay-Specific Cutoff Value for Seated Saline Suppression Test for Diagnosing Primary Aldosteronism

A seated saline loading test (SLT) using liquid chromatography-tandem mass spectrometry (LC-MS/MS) is one of the most accepted confirmatory tests of primary aldosteronism. However, LC-MS/MS is time-consuming and is not widely available in diagnostic laboratories compared to immunoassay. With immunoassay, it is unknown whether SLT in the seated position is more accurate than that of the supine position, and a cutoff value of post-seated SLT plasma aldosterone concentration (PAC) must be established in the Korean population. Ninety-eight patients underwent SLT in both positions, and post-SLT PAC was measured by LC-MS/MS and radioimmunoassay. We confirmed primary aldosteronism if post-seated SLT PAC by LC-MS/MS exceeded 5.8 ng/dL. The area under the receiver operating characteristic curve was greater for seated than supine SLT (0.928 vs. 0.834, P=0.003). The optimal cutoff value of post-seated SLT by radioimmunoassay was 6.6 ng/dL (sensitivity 83.3%, specificity 92.2%).

Addictive Aspects of Eating Disorders and Obesity / 신경정신의학

The aim of this literature review was to evaluate the hedonic aspect of eating-related disorders. Addiction research has implications for the study of eating disorders and obesity and therefore, we collated and summarized recent clinical and neuroscience findings in regard to the "wanting" or "liking" aspect of eating disorders and obesity. The addictive personality is prone to substance dependence and these personality types are also known to be susceptible to binge eating. The biological framework underpinning the hedonic aspect of abnormal eating behavior has two components: 1) the incentive component of "wanting" or, in its extreme, craving feeling involving the dopaminergic system, and 2) the pleasure or "liking" network involving the opioid and cannabinoid systems. The hedonic system is not merely related to food, but is part of a global organizational unit governing behavioral choices. In general, patients with anorexia nervosa (restricting) were less sensitive to reward, whereas patients with bulimia nervosa (binge/purge) were more sensitive to reward. People with obesity tended to be more sensitive to food as a reward, a function which involves the dopamine system. While recognizing the addictive aspect of abnormal eating behaviors, we have provided treatment recommendations with respect to these disorders and obesity.

The Development of the 'Mental Fitness' Scale / 신경정신의학

OBJECTIVES: The purpose of this study was to develop and validate the 'Mental Fitness'Scale, which was designed to measure the characteristics of being mentally fit or positive mental health. METHODS: Interviews using open-ended questions were conducted on 105 healthy adults between 20 and 65 years of age to obtain the 25 candidate items of the 'Mental Fitness' Scale. To evaluate the validity of the new scale, these items and the Beck Depression Inventory (BDI), the Positive and Negative Affect Scale (PANAS), and the Epworth Sleepiness Scale(ESS) were administered to 212 healthy adults. To assess test-retest reliability, the preliminary 'Mental Fitness' Scale items were administered two weeks later to 47 healthy subjects selected by random sampling. A comparison was made between the 212 healthy subjects and 42 psychiatric patients with depressive or anxiety disorders. RESULTS: Factor analysis yielded four subscales (mental energy, empathic communication, flexibility, and self-assurance). Five items were excluded due to their low factor loadings. The test-retest reliability coefficients were significantly high, ranging between 0.57-0.76. Internal consistency was computed, and Cronbach's alpha for four subscales ranged between 0.66-0.88, and was 0.90 for the total score. Concurrent validity was assessed by correlating the four subscales and the total score with total scores on the BDI, PANAS, and ESS. The correlations were all at significant levels. CONCLUSION: These results indicate that the 'Mental Fitness' Scale is a reliable and valid instrument for assessing positive mental health.

Relationship between Clinical History Method and Orbscan II for Measuring Corneal Power after LASIK

PURPOSE: To evaluate the relation between clinical history method and Orbscan II for corneal power measurement after laser in situ keratomileusis (LASIK). METHODS: A total of 77 consecutive eyes of 43 patients who were treated with LASIK for myopia were followed up for at least 6 months. Corneal power by clinical history methods (CK) was compared with 3.0 mm zones of simulated keratometry (Sim-K), with 0.5, 1.0, 1.5, 2.0 and 3.0 mm zones of axial power maps (AP) and with 2.0, 3.0, 3.5, 4.0 and 5.0 mm zones of total optical power maps (TOP). RESULTS: Sim-K and all AP-map zones using Orbscan II were significantly higher (P<.001) than the CK value, while all TOP-map zones were significantly lower (P<.001) than the CK value. Among them, 3.0 and 4.0 mm TOP-map zones showed the highest correlation with the corneal power by CK (r2=0.889, P<.001; r2=0.889, P<.001). The correlation was higher with 3.0 mm TOP-map zone (r2=0.800, P<.001) than with 4.0 mm TOP-map zone (r2=0.793, P<.001) in high myopia patients. CONCLUSIONS: Although 3.0 and 4.0 mm TOP-map zones of Orbscan II were correlated highly with the CK value, these correlations were relatively low in high myopia patients and 3.0 mm TOP-map zone was better correlated than 4.0 mm TOP-map zone in these patients.

Risk Factors and Clinical Evaluation for Corneal Ectasia after LASIK

PURPOSE: To describe the clinical evaluation of corneal ectasia after laser in situ keratomileusis (LASIK) and evaluate risk factors. METHODS: Sixteen patients (21 eyes) who had undergone LASIK with corneal ectasia from 1997 to 1999 were reviewed retrospectively. The uncorrected visual acuity, best-corrected visual acuity (BCVA), spherical equivalent (SE), pachymetry, keratometry, intraocular pressure (IOP) and corneal topography were measured before and after LASIK. The targeted residual bed thickness (TRBT) and the ablation percentage of the total corneal thickness were checked. To determine risk factors, we reviewed 60 eyes with uneventful LASIK for 4 years after LASIK. The control group was selected with matched preoperative SE and TRBT similar to the ectasia group. RESULTS: Five (31.3%) of 16 patients developed ectasia bilaterally and the rate of preoperative asymmetric bow-tie pattern was 64.7% in corneal topography. At the final post-LASIK follow-up, disagreement of apices location on anterior and posterior was 33.3% in the right eye and 50.0% in the left eye. The mean time to onset of ectasia was 26.9 15.1 months and 28.6% developed ectasia after more than 40 months after LASIK. In the ectasia group, pachymetry before LASIK, TRBT and pachymetry at postoperative 2 months were thinner than the control group (p<0.05). CONCLUSIONS: Asymmetric bow tie pattern showed a high frequency in the corneal topography of the ectasia group before LASIK and about 1/3 of the cases developed ectasia more than 3 years after LASIK. The incidence of pachymetry before and after LASIK and TRBT was related to the development of ectasia.

Clinical Outcomes of Wavefront-guided LASIK: 6-Months Follow-up

PURPOSE: To observe the result of wavefront-guided (WFG) LASIK and investigate the ocular high order aberrations of WFG LASIK compare with conventional LASIK. METHODS: The uncorrected visual acuity (UCVA), manifest refraction, total high order aberration, coma and spherical aberration in 22 eyes of 13 patients who had undergone WFG LASIK were measured preoperative and at 1, 3 and 6 months postoperatively. The ocular high order aberrations of 19 eyes from 11 patients who had undergone convetional LASIK were measured at 6 months after surgery. The ocular high order aberrations of the WFG LASIK and conventional LASIK groups were compared. RESULTS: In the WFG LASIK group, the UCVA and spherical equivalent increased from 0.06 to 1.08 and from -6.13D to -1.16D, respectively after 6 months. The total high order aberration and coma (RMS) were 0.40 and 0.31 in conventional LASIK and 0.28 and 0.16 in WFG LASIK after 6 months. There was a statistically significant difference (p<0.05). CONCLUSIONS: The clinical outcomes of wavefront-guided LASIK by 6 months were a stable improvement in the visual acuity and a correction of all the optical aberrations of the eye. The postoperative high order aberration was significantly smaller than that in the conventional LASIK group.

Comparison of Contrast Sensitivity with ACV (Visual Capacity Analyzer) in Different Types of Posterior Capsular Opacification

PURPOSE: To compare contrast sensitivity (CS) in type and degree of posterior capsule opacification (PCO) in pseudophakic eyes before and after neodymium: YAG capsulotomy. METHODS: Nine eyes with fibrosis-type PCO and 26 with Elschnig-pearl type PCO were examined for best corrected visual acuity (BCVA) and CS before and 1 week after capsulotomy. CS was tested with visual capacity analyzer (ACV) which uses a Landolt ring of 5 different spatial frequencies (SF) under two different conditions of day (100cd/m2) and night (30cd/m2). The patients were divided into two groups based on the BCVA before capsulotomy: Group A, 4 eyes and 18 eyes with below 0.63 in fibrosis-type and pearls-type PCO, respectively; Group B, 5 eyes and 8 eyes with above 0.63 in fibrosis-type and pearls-type PCO, respectively. RESULTS: The patients with PCO had worse BCVA and CS, but these were improved by Nd: YAG capsulotomy. This was not affected by the types and degrees of PCO. In the daytime condition, CS of B group was worse at all SF in patients with pearl-type PCO than in those with fibrosis-type PCO before capsulotomy, except 19 cpd (p0.05). CONCLUSIONS: In the daytime condition, the patients with pearls-type PCO of relatively poor BCVA had lower CS than those with fibrosis-type PCO.

Effect of Panax ginseng on latency of passive avoidance response and neuronal damage of hippocampus

The effects of crude saponin (SAP) and alkaloid (ALK) fractions of Panax ginseng C.A. Meyer on the detrimental effects of electroconvulsive shock (ECS) and scopolamine on passive avoidance response (PAR) were studied in male Sprague-Dawley rats, referring their effects on the neuronal injury and plasticity of hippocampus in response to electrolytic lesion of left entorhinal cortex (ECL). The detrimental ECS effect on PAR was attenuated by pre- and post-treatments with SAP and ALK, respectively, or by pretreatment with aminoguanidine (AG), an inhibitor of diamine oxidase and NO synthase. And the detrimental scopolamine effect on PAR was also inhibited by pretreatment with ALK or AG, and by posttreatment with SAP or ALK, respectively. On the 7th day after ECL, the brain sections stained by cresyl violet and by acetylcholinesterase (AChE) histochemistry, respectively, showed the chromatolysis and numeral decrease of neurons and the reduction of AChE reactivity in the hippocampus CA1 area and to a lesser extent, in the dentate gyrus. The neuronal cell death of the CA1 area was significantly reduced by SAP, ALK, or AG, and the reduction of AChE reactivity was significantly attenuated by SAP or ALK and to a lesser extent by AG. These results suggests that the protective effect of ginseng SAP and ALK fractions on ECS- or scopolamine-induced impairment of PAR may be ascribed in part to preservation of hippocampal neurons, particularly cholinergic neurons.