Efficacy of combined 0.05% cyclosporine and 1% methylprednisolone treatment for chronic dry eye.

PURPOSE: To compare the efficacy of topical cyclosporine 0.05% (tCsA) and combined treatment with 1% methylprednisolone acetate for the treatment of moderate-to-severe chronic dry eye. PATIENTS AND METHODS: Forty-four patients with moderate-to-severe dry eye who had not responded to conventional treatment were treated with tCsA for 3 months. Twenty-one subjects (Group 1) were treated with 1% methyl prednisolone acetate and tCsA for the initial 3 weeks, and treated with tCsA only thereafter, and 23 subjects (Group 2) were treated with tCsA only. Symptom scores, tear break-up time (TBUT), Schirmer score, and corneal and conjunctival fluorescein staining were evaluated before and at 1, 2, and 3 months after treatment. Proinflammatory factors, interleukin-6 (IL-6), and interleukin-8 (IL-8) tear concentration were measured before treatment and at 3 months. RESULTS: Symptom scores, Schirmer scores, TBUT score, corneal fluorescein, and conjunctival staining showed significant improvement at 1 month compared to baseline in group 1 (all P < 0.001), and all the same but few exceptions in group 2 (P = 0.002 on Schirmer, P = 0.267 on cornea stating). In symptom scores, Schirmer scores, and corneal staining, greater improvements were observed for group 1 at 1 month compared to group 2 (P < 0.001, P = 0.039, P = 0.01, respectively). However, in TBUT score and conjunctival staining, there were no between-group differences (P = 0.277, P = 0.254, respectively). The time interval from treatment initiation to symptom relief was shorter for group 1 than group 2. Both groups showed decreased tear IL-6 and IL-8 concentrations at 3 months compared to baseline levels (P < 0.05). However, no between-group differences were noted in mean concentrations of IL-6 and IL-8 at baseline and at 3 months. CONCLUSIONS: Treatment with tCsA appears to be safe and effective in moderate-to-severe chronic dry eye. Additional short-term use of a topical steroid had the benefit of providing faster symptom relief and improvement of ocular sign without serious complications.

[Effect of an on-line health promotion program connected with a hospital health examination center on health promotion behavior and health status].

PURPOSE: The purpose of this study was to evaluate the effect of an On-line health promotion program connected with a hospital health examination center. METHODS: Based on contents developed, the www.kmwellbeing.com homepage was developed. The research design was a one group pretest-posttest design. Seventy-three clients participated in this study. The data were collected from January 3 to June 30, 2005. As a way of utilizing the homepage, this paper attempted to measure the change of pre and post program health promotion behavior and health status (perceived health status, objective health index-blood pressure, pulse, total cholesterol, blood sugar, waist flexibility, grip strength and lower extremity strength). Data were analyzed by descriptive statistics and paired t-test with the SPSS/Win 12.0 program. RESULTS: There were significant differences of perceived health status, systolic BP, waist flexibility and grip strength. However, there were no significant differences in health promotion behavior, diastolic BP, pulse, lower extremity strength, blood sugar and total cholesterol between pre program and post program. CONCLUSION: It is expected that an on-line health promotion program connected with a hospital health examination center will provide an effective learning media for health education and partially contribute to client's health promotion. A strategy, however, is needed to facilitate the continuous use of the on-line health promotion program for adult clients.