Normal-tension Glaucoma Management: A Survey of Glaucoma Sub-specialists in Korea

Purpose@#To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. @*Methods@#A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). @*Results@#A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). @*Conclusions@#Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

Normal-tension Glaucoma Management: A Survey of Glaucoma Sub-specialists in Korea

Purpose@#To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. @*Methods@#A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). @*Results@#A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). @*Conclusions@#Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

Mechanisms underlying TNFα-induced enhancement of force generation in airway smooth muscle.

Airway diseases such as asthma are triggered by inflammation and mediated by proinflammatory cytokines such as tumor necrosis factor alpha (TNFα). Our goal was to systematically examine the potential mechanisms underlying the effect of TNFα on airway smooth muscle (ASM) contractility. Porcine ASM strips were incubated for 24 h with and without TNFα. Exposure to TNFα increased maximum ASM force in response to acetylcholine (Ach), with an increase in ACh sensitivity (hyperreactivity), as reflected by a leftward shift in the dose-response curve (EC50 ). At the EC50 , the [Ca2+ ]cyt response to ACh was similar between TNFα and control ASM, while force increased; thus, Ca2+ sensitivity appeared to increase. Exposure to TNFα increased the basal level of regulatory myosin light chain (rMLC) phosphorylation in ASM; however, the ACh-dependent increase in rMLC phosphorylation was blunted by TNFα with no difference in the extent of rMLC phosphorylation at the EC50 ACh concentration. In TNFα-treated ASM, total actin and myosin heavy chain concentrations increased. TNFα exposure also enhanced the ACh-dependent polymerization of G- to F-actin. The results of this study confirm TNFα-induced hyperreactivity to ACh in porcine ASM. We conclude that the TNFα-induced increase in ASM force, cannot be attributed to an enhanced [Ca2+ ]cyt response or to an increase in rMLC phosphorylation. Instead, TNFα increases Ca2+ sensitivity of ASM force generation due to increased contractile protein content (greater number of contractile units) and enhanced cytoskeletal remodeling (actin polymerization) resulting in increased tethering of contractile elements to the cortical cytoskeleton and force translation to the extracellular matrix.

Intracranial Artery Stenting May Not Improve Cognitive Function: A Preliminary Study / 대한뇌졸중학회지

No abstract available.

Comparison of Ganglion Cell-Inner Plexiform Layer and Retinal Nerve Fiber Layer after Cataract Surgery

PURPOSE: To observe the change in the measured thickness of ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) thickness before and after cataract surgery. METHODS: Forty-six eyes of 32 patients, scheduled to have cataract surgery, were imaged with spectral-domain optical coherence tomography (OCT) (Cirrus HD OCT) before and 5 weeks after the surgery to measure GCIPL and RNFL thickness repeatly. RESULTS: All GCIPL and RNFL thickness parameters were significantly higher postoperatively compared with preoperative measurements (p < 0.001). RNFL thickness changed more than GCIPL; the increased amount of mean RNFL thickness (14.16%) was higher than GCIPL thickness (7.36%; p < 0.001). GCIPL and RNFL thicknesses and, GCIPL signal strength changes were significantly increased in all types of cataracts (p < 0.05). RNFL signal strength change was significantly increased in posterior subcapsular cataracts (p < 0.05). CONCLUSIONS: Cataracts may affect GCIPL and RNFL thicknesses. After cataract surgery, GCIPL thickness, similar to the RNFL thickness, was increased significantly. As GCIPL thickness may be less affected by cataracts than RNFL thickness, GCIPL thickness may be a more meaningful indicator for the diagnosis of glaucoma with cataract.

A Case of Optic Neuropathy Caused by Fungal Ball in an Onodi Cell

PURPOSE: To report a rare case of optic neuropathy caused by a fungal ball in an Onodi cell. CASE SUMMARY: A 63-year-old female was referred to our clinic with relapsed visual loss and ocular pain in the right eye. She had been diagnosed as optic neuritis 14 days before and given pulse steroid therapy. She recovered to normal but relapsed 7 days before. In medical referral there was no suspected multiple sclerosis but only a few inflammation in the paranasal sinuses. On our initial examination, best corrected visual acuity was counting finger at 10 cm in the right eye, and 1.0 in the left eye, along with relative afferent pupillary defect in the right eye. The fundoscopic examinations disclosed disc swelling; nearly total visual field defect was observed on visual field examination and visual evoked potential test revealed decreased amplitude at P100 wave in the right eye. Clinical impression was relapsed optic neuritis. After the administration of pulse steroid therapy, her disc swelling was decreased and visual acuity was recovered to 0.6, however, visual acuity was exacerbated to 0.4 in 2 weeks. We checked outside brain magnetic resonance imaging (MRI) and the result showed optic neuropathy caused by a fungal ball in an Onodi cell. The patient was referred to otorhinolaryngologist and fungal ball was removed by endoscopic sinus surgery. 3 weeks after surgery the patient's visual acuity was 0.9, no disc swelling was found and visual evoked potential was recovered to normal. CONCLUSIONS: An Onodi cell lesion should be considered in the differential diagnosis of optic neuritis, identified by imaging studies and promptly removed by surgery for visual recovery.

Wettability of titanium implants depending upon surface properties / 대한치과보철학회지

STATEMENT OF PROBLEM: When an implant is fixed, a fixture comes into contact with a tissue fluid. Adhesion of a tissue fluid to a surface of implant is various case by case. PURPOSE: The ultimate goal of this work is to analyze a correlation between a surface roughness and wettability of implant specimens. A measurement for wettability is performed considering 4 types of specimen implant with surface treatments different from each other to investigate the change of wettability with the elapse of time. MATERIAL AND METHODS: Firstly, 20 specimens of titanium were prepared. The specimen were made of a commercial Titanium Grade IV with the diameter of 10 mm and the thickness of 1 mm. According to the method of surface treatment, the specimens were classified into 4 groups of 5 specimens per group. Group A: Machined Surface Group B: Anodized surface Group C: RBM (HA blasting) surface Group D: CMP (calcium methaphosphate) coating surface. Surface roughness of specimen was measured using SV-3000S4 (Mituyoto, Japan). The measurement was based on the standard of JIS1994. Sessile drop method was used to measure the wettability, which measures contact angle between implant disc and saline with the time interval of 5, 10, and 15 seconds. SPSS 11.0 was used to analyze the collected data. In order to analyze the difference of wettability and surface roughness according to implant surface treatment method. The statistical significance was tested with the confidence level of 95 percent. Pearson's correlation coefficient was used to evaluate the correlation of surface roughness and wettability. RESULTS: The difference of surface roughness was statistically significant in the order of Group C (1.69 +/- 0.26), Group D (1.58 +/- 0.16), Group B (0.78 +/- 0.14) Group A (0.18 +/- 0.05). The wettability has also a statistically significant difference, which was in the order of group B (17.70 +/- 2.66), Group C (27.86 +/- 4.52), Group D (66.28 +/- 3.70) Group A (70.52 +/- 8.00). There was no difference in wettability with the passage of time. CONCLUSIONS: 1. The surface roughness was high in the order of RBM, CMP, Anodized, Machined group (P < .05). 2. The wettability was high in the order of Anodized, RBM, CMP, Machined group (P < .05). 3. There was no statistical significance in the correlation of surface roughness and wettability.

A Case of Vestibular and Facial Nerve Root Entry Zone Infarction in AICA Territory Presenting with Vertigo Which Mimics Labyrinthine Lesion

Vertigo mimicking labyrinthine lesions may have resulted from ischemic insult to the inner ear or the vestibular nerve and nucleus in the AICA infarction syndrome. A 56-year-old female was admitted to the emergency room with vertigo and hearing loss in right ear. On neurological examination, she had left beating jerky torsional and horizontal nystagmus with falling and past pointing to right side. Brain magnetic resonance images showed high signal intensity in anterolateral portion of inferior pons on T2- weighted images. Severe right facial palsy of peripheral type developed 24 hours after admission. Audiometry and electronystagmography documented absent auditory and vestibular function on the affected side. We argue that vertigo of the acute infarction in AICA territory can be involved the eight and seventh nerve root entry zoon and mimic labyrinthine lesions

Cerebral Infarction in Essential Thrombocythemia after Discontinuation of Hydroxyurea

Abnormalities in the number and function of platelets may contribute to thromboembolic complications in patients with essential thrombocythemia(ET). Physicians often use hydroxyurea which reduces the platelet count for the initial treatment of ET. A 74-year-old man with ET was presented with headache, dysarthria, and right hemiparesis 10 months after discontinuation of hydroxyurea. Initial platelet count was 450x103/microliter and we gave him heparin. However, his platelet count rised upto 1,019x103/microliter within 4 days. He was on hydroxyurea 1.5 g/day and his symptoms improved with decrease of platelet count. We report a case of left MCA(middle cerebral artery) multifocal infarction in ET after discontinuation of hydroxyurea.

A Study of the cPR Training Course for Nurse Teachers and Ambulance Drivers

No abstract available.

A Granuloma Caused by Candida guilliermondii

No abstract available.

A Case of Eosinophilic Pustular Folliculitis Associated with Plantar Lesion / 대한피부과학회지

We report a case of eosinophilic pustular folliculitis (EPF) with associated plantar lesions in a 45-year-old man. Exarnination of the skin disclosed an erythematous patch, approximstely 3 x 5cm, on the left cheek, which contained discrete and confluent pspulopustules and scaly circinated vesicular patch on the right foot. Histologic examination of a biopsy specirnen from the left cheek revealed the hair follicles and the sebaceous glands are infiltrated mainly by eosinophils and by some mononuclear and neutrophils. Histologic examination of a biopsy specimen from the right foot revealed a vesicle extending from the subcorneal portion to the lower epidermis, which was filled with neutrophils and a small number of eosinophils.

Porokeratosis Plantaris Palmaris et Disseminata ( PPPD ) Associated with Basal Cell Epithelioma / 대한피부과학회지

Porokeratosis may be due to an abnormal clone of cells, predisposing affected individusls to development of malignant neoplssm over involved area. A 58-year old female is prsented with basal cell epithelioma associated with PPPD, exhibiting the classical histopathologic criteria of the disease. Total excision for basal cell epithelioma and oral administration of etretinate for the treatment of porokeratosis plantaris, palmaris et disseminata and for the prevention of cancer developrnent resulted in good response.

A Study on 1 , 302 Cases of Skin Tumor / 대한피부과학회지

A study was made on 1,302 cases of skin tumors which were obtained mainly from surgical pathology specimen during the period of 14 years from 1973 to 1986 at Department of Dermatology in Korea University Hospital. The results were summarized as follows : 1. Of the 1,302 cases of skin tumors, 1,143 cases(87.8%) were benigh tumor, 159 cases(12.2%) of malignant tumor and male to female ratio was 1.1: l. 2. Among the 1,143 cases of benign tumors, 301 cases of epidermal cyst, 183 cases of lipoma, 173 cases of pigmented nevi and 88 cases of hemangioma were noted. 3. Among the 159 cases of malignant tumors, 46 cases of squamous cell carcinoma, 27 cases of basal cell carcinoma, 26 cases of malignant melanoma, and 17 cases of metastatic carcinoma were observed. 4. The sites of predilection of the epidermal cysts were trunk (21.9%), face (20.9%), and neck (13.9%) and lipoma was trunk (48.6%). The sites of predilection of the suamous cell carcinomas were penis (11.1%), sclap (12.9%), face (18.5%), and leg (11.1%), basal cell carcinoma was face (55.6%) and malignant melanoma was sole (26.9%). 5. Among the 17 cases of cutaneous metastatic cancer, primary sites were breast (4 cases), pancreas (1 cases), lung (2 cases), stomach (1 cases) and unkown sites (9 cases).