PURPOSE: Since the laparoscopic cholecystectomy became an usual procedure, operative indications of the gallbladder polyps have had the tendency to enlarge. There are no precise management plan about the gallbladder polyps which is not included in the accepted operative indications. Therefore a management plan may be required for the patients who has gallbladder polyps which is not accepted operative indications. METHODS: We retrospectively analysed 106 patients with gallbladder polyps who were diagnosed preoperatively by ultrasound and CT from January 1991 to January 2005. Our operation indications are polyp above 10 mm, symptomatic polyp, sessile polyp, coincidence of stone, focal thickening of gallbladder wall, diffuse wall thickening and detection during other operations. The gallbladder polyps which were suspected to the gallbladder cancer strongly on radiologic studies and polyps above 20 mm size were excluded in this studies. RESULTS: Among the 106 patients, 87 patients underwent operation, and polypoid lesions disappeared during the follow-up period in 3 patients, and 16 patients are on regular follow up. Fifty-six cases received operation with accepted operative indications, and the thirty-one cases underwent operation by the patient's demand. Two groups showed significant difference in true polyp on pathological diagnosis (P < 0.001). There was 16.07% true polyp in opertive indication based 56 patients and no true polyp in patient's demanded 31 cases. The pathologic diagnoses were cholesterol polyp in 27 patients (87.15%), no polyp in 2 patients, adenomatous hyperplasia in 2 patients. The correlation of the polyp size and pathologic diagnosis was an inverse relation to the polyp size and incidence of pseudopolyp (P=0.014). CONCLUSION: We propose that the 6-month-interval follow-up observation is fully safe for polyps sized below 10 mm and not included in accepted operative indications.
Cholecystectomy, Laparoscopic ; Cholesterol ; Diagnosis ; Follow-Up Studies ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Hyperplasia ; Incidence ; Polyps ; Retrospective Studies ; Surgical Procedures, Operative ; Ultrasonography

There is a considerable body of literature describing the trials of meditation as adjunctive treatment of psychiatry. Although meditation has included various concepts and activity through a long history, meditation used as a therapeutic intervention in psychiatry has usually been accepted as a kind of emotion and attention regulation training. The aim of this article was to review historical origin, clinical effectiveness, and neurobiological mechanism of meditation as treatment for psychiatric disorders. Meditation is originated from various types of religious tradition. In general, meditation is divided by the consciousness meditation and the awareness meditation. Concept of mindfulness-based therapy is mainly based on awareness meditation. In addition to two types of meditation, loving kindness meditation is developed and exercised in compassion-focused therapy. Neurobiological evidence suggests that meditation reduces stress-related autonomic and endocrine change. In addition, research using neuroimaging has provided biological evidence that a specific region of brain activity and connectivity is related to subjective experience of meditation. Clinical trials support the effectiveness of meditation for the treatment of anxiety, depression, and any other stress-related disorders. In the future, profound understanding of the neurobiological mechanism, clinical effectiveness, and side effects of meditation as treatment intervention of for psychiatric disorders would be provided for evidence based meditative practice.
Anxiety ; Brain ; Complementary Therapies ; Consciousness ; Depression ; Love ; Meditation* ; Mindfulness* ; Neuroimaging

PURPOSE: Bone marrow has long been a source of primary cells. This study was performed to evaluate the effects of age and sex on the cellular viability and expression of stem cell markers of mRNA and on the protein expression of bone marrow stem cells (BMSCs) derived from healthy donors. MATERIALS AND METHODS: Stem cells were isolated from human bone marrow and plated in culture plates. The shape of the BMSCs was observed under inverted microscope. Quantitative cellular viability was evaluated using a Cell-Counting Kit-8 assay. The expression of stem cell surface markers was tested and a series of quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot was performed to evaluate the expression in each group. RESULT: The shapes of the cells at 20s, 30s, and 50s were similar to each other. No significant changes in cellular viability were noted among different age groups or sex groups. The BMSCs expressed CD44, CD73, and CD90 surface markers but did not express CD14 and CD34. There were no noticeable differences in CD surface markers among the different age groups. The expressions of CD surface markers were similar between men and women. No significant differences in the secretion of vascular endothelial growth factors (VEGFs) were noted at Day 3 between different age groups. qRT-PCR regarding the expression showed differences between the age groups. However, Western blot analysis showed a decrease in expression but did not reach statistical significance (P>0.05). CONCLUSION: This study clearly showed no significant differences in shape, cell viability, expression of stem cell surface markers, or secretion of human VEGF among different age groups. However, western blot analysis showed a tendency of age-related decrease which did not reach statistical significance. Collectively, autologous or allogeneic BMSCs should be meticulously applied to obtain optimal results regarding age and sex.
Age Factors ; Blotting, Western ; Bone Marrow ; Cell Shape ; Cell Survival ; Female ; Humans ; Male ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Stem Cells ; Tissue Donors ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

Purpose: To introduce an intuitive method for measuring conjunctival microvascular blood flow velocity by imaging bulbar conjunctival microvessels using a slit-lamp biomicroscope equipped with a zoom lens and an ultra-high-speed camera. Methods: After obtaining consent from 10 patients (1 male, 9 females) who visited Yeouido St. Mary’s Hospital from August 21, 2020, to June 12, 2021, the patients were examined under a slit lamp microscope equipped with an ultra-high-speed camera and zoom lens. The blood flow in the conjunctival microvessels was photographed. The captured images were analyzed with ImageJ software to measure the blood flow velocity in the conjunctival microvessels, and we investigated whether the blood flow velocity correlated with the vessel diameter and age. Results: The median age of the subjects was 49.0 years. The mean conjunctival blood flow velocity in 53 microvessels was 0.786 ± 0.468 mm/s. The median conjunctival microvascular diameter was 7.06 μm (interquartile range 5.84 to 9.23 μm). The conjunctival microvascular diameter and blood flow velocity were not significantly correlated (Spearman’s p = 0.177), and the subjects’ age and conjunctival microvascular blood flow velocity were also not correlated (Spearman’s p = 0.669). Conclusions In this study, the blood flow velocity in the bulbar conjunctival microvessels could be measured easily by means of image analysis using a slit-lamp microscope equipped with an ultra-high-speed camera with a zoom lens.

Purpose: To analyze trends in corneal transplantation surgery and determine the number of domestic and imported corneal grafts used in South Korea.Method: The total number of keratoplasties and number of each individual surgical procedure conducted in 2010 and 2020 were identified using Health Insurance Review and Assessment Service data. The number of keratoplasties using domestic corneas in 2010 and 2020 was determined from the annual report of the Korean Network for Organ Sharing (KONOS). The number of keratoplasties using imported corneas was calculated by subtracting the number of keratoplasties using domestic corneas from the total number of keratoplasties. Results: In 2010, 802 keratoplasties were performed in Korea, of which 299 (37.3%) used imported corneas; 715 (89.2%) were penetrating keratoplasties and 87 (10.8%) were anterior lamellar keratoplasties. In 2020, 911 keratoplasties were done in Korea and 564 (61.9%) used imported corneas; 541 (59.4%) were penetrating keratoplasties, 60 (6.6%) were anterior lamellar keratoplasties, and 310 (34.0%) were endothelial keratoplasties. From 2010 to 2020, the number of penetrating keratoplasties in Korea decreased, while the numbers of endothelial keratoplasties and keratoplasties using imported corneas increased. Conclusions There was a 30% decrease in the number of penetrating keratoplasties from 2010 to 2020, and a 30% increase in the numbers of endothelial keratoplasties and keratoplasties using imported corneas. The proportions of endothelial keratoplasties and imported corneas have increased steadily in Korea over the last 10 years.

Purpose: In the present study, we introduce human lacrimal gland imaging using an ultrasound biomicroscopy (UBM) with a soft cover and show their findings Methods: The representative UBM findings of palpebral lobes in seven subjects (four with non-Sjögren dry eye syndrome, one with Sjögren syndrome, and two healthy subjects) were described in this study. To prolapse the palpebral lobe, the examiner pulled the temporal part of the upper eyelid in the superotemporal direction and directed the subject to look in the inferonasal direction. We scanned the palpebral lobes longitudinally and transversely using UBM. We used an Aviso UBM with a 50 MHz linear probe and ClearScan. Results: In UBM of two healthy subjects, the echogenicity of the lacrimal gland was lower than that of the sclera and homogeneous. But the parenchyma of a patient with Sjögren dry eye syndrome was quite inhomogeneous compared to the healthy subjects. In two patients with dry eye syndrome, we were able to observe some lobules in the parenchyma. We could find excretory ducts running parallel at the surface of the longitudinal section in some subjects. In the longitudinal UBM scan of a subject, we observed a tubular structure at a depth of 1,500 μm that was considered a blood vessel. It ran from the superonasal to the inferotemporal direction. In a subject, we observed a large cyst beneath the conjunctiva. Conclusions Lacrimal gland imaging using UBM has both advantages of optical coherence tomography and sonography, and could be useful for evaluating dry eye syndrome.

Purpose: To evaluate the effectiveness of an instrument devised for slit-lamp examination of donor corneas suspended in preservation medium. Methods: The study examined two donor corneas received at Yeouido St. Mary's Hospital in February 2023 and March 2023. The instrument has three main components: a plastic holder to hold the preservation medium bottle, a cube with a mirror for reflecting the slit beam, and a stand to attach the device to the slit-lamp. Using the instrument, the donor corneas were examined via slit-lamp: microscopy with the endothelium facing upward and downward. Specular microscopy and anterior segment optical coherence tomography (OCT) were also performed on the preserved donor corneas. Results: Slit-lamp examination of donor corneas in preservation medium using the instrument showed overall corneal buttoning and optical sections of the donor cornea. Using specular reflection and retroillumination, the endothelial layer was partially visible. However, specular microscopy and anterior segment OCT could not examine the donor cornea in preservation medium using the instrument. Conclusions The devised instrument facilitates slit-lamp examination of donor corneas in preservation medium, enabling a qualitative assessment of donor corneas before corneal transplantation surgery.