PURPOSE: To describe the ocular surface and tear function findings in premature and term babies. METHODS: Sixty eyes of 30 premature babies and 60 eyes of 30 healthy term babies were studied. The subjects underwent routine ophthalmic examinations: corneal sensitivity test, corneal fluorescein test, Schirmer test with anesthesia, tear breakup time test, lipid layer pattern test and conjuctival impression cytology. RESULTS: The mean corneal sensitivity scores were 35.2+/-5.0 mm and 54.2+/-3.7 mm in the premature and term babies, respectively (P<0.001). The mean Schirmer test score with anesthesia was 6.1+/-1.1 mm in the premature babies compared with 8.9+/-1.1 mm in the term babies (P<0.001). Premature babies had a mean lipid layer pattern score of 7.6+/-0.6 points, compared with 7.7+/-0.7 points in the term babies (P>0.001). Mean squamous metaplasia scores were 1.05+/-0.59 in the premature and 0.18+/-0.39 in the term babies (P<0.001). CONCLUSIONS: Premature infants had decreased tactile corneal sensitivity and reduced basal tear secretion as compared with full term infants. The premature infants did not have severe ocular surface disease from dry eyes because the lipid layers provide a protective effect for the ocular surface.
Anesthesia ; Fluorescein ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Metaplasia ; Tears*

PURPOSE: To describe the ocular surface and tear function findings in premature and term babies. METHODS: Sixty eyes of 30 premature babies and 60 eyes of 30 healthy term babies were studied. The subjects underwent routine ophthalmic examinations: corneal sensitivity test, corneal fluorescein test, Schirmer test with anesthesia, tear breakup time test, lipid layer pattern test and conjuctival impression cytology. RESULTS: The mean corneal sensitivity scores were 35.2+/-5.0 mm and 54.2+/-3.7 mm in the premature and term babies, respectively (P<0.001). The mean Schirmer test score with anesthesia was 6.1+/-1.1 mm in the premature babies compared with 8.9+/-1.1 mm in the term babies (P<0.001). Premature babies had a mean lipid layer pattern score of 7.6+/-0.6 points, compared with 7.7+/-0.7 points in the term babies (P>0.001). Mean squamous metaplasia scores were 1.05+/-0.59 in the premature and 0.18+/-0.39 in the term babies (P<0.001). CONCLUSIONS: Premature infants had decreased tactile corneal sensitivity and reduced basal tear secretion as compared with full term infants. The premature infants did not have severe ocular surface disease from dry eyes because the lipid layers provide a protective effect for the ocular surface.
Anesthesia ; Fluorescein ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Metaplasia ; Tears*

PURPOSE: To report upon two cases of anterior capsule opacification (ACO) proliferating into the pupillary region of the anterior surface of a single piece acrylic AcrySof(R) intraocular lens (IOL) (SA60AT, Alcon Laboratories, Inc., USA). The surgical removal of the ACO was also reported. METHODS: An 80-year-old woman and a 75-year-old woman underwent phacoemulsification with implantation of a single piece foldable AcrySof(R) IOL in the posterior capsular bag. ACO proliferating from the opposite sides of the IOL along the central axis were found three months after surgery. To recover visual acuity in the 80-year-old woman's eye, ACO was surgically removed with a Sinskey hook and irrigation and aspiration system. RESULTS: The patient's visual acuity was recovered after surgical removal of the ACO. Histopathologic findings of the removed tissues revealed fibroblastic proliferation of lens epithelial cells. The ACO in 75-year-old woman's eye was not treated, as it was not associated with a visual disturbance. CONCLUSIONS: In eyes containing an AcrySof(R) IOL, clinically significant ACO proliferation into the pupillary region along the central axis can occur. Surgical removal can be beneficial for recovery of visual acuity.
Aged ; Aged, 80 and over ; Axis, Cervical Vertebra ; Capsule Opacification ; Epithelial Cells* ; Female ; Fibroblasts* ; Humans ; Lenses, Intraocular* ; Phacoemulsification ; Visual Acuity

OBJECTIVES: This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. METHODS: A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. RESULTS: The satisfaction surveys in all three periods showed similar results for patients (4.46+/-0.70 point) and healthcare practitioners, including nurses (3.82+/-0.62 point) and physicians (3.60+/-0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. CONCLUSIONS: The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage.
Blood Glucose ; Blood Pressure ; Compliance ; Cost-Benefit Analysis ; Delivery of Health Care ; Diabetes Mellitus ; Gangwon-do* ; Hemoglobin A, Glycosylated ; Humans ; Hypertension ; Korea* ; Life Style ; Patient Compliance ; Patient Satisfaction ; Rural Health Services ; Telemedicine*

Dexamethasone converts pluripotent pancreatic AR42J cells into exocrine cells expressing digestive enzymes. In order to address molecular mechanism of this differentiation, we have investigated the role of mitogen-activated protein (MAP) kinase pathway and gene expressions of p21(waf1/cip1)and nuclear oncogenes (c-fos and c-myc) during AR42J cell differentiation. Dexamethasone markedly increased the intracellular and secreted amylase contents as well as its mRNA level. However, cell growth and DNA content were significantly decreased. With these phenotypic changes, AR42J cells induced transient mRNA expression of p21(waf1/cip1)gene, which reached maximal level by 6 h and then declined gradually toward basal state. In contrast to p21(waf1/cip1), c-fos gene expression was transiently inhibited by 6 h and then recovered to basal level by 24 h. Increased c-myc expression detected after 3 h, peaked by 12 h, and remained elevated during the rest of observation. Dexamethasone inhibited epidermal growth factor-induced phosphorylation of extracellular signal regulated kinase. Inhibition of MAP kinase pathway by PD98059 resulted in further elevation of the dexamethasone-induced amylase mRNA and p21(waf1/cip1)gene expression. These results suggest that p21(waf1/cip1)and nuclear oncogenes are involved in dexamethasone-induced differentiation and inhibition of MAP kinase pathway accelerates the conversion of undifferentiated AR42J cells into amylase-secreting exocrine cells.
Amylases/genetics ; Animals ; Cell Differentiation/*drug effects ; Cell Division/drug effects ; Cell Line, Tumor ; Cyclins/genetics/*metabolism ; Dexamethasone/*pharmacology ; Gene Expression Regulation/drug effects ; Genes, fos/genetics ; Genes, myc/genetics ; MAP Kinase Signaling System/*drug effects ; Mitogen-Activated Protein Kinases/*metabolism ; Pancreas/cytology/*drug effects/enzymology/metabolism ; RNA, Messenger/genetics/metabolism ; Rats ; Support, Non-U.S. Gov't

BACKGROUNDS: Patient counseling has been forced since June. 19, 2014. Prior to this, there was no study to try to standardize medication counseling to improve quality. PURPOSE: This study was to investigate satisfaction level and comprehension level between the pharmacist group and the patient group about standardized medication counseling sheet. METHODS: Questionnaires to assess standardized patient counseling sheet were posted at online survey software (Qualtrics) to pharmacists who worked at community pharmacy and patients who had visited community pharmacy before. RESULTS: Three hundred thirty five patients and three hundred nineteen pharmacists were responded to the questionnaire (Response rate: 72.9%). More than half of each group were satisfied with standardized medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged' and patient group were more satisfied than pharmacist group. Similarly, more than half of each group comprehended with the medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged'. Patient group tended to expect longer patient counseling time per one drug than pharmacist group. Also, the majority of both groups wanted to provide standardized medication counseling sheets constantly and extend for all drugs. CONCLUSION: Both groups were satisfied and comprehended standardized medication counseling sheets, and agreed to expand standardized medication counseling sheets to all drugs. So, it is necessary to build the standardized medication counseling of all drugs.
Comprehension* ; Counseling* ; Female ; Humans ; Nursing ; Pharmacies ; Pharmacists* ; Pregnant Women

STATEMENT OF PROBLEM: Titanium is well known as a proper metal for the dental restorations, because it has an excellent biocompatibility, resistance to corrosion, and mechanical property. However, adhesion between titanium and dental porcelains is related to the diffusion of oxygen to the reaction layers formed on cast-titanium surfaces during porcelain firing and those oxidized layers make the adhesion difficult to be formed. Many studies using mechanical, chemical and physical methods to enhance the titanium-ceramic adhesion have been actively performed. PURPOSE: This study meant to comparatively analyse the adhesion characteristics depending on different titanium surface coatings after coating the casts and wrought titanium surfaces with Au and TiN. MATERIAL AND METHOD: In this study, the titanium specimens (CP-Ti, Grade 2, Kobe still Co. Japan) were categorized into cast and wrought titanium. The wrought titanium was cast by using the MgO-based investment(Selevest CB, Selec). The cast and wrought titanium were treated with Au coating(ParaOne(R), Gold Ion Sputter, Model PS-1200) and TiN coating(ATEC system, Korea) and the ultra low fusing dental porcelain was fused and fired onto the samples. Biaxial flection test was done on the fired samples and the porcelain was separated. The adhesion characteristics of porcelain and titanium after firing and the specimen surfaces before and after the porcelain fracture test were observed with SEM. The atomic percent of Si on all sample surfaces was comparatively analysed by EDS. In addition, the constituents of specimen surface layers after the porcelain fracture and the formed compound were evaluated by X-ray diffraction diagnosis. RESULT: The results of this study were obtained as follows : 1. The surface characteristics of cast and wrought titanium after surface treatment(Au, TiN, Al2O3 sandblasting) were similar and each cast and wrought titanium showed similar bonding characteristics. 2. Before and after the biaxial flection test, the highest atomic weight change of Si component was found in Al2O3 sandblasted wrought titanium(28.6at.% --> 8.3at.%). On the other hand, the least change was seen in Au-Pd-In alloy(24.5at.%--> 19.1at.%). 3. Much amount of Si components was uniformly distributed in Au and TiN coated titanium, but less amount of Si's was unevenly dispersed on Al2O3 sandblasting surfaces. 4. In X-ray diffraction diagnosis after porcelain debonding, we could see Au2Ti compound and TiN coating layers on Au and TiN coated surfaces and TiO2, typical oxide of titanium, on all titanium surfaces. 5. Debonding of porcelain on cast and wrought titanium surface after the biaxial flection is considered as a result of adhesion deterioration between coating layers and titanium surfaces. We found that there are both adhesive failure and cohesive failure at the same time. CONCLUSION: These results showed that the titanium-ceramic adhesion could be improved by coating cast and wrought titanium surfaces with Au and TiN when making porcelain fused to metal crowns. In order to use porcelain fused to titanium clinically, it is considered that coating technique to enhance the bonding strength between coating kKlayers and titanium surfaces should be developed first.
Adhesives ; Corrosion ; Crowns ; Dental Porcelain* ; Diagnosis ; Diffusion ; Fires ; Hand ; Oxygen ; Tin ; Titanium* ; X-Ray Diffraction

The reactive oxygen species (ROS) are considered to be an important mediator in pancreatic beta cell destruction, thereby triggering the development of insulin-dependent diabetes mellitus. In the present study, HIV-1 Tat-mediated transduction of Cu, Zn-superoxide dismutase (SOD) was investigated to evaluate its protective potential against streptozotocin (STZ) -induced cytotoxicity in insulin-producing MIN6N cells. Tat-SOD fusion protein was successfully delivered into MIN6N cells in a dose-dependent manner and the transduced fusion protein was enzymatically active for 48 h. The STZ induced-cell destruction, superoxide anion radical production, and DNA fragmentation of MIN6N cells were significantly decreased in the cells pretreated with Tat-SOD for 1 h. Furthermore, the transduction of Tat-SOD increased Bcl-2 and heat shock protein 70 (hsp70) expressions in cells exposed to STZ, which might be partly responsible for the effect of Tat-SOD. These results suggest that an increased of free radical scavenging activity by transduction of Tat-SOD enhanced the tolerance of the cell against oxidative stress in STZ-treated MIN6N cells. Therefore, this Tat-SOD transduction technique may provide a new strategy to protect the pancreatic beta cell destruction in ROS-mediated diabetes.
Diabetes Mellitus, Type 1 ; DNA Fragmentation ; HIV-1 ; HSP70 Heat-Shock Proteins ; Insulin-Secreting Cells ; Oxidative Stress ; Reactive Oxygen Species ; Streptozocin ; Superoxide Dismutase ; Superoxides

PURPOSE: The aim of this study was to compare the clinical usefulness of serum procalcitonin (PCT) levels in Mycoplasma pneumoniae pneumonia (M. pneumonia) and viral pneumonia in children. METHODS: We retrospectively analyzed the medical records of 348 patients admitted between June 2015 and December of 2015. There were 162 patients with M. pneumonia without virus coinfection (group 1) and 186 patients with viral pneumonia (group 2). All subjects had radiographic evidence of pneumonia with available specimens for both M. pneumonia and viral testing, and levels of serum PCT, white blood cell counts (WBC), neutrophil portion, and C-reactive protein (CRP). Fifty-eight children who performed follow-up sampling at the time of no fever for more than 48 hours were subdivided into group 3 (M. pneumonia with follow-up sampling, n=41) and group 4 (viral pneumonia with follow-up sampling, n=17). RESULTS: No difference was noted in the levels of serum PCT (P=0.168), CRP (P=0.296), WBC (P=0.732), and neutrophil proportion (P=0.069) between groups 1 and 2, after adjusting for age. Serial changes in serum PCT levels between the first and second samples were significant in group 3 (P=0.046). Serial changes in serum CRP levels between the first and second samples were significant in group 4 (P=0.008). CONCLUSION: Serum PCT and CRP levels may change differently after infection according to the etiology of pneumonia.
C-Reactive Protein ; Child* ; Coinfection ; Cross-Sectional Studies* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Medical Records ; Mycoplasma pneumoniae ; Mycoplasma* ; Neutrophils ; Pneumonia ; Pneumonia, Mycoplasma* ; Pneumonia, Viral* ; Retrospective Studies

PURPOSE: TPN has been widely used to treat nutritional depletion since the late 1960s. However, many metabolic complications may occur as a result of parenteral feeding. Among these, hepatic complications has received increasing attention. A retrospective review of liver function abnormalities in adult patients who underwent TPN was done to determine the frequency and magnitude of the abnormalities in a liver function test. METHODS: From January 2001 to Jun 2001, 160 adult patient receiving TPN were reviewed. Of these, 111 had a malignant disease and 49 had a benign disease. The duration of TPN therapy ranged from 5 days to 52 days, with a mean duration of 14 days. Abnormalities of liver function test were defined as a value greater than the upper normal limit. Forty cases of gastric cancer were analyzed to determine the risk factors that contribute to abnormal liver function in individual patients receiving TPN. RESULTS: Abnormalities of the liver function test appeared after 6~7 days of therapy. Increases in the ALP levels were noted in 34 out of 93 patients (37.6%), in the AST levels in 42 out of 116 patients (36.2%), in the ALT levels in 54 out of 125 patients (43.2%), in the LDH levels in 20 out of 72 patients (27.8%), in the gamma-GTP levels in 44 out of 81 patients (54.3%), and in the bilirubin levels in 30 out of 126 patients (23.8%). The serum ALP level rose to 1.6 times upper the limit of normal; AST, 1.7 times; ALT, 2.0 times; LDH, 1.2 times; gamma-GTP, 2.4 times; bilirubin, 2.4 times. gamma-GTP value was most sensitive. In 40 gastric cancers, factors as age, the amount of TPN solution, the duration of TPN, intraoperative chemotherapy, transfusion, and postoperative infection were investigated. However, no association with TPN-associated liver function abnormalities was found. CONCLUSION: The incidences of an abnormal liver function during TPN were 23.8~54.3%. However, the liver function abnormalities that developed during short term-TPN were reversible and not serious.
Adult ; Bilirubin ; Drug Therapy ; Humans ; Incidence ; Liver Function Tests ; Liver* ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms