No abstract available.
Child* ; Drug Therapy ; Humans

Over the past decade, significant advances have been made in both the diagnosis and treatment of diabetic retinopathy. Ultrawide field fundus photography and spectral domain optical coherence tomography have allowed more accurate, convenient, and early diagnosis of diabetic retinopathy. Numerous randomized clinical trials have demonstrated the effectiveness of anti-vascular endothelial growth factor agents for the treatment of diabetic retinopathy, although more work is necessary in terms of long-term clinical outcomes and socioeconomic costs associated with these treatments.
Diabetic Retinopathy* ; Diagnosis* ; Early Diagnosis ; Endothelial Growth Factors ; Epidemiology ; Photography ; Tomography, Optical Coherence

PURPOSE: To evaluate segmentation reliability in diabetic macular edema (DME) estimates between a Cirrus™ HD-OCT image analysis algorithm and an Iowa reference algorithm, which are an automatic segmentation software. METHODS: Thirty eyes from 23 patients diagnosed with DME were included and underwent spectral-domain optical coherence scans (Cirrus™ HD-OCT). Central foveal thickness (CFT) and ganglion cell layer-inner plexiform layer segmentation data were compared with those produced by the Cirrus™ HD-OCT segmentation algorithm and Iowa reference algorithm. Measurement agreement was assessed using intraclass correlation (ICC) and segmentation errors were confirmed by 2 ophthalmologists. RESULTS: The mean CFT in the 1-mm central area determined by the manufacturer-supplied Cirrus software and Iowa reference algorithm was 512.07 ± 182.35 µm and 476.53 ± 32.36 µm, respectively (p < 0.05). The mean paired difference was 35.53 ± 92.46 µm (ICC, 0.929). Segmentation errors were demonstrated in eyes with a CFT less than 400 µm, specifically for 45% of scans obtained by the Cirrus algorithm and 9% from the Iowa algorithm; in eyes with a CFT equal to or higher than 400 µm, the error rates were 95% and 42%, respectively. CONCLUSIONS: CFT measurement in eyes with diabetic macular edema using the Cirrus algorithm and Iowa algorithm showed relatively high degrees of agreement and significant correlation. In eyes with a CFT equal to or higher than 400 µm, the Iowa algorithm showed higher reliability in retinal segmentation than the Cirrus algorithm.
Ganglion Cysts ; Humans ; Iowa ; Macular Edema* ; Retinaldehyde ; Tomography, Optical Coherence

PURPOSE: The exposure to domestic animals has been increased, but there is no systematic evaluation for the clinical importance of animal antigens in Korea. The purpose of this study is to evaluate the significance of animal epithelial antigens as the causative allergens in childhood asthma and rhinitis. METHODS: In 228 children with asthma and rhinitis, allergic skin tests were done with 72 extracts, including 5 animal epithelial antigens. RESULTS: According to the results of allergy skin tests, 208 out of 228 children showed positive skin reactions to more than one antigens, and 128(61.4%) showed positive reactions to animal epithelial extracts. Among them, 17(8.1%) were mites non-sensitive to house dust and sensitive to animal epithelium. The positive reaction to each antigens were as follows:D. farinae(72.6%), D. pteronyssinus(69.7%), rabbit(40.3%), cat(33.1%), dog(24.0%), horse(16.8 %), and cow(14.9%). The degree of skin reactions to animal epithelial antigens were weaker than those to house dust mites. The positive concordance rates between skin tests and specific IgE reactions to D. pteronyssinus and cat/dog were 89.1%, and 25.9%, respectively. We experienced six patients with asthma and rhinitis who suspected animal epithelium as a causative allergen. CONCLUSION: Up to 61.4% of children with respiratory allergy showed positive reactions to animal epithelial extracts and 8.1% of them were house dust mites non-sensitive cases. Therefore, animal epithelium should be investigated as a causative allergen when skin reactions were strong and showed positive specific IgE antibodies.
Allergens ; Animals* ; Animals, Domestic ; Antibodies ; Asthma* ; Child* ; Dust ; Epithelium* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea ; Mites ; Pyroglyphidae ; Rhinitis* ; Skin ; Skin Tests

BACKGROUND:We performed spectral analysis and determined the 1/f noise of heart rate variability during enflurane anaesthesia in order to assess the effect of the activity of the autonomic nervous system. METHODS: Data were acquired from 15 patients (ASA I-II) who received gynecological surgery under general anesthesia using enflurane, nitrous oxide and oxygen. We analyzed the spectral components of heart rate variability (HRV) according to the following five periods: 1) before premedication, 2) after induction, 3) during skin incision, 4) during recovery, and 5) after surgery. For each power spectrum the density and frequency components were identified as follows: (1) low frequency (LF) component (0.04-0.15 Hz) was associated with parasympathetic and sympathetic tone, and was affected by body temperature, the renin-angiotensin system, baroreceptor and vasomotor sympathetic modulation, (2) high frequency (HF) component (0.15-0.5 Hz) was mediated parasympathetic tone and reflected the mechanical influence of the ventilation. In addition the LF/HF ratio, which reflected cardiac sympathovagal balance was monitored. RESULTS: The LF/HF ratio, which reflects the balance of the autonomic nervous system increased remarkably during skin incision and recovery. Also, the beta index, which is related to body activity decreased during skin incision and recovery. CONCLUSIONS: Increased LF/HF was found to be caused by mechanical stimulation, which reflects autonomic nervous system balance, and the beta index was useful for the assessment of body activity.
Anesthesia* ; Anesthesia, General ; Autonomic Nervous System ; Body Temperature ; Enflurane* ; Female ; Gynecologic Surgical Procedures ; Heart Rate* ; Heart* ; Humans ; Nitrous Oxide ; Noise ; Oxygen ; Premedication ; Pressoreceptors ; Renin-Angiotensin System ; Skin ; Ventilation

Purpose: To determine subjective symptoms and medical history of patients with intermittent exotropia in a large study population. Methods: The Korean Intermittent Exotropia Multicenter Study (KIEMS) is a nationwide, observational, cross-sectional, multicenter study conducted by the Korean Association for Pediatric Ophthalmology and Strabismus including 5,385 patients with intermittent exotropia. Subjective symptoms and medical history of patients with intermittent exotropia were extracted by a comprehensive survey based on a self-administered questionnaire according to the study protocol of the KIEMS. Results: The mean age of symptom onset was 5.5 years. The most common symptom reported in patients with intermittent exotropia was photophobia (52.1%), followed by diplopia at near fixation (7.3%) and distance fixation (6.2%). Preterm birth was found in 8.8%, and 4.1% had perinatal complications. A family history of strabismus was present in 14.9%, and 5.5% of patients had a family member who underwent strabismus surgery. Conclusions The KIEMS is one of the largest clinical studies on intermittent exotropia. Intermittent exotropia frequently caused photophobia and diplopia, and patients with a family history was not uncommon.

PURPOSE: Point mutation of the K-ras gene causes irreversible binding of GTP to the P21-ras protein, which induces nuclear transcription factors and enhances cellular proliferation. Point mutation of the K-ras gene is known to be a poor prognostic marker of an adenocarcinoma of the lung. As about 30% of adenocarcinomas harbor the K-ras mutation, studies are being undertaken trying to use the K-ras mutation as a marker for the early detection of lung cancer. In Korea, squamous cell carcinomas are more prevalent than adenocarcinomas, but the incidence of the K-ras mutation has not been properly investigated. MATERIALS AND METHODS: Using 25 surgically resected lung cancer specimens (10 squamous cell lung carcinomas, 10 adenocarcinomas and 5 non-small cell lung cancers), 25 pairs of DNA were extracted from cancerous and normal lung tissues. After PCR, with two sets of primers flanking codons 12~13 and 61 of the K-ras gene, the mutation was screened using single strand conformational polymorphism (SSCP). To verify the SSCP findings, automatic sequencing was also performed for all DNA's from the tumor and normal lung tissues. RESULTS: No samples with a band shift in SSCP were observed. In the sequencing of the 25 pairs of DNA, there were no mutations in codons 12, 13 or 61 of the K-ras gene. CONCLUSION: As there were no mutations in the K-ras codons 12, 13 and 61 in this study, the incidence of the K-ras mutation, in Korean lung cancer, may well be very low. However, further investigations on a larger population will be required, as we only studied 25 non-small cell lung cancer specimens, with only 10 adenocarcinomas.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cell Proliferation ; Codon ; DNA ; Genes, ras* ; Guanosine Triphosphate ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Transcription Factors