PURPOSE: To determine whether transpupillary thermotherapy can achieve significant efficacy in maintaining vision without significant adverse effects when used to treat age-related macular degeneration associated with choroidal neovascularization. METHODS: Retrospective chart reviews were made for 33 eyes of 32 patients diagnosed with age-related macular degeneration, and who had received transpupillary thermotherapy due to the development of choroidal neovascularization. Transpupillary thermotherapy was performed 1.4 times on average. RESULTS: Three months after the final therapy, 6 eyes (18%) showed improved vision, 11 eyes (34%) showed no change in vision, and 16 eyes (48%) showed worsening of vision. Of the 21 eyes of 21 patients who were available for optical coherence tomography before and after transpupillary thermotherapy, 19 eyes (90.5%) showed reduced macula thickness, and fundus photographs taken during the latest hospital visit revealed 11 eyes showing fibrosis. CONCLUSIONS: Although it negatively influences subretinal fluid absorption, transpupillary thermotherapy is effective in stabilizing choroidal neovascularization and improving visual accuracy in a short period of time. Thus, further study is warranted.
Absorption ; Choroid* ; Choroidal Neovascularization* ; Fibrosis ; Humans ; Hyperthermia, Induced* ; Macular Degeneration ; Retrospective Studies ; Subretinal Fluid ; Tomography, Optical Coherence

PURPOSE: To report the anti-inflammatory effect and best-corrected visual acuity (BCVA) response after oral glucosamine (Glucosamine Sulfate 750(R), General Nutrition Companies, Inc.) and aspirin (Aspirin protect(R), Bayer) therapy in patients with uveitis. METHODS: Twenty-seven patients (43 eyes) with uveitis, not easily managed with conventional therapy, were treated with oral glucosamine 750 mg and aspirin 100 mg daily, and underwent BCVA testing and slit-lamp examination of anterior chamber inflammation. Changes in the dose of previously-used oral steroids and immunosuppressants were recorded at baseline, every 2 weeks for the first 2 months, and once every month thereafter. RESULTS: The mean follow-up period was 15.0+/-3.69 weeks and inflammation started to improve within 4.6 weeks. The change in visual acuity was not statistically significant, but grade of inflammation decreased by as much as 1.02+/-1.28, significantly (p<0.01) after treatment. In 12 patients (19 eyes, 44.2%) the dosage of systemic steroids and immunosuppressants could be Reduced. 7 patients (10 eyes, 23.3%) experienced aggravation of uveitis and the dosage of glucosamine and aspirin was increased. CONCLUSIONS: Concurrent oral administration of glucosamine and aspirin could not completely inhibit the recurrence of inflammation nor control it, but consistent use of these drugs may help to reduce inflammation without serious side effects. A longer prospective control study with larger sample size is required to further evaluation of the efficacy of the medication.
Administration, Oral ; Anterior Chamber ; Aspirin ; Eye ; Follow-Up Studies ; Glucosamine ; Humans ; Immunosuppressive Agents ; Inflammation ; Recurrence ; Sample Size ; Steroids ; Uveitis ; Visual Acuity

OBJECTIVE: Low cholesterol is associated with depression among western countries. The objective of this study was to examine the relationship between cholesterol and depression in Korean population with low levels of serum cholesterol. METHODS: The data of about 740,000 individuals, aged 30-64 years at entry in the Korean Cancer Prevention Study, were used. Total cholesterol levels were measured in 1992. Depression was measured using the modified DSM-IV (Diagnostic Criteria of Major Depressive Episode in Diagnostic and Statistical Manual of Mental Disorders-IV) scale. Total cholesterol was classified into four groups (quartile). Odds Ratios of low level of cholesterol were evaluated using multi-variable logistic models. RESULTS: The prevalence of major depression was 7.7% in men and 10.4% in women. After adjustment for various confounding variables, an inverse association was detected between cholesterol levels and depression intensity among men and women. The odds ratio (95% confidence interval) of the lowest quartile of cholesterol was 1.16 (1.13-1.20) on major depression compared with the highest quartile of cholesterol in men. The corresponding odds ratio among women was 1.09 (1.04-1.15). The strongest association among 9 items of depression was found at "decreased appetite and lost weight" in both men (OR=1.68) and women (OR=1.43). CONCLUSION: Low cholesterol is associated with major depression in men and women. Further studies are necessary to evaluate the cross-validation, to explore the biological mechanism, and to identify the clinical implication.
Appetite ; Cholesterol ; Confounding Factors (Epidemiology) ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Female ; Humans ; Logistic Models ; Male ; Odds Ratio ; Prevalence

Purpose: Insulin is known to induce relaxation in various vasculatures by increasing the release of nitric oxide or the expression of nitric oxide synthase. However, its action mechanisms on the corpus cavernosum remain to be uncovered. This study aimed to investigate the relaxative responses and the mechanism of normal cavernous smooth muscles to insulin. Methods and Materials: Rabbit corpus cavernous tissues were prepared in 2x2x8 mm sized strip for isotonic tension recording. The dose-dependent relaxation responses of norepinephrine (10(-4)M)-precontracted strips to insulin (10(-6)M)were measured. The relaxation responses of NE (10(-4)M)-precontracted strips to insulin (10(-6)M) were measured under low to high glucose concentrations (0, 0.1, 1 and 11mM) in physiological solution. The relaxation responses of the NE-precontracted strips to insulin (10(-6)M) were also observed after endothelial denudation, 30-minute preincubation with L-NAME (5mM) or 30-minute preincubation with indomethacin (10(-4)M). Results: The cavernosal strips were relaxed by insulin in a dose-dependent manner. The insulin-induced relaxation was dose-dependently increased by glucose. The endothelial denudation or indomethacin pretreatment almost abolished the insulin-induced relaxation, but L-NAME rarely affected the relaxation. Conclusions: Insulin induces an endothelium-dependent relaxation of rabbit cavernous smooth muscles, which is mostly NO-independent, but seems to be related with prostaglandins or their metabolites.
Glucose ; Indomethacin ; Insulin ; Muscle, Smooth* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Norepinephrine ; Prostaglandins ; Relaxation*

PURPOSE: To evaluate the efficacy, safety, and satisfaction of patients who underwent the aspheric micro-monovision protocol for the correction of myopia with presbyopia. METHODS: A retrospective, noncomparative study included 40 eyes of 20 consecutive patients with myopia and presbyopia who were treated with LASIK-induced micro-monovision. Monocular and binocular visual outcomes of uncorrected and best-corrected distance, intermediate, and near visual acuity were measured. Depth of focus, spherical aberration, stereopsis and satisfaction were evaluated before surgery and 3 months after surgery. RESULTS: Mean patient age was 48.7 years. Monocular uncorrected distance visual acuity was 0.8 in 94% of dominant eyes, and monocular uncorrected near visual acuity was J3 in 94% in non-dominant eyes. Binocular uncorrected near visual acuity was J2 in 94% and J5 in 100% of dominant and non-dominant patient eyes, respectively. Binocular uncorrected distance visual acuity was 1.0 in 100% of patients, and binocular uncorrected near visual acuity was J2 in 94% of patients. Our results showed a significant improvement in depth of focus and a positive shift in spherical aberration in dominant eyes; however, there were no significant changes in the non-dominant eyes. There was no change in stereopsis or contrast sensitivity at any of the tested spatial frequencies. Satisfactory scores were achieved in all eyes. CONCLUSIONS: The aspheric myopic micro-monovision protocol was well-tolerated, stable, and effective for treating patients with presbyopia in myopic astigmatism.
Astigmatism ; Contrast Sensitivity ; Depth Perception ; Eye ; Humans ; Keratomileusis, Laser In Situ ; Myopia ; Presbyopia ; Retrospective Studies ; Telescopes ; Visual Acuity

PURPOSE: We tried to evaluate the clinical characteristics, the treatment methods, the results of treatments, and the patterns of failure in ovarian dysgerminoma retrospectively. According to the results we would like to suggest the proper management guideline of stage la ovarian dysgerminoma patients who want to maintain fertility. METHODS AND MATERIALS : Between 1975 and 1990, 34 patients with ovarian dysgerminoma were treated at the Yonsei University Hospital. The case records of these patients have been reviewed for presenting symptoms, treatment methods, local control, and survival following treatment. Excluded from analysis were five patients with mixed ovarian germ cell tumors and gonadoblastomas (46,XY). Treatment results of the twenty nine patients were analysed by each treatment modality. Twenty one patients were treated with surgery and postoperative adjuvant radiotherapy(group 1). The other eight patients were treated with operation alone (group 2). The median age of twenty-nine patients was 23 years with a range of 8 to 39 years. Presenting symptoms were abdominal mass(20), pelvic discomfort or pain(5) et al. Radiotherapy was performed by 10MV LINAC or Co-60 teletherapy unit. The total radiation dose of the whole abdomen was 20-25 Gy/3weeks, 1-1.5 Gy/fraction with a boost to the whole pelvis 10-15 Gy / 1-2 weeks1.8-2.0 Gy/fraction. Advanced stage disease (stage II or stage III) patients received prophylactic mediastinal and supraclavicular irradiation to a dose of 16-26 Gy. Median duration of follow-up of living patients was 80 months (range : 13-201 months) RESULTS: All of the twenty one patients of group 1 were alive without disease (100%). Among the eight patients who were not treated with radiotherapy (group 2), six patients developed local recurrence. Four patients referred with recurrent disease were treated with salvage radiotherapy. Three of four patients were salvaged and one patient who had recurrent intra-abdominal disease died of progressed carcinomatosis at 11 months after salvage radiotherapy. The other two patients with recurrence were salvaged with chemotherapy (1 patient) or re-operation (1 patient). Twenty eight patients remained alive without disease at last follow up, so the 5 year local control rate and 5 year overall survival rate for all groups were 96.6% (28/29), respectively. Among thirteen patients with stage la unilateral tumors seven patients were treated with postoperative radiotherapy and the other six patients were treated with unilateral salpingo-oophorectomy alone. Five patients who did not received radiotherapy developed local failure but all of the recurrent ovarian dysgerminomas were salvaged with radiotherapy, chemotherapy or re-operation, So all the 13 patients with stage la ovarian dysgerminoma were free of disease from 20-201 months (median 80 months). CONCLUSION: The authors consider external irradiation to be an effective treatment as a complement to surgery in ovarian dysgerminoma. For those patients with disease presenting in stage la tumors who wish to maintain fertility, unilateral salpingo-oophorectomy alone may be curative and spare ovarian function considering excellent salvage rate of recurrent ovarian dysgerminoma in present study.
Abdomen ; Carcinoma ; Complement System Proteins ; Drug Therapy ; Dysgerminoma ; Fertility ; Follow-Up Studies ; Gonadoblastoma ; Humans ; Neoplasms, Germ Cell and Embryonal ; Pelvis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate

Maternal hyperthermia, which is currently confirmed as one of major causative factors inducing growth retardation, congenital anomalies and abortion, is known to influence normal development of CNS and various organ system. In addition, maternal hyperthermia could induce severe developmental defects including development of the limb. However, it is not clearly identified how maternal hyperthermia affects the expression of chondrogenesis-related proteins in developing limb of mouse. Thus, this study is aimed to investigate the effects of the maternal hyperthermia on the expression of a various proteins in developing upper limb. To elucidate it, ICR mice were used in this study, and the animals were divided into control and heat shock groups. The heat shock treatment was given to embryonic day (ED) 8. The animals were sacrificed on ED 11, 13, 15 and 17, and the humerus were removed. Chondrogenesis-related factors such as FGF8, SOX9 and collagen II were detected on ED 11, 13 and 15 using western blot and immunohistochemistry. Developing humerus on ED 17 was stained with alizarin red S and alcian blue. The expression of FGF8 of heat shock groups was continued even though the development was succeeded. SOX9 expression in heat shock groups was significantly elevated on ED 13 compared to the control embryos. In addition, collagen II expression of heat groups was significantly higher than that of the control group on ED 13 and 15. The results of this study suggest that hyperthermia causes delayed endochondral ossification in long bone through continuous expression of FGF8, SOX9 and collagen II proteins even though the endochondral ossification is succeeded.
Animals ; Anthraquinones ; Blotting, Western ; Collagen ; Embryonic Structures ; Extremities ; Fever ; Hot Temperature ; Humerus ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; Osteogenesis ; Proteins ; Shock

Maternal hyperthermia, which is currently confirmed as one of major causative factors inducing growth retardation, congenital anomalies and abortion, is known to influence normal development of CNS and various organ system. In addition, maternal hyperthermia could induce severe developmental defects including development of the limb. However, it is not clearly identified how maternal hyperthermia affects the expression of chondrogenesis-related proteins in developing limb of mouse. Thus, this study is aimed to investigate the effects of the maternal hyperthermia on the expression of a various proteins in developing upper limb. To elucidate it, ICR mice were used in this study, and the animals were divided into control and heat shock groups. The heat shock treatment was given to embryonic day (ED) 8. The animals were sacrificed on ED 11, 13, 15 and 17, and the humerus were removed. Chondrogenesis-related factors such as FGF8, SOX9 and collagen II were detected on ED 11, 13 and 15 using western blot and immunohistochemistry. Developing humerus on ED 17 was stained with alizarin red S and alcian blue. The expression of FGF8 of heat shock groups was continued even though the development was succeeded. SOX9 expression in heat shock groups was significantly elevated on ED 13 compared to the control embryos. In addition, collagen II expression of heat groups was significantly higher than that of the control group on ED 13 and 15. The results of this study suggest that hyperthermia causes delayed endochondral ossification in long bone through continuous expression of FGF8, SOX9 and collagen II proteins even though the endochondral ossification is succeeded.
Animals ; Anthraquinones ; Blotting, Western ; Collagen ; Embryonic Structures ; Extremities ; Fever ; Hot Temperature ; Humerus ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; Osteogenesis ; Proteins ; Shock

PURPOSE: This paper reports a dosimetric study of 88 patients treated with a combination of external radiotherapy and high dose rate ICR for FIGO stage IIB carcinoma of the cervix. The purpose is to investigate the correlation between the radiation doses to the rectum. external radiation dose to the whole pelvis. ICR reference volume. TDF, BED and the incidence of late rectal complications, retrospectively METHODS AND MATERIALS: From November 1989 through December 1992, 88 patients with stage IIB cervical carcinoma received radical radiotherapy at Department or Radiation Oncology in Yonsei University Hospital. Radiotherapy consisted of 44-54 Gy(median 49 Gy) external beam irradiation plus high dose rate intracavitary brachy therapy with 5 Gy per fraction twice a week to a total dose of 30 Gy on point A. The maximum dose to the rectum by contrast(r,R) and reference rectal dose by ICRU 38(dr, DR) were calculated. The ICR reference volume was calculated by Gamma Dot 3.11 HDR planning system, retrospectively. The time-dose factor(TDF) and the biologically effective dose (BED) were calculated. RESULTS: Twenty seven(30.7%) of the 88 patients developed late rectal complications : 12 patients(13.6%) for grade 1, 12 patients(13.6%) for grade 2 and 3 patients(3.4%) for grade 3. We found a significant correlation between the external whole pelvis irradiation dose and grade 2, 3 rectal complicaition. The mean dose to the whole pelvis for the group of patients with grade 2, 3 complication was higher, 4093.3+/-453.1 cGy, than that for the patients without complication 3873.8+/-415.6 (0.05p<0.1). The gradual increase in the frequency of grade 2, 3 rectal compication increased as a function of the dose of external beam therapyto the whole pelvis(midline shielding start dose) and total rectal dose. The mean total rectal dose by rectal barium(R) for the group of patients with grade 2, 3 rectal complication was higher, 7163.0+/-838.5 cGy, than that for the patients without rectal complication, 6772.7+/-884.0(p<0.05). There was no correlation of the rate of grade 2, 3 rectal complication with the ICR rectal doses(r,dr), ICR reference volume, TDF and BED. CONCLUSION: This investigation has revealed a significant correlation between the dose calculated at the rectal dose by ICRU 38(DR) or the most anterior rectal dose by contrast(R), dose to the whole pelvis and the incidence of grade 2,3 late rectal complications in patients with stage IIB cervical cancer undergoing external beam radiotherapy and HDR ICR. Thus there rectal reference points doses and whole pelvis dose appear to be useful prognostic indicators of late rectal complication in high dose rate ICR treatment in cervical carcinoma.
Brachytherapy* ; Cervix Uteri* ; Female ; Humans ; Incidence ; Pelvis ; Radiation Oncology ; Radiotherapy ; Rectum ; Retrospective Studies ; Uterine Cervical Neoplasms

Objective: There have been many biological studies on suicide behaviors of borderline personality disorder (BPD), however few studies have sought to psychoanalytic characteristics including defense mechanisms. Therefore, we investigated psychological, symptomatic, and personality characteristics including defense mechanisms in suicide attempters and non-suicide attempters among patients with BPD. Methods: We enrolled 125 patients with BPD. Forty-two patients with a history of one or more suicide attempts formed the suicide attempters group and 83 patients with no such history formed the non-suicide attempters group. We collated the differences in clinical and psychological characteristics between the two groups by using the Symptom Checklist-90-Revised (SCL-90-R), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Personality Disorder Questionnaire-4+ (PDQ-4+), and the Defense Style Questionnaire (DSQ). Results: The suicide attempters group scored higher on the hostility subscale of SCL-90-R. The suicide attempters group also scored higher on the Infrequency, Back Infrequency, Lie, Masculinity-femininity, Paranoia, Psychasthenia, and Schizophrenia scales of the MMPI-2. The incidence of paranoid and antisocial personality disorders, as assessed by the PDQ-4+, was significantly different in both groups. Maladaptive, self-sacrificing defense style, splitting and affiliation on the DSQ were also higher for the suicide attempters group. In the results of the logistic regression analysis, gender, the F(B) and L scales on the MMPI-2, and ‘splitting of other’s image’ defense mechanism on the DSQ were the factors that significantly influenced to suicide attempts. Conclusion These findings suggest that impulsive psychiatric features and maladaptive defense style may be related to suicidal risk in patients with BPD. Therefore, our findings may help clinicians in estimating the risk of suicide in patients with BPD.