Usual managements of flat anterior chamber following filtering surgery are deepening of anterior chamber using cycloplegics and mydriatics, and pressure patch technique compressing the fistula. But the pressure patch technique may worsen chamber depth problem because exact compression on the filtering area is difficult by pressure patching. Prolonged pressure patching may also cause deterioration of filtering function. The tampon with glaucoma shell provides enough resistance to excessive outflow, allows the anterior chamber to reform promptly, and can prevent choroidal separation. We treated the flat anterior chamber following trabeculectomy using glaucoma shell in 7 eyes. The anterior chamber in each eye was restored promptly within 2-4 days after the placement of glaucoma shell. Glaucoma shell is easy to handle, gives minimal discomfort to patient, and may need less time to restore flat anterior chamber than pressure patching.
Anterior Chamber* ; Choroid ; Filtering Surgery ; Fistula ; Glaucoma* ; Humans ; Mydriatics ; Trabeculectomy*

BACKGROUND: The typical Korean diet includes rice, which is usually served in a rice bowl. We investigated the effects of a meal plan using rice bowls of varying sizes on dietary energy intake (EI), body weight (BW), and blood glucose levels. METHODS: Forty-two obese women with type 2 diabetes mellitus were randomly assigned to use either a 200 mL small rice bowl (SB), a 380 mL regular rice bowl (RB), or to a control group (C). Both intervention groups were asked to reduce their EI by 500 kcal/day for 12 weeks and simple instructions for using the assigned bowl were provided. Dietary EI and proportion of macronutrients (PMN) were estimated from 3-day dietary records. RESULTS: Reduction of EI was more prominent in the SB group compared to the RB and C group, although EI decreased significantly from baseline in all groups. Carbohydrate and fat intakes of the SB group were decreased greater than those of the RB and C group. However, changes in PMN were not significant across the 3 groups. Reduction of BW and HbA1c levels in the SB group was more prominent compared to the C group. Although, BW and HbA1c were decreased significantly from baseline in both bowl groups. There was no statistical difference between the two groups. CONCLUSION: The small rice bowl-based meal plan was effective at reducing EI, BW, and blood glucose levels, and the observed reductions in EI, carbohydrate, and fat intake were greater than those of the regular rice bowl-based meal plan.
Blood Glucose ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Energy Intake ; Female ; Humans ; Meals ; Obesity ; Weight Loss

PURPOSE: Exposure to dietary phytoestrogens such as genistein during early childhood is a growing public health concern. We examined the effect of early exposure to genistein on sexual maturation in immature rats. METHODS: Weaning (3wk-old) Sprague-Dawley female rats were assigned to three groups (n=6 for each): fed by high dose of genistein (100 mg/kg/d), low dose of genistein (10 mg/kg/d) and control group. First vaginal opening (VO) day was observed. Structural alterations in the ovary and uterus were assessed by histologically. Expression of genes of ERalpha, ERbeta, and progesterone receptor (PR) in the ovary and uterus were investigated by RT-PCR. RESULTS: High genistein group had earlier VO than control and low genistein group. Graafian follicle s and corpora lutea were observed from the ovary of genistein-treated groups, while primary, secondary follicles and small atretic follicles were observed in the control group. Hypertrophy of luminal and glandular uterine epithelia were found in the genistein-treated groups while poor development of gland and fewer myometrial cell layers were evident in control group. In ovary, the transcriptional activities of ERalpha and ERbeta were higher in high genistein group than in controls. In uterus, the transcriptional activities of ERalpha, ERbeta and PR were higher in low genistein group than in controls. CONCLUSION: Acute exposure to genistein during the prepubertal period could activate the reproductive endocrine system resulting in the early onset of puberty in female rats. Further clinical investigation on the effect of genistein on the sexual maturation in children is warranted.
Animals ; Child ; Corpus Luteum ; Endocrine System ; Estrogen Receptor alpha ; Estrogen Receptor beta ; Female ; Genistein ; Humans ; Hypertrophy ; Ovarian Follicle ; Ovary ; Phenobarbital ; Phytoestrogens ; Puberty ; Public Health ; Rats ; Receptors, Progesterone ; Sexual Maturation ; Uterus ; Weaning

The purpose of the study was to find the sociopsychological factors predicting the intention of compliance with the dietary regimen in diabetes with a questionnaire. Data were collected from 282 adult noninsulin-dependent diabetics in Seoul, Kyoggida, and Kyongsangbukdo in Korea. Stepwise multiple regression analysis was conducted with predictor variables from theories of the Health Belief Model, Social Cognitive Model, The Theory of Reasoned Action, and Social Support. The behavioral intention of compliance with the prescribed diet was the independent variable. Subjects norm self-efficacy knowledge about diet therapy, outcome expectation, relationship with medical team, threat of deterioration of disease, and social support were the independent variables, The mean score of behavior intention was high ie 35.3 out to 42. Subjective norm and self-efficacy were the significant variables to predict the intention of dietary compliance. These variables comprised 39% of the common variance. To increase dietary compliance by influence of the referents and improve self-efficacy significant referents must be included and concrete and practical methods to follow the dietary regimen must be provided in nutrition education.
Adult ; Compliance* ; Diet ; Diet Therapy ; Education ; Humans ; Intention ; Korea ; Seoul ; Surveys and Questionnaires

The purpose of this study was to find the sociopsychological factors influencing the compliance of dietary regimen in diabetes by using focus group interviews. The data were collected from fifty three diabetes patients in eleven focus groups from September 1997 to March, 1998 in Seoul and Suwon Korea. The interviews were tape-recorded and the contents of the interviews were analysed by researchers. The subjects knew the causes, complications, and therapies of diabetes although they were incorrect at times . Patients had a wide range of outcome expectations from very optimistic to pessimistic. They recognized diabetes as a disease which needs life-time care, and they though that good care could provide a normal life. One the other hand they thought diabetes could lead to death through complications, and cause financial problems as well as social isolation. As for self-efficacy they recognized the importance of compliance to diet regimen but they thought the diet therapy was very difficult and were not very willing to follow it. They felt medical professionals, especially doctors, were influential for the therapies. However they frequently felt counselling provided by doctors was insufficient in time and content and led to attitude problems. They felt support from families and others was often insufficient and inadequate. Nutrition education fostering outcome expectation, social support, and self-efficacy is needed to increased compliance. The most influential referents were medical professional including doctors, nurses, dieticians, so their role in diet therapy should by emphasized.
Compliance* ; Diabetes Mellitus ; Diet ; Diet Therapy ; Education ; Focus Groups* ; Foster Home Care ; Gyeonggi-do ; Hand ; Humans ; Korea ; Nutritionists ; Seoul ; Social Isolation

BACKGROUND: Arterial stiffness is an important factor in atherosclerosis. Thus we examined whether aerobic exercise could reduce arterial stiffness in obese women with type 2 diabetes without diabetic complication. METHODS: A total of 35 women with type 2 diabetes (body mass index, 26.6+/-2.8 kg/m2; age, 56.4+/-1.9 years; duration of diabetes, 4.7+/-4.8 years) were assigned to aerobic exercise group (AEG) or control group (CG). AEG completed a 12-week exercise program (3.6 to 5.2 metabolic equivalents, 3 day/week, 60 min/day), with their exercise activities monitored by accelerometers. We measured abdominal total fat area (TFA), visceral fat area (VFA), and subcutaneous fat area (SFA) by computed tomography, insulin sensitivity by insulin tolerance test (K(ITT)), and augmentation index (AIx) by SphygmoCor at baseline and at the end of the 12-week program. RESULTS: The AIx was improved in the AEG compared with the CG (P<0.001). The percent change of AIx had significant correlation with the improvement of physical activity energy expenditure (PAEE), aerobic capacity, TFA, and SFA (r=-0.416, P=0.013; r=0.560, P<0.001; r=0.489, P=0.003; r=0.531, P=0.001, respectively), but not with insulin sensitivity, energy intake, or VFA. CONCLUSION: Improvement in aortic stiffness by aerobic exercise is related with the improvement of aerobic capacity, PAEE, and total fat but not with insulin sensitivity or energy intake in obese women with type 2 diabetes.
Abdominal Fat ; Atherosclerosis ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Energy Intake ; Energy Metabolism* ; Exercise* ; Female ; Humans ; Insulin ; Insulin Resistance* ; Intra-Abdominal Fat ; Metabolic Equivalent ; Motor Activity* ; Subcutaneous Fat ; Vascular Stiffness*

PURPOSE: Ezrin is a membrane cytoskeletal linker protein and it is known to be associated with metastasis of primary osteosarcoma. The aim of this study is to determine the relationship between an ezrin expression and several key clinical parameters and to elucidate its potential prognostic value for patients with osteosarcoma. MATERIALS AND METHODS: Seventy patients with histologically confirmed osteosarcoma and who had no distant metastasis were enrolled between 1995 and 2005 at Yonsei Cancer Center, Severance Hospital, Korea. The clinical parameters were retrospectively reviewed and immunohistochemical staining (IHC) for ezrin was performed using the surgically resected specimens. RESULTS: Of the 70 tumor specimens, 39 (55.7%) revealed an ezrin expression. More of an osteoblastic histology and an elevated initial ALP level were observed in the ezrin positive patients than in the ezrin negative patients (p=0.008 and 0.001, respectively). The proportion of patients who favorably responded to neoadjuvant chemotherapy (> or =90% necrosis) was significantly higher in the group of ezrin positive patients than that in the group of ezrin negative patient (72.2% vs 45.2%, respectively, p=0.024). The ezrin positive patients showed more frequent recurrence than did the ezrin negative patients (64.1% vs 35.5%, respectively, p=0.017). The patients with an ezrin expression also demonstrated poorer survival than did those patients without ezrin expression (5-year EFS: 31.7% vs 61.3%, respectively, p=0.023, 5-year OS: 53.4% vs 71.0%, respectively, p=0.022). When comparing EFS according to both an ezrin expression and chemoresponsiveness, there were trends that the ezrin negative/chemoresponsive group showed the best 5-year EFS (71.4%), followed by the ezrin negative/chemoresistant group (52.9%), the ezrin positive/chemoresponsive group (38.1%) and the ezrin positive/chemoresistant group (13.6%). These trends were statistically significant (p=0.036). CONCLUSION: The expression of ezrin by IHC staining was found in 55.7% of the patients with metastasis-free osteosarcoma. Immunoreactivity to ezrin is a negative prognostic factor for survival for the patients suffering with osteosarcoma. Identifying an ezrin expression might offer a valuable piece of information when treating patients with primary osteosarcoma.
Cytoskeletal Proteins ; Humans ; Korea ; Membranes ; Neoplasm Metastasis ; Osteoblasts ; Osteosarcoma ; Recurrence ; Retrospective Studies ; Stress, Psychological

BACKGROUND: The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus. METHODS: A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] < 23 kg/m2; n = 17), an overweight group (OW; 23 < or = BMI < 25 kg/m2; n = 24) and an obese group (OB; BMI > or = 25 kg/m2; n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl. RESULTS: After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 +/- 5%; OW, -4 +/- 5%; OB, -3 +/- 6%) and increased fat intakes were found in all three groups, which complies with Korean Diabetes Association recommendations. The protein proportion of TEI significantly increased only in the OW group. Body weight decreased both in the OW and OB groups. CONCLUSION: A short-term, small-rice-bowl-based meal plan was effective for body weight control and macronutrient balance in overweight or obese women in Korea with type 2 diabetes.
Body Mass Index ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Diet Records ; Energy Intake ; Female ; Humans ; Korea ; Meals ; Overweight

BACKGROUND: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, the effects on muscle mass, changes of dietary quality, and insulin sensitivity are unknown for Korean obese type 2 diabetic subjects. Therefore, this study examined such effects of LCDs. METHODS: A total of 30 obese type 2 diabetic subjects (body mass index, 27.0 +/- 2.2 kg/m2) were randomly assigned to an LCD or control group. Subjects on LCDs took 500~1,000 kcal fewer energy than their usual dietary intake (1,000~1,500 kcal/day) over the course of 12 weeks. The abdominal VF and femoral muscle mass were evaluated by computed tomography, and insulin sensitivity was assessed using an insulin tolerance test (Kitt; rate constant for plasma glucose disappearance, %/min). Dietary nutrient intake consumed by subjects was assessed by 3-day food records. RESULTS: The percent VF reduction was -23.4 +/- 17.2% in the LCD group and -9.8 +/- 11.8% in the control group after 12 weeks (P < 0.001, P = 0.002). However, significant decrease in femoral mass or proportional change of marcronutrient intake and mean adequacy ratio were not found in the LCD group, as compared to the control group. Insulin sensitivity improved in the LCD group, as compared to the control group (P = 0.040). CONCLUSION: LCD effectively improved insulin sensitivity and reduced abdominal VF without reduction of femoral muscle and dietary quality in obese type 2 diabetic subjects.
Caloric Restriction ; Diabetes Mellitus, Type 2 ; Glucose ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Muscles ; Plasma ; Weight Loss

BACKGROUND: Combination fitness regimens (including aerobic and resistance exercises) are effective for improving cardio-respiratory fitness, reducing visceral fat and increasing insulin sensitivity in diabetic patients. The combination exercise intensity that a patient is capable of is limited by his or her aerobic capacity and one repetition maximum (1RM). We investigated the relationships between 1RM, aerobic exercise capacity and body mass index in patients with type 2 diabetes. METHODS: A total of 177 (men: 85, women: 92) diabetic subjects with HbA1c < or = 10% were enrolled. Muscle strength and 1RM were assessed bychest press (upper body) and leg press (lower body). We assessed aerobic capacity by VO2max and muscle mass by bioimpedance analysis. RESULTS: There was no correlation between 1RM and VO2max in type 2 diabetic patients (upper: P = 0.122, lower: P = 0.138 for men, and upper: P = 0.952, lower: P = 0.570 for women). However, 1RM was significantly correlated with muscle mass both in men and women (upper: r = 0.493, P < 0.001, r = 0.315, P = 0.002 lower: r = 0.437 P < 0.001, r = 0.307, P =0.003, respectively). There was also a significant correlation between 1RM and BMI. In obese male subjects with BMI > or = 25 kg/m2, we observed a significant correlation between muscle mass and BMI (r = 0.374, P = 0.032), but this correlation was not observed in women. CONCLUSION: Clinicians treating Korean type 2 diabetic subjects should recommend resistance exercise to their patients. In particular, obese women with diabetes may receive greater benefits by increasing muscle mass through resistance exercises.
Body Mass Index ; Diabetes Mellitus ; Exercise ; Female ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Leg ; Male ; Muscle Strength ; Muscles ; Resistance Training