1.Efficacy of Intravitreal Anti-vascular Endothelial Growth Factor or Steroid Injection in Diabetic Macular Edema According to Fluid Turbidity in Optical Coherence Tomography.
Kyungmin LEE ; Heeyoung CHUNG ; Youngsuk PARK ; Joonhong SOHN
Korean Journal of Ophthalmology 2014;28(4):298-305
PURPOSE: To determine if short term effects of intravitreal anti-vascular endothelial growth factor or steroid injection are correlated with fluid turbidity, as detected by spectral domain optical coherence tomography (SD-OCT) in diabetic macular edema (DME) patients. METHODS: A total of 583 medical records were reviewed and 104 cases were enrolled. Sixty eyes received a single intravitreal bevacizumab injection (IVB) on the first attack of DME and 44 eyes received triamcinolone acetonide treatment (IVTA). Intraretinal fluid turbidity in DME patients was estimated with initialintravitreal SD-OCT and analyzed with color histograms from a Photoshop program. Central macular thickness and visual acuity using a logarithm from the minimum angle of resolution chart, were assessed at the initial period and 2 months after injections. RESULTS: Visual acuity and central macular thickness improved after injections in both groups. In the IVB group, visual acuity and central macular thickness changed less as the intraretinal fluid became more turbid. In the IVTA group, visual acuity underwent less change while central macular thickness had a greater reduction (r = -0.675, p = 0.001) as the intraretinal fluid was more turbid. CONCLUSIONS: IVB and IVTA injections were effective in reducing central macular thickness and improving visual acuity in DME patients. Further, fluid turbidity, which was detected by SD-OCT may be one of the indexes that highlight the influence of the steroid-dependent pathogenetic mechanism.
Aged
;
Angiogenesis Inhibitors/*therapeutic use
;
Bevacizumab/*therapeutic use
;
Diabetic Retinopathy/*drug therapy/physiopathology
;
Female
;
Glucocorticoids/*therapeutic use
;
Humans
;
Intravitreal Injections
;
Macular Edema/*drug therapy/physiopathology
;
Male
;
Middle Aged
;
Nephelometry and Turbidimetry
;
Retina/pathology
;
*Subretinal Fluid
;
Tomography, Optical Coherence
;
Treatment Outcome
;
Triamcinolone Acetonide/*therapeutic use
;
Vascular Endothelial Growth Factor A/antagonists & inhibitors
;
Visual Acuity/physiology
2.Comparison of Injection of Intravitreal Drugs with Standard Care in Macular Edema Secondary to Branch Retinal Vein Occlusion.
Kyungmin LEE ; Heeyoung JUNG ; Joonhong SOHN
Korean Journal of Ophthalmology 2014;28(1):19-25
PURPOSE: To compare the long-term efficacy and safety of intravitreal triamcinolon with or without rescue laser therapy (intravitreal triamcinolone injection [IVTA] group), bevacizumab with or without rescue laser treatment (intravitreal bevacizumab injection [IVB] group), or a combination of both with or without rescue laser therapy (IVTA + IVB group), with standard care for patients with macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: We reviewed the medical records of 151 patients treated with intravitreal injection with or without rescue laser for treatment of macular edema caused by BRVO, and who were followed up at 1, 3, 6, 12, and 24 months. During the observation period, rescue grid laser or repeated intravitreal injection with initial drug was performed if recurrence of macular edema was confirmed. Visual acuity, change in visual acuity, and intraocular pressure were compared in each phase. RESULTS: Totals of 16%, 5.6%, and 0% of participants in the three groups showed significant visual loss of more than three lines of the Snellen chart at last follow-up. The IVTA group was the least effective treatment modality, with statistical significance. The development rates of elevated intraocular pressure were similar among the groups. CONCLUSIONS: Although IVTA yielded effects similar to those of standard grid photocoagulation based on the Standard Care vs Corticosteroid for Retinal Vein Occlusion study, IVB or IVTA + IVB with or without rescue laser treatment resulted in improvement in visual acuity at 24 months after the start of treatment and was associated with few serious adverse side effects. Thus, these approaches could be useful for treating macular edema arising secondary to BRVO.
Angiogenesis Inhibitors/administration & dosage
;
Antibodies, Monoclonal, Humanized/*administration & dosage
;
Female
;
Follow-Up Studies
;
Glucocorticoids/administration & dosage
;
Humans
;
Intravitreal Injections
;
Laser Therapy/*methods
;
Macular Edema/diagnosis/etiology/*therapy
;
Male
;
Middle Aged
;
Recurrence
;
Retinal Vein Occlusion/*complications/diagnosis/therapy
;
Retrospective Studies
;
Tomography, Optical Coherence
;
Treatment Outcome
;
Triamcinolone Acetonide/*administration & dosage
;
Vascular Endothelial Growth Factor A/*antagonists & inhibitors
;
Visual Acuity
3.Comparison of Injection of Intravitreal Drugs with Standard Care in Macular Edema Secondary to Branch Retinal Vein Occlusion.
Kyungmin LEE ; Heeyoung JUNG ; Joonhong SOHN
Korean Journal of Ophthalmology 2014;28(1):19-25
PURPOSE: To compare the long-term efficacy and safety of intravitreal triamcinolon with or without rescue laser therapy (intravitreal triamcinolone injection [IVTA] group), bevacizumab with or without rescue laser treatment (intravitreal bevacizumab injection [IVB] group), or a combination of both with or without rescue laser therapy (IVTA + IVB group), with standard care for patients with macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: We reviewed the medical records of 151 patients treated with intravitreal injection with or without rescue laser for treatment of macular edema caused by BRVO, and who were followed up at 1, 3, 6, 12, and 24 months. During the observation period, rescue grid laser or repeated intravitreal injection with initial drug was performed if recurrence of macular edema was confirmed. Visual acuity, change in visual acuity, and intraocular pressure were compared in each phase. RESULTS: Totals of 16%, 5.6%, and 0% of participants in the three groups showed significant visual loss of more than three lines of the Snellen chart at last follow-up. The IVTA group was the least effective treatment modality, with statistical significance. The development rates of elevated intraocular pressure were similar among the groups. CONCLUSIONS: Although IVTA yielded effects similar to those of standard grid photocoagulation based on the Standard Care vs Corticosteroid for Retinal Vein Occlusion study, IVB or IVTA + IVB with or without rescue laser treatment resulted in improvement in visual acuity at 24 months after the start of treatment and was associated with few serious adverse side effects. Thus, these approaches could be useful for treating macular edema arising secondary to BRVO.
Angiogenesis Inhibitors/administration & dosage
;
Antibodies, Monoclonal, Humanized/*administration & dosage
;
Female
;
Follow-Up Studies
;
Glucocorticoids/administration & dosage
;
Humans
;
Intravitreal Injections
;
Laser Therapy/*methods
;
Macular Edema/diagnosis/etiology/*therapy
;
Male
;
Middle Aged
;
Recurrence
;
Retinal Vein Occlusion/*complications/diagnosis/therapy
;
Retrospective Studies
;
Tomography, Optical Coherence
;
Treatment Outcome
;
Triamcinolone Acetonide/*administration & dosage
;
Vascular Endothelial Growth Factor A/*antagonists & inhibitors
;
Visual Acuity
4.A Study on Application of Food Photographs for Estimating Individuals' Dietary Intake.
Jong Sook KWON ; Kyungmin KIM ; Hye Kyeong KIM
Korean Journal of Community Nutrition 2010;15(6):760-775
This study was performed to investigate the validity of food photographs for estimating individuals' dietary intakes and compare it with other dietary assessment methods. Subjects were 7 professors, 2 researchers, 12 dietitian and 16 graduate students majoring in food and nutrition. Among the subjects, 20 subjects had research experiences in the dietary intake survey more than one year while 17 had not. Each subject estimated 50 food portions displayed in computer monitor by comparing with standard food photographs, which were weighed portions of 28 foods from typical Korean diet. No significant differences between the estimated value and the weighed value of 17 (34%) food portions were shown in research-experienced group and those of 14 (28%) food portions were shown in no-researchexperienced group. 24-hour recall was the most frequently-used method for dietary assessment followed by in the order of food frequency questionnaire, dietary record, diet history and weighing method. After estimating food portions by photographs, 30 subjects (81%) were willing to use the method for dietary assessment because of its convenience and easy communication between researcher and subject. This study suggests that digital photography method would be a useful and convenient new instrument for estimating individuals' dietary intake. However, it is necessary to create standard database for food portions and carry out systematic education for food estimation in order to apply this method in the fields.
Diet
;
Diet Records
;
Humans
;
Organothiophosphorus Compounds
;
Photography
;
Surveys and Questionnaires
5.Predictors Associated With HIV Status Non-Disclosure in Korea
Journal of Korean Medical Science 2022;37(16):e125-
Background:
Human immunodeficiency virus (HIV) disclosure provides personal support to people living with HIV/acquired immunodeficiency syndrome (PLWH). In addition, it has important implications for disease prevention and treatment. Research on disclosure has been conducted worldwide; however, data from South Korea are insufficient. The purpose of this study was to examine whether certain demographic, medical, and psychosocial factors act as predictors of HIV serostatus non-disclosure among PLWH in South Korea.
Methods:
Participants consisted of 147 PLWH who visited the outpatient infection clinic between June 2020 and January 2021. Demographics, medical factors, HIV-related stigma, and depressive and anxiety symptoms were measured.
Results:
The overall disclosure rate among participants was 61.2%. Logistic regression analysis showed that lower depression (odds ratio [OR], 0.918; P = 0.021) and higher disclosure concerns (OR, 1.133; P = 0.004) were significant predictors of non-disclosure. Further, married state was a major predictor of non-disclosure when single referred (OR, 3.002; P = 0.024); however, divorce, separation, and widowed status had no significant consequences.
Conclusion
In South Korea, the rate of HIV disclosure is lower than in other countries.The higher disclosure concerns, lower depression and married state were suggested to be important predictors of HIV non-disclosure. High level of perceived stigma and experienced discrimination of PLWH may have affected the results. The social atmosphere linking sexual promiscuity and disease may also have influenced these results. Nationwide efforts should continue to reduce the overall stigma and create a social environment where PLWH can feel safe to disclose their disease conditions.
6.Validity of Three-dimensional Facial Scan Taken with Facial Scanner and Digital Photo Wrapping on the Cone-beam Computed Tomography: Comparison of Soft Tissue Parameters
Hussein ALJAWAD ; Kyungmin Clara LEE
Journal of Korean Dental Science 2022;15(1):19-30
Purpose:
The purpose of the study was to assess the validity of three-dimensional (3D) facial scan taken with facial scanner and digital photo wrapping on the cone-beam computed tomography (CBCT).
Materials and Methods:
Twenty-five patients had their CBCT scan, two-dimensional (2D) standardized frontal photographs and 3D facial scan obtained on the same day. The facial scans were taken with a facial scanner in an upright position. The 2D standardized frontal photographs were taken at a fixed distance from patients using a camera fixed to a cephalometric apparatus. The 2D integrated facial models were created using digital photo wrapping of frontal photographs on the corresponding CBCT images. The 3D integrated facial models were created using the integration process of 3D facial scans on the CBCT images. On the integrated facial models, sixteen soft tissue landmarks were identified, and the vertical, horizontal, oblique and angular distances between soft tissue landmarks were compared among the 2D facial models and 3D facial models, and CBCT images.Result: The results showed no significant differences of linear and angular measurements among CBCT images, 2D and 3D facial models except for Se-Sn vertical linear measurement which showed significant difference for the 3D facial models. The Bland–Altman plots showed that all measurements were within the limit of agreement. For 3D facial model, all Bland–Altman plots showed that systematic bias was less than 2.0 mm and 2.0° except for Se-Sn linear vertical measurement. For 2D facial model, the Bland-Altman plots of 6 out of 11 of the angular measurements showed systematic bias of more than 2.0°.
Conclusion
The facial scan taken with facial scanner showed a clinically acceptable performance. The digital 2D photo wrapping has limitations in clinical use compared to 3D facial scans.
8.Value of Fluoroscopic Defecography in Constipated Children With Abnormal Colon Transit Time Test Results
Kyungmin KIM ; Hae Jeong JEON ; Sun-Hwan BAE
Journal of Neurogastroenterology and Motility 2020;26(1):128-132
Background/Aims:
Colon transit time (CTT) test is regarded as the gold standard for evaluating colon transit function. Fluoroscopic defecography (FD) is a dynamic radiologic test to assess anorectal function. The aim is to evaluate the value of FD in constipated children with abnormal CTT test results.
Methods:
Fifty-one children (27 girls) with a mean age of 9.8 ± 3.2 years who met Rome III criteria for constipation and older than 5 years with abnormal CTT test results underwent FD.
Results:
Of 51 children, 27 (52.9%) showed positive findings on FD, including pelvic floor dyssynergia (PFD) (10/27, 37.0%), structural abnormality (15/27, 55.6%) (rectocele 53.3%, intussusception 33.3%, and both 13.4%), and both PFD and rectocele (2/27, 7.4%). In terms of CTT test subtype, of 35 children who had outlet obstruction type in CTT test, 19 (54.2%) had positive findings, including PFD (8/19, 42.1%), structural abnormality (9/19, 47.4%) (rectocele 55.6%, intussusception 22.2%, and both 22.2%), and both PFD and rectocele (2/19, 10.5%). Of the 16 children who had slow transit type of CTT test, 8 (50.0%) had positive findings, including PFD (2/8, 25.0%) and structural abnormality (6/8, 75.0%). Of the 6 children who had structural abnormality, 3 (50.0%) had rectocele and 3 (50.0%) had intussusception. For the 2 children (2/16, 12.5%) who had PFD, puborectalis muscle relax failure was found on FD. Puborectalis muscle relax failure was treated with biofeedback and medication. In the minor abnormalities, medication continued without additional therapeutic modalities.
Conclusions
FD was valuable for both diagnoses of underlying causes and interpretation of CTT test results in children with abnormal CTT test results. Therefore, this study suggests that FD and CTT tests should be incorporated into logical thinking for constipation in children.
10.Characteristics and Effectiveness of Individual Psychotherapy for Palliative and End-of-Life Care: A Literature Review for Randomized Controlled Trials
Psychiatry Investigation 2024;21(5):433-448
Objective:
The introduction of psychotherapy in palliative and end-of-life care settings has become increasingly common and is effective in decreasing many psychological problems. This review reports the characteristics and effectiveness of individual psychotherapeutic interventions for patients receiving palliative and end-of-life care. In addition, the review reports the effectiveness of psychotherapies considering the expected life expectancy.
Methods:
The PubMed, Google Scholar, and Cochrane Library databases were searched for English-language articles published between January 2000 to May 2023.
Results:
Twenty-six studies were included and classified into a total of nine types of psychotherapies, namely, dignity therapy (DT), life review therapy, narrative therapy, managing cancer and living meaningfully (CALM), individual meaning-centered psychotherapy, meaning and purpose therapy, meaning-making therapy, meaning-of-life therapy, and cognitive therapy.
Conclusion
Most of the psychotherapies provided to patients receiving palliative and end-of-life care showed effectiveness in the reduction of negative emotions and positive factors related to end-of-life issues. Most studies targeted patients with advanced cancer; however, studies on DT did not limit the target group to patients with cancer. Considering the expected life expectancy, CALM was found to be suitable for patients receiving early palliative care.