PURPOSE: To compare the epithelial wound healing response of two preservative-free fluoroquinolones, moxifloxacin and levofloxacin, in patients who underwent cataract surgery. MATERIALS AND METHODS: In this prospective, evaluator-masked, randomized clinical trial, 59 eyes of 50 patients who underwent cataract surgery were enrolled. Patients were randomized to receive moxifloxacin 0.5% (n=32 eyes) or levofloxacin 0.5% (n=27 eyes). All patients instilled moxifloxacin or levofloxain four times daily for 1 week prior to surgery and 2 weeks after surgery. The epithelial wound healing status in the corneal incision site was scanned with a raster scan mode of fourier-domain optical coherence tomography (FD-OCT). The number of eyes showing epithelial defect images and average number of corneal epithelial defect cuts per eye were compared between groups. All patients were evaluated on postoperative days 1, 2, 3, and 10. RESULTS: On postoperative days 1, 2, and 3, the number of eyes showing epithelial defects in FD-OCT was not statistically different (all p>0.05). The average number of corneal epithelial defect cuts was also not statistically different between the two groups (all p>0.05). No eyes showed epithelial defects on postoperative day 10 in either group. CONCLUSION: There were no differences on epithelial wound healing comparing these two different fluoroquinolones at the incision site of cataract surgery.
Aged ; Aza Compounds/therapeutic use ; Cataract Extraction ; Cornea/drug effects/*surgery ; Female ; Fluoroquinolones/*therapeutic use ; Humans ; Levofloxacin/therapeutic use ; Male ; Middle Aged ; Quinolines/therapeutic use ; Tomography, Optical Coherence ; Wound Healing/*drug effects

PURPOSE: To evaluate the efficacy of 3% diquafosol tetrasodium (DQ) after laser-assisted in-situ keratomileusis (LASIK). METHODS: This prospective randomized study included 150 eyes in 75 patients who were scheduled for LASIK. The patients in the 3% diquafosol tetrasodium (DQ) group (37 patients, 74 eyes) were instructed to apply one drop of DQ, six times daily post-op, while the patients in the 0.3% sodium hyaluronate (HA) group (38 patients, 76 eyes) were instructed to apply one drop of HA, six times daily post-op. A Schirmer test, tear film break-up time (BUT), corneal and conjunctival fluorescein staining score (FLSS), and ocular surface disease index (OSDI) were evaluated pre-op and at 1, 4, and 12 weeks post-op while the tear osmolarity was evaluated pre-op and at 4 and 12 weeks post-op. RESULTS: There was no significant difference between the two groups regarding Schirmer test results or tear osmolarity and conjunctival FLSS. The BUT was significantly higher in the DQ group at 1 week and 12 weeks post-op. The corneal FLSS was significantly lower in the DQ group at 1 week, 4 weeks and 12 weeks post-op. The OSDI was significantly lower in the DQ group at 1 week post-op. CONCLUSIONS: Use of 3% diquafosol tetrasodium after surgery improved ocular dryness and increased the tear film stability.
Fluorescein ; Humans ; Hyaluronic Acid ; Keratomileusis, Laser In Situ ; Osmolar Concentration ; Prospective Studies ; Tears

PURPOSE: Three dimensional conformal radiotherapy planning is being used widely for the treatment of patients with brain tumor. However, it takes much time to develop an optimal treatment plan, therefore, it is difficult to apply this technique to all patients. To increase the efficiency of this technique, we need to develop standard radiotherapy plans for each site of the brain. Therefore we developed several 3 dimensional conformal radiotherapy plans (3D plans) for tumors at each site of brain, compared them with each other, and with 2 dimensional radiotherapy plans. Finally model plans for each site of the brain were decided. MATERIALS AND METHODS: Imaginary tumors, with sizes commonly observed in the clinic, were designed for each site of the brain and drawn on CT images. The planning target volumes (PTVs) were as follows; temporal tumor-5.7x8.2x7.6 cm, suprasellar tumor-3x4x4.1 cm, thalamic tumor-3.1x5.9x3.7 cm, frontoparietal tumor-5.5x7x5.5 cm, and occipitoparietal tumor-5x5.5x5 cm. Plans using parallel opposed 2 portals and/or 3 portals including fronto-vertex and 2 lateral fields were developed manually as the conventional 2D plans, and 3D noncoplanar conformal plans were developed using beam's eye view and the automatic block drawing tool. Total tumor dose was 54 Gy for a suprasellar tumor, 59.4 Gy and 72 Gy for the other tumors. All dose plans (including 2D plans) were calculated using 3D plan software. Developed plans were compared with each other using dose-volume histograms (DVH), normal tissue complication probabilities (NTCP) and variable dose statistic values (minimum, maximum and mean dose, D5, V83, V85 and V95). Finally a best radiotherapy plan for each site of brain was selected. RESULTS: 1) Temporal tumor; NTCPs and DVHs of the normal tissue of all 3D plans were superior to 2D plans and this trend was more definite when total dose was escalated to 72 Gy (NTCPs of normal brain 2D plans : 27%, 8% 3D plans : 1%, 1%). Various dose statistic values did not show any consistent trend. A 3D plan using 3 noncoplanar portals was selected as a model radiotherapy plan. 2) Suprasellar tumor; NTCPs of all 3D plans and 2D plans did not show significant difference because the total dose of this tumor was only 54 Gy. DVHs of normal brain and brainstem were significantly different for different plans. D5, V85, V95 and mean values showed some consistent trend that was compatible with DVH. All 3D plans were superior to 2D plans even when 3 portals (fronto-vertex and 2 lateral fields) were used for 2D plans. A 3D plan using 7 portals was worse than plans using fewer portals. A 3D plan using 5 noncoplanar portals was selected as a model plan. 3) Thalamic tumor; NTCPs of all 3D plans were lower than the 2D plans when the total dose was elevated to 72 Gy. DVHs of normal tissues showed similar results. V83, V85, V95 showed some consistent differences between plans but not between 3D plans. 3D plans using 5 noncoplanar portals were selected as a model plan. 4) Parietal (fronto- and occipito-) tumors; all NTCPs of the normal brain in 3D plans were lower than in 2D plans. DVH also showed the same results. V83, V85, V95 showed consistent trends with NTCP and DVH. 3D plans using 5 portals for frontoparietal tumor and 6 portals for occipitoparietal tumor were selected as model plans. CONCLUSION: NTCP and DVH showed reasonable differences between plans and were thought to be useful for comparing plans. All 3D plans were superior to 2D plans. Best 3D plans were selected for tumors in each site of brain using NTCP, DVH and finally by the planner's decision.
Brain Neoplasms* ; Brain Stem ; Brain* ; Humans ; Rabeprazole ; Radiotherapy ; Radiotherapy, Conformal*

BACKGROUND: The objective confirmation of subjective symptom of patient is important in the primary care consisted largely by functional disorders of which mechanisn could not explain the symptoms clearly. Definite diagnostic method is not established yet for the functional disorders desptie the fact that various investigations have been done. So, we tried to reveal the relationship between the value of indicator drop(ID) from electroacupunctrure point accordint to Voll and the clinical diagnosis and subjective symptom by using noninvasive electroacupuncture diagnosis according to Voll. METHODS: Among the patients of three university level hospital health care center from April to June 1997, consenting 203 persons were enrolled. Various laboratory finding and ID from EAV were measured by double blind test method. In parallel, Subjective symptom was classified by each organ. Validity was tested by the relationship between the gastrofiberscopy finding and the stomach control measurement point ID. RESULTS: There were statistically significant ID increases in the CMPs of endocrine, lung, circulation system, gastrointestinal system, kidney and bladder compared to alboratory findings or subjective symptom by the comparison between the variables of the assessed clinical or laboratory findings and organ specific CMP score. Especially, the ID increase of stomach shows 79.3%-90.9% positive predictive value to positve findings of gastrofiberscopy when gastofiberscopy is defined to confirmation test of gastritis, gastric ulcer and duodenal ulcer. CONCLUSION: Our results show that the noninvasive electrodiagnostic method result by measuring EAV of organ system is related statistically to subjective symptoms and laboratory findings. Also they show that it could be useful tool as a clinical diagnostic method. We suggest that further study is needed to reveal organ specific sensitivity, specificity, positivE and negative predictive value by using ccnfirmation method of organ specific disease.
Delivery of Health Care ; Diagnosis ; Duodenal Ulcer ; Electroacupuncture ; Gastritis ; Humans ; Kidney ; Lung ; Primary Health Care ; Sensitivity and Specificity ; Stomach ; Stomach Ulcer ; Urinary Bladder