To investigate the effect of illumination on visual acuity and visual field in eyes with multifocal intraocular lens (IOL), the near and far visual acuity of the eyes with multifocal implants were compared to those of the eyes with monofocal implants in the diminished illumination, and the visual fields of two groups were also compared by the different target size and intensity. The near and far visual acuity of the eyes with multifocal implants were significantly decreased as compared to those of the eyes with monofocal implants under diminished illumination, and the visual field of the multifocal implanted eyes also significantly decreased as compared to that of the monofocal implanted eyes by the reduction of spot size and intensity. From the above results, it is assumed that the bifocal separation of incident light to two simultaneous focal points in the multifocal implants causes more decreased visual acuity and narrower visual field in the diminished illumination as compared to that of the eyes with monofocal implants.
Adult ; Cataract Extraction ; Female ; Humans ; *Lenses, Intraocular ; Light ; *Lighting ; Male ; Visual Acuity/*physiology ; Visual Fields/*physiology

Carcinoma of lung is classified by histologic cell type, this is based on predominant major cell population by tissue specimen. But in fact a range of 13% to 63% of lung cancer has been appeared to be heterogeneous cell type at the light microscopic level. After treatment of the mixed lung cancer and/or with time there are reports that cell type is changed. Because it is possible that the tumor were pleomorphic and that the antitumor therapy eliminated the more sensitive cell population and permitted the subsequent emergence of the more resistant cell population. The authors reported here, a case of 32 year old female patient with mixed lung cancer composed of three cell type, and this is the first case in Korea.
Adult ; Female ; Humans ; Korea ; Lung ; Lung Neoplasms ; Population Characteristics

The Diabetes Educator Training Module (DETM), which was developed in 2011, contained more than 900 slides. The purpose of the DETM is to help Korean diabetes educators develop programs for diabetic patients and health professionals. In this paper, we present information regarding the history, the principles of development, the contents, and the use of the DETM program. We hope that the DETM will be a useful tool for helping diabetic patients to understand their disease and to improve their glycemic control and treatment adherence.
Health Occupations ; Humans ; Patient Education as Topic ; Teaching Materials

BACKGROUND: Clinical and Radiographic studies to differentiate benign from malignant pulmonary nodules have previously focused on clinical status and the morphologic and the computed tomographic attenuation characteristics of the lung nodules. Distinctive differences in the vascularity and pathophysiology of malignant versus benign pulmonary nodules were identified. We evaluated the diagnostic method for differentiating malignant from benign solitary pulmonary nodule by contrast enhancement on the spiral CT. METHOD: Sixteen patients with solitary pulmonary nodule were examined(Tuberculoma 8, primary lung cancer 8). Serial thin section on the spiral CT was performed before and after(45second, 2min, 5min) the onset of the injection of 100mL of nonionic contrast material(2mL/sec). RESULTS: There was no difference in size of nodule and pre-contrast CT number (Hounsfield unit) between benign and malignant nodules. At forty-five second after the onset of the injection, malignant neoplasms(19.6+/-7.9 HU) enhanced significantly more than tuberculomas(4.9+/-9.4 HU, p=0.008). At 2 minute and 5 minute after, malignant neoplasms(34.0+/-19.2HU, 340+/-15.4HU) enhanced significantly more than tuberculomas (6.7+/-9.7HU, p=0.007 and 7.7+/-11.5HU, p=0.011). On cut-off value 20HU(contrast enhancement) 2 minute after the injection of contrast media, sensitivity was 87% and specificity was 87%. No correlation between the contrast enhancement and size of the nodules was observed. CONCLUSION: Studies with the use of an intravenously administered noniodinated contrast medium in examining the enhancement properties of lung nodules was performed. The contrast enhancement was useful in differential diagnosis of solitary pulmonary nodules.
Contrast Media ; Diagnosis, Differential ; Humans ; Lung ; Lung Neoplasms ; Sensitivity and Specificity ; Solitary Pulmonary Nodule* ; Tomography, Spiral Computed* ; Tuberculoma

BACKGROUND / PURPOSE: Hepatocellular carcinoma (HCC) is a common cancer with a poor prognosis. A better understanding of the molecular mechanisms underlying the genesis of HCC, as well as the progression of HCC, allow for improved prediction of the prognosis of patients with HCC and more effective treatment. In this study, we determined the expression of vimentin and matrix metalloproteinase 2 (MMP 2) and evaluated the clinical significance in (HCC). METHODS: Immunohistochemical staining was performed for vimentin and MMP 2 in 98 surgically resected HCC specimens using the tissue microarray method. The clinicopathologic data and the outcomes were reviewed, and the levels of expression of vimentin and MMP 2 were compared. RESULTS: Positive expression of vimentin and MMP 2 was observed in 7.1% and 41.8% of specimens, respectively. The overexpression of vimentin and MMP 2 had a positive correlation with tumor cell proliferative activity, as measured by the Ki-67 labeling index (p<0.001 and p=0.043, respectively), but was not correlated with the TUNEL labeling index. Other clinicopathological factors, such as platelet count, serosal invasion, Edomondson grade, capsule infiltration, TNM stage(UICC, 6th edition) and extrahepatic metastases in patients with recurrences had a significant correlation with vimentin. The presence of portal vein thrombosis approached statistical significance with MMP 2 expression. In the survival analysis, overexpression of vimentin and MMP 2 was correlated with a poor overall survival rate based on univariate analysis (p=0.002 and, p=0.047, respectively), but not based on multivariate analysis. CONCLUSION: In HCC, vimentin and MMP 2 may have a role in cancer progression with more aggressive potential, thus suggesting their use as a prognostic markers in HCC.
Carcinoma, Hepatocellular ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Matrix Metalloproteinase 2 ; Multivariate Analysis ; Neoplasm Metastasis ; Platelet Count ; Portal Vein ; Prognosis ; Recurrence ; Survival Analysis ; Survival Rate ; Thrombosis ; Vimentin

A 67-year-old male was admitted to the hospital for evaluation of incidentally detected anemia and mild azotemia. Urinalysis showed no abnormal finding and 24 hr urine protein amount was clinically insignificant (270 mg/day). Urine and serum protein electrophoresis were negative for a monoclonal spike. However, urine and serum immunoelectrophoresis demonstrated the presence of monoclonal free kappa light chains. Renal biopsy showed the features of chronic tubulointerstitial disease and on the immunofluorescence studies, kappa light chain was in a linear pattern in basement membranes of glomeruli and tubules. Work-up for multiple myeloma including bone marrow biopsy showed results compatible with multiple myeloma. Treatment was started with vincristine, adriamycin and doxorubicin at monthly interval for three months followed by autologus peripheral blood stem cell transplantation. At follow-up 5 months after autologus peripheral blood stem cell transplantation, the patient is well with a serum creatinine of 2.3-2.6 mg/dL and 24 hr urine protein of 200-350 mg.
Aged ; Anemia ; Azotemia ; Basement Membrane ; Biopsy ; Bone Marrow ; Creatinine ; Doxorubicin ; Electrophoresis ; Fluorescent Antibody Technique ; Follow-Up Studies ; Humans ; Immunoelectrophoresis ; Male ; Multiple Myeloma ; Peripheral Blood Stem Cell Transplantation ; Proteinuria* ; Urinalysis ; Vincristine

BACKGROUND AND OBJECTIVES: Cholera toxin B (CTB) is an effective immunomodulating agent. Mucosal tolerance is a well recognized method for inducing tolerance, but large amounts of antigen is needed. The dosage required can be dramatically reduced through coupling the antigen to the CTB. This study aimed to examine whether mucosal administration of house dust mite coupled to CTB (HDM-CTB conjugate) would modulate specific type 1 hypersensitivity in the murine model of allergic rhinitis and to evaluate the prophylactic and long-term therapeutic effects. MATERIALS AND METHOD: C57BL/6 mice were sensitized with Dermatophagoides farinae extract. After administration of HDM-CTB conjugate, several parameters of allergic response were evaluated. RESULTS: After mucosal adminstration of HDM-CTB conjugate, allergic symptoms, eosinophilic infiltration into nasal mucosa, specific IgE, and the splenic T cell proliferation after Dermatophagoides farinae allergen challenge were suppressed. CONCLUSION: These findings show that HDM-CTB conjugate has an anti-allergic effect in the murine model of allergic rhinitis and suggest that house dust mite allergy can be modulated with mucosal administration of allergen coupled to CTB.
Administration, Mucosal ; Animals ; Cell Proliferation ; Cholera Toxin ; Dermatophagoides farinae ; Dust* ; Eosinophils ; Hypersensitivity ; Immunoglobulin E ; Immunotherapy ; Mice* ; Nasal Mucosa ; Pyroglyphidae ; Rhinitis*

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.