PURPOSE: To investigate the effects of glucose concentrations on formation of reactive oxygen products and cellular activity in human retinal pigment epithelial cells. METHODS: Human retinal pigment epithelial cells were cultured with high glucose (200 mg/100 ml, 300 mg/100 ml, 400 mg/100 ml) and normal glucose (100 mg/100 ml). The amounts of reactive oxygen products were assayed with dihydroethidium (DHE). Paraquat-induced cellular activity was determined by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) method. RESULTS: Reactive oxygen products of human retinal pigment epithelial cells were increased 120%, 250% and 390% in high glucose (200 mg/100 ml, 300 mg/100 ml, 400 mg/100 ml) media compared to those of normal glucose (100 mg/100 ml) media. Paraquat-induced cell toxicity was increased by high glucose concentrations. CONCLUSIONS: High glucose increased formation of reactive oxygen products in human retinal pigment epithelial cells. These results suggest that high glucose can make human retinal pigment epithelial cells more sensitive to oxidative cellular injury.
Epithelial Cells* ; Glucose* ; Humans ; Oxygen* ; Retinaldehyde*

PURPOSE: To investigate the minimal requirements of the limbal epithelium for successful limbal stem cell transplantation and the healing process. METHODS: Nine rabbits were divided into 4, 6, and 8 clock-hour transplantation groups. Limbal autografts from the healthy fellow eye were transplanted to the iatrogenic damaged eye. The amniotic membrane served as a stem cell niche. Experimental corneas were evaluated by slit lamp examination and immunohistochemistry. RESULTS: In the over 9 hours transplantation group, the healing process of the epithelium from the limbal stem cell was revealed and cornea-specific keratin k3, transcription factor p63, and connexin 43 were detected by immunohistochemistry. The normal corneal epithelium was regenerated after 60 days postoperatively in the fellow donor eye. CONCLUSIONS: Limbal cell transplantation of over 9 hours seems to be a safe and effective method in the treatment of severe ocular surface disorders. In addition, the donation of limbal epithelium for up to 8 hours did not affect the normal corneal regenerating capability.
Amnion ; Autografts ; Cell Transplantation* ; Connexin 43 ; Cornea* ; Epithelium* ; Epithelium, Corneal ; Humans ; Immunohistochemistry ; Rabbits ; Stem Cell Niche ; Stem Cell Transplantation ; Stem Cells ; Tissue Donors ; Transcription Factors ; Transplants*

Background and Objectives: A mobile application (app)-based electrocardiogram (ECG) consultation system (InterMD Co., Ltd., Seoul, Korea) using the collective intelligence (CI) and the availability of large-scale digitized ECG data would extend the utility of ECGs beyond their current limitations, while at the same time preserving interpretability that remains critical to medical decision-making. Methods: We developed a new mobile app-based ECG consultation system by CI for general practitioners. We compared the responses of ECG reading between the mobile app-based CI system and the conventional system in a tertiary referring hospital. Results: We analyzed 376 consecutive ECGs between December 2017 and May 2019. Of these, 159 ECGs (42.3%) were interpreted by CI through the mobile app-based ECG consultation system and 217 ECGs (57.7%) were analyzed by cardiologists in the conventional systems based on electronic medical record data in a tertiary hospital. All ECG readings were confirmed by an electrophysiologist (EP). The time to an initial response by the CI system was faster than that of the conventional system (6.6 hours vs. 35.8 hours, p<0.0001). The number of responses of each ECG in CI system outnumbered those of the conventional system in the tertiary hospital (3.1 vs. 1.2, p<0.0001). The consensus of the ECG readings with EP was similar in both systems (98.6% vs. 100%, p=0.158). Conclusions The mobile app-based ECG consultation system by CI is as reliable method as the conventional referral system. It would expand the app of the 12-lead ECG with the collaboration of physicians in clinics and hospitals without time and space constraints.

Background and Objectives: A mobile application (app)-based electrocardiogram (ECG) consultation system (InterMD Co., Ltd., Seoul, Korea) using the collective intelligence (CI) and the availability of large-scale digitized ECG data would extend the utility of ECGs beyond their current limitations, while at the same time preserving interpretability that remains critical to medical decision-making. Methods: We developed a new mobile app-based ECG consultation system by CI for general practitioners. We compared the responses of ECG reading between the mobile app-based CI system and the conventional system in a tertiary referring hospital. Results: We analyzed 376 consecutive ECGs between December 2017 and May 2019. Of these, 159 ECGs (42.3%) were interpreted by CI through the mobile app-based ECG consultation system and 217 ECGs (57.7%) were analyzed by cardiologists in the conventional systems based on electronic medical record data in a tertiary hospital. All ECG readings were confirmed by an electrophysiologist (EP). The time to an initial response by the CI system was faster than that of the conventional system (6.6 hours vs. 35.8 hours, p<0.0001). The number of responses of each ECG in CI system outnumbered those of the conventional system in the tertiary hospital (3.1 vs. 1.2, p<0.0001). The consensus of the ECG readings with EP was similar in both systems (98.6% vs. 100%, p=0.158). Conclusions The mobile app-based ECG consultation system by CI is as reliable method as the conventional referral system. It would expand the app of the 12-lead ECG with the collaboration of physicians in clinics and hospitals without time and space constraints.

This article was published with an error.

The best available evidence indicates that the prevalence of supraventricular tachycardia (SVT) in the general population is 2.29 per 1,000 persons. Women have twice the risk of developing paroxysmal supraventricular tachycardia (PSVT) compared to men. Individuals aged >65 years have >5 times the risk of developing PSVT compared to younger persons. Twelve-lead electrocardiograms (ECGs) obtained during both tachycardia and sinus rhythm may reveal the etiology and help diagnose SVT. It is important to conduct a 12-lead ECG to differentiate tachycardia mechanisms according to whether the atrioventricular (AV) node is an obligate component. Invasive electrophysiologic (EP) study and catheter ablation have become a standard treatment for SVT, in addition to being an acute medical treatment. Diagnostic EP study complications are rare, but can be life threatening.
Catheter Ablation ; Electrocardiography ; Female ; Humans ; Male ; Prevalence ; Tachycardia ; Tachycardia, Supraventricular*

Familial hypercholesterolemia (FH) is associated with premature atherosclerotic cardiovascular diseases, and is inherited as an autosomal dominant trait. The prevalence of heterozygous FH is one in five hundred people. Owing to dysfunctional low density lipoprotein (LDL) receptors due to genetic mutations, serum low density lipoprotein-cholesterol (LDL-C) levels are considerably increased from birth. FH is clinically diagnosed by confirmation of family history and characteristic findings such as tendon xanthoma or xanthelasma. Thus, clinical concern and suspicion are important for early diagnosis of the disease. Current guidelines recommend lowering LDL-C concentration to at least 50% from baseline. Statins are shown to lower LDL-C levels with high safety, and thus, have been the drug of choice. However, it is difficult to achieve an ideal level of LDL-C with a single statin therapy in the majority of FH patients. Alternatively, lipid lowering combination therapy with the recently-introduced ezetimibe has shown more encouraging results.
Azetidines ; Cardiovascular Diseases ; Early Diagnosis ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipoproteinemia Type II ; Lipoproteins ; Parturition ; Prevalence ; Tendons ; Xanthomatosis ; Ezetimibe

PURPOSE: The diagnosis-related group (DRG) system has been adapted to reduce overall medical costs by grouping and classifying relatively homogenous patients based on similar resource consumption patterns in the treatment. However, despite its wide range of disease manifestation from early inflammation to severe peritonitis, acute appendicitis is included in the DRG system. Responding to a need to assess the DRG system for patients diagnosed with appendicitis, this study evaluates the efficacy of the current DRG system applied to a broad spectrum of the patients with appendicitis undergoing laparoscopic appendectomy. METHODS: A retrospective review was conducted of the patients who underwent laparoscopic appendectomy. Based on the DRG codes' classification, the patients were analyzed for the amount of DRG reimbursement and the total in-patient cost in relation to the time sequence of the disease onset. Statistical analysis was performed to find factors correlated with the DRG reimbursement and total in-patient cost. RESULTS: Findings indicate that, as the symptom duration becomes prolonged, the CRP level and the use of peritoneal drainage increased. Patients with a symptom duration greater than 24 hours required approximately 5 days of hospital stay, 0.5 day longer in the length of hospital stay than that of patients with less than 12 hours of the onset time. As expected, the amount of DRG reimbursement and the total in-patient cost accumulated as the symptom duration increased. CONCLUSION: The current DRG reimbursement system for the patients undergoing laparoscopic appendectomy recompenses a broad spectrum of patients diagnosed with appendicitis effectively.
Appendectomy* ; Appendicitis ; Classification ; Diagnosis-Related Groups* ; Drainage ; Humans ; Inflammation ; Korea ; Laparoscopy ; Length of Stay ; Peritonitis ; Retrospective Studies ; Severity of Illness Index