We have investigated the potential usefulness of stereoscopic viewing of optic disc photographs in marking the disc margin in computerized analysis with the Rodenstock Analyzer in 48 eyes of 26 patients with ocular hypertension or primary open-angle glaucoma. Marking of the disc margin without Method 1) and with the aid of stereoscopic viewing of disc photographs (Method 2) three consecutive times by one observer at the same sitting, and three subsequent topographic analyses of each method were done on each 48 eyes. The mean intraphotographic variabilities of such optic disc parameters as rim area, and cup volume with Method 2 were significantly less than those with Method 1 overall and in 16 eyes (33%) with poor video images having an ill-defined disc margin (p less than 0.05 for each), but not in 32 eyes (67%) with clear video images having a well-defined disc margin. Furthermore, the mean paired differences of rim area, disc area and cup volume between the two methods (Method 1 minus Method 2) were also statistically significant overall and in eyes with poor video images (p less than 0.05 for each).
Adult ; Aged ; Female ; Glaucoma, Open-Angle/pathology ; Human ; *Image Interpretation, Computer-Assisted ; Male ; Middle Age ; Ocular Hypertension/diagnosis ; Optic Disk/*anatomy & histology/pathology ; Photography

OBJECTIVES: This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. METHODS: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. RESULTS: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for beta-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. CONCLUSIONS: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.
Adrenergic beta-Antagonists/therapeutic use ; Age Factors ; Aged ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases/complications/drug therapy/*epidemiology ; Diabetes Complications ; Diabetes Mellitus/diagnosis ; Female ; Humans ; Hypercholesterolemia/complications/diagnosis ; Hypertension/complications/diagnosis ; Male ; Middle Aged ; Percutaneous Coronary Intervention/*statistics & numerical data/trends ; Prevalence ; Registries/statistics & numerical data ; Risk Factors ; Smoking ; Time Factors

PURPOSE: The mechanisms, which alter urinary bladder muscle function during infectious cystitis, are poorly understood. The objective of this study was to identify potential resident targets for endotoxin lipopolysaccharide(LPS) within normal bladder smooth muscle and test the hypothesis that LPS induces an inflammatory response within the bladder muscle and that this is associated with a decrease in muscle contractility. MATERIALS AND METHODS: Male rats were studied 24 hours after a single bolus i.p. injection of LPS(15mg/kg). Whole-mount preparations of the bladder muscle were immunohistochemically stained for neutrophils(myeloperoxidase), macrophages(ED2), activated leukocytes(LFA-1) and mast cells(FITC-Avidin). Contractile activity was assessed from muscle strips of the bladder in response to bethanechol(0.3-300microM). Voiding frequency and urine volume for 24 hours were measured using metabolic cage. Cystometry was performed to measure the intravesical bladder pressure. RESULTS: Using the resident macrophage marker ED2, dense network of macrophages were observed within the bladder muscle of control and LPS treated rats. Few neutrophils(myeloperoxidase-positive cells, 2.3 +/- 0.38 cells, x200) were detected in whole-mounts of bladder muscle of control rats, while LPS pretreatment resulted in a significant increase in the number of neutrophils which demonstrate inflammatory response(10.8 +/- 1.70 cells, x200, p<0.001). LFA-1 immunohistochemistry demonstrated an increased presence of LFA-1 positive cells in bladder muscle of LPS treated rats, which had a morphology similar to both neutrophils and resident macrophages. The expression of LFA-1 is known as a marker of cells that are in an activated state. LPS pretreatment resulted in a significant reduction in bladder muscle contractions in response to bethanechol(i.e. control = 0.049 +/- 0.010 vs. LPS= 0.029 +/- 0.003 gr/mm2/sec, 100microM, p<0.05). Voiding frequency of LPS treated rats was significantly increased compared to that of control rats. In LPS treated rats, voiding phase representing bladder contractility in cystometry was observed. CONCLUSIONS: These data demonstrate that a single intraperitoneal injection of LPS initiates an inflammatory response within the bladder muscle that is associated with a decrease in the functional activity of the bladder. We hypothesize that secretions from the resident macrophages and extravasated leukocytes within the muscle cause the observed suppression in bladder muscle activity in vitro.
Animals ; Cystitis ; Humans ; Immunohistochemistry ; Inflammation* ; Injections, Intraperitoneal ; Leukocytes ; Lymphocyte Function-Associated Antigen-1 ; Macrophages ; Male ; Muscle Contraction ; Muscle, Smooth ; Neutrophils ; Rats* ; Urinary Bladder*

Background and Objectives: Cryoballoon catheter ablation for the treatment of patients with symptomatic atrial fibrillation (AF) has been adopted globally, but there are limited multicenter reports of 12-month outcomes in the Korean patient population. This analysis evaluated the clinical performance and safety of cryoballoon ablation (CBA) according to standard-of-care practices in Korea. Methods: This evaluation of Korean patients with AF was conducted within the larger Cryo Global Registry, which is a prospective, multicenter, post-market registry. Freedom from a ≥30-second recurrence of atrial arrhythmias (after a 90-day blanking period until 12 months) and procedural safety were examined in subjects treated with CBA at 3 Korean centers. Results: Overall, 299 patients with AF (60±11 years old, 24.7% female, 50.5% paroxysmal AF) underwent CBA using the Arctic Front Advance cryoballoon. Of those, 298 were followed-up for at least 12 months. Mean procedure-, left atrial dwell- and fluoroscopy time was 76±21 minutes, 56±23 minutes, and 27±23 minutes, respectively. Freedom from AF recurrence at 12 months was 83.9% (95% confidence interval [CI], 76.9–88.9%) in the paroxysmal and 61.6% (95% CI, 53.1–69.0%) in the persistent AF cohort. Rhythm monitoring was performed on average 4.7±1.4 times during the follow-up period. Serious device- or procedure-related adverse events occurred in 2 patients (0.7%). The 12-month Kaplan-Meier estimate of freedom from repeat ablation and cardiovascular-related hospitalization was 93.8% (95% CI, 90.4–96.1%) and 89.7% (95% CI, 85.6–92.7%), respectively. Conclusions CBA is an efficient, effective, and safe procedure for the treatment of AF patients when used according to real-world practices in Korea.Trial Registration: ClinicalTrials.gov Identifier: NCT02752737

This study is the retrospective evaluation of ninety-six patients with biopsy-proven carcinoma of nasopharynx treated with radiotherapy at Yonsei University, College of Medicine, radiation Oncology from January 1971 to December 1985. Patient's age ranged from 15 to 71 years with a median age of 49 years. Fifty-two point five percent of local control and 47.5% of actuarial 5 year survival were achieved with radical radiotherapy. Five year survival rate for Stage I & II, III and IV were 75.0%, 74.6% and 41.4%, respectively. Distant metastasis rate was related with N stage (N1 12.5%, N1 0%, N2 23.5%, N3 32.1%) and histologic type (lymphoepithelioma 41.7%, squamous cell carcinoma 6.5%) but not with T stage. Thirty-one of sixty-seven patient covered adequate radiation field received induction chemotherapy. However induction chemotherapy dose not appear to improve over all survival.
Carcinoma, Squamous Cell ; Humans ; Induction Chemotherapy ; Nasopharynx ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate

Central diabetes insipidus (CDI) is a clinical syndrome that result from a failure of the neurohypophyseal axis to produce or release a sufficient quantity of arginine vasopressin (AVP) to permit normal function of the urinary concentrating mechanism. Polyuria and polydipsia are the symptoms associated with CDI. The most common cause of CDI is idiopathic variety and head trauma, neurohypophyseal surgery, primary or metastatic brain tumors acount for most of the remaining cases. CDI in Langerhans cell histiocytosis (LCH) is thought to be to infiltration of the hypothalamus-neurohypophyseal system. We report a patient with CDI and LCH underwent water depriviation test, MR imaging of the pituitary-hypothalamic region, and VATS associated open lung biopsy.
Arginine Vasopressin ; Axis, Cervical Vertebra ; Biopsy ; Brain Neoplasms ; Craniocerebral Trauma ; Diabetes Insipidus* ; Diabetes Insipidus, Neurogenic ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Lung ; Magnetic Resonance Imaging ; Polydipsia ; Polyuria ; Thoracic Surgery, Video-Assisted

PURPOSE: The purpose of this study was to evaluate the hospital utilization of cancer patients in Inchon and to assess the feasibility of Inchon Cancer Registry (ICR). MATERIALS AND METHODS: We used two data sources from Korean Central Cancer Registry (KCCR) and Korean Medical Insurance (KMI) for analysis. RESULTS: KCCR data analysis showed that 50.8% of cancer patients visited hospitals in Seoul, 46% visited hospitals in Inchon, and 2.6% in other areas at first visit. The analysis of KMI data showed that 43% of cancer patients visited hospital in Seoul, 38.5% visited hospitals in Inchon, and 18.5% in other areas at first visit. From these results, we found many cancer patients visited hospitals located in Seoul. We estimated that 52.1% would be missed when we performed cancer registry project in Inchon area alone from the KCCR data analysis. On the other hand, 60% would be missed from the KMI data. However, if we used registration data at the nation-wide level and actively registered cancer patient data in Inchan, expected unregistration rates would be 5%. CONCLUSION: Even though registration rate to KCCR was relatively low (74%) in Inhon and many patients were treated in other area, we are convinced that almast all cancer patients would be registered because most cancer patients visited at least one of the cancer registry hospitals at the nation-wide level. Therefore, if ICR used KCCR and encouraged the hospitals in Inchon to actively participate in cancer registration, the population-based cancer registration in Inchon would be possible.
Information Storage and Retrieval ; Hand ; Humans ; Incheon* ; Insurance ; Seoul ; Statistics as Topic

No abstract available.
Exosomes* ; Lymphatic System* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND/AIMS: A diagnosis of acute diverticulitis is based on computed tomography (CT). Colonoscopy is commonly performed after the acute event to exclude other diagnoses. This study aimed to determine whether colonoscopy is necessary and what additional information is gained from a colonoscopy after acute diverticulitis. METHODS: Acute diverticulitis was diagnosed by clinical criteria and characteristic CT findings. We analyzed the number of patients in whom colorectal cancers were diagnosed and other incidental findings of polyps and other diseases. RESULTS: A total of 177 patients were analyzed retrospectively. The mean age was 43.3+/-15.3 years (range, 13-82 years) and 97 patients (54.8%) were male. Sixty-one patients had undergone a colonoscopy within 1 year of the acute attack. Advanced adenomatous lesions and colonic malignancy were not detected. Nineteen patients (31.1%) had > or =1 polyp and 11 patients (18.0%) had an adenomatous polyp. No new or different diagnosis was made after colonoscopy. None of the 116 patients who did not undergo colonoscopy within a year after acute diverticulitis had a diagnosis of colorectal cancer registered with the Korea Central Cancer Registry. CONCLUSIONS: Routine colonoscopy yields little benefit in patients with acute diverticulitis diagnosed by typical clinical symptoms and CT. The current practice of a colonoscopy after acute diverticulitis needs to be reevaluated.
Adenomatous Polyps ; Colon ; Colonoscopy* ; Colorectal Neoplasms ; Diagnosis* ; Diverticulitis* ; Humans ; Incidental Findings ; Korea ; Male ; Polyps ; Retrospective Studies

BACKGROUND/AIMS: The internet has become an important source of medical information not only for doctors but also for patients. Therefore, this study evaluated the quality of medical information on endoscopy under conscious sedation on the internet in Korea. METHODS: 147 patients (mean age: 51 years, male:female 76:71) who visited the gastroenterology clinic were surveyed using a questionnaire about use of medical information on the Internet. The first 20 Internet sites using the key word 'endoscopy under sedation' were retrieved from the 5 most frequently used Internet search engines. The quality of information from a total of 63 websites was evaluated using a checklist. RESULTS: Among a total 63 sites about endoscopy under sedation, 46 sites (73.0%) were made by private hospitals or private clinics and 60 sites (95%) were made for patients. The definition of endoscopy under conscious sedation was accurately mentioned in only 7 sites (11%). The complications and risk factors were mentioned in 29 sites (46%). CONCLUSIONS: Most websites made by private hospitals or private clinics overempha sized the merits of sedation. Websites with a more balanced point of view by official organizations may help improve the quality of medical information on the Internet.
Checklist ; Conscious Sedation* ; Endoscopy* ; Gastroenterology ; Hospitals, Private ; Humans ; Internet ; Korea ; Risk Factors ; Search Engine ; Surveys and Questionnaires