Effect of Korean Red Ginseng supplementation on dry eye syndrome in glaucoma patients - A randomized, double-blind, placebo-controlled study

BACKGROUND: Many patients with glaucoma have difficulty using antiglaucoma eye drops because of dry eye symptom. In this prospective, randomized, double-blind, placebo-controlled study, we evaluated the effect of Korean Red Ginseng on dry eye syndrome in patients with glaucoma treated with antiglaucoma eye drops. METHODS: Forty-nine participants were allocated to the Korean Red Ginseng (3 g/day; n = 24) or placebo (n = 25) groups for 8 weeks. Tear film stability, fluorescein corneal staining, conjunctival hyperemia, tear production, grade of meibomian gland dysfunction, and dry eye questionnaire (Ocular Surface Disease Index) were evaluated at baseline and on completion of the treatment. RESULTS: Almost all patients displayed dry eye symptoms and signs at baseline. After the 8-week intervention, Korean Red Ginseng supplementation significantly improved the tear film stability and total Ocular Surface Disease Index score, as compared to placebo (p < 0.01). CONCLUSION: Korean Red Ginseng supplementation may provide an additional treatment option for dry eye and patients with glaucoma using antiglaucoma eye drops.ope

Comparison and Investigation of the National Standards for Tinted Contact Lenses between Various Countries

Purpose : In this study we investigated the safety level of the national standard for tinted soft contact lenses by comparing the standards in various countries. Methods : To evaluate the current guidelines for tinted soft contact lenses such as form and appearance, diameter, curvature radius, vertex power, cylindrical refractivity and cylindrical axis, luminous/ultraviolet ray (UV) transmittance, moisture content, oxygen permeability coefficient, extractables, elution test, cytotoxicity, sensitization, eye irritation test, acute systemic/subchronic/subacute toxicity, genotoxicity and biocompatibility safety test using rabbit eyes and sterility test. We compared the standards of International Organization for Standardization (ISO), Food and Drug Administration (FDA) of the United States, Ministry of Health, Labor and Welfare (MHLW) of Japan and Ministry of Food and Drug Safety (MFDS) of Korea. Results : The guidelines for tinted soft contact lenses of ISO, FDA and MFDS are similar to soft contact lenses but MHLW of Japan classifies these lenses and sets specific guidelines. First, the oxygen permeability coefficient measured at 6mm from the center should be maintained over 80%. Also, coloring should not affect the oxygen permeability coefficient significantly. Regarding the physical (form and appearance, diameter, curvature radius, moisture content) and optical (vertex power, cylindrical refractivity and cylindrical axis, luminous/UV transmittance, oxygen permeability coefficient) characteristics, no differences were found between ISO and MFDS. However, several differences were found in chemical characteristics (extractables, elution test) and biological stability (cytotoxicity, sensitization, eye irritation test, acute systemic/subchronic/subacute toxicity test, genotoxicity, biocompatibility safety test using rabbit eyes, sterility test). For example, the elution test is required only by MFDS. Conclusions : The reinvestigation into the effectiveness of the elution test is needed and new evaluation measures including scanning electron microscopy and atomic force microscopy designed for tinted soft contact lenses to evaluate the size of the optical area, the location and roughness of the pigmented layer are required.ope

Development of a nomogram using fundus photography to predict glaucoma progression in patients showing disc hemorrhage

To develop a nomogram to predict the progression of glaucoma by fundus photography in patients with disc hemorrhage. Retrospective review of the medical records of patients with disc hemorrhage, which was detected during follow up with open angle glaucoma, from January 2010 to March 2018. Patients were divided into glaucoma progression (n = 52) or non-progression (n = 38) groups. We assessed proximal location and morphology of disc hemorrhage; relationship to retinal nerve fiber layer defects with disc hemorrhage; and angular extent of disc hemorrhage, between groups using fundus photography. Multiple logistic regression analysis was performed to select prognostic factors, and we constructed a nomogram to predict glaucoma progression. The number of disc hemorrhage at the border of retinal nerve fiber layer defects (P = 0.001) and peripapillary disc hemorrhage (P = 0.008) were significantly higher in the progression group. We used angular extent; location of disc hemorrhage with retinal nerve fiber layer defects; and proximal location of disc hemorrhage to construct the nomogram. The area under the receiver operating characteristic curve of the nomogram was 0.847. We created the nomogram using fundus photography in patients showing disc hemorrhage as a novel and accurate screening method to predict glaucoma progression and aid clinicians to decide on the best treatment plan.ope

Asymmetry of Peak Thicknesses between the Superior and Inferior Retinal Nerve Fiber Layers for Early Glaucoma Detection: A Simple Screening Method

PURPOSE: To assess whether the asymmetry in the peripapillary retinal nerve fiber layer (pRNFL) thickness between superior and inferior hemispheres on optical coherence tomography (OCT) is useful for early detection of glaucoma. MATERIALS AND METHODS: The patient population consisted of Training set (a total of 60 subjects with early glaucoma and 59 normal subjects) and Validation set (30 subjects with early glaucoma and 30 normal subjects). Two kinds of ratios were employed to measure the asymmetry between the superior and inferior pRNFL thickness using OCT. One was the ratio of the superior to inferior peak thicknesses (peak pRNFL thickness ratio; PTR), and the other was the ratio of the superior to inferior average thickness (average pRNFL thickness ratio; ATR). The diagnostic abilities of the PTR and ATR were compared to the color code classification in OCT. Using the optimal cut-off values of the PTR and ATR obtained from the Training set, the two ratios were independently validated for diagnostic capability. RESULTS: For the Training set, the sensitivities/specificities of the PTR, ATR, quadrants color code classification, and clock-hour color code classification were 81.7%/93.2%, 71.7%/74.6%, 75.0%/93.2%, and 75.0%/79.7%, respectively. The PTR showed a better diagnostic performance for early glaucoma detection than the ATR and the clock-hour color code classification in terms of areas under the receiver operating characteristic curves (AUCs) (0.898, 0.765, and 0.773, respectively). For the Validation set, the PTR also showed the best sensitivity and AUC. CONCLUSION: The PTR is a simple method with considerable diagnostic ability for early glaucoma detection. It can, therefore, be widely used as a new screening method for early glaucoma.ope

Thalidomide and dexamethasone maintenance after autologous stem cell transplantation in newly diagnosed multiple myeloma patients: A prospective multi-center study in Asia

학위논문 (석사)-- 서울대학교 대학원 : 의과대학 의학과, 2019. 2. 윤성수.Clinical outcome of multiple myeloma has been improved with maintenance therapy. Thalidomide is the first immunomodulatory drug to be studied as maintenance therapy and has widely been used in Korea in spite of the concerns about uncertain survival benefit and considerable side effects. Currently, next-generation immunomodulatory drugs and proteasome inhibitors are actively investigated as promising maintenance treatment. However, in real clinical practice, it is often difficult to use these new drugs because of medical expense or drug accessibility. In such a situation, thalidomide is still considered to be an applicable alternative. From this point of view, this study is an open-label, multicenter, prospective phase II study to investigate the efficacy and toxicity of thalidomide maintenance in Korean patients who were newly diagnosed with multiple myeloma. Patients who underwent induction treatment followed by autologous stem cell transplantation were enrolled in this study. Treatment was planned for a total of 12 cycles, but terminated in case of disease progression or unacceptable toxicity. Each cycle was scheduled for 28 days, with 28 days of thalidomide at a dose of 100 mg and 4 days of dexamethasone at a dose of 40 mg. The primary endpoint of this study was event-free survival (EFS) at 1 year, which was defined as the time from randomization to disease relapse, progression, serious side effects or death of any cause. Key secondary endpoints included progression free survival (PFS), overall survival (OS) and toxicity profile. From July 2013 to November 2015, a total of 43 patients from 7 medical centers were consecutively enrolled. Median follow-up duration of study participants was 17.3 months (range, 1.1 – 32.2 months). Only 28 patients (65.1%) completed all 12 cycles of maintenance treatment, and median duration of treatment was 5.6 months (Interquartile range [IQR], 2.9 – 6.9 months) in patients who experienced early termination of the study. EFS at 1 year was 65.1% (95% confidence interval [CI], 48.9 – 77.3). PFS and OS at 1 year was 85.6% (95% CI, 70.7 – 93.3) and 90.4% (95% CI, 96.3 – 76.3), respectively. Of those who failed to achieve a complete response after autologous stem cell transplantation, 4 patients with partial response and 3 patients with very good partial response attained complete response during maintenance treatment. In univariate analysis of EFS, there were no clinical factors that were significantly associated with EFS. However, in univariate analysis for PFS, patients with previous thalidomide exposure benefitted with thalidomide maintenance (Hazard ratio [HR] 0.3295% CI, 0.11 – 0.95p = 0.041). In terms of side effects, 39 patients (90.7%) experienced adverse events of any grade, and 14 patients (32.6%) experienced grade 3 or 4 adverse events. Peripheral neuropathy, which is a well-described side effect of thalidomide, occurred in 20 patients (46.5%) during the total study period. Thalidomide dose was modified in case of peripheral neuropathy, but it was still most common side effect that caused early termination of treatment. To summarize, thalidomide showed comparable efficacy with previously reported Western studies. But a considerable proportion of patients experienced adverse events which caused treatment cessation. In conclusion, if there is a limitation in maintenance with other novel agents, thalidomide can be a reasonable strategy although side effects draw concern.다발골수종의 치료 성적은 유지요법의 발전과 함께 향상되어 왔다. 비록 탈리도마이드는 부작용이 드물지 않으며 전체 생존율에 대한 연구 결과가 일관되지 않다는 제한점이 있기는 하지만 탈리도마이드는 면역조절제 중 가장 먼저 유지요법으로써 연구되었던 약제이며 한국에서 흔하게 사용되어 온 약제이다. 현재는 차세대 면역조절제와 단백체저하제가 새로운 유지요법으로 활발하게 연구되고 있기는 하지만, 실제 진료 현장에서는 비용 및 약제 접근성의 측면에서 이러한 새로운 약제의 사용이 제한적인 경우가 드물지 않으며 이러한 경우 탈리도마이드는 여전히 사용 가능한 선택지이다. 본 연구는 다발골수종으로 처음 진단되어 유도요법과 자가조혈모세포이식을 시행한 한국 환자들에서 탈리도마이드 유지요법의 효용성과 부작용에 대하여 확인하고자 하는 공개, 다기관 전향적 2상 연구이다. 본 연구에 등록된 환자들은 유도요법 및 자가조혈모세포이식 후 총 12주기 동안 탈리도마이드와 덱사메타손을 병합하여 투약 받았다. 각 주기는 28일로 구성되었으며 1주기의 치료 당 탈리도마이드는 100 mg을 28일 동안, 덱사메타손은 40 mg을 4일 동안 투약하였다. 연구의 일차 목적은 시험약 투약 시작 후 1년 시점의 무사건 생존율이었으며, 이는 질병의 재발, 진행, 심각한 독성으로 인한 치료 중단 혹은 원인과 관계없이 사망하는 경우로 정의하였다. 이외에도 무진행 생존율, 전체 생존율 및 안전성에 대하여도 조사하였다. 2013년 7월부터 2015년 11월까지 한국의 7개 의료 기관에서 총 43명의 환자가 등록되었다. 전체 환자의 중앙 추적 관찰 기간은 17.3개월 (범위, 1.1 – 32.2)이었다. 이 중 33명 (76.7%)의 환자만이 계획한 12주기의 유도요법을 모두 완료하였으며, 치료를 도중에 중단한 환자에서 치료 유지 기간의 중앙값은 5.6개월 (사분위범위, 2.9 – 6.9)이었다. 전체 환자에서 1년 무사건 생존율은 65.1% (95% 신뢰구간, 48.9 – 77.3) 이었으며 1년 무진행 생존율은 85.6% (95% 신뢰구간, 70.7 – 93.3), 1년 전체 생존율은 90.4% (95% 신뢰구간, 96.3 – 76.3)이었다. 자가조혈모세포이식 후 완전반응을 얻지 못했던 환자들 중, 4명의 부분반응 환자와 3명의 우수부분반응 환자가 유도요법을 받으면서 완전반응을 획득하였다. 무사건 생존율에 대한 단변량 분석에서는 생존율에 유의하게 영향을 주는 임상적 요소를 확인하지 못하였으나, 무진행 생존율에 대한 단변량 분석에서는 유도요법에서부터 탈리도마이드가 포함된 요법을 투약 받은 환자군이 우월함을 확인하였다 (위험도, 0.3295% 신뢰구간, 0.11 - 0.95p = 0.041). 다만, 전체 환자 중 39명이 (90.7%) 유지요법 중 부작용을 경험하였고, 3단계 이상의 독성을 경험한 환자는 14명 (32.6%)이었다. 탈리도마이드의 가장 흔한 부작용 중의 하나로 알려진 말초신경병증은 20명 (46.5%)의 환자에서 발생하였으며, 말초신경병증이 발생한 경우 탈리도마이드의 용량을 조절하기는 하였으나 여전히 약제 중단을 야기하는 부작용 중 가장 흔한 원인으로 작용하였다. 요약하자면 한국 환자에서 탈리도마이드 유지요법에 대하여 연구한 본 연구에서 탈리도마이드유지요법은 기존의 보고와 비슷한 정도의 효용성을 보였으나, 상당한 수의 환자가 약제 관련 부작용을 경험하였으며 이는 유지요법을 중단하게 하는 주된 요인이 되었다. 결론적으로, 레날리도마이드와 같은 새로운 약제를 사용하기 어려운 상황에서, 탈리도마이드 유지요법은 고려해 볼 수 있는 효과적인 치료 중 하나이지만, 치료 중 말초신경병증과 같은 약제 부작용에 각별히 유의하여야 한다.Ⅰ. Abstract ⅰ Ⅱ. Contents ⅳ Ⅲ. Introduction 1 Ⅳ. Methods 5 Ⅴ. Results 9 Ⅵ. Discussion 23 Ⅶ. Reference 28 Ⅷ. 국문초록 33 Table Table 1. 11 Table 2. 15 Table 3. 18 Table 4. 20 Table 5. 22 Figure Figure 1. 10 Figure 2. 16Maste

소설 「가족시네마」와 영화 <가족시네마>의 비교연구

학위논문(석사)--서울대학교 대학원 :협동과정 비교문학전공,2002.Maste

Association between alcohol consumption and depression level

보건학과/박사[한글] 이 연구의 목적은 알코올섭취와 우울정도의 관련성을 알아보기 위해 수행되었다. 이를 위해 이 연구는 기존 문헌 결과들을 계량적으로 병합하기 위하여 메타분석을 수행한 후, 지역사회 주민자료 및 알코올중독 입원환자에 대한 단면 연구를 수행하였다. 메타분석은 1990년부터 2003년까지 지역사회를 대상으로 한 논문을 대상으로 분석하였다. 알코올중독 입원환자는 우리 나라 각 지역별로 대표적 알코올중독 치료기관 15개 기관에서 DSM-IV 기준 알코올중독환자 515명을 대상으로 하였으며, 지역사회는 확률추출 방법을 통해 선정된 지역을 방문 조사하여 2,565명을 대상으로 하였다. 지역사회 주민들의 알코올 섭취는 AUDIT, 우울정도는 BDI로 측정하였다. 또한 혼란변수로써 건강수준, 연령, 성별, 결혼상태, 학력, 운동여부, 흡연여부를 조사하여 이들 변수들의 영향을 통제하였다. 메타분석결과 우울증과 알코올중독의 비차비는 2.42 (95% 신뢰구간 1.98-2.97)로서 유의한 양의 관련성이 있었다. 지역사회 주민대상 단면연구에서는 AUDIT를 종속변수로 다중회귀분석을 수행한 결과 BDI와 AUDIT는 다른 혼란변수를 통제한 후 유의한 음의 상관관계(p=0.01)를 보였으나 정상음주군과 문제음주군을 층화하여 다중회귀분석을 수행한 결과 정상음주군에서는 유의한 음의 상관관계(p=0.01), 문제음주군에서는 유의한 양의 상관관계(p=0.05)가 있었다. 또한 알코올중독 입원환자에서도 유의한 양의 상관관계(p<.001)이었다. 서양인을 대상으로 알코올섭취와 우울정도의 유의한 양의 상관관계를 보고하였던 기존 연구들과는 달리 우리 나라에서는 정상음주군에서 유의한 음의 상관관계를 보여주었으며, 문제음주군과 알코올중독 입원환자들에서는 유의한 양의 상관관계를 보여 서구의 연구결과와 상이하였다. 따라서 이들 질병들의 보다 효과적인 예방, 치료 및 재활 전략에 이 연구결과와 같은 우리 나라 주민들의 특수성이 반영되어야 할 것이다. [영문]This study was conducted to assess the association between alcohol consumption and depression level. For the quantitative summarizing the results of the previous studies, meta-analysis was performed. The study hypothesis were investigated by cross-sectional study based on community population and the alcoholics inpatients population. The subjects for meta-analysis were the studies published from the year of 1990 to 2003. The alcoholics inpatients analyzed were 515 persons who admitted to 15 institutions of the representative alcoholics hospital in Korea. The subjects of population based analysis were 2,565 persons who lived in Gangneung, Korea. Alcoholism was assessed by AUDIT(Alcohol Use Disorders Identification Test), and depression was assessed by BDI(Beck Depression Inventory). The overall effect size of depression on alcoholics was 2.42(95% C.I. 1.98∼2.97). After controlling the risk facters of alcoholics and depression level, AUDIT was significantly negatively associated with BDI by multiple regression(p=0.01). AUDIT was significantly negatively associated with BDI in the normal drinking group(p=0.01) whose AUDIT score was less then 12, while AUDIT was significantly positively associated in the problem drinking group(p=0.05) whose AUDIT score was above 12 and also in alcoholics inpatients group(p<.001). In conclusion, contrary to the results of western countries, this study showed significant negative association between alcohol consumption and depression level in normal drinking group and significant positive association in problem drinking group and alcoholics. This study suggest that it should be considered Korean situation for developing the strategies for prevention, treatment and rehabilitation of alcoholics and depression.ope

위상최적화를 이용한 굽음보 구조에서의 기계적 파동필터 설계

학위논문 (석사)-- 서울대학교 대학원 : 기계항공공학부(멀티스케일 기계설계전공), 2013. 2. 김윤영.We carried out a design of a mechanical wave filter to reduce wave transmission in a curved beam structure. Filtering phenomenon of the wave transmission in specific frequency range may be seen at infinitely periodic elastic structures composed of different materials. In a curved beam, however, implementation of the periodic structure is very limited. The dimension of the curved region which connects two waveguides is generally not long enough to cover broad target frequency. The periodic structure repeated only in a few times cannot guarantee the performance of wave filtering in the curved beam. To overcome the difficulty, we formulated the design problem of the curved beam as a topology optimization problem. A curved region between two straight waveguides was considered as a design domain to minimize the power transmission of waves at target frequencies. Compared to a periodic curved structure, the designed ones by topology optimization show the improvement of the performance in reducing the wave transmission at the target frequencies.Abstract i Contents ２ List of Figures ４ Chapter1 Introductions １ Chapter2 Dispersion curve of curved beam structures ４ Chapter3 Dispersion curve of periodic structures ９ 3.1 Bragg Condition ９ 3.2 Matrix Representation of Wave Motion １１ 3.3 Transfer Matrix of Periodic Structure １３ 3.4 Dispersion Curve of Periodic Structure １６ Chapter4 Finite element analysis of curved beam structures ２１ 4.1 Calculation of Power Coefficient ２１ 4.2 PML ２３ Chapter5 Topology Optimization Formulation ２７ 5.1 Problem Definition ２７ 5.2 Optimization Formulation ２８ Chapter6 Numerical Example ３１ 6.1 Optimization for curved beam structure ３１ 6.2 Result for different target frequency ３１ 6.3 Comparison between periodic and optimized curved beam ３２ Conclusion ３７ Acknowledgement ３８ References ３９ 초록 ４２Maste

The Relationship Gap between Expectations of College Life and the Satisfaction with College Life and Psychological Well-being : the Mediating Effect of the Characteristics

본 연구에서는 대학생 297명을 대상으로 대학생활 기대-만족 차이와 심리적 안녕감 간의 관계에서 성격적 특성(낙관성, 외향성, 신경증)이 대학생들이 지각하는 심리적 안녕감에 어떠한 영향을 주는지 알아보았다. 중다 회귀 방법을 이용하여 분석한 결과, 대학생활 기대-만족차이와 심리적 안녕감 간의 관계에 있어서 모든 성격적 특성이 부분매개 하는 것으로 나타났다. 본 연구 결과를 통해 대학생활에 대한 입학 전의 기대감과 입학 후에 지각하는 만족감의 차이가 대학생들의 심리적 안녕감에 어떠한 영향을 미치는지에 대한 이해를 높일 수 있을 것이다. This study gathered research from 297 college students on how their expectations of college life compared to their satisfaction with college life. It studied how this related to personality traits and psychological well-being. This study considers the gap between college life expectations and satisfaction with college life as variables for predicting the effect on the psychological well-being of students. The multiple regression analysis results found that individual personality traits mediated the relationship between the difference between college life expectations and satisfaction with college life and psychological well-being. The results provide an understanding of how psychological well-being is influenced by the gap between expectations of college life and satisfaction with college life and personality traits

Lattice corneal dystrophy type IIIA with hyaline component from a novel A620P mutation and distinct surgical treatments.

PURPOSE: The aim of this study was to report a lattice corneal dystrophy (LCD) family with a novel mutation of A620P in the TGFBI gene, its long-term treatment, follow-up data, and related pathologic findings. METHODS: A total of 28 family members were clinically examined, and blood samples or buccal epithelial cells were taken for DNA analysis. All exons from the entire TGFBI gene coding region were analyzed for mutations in 3 affected members. Exon 14 was amplified in other family members and in 100 normal Korean persons as control. Corneal tissues from 1 affected family member were examined using light and electron microscopy. RESULTS: Clinical examination revealed relatively late-onset LCD with asymmetric progression and recurrent corneal erosion. The affected family members have been treated with penetrating keratoplasty, deep lamellar keratoplasty, and phototherapeutic keratectomy for up to 19 years. Screening of the TGFBI gene revealed a novel A620P mutation, which was found in all affected members. The amyloid origin of deposits was confirmed by Congo red and was also partially stained with Masson trichrome. Although there were no electron-dense bodies as in granular dystrophy, transmission electron microscopy demonstrated that the stromal deposits were not homogenous and contained a variety of constituents with different electron densities. CONCLUSIONS: We present the characteristics and surgical treatment of corneas with a novel A620P mutation in TGFBI showing LCD type IIIA with hyaline component.ope