Efficacy and Safety of a Dexamethasone Implant in Patients with Diabetic Macular Edema at Tertiary Centers in Korea

Purpose. To evaluate the real-world efficacy and safety of the dexamethasone implant (DEX implant) in patients with diabetic macular edema (DME). Methods. Retrospective, multicenter, and noncomparative study of DME patients who were treated with at least one DEX implant. A total of 186 eyes from 165 patients were included. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), complications, and number of retreatments were collected. Data at baseline and monthly for 6 months were analyzed. Results. The average baseline BCVA and CRT were 0.60 LogMAR and 491.6 μm, respectively. The mean BCVA improved until 3 months and then decreased up to 6 months of follow-up (0.53, 0.49, and 0.55 LogMAR at 1, 3, and 6 months; p=0.001, <0.001, and 0.044, resp.). The change of mean CRT was similar to BCVA (345.0, 357.7, and 412.5 μm at 1, 3, and 6 months, p<0.001, <0.001, and <0.001, resp.). 91 eyes (48.9%) received additional treatment with anti-VEGF or DEX implant. The average treatment-free interval was 4.4 months. In group analyses, the DEX implant was more effective in pseudophakic eyes, DME with subretinal fluid (SRF), or diffuse type. Conclusions. Intravitreal dexamethasone implants are an effective treatment for patients with DME, most notably in pseudophakic eyes, DME with SRF, or diffuse type. A half of these patients require additional treatment within 6 months

Comparison of Monthly Ibandronate Versus Weekly Risedronate in Preference, Convenience, and Bone Turnover Markers in Korean Postmenopausal Osteoporotic Women

Patient preferences, convenience, and bone turnover markers were evaluated for the monthly ibandronate over the weekly risedronate regimen in Korean postmenopausal osteoporotic women. This was a 6-month, prospective, randomized, open-label, multicenter study with a two-period and two-sequence crossover treatment design. After a 30-day screening period, eligible participants with postmenopausal osteoporosis were randomized to receive either monthly oral ibandronate 150 mg for 3 months followed by weekly oral risedronate 35 mg for 12 weeks (sequence A) or the same regimen in reverse order (sequence B). Patient preference and convenience were evaluated by questionnaire. The changes in serum C-telopeptide after 3 months of treatment were analyzed. A total of 365 patients were enrolled in this study (sequence A 182, sequence B 183). Of patients expressing a preference (83.4%), 74.8% preferred the monthly ibandronate regimen over the weekly regimen (25.2%). More women stated that the monthly ibandronate regimen was more convenient (84.2%) than the weekly regimen (15.8%). There was no significant difference in the change in bone turnover marker between the two treatments. The two regimens were similarly tolerable. There were fewer adverse events in the monthly ibandronate group compared to the weekly risedronate group in terms of gastrointestinal side effects (nausea and abdominal distension). This study revealed a strong preference and convenience for monthly ibandronate over weekly risedronate in Korean postmenopausal osteoporotic women. There was no significant difference in change of bone turnover marker and safety profile between the two regimens

Oxidative stress markers in tears of patients with Graves’ orbitopathy and their correlation with clinical activity score

Abstract Background To investigate the concentrations of oxidative stress markers, 8-hydroxy-2′-deoxyquanosine (8-OHdG) and malondialdehyde (MDA), in tears and their correlation with the clinical activity score (CAS) in patients with Graves’ orbitopathy (GO) according to disease activity. Methods We recruited 27 participants with inactive stage GO, 35 participants with active stage GO, and 25 healthy controls without GO. The tear concentrations of 8-OHdG and MDA were determined by enzyme-linked immunosorbent assay. The correlation between CAS and the concentrations of tear 8-OHdG and MDA were analyzed according to the disease activity in the GO patients. Results The levels of 8-OHdG and MDA were 56.30 ± 16.81 ng/mL and 5.39 ± 1.31 pmol/mg, respectively, in the control subjects, and 123.46 ± 22.67 ng/mL and 13.59 ± 3.93 pmol/mg, respectively, in patients with inactive stage GO, and 215.14 ± 35.61 ng/mL and 22.52 ± 4.63 pmol/mg, in patients with active stage GO. The mean concentrations of 8-OHdG and MDA were higher in patients with inactive and active stage GO compared with the control group (all P < 0.001). Furthermore, in the active stage group, tear concentrations of 8-OHdG and MDA were higher than those in the inactive stage group (all P < 0.001). The level of 8-OHdG (r = 0.676, P < 0.001) and MDA (r = 0.506, P = 0.002) correlated with CAS in the active stage GO group. Conclusions The concentrations of 8-OHdG and MDA in tears increased in patients with GO, especially in those in the active stage. In patients with active stage GO, CAS correlated significantly with the tear 8-OHdG and MDA levels

Postural effects on intraocular pressure and ocular perfusion pressure in patients with non-arteritic anterior ischemic optic neuropathy

Abstract Background To investigate postural effects on intraocular pressure (IOP) and ocular perfusion pressure (OPP) in patients with non-arteritic ischemic optic neuropathy (NAION). Methods IOP and blood pressure (BP) were measured in 20 patients with unilateral NAION 10 min after changing to each of the following positions sequentially: sitting, supine, right lateral decubitus position (LDP), supine, left LDP, and supine. IOP was measured using a rebound tonometer and OPP was calculated using formulas based on mean BP. The dependent LDP (DLDP) was defined as the position when the eye of interest (affected or unaffected eye) was placed on the dependent side in the LDP. Results IOPs were significantly higher (P = 0.020) and OPPs were significantly lower (P = 0.041) in the affected eye compare with the unaffected eye, with the affected eye in DLDP. Compared with the mean IOP of the unaffected eyes, the mean IOP of the affected eyes increased significantly (+2.9 ± 4.4 versus +0.7 ± 3.1 mmHg, respectively; P = 0.003) and the mean OPP decreased significantly (−6.7 ± 9.4 versus −4.9 ± 8.0 mmHg, respectively; P = 0.022) after changing positions from supine to DLDP. In addition, changing position from supine to DLDP showed significantly larger absolute changes in IOP (4.13 ± 3.19 mmHg versus 2.51 ± 1.92 mmHg, respectively; P = 0.004) and OPP (9.86 ± 5.69 mmHg versus 7.50 ± 5.49 mmHg, respectively; P = 0.009) in the affected eye compared with the unaffected eye. In the affected eye, there was a significant positive correlation between absolute change in IOP and OPP when changing position from supine to DLDP (Rho = 0.512, P = 0.021). Conclusions A postural change from supine to DLDP caused significant fluctuations in IOP and OPP of the affected eye, and may significantly increase IOP and decrease OPP. Posture-induced IOP changes may be a predisposing factor for NAION development

Analysis of Clinical Factors Associated with Retinal Morphological Changes in Patients with Primary Sjögren's Syndrome

<div><p>Purpose</p><p>To investigate clinical factors associated with abnormal retinal morphologies in patients with primary Sjögren's syndrome (pSS).</p><p>Methods</p><p>One-hundred-thirty patients with pSS who underwent immunoserological tests, minor salivary gland biopsies, and optical coherence tomography examinations were retrospectively analyzed. Risk factors for abnormally reduced peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell–inner plexiform layer (mGCIPL) thicknesses were evaluated, as well as the correlation between clinical factors and pRNFL and mGCIPL thicknesses.</p><p>Results</p><p>Anti-Sjögren's syndrome type B (SSB) antibody positivity (<i>P</i> = 0.048) was identified as a risk factor associated with abnormally reduced pRNFL thickness, and anti-SSB positivity (<i>P</i> = 0.005) and erythrocyte sedimentation rate (ESR) level (<i>P</i> = 0.031) were identified as risk factors associated with an abnormally reduced mGCIPL thickness as revealed by multivariate logistic regression analysis. There was a significant negative correlation between anti-SSB antibody levels and the thickness of pRNFL and mGCIPL. The thicknesses of pRNFL and mGCIPL were significantly reduced in anti-SSB–positive eyes when compared to anti-SSB–negative eyes (<i>P</i> < 0.05). However, histopathologic grading was not associated with the pRNFL and mGCIPL thicknesses.</p><p>Conclusion</p><p>Anti-SSB antibody positivity and ESR levels may be useful for predicting an abnormally reduced pRNFL or mGCIPL thickness in patients with pSS. Our results may provide clinical evidence to substantiate the association between aberrant autoimmunity and inner retinal changes in patients with pSS.</p></div

Comparison of serologic and histopathologic values between pSS patients with normal and abnormal pRNFL or mGCIPL thicknesses.

<p>Comparison of serologic and histopathologic values between pSS patients with normal and abnormal pRNFL or mGCIPL thicknesses.</p

Representative case of anti-SSB positive patient (right eye of 51 year-old female) who showed abnormally reduced thickness of the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell–inner plexiform layer (mGCIPL).

<p>Color coding is as follows: green = normal range, yellow = below the 5th percentile of normal distribution and red = below the 1st percentile of normal distribution. (A) pRNFL thickness below the 5th percentile in average thickness and in at least one segment of the quadrant was considered as an indicator of abnormally reduced pRNFL thickness. (B) mGCIPL thickness below the 5th percentile in average and minimum thickness and in at least one of six sectors was considered as an indicator of abnormally reduced mGCIPL thickness. The patient showed nonspecific findings in RNFL photo (C) and visual field exam (D).</p

Scatterplot and linear regression line showing the relationship between OCT measurements and anti-SSB antibodies in patients with primary Sjögren's syndrome.

<p>(A) Average, inferior, and temporal pRNFL thicknesses were significantly correlated with the levels of anti-SSB (<i>P</i> < 0.05). (B) All the parameters of mGCIPL thicknesses were significantly correlated with the anti-SSB levels (<i>P</i> < 0.01).</p

Mikroişlenmiş basınç sensörü

Cataloged from PDF version of article.Thesis (M.S.): Bilkent University, Department of Electrical and Electronics Engineering, İhsan Doğramacı Bilkent University, 2017.Includes bibliographical references (leaves 48-52).Capacitive Micromachined Ultrasonic Transducer (CMUT) is a microelectromechanical device that is basically formed by a moving top electrode, a stable bottom electrode and a gap in between. In spite of its this simple mass-spring construction, CMUT is a nonlinear device and its working principles have been formulated. According to these studies, the top electrode can be set in motion by the applied pressure on it and by depending on the amount of that pressure, the resonant frequency of the CMUT can be altered. Therefore, it is possible to use CMUT to obtain a pressure sensor. In this respect, what we have to do is keep tracking of its resonant frequency to deduce the pressure. The most e ective way of doing it, on the other hand, is using an oscillator circuit which also provides us the capability of tracking the resonant frequency in real time. Also, to design an integrated circuit that works with the CMUT, the best way is utilizing a Colpitts oscillator. In this thesis, we design a pressure sensor with CMUT based Colpitts oscillator. In order to achieve our design, rst of all, we examine the small signal equivalent circuit model of an uncollapsed mode CMUT and investigate the related analytical equations that models the behavior of it. To simplify the equations, we liken the small signal equivalent circuit model to a crystal oscillator by making necessary transformations. After that, we investigate the \feedback system approach" and \negative resistance concept" methods that help us to analyze the oscillator circuits; and we determine the Colpitts oscillator circuit as the oscillator circuit part of our device. We evaluate the CMUT based Colpitts oscillator circuit and derive the limitations on the circuit parameters for achieving a power e cient device. In addition to that, we discuss the dc biasing of the oscillator circuit that does not cause any loading e ect on the oscillator circuit and design a ring oscillator and a charge pump circuit which help us to obtain bias voltage on the CMUT. Finally, we calculate the sensitivity (in Hz/Pa) and the temperature sensitivity of a CMUT in addition to the Quality factor of our circuit; and by being based on these calculations, we obtain the optimum CMUT parameters for the best available sensitivity and conclude the design. At the end, we design a CMUT based Colpitts oscillator that works as a pressure sensor which measures pressure between zero atm and one atm with sensitivity of 14.6 Hz/Pa at 1 atm. The selected CMUT parameters, on the other hand, for the radius of the CMUT cell, the gap height of the CMUT cell, the thickness of the insulator layer and the thickness of the top plate are 44 m, 100 nm, 100 nm and 3 m respectively. The Quality factor of the circuit is 5 and the inherent Quality factor of the CMUT is 432.by Hasan Karaca.M.S