• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.76-82
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• 2006

Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.195-201
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• 2011

Background: Osteopontin (Opn) is recognized as an important adhesive bone matrix protein and a key cytokine involved in immune cell recruitment and tissue repair and remolding. However, serum levels of osteopontin have not been evaluated in patients with chronic obstructive pulmonary disease (COPD). Thus, the aim of this study was to evaluate and compare the serum levels of osteopontin in patients experiencing COPD exacerbations and in patients with stable COPD. Methods: Serum samples were obtained from 22 healthy control subjects, 18 stable COPD patients, and 15 COPD with exacerbation patients. Serum concentrations of osteopontin were measured by the ELISA method. Results: Serum levels of osteopontin were higher in patients with acute exacerbation than with stable COPD and in healthy control subjects ($62.4{\pm}51.9ng/mL$, $36.9{\pm}11.1ng/mL$, $30{\pm}11ng/mL$, test for trend p=0.003). In the patients with COPD exacerbation, the osteopontin levels when the patient was discharged from the hospital tended to decrease compared to those at admission ($45{\pm}52.1ng/mL$, $62.4{\pm}51.9ng/mL$, p=0.160). Osteopontin levels significantly increased according to patient factors, including never-smoker, ex-smoker and current smoker ($23{\pm}5.7ng/mL$, $35.5{\pm}17.6ng/mL$, $58.6{\pm}47.8ng/mL$, test for trend p=0.006). Also, osteopontin levels showed a significantly negative correlation with forced expiratory volume in one second ($FEV_1$%) predicted in healthy controls and stable COPD patients (r=-0.389; p=0.013). C-reactive protein (CRP) was positively correlated with osteopontin levels in patients with COPD exacerbation (r=0.775; p=0.002). Conclusion: The serum levels of osteopontin increased in patients with COPD exacerbation and tended to decrease after clinical improvement. These results suggest the possible role of osteopontin as a biomarker of acute exacerbation of COPD.

• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.11-18
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• 2007

Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

• Radiation Oncology Journal
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• v.25 no.3
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• pp.145-150
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• 2007

Purpose: To investigate the degree and effect of cyclooxygenase (COX)-2 expression on the survival of patients with glioblastoma multiforme (GM). Materials and Methods: Between 1997 and 2006, thirty consecutive GM patients treated with surgery and postoperative radiotherapy (dose range: $44{\sim}65.1$ Gy, median dose: 61.2 Gy) were included in the study. Three patients were excluded that discontinued radiotherapy before receiving a dose of 40 Gy due to mental deterioration. The expression of the COX-2 protein in surgical specimens was examined by immunohistochemical analysis. Survival analysis and verification were performed with respect to sex, age, performance status, resection extent, radiotherapy dose, and degree of COX-2 expression using the Kaplan-Meier method and the log rank test. Results: The median length of follow-up was 13.3 months (range:$6{\sim}83$ months). Staining for COX-2 was positive in all patient samples. Staining for COX-2 that was positive for over 75% of the tumor cells was found in 24 patients. Staining for COX-2 that was positive in less than 25% of tumor cells was found in 3 patients (10.0%), staining for COX-2 that was positive in 25 to 50% of tumor cells was found in 1 patient (3.3%), staining for COX-2 that was positive in 50 to 75% of tumor cells was found in 2 patients (6.7%) and staining for COX-2 that was positive in 75 to 100% of tumor cells was found in 24 patients (80.0%). The median survival and two-year survival rate were 13.5 months and 17.5%, respectively. The survival rate was influenced significantly by the degree of resection (tumor removal by 50% or more) and radiotherapy dose (59 Gy or greater) (p<0.05). The median survival of patients with staining for COX-2 that was positive in less than 75% of tumor cells and in at least 75% of tumor cells was 15.5 and 13.0 months, respectively (p>0.05), and the two-year survival for these groups was 33.3 and 13.3%, respectively (p>0.05). Conclusion: The absence of a statistical correlation between the degree of COX-2 expression and survival in GM patients, despite the high rate of COX-2 positive tumor cells in the GM patient samples, requires further studies with a larger series to ascertain the prognostic value of the degree of COX-2 expression in GM patients.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.314-320
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• 2000

Purpose :To investigate whether changes in plasma concentrations of transforming growth factor-$\beta$1(TGF-$\beta$1), tumor necrosis factor-alpha (TNF-$\alpha$) and interleukin-6 (IL-6) could be used to identify the development of radiation-induced pneumonitis in the lung cancer patients. Methods and Materials :Seventeen patients with lung cancer (11 NSCLC, 6 SCLC) were enrolled in a prospective study designed to evaluate clinical and molecular biologic correlation of radiation-induced pneumonitis. The study began in May 1998 and completed in July 1999. All patients were treated with radiotherapy with curative intent : 1.8 Gy per day, 5 fractions per week. Serial measurements of plasma TGF-$\beta$1, TNF-$\alpha$ and IL-6 were obtained in all patients before, weekly during radiotherapy and at each follow-up visits after completion of treatment. These measurements were quantified using enzyme linked immunosorbent assay (ELISA). All patients were evaluated for signs and symptoms of pneumonitis at each follow-up visit after completion of radiotherapy. High resolution CT (HRCT) scans were obtained when signs and symptoms of pneumonitis were developed after completion of radiotherapy. Results : Thirteen patients eventually developed signs and symptoms of clinical pneumonitis 씬file four patients did not. TGF-$\beta$ 1 levels were elevated in all 13 patients with pneumonitis, which showed characteristic pattern of elevation (38.45 ng/ml at pretreatment, 13.66 ng/ml during radiotherapy, then 60.63 ng/ml at 2-4 weeks after completion of radiotherapy). The levels of TNF- $\alpha$ and IL-6 were also elevated In the group of patients who developed pneumonitis but the pattern was not characteristic. Conclusions : Changes in plasma TGF$\beta$-1 levels before, during and after radiotherapy appears to be a useful means by which to identify patients at risk for the development of symptomatic pneumonitis. Other cytokines like TNF- $\alpha$ and IL-6 shows no meaningful changes in association with radiation pneumonitis.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.2
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• pp.237-246
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• 2015

Purpose: The present study was conducted to reveal the correlation of structural denaturation and decrease of enzyme activity when the antioxidative enzymes, superoxide dismutase (SOD) and catalase (CAT) were repeatedly exposed to UV-B, and further investigate whether the denaturation and inactivation of those enzymes can be effectively blocked by using UV-inhibitory RGP lens. Methods: Each enzyme solution was prepared from the standardized SOD and CAT, and repeatedly exposed to UV-B of 312 nm for 30 minutes, 1 hour and 2 hours a day over 1, 2, 3, 4 and 5 days. Structural denaturation of SOD and CAT induced by repeat UV-B irradiation was confirmed by the electrophoretic analysis, and their enzyme activity was determined by the colorimetric assay using the proper assay kit. At that time, the change in structure and activity of the antioxidant enzymes directly exposed to UV-B was compared to the case that UV-B was blocked by UV-inhibitory RGP lens. Results: SOD exposed repeatedly to UV-B showed the polymerization pattern in the electrophoretic analysis when it repeatedly exposed for 30 min a day, however, the change of its activity was less than 10%. On the other hand, CAT repeatedly exposed to UV-B reduced size and density of the electrophoretic band which indicated a structure denaturation, and its activity was significantly decreased. In the case that the repeat exposure time was longer, CAT activity was completely lost even though some enzyme band occurred in the electrphoretic analysis. In addition, the degeneration of CAT due to UV-B irradiation was inhibited to some extent by using RGP lens with a UV-B blocking of 63.7%, however, it was not completely inhibited. Conclusions: From these results, it was revealed that the structural denaturation of antioxidative enzymes was not perfectly correlated with the reduction in enzyme activity according to the type of enzyme. It is recommended to minimize the exposure time to UV when wearing contact lens, or wear the contact lenses having UV blocking rate of the FDA Class I blocker or the sunglasses having equivalent UV-blocking rate for reducing the damage of antioxidative enzymes induced by UV.

• Journal of Korean Ophthalmic Optics Society
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• v.17 no.4
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• pp.365-372
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• 2012

Purpose: To investigate ocular higher order aberrations (HOA) and spherical aberration changes caused by an aspheric soft contact lens designed to reduce spherical aberration (SA) of the eye. Methods: Fifty subjects who have successfully experienced soft contact lenses were refitted with aspheric design (Soflens Daily Disposable: SDD, Bausch+Lomb) soft contact lens. Ocular higher order aberrations (HOA) and stand alone SA were measured and analyzed for a 4-mm pupil size using Wave-Scan Wavefront$^{TM}$ aberrometer (VISX, Santa Clara, CA, USA). High and low contrast log MAR visual acuity and contrast sensitivity function (CSF) were also measured under photopic and mesopic conditions (OPTEC 6500 Vision Tester$^{(R)}$). All measurements were conducted monocularly with an undilated pupil. Results: The RMS mean values for total HOA with SDD contact lenses were significantly lower than those at with unaided eyes (p<0.001) and a reduction for SA in the SDD was close to the baseline SA (zero ${\mu}m$) (p<0.001). For the SDD lens, there was a statistically significant correlation between the changes in the total HOA and the contact lens power (r=0.237, p=0.018) as well as between the changes in SA and the lens power (r=0.324, p=0.001). High contrast visual acuity (HCVA) and low contrast visual acuity (LCVA) with SDD lenses were $-0.063{\pm}0.062$ and $0.119{\pm}0.060$, respectively under photopic and $-0.003{\pm}0.063$ and $0.198{\pm}0.067$, respectively under mesopic condition. Contrast Sensitivity Function (CSF) with SDD lenses under both photopic and mesopic conditions was $3.095{\pm}0.068$ and $3.087{\pm}0.074$, respectively. Conclusions: The SDD contact lens designed to control SA reduced the total ocular HOA and SA of the eye, resulting in compensating for positive SA of the eyes. Thus, the optical benefits of the lens with SA control would be adopted for improving the quality of vision.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.4
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• pp.551-555
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• 2014

Purpose: This study is to investigate if the improvement of visual sensory (VS) by amblyopia treatment affects the ocular functions in refractive errors, accommodative errors and phoria at distance and near. Methods: 10 subjects (17 eyes, mean age of $10.7{\pm}2.9$ years) who treated amblyopia completely, were participated for this study. Refractive errors, accommodative errors, and distance and near phoria were compared between before and after treatments of amblyopia. Refractive errors and accommodative errors at 40 cm were measured using openfield auto-refractor (NVision-5001, Shin Nippon, Japan) and using monocular estimated method (MEM) respectively. Phoria was determined at 3 m for distance and at 40 cm for near using Howell phoria card, cover test or Maddox rod. Results: Mean corrected visual acuity (CVA) significantly increased from $0.46{\pm}0.11$ (decimal notation) for before amblyopia treatment to a level of $1.03{\pm}0.13$ for after amblyopia treatment (p < 0.001). For spherical refractive error, hyperopia significantly decreased from $+2.29{\pm}0.86D$ to a level of $+1.1{\pm}2.38D$ (p < 0.05) but astigmatism did not significantly change; $-1.80{\pm}1.41D$ for before treatment and $-1.65{\pm}1.30D$D for after treatment (p > 0.05). Accommodative error significantly decreased from accommodative lag of $+1.1{\pm}0.75D$ to a level of $+0.5{\pm}0.59D$ (accommodative lag) (p < 0.05). Distance phoria significantly changed from eso $2.9{\pm}6.17PD$ (prism diopters) to a level of eso $0.2{\pm}3.49PD$ (p < 0.05), and near phoria also significantly changed from eso $0.4{\pm}2.32PD$ to level of exo $2{\pm}4.9PD$ (p < 0.05). There was a high correlation (r = 0.88, p < 0.001) between improvement of visual acuity and decrease of accommodative lag. Conclusions: Hyperopic refractive error decreased with improvement of CVA or VS by amblyopia treatment. And the improvement of VS by amblyopia treatment also improved accommodative error, and changed phoria coupled with accommodation.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.4
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• pp.533-538
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• 2014

Purpose: This study is to investigate correlation between eye fatigue and letter contrast according to letter contrast changes on monitor display. Methods: Reading speed test were carried out for 53 subjects (mean age: $22.68{\pm}1.85$ years) who have over Best-corrected visual acuity (BCVA) 1.0, and 45 subjects, who could read over 123 out of 163 letters among 53 subjects were selected. They were asked to read the letters which were composed of Black (contrast 100%), Dark gray (contrast 80%), Gray (contrast 80%), Light gray (contrast 30%) randomly. The change of their eye fatigue by letter contrast on monitor display was measured by monitoring their eyes with an eye-tracker while they were reading letters. Results: Event Duration (sec) was 33.635 for Black, 32.266 Dark gray, 33.936 for Gray, and 34.848 for Light gray. Average of Fixation Duration (sec) was 0.224 for Black, 0.218 for Dark gray, 0.239 for Gray and 0.243 for Light gray. Average of Pupil diameter (mm) was 41.133 mm for Black, 41.160 mm for Dark gray, 40.880 mm for Gray and 40.459 mm for Light gray. Frequency (blinks/sec) was 0.211 for Black, 0.206 for Dark gray, 0.221 for Gray, and 0.238 for Light gray. Conclusions: Event Duration and average of Fixation Duration were the shortest for Dark gray and the longest for Light gray. In average Pupil diameter was the biggest Dark gray and the smallest for Light gray. Blink Frequency (blinks/sec) was the lowest for Dark gray and the highest for Light gray. Visual fatigue by brightness of letters on monitor display was the least for Dark gray followed by Black, Gray and Light gray.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.2
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• pp.51-57
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• 2008

Purpose: This study has been conducted to know how the size and position of the circle of least confusion has an influence on the vision for minimization of asthenopia when astigmatism is corrected and appropriated prescription to provided clear vision life. Methods: The method of the study has been worked on 68 students (136 eyes) of man and woman enrolled in university of Gyeong-gi-do aged 20 to 40, who have myopic astigmatism in order to know how the corrected vision changes according to the size and position of the circle of least confusion of astigmatism, the vision has been tested by giving the vision whose astigmatic power of 0.25D and 0.50D was just reduced, low correcting the astigmatic power into 0.50D, and at the same time inserting additionally spherical power -0.25D, all under a condition that the corrected vision after completely corrected astigmatism, and the axis of astigmatism was not changed. Results: The average vision was 1.047 when the astigmatic power was fully corrected, and in low correction of 0.25D, it was 0.914, and in low correction of 0.50, it was 0.772. It has been learned that the bigger the circle of least confusion was the bigger the range of vision reduction and the corrected vision in astigmatism has correlation with the size of the circle of least confusion. It has been examined that the average vision according to position of the circle of least confusion in astigmatism was 1.047 when the astigmatic power was completely corrected and focused on the retina with state of point, and in case that the astigmatic power was 0.50D of state of low correction, that is, the circle of least confusion was focused before retina, it was 0.828, and it was also 0.826 when the astigmatic power is low corrected with 0.50D and the circle of least confusion was focused on the retina. Explained briefly, It has been examined that in case that the state of low correction of the astigmatic power was same, the vision reduction was less in the image of the circle of least confusion focused upon the retina than in the image of its being focused before the retina. Conclusions: In case that the refractive power of cylindrical lens is reduced in test of wearability in astigmatism, there needs surely an adjustment of spherical lens that can place the circle of least confusion on the retina.