• Title/Summary/Keyword: retinal

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The Usefulness of F-18-FDG PET and The Effect of Scan Protocol in Diagnosis of Intraocular Tumors (안구 내 종양의 진단에 있어서 F-18-FDG PET의 유용성과 검사 방법의 영향)

  • Lee, Jae-Soung;Yang, Won-Il;Kim, Byoung-Il;Choi, Chang-Woon;Lim, Sang-Moo;Lee, Tae-Won;Sin, Min-Kyeung;Hong, Soung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.5
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    • pp.439-451
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    • 1999
  • Purpose : It is important to differentiate malignant from benign lesions of intraocular masses in choosing therapeutic plan. Biopsy of intraocular tumor is not recommended due to the risk of visual damage. We evaluated the usefulness of F-18-FDG PET imaging in diagnosing intraocular neoplasms. Materials and Methods: F-18-FDG PET scan was performed in 13 patients (15 lesions) suspected to have malignant intraocular tumors. There were 3 benign lesions (retinal detachment, choroidal effusion and hemorrhage) and 10 patients with 12 malignant lesions (3 melanomas, 7 retinoblastomas and 2 metastatic cancers). Regional eye images ($256{\times}256$ and $128{\times}128$ matrices) were obtained with or without attenuation correction. Whole body scan was also performed in eight patients (3 benign and 6 malignant lesions). Results: All malignant lesions were visualized while all benign lesions were not visualized. The mean peak standardized uptake value (SUV) of malignant lesions was $2.64{\pm}0.57g/ml$. There was no correlations between peak SUV and tumor volume. Two large malignant lesions ($> 1000 mm^3$) showed hot uptake on whole body scan. But two medium-sized lesions ($100-1000mm^3$) looked faint and two small ($<100mm^3$) lesions were not visualized. The images reconstructed with $256{\times}256$ matrix showed lesions more clearly than those with $128{\times}128$ matrix Conclusion: F-18-FDG PET scan is highly sensitivity in detecting malignant intraocular tumor For the evaluation of small-sized intraocular lesions, whole body scan is not appropriate because of low sensitivity. A regional scan with sufficient acquisition time is recommended for that purpose. Image reconstruction in matrix size of $256{\times}256$ produced clearer images than the ones in $128{\times}128$, but it does not affect the diagnostic sensitivity.

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Bilateral retinoblastoma: Long-term follow-up results from a single institution (단일기관의 장기추적 결과)

  • Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.674-679
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    • 2009
  • Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.

A Clinical Study of Child Abuse (아동학대로 진단된 환아의 임상적 고찰)

  • Choi, Yoon Jin;Kim, Shin Mi;Sim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.436-442
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    • 2007
  • Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

Effect of n-3 Fatty Acid Deficiency on Fatty Acid Composition in Brain, Retina and Liver Using a Novel Artificial Rearing System (인공 사육 동물 모델 시스템을 이용한 n-3 지방산 결핍이 쥐의 뇌, 망막, 간의 지방산 조성에 미치는 영향)

  • Lim, Sun-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.4
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    • pp.466-475
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    • 2005
  • Docosahexaenoic acid (22:6n-3, DHA) is highly enriched in membrane of brain and retina, and plays an important role in maintaining an optimal function of the central nervous system. We investigated the effect of n-3 fatty acid deficiency on rat brain, retina and liver fatty acyl composition at two different ages (3 wks and 15 wks) under DHA deficient condition. Rat pups born to dams fed a diet with $3.1\%$ of total fatty acids as $\alpha-linolenic$ acid (LNA) were fed using an artificial rearing system either an n-3 deficient (n-3 Def) or n-3 adequate (n-3 Adq) diet. Both diets contained $17.1\%$ linoleic acid (LA) but the n-3 Adq diet also contained $3.1\%$ LNA. Rats consuming the n-3 Def diet showed a lower brain $(50\%\;in\;13\;wks\;and\;70\%\;in\;15\;wks,\;p<0.05)$ and retinal $(50\%\;in\;13\;wks\;and\;63\%\;in\;15\;wks,\;p<0.05)$ DHA than those on the n-3 Adq diet, which was largely compensated for by an increase in docosapentaenoic acid (22:5n-6, DPAn-6). In the liver of the n-3 Def group, the percentage of DHA decreased by $97\%$ at 3 wks of age with an apparent increase in DPAn-6 relative to the n-3 Adq group (p<0.05), while there was a $65\%$ lower liver DHA in n-3 Def group at 15 wks of age than the n-3 Adq group (p<0.05). Liver arachidonic acid (20:4n-6, AA) was increased at 3 wks of age but decreased at 15 wks of age in the n-3 Def group compared with n-3 Adq group (p<0.05). In conclusion, the replacement of DHA by DPAn-6 in brain and retina fatty acid composition may be related to the suboptimal function in spatial learning, memory and visual acuity. This artificial rearing method presents a first generation model for n-3 deficiency that is similar to the case of human nutrition that commonly employed two generation model.

Modulation of Immune Parameters by Aging Process (노화에 따른 면역지표의 변화에 관한 연구)

  • Lee, Ji-Hye;Jung, Ji-Hye;Kim, Hyun-Sook
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.152-160
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    • 2010
  • The purpose of this study was to investigate the effects of aging process on the immunity in human subjects. In this investigation, nineteen families of three generations (daughters on college age, their mothers, and grandmothers) participated to avoid genetic variation among individuals. Dietary food records, anthropometric measurements and biochemical assessments of serum nutrients were used to evaluate the nutritional status of subjects. The immune parameters of subjects were assessed by the total and differential WBC count. Total B and T lymphocytes, and T cell subsets were quantified by flowcytometer. Serum immunoglobulin G, A, M concentrations were also measured as an index of humoral immunity. The result of this study can be summarized as follows: 1. Along with the aging process, body fat was found to be increased whereas lean body mass and total body water were diminished. Since there were no significant difference in serum vitamin E levels in all age groups, serum retinal concentrations tended to decrease as one gets old. 2. Although total number of T lymphocytes seemed to be unchanged, B lymphocytes and NK cell numbers were increased by aging. The Percentage of CD8 + lymphocytes was lower in the elderly subjects compared with the younger, resulting in higher ratio of CD4 +/CD8 + lymphocytes in the elderly. Serum Ig G and Ig A levels remained unchanged, but IgM levels were significantly decreased as the age processes continue. Taking all together, it could be suggested that the alteration of immune cell population by aging is selective and possibly nonage factors such as nutrition may be attributable to the change of immunity in the elderly. The nutritional status and aging process may selectively affect both the cell-mediated (CD8 +, CD4 + CD8 + ratio, NK cell) and humoral (B lymphocyte, Immunoglobulin M, G) immune parameters in human subjects.

The Study of Spontaneous Developmental Abnormalities and Toxicology of Benomyl and Its Metabolite on Salamander, Hynobius leechii.

  • Park, Yong-Uk
    • Proceedings of the Korea Society of Environmental Biology Conference
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    • 2005.12a
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    • pp.38-45
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    • 2005
  • The egg bags of Korean salamander(Hynobius leechii) were collected from farmlands in Gyeongsangnam-do area. The assumed breeding time, numerical variation of embryos in each egg bag, mortality and the rates of abnormalities were investigated. The toxicity of benomyl, the metabolite carbendazim and BIC which were frequently spread in agricultural area and caused spontaneous embryonic malformation was investigated. The assumed breeding time between the end of February and the end of March has the difference about a month because of a habitat and it takes about 2 or 3 weeks from laying eggs to hatching. The length of each egg bag and the number of embryos were very varied in each area. It is due to geographical variation. Among egg bags in total study area, only 406 of egg bags(17.70% of total egg bags) developed all of embryos to normal larvae, and 78.49% of total embryos were normally developed. The patterns of spontaneous embryonic malformation were 26 species from A to Z and the abnormal patterns in individual were 8 species and above. the geographical differences about the abnormal pattern were identified and 11 habitats categorized 4 groups. The most frequent abnormality in Gyeongsangnam-do area is the dysplasia of external gill. The caudal dysplasia, abdominal blister and dysplasia of fin were also frequently observed. Individuals showing severe external defect were histologically studied and they showed retinal hypo-pigmentation, thyroid carcinoma, somatic muscular dysplasia, degeneration of cephalic neuron and various organ dysplasia. Benomyl and carbendazim were treated by 10pM$^{\sim}$10uM and BIC was treated by 1$^{\sim}$40ppm to know the effect of toxicity about toxic substance of salamander. After benomyl was treated, a survival rate was sharply dropped from 2 to 8 days. $LC_{100}$ identified in $1{\mu}M$, $LC_{50}$ identified between 100nM and $1{\mu}M$. $EC_{50}$ was assumed between 10nM and 100nM. The prevalent external malformation was abdomen swelled abnormally and histo-pathological effects were abdomen, neural tube and lens hernia. This suggests that benomyl is the toxicitic substance which inhibits the development of digestive system and nervous system. The result of treated carbendazim was similar to that of the treated benomyl. The survival rate is sharply dropped between 2 and 6 days. $LC_{100}$ was identified $1{\mu}M$ and $LC_{50}$ was identified between 10nM and 100nM. This shows that cabendazim has stronger lethal toxicity than benomyl. Ventral blister, eye dysplasia and cephalic dysplasia in the individual of external malformation mean that cabendazim affected nervous system much more than benomyl. Because the toxicity of BIC affected less in the beginning but affected more in the near hatching period, the period causing toxicity is somewhat different. $LC_{100}$ identified near 40ppm and $LC_{50}$ identified near 25ppm. The external defect shows mainly ventral blister and histo-pathological results show intestinal deformities. This result suggests the BIC inhibited strongly the development of digestive system. These abnormal developments may be caused by antimitotic action, inhibition of tubulin complex, destruction of microtubule, inhibitions of neurulation and closing of neural fold, and by the inhibition of movement of neural crest cells of benomyl. These abnormal developments may be caused by the rupture of epithelium, the loss of microtubule, the reduction of spindle size, the inhibition of spindle assembly formation, the destruction of spindle poles of carbendazim. These abnormal developments may be caused cytotoxicity by inhibition of the synthesis of a number of macromolecules and similar reaction the inhibition of benomyl.

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Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration (중기 나이관련황반변성 환자에서 항산화영양제 복용 후 장기 관찰 결과)

  • Bang, Seul Ki;Kim, Eung Suk;Kim, Jong Woo;Shin, Jae Pil;Lee, Ji Eun;Yu, Hyeong Gon;Huh, Kuhl;Yu, Seung-Young
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1152-1159
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    • 2018
  • Purpose: We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD). Methods: This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography. Results: The mean patient age was $72.46{\pm}7.16years$. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was $0.13{\pm}0.14logMAR$ and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly. Conclusions: Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.

Choroidal Thickness in Thyroid-associated Ophthalmopathy between Normal Tension Glaucoma Using Optical Coherence Tomography (스펙트럼영역 빛간섭단층촬영으로 측정한 갑상선 안병증 환자와 녹내장환자의 맥락막 두께 분석)

  • Lee, Bo Young;La, Tae Yoon;Choi, Jin A
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.8
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    • pp.960-967
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    • 2017
  • Purpose: To compare the macular choroidal thickness in patients with thyroid-associated ophthalmopathy (TAO) with those with normal tension glaucoma (NTG). Methods: A total of 70 normal eyes, 74 eyes with TAO and 60 eyes with NTG were enrolled in this study. All patients underwent spectral-domain optical coherence tomography (SD-OCT) (Cirrus HD-OCT, Carl Zeiss Meditec Inc., Dublin, CA, USA). Macular choroidal thickness was assessed using enhanced depth imaging. The average macular choroidal thickness was defined as the average value of three measurements: at the fovea and at the points located 1.5 mm in the nasal and temporal directions from the fovea. Generalized estimating equations were used to uncover factors affecting the average macular choroidal thickness. Results: The average, superior and inferior quadrant retinal nerve fiber layer thicknesses were significantly thinner in the NTG group compared with the TAO and control groups (p < 0.001). The average macular choroidal thickness of the TAO group, NTG group and controls was $281.01{\pm}60.06{\mu}m$, $241.66{\pm}55.00{\mu}m$ and $252.07{\pm}55.05{\mu}m$, respectively, which were significantly different (p = 0.013). The subfoveal, nasal and temporal side choroidal thicknesses were significantly thinner in the NTG group compared with the TAO group (p = 0.014, 0.012 and 0.034, respectively). Subjects with TAO were associated with a thicker average macular choroidal thickness compared with the NTG group after adjusting for age, sex, spherical equivalent and intraocular pressure (${\beta}=32.61$, p = 0.017). Conclusions: Macular choroidal thickness was significantly thicker in patients with TAO compared with those with NTG. Further evaluation is required to determine if a thick choroid in subjects with TAO has any role in glaucomatous optic neuropathy.

Intravitreal Anti-vascular Endothelial Growth Factor Injections to Treat Neovascular Age-related Macular Degeneration: Long-term Treatment Outcomes (삼출 나이관련황반변성에 대한 항혈관내피성장인자 유리체내주사 치료의 장기 임상 결과)

  • Park, Yu Jeong;Son, Gi Sung;Kim, Yoon Jeon;Kim, June-Gone;Yoon, Young Hee;Lee, Joo Yong
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1142-1151
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    • 2018
  • Purpose: We assessed the visual and anatomical outcomes, and the safety profile of long-term intravitreal anti-vascular endothelial growth factor (VEGF) injections (aflibercept, ranibizumab, and bevacizumab) given to treat neovascular age-related macular degeneration (NAMD). Methods: We analyzed medical records collected over 7 years of treatment-naive NAMD patients who received outpatient clinic-based intravitreal anti-VEGF injections. All were treated employing either "treat-and-extend" or "as needed" protocols at the discretion of the retinal specialist. The number of injections, adverse events associated with injection, and measures of visual acuity (VA), central foveal thickness (CFT), and intraocular pressure (IOP) were recorded. Results: Overall, we assessed 196 eyes of 196 patients (average age $68.6{\pm}9.6years$; 77 females). Patients received an average of $17.3{\pm}13.5$ injections over $78.0{\pm}16.5months$ of clinical follow-up. The initial mean VA (logMAR) was $0.75{\pm}0.58$ and the CFT was $349.7{\pm}152.6{\mu}m$. Both parameters exhibited maximal improvements at the 6-month visit (p < 0.05). However, the clinical outcomes worsened over the 7-year clinical course; the best-corrected visual acuity (BCVA) was $0.91{\pm}0.78$ and the CFT was $284.5{\pm}105.8{\mu}m$ at 7 years. The BCVA at 7 years was significantly correlated with the initial BCVA. IOP-related events increased 11-fold and anterior chamber reactions increased 3-fold over the years, but no significant complications such as endophthalmitis were recorded. Conclusions: The use of intravitreal anti-VEGF agents was associated with initial visual improvements over 6 months but did not prevent the worsening of NAMD over 5 years. The BCVA at the initial visit was a strong predictor of the final BCVA. A more intensive injection schedule might improve long-term outcomes.

Nomad Thinking Implied in Duchamp's Readymades (뒤샹의 레디메이드에 함의된 노마드적 사유)

  • Song, Hayoung
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.3
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    • pp.215-222
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    • 2021
  • Duchamp chose readymades mainly for his denial of retinal painting and his desire and fluid thinking for changes inside him. His thinking is well presented in his readymade works. One of his early readymades, Bicycle Wheel, expresses correlations between beings and capital. Its essence is capital and the desire of beings. It is connected to Desire or Desire-Machine proposed as a social reform and creation model by Gilles Deleuze and Félix Guattari. Bicycle Wheel does not simply end in desire relations between capital and beings, though. When the desire of beings is converted into positive desire, it can keep inventing and creating something that is repetitive, fluid, and new. Duchamp tried to convey this positive desire through his readymade Fountain. Duchamp created a ready-made article toilet into a work of art in Fountain, being driven by desire flowing inside him. This is connected to the attributes of nomads that refused to settle down and continue to flow in search of new landscapes. This way of his thinking is clearly reflected in his Box in a Valise. He was motivated to create this work by his fluid thinking. In this work, various situations can unfold often according to the directions of two elements, place and arrangement. Here, place guarantees fluidity, and arrangement variability or desire. According to Gilles Deleuze and Félix Guattari, fluidity represents nomads with the characteristics of flow and variation, and desire represents productivity or production or creation. Box in a Valise represents nomads themselves. The nomads defined by Gilles Deleuze and Félix Guattari keep flowing and create a new world. They are in line with the thinking of Duchamp that refused to settle down at one place and escape from the old order to create a new artistic world. This type of nomads can be called revolutionists or creators that acknowledge differences and create. Nomads also contain the concept of resistance to the old order. Deleuze and Guattari proposed a war machine as a model of this resistance. Duchamp and his readymades can thus be called war machines.