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1.
BMC Cancer ; 20(1): 118, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32050941

RESUMO

BACKGROUND: Although shear wave elastography (SWE) is reported to be useful in detecting malignant thyroid nodules, it shows a wide range of cut-off values of elasticity index (EI) in detecting malignant nodules. The cause of discrepancy remains unclear. Fibrosis of the tumors is known to increase the EI in SWE, and matching of SWE and surgical histopathology has not been fully illustrated in thyroid cancer. We aimed to evaluate the reproducibility of the new total nodular region of interest (ROI) method excluding the subjective features of focal circular ROI placement and to determine the lesion that causes the elevation of EI on SWE and on histopathology. METHODS: A total of 29 thyroid cancers from 28 patients were included. We evaluated the reproducibility of EI in the new total nodular ROI using Q-Box Trace program and compared the EI in focal nodular ROI using a 3-mm circular area. We analyzed the correlation between fibrosis and EI. RESULT: The coefficient of variation (CV) of the intrarater assay was significantly lower in total nodular ROI than in focal nodular ROI within the image in rater 1 (1.7% vs. 13.4%, p < 0.001) and in rater 2 (1.4% vs. 16.9%, p < 0.001) and in different images in rater 1 (7.6% vs. 12.3%, p = 0.040) and in rater 2 (7.5% vs. 19.8%, p = 0.004). Moreover, CV of the interrater assay showed similar results (14.9% vs. 19%, p = 0.030). Interrater intraclass correlation coefficient showed better agreement in total nodular ROI than in focal nodular ROI (0.863 vs. 0.783). The degree of fibrosis on histopathology showed significant correlations with EI (EMean, p < 0.001; EMax, p = 0.027), and the location of fibrosis was concordant with the high EI area on SWE. CONCLUSION: Our study revealed that the new total nodular ROI method showed higher reproducibility and better agreement in intra- and interrater assay than the focal nodular ROI method, suggesting a valuable and standardized method in clinical practice. Moreover, our results showed that fibrosis in the histopathology increased EI on SWE and might lead to the discrepancy of the cut-off values in detecting thyroid cancer.

2.
Genes Genomics ; 42(1): 67-76, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31736007

RESUMO

BACKGROUND: Phenylalanine ammonia-lyase (PAL) catalyzes the first step in the biosynthetic phenylpropanoid pathway (PPP) via deamination of phenylalanine to trans-cinnamic acid, a precursor for the lignin and flavonoid biosynthetic pathways. Although its role is well-established in various plants, the functional significance of PAL genes in rice remains poorly understood. OBJECTIVE: This study aims to find out the global feature of rice PAL genes associated with phosphate use efficiency. METHODS: To identify the biological functions of individual rice PAL genes, we performed meta-expression profiling analysis based on phylogenomics of rice PAL genes and confirmed the expression patterns using Quantitative real-time PCR (qPCR). RESULTS: We identified nine genes that were remarkably up-regulated during long-term phosphate (Pi) starvation and recovery processes through RNA-Seq data analysis. Expression patterns of the nine rice PAL genes under Pi starvation were further confirmed by qPCR, indicating that the function of PAL genes is strongly associated with Pi starvation response in rice. CONCLUSION: Our study reports the functional significance of rice PAL genes involved in adaptation to low Pi growth conditions and provides useful information to improve Pi use efficiency in crop plant.

3.
Ann Lab Med ; 40(3): 224-231, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31858762

RESUMO

BACKGROUND: Pathogenic variants of USH1C, encoding a PDZ-domain-containing protein called harmonin, have been known to cause autosomal recessive syndromic or nonsyndromic hearing loss (NSHL). We identified a causative gene in a large Korean family with NSHL showing a typical pattern of autosomal dominant (AD) inheritance. METHODS: Exome sequencing was performed for five affected and three unaffected individuals in this family. Following identification of a candidate gene variant, segregation analysis and functional studies, including circular dichroism and biolayer interferometry experiments, were performed. RESULTS: A novel USH1C heterozygous missense variant (c.667G>T;p.Gly223Cys) was shown to segregate with the NSHL phenotype in this family. This variant affects an amino acid residue located in the highly conserved carboxylate-binding loop of the harmonin PDZ2 domain and is predicted to disturb the interaction with cadherin-related 23 (cdh23). The affinity of the variant PDZ2 domain for a biotinylated synthetic peptide containing the PDZ-binding motif of cdh23 was approximately 16-fold lower than that of the wild-type PDZ2 domain and that this inaccessibility of the binding site was caused by a conformational change in the variant PDZ2 domain. CONCLUSIONS: A heterozygous variant of USH1C that interferes with the interaction between cdh23 and harmonin causes novel AD-NSHL.

4.
Elife ; 82019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31808741

RESUMO

The target of rapamycin (TOR) kinase is an evolutionarily conserved hub of nutrient sensing and metabolic signaling. In plants, a functional connection of TOR activation with glucose availability was demonstrated, while it is yet unclear whether branched-chain amino acids (BCAAs) are a primary input of TOR signaling as they are in yeast and mammalian cells. Here, we report on the characterization of an Arabidopsis mutant over-accumulating BCAAs. Through chemical interventions targeting TOR and by examining mutants of BCAA biosynthesis and TOR signaling, we found that BCAA over-accumulation leads to up-regulation of TOR activity, which causes reorganization of the actin cytoskeleton and actin-associated endomembranes. Finally, we show that activation of TOR is concomitant with alteration of cell expansion, proliferation and specialized metabolism, leading to pleiotropic effects on plant growth and development. These results demonstrate that BCAAs contribute to plant TOR activation and reveal previously uncharted downstream subcellular processes of TOR signaling.

5.
Clin Neuropathol ; 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31829926

RESUMO

OBJECTIVE: The Korean patient with Perry syndrome (PS) was the first to come to autopsy. We report a pathologically confirmed patient with PS, and compare to pathological findings of previous literatures. MATERIALS AND METHODS: The patient had a family history of parkinsonism and had a mutation in the DCTN1 gene. After death an autopsy was performed. We analyzed macroscopic and microscopic findings of the patient. RESULTS: There was no prominent cortical atrophy, but microscopy showed severe neuronal loss, microvacuolation, and gliosis in the substantia nigra (SN). We identified transactive response DNA-binding protein 43 (TDP-43)-positive neuronal cytoplasmic inclusions, dystrophic neurites, and glial cytoplasmic inclusions in surviving SN neurons. In addition, some neurofibrillary tangles (NFTs) were also seen in the parahippocampal gyrus. CONCLUSION: The neuropathology, including TDP-43 proteinopathy, is comparable to that reported previously in Caucasian populations. In addition to the stereotypic features of PS, our patient had NFTs in the parahippocampal gyrus, the pathology similar to that is described as primary age-related tauopathy (PART). These observations suggest that comorbid age-related neuropathologic change may also contribute to cognitive impairment in PS.
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6.
J Korean Med Sci ; 34(37): e234, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31559708

RESUMO

BACKGROUND: Prostate cancer (PC) is the second most common type of cancer in men worldwide and the fifth most common cancer among Korean men. Although most PCs grow slowly, it is unclear whether a longer time interval from diagnosis to treatment causes worse outcomes. This study aimed to investigate whether the time interval from diagnosis to radical prostatectomy (RP) in men with clinically localized PC affects postoperative oncologic outcomes. METHODS: We retrospectively analyzed data of 427 men who underwent RP for localized PC between January 2005 and June 2016. The patients were divided into two groups based on the cutoff median time interval (100 days) from biopsy to surgery. The associations between time interval from biopsy to surgery (< 100 vs. ≥ 100 days) and adverse pathologic outcomes such as positive surgical margin, pathologic upgrading, and upstaging were evaluated. Biochemical recurrence (BCR)-free survival rates were analyzed and compared based on the time interval from biopsy to surgery. RESULTS: Pathologic upgrading of Gleason score in surgical specimens was more frequent in the longer time interval group and showed marginal significance (38.8% vs. 30.0%; P = 0.057). Based on multivariable analysis, an association was observed between time interval from biopsy to surgery and pathologic upgrading (odds ratio, 2.211; 95% confidence interval [CI], 1.342-3.645; P = 0.002). BCR-free survival did not differ based on time interval from biopsy to surgery, and significant association was not observed between time interval from biopsy to surgery and BCR on multivariable analysis (hazard ratio, 1.285; 95% CI, 0.795-2.077; P = 0.305). CONCLUSION: Time interval ≥ 100 days from biopsy to RP in clinically localized PC increased the risk of pathologic upgrading but did not affect long-term BCR-free survival rates in Korean men.

7.
Diabetes Res Clin Pract ; 155: 107796, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31326458

RESUMO

AIM: The aim of this study was to analyze the efficacy, insulin sensitivity and safety in the event of administering sulfonylurea-based drugs and metformin in combination with basal insulin. METHODS: A randomized, open-label, parallel, 16-week trial was conducted across four study centers. The 97 type 2 diabetic patients were selected and randomized into two groups, the insulin glargine plus fixed-dose combination glimepiride 1 mg and metformin 500 mg twice daily group (the G/M group) and the insulin glargine plus glimepiride 4 mg once daily group (the G group). The primary endpoint evaluated was change in HbA1c. The secondary endpoints evaluated were changes in fasting blood glucose (FPG), 2-h post prandial glucose (PPG 2 h), insulin, and C-peptide levels. RESULTS: The G/M group was found to have experienced a significantly greater decrease in HbA1c, as well as PPG 2 h compared to the G group. While no significant intergroup difference was found regarding FPG in the ITT, the G/M group in the PP set experienced a significantly greater decrease in FPG. CONCLUSION: Comparison of combined therapy consisting of either the G/M group or the G group indicated that both forms of therapy are relatively safe but that the former more effectively decreases blood glucose levels.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Resistência à Insulina , Insulina/uso terapêutico , Metformina/uso terapêutico , Compostos de Sulfonilureia/uso terapêutico , Glicemia/análise , Diabetes Mellitus Tipo 2/sangue , Quimioterapia Combinada , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Segurança
8.
Nanoscale ; 11(26): 12637-12642, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31237267

RESUMO

The insufficient electrical conductivity and mechanical stretchability of conventional graphene fibers based on reduced graphene oxide liquid crystals (rGO-LCs) has limited their applications to numerous textile devices. Here, we report a simple method to fabricate multifunctional fibers with mechanically strong rGO cores and highly conductive CVD graphene shells (rGO@Gr fibers), which show an outstanding electrical conductivity as high as ∼137 S cm-1 and a failure strain value of 21%, which are believed to be the highest values among polymer-free graphene fibers. We also demonstrate the use of the rGO@Gr fibers for high power density supercapacitors with enhanced mechanical stability and durability, which would enable their practical applications in various smart wearable devices in the future.

9.
Adv Mater ; 31(33): e1901716, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31231874

RESUMO

Lead-(Pb-) halide perovskite nanocrystals (NCs) are interesting nanomaterials due to their excellent optical properties, such as narrow-band emission, high photoluminescence (PL) efficiency, and wide color gamut. However, these NCs have several critical problems, such as the high toxicity of Pb, its tendency to accumulate in the human body, and phase instability. Although Pb-free metal (Bi, Sn, etc.) halide perovskite NCs have recently been reported as possible alternatives, they exhibit poor optical and electrical properties as well as abundant intrinsic defect sites. For the first time, the synthesis and optical characterization of cesium ytterbium triiodide (CsYbI3 ) cubic perovskite NCs with highly uniform size distribution and high crystallinity using a simple hot-injection method are reported. Strong excitation-independent emission and high quantum yields for the prepared NCs are verified using photoluminescence measurements. Furthermore, these CsYbI3 NCs exhibit potential for use in organic-inorganic hybrid photodetectors as a photoactive layer. The as-prepared samples exhibit clear on-off switching behavior as well as high photoresponsivity (2.4 × 103 A W-1 ) and external quantum efficiency (EQE, 5.8 × 105 %) due to effective exciton dissociation and charge transport. These results suggest that CsYbI3 NCs offer tremendous opportunities in electronic and optoelectronic applications, such as chemical sensors, light emitting diodes (LEDs), and energy conversion and storage devices.

10.
Ophthalmol Retina ; 3(5): 444-450, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31044738

RESUMO

PURPOSE: Accurate image-based ophthalmic diagnosis relies on fundus image clarity. This has important implications for the quality of ophthalmic diagnoses and for emerging methods such as telemedicine and computer-based image analysis. The purpose of this study was to implement a deep convolutional neural network (CNN) for automated assessment of fundus image quality in retinopathy of prematurity (ROP). DESIGN: Experimental study. PARTICIPANTS: Retinal fundus images were collected from preterm infants during routine ROP screenings. METHODS: Six thousand one hundred thirty-nine retinal fundus images were collected from 9 academic institutions. Each image was graded for quality (acceptable quality [AQ], possibly acceptable quality [PAQ], or not acceptable quality [NAQ]) by 3 independent experts. Quality was defined as the ability to assess an image confidently for the presence of ROP. Of the 6139 images, NAQ, PAQ, and AQ images represented 5.6%, 43.6%, and 50.8% of the image set, respectively. Because of low representation of NAQ images in the data set, images labeled NAQ were grouped into the PAQ category, and a binary CNN classifier was trained using 5-fold cross-validation on 4000 images. A test set of 2109 images was held out for final model evaluation. Additionally, 30 images were ranked from worst to best quality by 6 experts via pairwise comparisons, and the CNN's ability to rank quality, regardless of quality classification, was assessed. MAIN OUTCOME MEASURES: The CNN performance was evaluated using area under the receiver operating characteristic curve (AUC). A Spearman's rank correlation was calculated to evaluate the overall ability of the CNN to rank images from worst to best quality as compared with experts. RESULTS: The mean AUC for 5-fold cross-validation was 0.958 (standard deviation, 0.005) for the diagnosis of AQ versus PAQ images. The AUC was 0.965 for the test set. The Spearman's rank correlation coefficient on the set of 30 images was 0.90 as compared with the overall expert consensus ranking. CONCLUSIONS: This model accurately assessed retinal fundus image quality in a comparable manner with that of experts. This fully automated model has potential for application in clinical settings, telemedicine, and computer-based image analysis in ROP and for generalizability to other ophthalmic diseases.


Assuntos
Oftalmoscopia/métodos , Retinopatia da Prematuridade/diagnóstico por imagem , Algoritmos , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Recém-Nascido , Masculino , Curva ROC
11.
Am J Ophthalmol ; 205: 35-42, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30959001

RESUMO

PURPOSE: To investigate association between the development of retinal vein occlusion (RVO) and blood high-density lipoprotein cholesterol (HDL-C). DESIGN: A retrospective, nationwide, population-based cohort study. METHODS: This study was set in the Republic of Korea and included 23,149,403 people ≥20 years of age who underwent the Korean National Health Screening Program examination between January 2009 and December 2012. Among them, the RVO group was composed of patients with an initial diagnosis of RVO made between 2009 and 2015 (n = 117,639). The earliest claim with an RVO diagnostic code was considered as the incident time. The predictive value of HDL-C level for RVO was analyzed using hazard ratios. The primary outcome measure was the incident cases of RVO. RESULTS: Subjects with RVO were generally older; had high body mass index, waist circumference, fasting blood glucose, blood pressure, total and low-density lipoprotein cholesterol, and triglyceride values, and low glomerular filtration rate and HDL-C values; and were more likely to experience diabetes mellitus and hypertension compared with the non-RVO group. The fully adjusted hazard ratio of RVO was 1.12 (95% confidence interval 1.10-1.14) in the lowest quartile of HDL-C versus in the highest quartile. The association between the development of RVO and HDL-C was higher those with a younger age, male sex, current smoking habit, diabetes mellitus, and hypercholesterolemia. In addition, we observed a significant synergistic effect of low HDL-C level with obesity and hypertension. CONCLUSION: This is the first nationwide population-based epidemiologic study evaluating the association between HDL-C level and the risk of RVO development. A significant association between low HDL-C and RVO development was found.

12.
Sci Rep ; 9(1): 3927, 2019 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-30850639

RESUMO

We identified clinical characteristics and risk factors of choroidal neovascularization (CNV) in eyes with prior episode of central serous chorioretinopathy (CSC). This retrospective case-control study included those initially diagnosed with CSC and developed CNV secondarily (Group 1, n = 16), those diagnosed with CNV in eyes of previous putative CSC (Group 2, n = 14), and those initially diagnosed with CSC, and did not develop CNV secondarily, as a control group for Group 1 (Group 3, n = 250). Clinical characteristics including treatment outcomes were assessed. Demographics and multimodal imaging at the time of CSC diagnosis of secondary CNV were compared between the groups to identify risk factors. Duration from diagnosis of CSC to development of CNV in Group 1 was 40.2 ± 42.0 months. Classic CNV was noted in 23 (76.7%) eyes. After treatment with intravitreal antiangiogenics with average of 4.9 times, visual acuity improved in Group 1 and Group 2 (p = 0.002). Multivariate analysis revealed that systemic hypertension, pigmentary changes, and double layer sign were associated with development of CNV secondary to CSC (p < 0.05). Hypertension, pigmentary changes, and double layer sign were independent risk factors for CNV secondary to CSC. The CNV's responded well to treatment, resulting in improved vision.

13.
Microbiologyopen ; 8(8): e00808, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30793504

RESUMO

The production and release of extracellular vesicles (EVs) is a common process occurring in various types of bacteria. However, little is known regarding the functions of EVs derived from marine bacteria. We observed that during cell growth, Sediminicola sp. YIK13, a proteorhodopsin (PR)-containing marine flavobacterium, produces EVs (S13EVs). Transmission electron microscopy showed that Sediminicola sp. YIK13 released two spherical vesicle types, with mono- and/or bi-layered membranes, in the culture. Interestingly, the S13EVs have an orange pigment, indicating the presence of putative carotenoid and PR pigments ascribed to the parental cells. The S13EVs demonstrated the same PR-derived absorption peak spectrum and light-induced proton pump activity as the parental cells. Western blot (immunoblot) analysis of the S13EVs revealed the presence of PR. We confirmed the 16S rRNA gene, pro gene, and genes required for chromophore retinal synthesis, namely blh and crtI, in the DNA packaged into these vesicles. In addition, by metagenomic sequencing, we found microbial rhodopsin-related genes in vesicles derived from natural aquatic environments. Our results suggest that EVs as well potentially pursue horizontal gene transfer of diverse microbial rhodopsin genes in marine ecosystems.

14.
Retina ; 39(10): 1995-2003, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30024574

RESUMO

PURPOSE: To compare typical polypoidal choroidal vasculopathy (T-PCV) and polypoidal choroidal neovascularization (P-CNV), which can be defined as two subtypes of PCV, and to elucidate the significance of the classification. METHODS: Seventy-seven patients diagnosed with PCV and followed up for more than 12 months were reviewed. The PCV cases were divided into a T-PCV group (n = 36) and a P-CNV group (n = 41) according to the presence of features of pachychoroid or age-related macular degeneration. Angiographic and tomographic characteristics and changes in vision during the follow-up period were compared between the two groups. RESULTS: Logarithm of the minimum angle of resolution visual acuity of T-PCV and P-CNV was 0.27 ± 0.31 and 0.62 ± 0.47 at baseline (P < 0.001) and 0.28 ± 0.41 and 0.54 ± 0.52 at the final visit (P = 0.006), respectively. A marginally higher rate of complete response to anti-vascular endothelial growth factor treatment was noted in the T-PCV group (47.2%) compared with the P-CNV group (26.8%) (P = 0.05). At the final visit, subfoveal fibrosis was noted in 11.1% of the T-PCV group and 39.0% of the P-CNV group (P = 0.009). CONCLUSION: The two subtypes of PCV, P-CNV and T-PCV, behave differently in terms of angiographic and tomographic manifestations and visual outcomes. Classifying PCVs would be helpful not only for pathogenic implications, but also for prognostic significance.

15.
Retina ; 39(6): 1117-1124, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29517581

RESUMO

PURPOSE: To report the clinical outcomes of reduced-fluence photodynamic therapy (PDT) for symptomatic subfoveal retinal pigment epithelial detachment (RPED) in central serous chorioretinopathy and identify prognostic factors affecting treatment outcome. METHODS: This retrospective interventional study included 35 eyes of 35 patients with serous subfoveal RPED with choroidal hyperpermeability. Cases with evidence of age-related macular degeneration were excluded from the study. Reduced-fluence PDT was applied to each patient. Best-corrected visual acuity, anatomical resolution of RPED, subjective symptom improvement, and complications were analyzed. RESULTS: One month after reduced-fluence PDT, 28 eyes (80.0%) manifested complete resolution of subfoveal RPED. Among the patients whose eyes manifested complete resolution, 19 (67.9%) reported subjective vision improvement. This subjective improvement was significantly associated with the presence of dysmorphopsia at baseline. Logarithm of the minimal angle of resolution visual acuity improved from 0.15 (Snellen equivalent of 20/28) to 0.09 (20/25) between baseline and 3 months after PDT (P = 0.008). Older age and increased RPED height were independent risk factors of poor resolution of RPED after PDT. The mean follow-up period after treatment was 10.4 ± 13.6 months; recurrence of RPED did not occur in any case. CONCLUSION: Subfoveal RPED in central serous chorioretinopathy responded well to reduced-fluence PDT, especially in younger patients with less RPED. Dysmorphopsia, rather than decreased visual acuity, is a main symptomatic presentation in subfoveal RPED.

16.
Retina ; 39(4): 766-778, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29266046

RESUMO

PURPOSE: To evaluate clinical characteristics and possible mechanisms of retinal artery occlusion (RAO) after intravascular procedures. METHODS: This study is retrospective case series and literature review. Twenty-seven patients with intravascular procedure-associated RAO (10 new patients and 17 from previous reports) were divided into Groups 1 and 2 according to assumed etiology-dislodged and new emboli, respectively. Clinical features and etiology of RAO were analyzed. RESULTS: Branch and central RAO were observed in 17 (63%) and 10 (37%) patients, respectively, and 61.1% of patients exhibited final BCVA ≥20/40. Intravascular procedures were performed at the carotid artery (48.1%), heart (25.9%), carotid artery or heart (3.7%), brain (11.1%), scalp/glabella (7.4%), and thyroid (3.7%). Ratio of patients with immediate and delayed (≥24 hours after procedure) onset of RAO was 17 (63.0%):10 (37.0%). In Group 1 (n = 16), RAO was associated with dislodged plaques in the carotid artery (9; 56.3%), heart (6; 37.5%), or carotid artery/heart (1; 6.3%), and one patient each experienced acute brain infarction and contralateral branch retinal artery occlusion. In group 2 (n = 11), RAO was associated with new thrombi (6; 54.5%) or emboli (5; 45.5%), and one patient experienced ocular pain, ophthalmoplegia, and blepharoptosis. CONCLUSION: Intravascular procedures might result in RAO because of embolic plaques dislodged from the carotid artery or heart, or new thrombi or embolic materials migrating through collateral channels. Branch retinal artery occlusion was more frequent than central retinal artery occlusion after intravascular procedures, which resulted in relatively good visual outcomes. Patients should be informed about immediate or delayed presentation of RAO after intravascular procedures.

17.
Graefes Arch Clin Exp Ophthalmol ; 257(2): 279-288, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30564905

RESUMO

PURPOSE: To investigate the angiographic, tomographic, and clinical characteristics of idiopathic central serous chorioretinopathy (CSC) in elderly patients. METHODS: The patients were divided into two groups according to a cutoff age of 60 years at baseline. Patients underwent spectral domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography. Angiographic and tomographic features were compared between the two groups (young vs. elderly group). RESULTS: Of 176 patients, 26 patients (15.1%) were 60 years or older. Complete resolution of subretinal fluid after treatment was noted in 72.0% of the elderly group and 90.8% of the young group (P = 0.021). The elderly group showed worse baseline and final vision, more bilateral involvement, and lower male preponderance than the young group (P < 0.05, respectively). The elderly group was also associated with a higher frequency of retinal pigment epithelium depigmentation, foveal thinning, and double-layer sign compared with the young group (P < 0.05, respectively). CONCLUSION: CSC in elderly patients was associated with a lower resolution of serous detachment, increased impairment of retinal pigment epithelial layers, foveal thinning, and worse visual outcome, suggesting a chronic insult to the choroidal vessels involving more severe damage to the outer retinal layers.


Assuntos
Coriorretinopatia Serosa Central/diagnóstico , Corioide/patologia , Angiofluoresceinografia/métodos , Fóvea Central/patologia , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologia , Adulto , Idoso , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
Korean J Ophthalmol ; 32(6): 459-469, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30549469

RESUMO

PURPOSE: To evaluate changes in the peripapillary retinal nerve fiber layer (RNFL) thicknesses using spectral-domain optical coherence tomography (SD-OCT) in hydroxychloroquine (HCQ) users. METHODS: The medical records of HCQ users were retrospectively reviewed. In these HCQ users, an automated perimetry, fundus autofluorescence photography, and SD-OCT with peripapillary RNFL thickness measurements were performed. The peripapillary RNFL thicknesses were compared between the HCQ users and the control groups. The relationships between the RNFL thicknesses and the duration or cumulative dosage of HCQ use were analyzed. RESULTS: This study included 77 HCQ users and 20 normal controls. The mean duration of HCQ usage was 63.6 ± 38.4 months, and the cumulative dose of HCQ was 528.1 ± 3.44 g. Six patients developed HCQ retinopathy. Global and six sectoral RNFL thicknesses of the HCQ users did not significantly decrease compared to those of the normal controls. No significant correlation was found between the RNFL thickness and the duration of use or cumulative dose. The eyes of those with HCQ retinopathy had temporal peripapillary RNFL thicknesses significantly greater than that of normal controls. CONCLUSIONS: The peripapillary RNFL thicknesses did not change in the HCQ users and did not correlate with the duration of HCQ use or cumulative doses of HCQ. RNFL thickness is not a useful biomarker for the early detection of HCQ retinal toxicity.


Assuntos
Antirreumáticos/uso terapêutico , Hidroxicloroquina/uso terapêutico , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Doenças Reumáticas/tratamento farmacológico , Adulto , Antirreumáticos/administração & dosagem , Feminino , Humanos , Hidroxicloroquina/administração & dosagem , Masculino , Fibras Nervosas/efeitos dos fármacos , Disco Óptico/patologia , Células Ganglionares da Retina/efeitos dos fármacos , Estudos Retrospectivos , Tomografia de Coerência Óptica
19.
Br J Ophthalmol ; 2018 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-30470715

RESUMO

BACKGROUND: Prior work has demonstrated the near-perfect accuracy of a deep learning retinal image analysis system for diagnosing plus disease in retinopathy of prematurity (ROP). Here we assess the screening potential of this scoring system by determining its ability to detect all components of ROP diagnosis. METHODS: Clinical examination and fundus photography were performed at seven participating centres. A deep learning system was trained to detect plus disease, generating a quantitative assessment of retinal vascular abnormality (the i-ROP plus score) on a 1-9 scale. Overall ROP disease category was established using a consensus reference standard diagnosis combining clinical and image-based diagnosis. Experts then ranked ordered a second data set of 100 posterior images according to overall ROP severity. RESULTS: 4861 examinations from 870 infants were analysed. 155 examinations (3%) had a reference standard diagnosis of type 1 ROP. The i-ROP deep learning (DL) vascular severity score had an area under the receiver operating curve of 0.960 for detecting type 1 ROP. Establishing a threshold i-ROP DL score of 3 conferred 94% sensitivity, 79% specificity, 13% positive predictive value and 99.7% negative predictive value for type 1 ROP. There was strong correlation between expert rank ordering of overall ROP severity and the i-ROP DL vascular severity score (Spearman correlation coefficient=0.93; p<0.0001). CONCLUSION: The i-ROP DL system accurately identifies diagnostic categories and overall disease severity in an automated fashion, after being trained only on posterior pole vascular morphology. These data provide proof of concept that a deep learning screening platform could improve objectivity of ROP diagnosis and accessibility of screening.

20.
Ann Coloproctol ; 34(4): 197-205, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30208683

RESUMO

PURPOSE: The quality of bowel preparation is a major determinant of the quality of colonoscopy. This study evaluated lifestyle factors, including usual dietary style, associated with bowel preparation. METHODS: This retrospective study evaluated 1,079 consecutive subjects who underwent complete colonoscopy from December 2012 to April 2014 at National Cancer Center of Korea. Questionnaires on bowel preparation were completed by the subjects, with the quality of bowel preparation categorized as optimal (excellent or good) or suboptimal (fair, poor or inadequate). Lifestyle factors associated with bowel preparation were analyzed. RESULTS: The 1,079 subjects included 680 male (63.0%) and 399 female patietns (37.0%), with a mean age of 49.6 ± 8.32 years. Bowel preparation was categorized as optimal in 657 subjects (60.9%) and as suboptimal in 422 (39.1%). Univariate analyses showed no differences between groups in lifestyle factors, such as regular exercise, alcohol intake, smoking, and dietary factor. Body mass index (BMI) > 25 kg/m2 was the only factor associated with suboptimal bowel preparation on both the univariate (P = 0.007) and the multivariate (odds ratio, 1.437; 95% confidence interval, 1.104-1.871; P = 0.007) analyses. CONCLUSION: Most lifestyle factors, including dietary patterns, exercise, alcohol intake and smoking, were not associated with suboptimal bowel preparation in Koreans. However, BMI > 25 kg/m2 was independently associated with suboptimal bowel preparation. More intense preparation regimens before colonoscopy can be helpful in subjects with BMI > 25 kg/m2.

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