Functional Profiling of Human MeCP2 by Automated Data Comparison Analysis and Computerized Expression Pathway Modeling / 대한의료정보학회지

OBJECTIVES: Methyl-CpG binding protein 2 (MeCP2) is a ubiquitous epigenetic factor that represses gene expression by modifying chromatin. Mutations in the MeCP2 gene cause Rett syndrome, a progressive neurodevelopmental disorder. Recent studies also have shown that MeCP2 plays a role in carcinogenesis. Specifically, functional ablation of MeCP2 suppresses cell growth and leads to the proliferation of cancer cells. However, MeCP2's function in adult tissues remains poorly understood. We utilized a weight matrix-based comparison software to identify transcription factor binding site (TFBS) of MeCP2-regulated genes, which were recognized by cDNA microarray analysis. METHODS: MeCP2 expression was silenced using annealed siRNA in HEK293 cells, and then a cDNA microarray analysis was performed. Functional analysis was carried out, and transcriptional levels in target genes regulated by MeCP2 were investigated. TFBS analysis was done within genes selected by the cDNA microarray analysis, using a weight matrix-based program and the TRANSFAC 6.0 database. RESULTS: Among the differentially expressed genes with a change in expression greater than two-fold, 189 genes were up-regulated and 91 genes were down-regulated. Genes related to apoptosis and cell proliferation (JUN, FOSL2, CYR61, SKIL, ATF3, BMABI, BMPR2, RERE, and FALZ) were highly up-regulated. Genes with anti-apoptotic and anti-proliferative functions (HNRPA0, HIS1, and FOXC1) were down-regulated. Using TFBS analysis within putative promoters of novel candidate target genes of MeCP2, disease-related transcription factors were identified. CONCLUSIONS: The present results provide insights into the new target genes regulated by MeCP2 under epigenetic control. This information will be valuable for further studies aimed at clarifying the pathogenesis of Rett syndrome and neoplastic diseases.

Functional Profiling of Human MeCP2 by Automated Data Comparison Analysis and Computerized Expression Pathway Modeling / 대한의료정보학회지

OBJECTIVES: Methyl-CpG binding protein 2 (MeCP2) is a ubiquitous epigenetic factor that represses gene expression by modifying chromatin. Mutations in the MeCP2 gene cause Rett syndrome, a progressive neurodevelopmental disorder. Recent studies also have shown that MeCP2 plays a role in carcinogenesis. Specifically, functional ablation of MeCP2 suppresses cell growth and leads to the proliferation of cancer cells. However, MeCP2's function in adult tissues remains poorly understood. We utilized a weight matrix-based comparison software to identify transcription factor binding site (TFBS) of MeCP2-regulated genes, which were recognized by cDNA microarray analysis. METHODS: MeCP2 expression was silenced using annealed siRNA in HEK293 cells, and then a cDNA microarray analysis was performed. Functional analysis was carried out, and transcriptional levels in target genes regulated by MeCP2 were investigated. TFBS analysis was done within genes selected by the cDNA microarray analysis, using a weight matrix-based program and the TRANSFAC 6.0 database. RESULTS: Among the differentially expressed genes with a change in expression greater than two-fold, 189 genes were up-regulated and 91 genes were down-regulated. Genes related to apoptosis and cell proliferation (JUN, FOSL2, CYR61, SKIL, ATF3, BMABI, BMPR2, RERE, and FALZ) were highly up-regulated. Genes with anti-apoptotic and anti-proliferative functions (HNRPA0, HIS1, and FOXC1) were down-regulated. Using TFBS analysis within putative promoters of novel candidate target genes of MeCP2, disease-related transcription factors were identified. CONCLUSIONS: The present results provide insights into the new target genes regulated by MeCP2 under epigenetic control. This information will be valuable for further studies aimed at clarifying the pathogenesis of Rett syndrome and neoplastic diseases.

Acute Effects of Capsaicin on Proopioimelanocortin mRNA Levels in the Arcuate Nucleus of Sprague-Dawley Rats

OBJECTIVE: Capsaicin, a noxious stimulant and main component of the hot flavor of red peppers, has an analgesic effect when administered to humans. We investigated the expression of proopioimelanocortin (POMC) mRNA in the arcuate nucleus of Sprague-Dawley (SD) rats after administering capsaicin, hypothesizing that administering capsaicin activates the central opioid system. METHODS: SD rats were divided randomly into two groups; one group received a saline injection and the other received a capsaicin injection. The POMC mRNA level in the arcuate nucleus of the hypothalamus was measured by the reverse transcription-polymerase chain reaction at 0, 20, 40, 60, and 120 minutes after capsaicin administration. RESULTS: Capsaicin administration resulted in a significantly increased POMC mRNA level, compared to that in saline-treated rats at the 20-minute time point (t=-4.445, p=0.001). However, no significant group differences were observed at other times (t=-1.886, p=0.089; t= -0.973, p=0.353; t=-2.193, p=0.053 for 40, 60, and 120 minutes, respectively). CONCLUSION: The analgesic effect of capsaicin might be associated with increased activity of the cerebral opioid system. This finding suggests that capsaicin acted for nociception and analgesia and could affect alcohol-intake behavior, which might further imply that a food culture could affect drinking behavior.

COCAW: A Genome-wide Pattern Search System for Designing Microbial Probes

A few bioinformatics tools have been used to find out conserved regions as probes. We have developed a system based on a heuristic method with web interfaces to find out conserved regions against microbial genomes. The system runs in real time by using relative entropy in limited narrow regions and detecting similar regions between pair regions with local alignment. The system could be useful to find out conserved regions as genome-wide scale.

A Study of the Reliability and Validity of the Korean Version of the Penn Alcohol Craving Scale for Alcohol-Dependent Patients

OBJECTIVE: The Penn Alcohol Craving Scale (PACS) is a stronger predictor of subsequent drinking and relapse of alcohol dependence that can be administered more quickly and easily than other craving scales. The goal of this study was to develop the Korean version of the Penn Alcohol Craving Scale (PACS-K). METHODS: To examine the psychometric properties of the PACS-K, responses were chosen from 80 patients admitted to a treatment facility for alcohol dependence. RESULTS: The PACS-K possesses good psychometric properties, as assessed by Cronbach's alpha estimates (Cronbach's alpha=0.91). The test-retest reliability of the PACS-K showed high correlation (p<0.01) when the retest interval was 1 day. When the validity of the PACS-K was investigated using correlation analysis with two other craving scales (the Obsessive Compulsive Drinking Scale (OCDS) and the Visual Analogue Scale (VAS), high correlations were obtained between total PACS scores and total OCDS scores, and between total PACS scores and VAS scores (p<0.01, respectively). CONCLUSION: The PACS-K is a reliable and valid measure of alcohol cravings, and it could be useful for predicting which individuals are at risk for subsequent relapse.

The Study on Reliability and Validity of Korean Alcohol Urge Questionnaire(AUQ-K) for Alcohol Dependence

OBJECTIVES: The Alcohol Urge Questionnaire(AUQ) has been used in alcohol dependence treatment and research. The goal of this study is to develop of the Korean Alcohol Urge Questionnaire(AUQ-K). METHODS: To examine the AUQ-K's psychometric properties, responses from 104 patients admitted in alcohol dependence treatment facility were investigated. RESULTS: The internal consistency of the 8-item AUQ-K, measured by coefficient alpha, was high(Cronbach's alpha =0.78). AUQ-K scores showed significant correlation when the retest interval was 1 day(p<0.01). The AUQ-K's validity was investigated using correlational analyses with two other craving scales[the Obsessive Compulsive Drinking Scale(OCDS) and the Visual Analogue Scale(VAS)]. The high correlations were obtained between total AUQ-K scores and total OCDS scores, and between total AUQ-K scores and the VAS scores(p<0.01, respectively). CONCLUSION: The AUQ-K is a reliable and valid short scale for measurement of self-reported alcohol craving. This scale may offer significant advantages over existing single-item measures of alcohol craving in the fields of alcohol dependence treatment and research.

A Study on Relapse Predictors in Korean Alcohol-Dependent Patients: A 24 Weeks Follow up Study

OBJECTIVES: The aim of this prospective study is to investigate predictors estimating relapse in Korean alcohol-dependent patients using variables like alcohol history, drinking craving, treatment motivation and insight. METHODS: Alcohol dependent patients(N=48) who completed questionnaires about sociodemographic variables and drinking history, Timeline Follow-Back(TLFB), Obsessive-Compulsive Drinking Scale(OCSD), Alcohol Urge Questionnaire(AUQ), Pennsylvania Alcohol Craving Scale(PACS), University of Rhode Island Change Assessment(URICA), Hanil Alcohol Insight Scale(HAIS) were followed-up for 24weeks. Subjects who drank heavily(5 standard drinking or more/day) or were not followed up anymore were classified as the relapse group. We used logistic regression analysis with backward elimination of SPSS PC+11.5 to investigate relapse estimate predictors. RESULTS: Average drinking amount per drinking day for last 1 year and HAIS score were predictors of relapse in alcohol-dependent patients. CONCLUSIONS: Our findings suggest that therapist should give more attention to alcohol-dependent patients who had more drinks per drinking day for last 1 year and had lower insight level.

Mutations of CAPN3 in Korean Patients with Limb-Girdle Muscular Dystrophy

The limb-girdle muscular dystrophy type 2A (LGMD2A) is a recessively inherited disease caused by a mutation of the calpain 3 gene (CAPN3), and is considered one of the most prevalent subtypes of limb-girdle muscular dystrophy (LGMD). In this study, we aimed to identify CAPN3 mutations and to characterize the phenotype of Korean patients with LGMD2A. Among 35 patients with LGMD, four patients, who showed calpain 3 deficiency on western blot analysis, were analyzed in this study. Total RNA extracted from frozen muscle tissue was amplified by reverse transcriptase polymerase chain reaction (RT-PCR) using six primer pairs covering all coding sequences of CAPN3, and direct sequencing was performed. Clinical and pathological features of the patients were also reviewed. We found four different mutations in five alleles from three patients. Of the pathogenic mutations identified, two were novel (c.2125T>C and c.2355-2357delTTC), and the others had been reported elsewhere (c.440G>C, c.1076C>T). All patients showed a high CK level with predominant proximal leg weakness, and the onset was in their childhood except for one patient. Among two novel CAPN3 mutations, one was a missense mutation (c.2125T>C [p.709Ser>Pro]), and the other was a small in-frame deletion causing omission of a single amino acid (c.2355-2357delTTC [p.786delPhe]). The clinical features of our patients were generally compatible with the characteristics of LGMD2A patients described in the previous studies.

Change of the Expression of Human Telomerase Reverse Transcriptase mRNA and Human Telomerase RNA after Cisplatin and 5-Fluorouracil Exposure in Head and Neck Squamous Cell Carcinoma Cell Lines

Telomerase activity appears to be associated with cell immortalization and malignant progression. Understanding how telomerase activity is regulated in vivo is important not only for understanding the molecular biology of telomerase but also for the potential clinical application of anticancer drugs. This study evaluated telomerase activity and quantified the expression of human telomerase reverse transcriptase (hTERT) mRNA and human telomerase RNA (hTR) using a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) method before and after the exposure of cisplatin and 5-fluorouracil (5-FU) in two head and neck squamous cell carcinoma (HNSCC) cell lines. Two human HNSCC cell lines (PNUH-12 and SNU-899) were studied. Cell cytotoxicity, the change of telomerase activity, and hTERT mRNA and hTR expression by 5-FU and cisplatin exposure were assessed by MTT assay, TRAP assay, and real-time RT-PCR, respectively. In two cell lines, after cisplatin exposure, the telomerase activity and hTERT mRNA expression decreased, but hTR expression in- creased according to the concentration of drug. However, in both cell lines, the telomerase activity and hTR did not show any significant change after 5-FU treatment, but the expression of hTERT mRNA decreased. These results suggest that there may be other important regulating mechanism except hTERT mRNA as the regulation factor of telomerase activity in HNSCC cell lines.

Mutations and Polymorphims of MECP2 Gene in Rett Syndrome / 대한산부인과학회지

OBJECTIVE: Rett syndrome (RTT) is a severe progressive neurodevelopmental disorder affecting primarily females by mutations in MECP2 gene. The aim of this study was to compare the pattern of mutations in MECP2 gene in Korean RTT with worldwide reports. METHODS: Six girls clinically diagnosed as RTT from April 2001 to March 2003 were recruited. Diagnosis was made according to the diagnostic criteria recommended by Rett Syndrome Diagnostic Criteria Work Group in 1988. Molecular analysis of MECP2 gene was done and compared with worldwide reports. RESULTS: Three of six RTT had mutations in TRD domain of exon 4 in MECP2 gene. Two of these mutations were nonsense mutaions which were previously reported by others, however, one case was a novel mutation with 44 bp deletion which causes frameshift and premature termination of translation at codon 409. Two single nucleotide polymorphism (SNP) was detected in the exon 1 and exon 4. Since the SNP in exon 1 has not been reported by others, it may be a Korean-specific SNP. Because of the size of cases in this study, the genotype-phenotype relationship could not be assessed. CONCLUSION: The results of this study shows the common types of point mutations as well as a novel type of deletion in MECP2 gene in RTT.

Diagnostic mutational analysis of MECP2 in Korean patients with Rett syndrome

Rett syndrome (RTT) is an X-linked dominant neurodevelopmental disorder affecting 1 per 10,000- 15,000 female births worldwide. The disease-causing gene has been identified as MECP2 (methyl- CpG-binding protein 2). In this study, we performed diagnostic mutational analysis of the MECP2 gene in RTT patients. Four exons and a putative promoter of the MECP2 gene were analyzed from the peripheral blood of 43 Korean patients with Rett syndrome by PCR-RFLP and direct sequencing. Mutations were detected in the MECP2 gene in approximately 60.5% of patients (26 cases/43 cases). The mutations consisted of 14 different types, including 9 missense mutations, 4 nonsense mutations and 1 frameshift mutation. Of these, three mutations (G161E, T311M, p385fsX409) were newly identified and were determined to be disease-causing mutations by PCR- RFLP and direct sequencing analysis. Most of the mutations were located within MBD (42.3%) and TRD (50%). T158M, R270X, and R306C mutations were identified at a high frequency. Additionally, an intronic SNP (IVS3+23C>G) was newly identified in three of the patients. IVS3+23C>G may be a disease-related and Korea-specific SNP for RTT. L100V and A201V are apparently disease-causing mutations in Korean RTT, contrary to previous studies. Disease-causing mutations and polymorphisms are important tools for diagnosing RTT in Koreans. The experimental procedures used in this study should be considered for clinical molecular biologic diagnosis.

A Case of R122H Mutation of Cationic Trypsinogen Gene in a Pediatric Patient with Hereditary Pancreatitis Complicated by Pseudocyst and Hemosuccus Pancreaticus / 대한소화기학회지

Hereditary pancreatitis is a rare autosomal dominant inherited disease with 80% penetration rate. The disease is characterized by recurrent episodes of pancreatitis often beginning in childhood, positive family history with at least two other affected members and no known precipitating factors. Most forms of hereditary pancreatitis are caused by one of two commoner mutations, R122H in exon 3 and N29I in exon 2 of the cationic trypsinogen (CT) (PRSS1) gene, located on chromosome 7. These genetic defects are speculated to cause excessive trypsin activity or to prevent inactivation of prematurely activated trypsin, resulting in pancreatitis. We performed mutation analysis of a Korean family with two members having clinically suspicious hereditary pancreatitis. We analyzed the CT gene in DNA samples extracted from peripheral blood of five family members. First of all, polymerase chain reaction and restriction enzyme digestion were performed in exon 3 of the CT gene. And then DNA products were purified and sequenced. We found out that three members of the family, the mother and two daughters, had a R122H mutation of the CT gene. We report the first family of hereditary pancreatitis associated with the CT gene mutation, an arginine to histidine amino acid substitution at residue 122, in Korea.

Gender Differences in Alcohol Metabolizing Hepatic Enzyme Genotypes in Korean Patients with Alcohol Dependence / 신경정신의학

OBJECTIVES: There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. METHODS: The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. RESULTS: First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. CONCLUSION: These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 genotype in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

Isolation of Nontuberculous Mycobacteria by DNA Probe and Clinical Characteristics of Patients with NTM Pulmonary Disease / 결핵및호흡기질환

BACKGROUND: Nontuberculous mycobacterial (NTM) infections are increasingly being recognized as a cause of chronic pulmonary disease. This study describes the prevalence of NTM species from clinical specimens and the clinical characteristics of NTM pulmonary disease. MATERIAL AND METHODS: The NTM isolated from March 2003 to December 2003 at the Kosin Medical Center were identified using an oligonucleotide chip containing the internal transcribed space (ITS) sequence. The medical records of the patients with the NTM isolates, who fulfilled the 1997 ATS diagnostic criteria for NTM pulmonary disease, were analyzed, retrospectively. RESULTS: Twenty four species (24.2%) of NTM were isolated from 99 cultured AFB specimens. M. avium complex (MAC) (13 isolates), M. szulgai (3), M. kansasii (2), M. malmoense (2), M. abscessus (1), M. chelonae (1), M. scrofulaceum (1), and unclassified (1). Of the 23 patients with isolated NTM, 11 patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria; MAC was found in 6 cases (54.5%), M. szulgai in 2 cases (18.2%), and M. abscessus, M. szulgai, M. kansasii and M. malmoense in 1 case each (9.1%). Ten patients (91%) were male and the median age at diagnosis was 61 years. In the pre-existing diseases, malignant disease was found in 6 cases including 5 patients with lung cancer, and history of old pulmonary tuberculosis was identified in 4 cases. The radiological patterns showed lung destruction lung in 3 cases, a cavitary mass in 3 cases, a nodular pattern in 2 cases, and reticulonodular, consolidation and a bronchiectasis pattern were in 1 case each. CONCLUSION: Various types of NTM pulmonary diseases were`found in a tertiary hospital at Busan, Korea. The NTM pulmonary diseases were caused by MAC, M. szugai, M. kansasii, M. malmoense, M. abscessus, M. chelonae, and M. scrofulaceum in the order of frequency.

Clinical Observation on Scrotal Trauma / 대한비뇨기과학회지

We have reported 50 cases of scrotal trauma during the period from Feb. l, l982 to Apr. 1. 1985. All of them were evaluated by careful physical examination and ultrasound. And then all suspicious cases of testicular rupture and severe scrotal swelling were explored surgically as soon as possible. The results were as follows: 1. Kick or blow was the most frequent cause of the injury (78%) and the next was gunshot injury (12%). 2. The incidence of testicular rupture in patients with scrotal trauma was 38%. 3. The rate of orchiectomy in the cases of early exploration was 16.7% and 61.5% in delay exploration. 4. Ultrasound examination was helpful in identifying rapidly those patients who needed surgical repair. Homogenous echoes were produced by normal testicular contents, whereas areas of disruption and hemorrhage appeared dense clusters of echoes. Accurate diagnostic rates of testicular rupture and scrotal hematoma by scrotal sonography were 9l.7% (11/l2) and 95% (19/20). 5. The complications including epididymitis, hydrocele scrotal abscess and testicular atrophy occurred 38.9% in conservative treatment, l6.7% in early exploration and 25% in delay exploration. 6. Early exploration for scrotal trauma decreased not only the change of the testicular loss but also complications.

Trabeculectomy with Adjunctive Mitomycin-C: Compariative Study of Subconjunctival Injection and Soaking of Mitomycin-C (I)

We conducted retrospective study to compare MMC subconjunctival injection with MMC soaking for surgical outcome and postoperative complications as an adjunct to trabeculectomy in eyes with primary glaucoma. Thirty-two eyes of 27 patients with primary glaucoma who ahd undergone primary trabeculectomy with adjunctive subconjunctival mitomycin-C injection (Group I, 0.04mg/ml, 0.05ml) were compared with subconjunctival mitomycin-C soaking group (Group II, 0.4mg/ml, 3 min) of 30 eyes of 25 patietns with primary glaucoma who had undergone primary trabeculectomy. Minimal follow-up period was 3 months and mean follow-up period was 14.5 months in group I, 15.7 months in group II. Preoperative mean IOP was 33.9+/-9.3mmHg in group I, 28.3+/-10.1mmHg in group II and there was no statistical significance. Postoperative mean IOP in 1, 3, 5 months were 16.4+/-7.0, 16.1+/-7.5, 16.9+/-5.8mmHg in group I, 13.2+/-4.4, 14.2+/-4.1, 15.1+/-4.7 mmHg in group II, respectively. Twenty-six eyes(81%) in group I and twenty-three eyes (77%) in group II achieved an intraocular pressure of less than 21 mmHg and good bleb formation. Postoperative complications were hyphema(9% in group I, 10% in group II), shallow anterior chamber (6% in group I, 3% in group II), bleb leaking (3% in group I, 0% in group II), hypotony maculopathy (3% in group I, 3% in group II), avascular cystic bleb(13% in group I, 25% in group II) and belb fibrosis (18% in group I, 25% in group II). There was no statistical significance. The rates of surgical success and postoperative compliations were similar in the two groups. Subconjunctival injection is another useful adjunctive application method of MMC. The method is able to control accurate amount and to improve surgical outcome in trabeculectomy.

Filtering Operation with Adjunctive Mitomycin-C in Rabbit: Comparative Study by Subconjunctival Injection and Soaking of Mitomycin-C

We examined the differences of the glaucoma filtering blebs according to the application methods of mitomycin C (subconjunctival injection and soaking). We performed filtering surgery from the anterior chamber to the subconjunctival space with the silicone tube, in both eyes of 12 grey rabbits. In one eye, subconjunctival injection of the mitomycin-C 0.05ml after filtering surgery (concentration 0.004, 0.008, 0.012, 0.016%) was performed and on the other eye, Weck-Cel sponge soaked with the 0.04% mitomycin-C was applied for 3 minutes and the wound was washed with copious amount of balanced salt solution before the closure of wound. We examined the size, shape, vascular distribution of the filtering blebs and status of the anterior chamber after filtering surgery. We obtained the tissues of the filtering bleb at 7days, 14days and 21days after surgery and microscopic examinations were performed. In subconjunctival injection with the 0.004% of mitomycin-C, bleb size and its duration was small and short than those eyes with the soaking. In eyes with subconjunctival injection with the 0.008% of mitomycin-C, bleb size and its duration showed similiar blebs to soaking cases and anterior chamber was shallow in one eye. In case of 0.012% subconjunctival injection, bleb size and duration were greater than those with soaking and slightly shallow anterior chamber was shown in all cases. In cases of subconjunctival injection with 0.016% mitomycin-C, shallow anterior chamber and hypotony were common. In histological examination, there was similiar findings of fibroblast activity between 0.008% subconjunctival injection and 0.004% soaking cases. Therefore we conclude that the concentration of mitomycin-c in subconjunctival injection for glaucoma filtering surgery should not be higher than 0.008%.

A comparison of the results of congenital red-green color defects mesured by Color Perception Tests

124 cases with congenital red-green color defects were examined using hahn`s color vision test, double 15 hue test, and Nagel`s anomaloscope. In the Neitz anomaloscope test, 5 cases(4%) showed protanomaly, 1 case(1%) extreme protanomaly, 16 cases (13%) protanopia, 45 cases(36%) deuteranomaly, 52 cases(42%) deuteranopia, and 5 cases (4%) normal state. 5 cases(4%) of protan was classified by degree of color defects, 1 case with mild defect, 1 case with moderate defect, and 3 cases with severe defect by the Hahn`s color vision test. 14 cases (10.4%) of deutan eye the following:5 cases in mild, 6 cases in noderate, and 3 cases in severe defect. 105 cases (85.6%) were the unclassified type. In comparision with Hahn`s color vision test and anomaloscope, the concordance rate was 57.1%(8/14) in only mild and severe color defect of deutan. In the Double 15 hue test, 29 cases (23%) showed in 60.9%(25/41) in deutan. By the degree of color defect, 6 cases showed medium response, 23 cases strong response in protan. 4 cases showed medium, 37 cases strong response in deutan. The concordance rates are 57%(13/23) in protan and 68%(25/37) in deutan in strong response. We conclude that Neitz anomaloscope test is better method than Hahn`s color vision test and double 15 hue test in qualitative and qualntitative dignosis of cogenital red-green color defects.

Trabeculectomy with Adjunctive Mitomycin-C: Comparative Study of Subconjunctival Injection and Soaking of Mitomycin-CII

We conducted a prospective study to compare MMC subconjunctival injection with MMC soaking for surgical outcome and postoperative complications as an adjunct to trabeculectomy in eyes with glaucoma. Eleven patients with bilateral glaucoma had undergone primary trabeculectomy with adjunctive subconjunctival mitomycin-C injection in one eye[Group I] and primary trabeculectomy with subconjunctival mitomycin-C soaking in the other eye[Group II]. Minimal follow-up period was 6 months and mean follow-up period was 12.8 months. Preoperative mean IOP was 35+/-10.9 mmHg in the group Iand 33+/-14.4 mmHg in the group II, and there was no statistical significance. Postoperative mean IOP at 1, 3, 6 months were 13+/-2.3, 13+/-3.1, 13.6+/-2.9 mmHg in the group I, and 11.3+/-3.3, 12.2+/-3.4, 12.9+/-2.7 mmHg in the group IIand no statistical significance. Each of ten eyes[91%] in both groups achieved intraocular pressure of less than 21 mmHg and good bleb formation without any medication. Postoperative complications were transient hyphema[18% in the group I, 9% in the group II], cystic bleb[9% in the group I, 27% in the group II] and shallow anterior chamber[9% in the group II]. Postoperative corneal endothelial cell density per square millimeter averaged 2, 221+/-306/mm2[mean+/-standard deviation] in the group I and 2, 195+/-272/mm2in the group II and there was no statistical significance. The rates of surgical success and postoperative complications were similiar in the two groups. Subconjunctival injection has similar effect to soaking method. This method enables us to have accurate control of concentration and amount of MMC, and thereby reduces complications and improves surgical outcomes in trabeculectomy.

Distance Stereoacuity in Children with Intermittent Exotropia Using B-VAT II Video Acuity Tester

The purpose of this study is to determine if distance stereoacuity could be used as an objective means of assessing control in intermittent exotropia. We evaluated distance stereoacuity in 37 patients with intermittent exotropia showing orthophoria postopratively using the Mentor B-VAT II Videoacuity tester. All patients had fusion at near but 14 of 31 patients(38%) had fusion at distance preoperatively. The mean preoperative distance stereoacuities were 216 seconds with binocular vision circle(BVC) and 351 seconds with binocular vision random dot E(BVRDE) ( p=0.0002). The postoperative improvement was statistically significant with BVC(p=0.001), not statistically significant with BVRDE(p=0.7). On our results it seems to be easier to know BVC than BVRDE in children. It suggests that the BVC is a useful test for assessing control in intermittent exotropia.