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Biomedical subjects

D H Shin

Publications and source records attributed to D H Shin.

At least 19 recordsLinked to original sources
PubMed1992

Visual field defects in patients with normal-tension glaucoma and patients with high-tension glaucoma.

We compared the automated visual field test results of 24 patients with normal-tension glaucoma and 24 patients with high-tension glaucoma who were closely matched for the amount of visual field loss to determine any differences in the characteristics of visual field defects between the two groups. Patients were matched with a maximum allowable difference in mean deviation of 0.3 dB. Although the normal-tension group had a greater amount of focal visual field loss (pattern standard deviation), the difference was not statistically significant (P = .628). Additionally, there was no statistically significant difference in the amount of diffuse or focal visual field damage in the superior hemifields between the two groups; however, the patients with normal-tension glaucoma had a significantly greater amount of localized visual field loss in the inferior hemifield than the patients with high-tension glaucoma (P = .015). Our data support the hypothesis that a vascular mechanism may have a greater role in the pathogenesis of optic nerve damage and visual field loss in patients with normal-tension glaucoma than in patients with high-tension glaucoma.

Aged↗
PubMed1992

Statistical techniques in ophthalmic journals.

Over the years, the use of statistics to evaluate experimental data in ophthalmology has increased. The present study sought to assess the frequency and types of statistical techniques used in ophthalmic journals. We reviewed 974 original articles from the Archives for 1970, 1980, and 1990; the American Journal of Ophthalmology for 1990; and Ophthalmology for 1990. Of the 592 articles reviewed for 1990, 391 (66.0%) contained statistics, with measures of central tendency most commonly used (385 articles [65.0%]), followed by dispersion (298 [50.3%]), t test (120 [20.3%]), and contingency tables (98 [16.6%]). A reader familiar with 10 statistical techniques would have "statistical accessibility" to 526 (88.9%) of 1990 articles. A statistically significant difference was found in the percentage of articles containing statistical methods among the journals (P = .0003; Archives, 75.3%; Ophthalmology, 66.8%; and American Journal of Ophthalmology, 55.2%).

Animals↗
PubMed1992

Quantitative evaluation of optic disc pallor in pseudotumor cerebri patients.

We quantified optic disc pallor in patients with pseudotumor cerebri with the Rodenstock Optic Nerve Head Analyzer before and after optic nerve sheath decompression. Mean frequency distribution of pallor peaked between the pallor values of 0.10 and 0.20 in four pseudotumor cerebri patients and between 0.50 and 0.60 in five normal subjects. The red dominant pallor reflectance in pseudotumor cerebri patients decreased significantly and shifted toward the reflectance of normal subjects gradually during the 9 weeks after successful optic nerve sheath decompression, coinciding with the ophthalmoscopic resolution of papilledema. The computerized pallor measurement with the Rodenstock Optic Nerve Head Analyzer allows an objective and quantitative assessment of papilledema in pseudotumor cerebri patients.

Adult↗
PubMed1992

Intraocular pressure-related pattern of optic disc cupping in adult glaucoma patients.

The pattern of glaucomatous optic disc cupping was investigated in 67 eyes of 67 primary open-angle glaucoma patients with early-to-moderate visual field loss and a wide range of intraocular pressure. We determined the position of the deepest point of the optic disc cup using the Rodenstock Analyzer. This position correlated significantly with intraocular pressure: the deepest point tended to be located below the center of the optic disc at high intraocular pressure and above the center at low intraocular pressure. There was no significant correlation between the position of the deepest cup point along the horizontal axis and intraocular pressure. The position of the deepest point of the cup also correlated significantly with the severity of glaucoma, albeit less strongly than with intraocular pressure: it tended to be in the inferior portion of the disc at an early stage of glaucoma and in the superior portion of the disc at a more advanced stage of glaucoma. Therefore, the inferior portion of the optic nerve head appears to be most yielding to changes of intraocular pressure. These findings are consistent with histologic evidence of the least connective tissue support in the inferoperipheral region of the lamina cribrosa and with greater prevalence of inferior rim loss and corresponding superior visual field defects in early to moderately advanced primary open-angle glaucoma patients.

Aged↗
PubMed1992

The medical treatment of a tuberculous tracheo-oesophageal fistula.

Tracheo-oesophageal (TE) fistulas caused by Mycobacterium tuberculosis are rare and usually require both surgical treatment and medical treatment with antituberculosis drugs. A patient with a tuberculous TE fistula and mediastinal lymphadenitis was successfully treated by medical management alone.

Adult↗
PubMed1992

Risk factors for retinal vein occlusions. A case-control study.

The authors conducted a case-control study of risk factors for retinal vein occlusions using 87 patients with vein occlusions, chosen randomly from photographic files from their institution between 1985 and 1990, and a control group of 85 subjects 38 years of age (the youngest individual in the vein occlusion group) or older, who were randomly selected from the records of two general ophthalmologists in the authors' department. Certain risk factors for retinal vein occlusion were highly significant when subjects with retinal vein occlusion were compared with the control group. These risk factors included systemic hypertension (odds ratio [OR], 3.86; 95% confidence interval [Cl], 2.08 to 7.16), open-angle glaucoma (OR, 2.89; 95% Cl, 1.38 to 6.05), and male sex (OR, 2.61; 95% Cl, 1.43 to 4.79). Race, presence of diabetes mellitus, history of coronary artery disease or stroke, and family history of diabetes, glaucoma, coronary artery disease, or stroke were not significant risk factors in the population studied. Logistic analysis of the risk factors showed no interactions. Risk factors for branch retinal vein occlusion and central retinal vein occlusion were identical.

Adult↗
PubMed1992

Intraocular pressure-dependent dynamic changes of optic disc cupping in adult glaucoma patients.

The authors performed a study of intraocular pressure-dependent changes in optic disc cupping in 17 adults with chronic open-angle glaucoma. Analyses with the Rodenstock Optic Nerve Head Analyzer were performed at baseline low intraocular pressure during therapy, after elevation of intraocular pressure (from therapeutic failure or noncompliance), and after reduction of intraocular pressure with successful therapy. Optic disc cupping increased significantly upon short-term increase of intraocular pressure from baseline of 20.4 +/- 2.5 mmHg to 31.1 +/- 5.9 mmHg. Optic disc cupping reverted to baseline after persistent intraocular pressure reduction to 19.3 +/- 4.8 mmHg. These data demonstrate intraocular pressure-dependent dynamic changes of optic disc cupping in patients with demonstrable glaucomatous optic nerve damage. They underscore the detrimental effect of elevated intraocular pressure and the beneficial effect of intraocular pressure reduction on optic disc cup changes.

Adult↗
PubMed1992

Age-related decline of disc rim area in visually normal subjects.

Optic disc parameters and axial lengths were measured in 81 visually normal young and elderly white adults (young [n = 41]: 27.2 +/- 5.7 years versus elderly [n = 40]: 68.8 +/- 8.4 years) using Rodenstock Optic Disc Analyzer and A-scan sonography. Axial lengths correlated positively with optic disc parameters (Spearman correlation analysis: rim area: P = 0.042, disc area: P = 0.052, and cup volume: P = 0.010). Older subjects had a shorter axial length (23.09 +/- 1.02 mm) and smaller disc rim area (1.171 +/- 0.338 mm2) than younger subjects (23.60 +/- 1.15 mm and 1.325 +/- 0.314 mm2; Mann-Whitney U test: P = 0.011 and P = 0.013, respectively). While both axial length and disc rim area declined with age (0.011 mm and 0.003 mm2 per year; Spearman correlation analysis: P = 0.032 and P = 0.020, respectively), the cup-to-disc and rim area-to-disc area ratios appeared to remain relatively constant throughout adult life. The age-related decline of disc rim area is consistent with histologic evidence of age-related decline of ganglion cell axons. The rim area-to-disc area ratio seems less affected by age, and is thus a better parameter to isolate age-related change from disease-related change of optic nerve in a longitudinal follow-up of diseases involving the optic nerve head.

Adolescent↗
PubMed1992

Mediastinal pancreatic pseudocyst with recurrent pleural effusion. Demonstration by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan.

Mediastinal pseudocysts of internal pancreatic fistulas are rare as a cause of bilateral pleural effusions even in relapsing pancreatitis. We describe a 38-year-old man with recurrent bilateral pleural effusion as a complication of a pancreatic pseudocyst. Extension of a pancreatic pseudocyst into the posterior mediastinum was clearly identified by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan of the abdomen and chest, and the complication was successfully treated by surgical management. We stress the importance of definite assessment of the communication of pancreatic pseudocyst with mediastinum in patients with pancreatitis who develop recurrent pleural effusions.

Adult↗
PubMed1992

Endobronchial tuberculosis. Clinical and bronchoscopic features in 121 cases.

The clinical and bronchoscopic features of endobronchial tuberculosis in 121 patients were retrospectively investigated. The peak incidence occurred in the second decades, with 3.8 times higher incidence noted in female than in male subjects. A barking cough with sputum was the most common chief complaint in 61.1 percent. Parenchymal infiltration and/or consolidation was the most common roentgenographic finding of the chest in 58.6 percent. Hypertrophy with luminal narrowing was the most common bronchoscopic finding in 43 percent. Bronchoscopically, right upper and right main bronchus were the most frequently involved in 30.5 percent. It was concluded from these data that using fiberoptic bronchoscopy allows not only substantial meaningful assessment of endobronchial tuberculosis but also relieves atelectasis eventually resulting in successful treatment with antituberculosis drugs.

Bronchi↗
PubMed1992

Positive family history of glaucoma is a risk factor for increased IOP rather than glaucomatous optic nerve damage (POAG vs OH vs normal control).

To elucidate the family history of glaucoma (FHG) as a risk factor for ocular hypertension(OH) vs glaucomatous optic nerve damage, we reviewed the clinical records of 361 primary open-angle glaucoma(POAG) patients, 178 OH subjects, and 927 normal controls randomly selected from an urban medical center eye clinic. The prevalence of a positive FHG was 27% in the POAG patients, 47% in the OH subjects, and 11% in the normal controls. Whereas a positive FHG was a significant risk factor for both OH and glaucoma compared to normal control subjects (OR = 7.56, 95% CI: 5.27-10.85, P < .0001 for OH; OR = 3.15, 95% CI: 2.31-4.31, P < .0001), it was a risk factor more significantly for OH than for glaucoma being significantly more prevalent in OH than in POAG (OR = 2.40, 95% CI: 1.65-3.49, P < .0001). These results suggest the importance of additional risk factors other than IOP for glaucomatous optic nerve damage.

Aged↗
PubMed1992

Glaucoma risk factors in primary open-angle glaucoma patients compared to ocular hypertensives and control subjects.

To investigate the risk factors for glaucoma, we reviewed the clinical record of 361 primary open-angle glaucoma (POAG) patients, 178 ocular hypertensives (OH), and 927 controls without POAG or OH, randomly selected from an urban medical center eye clinic. Old age defined as > or = 55 year, (odds ratio ratio (OR) = 3.13 95% confidence interval (CI): 2.06-4.76, P < .0001), black race (OR = 2.58, 95% CI: 1.79-3.74, p < .0001), hypertension (OR = 1.709, 95% CI: 1.15-2.51, P < .0108), and diabetes mellitus (OR = 1.83, 95% CI: 1.08-3.09, P = .0308) were identified as significant risk factors in POAG compared to OH. Old Age (OR = 4.94, 95% CI: 3.62-6.76, p < .0001), and black race (OR = 2.04, 95% CI: 1.59-2.61, P < .0001), HTN (OR = 1.63, 95% CI: 1.26-2.11, P = .0002), and DM (OR = 1.40 95% CI: 1.02-1.92 P = .0450) were also significant risk factors when compared to normal controls. However, when the 361 POAG patients were compared to 361 controls matched with respect to age, race, and sex, hypertension and diabetes mellitus did not appear to be independent risk factors. Family history of glaucoma was found to be a risk factors more significantly for OH (OR = 6.79, 95% CI: 4.39-10.50, P < .0001) than for POAG (OR = 2.83, 95% CI: 1.90-4.21, P < .0001) compared to the matched control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1992

Tuberculosis of the ribs: a recurrent attack of rib caries.

Rib tuberculosis is an extremely rare condition with the incidence not exceeding 3 percent of all skeletal tuberculosis. The authors experienced a recalcitrant case of pulmonary tuberculosis accompanied by chest wall cold abscesses involving ribs recurring at a new site in approximately 10 months despite of medical and surgical treatment. The patient has twice taken thoracotomy for abscess drainage and during the second thoracotomy, a partial resection of involved ribs was performed.

Adolescent↗
PubMed1992

Adjunctive viscoelastic therapy for postoperative ciliary block.

Following Molteno device implantation, trabeculectomy, or needling revision of trabeculectomy, six eyes of six chronic glaucoma patients developed a flat anterior chamber without hypotony, ciliochoroidal detachment, pupillary block, or external wound leak. The ciliary block did not respond to vigorous medical and laser therapy. We performed an intracameral injection of sodium hyaluronate, which resulted in maintenance of a full anterior chamber and normal intraocular pressure in all of the six eyes. The use of intracameral viscoelastic appears to be a reasonable adjunct for management of ciliary block not responsive to vigorous medical therapy and intracameral air injection trial, before attempting more extensive surgery.

Aged↗
PubMed1992

Asbestos and the histogenesis of lung carcinoma.

Individuals exposed to asbestos develop and die of bronchogenic carcinoma at rates well above individuals not exposed, but there is disagreement as to what factors other than the asbestos may be important in the histogenesis of the carcinoma. This report discusses the various theories as to how and why asbestos, cigarette smoke, asbestosis, and pleural disease may be involved in the development of the carcinoma. The authors conclude that other disease processes may mark individuals particularly likely to develop carcinoma of the lung, but that asbestos fibers have an independent role in the histogenesis of carcinoma of the lung.

Asbestos↗
PubMed1991

Transcriptional regulation of p90 with sequence homology to Escherichia coli glycerol-3-phosphate acyltransferase.

We have previously isolated cDNA clones for several mRNAs that are dramatically increased in livers of fasted mice refed a high carbohydrate diet. We report here the sequence and regulation of one such mRNA; the 6.8-kilobase mRNA has an open reading frame of 2481 nucleotides, and the coded protein contains 827 amino acid residues (Mr of 90,000) with a 30% identity and an additional 42% similarity in an approximately 300-amino acid stretch to Escherichia coli glycerol-3-phosphate acyltransferase. The p90 mRNA is highly expressed in liver and in adipose tissue. When previously fasted mice were refed a high carbohydrate, fat-free diet, the liver mRNA level for p90 was increased about 20-fold at 8 h. Administration of dibutyryl cAMP at the time of refeeding prevented the increase in the p90 mRNA by 70%. In addition, there was no increase in the p90 mRNA level when previously starved streptozotocin-diabetic mice were refed. In diabetic animals, the p90 mRNA level increased by 2-fold 1 h after insulin injection and reached a maximum of 19-fold after 6 h. The increase in transcription rate of the p90 gene preceded that of steady state mRNA level caused by fasting/refeeding, and cAMP abolished the increase in transcription. Transcription of the p90 gene was not detectable in either fasted or refed streptozotocin-diabetic mice, but increased 4-fold 30 min after insulin administration and further increased up to 8-fold at 2 h. On-going protein synthesis was necessary for this increase.

Amino Acid Sequence↗
PubMed1991

Visual field defects in diabetic patients with primary open-angle glaucoma.

We reviewed the automated visual field tests of 110 nondiabetic and 87 diabetic patients with primary open-angle glaucoma randomly selected from a large glaucoma practice to investigate a possible qualitative difference in the pattern of visual field defects between nondiabetic and diabetic patients with primary open-angle glaucoma. A single reviewer analyzed, in masked fashion, the visual field tests of each patient and decided whether or not visual field defects were present mainly in the inferior half of the visual field. Of the 110 nondiabetic patients, 40 (36.4%) had visual field defects located mainly in the inferior half of the visual field in one or both eyes, whereas 56 of the 87 (64.4%) diabetic patients had such defects. This difference was statistically significant (P = .0001). We believe that a vascular factor, such as that attributable to diabetes mellitus, may influence glaucomatous optic nerve damage, thus causing a difference in the pattern of visual field loss in patients with primary open-angle glaucoma.

Adult↗