Screening Tool for Anxiety Disorders: Development and Validation of the Korean Anxiety Screening Assessment

OBJECTIVE: This study evaluated the psychometric properties of the Korean Anxiety Screening Assessment (K-ANX) developed for screening anxiety disorders. METHODS: Data from 613 participants were analyzed. The K-ANX was evaluated for reliability using Cronbach’s alpha, item-total correlation, and test information curve, and for validity using focus group interviews, factor analysis, correlational analysis, and item characteristics based on item response theory (IRT). The diagnostic sensitivity and specificity of the K-ANX were compared with those of the Beck Anxiety Inventory (BAI) and Generalized Anxiety Disorder 7-item scale (GAD-7). RESULTS: The K-ANX showed excellent internal consistency (α=0.97) and item-total coefficients (0.92–0.97), and a one-factor structure was suggested. All items were highly correlated with the total scores of the BAI, GAD-7, and Penn State Worry Questionnaire. IRT analysis indicated the K-ANX was most informative as a screening tool for anxiety disorders at the range between 0.8 and 1.6 (i.e., top 21.2 to 5.5 percentiles). Higher sensitivity (0.795) and specificity (0.937) for identifying anxiety disorders were observed in the K-ANX compared to the BAI and GAD-7. CONCLUSION: The K-ANX is a reliable and valid measure to screen anxiety disorders in a Korean sample, with greater sensitivity and specificity than current measures of anxiety symptoms.

Candida albicans Biofilm Formation and Pathophysiology / 대한의진균학회지

Candida species are frequently found in the normal microorganism of humans, which facilitates their encounter with most implanted biomaterials and host surfaces. Medical devices such as stents, prostheses, implants and various types of catheters have all been shown to support colonization and biofilm formation by Candida. Candida albicans remains the fungal species most commonly associated with biofilm formation and the increase in Candida infections in the last decades has almost paralleled the increase and widespread use of a broad range of medical implant devices, mainly in populations with impaired host defenses. The formation of C. albicans biofilms carries important clinical repercussions because of their increased resistance to antifungal therapy and the ability of cells within biofilms to withstand host immune defenses. Also, biofilm formation on medical devices can negatively impact the host by serving as a reservoir or source for future continuing infections. This review article aims to provide insights on various aspects of C. albicans biofilms, formation and structure, their role in pathogenesis and antifungal drug resistance.

A Case of Pseudomelanosis Duodeni / 대한소화기내시경학회지

Pseudomelanosis duodeni is a rare benign condition in which dark pigments accumulate in macrophages located in the lamina propria of the duodenal mucosa. Most reported cases had hypertension with or without chronic renal failure, and were taking antihypertensive agents and iron supplements. Therefore, it has been assumed that pseudomelanosis duodeni is associated with these medications. Our case was a 77 year-old female patient diagnosed as having hypertension, congestive heart failure, iron deficiency anemia, and depression, who had been treated with antihypertensive agents and iron supplement. Upper gastrointestinal endoscopy revealed many tiny discrete dark macules scattered throughout the first and second portions of the duodenum. Endoscopic mucosal biopsy disclosed macrophages with Prussian blue and Fontana-Masson stain positive pigments, which suggested that the nature of pigment was iron sulfide.

Role of p53 gene mutation in tumor aggressiveness of intracranial meningiomas

The mutations that occur in the p53 tumor suppressor gene have been studied in various human malignant tumors. However, little is known about this gene in meningiomas. To investigate the relationship and frequency of p53 gene mutations, the p53 polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and immunohistochemical study were performed on the 41 intracranial meningiomas (21 benign, 11 atypical, and 9 malignant). The higher the p53 protein expression rate, the poorer the histologic grade (9.5%, 72.7%, and 88.9% in benign, atypical and malignant meningioma, respectively) (p=0.000). The p53 protein expression rate was higher in recurrent meningioma (71.4%) than in nonrecurrent meningioma (10.5%) (p=0.002). PCR-SSCP method was performed in positive p53 protein immunoreactivity cases. p53 gene mutation rate was higher in the atypical (62.5%) and malignant (25%) meningiomas than in the benign meningioma (0%) (p=0.232). Also, the rate was higher in recurrent menigioma (20%) than in nonrecurrent meningioma (0%) (o=0.495). Among five to eight exons of the p53 gene, the mutation was observed on exon 7 more frequently. In conclusion, p53 immunoreactivity and p53 gene mutation are closely correlated with histologic grade and histologic atypia of intracranial meningiomas. p53 gene mutation would be considered as a useful marker to detect the progression of intracranial meningiomas.

Incision and Suture Technique for Experimental Correction of Hyperopia in Rabbits

A new surgical technique to correct hyperopia by steepening the central corneal curvature was performed experimentally on the eyes of rabbits. After X-shaped incIsIOns at four quadrants of the mid-peripheral cornea, four circumferential interrupted sutures with nearly full depth reaching to Descemet's membrane were performed across the incIsions. The knots were tightened in order to shorten the cornea in the direction of the suture and eventually to shorten the circumference of the mid-peripheral cornea, which, in turn, induced a forward bulging of the central cornea. Twenty-three eyes of 12 albino rabbits were divided into group A (7 eyes) with 4mm of optical zone, group B (9 eyes) with 6mm of optical zone, and group C which, as the control group, consisted of 7 contralateral eyes of gorup A without any incision or suture. There were significant changes (p

Clinical Results of UNI(R) Intraocular Lens Implantation

We evaluated the clinical results of 43 patients (47 eyes) who underwent cataract extraction and implantation of domestic posterior chamber intraocular lens manufactured by Universal Optics Co. (UNI(R) IOL) and could be followed up over 6 months. The mean follow-up period was 10.2 months with a range of 6 to 15 months. The results were as follows: 1. The final corrected visual acuity of 0.5 or better was noted in 41 eyes (87.2%). 2. The difference between the calculated postoperative refraction and the actual postoperative refraction was less than +/-1.00 D in 33 eyes (70.2%). 3. The corneal thickness increased 8.2% at postoperative period of 3 days and returned to preoperative level at postoperative period of 4 weeks. 4. The corneal endothelial cell density decreased 11.2% at postoperative period of 4 weeks and 12.8% at postoperative period of 6 months. 5. The early postoperative inflammatory reaction in anterior chamber and deposits on the surface of intraocular lens decreased gradually in the course of postoperative period. 6. The postoperative complications included posterior capsular opacification (7 eyes), fibrinous membrane (3 eyes), and hyphema (2 eyes). The above results showed that the visual outcome and the safety of UNI(R) IOL were favorable.

The Clinical Report on Six Cases of Epikeratoplasty

After the first description of epikeratoplasty for the correction of aphakia by Kaufman in 1980, the application of epikeratoplasty has been extended further to keratoconus and high myopia. Six epikeratoplasty for 5 eyes of high myopia and 1 eye of keratoconus were performed and followed upto average 4.9 months. All cases improved their uncorrected visual acuity and the preoperative best corrected visual acuity improved or had no change postoperatively except one case on the last visit. In the cases of high myopia, the mean preoperative spherical equivalent of -19.4D was corrected to average -0.23D with the range of -1.75D to +2.5D postoperatively. In the case of keratoconus, there was the mean decrease in 12.0D of myopia in terms of spherical equivalent and the cornea was flattened by over 8D in keratometry readings.

Results of Cyclotporin A therapy in Behcet's Disease

15 patients with active Behcet's uveitis, suffering from marked deterioration of visual acuity in at least one eye were treated with cyclosporin A(CYA), 5 mg/kg/day for 6 months. All patients showed improved or same visual acuity after 1 month trial. All except 4 cases maintained same or improved visual acuity after trial of 6 months. There were minor side effects noted during the trial of 6 months except one who had suffered from the chronic persistent hepatitis. The authors conclude that CYA seems to be effective drug for the treatment of severe Behcet's uveitis.

Experimental Intraocular Fibrovascular Proliferation Through Sclerommy Wound

In the process of closing a scleral wound caused by various conditions, incarceration af the conjunctiva, Tenon's capsule or vitreous in the wound can occur unexpectedly. We created such conditions experimentally to determine their intraocular complications. The experimental, materials were 12 albino rabhits(24 eyes) and the rabbits were divided into two groups(I and II). Group I rabbits(12 eyes) received no vinectormy and group II rabbits(12 eyes) received a vitrectormy. After the conjunctiva and Tenon's capsule flap was made, the tissue flap was inserted into the vitreous cavity through the sclerotomy site- Fundus examination with an indirect ophthalmoscope and enucleation for histology were performed at 3 days, 1 week, 3 weeks, 6 weeks, 3 months and 6 months after the experiment. The results were as follows: 1, Intraocular fibrovascular proliferation developed in all experimental rabbit eyes. 2. The more vitreous hemorrhage developed, the greater was the fibrovascular proliferation and the degree of fibrovascular proliferation was more marked in group II than group I. 3. The fibrovascular proliferation developed to a band in 3 weeks, then regressed gradually. 4. The fibrovascular band was composed of fibroblasts, stromal matrix and few vessels.

Experimental Intraocular Fibrovascular Proliferation Through Sclerommy Wound

In the process of closing a scleral wound caused by various conditions, incarceration af the conjunctiva, Tenon's capsule or vitreous in the wound can occur unexpectedly. We created such conditions experimentally to determine their intraocular complications. The experimental, materials were 12 albino rabhits(24 eyes) and the rabbits were divided into two groups(I and II). Group I rabbits(12 eyes) received no vinectormy and group II rabbits(12 eyes) received a vitrectormy. After the conjunctiva and Tenon's capsule flap was made, the tissue flap was inserted into the vitreous cavity through the sclerotomy site- Fundus examination with an indirect ophthalmoscope and enucleation for histology were performed at 3 days, 1 week, 3 weeks, 6 weeks, 3 months and 6 months after the experiment. The results were as follows: 1, Intraocular fibrovascular proliferation developed in all experimental rabbit eyes. 2. The more vitreous hemorrhage developed, the greater was the fibrovascular proliferation and the degree of fibrovascular proliferation was more marked in group II than group I. 3. The fibrovascular proliferation developed to a band in 3 weeks, then regressed gradually. 4. The fibrovascular band was composed of fibroblasts, stromal matrix and few vessels.

Experimental intraocular fibrovascular proliferation through sclerotomy wound

In the process of closing scleral wounds caused by various conditions, incarceration of conjunctiva, Tenon's capsule, or vitreous in the wound can occur unexpectedly. We created such conditions experimentally in order to discover their intraocular complications. The experimental materials consisted of 12 albino rabbits (24 eyes) divided into two groups (Groups I & II). Vitrectomy was performed in the Group I rabbits (12 eyes) but not in the Group II rabbits (12 eyes). Flaps of conjunctiva and Tenon's capsule were made and inserted into the vitreous cavity through the sclerotomy site, which was soon closed. Fundal examination of the rabbits was carried out using an indirect ophthalmoscope at intervals after the procedure; first at 3 days, then at 1, 3, and 6 weeks, and then at 3 months and 6 months, respectively. Enucleation of the rabbits' eyes 4 from two different rabbits at each of these intervals was carried out, and the extracted eyes were examined under a light microscope at each interval. The results are summarized as follows: 1. All rabbit eyes studied showed intraocular fibrovascular proliferation. 2. The extent of tissue proliferation, which was proportional to the amount of vitreous hemorrhage, was greater in Group II than in Group I. 3. The proliferated tissue developed to "band" by three weeks postexperiment, after which it gradually regressed. 4. The fibrovascular band was made of fibroblasts, stromal matrix, and capillaries.

Surgical correction of astigmatism using paired T-incisions

Transverse incision astigmatic keratotomy procedures were performed, combined with radial keratotomy, in 16 eyes for correction of astigmatism and coexisting myopia. We used a transverse incision technique in which T-incisions vertically intersected radial incisions of the steepest corneal meridian. After a mean follow-up period of 10 months with a range of six to 27 months, an average 1.92 diopters of the cylinder was corrected. In comparison with 2.11 diopters of the cylinder corrected at postoperative one day, there was a 22.8% decrease in the effect of astigmatism correction after a postoperative period averaging 10 months.

The clinical report on six cases of epikeratoplasty

After the first description of epikeratoplasty for the correction of aphakia by Kaufman in 1980, the application of epikeratoplasty has been extended further to the treatment of keratoconus and high myopia. Six epikeratoplasty for five eyes of high myopia and one eye of keratoconus were performed and followed up for an average of 4.9 months. All cases improved their uncorrected visual acuity, and the preoperative best corrected visual acuity improved or had no change postoperatively except for one case. In the cases of high myopia, the mean preoperative spherical equivalent of -19.4 D was corrected to an average -0.23 D with a range of -1.0 D to +2.5 D postoperatively. In the case of keratoconus, there was a mean decrease in 12.0 D of myopia in terms of the spherical equivalent, and the cornea was flattened by over 8 D in keratometry readings.

The Effect of Cryotherapy on Stage 3 Retinopathy of Prematurity

Sixteen eyes of 8 premature infants with stage 3 retinopathy of prematurity were treated with cryotherapy. Transconjunctival or transscleral cryotherapy was applied to the avascular retina with a cataract cryoprobe under general anesthesia. The mean follow up period was 8.2 months with a range of 4.5 to 14 months. Twelve(75%) of 16 treated eyes showed complete resolution of retinopathy of prematurity, while 4(25%) of 16 treated eyes showed cicticial change: 1 eye became cicatricial Grade I and 3 eyes Grade II.

The Effect of Cryotherapy on Stage 3 Retinopathy of Prematurity

Sixteen eyes of 8 premature infants with stage 3 retinopathy of prematurity were treated with cryotherapy. Transconjunctival or transscleral cryotherapy was applied to the avascular retina with a cataract cryoprobe under general anesthesia. The mean follow up period was 8.2 months with a range of 4.5 to 14 months. Twelve(75%) of 16 treated eyes showed complete resolution of retinopathy of prematurity, while 4(25%) of 16 treated eyes showed cicticial change: 1 eye became cicatricial Grade I and 3 eyes Grade II.