Use of Salimeters and Sodium Reduction Education in School Foodservice in the Gyeonggi Area

This study used survey data to identify the use of salimeters and the prevalence of sodium reduction education in the Gyeonggi region. A survey with 211 dietitians working in school foodservice (106 in elementary schools, 69 in middle schools, and 36 in high schools) was conducted from August 6 to August 17, 2012. The data were analyzed using the SPSS program. Though 86.6% of school kitchens had salimeters, the rate for checking the sodium content of soup or stew was just 62.7% and the rate for checking the sodium content of kimchi and solid food was very low. Since salimeters are mostly used to measure sodium in liquid foods, it is urgent to provide an education and manual on using salimeters and to promote salimetry for kimchi and side dishes. It is also important to provide students with nutritional information by clearly posting the sodium content of food on menus and compelling students to notice them. Sodium reduction education for cooks was conducted in the 70.3% of the kitchens; however, the dietitians perceived that the cooks did not understand the importance of the education. Also, sodium reduction education for students was mostly provided through indirect methods, rather than face-to-face education, resulting in poor educational data (only 36.4% comprehending). By providing detailed guidelines for sodium reduction and labelling accurate content of sodium of the menus, we will be able to enforce practices for sodium reduction in school lunches.

Clinical Manifestations of Amblyopia in Siblings

PURPOSE: To evaluate the clinical characteristics of amblyopia between amblyopic siblings. METHODS: Siblings diagnosed with monocular amblyopia were included in the present study and were classified into older and younger groups according to age. All siblings were treated for amblyopia for at least three months. The age at diagnosis, type of amblyopia, and visual acuities of the amblyopic eye and sound eye were compared between the two groups. The therapeutic results were analyzed. RESULTS: The age at diagnosis of 13 sibling pairs was 4.7 +/- 1.6 and 3.8 +/- 1.6 years, a difference that was not statistically different (p = 0.169). Nine of 13 sibling pairs had the same type of amblyopia; anisometropic amblyopia in 7 pairs and strabismic amblyopia in 2 sibling pairs. There were no significant differences in the visual acuities of the amblyopic eye and sound eye at diagnosis. There were no differences in visual acuity or lines of improvement from baseline visual acuity in the amblyopic eye at the final follow-up. CONCLUSIONS: Age at diagnosis, cause of amblyopia, and visual acuities of the amblyopic and sound eyes were similar in siblings with monocular amblyopia. There was no difference in treatment results for amblyopia between siblings.

Comparison of Outcomes of Unilateral Lateral Rectus Recession for Exotropia between First and Second Operations

PURPOSE: To compare the outcomes of unilateral lateral rectus recession between the first operation and second operation for exotropia. METHODS: Thirty-two patients who underwent unilateral lateral rectus recession for exotropia of 15 to 20 prism diopters (PD) were investigated. The follow-up period was at least 6 months. We classified 17 patients without a surgical history for exotropia (first operation group) and 15 patients with a previous procedure (second operation group). Surgical success was defined as an exodeviation or esodeviation of less than 10 PD at the primary position. Postoperative deviation angles and success rates were compared between the two groups. RESULTS: There were no significant differences in the age, gender, visual acuity (logarithm of the minimal angle of resolution), preoperative deviation, and amount of recession between the two groups. Postoperative deviations were -1.7 +/- 5.5:1.3 +/- 5.1 PD at one day, 4.3 +/- 3.8:5.6 +/- 5.1 PD at 1 month, 4.3 +/- 4.3:3.0 +/- 8.1 PD at 3 months, and 5.0 +/- 4.3:4.5 +/- 7.2 PD at 6 months post-operation, and there was no statistically significant difference between the two study groups. Surgical success rate were 95.2:100% at one day, 95.2:92.9% at 1 month, 90.5:85.7% at 3 months, and 90.0:92.9% a 6 months post-operation. CONCLUSIONS: In patients with exotropia of 15 to 20 PD, no significant difference was found in terms of the postoperative deviation angle and the surgical success rate between the first operation and the second operation groups. Unilateral lateral rectus recession can lead to similar results in 15 to 20 PD exotropia for the first operation or recurrent exotropia.

Comparison of Outcomes of Unilateral Lateral Rectus Recession for Exotropia between First and Second Operations

PURPOSE: To compare the outcomes of unilateral lateral rectus recession between the first operation and second operation for exotropia. METHODS: Thirty-two patients who underwent unilateral lateral rectus recession for exotropia of 15 to 20 prism diopters (PD) were investigated. The follow-up period was at least 6 months. We classified 17 patients without a surgical history for exotropia (first operation group) and 15 patients with a previous procedure (second operation group). Surgical success was defined as an exodeviation or esodeviation of less than 10 PD at the primary position. Postoperative deviation angles and success rates were compared between the two groups. RESULTS: There were no significant differences in the age, gender, visual acuity (logarithm of the minimal angle of resolution), preoperative deviation, and amount of recession between the two groups. Postoperative deviations were -1.7 +/- 5.5:1.3 +/- 5.1 PD at one day, 4.3 +/- 3.8:5.6 +/- 5.1 PD at 1 month, 4.3 +/- 4.3:3.0 +/- 8.1 PD at 3 months, and 5.0 +/- 4.3:4.5 +/- 7.2 PD at 6 months post-operation, and there was no statistically significant difference between the two study groups. Surgical success rate were 95.2:100% at one day, 95.2:92.9% at 1 month, 90.5:85.7% at 3 months, and 90.0:92.9% a 6 months post-operation. CONCLUSIONS: In patients with exotropia of 15 to 20 PD, no significant difference was found in terms of the postoperative deviation angle and the surgical success rate between the first operation and the second operation groups. Unilateral lateral rectus recession can lead to similar results in 15 to 20 PD exotropia for the first operation or recurrent exotropia.

The Effect of Subconjunctival Injection of Bevacizumab After Resection of Muscle in Rabbit Models

PURPOSE: To study the effects of subconjunctival injection on the conjunctiva and muscles after muscle resection in a rabbit model. METHODS: Resection surgery of 5 mm was performed on both the superior rectus muscle (SR) and the inferior rectus muscle (IR) in five white rabbits. As such, 2.5 mg bevacizumab was subconjunctivally injected around the right SR and IR in the experimental group. The left eyes were not injected and were instead used as the control group. The degrees of injection and edema of conjunctiva were classified on a scale from 0 to 4 via gross examination by five examiners at two and four weeks after surgery. The strength of the muscle attachment was assessed, and the degrees of conjunctival inflammation and inflammation and fibrosis of the muscle were classified on a scale from 0 to 4 at four weeks after surgery via histologic examination. RESULTS: The results of gross examination at two and four weeks after surgery showed positive correlation among the five examiners (k=0.52, k=0.4), although there was no statistically significant difference between the experimental and control groups (p=0.285, p=0.364). There was also no significant difference between the two groups with regard to tensile strength of the attachment (p=0.414), inflammation of the conjunctiva and muscle, or fibrosis of the muscle in histologic examination (p=0.698, p=0.702, p=0.232, respectively). CONCLUSIONS: There were no significant effects on the inflammation and fibrosis of the conjunctiva or muscles due to subconjunctival injection of 2.5 mg of bevacizumab after muscle resection in a rabbit model.

The Comparison of Surgical Results Between Non-accommodative and Partially Accommodative Esotropia

PURPOSE: To examine the differences in surgical results between non-accommodative esotropia (NAE) and partially accommodative esotropia (PAE). METHODS: This retrospective study included 47 patients undergoing surgery for pediatric esotropia, defined as esotropia with a decrease in the deviated angle of greater than ten prism diopters (PD) upon administration of hyperopic spectacles. On the other hand, NAE was defined as esotropia with a decrease in the deviated angle of less than 10PD. We compared age at surgery, deviated angle at surgery, frequency of amblyopia, and deviated angle at each postoperative period in two groups. RESULTS: Twenty-nine patients belonged to the PAE group, and 18 patients belonged to the NAE group. The age at surgery in the PAE group was higher than that of the NAE group, and the deviated angle for surgical correction was smaller in the PAE group than in the NAE group. No statistically significant difference in the frequency of amblyopia presentation was found between the two groups. The surgical success rates were much higher in the PAE group at postoperative two years and at the final visit compared to those of the NAE group. CONCLUSIONS: In esotropic children who underwent surgery, the long-term surgical success rate was highest in the cases in which the esotropic angle was decreased by hyperopic correction.

Comparison of Part-time Occlusion Therapy and Intermittent Atropine Penalization Therapy for Amblyopic Children of School Age

PURPOSE: To compare the outcome of part-time occlusion therapy and intermittent atropine penalization therapy in amblyopic school-age patients. METHODS: In the present study, the authors retrospectively analyzed school-age amblyopic patients treated with part-time occlusion therapy (Group 1) and intermittent atropine penalization therapy (Group 2) as primary treatments. Age, visual acuity (logMAR) and interocular acuity differences at the beginning of treatment, cause of amblyopia, depth of amblyopia, and compliance for treatment were analyzed. Visual acuity and the lines of improvement from baseline visual acuity in the amblyopic eye were compared between the two groups with high compliance. RESULTS: The number of patients was 43 in Group 1 and 23 in Group 2. Age and the baseline visual acuity were not significantly different between Group 1 and Group 2. Group 2 had a higher level of compliance than did Group 1 (91.7; 63.4%), but there was no statistical difference between the groups (p=0.064). The visual acuity (logMAR, 0.27:0.05, p=0.020) and the lines of improvement of the amblyopic eye at the final follow-up (2.7:4.2 lines, p=0.010) were better in Group 1 than in Group 2 with high compliance. CONCLUSIONS: In amblyopic school-age children, part-time occlusion therapy could be conducted as primary treatment in cases with high compliance. Intermittent atropine penalization therapy can be attempted if there is low compliance in occlusion therapy.

Upper Lid Pilomatricoma: A Report of Four Cases

PURPOSE: Four patients who presented with an upper lid mass were diagnosed with pilomatricoma after excisional biopsy. We report the cases to improve the differential diagnoses of upper lid masses through investigation of the clinical manifestations and radiological findings of pilomatricoma. CASE SUMMARY: Three females and one male with ages of six, seven, eight and 46 years, respectively, each presented with a slowly growing and painless upper lid mass of a three-month duration. In the six-year-old patient who had a history of trauma related to the mass, the mass was fixed to the skin, although the masses were movable in the other patients. Upon computed tomography (CT), well-circumscribed, enhancing nodules were found. Excisional biopsy was performed for definite diagnosis and treatment. All completely excised masses were hard and encapsulated with a thin membrane. The sizes of the masses were 12 mm, 10 mm, 10 mm, and 7 mm. Histopathologic examination with hematoxylin-eosin staining confirmed the masses to be pilomatricoma. There was no evidence of recurrence at 16, 2, 19, and 21 months after mass excision. CONCLUSIONS: In patients presenting with a painless upper lid mass, pilomatricoma should be considered in the differential diagnosis.

Effect of Excision of Avascular Bleb and Advancement of Adjacent Conjunctiva for Treatment of Hypotony

PURPOSE: To evaluate the efficacy of excision of avascular bleb and advancement of adjacent conjunctiva (EBAC) for treatment of hypotony after trabeculectomy with mitomycin C (MMC). METHODS: Fifteen patients (17 eyes) who received EBAC for correction of hypotony between September 1996 and October 2008 were reviewed retrospectively. The main outcomes were intraocular pressure (IOP) and postoperative complications. RESULTS: Hypotony (IOP <6 mmHg) of eight eyes (47.1%, seven patients) was caused by bleb perforation. Of these, two eyes (two patients) had a history of trauma. Hypotony appeared at 33.9+/-30.8 months, and EBAC was performed at 48.2+/-35.3 months after trabeculectomy with MMC. The mean follow-up period was 38.3+/-29.8 months. The qualified success rate of EBAC was 100% at 51 months after EBAC, and the complete success rate of EBAC was 76.5% at six months and 70.6% at 51 months, as determined by Kaplan-Meier analysis. Post-EBAC complications included blepharoptosis in four eyes (23.5%) and bleb perforation in one (5.9%). The blepharoptosis resolved within one month after EBAC in two patients. However, in the other patients, mild blepharoptosis remained at 17 and 22 months postoperatively. CONCLUSIONS: EBAC was found to be an effective method for treatment of hypotony after trabeculectomy with MMC, and postoperative blepharoptosis was a major complication.