Analyses of Tangential Retinal Displacement and Metamorphopsia after Idiopathic Epiretinal Membrane Surgery

Purpose@#To evaluate the correlation between tangential retinal displacement and the improvement of metamorphopsia after idiopathic epiretinal membrane surgery. @*Methods@#The medical records of 36 eyes from 36 patients with idiopathic epiretinal membrane who underwent pars plana vitrectomy and who were observed over 1 year between January 2017 and December 2018 were retrospectively reviewed. Preand postoperative visual acuity, vertical and horizontal metamorphopsia score using the M-CHART, vertical and horizontal retinal displacement, and the presence of an ectopic inner foveal layer (EIFL) using optical coherence tomography were investigated. @*Results@#Postoperatively, the ratios of vertical and horizontal retinal displacement were 12.11 ± 12.04% and 8.09 ± 11.43%, respectively. The postoperative horizontal metamorphopsia score significantly improved (p = 0.019) compared to preoperatively and there were no significant differences in the vertical metamorphopsia score (p = 0.790). There were no significant correlations between the ratio of the vertical retinal displacement and improvement of horizontal metamorphopsia score or between the ratio of the horizontal retinal displacement and improvement of vertical metamorphopsia score. The preoperative horizontal metamorphopsia score was significantly higher in patients with EIFL than in patients without EIFL (p = 0.021) as was the postoperative horizontal metamorphopsia score (p = 0.016). In the EIFL group, the disappeared EIFL group had significantly lower postoperative vertical (p = 0.001) and horizontal (p < 0.001) metamorphopsia scores compared to the persistent EIFL group. @*Conclusions@#Postoperative retinal displacement was not correlated with improvement in metamorphopsia. However, the presence of preoperative EIFL and postoperative changes affect the severity of postoperative metamorphopsia.

Analyses of Tangential Retinal Displacement and Metamorphopsia after Idiopathic Epiretinal Membrane Surgery

Purpose@#To evaluate the correlation between tangential retinal displacement and the improvement of metamorphopsia after idiopathic epiretinal membrane surgery. @*Methods@#The medical records of 36 eyes from 36 patients with idiopathic epiretinal membrane who underwent pars plana vitrectomy and who were observed over 1 year between January 2017 and December 2018 were retrospectively reviewed. Preand postoperative visual acuity, vertical and horizontal metamorphopsia score using the M-CHART, vertical and horizontal retinal displacement, and the presence of an ectopic inner foveal layer (EIFL) using optical coherence tomography were investigated. @*Results@#Postoperatively, the ratios of vertical and horizontal retinal displacement were 12.11 ± 12.04% and 8.09 ± 11.43%, respectively. The postoperative horizontal metamorphopsia score significantly improved (p = 0.019) compared to preoperatively and there were no significant differences in the vertical metamorphopsia score (p = 0.790). There were no significant correlations between the ratio of the vertical retinal displacement and improvement of horizontal metamorphopsia score or between the ratio of the horizontal retinal displacement and improvement of vertical metamorphopsia score. The preoperative horizontal metamorphopsia score was significantly higher in patients with EIFL than in patients without EIFL (p = 0.021) as was the postoperative horizontal metamorphopsia score (p = 0.016). In the EIFL group, the disappeared EIFL group had significantly lower postoperative vertical (p = 0.001) and horizontal (p < 0.001) metamorphopsia scores compared to the persistent EIFL group. @*Conclusions@#Postoperative retinal displacement was not correlated with improvement in metamorphopsia. However, the presence of preoperative EIFL and postoperative changes affect the severity of postoperative metamorphopsia.

Changes in the Foveal Avascular Zone after Uncomplicated Cataract Surgery Based on Optical Coherence Tomography Angiography

Purpose@#To report changes in the foveal avascular zone (FAZ) after uncomplicated cataract surgery using optical coherence tomography (OCT) angiography. @*Methods@#The present study evaluated 39 eyes that underwent cataract surgery between April 2019 and June 2019. Central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were measured by OCT. The area of the FAZ in the superficial vascular complex (SVC) and deep vascular complex (DVC) were measured using OCT angiography. @*Results@#In all eyes, except for five with cystoid macular edema, there was a statistically significant change in the CMT over time (p < 0.0001), and the CMT at 1 month postoperatively was significantly thicker than the preoperative CMT (p = 0.005). The SFCT was significantly thicker at 1 week and 1 month postoperatively relative to the preoperative values (p < 0.0001 and p = 0.004, respectively). The FAZ area in the SVC and DVC decreased significantly at 1 week and 1 month postoperatively compared with the preoperative values (p < 0.0001 and p = 0.007, respectively). In the five eyes that developed cystoid macular edema, the area of the FAZ in the DVC showed a significant increase at 1 month postoperatively compared with the preoperative value (p = 0.028). @*Conclusions@#The FAZ area in the SVC and DVC decreased postoperatively, suggesting that cataract surgery may affect perfusion in the macula.

Predictors of Retinal Pigment Epithelial Tears in Exudative Macular Degeneration with High Pigment Epithelial Detachment

Purpose@#To evaluate the risk factors for retinal pigment epithelium (RPE) tear after intravitreal anti-vascular endothelial growth factor treatment in patients with exudative age-related macular degeneration, associated with high pigment epithelial detachment (PED) (>400 μm). @*Methods@#Fifty-five treatment-naive patients with high PED (>400 μm) and exudative age-related macular degeneration, treated with an initial series of 3 monthly loading injections between January 2013 and December 2017, were retrospectively included. @*Results@#The RPE tear rate was 16.4% (9/55). The areas affected by choroidal neovascularization and PED were significantly larger in the tear group compared with the no-tear group (p = 0.004, p = 0.029, respectively). The rate of intraretinal fluid (IRF) was 89% and 28% in the tear and no-tear groups, respectively (p = 0.001), and the subfoveal choroidal thickness was significantly thinner in the tear group (p = 0.003). There was no significant difference with respect to age, sex, laterality, underlying disease, baseline visual acuity, diagnosis, type of PED, or presence of subretinal fluid between the tear and no-tear groups. According to logistic regression analysis findings, the presence of IRF is associated with a higher risk of RPE tear (odds ratio = 20.3, p = 0.007). @*Conclusions@#The presence of IRF was associated with RPE tear development after intravitreal injection for exudative age-related macular degeneration.

Fibroepithelial Polyp on the Eyelid Margin: A Case Report

PURPOSE: Fibroepithelial polyps on the eyelid or orbit have not been previously reported in Korea. Herein, we report our experience with a case of a primary localized fibroepithelial polyp of the eyelid. CASE SUMMARY: A 78-year-old male patient presented with a round mass on the lower eyelid which has been noticed 1 week prior. There was no pain and no tenderness. The mass was removed and excisional biopsy was performed. Histopathologic examination revealed findings suggestive of a fibroepithelial polyp. There was no local recurrence during 4 months of follow-up. CONCLUSIONS: Fibroepithelial polyp should be considered when determining the type of eyelid mass.

A new 3, 4-epoxyfurocoumarin from Heracleum moellendorffii Roots

Activity-guided isolation of Heracleum moellendorffii roots led to four coumarin derivatives as acetylcholinesterase inhibitors. The structures of these isolates were characterized by spectroscopic method to be angelicin (1), isobergapten (2), pimpinellin (3), and (3S, 4R)-3, 4-epoxypimpinellin (4). All the isolated compounds 1, 2, 3, and 4 showed moderate inhibition activities against acetylcholinesterase with the IC₅₀ values of 10.2, 18.1, 21.5 and 22.9 µM, respectively. (3S, 4R)-3, 4-Epoxypimpinellin (4) was newly isolated from the plant source.

The Clinical Differences between Urgent Visits and Non-Urgent Visits in Emergency Department During the Neonatal Period

As neonates are brought to the emergency department (ED) for various complaints, it is challenging for emergency physicians to clinically determine the urgency of the visit. We sought to explore clinical characteristics associated with urgent visits to the ED. We conducted a retrospective study by reviewing medical records of neonatal visits to a tertiary pediatric regional emergency center for 5 years. Cases of patients who were discharged after checking only chest or abdominal X-ray or discharged without workup, were classified as non-urgent visits. Cases where more examinations were performed, or when the patient was hospitalized, were classified as urgent visits. Various clinical features and process in the ED were compared between the groups. Of the 1,008 cases enrolled in this study, 856 (84.9%) were urgent and 152 (15.1%) were non-urgent visits. After adjustment by multiple logistic regression analysis, non-urgent visits were associated with self-referrals rather than physician-referrals (odds ratio [OR], 5.96), visits in the evening rather than at night or daytime (OR, 2.51), patient visits from home rather than from medical facilities (OR, 2.19; 95). Fever and jaundice were the most common complaints (25.7% and 24.5%, respectively), and their OR of non-urgent visit was relatively low (adjusted OR 0.03 and 0.03, respectively). However, other common complaints, such as vomiting and cough (7.4% and 7.1%, respectively), were more likely to be non-urgent visits (adjusted OR 2.96 and 9.83, respectively). For suspected non-urgent visits, emergency physicians need to try to reduce unnecessary workup and shorten length of stay in ED.

A Case of Fungal Ball Causing Acute Dacryocystitis

PURPOSE: We report a case of fungal ball after Endoscopic Dacryocystorhinostomy (DCR) in a 40-year-old female patient. CASE SUMMARY: A 40-year-old female patient was admitted to our hospital for left lower eyelid tenderness and bloody discharge from the lacrimal punctum. During a planned endoscopic DCR, the sac was opened after the osteotomy, and 2 fungal balls were found in the lacrimal sac. The masses were 7 × 5 mm and, 9 × 5 mm sized, irregularly shaped, and red in color. Aspergillus fumigatus was diagnosed pathologically. Postoperative paranasal sinus magnetic resonance imaging showed no residual fungal ball. During follow-up, the patient showed patent rhinostomy opening, and there was no evidence of fungal infection on nasal endoscopic finding. CONCLUSIONS: Although Aspergillus fumigatus is a rare cause of canalicular obstruction, fungal ball development in the lacrimal sac can cause acute dacryocystitis.

Alternating and Relapsing Migratory Orbital Myositis

No abstract available.

Eyelid Mass as Initial Presentation of Breast Cancer: A Case Report

PURPOSE: We report a case in which eyelid mass was the initial presentation of breast cancer. The diagnosis of breast cancer was made after lid biopsy. CASE SUMMARY: A 41-year-old female patient presented with a painful mass on the left lower lid after 1 month. There was a pinkish mass in the lateral portion of the tarsal conjunctiva, and computed tomography revealed a mass with an irregular margin on the lower lid connected to the left lacrimal gland. Biopsy was performed at the tarsal conjunctiva of the left eye, and histopathologic examination was suggestive of malignant epithelial cell neoplasm, especially metastatic carcinoma in the breast. The patient was diagnosed as having invasive ductal cancer, for which she is currently receiving chemotherapy. CONCLUSIONS: Metastases to the eyelid are very rare, accounting for less than 1% of all malignant eyelid lesions. We report a patient who presented with an eyelid mass as the initial presentation of breast cancer, which was diagnosed with metastatic breast cancer.

Community mental health status six months after the Sewol ferry disaster in Ansan, Korea / 한국역학회지

OBJECTIVES: The disaster of the Sewol ferry that sank at sea off Korea's southern coast of the Yellow Sea on April 16, 2014 was a tragedy that brought grief and despair to the whole country. The aim of this study was to evaluate the mental health effects of this disaster on the community of Ansan, where most victims and survivors resided. METHODS: The self-administered questionnaire survey was conducted 4 to 6 months after the accident using the Korean Community Health Survey system, an annual nationwide cross-sectional survey. Subjects were 7,076 adults (≥19 years) living in two victimized communities in Ansan, four control communities from Gyeonggi-do, Jindo and Haenam near the accident site. Depression, stress, somatic symptoms, anxiety, and suicidal ideation were measured using the Center for Epidemiologic Studies-Depression Scale, Brief Encounter Psychosocial Instrument, Patient Health Questionnaire-15, and Generalized Anxiety Disorder 7-Item Scale, respectively. RESULTS: The depression rate among the respondents from Ansan was 11.8%, and 18.4% reported suicidal ideation. Prevalence of other psychiatric disturbances was also higher compared with the other areas. A multiple logistic regression analysis revealed significantly higher odds ratios (ORs) in depression (1.66; 95% confidence interval [CI], 1.36 to 2.04), stress (1.37; 95% CI, 1.10 to 1.71), somatic symptoms (1.31; 95% CI, 1.08 to 1.58), anxiety (1.82; 95% CI, 1.39 to 2.39), and suicidal ideation (1.33; 95% CI, 1.13 to 1.56) compared with Gyeonggi-do. In contrast, the accident areas of Jindo and Haenam showed the lowest prevalence and ORs. CONCLUSIONS: Residents in the victimized area of Ansan had a significantly higher prevalence of psychiatric disturbances than in the control communities.

The Change in Corneal Astigmatism after Cataract Surgery in Patients with Small Amount of Astigmatism

PURPOSE: To analyze the change in posterior corneal astigmatism and total corneal astigmatism in patients with anterior corneal astigmatism less than 1.0 diopter (D). METHODS: In the present study we evaluated 52 eyes with anterior corneal astigmatism less than 1.0 D. Patients were divided into 2 groups according to steep axis: Group 1 included 33 eyes with within-the-rule (WTR) astigmatism and Group 2 included 19 eyes with against-the-rule (ATR) astigmatism. Anterior, posterior and total corneal astigmatism were measured using Scheimpflug imaging (Pentacam(R)). RESULTS: In Group 1, preoperative anterior astigmatism, posterior astigmatism and total astigmatism were 0.55 +/- 0.44 D, 0.31 +/- 0.14 D and 0.30 +/- 0.72 D, respectively. At postoperative 2 months, anterior astigmatism, posterior astigmatism and total astigmatism were 0.51 +/- 0.67 D, 0.31 +/- 0.15 D and 0.35 +/- 0.81 D, respectively. There was no statistically significant difference between preoperative and postoperative anterior, posterior and total corneal astigmatism in Group 1. In Group 2, preoperative anterior astigmatism, posterior astigmatism and total astigmatism were -0.48 +/- 0.46 D, 0.26 +/- 0.09 D and -0.51 +/- 0.65 D, respectively. At postoperative 2 months, anterior astigmatism, posterior astigmatism and total astigmatism were -0.17 +/- 0.68 D, 0.25 +/- 0.13 D and -0.30 +/- 0.55 D, respectively. There was no statistically significant difference between preoperative and postoperative anterior, posterior and total corneal astigmatism in the 2 groups. There was no statistical correlation between preoperative posterior corneal astigmatism and postoperative 2 months total corneal astigmatism. After vector analysis, surgically induced astigmatism (SIA) of the anterior and total astigmatism in Group 1 were 0.03 D @ 30degrees and 0.07 D @ 74degrees, respectively, and in Group 2 were 0.27 D @ 100degrees and 0.36 D @ 86degrees, respectively. CONCLUSIONS: In patients with preoperative total corneal astigmatism less than 1.0 D, posterior corneal astigmatism had a small effect on postoperative total corneal astigmatism.

Effects of Smoking on Menopausal Age: Results From the Korea National Health and Nutrition Examination Survey, 2007 to 2012 / 예방의학회지

OBJECTIVES: Decreased fertility and impaired health owing to early menopause are significant health issues. Smoking is a modifiable health-related behavior that influences menopausal age. We investigated the effects of smoking-associated characteristics on menopausal age in Korean women. METHODS: This study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Menopausal age in relation to smoking was analyzed as a Kaplan-Meier survival curve for 11 510 women (aged 30 to 65 years). The risk of entering menopause and experiencing early menopause (before age 48) related to smoking were assessed using a Cox proportional hazards model. RESULTS: The menopausal age among smokers was 0.75 years lower than that among non-smokers (p<0.001). The results of the Cox proportional hazards model showed pre-correction and post-correction risk ratios for entering menopause related to smoking of 1.26 (95% confidence interval [CI], 1.09 to 1.46) and 1.27 (95% CI, 1.10 to 1.47), respectively, and pre-correction and post-correction risk ratios for experiencing early menopause related to smoking of 1.36 (95% CI, 1.03 to 1.80) and 1.40 (95% CI, 1.05 to 1.85), respectively. CONCLUSIONS: Smokers reached menopause earlier than non-smokers, and their risk for experiencing early menopause was higher.

A Family with Axenfeld-Rieger Syndrome: Report of the Clinical and Genetic Findings

PURPOSE: To describe clinical findings in a Korean family with Axenfeld-Rieger syndrome. METHODS: A retrospective review of clinical data about patients with diagnosed Axenfeld-Rieger syndrome. Five affected members of the family underwent a complete ophthalmologic examination. We screened the forkhead box C1 gene and the pituitary homeobox 2 gene in patients. Peripheral blood leukocytes and buccal mucosal epithelial cells were obtained from seven members of a family with Axenfeld-Rieger syndrome. DNA was extracted and amplified by polymerase chain reaction, followed by direct sequencing. RESULTS: The affected members showed iris hypoplasia, iridocorneal adhesions, posterior embryotoxon, and advanced glaucoma in three generation. None had systemic anomalies. Two mutations including c.1362_1364insCGG and c.1142_1144insGGC were identified in forkhead box C1 in four affected family members. CONCLUSIONS: This study may help to understand clinical findings and prognosis for patients with Axenfeld-Rieger syndrome.

Association of the RORA Gene Polymorphism and Seasonal Variations in Mood and Behavior / 수면정신생리

OBJECTIVES: Several evidence has been suggested that the circadian gene variants contribute to the pathogenesis of seasonal affective disorder. In this study, we aimed to investigate the polymorphism in RORA (Retinoid-related orphan receptor A) gene in relation to seasonal variations among healthy young adults in Seoul, Korea. METHODS: A total of 507 young healthy adult subjects were recruited by advertisement. Seasonal variations were assessed by the Seasonality Pattern Assessment Questionnaire (SPAQ). Single-nucleotide polymorphism in the RORA rs11071547 gene was genotyped by PCR in 507 individuals. Considering summer type as confounding factor, we conducted analysis 478 subjects except 29 subjects of summer type. The Chi-square test was conducted to compare differences between groups of seasonals and non-seasonals. Association between genotypes and Global Seasonality Score (GSS) were tested using ANCOVA (Analysis of covariance). RESULTS: In this sample, the prevalence of SAD was 12.1% (winter type 9.3%, summer type 2.8%). There is no significant difference in genotyping distribution of RORA rs11071547 between groups of seasonals and non-seasonals. Global seasonality score (GSS) and scores of all subscales except body weight and appetite were not significantly different between the group with C allele homozygote and the group with T allele homozygote and heterozygote (p-value 0.138). Scores of body weight and appetite were significantly higher in group with C allele homozygotes. CONCLUSION: These results suggest that RORA gene polymorphism play a role in seasonal variations in appetite and body weight and is associated with susceptibility to seasonal affective disorder in some degree in the population studied.

A study on Compliance in Self-Medication of Pulmonary Tuberculosis patients / 성인간호학회지

This study was made to identify compliance in self-medication, and factors influencing the self-medication of pulmonary TB patients. Self-medication of pulmonary TB patients is a very important factor for the cure of the patients. In this study, variables were used from three theories of health behavior. These were the Health Belief Model, Health Locus of Control, Theory of Planned Behavior. These were included to examine their effect on self-medication. Data were collected during the period from July 1 to August 20, 1994 using a structured questionnaire. And they were analyzed by mean, standard deviation, ANOVA, Pearson Correlation Coefficient, and Multiple Regression analysis using the SAS program. The result were as follows : 1. The mean on the self-medication scores ranging from 6.0 to 12.0 was 10.93. The mean for the self-evaluation scores of the self-medication ranging from 50.0 to 100.0 was 86.51. 2. There were significant associations between the scores on self-medication and age(F=2.34, p=0.033), and method of treatment(F=4.65, P=0.018). And there were significant associations between the self-evaluation scores of self-medication and age (F=3.79, P=0.000), and presence of TB patients among family(F=4.92, P=0.000). 3. (a) The relationship between the scores on self-medication and perceived barrier in health belief revealed a significant correlation(r=-.2046, p=0.0082). (b) The relationship between the scores on self-medication and other-dependency in LOC revealed a significant correlation(r=0.2322, p=0.0018). (c) The relationship between the self-evaluation score of self-medication and other-dependency in LOC revealed a significant correlation(r=0.1946, p=0.0122). (d) The relationship between the attitude in self-medication of the subjects and the self-evaluation score of self-medication revealed a significant correlation(r=0.2102, p=0.0066). 4. (a) 14.8% of the score of compliance in self-medication of the subjects was explained by five variables : Behavioral Intention, Duration of Treatment, Age, Perceived Sensitivity and Perceived Sensitivity and Perceived Barrier. (b) 8.7% of the score of self-evaluation of self-medication was explained by three variables : Perceived Control, Perceived Sensitivity, and Age. In conclusion : This study provides insights and information which may be valuable for motivation and instruction to improve compliance in self-medication among pulmonary TB patients.