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Purpose@#To explore whether panretinal photocoagulation (PRP) improved retinal blood circulation in patients with diabetic retinopathy of various levels of severity based on changes in the retinal circulation time as measured by video fluorescein fundus angiography. @*Methods@#We recruited patients with severe diabetic retinopathy indicated for PRP; we performed video fluorescein fundus angiography before and after PRP. We measured changes in the arterial circulation time (ACT), arteriovenous passage time (APT), and venous filling time (VFT) in patients with diabetic retinopathy of varying severity, and compared the findings. We recorded HbA1c levels and hypertension status. @*Results@#We enrolled 33 patients, 17 with severe nonproliferative diabetic retinopathy (NPDR) and 16 with early proliferative diabetic retinopathy (PDR). After PRP, neither the ACT nor the APT changed significantly in patients with severe NPDR (p = 0.927, p = 0.138) or early PDR (p = 0.137, p = 0.268). After PRP, the VFT was significantly reduced in patients with both severe NPDR (p = 0.000) and early PDR (p = 0.022). The VFT reductions were similar in both groups (p = 0.217). @*Conclusions@#In patients with severe NPDR and early PDR, improvements in retinal blood circulation after PRP are reflected by reductions in the VFT evident on video fluorescein fundus angiography. We speculate that the improvements are similar in patients with severe NPDR and early PDR.
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Background@#To suggest measures to prevent burnout of physicians during the coronavirus disease 2019 (COVID-19) pandemic, we conducted a systematic review of research on physician burnout due to COVID-19. @*Methods@#Three foreign databases were used: MEDLINE, Embase, and the Cochrane Library. A search was performed using the following search terms: COVID-19, coronavirus, NCOV, physicians, doctors, residents, and burnout. Four rounds of review were performed to enhance the consistency of quality assessment. The Joanna Briggs Institute checklist for analytical cross-sectional studies was used to assess the quality of the eligible studies. @*Results@#A total of 465 studies were identified, of which 32 were selected. The quality assessment determined that 19 studies met the Joanna Briggs Institute criteria and had a low risk of bias. The most common tool used to measure physician burnout in the 32 studies was the Maslach Burnout Inventory. @*Conclusion@#This study systematically evaluated the literature on physician burnout. However, the generalizability of our findings to Korean physicians may be limited. The composition of the medical personnel in Korea, such as open doctors, volunteer doctors, medical professors, and public health doctors, differs significantly from that of other countries. Nevertheless, evaluating the current status of physician burnout due to COVID-19 globally may hold meaningful implications for policymaking.
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Purpose@#To explore whether panretinal photocoagulation (PRP) improved retinal blood circulation in patients with diabetic retinopathy of various levels of severity based on changes in the retinal circulation time as measured by video fluorescein fundus angiography. @*Methods@#We recruited patients with severe diabetic retinopathy indicated for PRP; we performed video fluorescein fundus angiography before and after PRP. We measured changes in the arterial circulation time (ACT), arteriovenous passage time (APT), and venous filling time (VFT) in patients with diabetic retinopathy of varying severity, and compared the findings. We recorded HbA1c levels and hypertension status. @*Results@#We enrolled 33 patients, 17 with severe nonproliferative diabetic retinopathy (NPDR) and 16 with early proliferative diabetic retinopathy (PDR). After PRP, neither the ACT nor the APT changed significantly in patients with severe NPDR (p = 0.927, p = 0.138) or early PDR (p = 0.137, p = 0.268). After PRP, the VFT was significantly reduced in patients with both severe NPDR (p = 0.000) and early PDR (p = 0.022). The VFT reductions were similar in both groups (p = 0.217). @*Conclusions@#In patients with severe NPDR and early PDR, improvements in retinal blood circulation after PRP are reflected by reductions in the VFT evident on video fluorescein fundus angiography. We speculate that the improvements are similar in patients with severe NPDR and early PDR.
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Background@#To suggest measures to prevent burnout of physicians during the coronavirus disease 2019 (COVID-19) pandemic, we conducted a systematic review of research on physician burnout due to COVID-19. @*Methods@#Three foreign databases were used: MEDLINE, Embase, and the Cochrane Library. A search was performed using the following search terms: COVID-19, coronavirus, NCOV, physicians, doctors, residents, and burnout. Four rounds of review were performed to enhance the consistency of quality assessment. The Joanna Briggs Institute checklist for analytical cross-sectional studies was used to assess the quality of the eligible studies. @*Results@#A total of 465 studies were identified, of which 32 were selected. The quality assessment determined that 19 studies met the Joanna Briggs Institute criteria and had a low risk of bias. The most common tool used to measure physician burnout in the 32 studies was the Maslach Burnout Inventory. @*Conclusion@#This study systematically evaluated the literature on physician burnout. However, the generalizability of our findings to Korean physicians may be limited. The composition of the medical personnel in Korea, such as open doctors, volunteer doctors, medical professors, and public health doctors, differs significantly from that of other countries. Nevertheless, evaluating the current status of physician burnout due to COVID-19 globally may hold meaningful implications for policymaking.
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Purpose@#Duchenne muscular dystrophy (DMD) is the most common lethal muscular dystrophy and is caused by the genetic variants of DMD gene. Because DMD is X-linked recessive and shows familial aggregates, prenatal diagnosis is an important role in the management of DMD family. We present our experience of prenatal molecular diagnosis and carrier detection based on multiplex polymerase chain reaction (PCR), multiplex ligation-dependent probe amplification (MLPA), and linkage analysis. @*Materials and Methods@#During study period, 34 cases of prenatal diagnosis and 21 cases of carrier detection were performed at the Seoul National University Hospital. Multiplex PCR and MLPA was used to detect the exon deletions or duplications. When the DMD pathogenic variant in the affected males is unknown and no DMD pathogenic variant is detected in atrisk females, linkage analysis was used. @*Results@#The prenatal molecular diagnosis was offered to 34 fetuses. Twenty-five fetuses were male and 6 fetuses (24.0%) were affected. Remaining cases had no pathogenic mutation. We had 24 (80.0%) cases of known proband results; exon deletion mutation in 19 (79.2%) cases and duplication in 5 (20.8%) cases. Linkage analysis was performed in 4 cases in which 2 cases (50.0%) were found to be affected. In the carrier testing, among 21 cases including 15 cases of mother and 6 cases of female relative, 9 (42.9%) cases showed positive results and 12 (57.1%) cases showed negative results. @*Conclusion@#Prenatal molecular diagnosis and carrier detection of DMD are effective and feasible. They are useful in genetic counseling for DMD families.
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The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is increasing globally. However, a few studies have addressed their epidemiology in Seoul, Korea. In this study, we conducted one-year surveillance of CRE among 1,468 clinical isolates of Enterobacteriaceae at the hospital in Seoul with molecular characterization of carbapenemase genes. About 85% of CRE-positive samples were isolated from the elderly age group (above 60 years). The most common isolated organisms were Klebsiella pneumoniae (K. pneumoniae) (56.5%) and Escherichia coli (E.coli) (17.0%). We detected six different Carbapenemase-producing Enterobacteriaceae (CPE) of blaKPC, blaNDM, blaOXA, blaVIM, blaIMP, and blaGES alone or in combination with other bla genes. Typically, 853 (58.1%) isolates were tested positive for at least one CPE. KPC (K. pneumoniae carbapenemase)-2 was the most common CPE type (46.0%) followed by NDM (New Delhi metallo-β-lactamase)-1 (5.9%). KPC-2 was most commonly found in K. pneumoniae (494/676 isolates [73.1%]) and E.coli (107/676 isolates [15.8%]), whereas NDM-1 was commonly found in Enterobacter cloacae complex (20/86 isolates [23.3%]). Detailed information and molecular characteristics of CPE is essential to prevent the spread of these pathogens.
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Purpose@#To compare the visual outcomes and corneal aberrations between wavefront-optimized (WFO) and corneal wavefront-guided (WFG) photorefractive keratectomy (PRK) in low to moderate myopia. @*Methods@#Twenty-seven eyes treated with WFO and 29 eyes treated with WFG PRK using a Schwind Amaris 750S Excimer laser were included after 6 months of postoperative follow-up. Uncorrected distance visual acuity, corrected distance visual acuity, refractive errors, corneal higher-order aberrations (HOA) and corneal thickness obtained using a Scheimpflug system, and central ablation depth and volume were evaluated during the preoperative period and again at the postoperative 6-month visits. @*Results@#Postoperatively, uncorrected distance visual acuity, corrected distance visual acuity, manifest spherical equivalent, and refractive astigmatism were improved in both groups, and there was no statistically significant difference between the two groups. There was no significant difference in safety, efficacy, or predictability of the refractive outcome. Postoperative total corneal HOA root mean square (RMS), coma RMS, and spherical aberration were significantly increased in both groups. Among these, only spherical aberration showed a significant difference between the two groups, with greater increase in the WFO group at 6 months postoperatively. The changes in corneal HOA RMS and spherical aberration were smaller in the WFG group, and this benefit was marked in eyes with high HOA RMS (≥0.4 μm) and spherical aberration (≥0.2 μm). Even though ablation volume in the WFG group was much larger than that of the WFO group, there was no significant difference in postoperative central and peripheral corneal thickness between the two groups. @*Conclusions@#Both WFO and WFG PRK using a Schwind Amaris 750S laser for low to moderate myopia were safe and effective at improving visual and refractive outcomes. However, WFG PRK induced fewer spherical aberrations than WFO PRK and may be more advantageous for eyes with high HOA root mean square or spherical aberration.
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A 57-year-old man presented with a tender, solitary, 0.3 cm-sized, subdermal nodule on the left periocular area for several months. He had surgery three times for recurrent primary mucinous eccrine adenocarcinoma on the right periocular area. Skin biopsy showed a tumor separated by strands of fibrous tissue and small compartments of tumor cells were surrounded by pale-staining mucin. The cluster of tumor cells contained atypical epithelial cells. The mucin stained with periodic acid-Schiff (PAS) and alcian blue at pH 2.5. Cytokeratin-7 (CK7) was positive for tumor cells, but cytokeratin-20 (CK20) and S-100 were negative. For evaluation of local metastasis, computed tomography was performed and there was no evidence of regional lymph node metastasis. The lesion was removed by local excision and the patient was under close follow up without any sign of recurrence. To our knowledge, double primary mucinous eccrine adenocarcinomas in the opposite body site has never been reported.
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Hypotonia, Ataxia, and Delayed Development Syndrome (HADDS) is an autosomal-dominant, extremely rare neurodevelopmental disorder caused by the heterozygous EBF3 gene mutation. EBF3 is located on chromosome 10q26.3 and acts as a transcription factor that regulates neurogenesis and differentiation. This syndrome is characterized by dysmorphism, cerebellar hypoplasia, urogenital anomaly, hypotonia, ataxia, intellectual deficit, and speech delay. The current report describes a 3-year-old Korean male carrying a de novo EBF3 mutation, c.589A>G (p.Asn197Asp), which was identified by whole exome sequencing. He manifested facial dysmorphism, hypotonia, strabismus, vermis hypoplasia, and urogenital anomalies, including vesicoureteral reflux, cryptorchidism, and areflexic bladder. This is the first report of a case of HADDS cause by an EBF3 mutation in the Korean population.
ABSTRACT
Hypotonia, Ataxia, and Delayed Development Syndrome (HADDS) is an autosomal-dominant, extremely rare neurodevelopmental disorder caused by the heterozygous EBF3 gene mutation. EBF3 is located on chromosome 10q26.3 and acts as a transcription factor that regulates neurogenesis and differentiation. This syndrome is characterized by dysmorphism, cerebellar hypoplasia, urogenital anomaly, hypotonia, ataxia, intellectual deficit, and speech delay. The current report describes a 3-year-old Korean male carrying a de novo EBF3 mutation, c.589A>G (p.Asn197Asp), which was identified by whole exome sequencing. He manifested facial dysmorphism, hypotonia, strabismus, vermis hypoplasia, and urogenital anomalies, including vesicoureteral reflux, cryptorchidism, and areflexic bladder. This is the first report of a case of HADDS cause by an EBF3 mutation in the Korean population.
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No abstract available.
Subject(s)
Animals , Alopecia Areata , Alopecia , Lasers, Excimer , Models, AnimalABSTRACT
To date, hundreds of fungal genomes have been sequenced, and many more are underway. Recently developed cutting-edge techniques generate very large amounts of data, and the field of fungal genomics in dermatology has consequently evolved substantially. Methodological improvements have broadened the scope of large-scale ecological studies in dermatology, including biodiversity assessments and genomic identification of fungi. Here, we aimed to provide a brief introduction to bioinformatic approaches to fungal genomics in the field of dermatology. We described the history and basic concepts of fungal genomics and presented sequencing-based techniques for fungal identification, including a list of the revised taxa of dermatophytes, as determined by current phylogenetic analysis. Finally, we discussed the emerging trends in fungal genomics in dermatology, such as next-generation sequencing.
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PURPOSE: This study evaluated the effects of personalized nutrition intervention for increasing hospital meal intake by elderly patients with malnutrition. METHODS: The subjects were 30 elderly patients with malnutrition who visited a general hospital located in Daegu. An individual nutrition intervention such as change of meal types or special meal service was given to the patients according to nutrition diagnosis related to inadequate intake of hospital meals. Nutritional intake status of the subjects was assessed by analyzing energy intake, protein intake, index of nutritional quality (INQ), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR). RESULTS: The causes of inadequate intake in the subjects were poor appetite or preference problems (46.7%), symptom-related problems (30.0%) and mastication problems (23.3%). The INQ of protein in the subjects was significantly increased from 0.81 ±0.17 to 1.41 ±0.25 after the nutrition intervention (p < 0.05). The NAR of protein (before 0.50 ±0.21, after 0.58 ±0.17), iron (before 0.72 ±0.30, after 0.84 ±0.29) and vitamin B2 (before 0.31 ±0.16, after 0.37 ±0.14) was also increased after the nutrition intervention (p < 0.05). The MAR of five nutrients, protein, calcium, iron, vitamin A and vitamin B2, was significantly increased by the nutrition intervention (p < 0.05). CONCLUSION: Personalized nutrition intervention according to nutrition diagnosis related to inadequate intake of hospital meals may improve the intake amount of elderly patients with malnutrition.
Subject(s)
Aged , Humans , Appetite , Calcium , Diagnosis , Energy Intake , Hospitals, General , Iron , Malnutrition , Mastication , Meals , Nutritive Value , Riboflavin , Vitamin AABSTRACT
An intrathyroid thyroglossal duct cyst (TGDC) presented as an anterior neck mass in a 62-year-old male without history of prior thyroid disease or infection. This cyst was clinically indistinguishable from a thyroid nodule. In addition to that, fine needle aspiration cytology revealed normal–looking squamous cells. Diagnosis, work-up, management approach, and treatment of intrathyroid TGDC are discussed as well as distinguishing features between intrathyrod TGDC with tract and without tract. This is the very rare case of intrathyroid TGDC in Korean population and the possibility of intrathyroid TGDC should remain in the differential diagnosis of thyroid nodule.
Subject(s)
Humans , Male , Middle Aged , Biopsy, Fine-Needle , Diagnosis , Diagnosis, Differential , Epithelial Cells , Neck , Thyroglossal Cyst , Thyroid Diseases , Thyroid Gland , Thyroid NoduleABSTRACT
Sweet syndrome (acute, febrile, neutrophilic dermatosis) is characterized by the acute onset of an eruption of painful nodules or erythematous or violaceous plaques on the limbs, face and neck. These symptoms are accompanied by fever. The diagnostic features include histopathological findings of dermal neutrophilic infiltration without leukocytoclastic vasculitis or peripheral blood leukocytosis. Sweet syndrome is associated with infection, malignancies, autoimmune disease, pregnancy, and drugs. Patients with Sweet syndrome demonstrate a complete and rapid response to systemic steroid administration. Recently, a distinct variant of Sweet syndrome was reported, termed “histiocytoid Sweet syndrome”, in which the infiltration of myeloperoxidase-positive histiocytoid mononuclear cells are observed (in contrast to the infiltration of neutrophils). The other clinical features are similar to those of classic Sweet syndrome. Pediatric Sweet syndrome is uncommon, and the histiocytoid type is even rarer. To date, four cases of histiocytoid Sweet syndrome have been reported in children. Herein, we describe a case of histiocytoid Sweet syndrome in an otherwise healthy 10-year-old boy with no underlying systemic disease in whom non-steroidal, anti-inflammatory drug treatment was successful.
Subject(s)
Child , Humans , Male , Pregnancy , Autoimmune Diseases , Extremities , Fever , Leukocytosis , Neck , Neutrophils , Peroxidase , Sweet Syndrome , VasculitisABSTRACT
Acne fulminans (AF) is a rare severe form of acne associated with systemic symptoms. It primarily affects male adolescents and is clinically characterized by painful ulcerative nodules on the face, chest, and back. The associated systemic symptoms, such as fever, myalgia, and arthralgia, are usually present at the onset. The etiology of AF remains unknown, but there are many theories, such as increased androgens, autoimmune complex disease, and genetic predisposition. Treatment can be challenging because its response to traditional acne therapies is poor. A combination of oral steroids and isotretinoin is the most recommended treatment. Herein, we report a case of a 16-year-old Korean man with acne fulminans presenting with tender, hemorrhagic, crusted, inflammatory nodules on the upper chest, which occurred after isotretinoin use. After treatment with oral isotretinoin and pulsed dye laser for 23 weeks, most of the lesions healed leaving some scars.
Subject(s)
Adolescent , Humans , Acne Vulgaris , Androgens , Arthralgia , Cicatrix , Fever , Genetic Predisposition to Disease , Isotretinoin , Lasers, Dye , Myalgia , Steroids , Thorax , UlcerABSTRACT
PURPOSE: We present clinical results of the use of the multipurpose conical porous synthetic orbital implant (MCOI) in surgical procedures of evisceration, enucleation, and secondary enucleation in ophthalmology patients. METHODS: A retrospective review was performed of 59 eyes in which conical implants were used, including 36 cases of eviscerations, 11 enucleations, and 9 secondary enucleations. In all of the cases, the follow-up period was greater than six months between 2004 and 2013. The results focus on documenting surgical findings, as well as postoperative complications among patients. RESULTS: Superior sulcus deformities were found in six eyes (10.2% of conical implant patients), and two eyes received additional surgical interventions to correct the deformities (3.4%). Blepharoptosis was found in four eyes (6.8%), two of which received upper eyelid blepharoplasty (3.4%). Fornix shortening was reported in only one eye (1.7%). Forty-one eyes had a satisfactory cosmetic appearance after the final prosthetic fitting of conical implants (69.5%). The most frequent postoperative complication was orbital implant exposure, which seemed to occur when the preoperative status of the conjunctiva, Tenon's capsule, and sclera preservation were poor in the eyes of the patients. CONCLUSIONS: There was a lower incidence of blepharoptosis and fornix shortening with the MCOI in comparison to spherical implants, while the incidence of orbital implant exposure was similar with the MCOI in comparison to other types of orbital implants. In addition, the MCOI may have advantages with respect to postoperative cosmetic outcomes.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Eye Diseases/surgery , Eye Enucleation , Eye Evisceration , Follow-Up Studies , Incidence , Orbital Implants , Postoperative Complications/epidemiology , Prosthesis Implantation/methods , Republic of Korea/epidemiology , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
Sarcopenia is a major component of age-related frailty and also a strong predictor of disability, morbidity, and mortality in the aging population. Resistance exercise could be the most effective intervention that improves muscle mass, muscle strength, and physical performance, thus preventing sarcopenia in older adults. The benefits of these exercise programs correlate with the intensity and the frequency of the exercise regimes used in the trials. Clinical trials vary in terms of population, setting, and exercise regimes; hence, more standardized clinical trials are required. In this review, we focus on the effects of resistance exercise on muscle mass, strength, cognitive and physical function, and the principle and applications of resistance exercise considering recent trends that include high-intensity interval training, high speed power training, eccentric exercise, and whole-body vibration exercise.
Subject(s)
Adult , Aged , Humans , Aging , Frail Elderly , Mortality , Muscle Strength , Sarcopenia , VibrationABSTRACT
Localized Darier's disease (DD) is a rare variant of DD. The disease is characterized by multiple hyperkeratotic papules in a unilateral, linear, zosteriform or Blaschkoid distribution with the histological features of classical DD. Unlike DD, which presents as a generalized condition, localized DD lacks family history and other clinical findings suggestive of DD such as distinctive nail abnormalities and keratotic papules on the palms and soles. Herein, we describe a case of localized DD in a 31-year old Korean man on the perianal area that was treated with topical retinoid cream.