Workload of Healthcare Workers During the COVID-19 Outbreak in Korea: A Nationwide Survey

Background@#As the coronavirus disease 2019 (COVID-19) pandemic is ongoing, heavy workload of healthcare workers (HCWs) is a concern. This study investigated the workload of HCWs responding to the COVID-19 outbreak in South Korea. @*Methods@#A nationwide cross-sectional survey was conducted from September 16 to October 15, 2020, involving 16 healthcare facilities (4 public medical centers, 12 tertiary-care hospitals) that provide treatment for COVID-19 patients. @*Results@#Public medical centers provided the majority (69.4%) of total hospital beds for COVID-19 patients (n = 611), on the other hand, tertiary care hospitals provided the majority (78.9%) of critical care beds (n = 57). The number of beds per doctor (median [IQR]) in public medical centers was higher than in tertiary care hospitals (20.2 [13.0, 29.4] versus 3.0 [1.3, 6.6], P = 0.006). Infectious Diseases physicians are mostly (80%) involved among attending physicians. The number of nurses per patient (median [interquartile range, IQR]) in tertiarycare hospitals was higher than in public medical centers (4.6 [3.4–5] vs. 1.1 [0.8–2.1], P =0.089). The median number of nurses per patient for COVID-19 patients was higher than the highest national standard in South Korea (3.8 vs. 2 for critical care). All participating healthcare facilities were also operating screening centers, for which a median of 2 doctors, 5 nurses, and 2 administrating staff were necessary. @*Conclusion@#As the severity of COVID-19 patients increases, the number of HCWs required increases. Because the workload of HCWs responding to the COVID-19 outbreak is much greater than other situations, a workforce management plan regarding this perspective is required to prevent burnout of HCWs.

Clinical Features of Adult COVID-19 Patients without Risk Factors before and after the Nationwide SARSCoV-2 B.1.617.2 (Delta)-variant Outbreak in Korea: Experience from Gyeongsangnam-do

Background@#Data on severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) delta variant virulence are insufficient. We retrospectively compared the clinical features of adult coronavirus disease 2019 (COVID-19) patients without risk factors for severe COVID-19 who entered residential treatment centers (RTCs) before and after the delta variant outbreak. @*Methods@#We collected medical information from two RTCs in South Korea. On the basis of nationwide delta variant surveillance, we divided the patients into two groups: 1) the delta-minor group (diagnosed from December 2020–June 2021, detection rate 90%). After propensity-score matching, the incidences of pneumonia, hospital transfer and need for supplemental oxygen were compared between the groups. In addition, risk factors for hospital transfer were analysed. @*Results@#A total of 1,915 patients were included. The incidence of pneumonia (14.6% vs.9.2%, P = 0.009), all-cause hospital transfer (10.4% vs. 6.3%, P = 0.020) and COVID-19-related hospital transfer (7.5% vs. 4.8%, P = 0.081) were higher in the delta-dominant group than those in the delta-minor group. In the multivariate analysis, the delta-dominant group was an independent risk factor for all-cause (adjusted odds ratio [aOR], 1.91; 95% confidence interval [CI], 1.16–3.13; P = 0.011) and COVID-19-related hospital transfer (aOR, 1.86; 95% CI, 1.04–3.32; P = 0.036). @*Conclusion@#Hospitalization rates were increased in the adult COVID-19 patients during the delta variant nationwide outbreak. Our results showed that the delta variant may be more virulent than previous lineages.

Diagnostic Yield of Diffusion-Weighted Brain Magnetic Resonance Imaging in Patients with Transient Global Amnesia: A Systematic Review and Meta-Analysis

Objective@#To investigate the diagnostic yield of diffusion-weighted imaging (DWI) in patients with transient global amnesia (TGA) and identify significant parameters affecting diagnostic yield. @*Materials and Methods@#A systematic literature search of the MEDLINE and EMBASE databases was conducted to identify studies that assessed the diagnostic yield of DWI in patients with TGA. The pooled diagnostic yield of DWI in patients with TGA was calculated using the DerSimonian-Laird random-effects model. Subgroup analyses were also performed of slice thickness, magnetic field strength, and interval between symptom onset and DWI. @*Results@#Twenty-two original articles (1732 patients) were included. The pooled incidence of right, left, and bilateral hippocampal lesions was 37% (95% confidence interval [CI], 30–44%), 42% (95% CI, 39–46%), and 25% (95% CI, 20–30%) of all lesions, respectively. The pooled diagnostic yield of DWI in patients with TGA was 39% (95% CI, 27–52%). The Higgins I2 statistic showed significant heterogeneity (I2 = 95%). DWI with a slice thickness ≤ 3 mm showed a higher diagnostic yield than DWI with a slice thickness > 3 mm (pooled diagnostic yield: 63% [95% CI, 53–72%] vs. 26% [95% CI, 16–40%], p 24 to 96 hours could increase the diagnostic yield.

Late Gadolinium Enhancement of Left Ventricular Papillary Muscles in Patients with Mitral Regurgitation

Objective@#Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. @*Materials and Methods@#This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. @*Results@#LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01–1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29–36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. @*Conclusion@#LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.

Diagnostic Yield of Diffusion-Weighted Brain Magnetic Resonance Imaging in Patients with Transient Global Amnesia: A Systematic Review and Meta-Analysis

Objective@#To investigate the diagnostic yield of diffusion-weighted imaging (DWI) in patients with transient global amnesia (TGA) and identify significant parameters affecting diagnostic yield. @*Materials and Methods@#A systematic literature search of the MEDLINE and EMBASE databases was conducted to identify studies that assessed the diagnostic yield of DWI in patients with TGA. The pooled diagnostic yield of DWI in patients with TGA was calculated using the DerSimonian-Laird random-effects model. Subgroup analyses were also performed of slice thickness, magnetic field strength, and interval between symptom onset and DWI. @*Results@#Twenty-two original articles (1732 patients) were included. The pooled incidence of right, left, and bilateral hippocampal lesions was 37% (95% confidence interval [CI], 30–44%), 42% (95% CI, 39–46%), and 25% (95% CI, 20–30%) of all lesions, respectively. The pooled diagnostic yield of DWI in patients with TGA was 39% (95% CI, 27–52%). The Higgins I2 statistic showed significant heterogeneity (I2 = 95%). DWI with a slice thickness ≤ 3 mm showed a higher diagnostic yield than DWI with a slice thickness > 3 mm (pooled diagnostic yield: 63% [95% CI, 53–72%] vs. 26% [95% CI, 16–40%], p 24 to 96 hours could increase the diagnostic yield.

Late Gadolinium Enhancement of Left Ventricular Papillary Muscles in Patients with Mitral Regurgitation

Objective@#Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. @*Materials and Methods@#This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. @*Results@#LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01–1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29–36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. @*Conclusion@#LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.

Sinus of Valsalva Thrombosis Detected on Computed Tomography after Transcatheter Aortic Valve Replacement

Background and Objectives@#Leaflet thrombosis after transcatheter aortic valve replacement (TAVR) has been reported recently, whereas thrombus formation in sinus of Valsalva has yet to be fully evaluated. This study describes clinical and cardiac computed tomography (CT) findings of patients with sinus of Valsalva thrombosis. @*Methods@#Between March 2011 and Aug 2019, 192 patients underwent cardiac CT after TAVR. After a retrospective review of CT images, 9 patients (82 years, male:female=2:7) who had sinus of Valsalva thrombosis identified by cardiac CT were selected for this study. Patient demographics, interval between TAVR and cardiac CT scan, location and CT attenuation of sinus of Valsalva thrombosis, and presence of concurrent leaflet thrombosis were evaluated. @*Results@#The median interval between TAVR and cardiac CT was 11 days. Sinus of Valsalva thrombosis was frequently detected in the non-coronary sinus (89%, 8/9), and predominantly located in the bottom of the sinus extending upward towards the sinotubular junction. Three patients had concomitant leaflet thrombosis, and 3 patients had subclinical embolic stroke noted on brain magnetic resonance imaging. All patients had been prescribed aspirin and clopidogrel after TAVR for at least 6 months without anticoagulants. @*Conclusions@#Cardiac CT after TAVR can detect sinus of Valsalva thrombosis, and attention should be paid to this potential source of subsequent systemic embolization.

Rapid detection of deformed wing virus in honeybee using ultra-rapid qPCR and a DNA-chip

Rapid detection of deformed wing virus in honeybee using ultra-rapid qPCR and a DNA-chip

Fast and accurate detection of viral RNA pathogens is important in apiculture. A polymerase chain reaction (PCR)-based detection method has been developed, which is simple, specific, and sensitive. In this study, we rapidly (in 1 min) synthesized cDNA from the RNA of deformed wing virus (DWV)-infected bees (Apis mellifera), and then, within 10 min, amplified the target cDNA by ultra-rapid qPCR. The PCR products were hybridized to a DNA-chip for confirmation of target gene specificity. The results of this study suggest that our method might be a useful tool for detecting DWV, as well as for the diagnosis of RNA virus-mediated diseases on-site.

Effects of Positive Psychological Capital, Reward on Retention Intention of Hospital Nurses / 간호행정학회지

Purpose@#This study is conducted in order to identify a positive psychological capital and rewards as variables in relation to the retention intention of hospital nurses. @*Methods@#The participants were consisted of 350 nurses with 6 months or more of total work experience in 1 senior general hospital and 2 general hospitals in Incheon and individual data were collected from July 22 to August 10. 2019. Collected data was analyzed by t-test, ANOVA, Pearson's Correlation Coefficient, and Multiple Regression Analysis using IBM SPSS statistics 24.0. @*Results@#It was confirmed that the factors affecting the retention intention were never had any resignation impulse' in the past year (β=.11,p=.023), positive psychological capital (β=.43, p<.001), privileged rewards (β=.25, p<.001), monetary rewards (β= -.20, p=.001), and job rewards (β=-.15, p=.039) and the explanatory power of the model was 27.8%. @*Conclusion@#Based on the result of this study, it is suggested to develop educational and training programs whose aim is to enhance the positive psychological capital. Moreover, it will be to promote retention intention of nurses and to extend the tenure through the proper reward system that meets the duty and ability, by which nurses realize that they are rewarded.

Rapid detection of deformed wing virus in honeybee using ultra-rapid qPCR and a DNA-chip

Fast and accurate detection of viral RNA pathogens is important in apiculture. A polymerase chain reaction (PCR)-based detection method has been developed, which is simple, specific, and sensitive. In this study, we rapidly (in 1 min) synthesized cDNA from the RNA of deformed wing virus (DWV)-infected bees (Apis mellifera), and then, within 10 min, amplified the target cDNA by ultra-rapid qPCR. The PCR products were hybridized to a DNA-chip for confirmation of target gene specificity. The results of this study suggest that our method might be a useful tool for detecting DWV, as well as for the diagnosis of RNA virus-mediated diseases on-site.

Effects of Positive Psychological Capital, Reward on Retention Intention of Hospital Nurses / 간호행정학회지

Purpose@#This study is conducted in order to identify a positive psychological capital and rewards as variables in relation to the retention intention of hospital nurses. @*Methods@#The participants were consisted of 350 nurses with 6 months or more of total work experience in 1 senior general hospital and 2 general hospitals in Incheon and individual data were collected from July 22 to August 10. 2019. Collected data was analyzed by t-test, ANOVA, Pearson's Correlation Coefficient, and Multiple Regression Analysis using IBM SPSS statistics 24.0. @*Results@#It was confirmed that the factors affecting the retention intention were never had any resignation impulse' in the past year (β=.11,p=.023), positive psychological capital (β=.43, p<.001), privileged rewards (β=.25, p<.001), monetary rewards (β= -.20, p=.001), and job rewards (β=-.15, p=.039) and the explanatory power of the model was 27.8%. @*Conclusion@#Based on the result of this study, it is suggested to develop educational and training programs whose aim is to enhance the positive psychological capital. Moreover, it will be to promote retention intention of nurses and to extend the tenure through the proper reward system that meets the duty and ability, by which nurses realize that they are rewarded.

Altered Thoracic Cage Dimensions in Patients with Chronic Obstructive Pulmonary Disease / 결핵및호흡기질환

BACKGROUND: Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage by increasing lung volume and hyperinflation. This study investigated changes in thoracic cage dimensions and related factors in patients with COPD. METHODS: We enrolled 85 patients with COPD (76 males, 9 females; mean age, 70.6±7.1 years) and 30 normal controls. Thoracic cage dimensions were measured using chest computed tomography at levels 3, 6, and 9 of the thoracic spine. We measured the maximal transverse diameter, mid-sagittal anteroposterior (AP) diameter, and maximal AP diameter of the right and left hemithorax. RESULTS: The average AP diameter was significantly greater in patients with COPD compared with normal controls (13.1±2.8 cm vs. 12.2±1.13 cm, respectively; p=0.001). The ratio of AP/transverse diameter of the thoracic cage was also significantly greater in patients with COPD compared with normal controls (0.66±0.061 vs. 0.61±0.86; p=0.002). In COPD patients, the AP diameter of the thoracic cage was positively correlated with body mass index (BMI) and 6-minute walk test distance (r=0.395, p<0.001 and r=0.238, p=0.028) and negatively correlated with increasing age (r=−0.231, p=0.034). Multiple regression analysis revealed independent correlation only between BMI and increased ratio of AP/transverse diameter of the thoracic cage (p<0.001). CONCLUSION: Patients with COPD exhibited an increased AP diameter of the thoracic cage compared with normal controls. BMI was associated with increased AP diameter in these patients.

Factors Influencing Smartphone Addiction in Adolescents

PURPOSE: The purpose of this study was to verify the relationship among depression, school adjustment, parent-child bonding, parental control and smartphone addiction, and to identify factors which influence smartphone addiction in adolescents. METHODS: A cross-sectional design was used, with a convenience sample of 183 middle school students from 3 middle schools. Data collection was conducted through self-report questionnaires from April to May, 2017. Data were analyzed using χ² test, Fisher's exact test, t-test, one-way ANOVA, correlation coefficient analysis, and binary logistic regression with SPSS Ver. 21.0. RESULTS: The mean score for smartphone addiction was 29.40. Of the adolescents, 21.3% were in the smartphone addiction risk group. Logistic regression analysis showed that gender (OR=7.09, 95% Cl: 2.57~19.52), school life (OR=0.86, 95% Cl: 0.79~0.93), smartphone usage time (OR=1.32, 95% Cl: 1.04~1.66), and parental control (OR=4.70, 95% Cl: 1.04~21.29) were effect factors for the smartphone addiction risk group. CONCLUSION: Findings indicate that school satisfaction was an important factor in adolescents' smartphone addiction. Control oriented parent management of adolescents' smartphone use did not reduce the risk of smartphone addiction and may have worsen the addiction. Future research is needed to improve understanding of how teachers and parents will manage their adolescents' use of smartphones.

Health-related Needs and Quality of Life in Childhood Cancer Survivors

PURPOSE: The purpose of this study was to identify the health-related needs and quality of life in childhood cancer survivors and to identify the relationship between health-related needs and quality of life. METHODS: Data were collected from April 11 to May 30, 2014. The participants aged 18~35 years diagnosed with a childhood cancer had completed actual treatment (surgery, chemotherapy, or radiation therapy) at least two years earlier. They were randomly selected from among childhood cancer survivors under follow-up management after cancer treatment at three general hospitals in Korea. Descriptive statistics, t-tests, one-way ANOVA, the post-hoc Scheffe test, and Pearson's correlation coefficients were used to analyze the data. RESULTS: Among the 371 participants, 214 (57.7%) were male and the mean age was 22.5 years. The mean score for health-related needs was 2.72 out of 5. Positive self-motivation need had the highest mean score of domain. The mean score for quality of life was 5.92 out of 10. Health-related needs and quality of life were negatively correlated (r= - .70, p<.001). CONCLUSION: Health-related needs of childhood cancer survivors should be regularly assessed to meet their needs and improve the quality of life of childhood cancer survivors.

Clinical Characteristics of the Development of Pneumothorax in Mechanically Ventilated Patients in Intensive Care Units / 대한구급학회지

BACKGROUND: Pneumothorax (PTX) can occur as a complication of positive pressure ventilation in mechanically ventilated patients. METHODS: We retrospectively reviewed the clinical characteristics of patients who developed PTX during mechanical ventilation (MV) in the intensive care unit (ICU). RESULTS: Of the 326 patients admitted (208 men and 118 women; mean age, 65.3 +/- 8.74 years), 15 (4.7%) developed PTX, which was MV-associated in 11 (3.3%) cases (6 men and 5 women; mean age, 68.3 +/- 9.12 years) and procedure-associated in 4. Among the patients with MV-associated PTX, the underlying lung diseases were acute respiratory distress syndrome in 7 patients, interstitial lung disease in 2 patients, and chronic obstructive pulmonary disease in 2 patients. PTX diagnosis was achieved by chest radiography alone in 9 patients and chest computed tomography alone in 2 patients. Nine patients were using assist-control mode MV with the mean applied positive end-expiratory pressure, 9 +/- 4.6 cmH2O and the mean tidal volume, 361 +/- 63.7 ml at the diagnosis of PTX. Two patients died as a result of MV-associated PTX and their systolic pressure was below 80 mmHg and heart rates were less than 80/min. Ten patients were treated by chest tube insertion, and 1 patient was treated by percutaneous pigtail catheter insertion. CONCLUSIONS: PTX can develop in patients undergoing MV, and may cause death. Early recognition and treatment are necessary to prevent hemodynamic compromise in patients who develop PTX.

A Case of Angioleiomyoma of Nasal Septum / 대한이비인후과학회지

Angioleiomyoma is a benign myogenic tumor that may develop wherever smooth muscle is present. It occurs commonly in the uterus, skin, and gastrointestinal tract and is rare within the nasal cavity, but only three of 24 reported cases of sinonasal leiomyoma may have originated from the nasal septum. Treatment of choice for these neoplasms is surgical excision. We present one case of nasal septal angioleiomyoma arising from the nasal septum with symptoms of nasal obstruction and epistaxis, which were successfully removed by endoscopic surgery.

Development of Acute Respiratory Failure on Initiation of Anti-Tuberculosis Medication in Patients with Pulmonary Tuberculosis: Clinical and Radiologic Features of 8 Patients and Literature Review / 대한구급학회지

BACKGROUND: Acute respiratory failure can occur paradoxically on initiation of anti-tuberculosis (TB) treatment in patients with pulmonary TB. This study is aimed to analyze the clinical features of anti-TB treatment induced acute respiratory failure. METHODS: We reviewed the clinical and radiological characteristics of 8 patients with pulmonary tuberculosis (5 men and 3 women; mean age, 55 +/- 15.5 years) who developed acute respiratory failure following initiation of anti-TB medication and thus required mechanical ventilation (MV) in the intensive care unit (ICU). RESULTS: The interval between initiation of anti-TB medication and development of MV-requiring acute respiratory failure was 2-14 days (mean, 4.4 +/- 4.39 days), and the duration of MV was 1-18 days (mean, 7.1 +/- 7.03 days). At admission, body temperature and serum levels of lactate dehydrogenase and C-reactive protein were increased. Serum levels of protein, albumin and creatinine were 5.8 +/- 0.98, 2.3 +/- 0.5 and 1.8 +/- 2.58 mg/ml, respectively. Radiographs characterized both lung involvements in all patients. Consolidation with the associated nodule was noted in 7 patients, ground glass opacity in 2, and cavitary lesion in 4. Micronodular lesion in the lungs, suggesting miliary tuberculosis lesion, was noted in 1 patient. At ICU admissions, the ranges of the APACHE II and SOFA scores were 17-38 (mean, 28.2 +/- 7.26) and 6-14 (mean, 10.1 +/- 2.74). The mean lung injury score was 2.8 +/- 0.5. Overall, 6 patients died owing to septic shock and multiorgan failure. CONCLUSIONS: On initiation of treatment for pulmonary TB, acute respiratory failure can paradoxically occur in patients with extensive lung parenchymal involvement and high mortality.

Ocular Perforation and Visual Field Defect Caused by an Acupuncture Needle: a Case Report

PURPOSE: To report a case of globe perforation and linear retinal tear after periocular acupuncture therapy which resulted in persistent temporal field defect with normal retinal function evidenced by multifocal electroretinogram (MERG). CASE SUMMARY: A 42-year-old female presented with decreased visual acuity and pain in her right eye after a periocular acupuncture therapy for blepharospasm. At initial presentation, the best corrected visual acuity (BCVA) was 0.08 in the injured eye and the intraocular pressure was 15 mmHg. Ultrasonography showed minimal vitreous hemorrhage and fundus examination revealed a linear retinal tear in the posterior pole sparing the macula. Consequently, barrier laser photocoagulation was performed around the lesion. The patient suffered from metamorphopsia and persistent decreased visual acuity even after 3 months. On fundus examination, epiretinal membrane with macular pucker was observed on the macula. Spectral domain optical coherence tomography (SD-OCT) revealed retinal nerve fiber layer defect with a full-thickness posterior wall tear. Multifocal electroretinogram showed normal retinal function; however, Humphrey visual field test demonstrated field defect corresponding to the injury. A 25-gauge pars plana vitrectomy was performed with membranectomy and ILM peeling. One month postoperatively, improvement in BCVA and metamorphopsia was achieved; however, the scotomata remained unchanged. CONCLUSIONS: Ocular perforation or retinal tear caused by an acupuncture needle is a rare condition that has not been reported previously in Korea. Furthermore, no case of traumatic visual field defect with preserved retinal function has been reported elsewhere. Hence, the authors present a case of isolated visual field defect without retinal dysfunction following full-thickness retinal tear caused by an acupuncture needle.

Anatomical Characteristics through Computed Tomography Analysis in Patients Undergoing Revision Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the non-dissected anatomic structures and abnormal computed tomographic findings that contribute to the recurrence of chronic rhinosinusitis (CRS) or the trail of revision endoscopic sinus surgery (ESS). SUBJECTS AND METHOD: The medical records of 34 subjects who were diagnosed with recurrent chronic rhinosinusitis, and required to undergo revision endoscopic sinus surgery were collected retrospectively. The subjects' computed tomography results were examined by a radiology specialist. RESULTS: The most common anatomic factors associated with the revision ESS for recurrence of CRS or retained inflammation were residual uncinate process (47.0%) and residual anterior ethmoidal cells followed by undissected posterior ethmoidal cells (38.2%) and obstructed sphenoid sinus ostium (32.3%). In addition, the uncorrected septal deviation, retained agger nasi cells or Haller cells and lateralized middle turbinate were also identified in the patients. CONCLUSION: From these data, we analyzed anatomical structures and CT findings related to the failure of primary ESS. We suggest that careful attention be given to these structures after primary ESS so as to reduce the failure rate and increase successful outcomes.