Both Ocular Perforation Caused by Periocular Acupuncture Therapy

Purpose@#To report a case of both ocular perforation due to periocular acupuncture therapy with vitrectomy in the right eye andbarrier laser photocoagulation without vitrectomy in the left eye.Case summary: A 58-year-old female presented with ocular pain and decreased visual acuity in both eye. She had received periocularacupuncture therapy 4 days earlier. Dilated fundoscopy revealed vitreous hemorrhage. B-scan ultrasonography revealedvitreous opacity. Thus, at the request of the patient, vitrectomy was performed in only the right eye, and did not performed in theleft eye. Intraoperatively, we identified retinal laceration in the temporal and inferior retina. In the left eye, the sites of retinal hemorrhagewere observed in the temporal and inferior retina in the fundus examination, and a barrier laser photocoagulation wasperformed around the lesion. At the three-month postoperative follow-up, the patient’s visual acuity was 0.5 in the right eye withoutmacular edema. In the left eye, visual acuity was 0.01 with macular edema observed on optical coherence tomography. @*Conclusions@#Authors present a case of a patient with vitreous hemorrhage and ocular perforations caused by periocular acupuncturetherapy in both eye, able to compare the results of eyes that performed vitrectomy and that did not performed vitrectomyin a same patient. The recovery of visual acuity in eye that performed vitrectomy was better than eye that did not performedvitrectomy. Therefore, we consider performing vitrectomy in patients with eye perforation.

Comparison of Myopic Progression before and after Orthokeratology Lens Treatment

PURPOSE: To compare the myopic progression before and after wearing an orthokeratology lens (OK). METHODS: Twenty-six patients (49 eyes) with at least 6 months of myopia prior to OK treatment were evaluated. Changes in the spherical equivalent (SE) refractive error and axial length were compared before and after OK use. Changes in the SE and axial length were also compared between two groups according to the myopic progression before baseline: Group 1 with myopic progression 1 D/year. RESULTS: The myopic progression rate decreased from −1.1 to −0.3 D/year after OK treatment (p < 0.001). Greater increases in axial length were observed in patients who were younger and had less myopia at baseline, a higher rate of myopia progression before baseline, and a shorter axial length at baseline (p < 0.001, p < 0.004, p < 0.007, and p < 0.001, respectively). The increase in axial length was significantly greater in the group with greater myopic progression before baseline (0.2 mm/year) than in the group with less myopic progression (0.1 mm/year) (p = 0.001). CONCLUSIONS: Myopic progression was reduced significantly after OK treatment.

Analysis of BRIP1 Variants among Korean Patients with BRCA1/2 Mutation-Negative High-Risk Breast Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of the current study is to assess the spectrum of genetic variation in the BRIP1 gene among Korean high-risk breast cancer patients who tested negative for the BRCA1/2 mutation. MATERIALS AND METHODS: Overall, 235 Korean patientswith BRCA1/2 mutation-negative high-risk breast cancerwere screened for BRIP1 mutations. The entire BRIP1 gene was analyzed using fluorescent-conformation sensitive gel electrophoresis. In silico analysis of BRIP1 variants was performed using PolyPhen-2 and SIFT. RESULTS: A total of 20 sequence alterations including 12 exonic and eight intronic variantswere found. Among the 12 exonic variants, 10 were missense and two were silent mutations. No protein-truncating mutation was found among the tested patients. Among the 10 missense variants, four (p.L263F, p.L340F, p.L474P, and p.R848H) were predicted to be pathogenic by both PolyPhen-2 and SIFT, and these variants were found in five patients. Of the four missense variants, p.L263F, p.L474P, and p.R848H localize to regions between the helicase motifs, while p.L340F resides in an iron-sulfur domain of BRIP1. CONCLUSION: No protein-truncating mutation in BRIP1 was found among the tested patients. The contribution of BRIP1 variants is thought to be minor in Korean non-BRCA1/2 high-risk breast cancer.

Symptom Prevalence and Work-related Risk Factors of Acute Pesticide Poisoning among Korean Farmers in Gyeong-gi Province / 農村醫學 地域保健

OBJECTIVE: The purpose of this study was to measure the symptom prevalence of acute pesticide poisoning among farmers in Gyeong-gi province and to investigate the occupational risk factors. METHODS: The subjects were 663 farmers using pesticide directly or indirectly and the survey was performed during 2013. 7. 11 - 2014. 8. 27. The data were analyzed by SPSS 21.0. RESULTS: The prevalence of acute pesticide poisoning was 6.63% and dizziness was the most common symptom. Acute pesticide poisoning was related with 'days of pesticide use per year','lifetime pesticide application days', 'the number of pesticide mixture' and 'type of farming'. CONCLUSION: It is necessary to manage and educate the pesticide poisoning-vulnerable group more systematically. Afterward additional study is needed to investigate the farming safety behavior and delicate amount of pesticide exposure.

Impact on Survival of Regular Postoperative Surveillance for Patients with Early Breast Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study is to evaluate the role of regular postoperative surveillance to improve the prognosis of patients with breast cancer after curative surgery. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 4,119 patients who received curative surgery for breast cancer at Samsung Medical Center between January 2000 and September 2008. Patients were divided into two groups (group I, regular postoperative surveillance; group II, control group) according to their post-therapy follow-up status for the first 5 years after surgery. RESULTS: Among the 3,770 patients selected for inclusion, groups I and II contained 3,300 (87%) and 470 (13%) patients, respectively. The recurrence rates at 5 years for groups I and II were 10.6% and 16.4%, respectively (hazard ratio, 0.85; 95% confidence interval [CI], 0.67 to 1.09; p=0.197). The 10-year mortality cumulative rates were 8.8% for group I and 25.4% for group II (hazard ratio, 0.28; 95% CI, 0.22 to 0.35; p < 0.001). In multivariate analysis for recurrence-free survival (RFS), age over 40 years (p < 0.001), histologic grade 1 (p < 0.001), and pathologic stage I (p < 0.001) were associated with longer RFS but not with follow-up status. Multivariate analysis for overall survival (OS) revealed that patients in group I showed significantly improved OS (hazard ratio, 0.29; 95% CI, 0.23 to 0.37; p < 0.001). Additionally, age over 40 years, histologic grade I, and pathologic stage I were independent prognostic factors for OS. CONCLUSION: Regular follow-up for patients with breast cancer after primary surgery resulted in clinically significant improvements in patient OS.

Type and cause of liver disease in Korea: single-center experience, 2005-2010

BACKGROUND/AIMS: The aim of this study was to describe the types and causes of liver disease in patients from a single community hospital in Korea between April 2005 and May 2010. METHODS: A cohort of patients who visited the liver clinic of the hospital during the aforementioned time period were consecutively enrolled (n=6,307). Consistent diagnostic criteria for each liver disease were set by a single, experienced hepatologist, and the diagnosis of all of the enrolled patients was confirmed by retrospective review of their medical records. RESULTS: Among the 6,307 patients, 528 (8.4%) were classified as acute hepatitis, 3,957 (62.7%) as chronic hepatitis, 767 (12.2%) as liver cirrhosis, 509 (8.1%) as primary liver cancer, and 546 (8.7%) as a benign liver mass or other diseases. The etiologies in the acute hepatitis group in decreasing order of prevalence were hepatitis A (44.3%), toxic hepatitis (32.4%), other hepatitis viruses (13.8%), and cryptogenic hepatitis (9.1%). In the chronic hepatitis group, 51.2% of cases were attributed to viral hepatitis, 33.3% to nonalcoholic fatty liver disease, and 13.0% to alcoholic liver disease (ALD). Of the cirrhoses, 73.4% were attributable to viral causes and 18.1% to alcohol. Of the hepatocellular carcinoma cases, 86.6% were attributed to viral hepatitis and 11.6% to ALD. Among the benign tumors, hemangioma comprised 52.2% and cystic liver disease comprised 33.7%. CONCLUSIONS: Knowledge of the current status of the type and cause of liver disease in Korea may be valuable as a basis for evaluating changing trends in liver disease in that country.

The Diagnostic Concordance of Femoral Hernia and the Factors Influencing Diagnosis

PURPOSE: Misdiagnosis is frequent in femoral hernia as inguinal hernia. The aims of this study were to examine the diagnostic concordance and to define the factors having influence on the correct diagnosis of femoral hernia. METHODS: Thirty-two patients who underwent femoral hernia operations were analyzed retrospectively. RESULTS: The mean age of the study subjects was 65.8+/-15.5 (36~97) and the female to male ratio was 5.4:1. The mean body mass index (BMI) was 19.8 kg/m2 (14.6~26.9 kg/m2). Twelve patients (37.5%) showed pre- and post-operative diagnostic concordance and 20 patients (62.5%) did not. Among the 20 misdiagnosed cases, 16 cases were misdiagnosed as inguinal hernia, 2 cases as lipoma, and 1 case as lymphadenopathy. The factors related to the correct diagnosis of femoral hernias were associated with groin mass (96.9%, 31/32: 23 painless and 8 painful), size fluctuation of mass (cyclic wax and wane pattern) (84.4%, 27/32), long duration of mass (over 1 month) (75.0%, 24/32), femoral venous compression CT findings (63.6%, 14/22), and positive ultrasonographic findings (42.1%, 8/19). Emergency operation was done in 12 cases (37.5%). Incarceration was found in 23 cases (71.9%) and most of the incarcerated organs were omental fat (11 cases) and small bowel (10 cases). Bowel resection was done in 4 cases and 2 patients combined inguinal hernia. CONCLUSION: Through the careful taking of medical history and physical examination, physicians can achieve the correct diagnosis and can also decrease the frequency of emergency operations and their related complications.

Nasal Non-Hodgkin's Lymphoma: CT Findings

PURPOSE: To describe the characteristics of CT findings in nasal lymphoma. MATERIALS AND METHODS: We retrospectively reviewed CT findings and pathologic findings of eight patients (six males and two females) aged between 24 and 68 years with pathologically-proven nasal lymphoma. We analyzed mass location, laterality, size, margin, mass effect, adjacent bony change and contrast enhancement pattern. RESULTS: All eight cases werenon-Hodgkin's lymphoma, intermediate grade, diffuse large cell type. Seven cases were B-cell type and one was T-cell. In all cases, tumors were located in the medial wall of the inferior turbinate. In four cases, they were also found in the anterior ethmoidal sinus, and in one case, in the nasal septum. The mean size of the main mass was 3.3 cm. In seven cases, tumors were unilateral (one on the right; six on the left), and in the remaining case, bilateral. In six cases tumor margin was smooth and in two cases focal nodularity was seen. In two cases there was no bony change, and in four, there was mucosal thickening along the nasal septum; in one of these four, minimal bony erosion was also found. In the other two cases, bony destruction was seen, and tumors were very large (7 cm in diameter) or bilterally located. In three cases, the nasal septum was displaced by the mass. In all cases with bony change, the nasal septum was involved. All tumors were homogeneously well enhanced after IV contrast administration. CONCLUSION: The main CT findings of nasal non-Hodgkin's lymphoma were smooth margin, unilateral location (mainly in the medial wall of the inferior turbinate and growing to the medial side without bony destruction) mucosal thickening along the nasal septum and clear homogeneous enhancement after IV contrast administration. These characteristics will help diagnosis, help determine the appropriate region for radiation and other appropriate therapy, and facilitate prognosis in patients with nasal non-Hodgkin's lymphoma.

A Digital Imaging Teaching File by Using the Internet, HTML and Personal Computers

PURPOSE: A film-based teaching file takes up space and the need to search through such a file places limitson the extent to which it is likely to be used. Furthermore it is not easy for doctors in a medium-sized hospitalto experience a variety of cases, and so for these reasons we created an easy-to-use digital imaging teaching filewith HTML(Hypertext Markup Language) and downloaded images via World Wide Web(WWW) services on the Internet. This was suitable for use by computer novices. MATERIALS AND METHODS: We used WWW Internet services as a resource for various images and three different IMB-PC compatible computers(386DX, 486DX-II, and Pentium) in downloading theimages and in developing a digitalized teaching file. These computers were connected with the Internet through ahigh speed dial-up modem(28.8Kbps) and to navigate the Internet. Twinsock and Netscape were used. HWP 3.0, Korean word processing software, was used to create HTML(Hypertext Markup Language) files and the downloaded images were linked to the HTML files. In this way, a digital imaging teaching file program was created. RESULTS: Access to aWeb service via the Internet required a high speed computer(at least 486DX II with 8MB RAM) for comfortabel use ;this also ensured that the quality of downloaded images was not degraded during downloading and that these were good enough to use as a teaching file. The time needed to retrieve the text and related images depends on the sizeof the file, the speed of the network, and the network traffic at the time of connection. For computer novices, adigital image teaching file using HTML is easy to use. CONCLUSION: Our method of creating a digital imaging teaching file by using Internet and HTML would be easy to create and radiologists with little computer experience who want to study various digital radiologic imaging cases would find it easy to use.