Assessment for Macular Thickness after Uncomplicated Phacoemulsification Using Optical Coherence Tomography

Purpose@#Macular edema including cystoid macular edema is one of the main causes of unfavorable visual outcomes after cataract surgery. The macular thickness and the occurrence of macular edema after uncomplicated cataract surgery was evaluated using optical coherence tomography (OCT) in this study. @*Methods@#Macular map images were taken by OCT before surgery and at 1 week, 1 month, and 2 months postsurgery. The subjects were classified into two groups (group 1, patients with no macular edema; group 2, patients with macular edema). Group 2 was defined as increase in central macular thickness (CMT) by 30% compared with that before surgery. The risk factors for macular edema were evaluated. Group 2 was divided into two subgroups: subclinical macular edema (group 2A) and cystoid macular edema (group 2B) and they were assessed in terms of the clinical course of best-corrected visual acuity and CMT. @*Results@#A total of 376 patients were enrolled in this study, of which 36 (9.57%, group 2) showed macular edema measured by OCT after the surgery. Univariate analysis for group 1 and 2 revealed that intracameral injection of epinephrine during phacoemulsification was associated with the development of macular edema. In group 2, five patients (1.33%) developed cystoid macular edema. Statistically significant differences in the clinical course of CMT were observed at 2 months (201.2 ± 23.1, 250.0 ± 29.8, and 371.0 ± 160.3 in group 1, group 2A, and group 2B, respectively; p 0.2 with CMT in the normal range. @*Conclusions@#The intracameral injection of epinephrine may cause macular edema after uncomplicated cataract surgery. Examination of CMT using OCT is recommended for the early detection of macular edema.

The Actual Condition and an Alternative of Students in the Department of Dental Hygiene about Dental Instrument Injuries during Clinical Practice / 치위생과학회지

Background@#Students in the department of dental hygiene are exposed to injections and sharp instruments during clinical practice. Therefore, it is necessary to develop measures for a safe practice environment. This study aimed to investigate dental stabbing accidents caused by dental instruments during clinical practice among students in the department of dental hygiene and suggest appropriate preventative measures. @*Methods@#This study was conducted from May 1 to June 30, 2016, with students in the department of dental hygiene located at several universities in Seoul and Gyeonggi area. The study included 339 participants. A frequency analysis was performed to determine the general characteristics of dental infection control. A cross-analysis was conducted to identify the relationship between dental infection control education, stabbing accident prevention education, and treatment after stabbing accidents with a dental instrument. @*Results@#Among the participants, 81.1% received dental infection control education and 66.4% received stabbing accident prevention education. Only 50.9% received hepatitis B vaccinations. @*Conclusion@#Dental infection control education and stabbing accident prevention education were shown to be effective in preventing dental instrument stabbing in students. However, post-accident processing, such as reporting to upper management and medical treatment after the accident, was insufficient. Therefore, it is necessary to present a treatment flowchart for dealing with stab accidents in clinical practice for students in the department of dental hygiene and strengthen education.

Comparison of Clinical Characteristics of Fluorescence in Quantitative Light-Induced Fluorescence Images according to the Maturation Level of Dental Plaque / 치위생과학회지

Background@#Proper detection and management of dental plaque are essential for individual oral health. We aimed to evaluatethe maturation level of dental plaque using a two-tone disclosing agent and to compare it with the fluorescence of dental plaque on the quantitative light-induced fluorescence (QLF) image to obtain primary data for the development of a new dental plaque scoring system. @*Methods@#Twenty-eight subjects who consented to participate after understanding the purpose of the study were screened. Theimages of the anterior teeth were obtained using the QLF device. Subsequently, dental plaque was stained with a two-tone disclosing solution and a photograph was obtained with a digital single-lens reflex (DSLR) camera. The staining scores were assigned as follows: 0 for no staining, 1 for pink staining, and 2 for blue staining. The marked points on the DSLR images were selected for RGB color analysis. The relationship between dental plaque maturation and the red/green (R/G) ratio was evaluated using Spearman’s rank correlation. Additionally, different red fluorescence values according to dental plaque accumulation were assessed using one-way analysis of variance followed by Scheffe’s post-hoc test to identify statistically significant differences between the groups. @*Results@#A comparison of the intensity of red fluorescence according to the maturation of the two-tone stained dental plaque confirmed that R/G ratio was higher in the QLF images with dental plaque maturation (p＜0.001). Correlation analysis between the stained dental plaque and the red fluorescence intensity in the QLF image confirmed an excellent positive correlation (p＜0.001). @*Conclusion@#A new plaque scoring system can be developed based on the results of the present study. In addition, these study @*results@#may also help in dental plaque management in the clinical setting.

Time to First Cigarette and Hypertension in Korean Male Smokers / 가정의학회지

BACKGROUND: Morning blood pressure surge affects to cardiovascular disease risk. Short time to first cigarette (TTFC) after waking can enhance morning blood pressure surge, and accelerate atherosclerosis METHODS: We investigated that the relationship between TTFC and blood pressure. The study subjects included male current smokers (n=211) who had health check-up in Hallym University Sacred Heart Hospital from July to September, 2014. We categorized the subjects into 2 groups according to TTFC; early TTFC (TTFC or =30 minutes), and the subjects who were taking antihypertensive medications or had a high blood pressure (>140 mm Hg or 90 mm Hg) were defined as hypertensive group. Multivariate logistic regression was performed to estimate the odds ratio and 95% confidence interval to investigate the association between TTFC and hypertensive group. RESULTS: Compared with late TTFC, early TTFC had higher odds (odds ratio [OR], 3.87; 95% confidence interval [CI], 1.89-7.94) for hypertensive group. After adjusting confounding factors, early TTFC was significantly associated with an increased risk of hypertension (OR, 4.43; 95% CI, 1.84-10.70). CONCLUSION: early TTFC after waking is associated with hypertension. It suggests delaying TTFC might help to control of blood pressure among the current smokers who are not ready to immediately quit smoking.

Differences in Factors Associated with Albuminuria according to Gender and Comorbidities of Hypertension and Diabetes / 가정의학회지

BACKGROUND: This study examined the differences in factors associated with albuminuria according to gender and comorbidities of hypertension (HTN) and diabetes mellitus (DM). METHODS: We included 3,859 participants aged 20 to 79 years (55% female) from the 5th Korea National Health and Nutrition Examination Survey. Participants were excluded if they took antihypertensive or anti-diabetic medication, had chronic renal failure, had malignant tumor, were pregnant or menstruating during the health examination, or had missing urine albumin data. Albuminuria was defined by the participant's urine albumin-creatinine ratio (uACR). Relationships between dependent and independent variables were analyzed using the Pearson's correlation test and simple linear regression. Due to possible muticollinearity, multiple linear regression analysis was used to determine whether the association between the dependent and independent variables of interest remained significant after adjustment for other potentially confounding independent variables. RESULTS: The variables significantly correlated with uACR were different between the genders and between subjects with HTN or DM as a comorbidity. In the multiple linear regression models, hemoglobin A1c (P=0.01) was positively associated with uACR in men without HTN and DM. In men with HTN or DM, systolic blood pressure and fasting glucose (P<0.01) were positively associated with uACR. In women with HTN or DM, waist circumference (P=0.011) and gamma-glutamyl transpeptidase (P<0.001) were positively correlated with uACR (P<0.05) and glucose level (P=0.019) was negatively correlated with uACR. CONCLUSION: The study suggested factors correlated with albuminuria were different for men and women according to comorbidities such as HTN and DM.

Clinical Characteristics and Metabolic Health Status of Obese Korean Children and Adolescents / 가정의학회지

BACKGROUND: This study aimed to determine the prevalence of metabolically healthy and unhealthy obesity (MHO and MUO, respectively) and examine the demographic, anthropometric, and lifestyle predictors of metabolic health status in Korean children and adolescents. METHODS: This study was based on data collected from the Korean Children-Adolescent Study in 2010. A total of 1,700 children (846 boys and 854 girls) were included in the primary cohort and classified into metabolically healthy and unhealthy groups according to factors related to the metabolic syndrome. Demographic and biochemical features were evaluated in study participants. Logistic regression estimated the odds ratios of having more fat mass among MUO compared with MHO children after adjusting for confounding factors. RESULTS: Mean body mass index was higher in the MUO group than in the MHO group (24.83 vs. 23.02 kg/m2, respectively). The proportion of obese participants was also higher in the MUO group (59.4%) than in the MHO group (20.7%). MHO children were more likely to have parents with better socioeconomic status and a higher fruit and vegetable intake compared with MUO children. Higher fat mass and percent fat was associated with MUO according to multiple logistic regression analysis. CONCLUSION: Fat mass and percent fat are associated with metabolically healthy phenotypes of obesity among children and adolescents.

The Association of Lung Age with Smoking Status in Korean Men / 가정의학회지

BACKGROUND: Lung age, calculated from sex, forced expiratory volume in one second (FEV1), and height, was developed to illustrate premature changes to the lungs and could be used to motivate smoking cessation. However, this method has not been tested in association with smoking in Korea. The purpose of this study was to investigate the association of lung age with smoking and other factors in Korean males. METHODS: We reviewed the records of 1,100 healthy men who visited a health promotion center at Ewha Womans University Medical Center from January 2008 to June 2009. Lung age was calculated from FEV1 and normal predictive values of spirometry according to age in the Korean population. The difference between lung age and chronological age was evaluated in relation to smoking status, weight, body mass index, waist, muscle mass, fat mass, and exercise. RESULTS: The age difference was significantly higher in current smokers than in non-smokers (12.47 +/- 19.90 vs. 7.30 +/- 19.52, P < 0.001). Additionally, the age difference was positively correlated with life time pack-year (beta = 0.223; P < 0.001) and fat mass (beta = 0.462; P < 0.001). Lung age increased 1 year for 4.48 pack-year increase or for 2.16% increase in fat mass. CONCLUSION: We found a significant relationship between lung age and both smoking status and fat mass in healthy Korean males. Lung age may be a useful tool for motivating cessation of cigarette smoking and management of risk factors related to obesity.

The perinatal outcome of vaginal delivery in twin pregnancy / 대한산부인과학회지

OBJECTIVE: To evaluate the perinatal outcome of vaginal delivery in twin pregnancy according to the presentation of the fetus. METHODS: A total of 274 cases suitable to this objective were selected from the 301 cases of twin pregnancy delivered between March 2000 and February 2005. They were categorized into 3 groups according to the presentation of the fetus; vertex/vertex as the group A (133 cases), vertex/nonvertex as the group B (80 cases), nonvertex in the first twin as the group C (61 cases). And then each group also was divided into 2 subgroups according to the mode of delivery; vaginal delivery and cesarean delivery. The difference between the subgroups in each group as to perinatal outcome was retrospectively compared and analyzed for statistical significance. RESULTS: The incidence of vaginal delivery in group A (46/133, 34.6%) was significantly higher than in group B (5/80, 6.3%) and C (5/61, 8.2%). A total of 218 (79.6%) cases were underwent the cesarean delivery and the most common indication of cesarean delivery was elective twin cesarean delivery in all 3 groups (65.4%, 93.8%, 91.8% respectively). The incidence of neonatal admission to the neonatal intensive care unit was, however, higher in vaginal delivery (40.2%) than in cesarean delivery (32.8%) in group A. The most common cause for neonatal intensive care unit admission was low birth weight for simple observation, and average admission dates of vaginal delivery was 17.0 days and cesarean delivery was 16.8 days. CONCLUSION: Vaginal delivery of twins depends on the presentation of the fetus, but no significant difference in perinatal outcome of group A were observed between the mode of delivery. Therefore attempt to decrease the incidence of elective twin cesarean delivery in group A is demanded.

Prognostic factors of stage IB1 cervical cancer treated surgically / 부인종양

OBJECTIVE: To determine pathologic variables associated with disease free interval and overall survival of patients with stage IB1 cervical cancer who underwent radical hysterectomy and pelvic lymph node dissection. METHODS: The records of 91 patients with stage IB1 cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy from 1997 to 2003 at Gil Medical Center were reviewed retrospectively. Clinical and pathologic variables including tumor size, histologic type, involvement of resection margin, parametrium invasion, lymph node metastasis, lymph-vascular space invasion (LVSI), depth of invasion and age were analyzed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by Cox's proportional hazards model. RESULTS: Univariate analysis revealed no significant differences in subgroups according to age, tumor size, histologic type and lymph-vascular space invasion (LVSI). However, significant differences in disease free interval were found in subgroups according to lymph node metastasis and depth of invasion. There were significant differences in overall survival in only subgroups according to lymph node metastasis. Multivariate analysis revealed that lymph node metastasis was the only independent significant prognostic factor. CONCLUSION: These results show that lymph node metastasis was the only independent prognostic factor in stage IB1 cervical cancer managed surgically.

A Comparison and Validity of Various Diagnostic Criteria of Irritable Bowel Syndrome / 대한소화관운동학회지

BACKGROUNDS: There has been some discordance in the prevalence of irritable bowel syndrome (IBS) probably due to different diagnostic criteria used by different study groups. The aims of this study was to determine the degree of agreement between different standard definitions and to test the validity of applying these different standards in epidemiological investigations of IBS among Korean population. METHODS: We recruited 1,038 patients who visited Yongdong Severance Hosipital for medical checkup and gave out the prepared questionnaires. Based on the returned questionnaires, degree of agreement between Manning, Rome I, and Rome II criteria was investigated by percent agreement and calculating kappa statics. Furthermore, clinical characteristics in different definition groups and patients of self-reported IBS were investigated and compared. RESULTS: Complete questionnaires were returned by 928 out of 1,038 subjects. The percent agreements ranged from 80.7 to 96.7 percent and kappa values ranged from 0.20 to 0.59. Best agreement occurred between Manning and Rome I criteria. Many subjects diagnosed as not having IBS by various diagnostic criteria of IBS thought themselves as having IBS. More sizable number of patients were suspected to have structural gastrointestinal diseases in IBS patients diagnosed by Manning, Rome I, and Rome II criteria compared with self-reported IBS subjects. CONCLUSIONS: It could be suspected that results of epidemiological investigations might be different according to standard definitions applied on each studies. Furthermore, some modifications of existing standard definitions of Western world would be required before applying them among Korean population.

Chromosome Aberrations and Sister-chromatid Exchanges in Workers Exposed to Mixed-organic Solvents in Shoe-making Workshops

Chromosome aberrations and sister chromatid exchanges (SCEs) in lymphocytes of peropheral blood as an indicator which could evaluate the effects of mutagenicity after in human exposure to mixed-organic solvents were measured. This study was conducted using 33 shoe making workers occupationally exposed to organic solvents and 33 unexposed control. The results were as follows. 1. The mean air concentrations of n-hexane, toluene, ethyl acetate in working environment were 9.8-14.8, 31.7-45.4 and 4.4-7.6 ppm, respectively. 2. The frequencies of chromosome aberration in exposed workers to mixed-organic solvents and the unexposed were 1.12+/-1.24, 0.36+/-0.70, respectively and their differences were statistically significant (p<0.01). However, the SCE frequencies were not statistically significant between the both groups. 3. The frequencies of chromosome aberration and SCE were no statistically differences by sex, smoking and drinking.