Clinical Manifestation of Infectious Keratitis in Ocular Graft Versus Host Disease

Purpose@#We evaluated the clinical manifestations of, and risk factors for, infectious keratitis in patients with ocular graft-versus-host disease (GVHD). @*Methods@#A total of 11 patients who developed infectious keratitis after a diagnosis of ocular GVHD between January 2015 and December 2020, and 36 who did not (the control group), were included in this retrospective study. We recorded sex, age, any underlying disease, any other organ affected by systemic GVHD, systemic immunosuppressant use, follow-up duration, clinical manifestations, the severity of ocular GVHD prior to infection, the size of the epithelial defect, the depth of infiltration, hypopyon status, and the results of microbiological tests. Systemic and ocular indices (including systemic GVHD status) were compared using the chi-squared test. Risk factors for infection were identified. @*Results@#Of the corneal indices, the presence of corneal filaments, the extent of corneal neovascularization, and the number of corneal epithelial defects were significantly higher in the infected group (p = 0.023, p = 0.004, and p = 0.001, respectively). GVHD severity was also significantly higher in that group (p < 0.001). The presence of corneal filaments, corneal neovascularization, and corneal epithelial defects prior to infection correlated significantly with the risk of infection (p = 0.046, p = 0.010, and p = 0.003, respectively). Multivariate analysis identified corneal epithelial defects as a significant risk factor for infection (p = 0.029). @*Conclusions@#In patients with ocular GVHD, corneal epithelial defects, corneal neovascularization, and corneal filaments prior to infection were associated with the development of infection. In particular, corneal epithelial defects before infection was a significant risk factor for infection.

Effects of Amniotic Membrane Extract Eye Drops on Persistent Epithelial Defects of the Cornea

Purpose@#To evaluate the clinical efficacy of amniotic membrane extract eye drops (AMEEDs) in patients with persistent epithelial defects (PEDs) of the cornea. @*Methods@#Sixteen patients with PEDs refractory to the conventional treatment were further treated with AMEEDs six times a day. Visual acuity, visual analog scale (VAS), esthesiometer score, and areas of the epithelial defects before and after 1 and 2 months of treatment were evaluated. After 2 months, AMEEDs were considered effective if all epithelial defects were healed, partially effective if the epithelial defects decreased in size compared with the baseline, and ineffective if the epithelial defects increased in size and required additional treatment. @*Results@#After 2 months of treatment with AMEEDs, there was a reduction in the area of epithelial defects (5.2 ± 3.1 mm2 vs. 0.1 ± 0.1 mm2, respectively, p = 0.01), as well as a significant improvement in best-corrected visual acuity (0.8 ± 0.5 logarithm of minimal angle of resolution [LogMAR] vs. 0.6 ± 0.3 LogMAR, respectively, p = 0.03), and VAS scores (4.3 ± 1.0 vs. 2.8 ± 0.7, respectively, p = 0.04) compared with the baseline values. Treatment with AMEEDs was effective in 13 (81.3%) patients and partially effective in three (18.8%) patients. @*Conclusions@#AMEEDs could stimulate epithelial wound healing and improve ocular symptoms in patients with refractory PED. Therefore, AMEEDs could be considered an effective treatment option for refractory PEDs.

Short-term Efficacy and Safety of Micropulse Transscleral Cyclophotocoagulation in Korean Patients

Purpose@#To evaluate the short-term efficacy and safety of a standardized micropulse transscleral diode laser cyclophotocoagulation (micropulse TS-CPC) procedure in Korean glaucoma patients. @*Methods@#In this retrospective study, the medical records of 19 eyes of 19 patients who were diagnosed with glaucoma, underwent micropulse TS-CPC and were followed for at least 3 months were reviewed. Visual acuity (VA), intraocular pressure (IOP), the number of IOP-lowering eye drops, and the success rate, defined as the percentage of eyes achieving an IOP of 6-21 mmHg with or without medication, or an IOP decrease of ≥20% compared to baseline after the procedure, were evaluated at baseline, 1 week, 1 month and 3 months postoperatively. @*Results@#The mean age was 58.0 years at the time of treatment. Among 19 eyes that were evaluated, two had a previous history of trabeculectomy, two had an Ahmed ® Glaucoma Valve implantation, one had selective laser trabeculoplasty, and four had vitrectomy. Baseline mean IOP was 26.21 ± 5.22 mmHg, which significantly decreased to 17.72 ± 4.25 mmHg at postoperative 3 months (p < 0.001). The success rate at postoperative 3 months was 84.2%. Five eyes experienced postoperative hypotony, and persistent corneal epithelial defects in three eyes were successfully treated with topical medication. Two of 19 eyes had a decrease in VA of unknown cause, and 9 eyes had mydriasis due to paralysis in iris constriction, which did not resolve until 3 months follow-up. @*Conclusions@#Micropulse TS-CPC had a relatively good IOP-lowering effect. However, a rather high proportion of patients had complications from a standardized protocol, and this should be considered when performing micropulse TS-CPC in Korean patients.

Bilateral Corneal Edema After Inhalation of Spray Paint

Purpose@#To report a case of acute bilateral corneal edema after inhalation of spray paint.Case summary: A 47-year-old male presented with blurred vision in both eyes 12 hours after inhalation of spray paint. He had no history of ocular surgery or chronic ocular disease. The corrected visual acuity was 20/100 in the right eye and 20/40 in the left eye. An ocular examination revealed diffuse bullous changes in the epithelium and mild stromal edema in the cornea of both eyes. At one week after treatment with topical hypertonic solutions and corticosteroids, the visual acuity had improved to 20/20 and slit-lamp examination showed clear corneas without edema. @*Conclusions@#Inhalation of a chemical substance can lead to acute bilateral corneal edema, even without direct contact, but the lesion may resolve rapidly.

Analysis of Nutrition Teachers' Awareness of Necessity for an Operating School Meal Support Center in Chungnam / 대한지역사회영양학회지

OBJECTIVES: We investigated the operation needs of school meal support centers (SMSC) in Chungnam-do based on analysis of nutrition teachers' perception of them. METHODS: The Chungnam government established the first SMSC in 2012. Thirteen SMSCs are currently being operated in Chungnam-do. To analyze the results quantitatively, we investigated nutrition teachers opinions regarding the necessity for SMSCs as a dependent variable and derived the independent variables based on the causal relationships with dependent variables using the ordered logit model. Those independent variables included region, school type, number of students, attitude regarding free meal policy, satisfaction with school meal policy, and preference for local food. RESULTS: Briefly, teachers in the region in which the SMSC was located more strongly supported the SMSC. In addition, teachers in public schools with a smaller number of students believed that having a SMSC is more beneficial, and that other variables also affected the necessity for SMSCs. Moreover, nutrition teachers preferred local foods rather than organic foods because of the unstable supply of organic foods. CONCLUSIONS: Based on the results of this study, it was recommended that the local government implement the policy consistently. Moreover, it was recommended that the government operate the SMSC more efficiently, enhance the roles of the SMSC as the local organization responsible for student nutritional planing and expand the coverage of agricultural products.

Analysis of Nutrition Teachers' Awareness of Necessity for an Operating School Meal Support Center in Chungnam / 대한지역사회영양학회지

OBJECTIVES: We investigated the operation needs of school meal support centers (SMSC) in Chungnam-do based on analysis of nutrition teachers' perception of them. METHODS: The Chungnam government established the first SMSC in 2012. Thirteen SMSCs are currently being operated in Chungnam-do. To analyze the results quantitatively, we investigated nutrition teachers opinions regarding the necessity for SMSCs as a dependent variable and derived the independent variables based on the causal relationships with dependent variables using the ordered logit model. Those independent variables included region, school type, number of students, attitude regarding free meal policy, satisfaction with school meal policy, and preference for local food. RESULTS: Briefly, teachers in the region in which the SMSC was located more strongly supported the SMSC. In addition, teachers in public schools with a smaller number of students believed that having a SMSC is more beneficial, and that other variables also affected the necessity for SMSCs. Moreover, nutrition teachers preferred local foods rather than organic foods because of the unstable supply of organic foods. CONCLUSIONS: Based on the results of this study, it was recommended that the local government implement the policy consistently. Moreover, it was recommended that the government operate the SMSC more efficiently, enhance the roles of the SMSC as the local organization responsible for student nutritional planing and expand the coverage of agricultural products.

Serum exosomal microRNAs as novel biomarkers for hepatocellular carcinoma

Recent studies have shown that circulating microRNAs are a potential biomarker in various types of malignancies. The aim of this study was to investigate the feasibility of using serum exosomal microRNAs as novel serological biomarkers for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We measured the serum exosomal microRNAs and serum circulating microRNAs in patients with CHB (n=20), liver cirrhosis (LC) (n=20) and HCC (n=20). Serum exosomal microRNA was extracted from 500 mul of serum using an Exosome RNA Isolation kit. The expression levels of microRNAs were quantified by real-time PCR. The expression levels of selected microRNAs were normalized to Caenorhabditis elegans microRNA (Cel-miR-39). The serum levels of exosomal miR-18a, miR-221, miR-222 and miR-224 were significantly higher in patients with HCC than those with CHB or LC (P<0.05). Further, the serum levels of exosomal miR-101, miR-106b, miR-122 and miR-195 were lower in patients with HCC than in patients with CHB (P=0.014, P<0.001, P<0.001 and P<0.001, respectively). There was no significant difference in the levels of miR-21 and miR-93 among the three groups. Additionally, the serum levels of circulating microRNAs showed a smaller difference between HCC and either CHB or LC. This study suggests that serum exosomal microRNAs may be used as novel serological biomarkers for HCC.