Effect of Loose Masks on Tear-film Break-up Time

Purpose@#We investigated the the effect of wearing a loose mask on tear-film break-up time using cross-sectional and experimental methods. @*Methods@#This was a comparative analysis of non-invasive tear-film break-up time (NIBUT) after wearing no mask, loose mask, and tight mask for 10 minutes each in 60 eyes with or without dry eye syndrome. NIBUT measurements were performed using a keratograph. @*Results@#The NIBUT values were 7.53 ± 0.83 seconds, 6.19 ± 0.78 seconds, and 7.36 ± 0.68 seconds for the no mask, loose mask, and tight mask groups, respectively. There was no significant difference between the no mask and tight mask groups (ρ-value = 0.517), but the loose mask group had a significantly reduced NIBUT compared with the other groups (ρ-value = 0.013 and 0.022, respectively). @*Conclusions@#Wearing a loose mask reduced the tear-film break-up time regardless of the presence or absence of dry eyes and may cause or worsen dry eye symptoms.

Effects of Subconjunctival Bevacizumab Injection after Primary Pterygium Surgery

Purpose@#This study evaluated the efficacy and safety of subconjunctival bevacizumab injection after primary pterygium surgery. @*Methods@#We performed a conjunctivo-limbal autograft after pterygium resection in 136 eyes of 128 patients with primary pterygium between December 2019 and July 2021. A subconjunctival bevacizumab injection of 2.5 mg (0.1 mL) was administered in the bevacizumab group but not in the control group (54 eyes of 48 patients). We compared pterygium recurrence rates between the two groups at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months after surgery. @*Results@#Pterygium recurrence occurred in one eye (1.21%) in the bevacizumab group and five eyes (9.25%) in the control group. Additionally, fibrovascular tissue proliferation was suppressed in the bevacizumab group and no postoperative complications were observed. @*Conclusions@#Pterygium recurrence occurred in one eye (1.21%) in the bevacizumab group and five eyes (9.25%) in the control group. Additionally, fibrovascular tissue proliferation was suppressed in the bevacizumab group and no postoperative complications were observed.

Factors Affecting Interpersonal Competence of Nursing Students: Focused on Self-Assertiveness and Empathy / 기본간호학회지

Purpose@#Interpersonal competence, a key competence for patient-centered care by nurses, should be understood. Therefore, factors influencing the interpersonal competence of nursing students should be identified to explore and enhance their interpersonal relationships during the undergraduate educational curriculum for nursing educators. In this study factors influencing interpersonal competence, especially on self-assertiveness and empathy in nursing students were identified and analysed. @*Methods@#A cross-sectional study design was used for the study in two Korean nursing colleges with similar baccalaureate nursing curricula. A total of 251 nursing students from freshman to senior year completed a questionnaire to measure related factors that were assumed to influence nursing students’ interpersonal competence. Data were collected from October 11~31, 2016. Study variables included self-assertiveness, empathy, interpersonal competence, and socio-demographic status. Multiple regression analysis was used for data analysis. @*Results@#Nursing students’ interpersonal competence was explained by personality (β=.22), self-assertiveness (β=.16) and empathy (β=.38). The explanatory power of these predictors was 26.8% (p<.001). @*Conclusions@#Nursing students’ interpersonal competence during the undergraduate nursing years can be enhanced by educational strategies that improve their interpersonal relationship as patient-centered care providers. Simultaneously, the attitude of the nurse educator is also important for nursing students who are to be treated as valuable learners and to improve students' empathy and self-assertiveness ability.

The Association between the Ratio of Energy Intake to Basal Metabolic Rate and Physical Activity to Sarcopenia: Using the Korea National Health and Nutrition Examination Surveys (2008–2011) / 가정의학회지

Background@#Sarcopenia is an important health problem, the risk factors of which a few studies have reported on. The purpose of this study was to evaluate the correlation between sarcopenia and the ratio of total energy intake to basal metabolic rate (BMR) as well as physical activity, and determine whether the relationship was different between younger and older age groups using data from the 2008–2011 Korea National Health and Nutrition Examination Survey. @*Methods@#We analyzed 16,313 subjects older than 19 years who had dual energy X-ray absorptiometry data. Sarcopenia was defined as an appendicular lean mass/weight (%) ratio of 1 standard deviation below the sex-specific mean value for a younger reference group, and BMR was calculated using the Harris–Benedict equation. A chi-squared test and logistic regression analyses were performed to evaluate the factors associated with sarcopenia. @*Results@#In this study, 15.2% of males and 15.4% of females had sarcopenia. Energy intake/BMR as well as physical activity was negatively related to sarcopenia risk. In stratified analysis by age and sex, strength exercises showed an inverse association with sarcopenia only in males under the age of 50 years (odds ratio, 0.577; P<0.0001), whereas higher energy intake/BMR was negatively associated with sarcopenia in each age and sex group. @*Conclusion@#Our findings suggest that adequate energy intake is important to prevent sarcopenia regardless of whether one exercises.

pH-Dependent Expression, Stability, and Activity of Malassezia restricta MrLip5 Lipase

Background@#The lipophilic yeasts Malassezia spp. are normally resident on the surface of the human body, and often associated with various skin diseases. Of the 18 known Malassezia spp., Malassezia restricta is the most predominantly identified Malassezia sp. found on the human skin. Malassezia possesses a large number of genes encoding lipases to degrade human sebum triglycerides into fatty acids, which are required not only for their growth, but also trigger skin diseases. Previously, we have shown that MrLIP5 (MRET_0930), one of the 12 lipase genes in the genome of M. restricta, and is the most frequently expressed lipase gene in the scalp of patients with dandruff. @*Objective@#In this study, we aimed to analyze the activity, stability, and expression of MrLip5, with particular focus on pH. @*Methods@#We heterologously expressed MrLip5 in Escherichia coli, and purified and analyzed its activity and expression under different pH conditions. @*Results@#We found that MrLip5 was most active and stable and highly expressed under alkaline conditions, which is similar to that of the diseased skin surface. @*Conclusion@#Our results suggest that the activity and expression of MrLip5 are pH-dependent, and that this lipase may play an essential role at the M. restricta-host interface during disease progression.

Antifungal Mechanism of Action of Lauryl Betaine Against Skin-Associated Fungus Malassezia restricta

Betaine derivatives are considered major ingredients of shampoos and are commonly used as antistatic and viscosity-increasing agents. Several studies have also suggested that betaine derivatives can be used as antimicrobial agents. However, the antifungal activity and mechanism of action of betaine derivatives have not yet been fully understood. In this study, we investigated the antifungal activity of six betaine derivatives against Malassezia restricta, which is the most frequently isolated fungus from the human skin and is implicated in the development of dandruff. We found that, among the six betaine derivatives, lauryl betaine showed the most potent antifungal activity. The mechanism of action of lauryl betaine was studied mainly using another phylogenetically close model fungal organism, Cryptococcus neoformans, because of a lack of available genetic manipulation and functional genomics tools for M. restricta. Our genome-wide reverse genetic screening method using the C. neoformans gene deletion mutant library showed that the mutants with mutations in genes for cell membrane synthesis and integrity, particularly ergosterol synthesis, are highly sensitive to lauryl betaine. Furthermore, transcriptome changes in both C. neoformans and M. restricta cells grown in the presence of lauryl betaine were analyzed and the results indicated that the compound mainly affected cell membrane synthesis, particularly ergosterol synthesis. Overall, our data demonstrated that lauryl betaine influences ergosterol synthesis in C. neoformans and that the compound exerts a similar mechanism of action on M. restricta.

Tooth Agenesis and Delay in Patients with Agenesis of Mandibular Second Premolars / 대한소아치과학회지

Tooth agenesis is a common human dental anomaly and the agenesis of mandibular second premolars has been proven to be the most frequently observed. The aim of this study is to investigate tooth agenesis and delayed tooth development in patients with agenesis of mandibular second premolars.This study reviewed 9 to 15 year-old patients with agenesis of mandibular second premolars who visited the department of pediatric dentistry of Yonsei University Dental Hospital and took panoramic radiographs from January 2014 to December 2016. On panoramic radiographs, agenesis of teeth was observed and developmental delay of teeth was evaluated by the Nolla method. Among 125 patients with agenesis of mandibular second premolars, 58 patients (46.4%) showed agenesis of other teeth and 38 patients (30.4%) showed delayed tooth development. In this study, patients with agenesis of mandibular second premolars were more likely to have tooth agenesis or delayed eruption of other teeth.

In Vitro Anti-Malassezia Activity of Castanea crenata Shell and Oil-Soluble Glycyrrhiza Extracts

BACKGROUND: A new shampoo with anti-Malassezia properties obtained from various plants is required to provide seborrheic dermatitis patients with a wider range of treatment options. OBJECTIVE: The aim of this study was to obtain in vitro susceptibility profiles of Malassezia restricta and M. globosa, the most important pathogenic organisms in the development of seborrheic dermatitis, to the plant extracts used in commercial anti-dandruff shampoos. METHODS: Minimal inhibitory concentrations (MICs) were determined for eight candidate plant extracts and two plant-derived natural products diluted with Leeming and Notman medium to final concentrations of 0.016 to 1 mg/ml. RESULTS: Castanea crenata shell, Camellia sinensis leaf, and oil-soluble Glycyrrhiza extracts presented relatively low MIC values (≤0.5 mg/ml) against both strains. The C. crenata shell and oil-soluble Glycyrrhiza extracts demonstrated especially high anti-Malassezia activity, suggesting their potential use in the treatment of seborrheic dermatitis. The extracts also showed fungistatic activity against other common facultative pathogenic yeasts, Cryptococcus and Candida. CONCLUSION: C. crenata shell and oil-soluble Glycyrrhiza extracts could potentially be used as active ingredients in anti-seborrheic and anti-dandruff shampoo formulations. They could be helpful for repeated treatments and regular prophylaxis of scalp seborrheic dermatitis.

Efficacy and Safety of Cream Containing Climbazole/Piroctone Olamine for Facial Seborrheic Dermatitis: A Single-Center, Open-Label Split-Face Clinical Study

BACKGROUND: Seborrheic dermatitis (SD) is a multifactorial disease; Malassezia species play an important role in its pathogenesis. OBJECTIVE: We aimed to determine whether a cream containing climbazole/piroctone olamine (C/P cream), antifungal agents with expected efficacy against Malassezia species, could improve SD symptoms. METHODS: We instructed 24 patients with mild-to-moderate SD to apply the C/P cream and emollient cream on the right and left sides of the face, respectively, every morning and evening for 4 weeks. The casual sebum level (measured with Sebumeter®; Courage & Khazaka Electronic GmbH, Germany) and the extent of erythema (measured with Mexameter®; Courage & Khazaka Electronic GmbH) on the face were measured at baseline and after 4 weeks. The minimal inhibitory concentration (MIC) was determined to demonstrate the antifungal activity of the C/P cream. RESULTS: The casual sebum level and erythema were measured at week 4, and the median values demonstrated a quantitative improvement on the C/P cream-treated right side of the face compared to the emollient cream-treated left side. For the C/P cream, the MICs were 0.625, 5, 0.625, and 2.5 mg/ml for Malassezia restricta, M. globosa, M. sympodialis, and M. slooffiae, respectively. CONCLUSION: Based on the reduced casual sebum level and extent of erythema, the antifungal activity of C/P cream against Malassezia species seems useful for the treatment of mild to moderate SD.

The Effect of Insomnia Severity on Daytime Sleepiness in Obstructive Sleep Apnea Syndrome / 수면정신생리

OBJECTIVES: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. METHODS: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; PSQI 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. RESULTS: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI (r(p) = 0.313, p = 0.008), AI (r(p) = 0.339, p = 0.004), ODI (r(p) = 0.289, p = 0.015) and ATI (r(p) = 0.256, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. CONCLUSION: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.

Mitochondrial Protein Nfu1 Influences Homeostasis of Essential Metals in the Human Fungal Pathogen Cryptococcus neoformans

Mitochondrial protein Nfu1 plays an important role in the assembly of mitochondrial Fe-S clusters and intracellular iron homeostasis in the model yeast Saccharomyces cerevisiae. In this study, we identified the Nfu1 ortholog in the human fungal pathogen Cryptococcus neoformans. Our data showed that C. neoformans Nfu1 localized in the mitochondria and influenced homeostasis of essential metals such as iron, copper and manganese. Marked growth defects were observed in the mutant lacking NFU1, which suggests a critical role of Nfu1 in Fe-S cluster biosynthesis and intracellular metal homeostasis in C. neoformans.

Lipolytic Enzymes Involved in the Virulence of Human Pathogenic Fungi

Pathogenic microbes secrete various enzymes with lipolytic activities to facilitate their survival within the host. Lipolytic enzymes include extracellular lipases and phospholipases, and several lines of evidence have suggested that these enzymes contribute to the virulence of pathogenic fungi. Candida albicans and Cryptococcus neoformans are the most commonly isolated human fungal pathogens, and several biochemical and molecular approaches have identified their extracellular lipolytic enzymes. The role of lipases and phospholipases in the virulence of C. albicans has been extensively studied, and these enzymes have been shown to contribute to C. albicans morphological transition, colonization, cytotoxicity, and penetration to the host. While not much is known about the lipases in C. neoformans, the roles of phospholipases in the dissemination of fungal cells in the host and in signaling pathways have been described. Lipolytic enzymes may also influence the survival of the lipophilic cutaneous pathogenic yeast Malassezia species within the host, and an unusually high number of lipase-coding genes may complement the lipid dependency of this fungus. This review briefly describes the current understanding of the lipolytic enzymes in major human fungal pathogens, namely C. albicans, C. neoformans, and Malassezia spp.