PURPOSE: To investigate the effect of an intravitreal injection of triamcinolone acetonide (TA) for the treatment of macular edema due to several causes. METHODS: One hundred eyes of 98 patients (DM, 58 eyes; branch retinal vein occlusion, 42 eyes) who received an intravitreal injection of 4mg (0.1cc) TA were included in this study. We performed preoperative and 1-, 3- and 6-month postoperative examinations that included stereoscopic biomicroscopy, fluorescein angiography (71 eyes) and optical coherence tomography (85 eyes). Pre- and postoperative visual acuity and IOP were measured. RESULTS: After 1 month, visual improvement by 1 line or more was achieved in 62 eyes (62.0%). Sixty-five eyes (65.0%) and 49 eyes (57.6%) showed improved visual acuity after 3 and 6 months, respectively. Macular thickness decreased by 46.5% after 1 month, by 49.4% after 3 months, and by 50.8% after 6 months. There were no significant differences in visual improvement or thickness reduction between diabetic macular edema and edema secondary to branch retinal vein occlusion. There was no correlation between improvement of visual acuity and macular edema thickness decrease. Complications included a transient rise in intraocular pressure in 9 eyes and a secondary cataract in one eye. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide 4 mg (0.1 cc) is an effective, simple and safe treatment for diabetic macular edema and macular edema secondary to branch retinal vein occlusion.
Capsule Opacification ; Edema ; Fluorescein Angiography ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema* ; Retinal Vein Occlusion ; Tomography, Optical Coherence ; Triamcinolone Acetonide ; Triamcinolone* ; Visual Acuity

We describe herein a case of life-threatening hypoglycemia due to spurious elevation of glucose concentration during the administration of ascorbic acid in a type 2 diabetic patient. A 31-year-old female was admitted for proliferative diabetic retinopathy treatment and prescribed high dose ascorbic acid. During hospitalization, she suddenly lost her consciousness and her glucose concentration was 291 mg/dL, measured using self-monitoring blood glucose (SMBG) device, while venous blood glucose concentration was 12 mg/dL. After intravenous injection of 50% glucose solution, the patient became alert. We reasoned that glucose measurement by SMBG device was interfered by ascorbic acid. Physicians should be aware of this interference; high dose ascorbic acid may cause spurious elevation of glucose concentration when measuring with SMBG devices.
Adult ; Ascorbic Acid/administration & dosage/adverse effects/contraindications/*therapeutic use ; Blood Glucose ; Blood Glucose Self-Monitoring/instrumentation/standards ; Diabetes Mellitus, Type 2/blood/drug therapy ; Female ; Humans ; Hypoglycemia/*diagnosis ; Renal Dialysis

BACKGROUND: Delivery of Bacille Calmette-Gurein (BCG) Tokyo vaccine, with the multipuncture device, has been much preferred over BCG Pasteur, with the intradermal method, possibly due to the easier manner of administration, a desire to avoid any trouble with scars, as well as side effects and higher profits to providers in South Korea. METHODS: To determine BCG scar status in 0~6 year old children vaccinated with two BCG vaccines (Pasteur BCG vaccine with intradermal method and BCG Tokyo vaccine with percutaneous method), the data from the national BCG scar survey in 2006 was analyzed. RESULTS: Based on the national survey, the high proportion that were vaccinated with BCG Tokyo vaccines with the multipuncture method (64.5%) was noted in 0~6 year old Korean children. From inspection of scar formation, as an indicator of vaccination, the median number of the visible pin scars from the percutaneous method was 16 (interquartile range, 12~18) in the Korean children, and pin scars decreased as the age of the children increased (p<0.001). CONCLUSION: The findings in this survey clearly showed a growing preference of parents for the BCG Tokyo vaccines by the multipuncture method in South Korea.
BCG Vaccine ; Child ; Cicatrix ; Humans ; Mycobacterium bovis ; Parents ; Republic of Korea ; Tokyo ; Tuberculosis ; Vaccination ; Vaccines

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.