Purpose: We investigated the effect of preoperative administration of analgesics and sedatives on pain levels during silicone tube intubation conducted under local anesthesia in patients with acquired nasolacrimal duct stenosis. Methods: We retrospectively reviewed the medical records from 121 patients at the ophthalmology department of our hospital from July 2016 to May 2022. In total, 71 patients were administered acetaminophen and diazepam orally, while the remaining 50 were not. Postoperative pain (measured using the visual analogue scale [VAS] score [0 = no pain, 10 = severe pain] immediately after operation), operative duration, and improvement in epiphora symptoms were compared between the two groups. Results: The premedication group had significantly lower VAS scores than the non-premedication group (5.23 ± 2.75 vs. 6.34 ± 2.33, p = 0.02). It also had a notably shorter (p < 0.01) operation duration and higher subjective improvement rate of epiphora symptoms. However, premedication did not influence the tube retention period post-surgery (p = 0.86). Conclusions The administration of analgesics and sedatives prior to silicone tube intubation effectively mitigates operative pain and reduces operation duration. Furthermore, it may help improve postoperative epiphora symptoms.

Intensive case management provided at the critical period following the onset of schizophrenia is crucial for early social and vocational recovery. We report the young schizophrenia patient who had been treated for 2 years but frequently relapsed and attempted suicide. After receiving cognitive behavioral case management from community mental health center, she has functionally recovered without recurrence for 4 years. Collaboration between psychiatrists of hospital and case manager of community mental health center was very important factor that contributed to her functional recovery. Cognitive behavioral case management promoting coping skills and reducing perceived stress was effective on successful social adaptation even during the stressful situations. In conclusion, psychosocial management including cognitive behavioral case management at the early stage of schizophrenia is crucial to prevent the relapse and to recover patients' function.
Adaptation, Psychological ; Case Management* ; Cooperative Behavior ; Critical Period (Psychology) ; Early Intervention (Education) ; Humans ; Mental Health ; Psychiatry ; Recurrence ; Schizophrenia* ; Suicide, Attempted

Cavernous hemangiomas rarely involve the female genital tract. It is difficult to identify vascular malformations when these lesions are concealed in the vagina or deep vulva area. We present a rare case of vaginal cavernous hemangioma in a 30-year-old primiparous woman with an early severe postpartum hemorrhage (PPH) and delayed continuous bleeding from the episiotomy site. She was treated successfully with transarterial embolization of the left vaginal artery. To our knowledge, this is the first reported case of PPH caused by rupture of a vaginal hemangioma during vaginal delivery in English literature.
Adult ; Arteries ; Episiotomy ; Female ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Postpartum Hemorrhage* ; Postpartum Period* ; Rupture ; Vagina ; Vascular Malformations ; Vulva

A nine-year old boy was found unconscious by his father in his apartment house. He was transferred to the emergency unit immediately but resuscitation was failed. Drain cleansing was performed just before the deceased came home. The father stated that there was foul odor in the house when he opened the door. The autopsy finding showed only nonspecific findings including severe pulmonary edema. Significant amount of sulfide ion was detected from blood and brain tissue. The cause of death was concluded as hydrogen sulfide poisoning.
Autopsy ; Brain ; Cause of Death ; Emergency Service, Hospital ; Fathers ; Humans ; Hydrogen Sulfide* ; Hydrogen* ; Male ; Odors ; Poisoning* ; Pulmonary Edema ; Resuscitation

Noncirrhotic hyperammonemia as a cause of acute confusion remains diagnostic challenge. Deficiency of ornithine transcarbamylase (OTC) is the urea cycle disorder, inborn errors caused by a defect of the enzymes in the urea cycle, leading to an accumulation of ammonia mainly in newborn. There were very few cases, in which OTC deficiency result in hyperammonemia in adulthood. Herein, we report a young adult woman of hyperammonemic encephalopathy with OTC deficiency, diagnosed by high blood ammonia, glutamine and low plasma levels of citrulline. Next generation sequencing showed the c.386+5G>A mutation of the OTC gene.

In criminal investigations, the accurate identification of specimens must be a vary important procedure in the estimation of post-mortem interval(PMI) using insect specimens. However, the morphological-based identification method has many limitations, as species identification for immature stages of many species being difficult or impossible, and more convenient methods are needed to identify necrophagopus fly species. So, many authors have proposed DNA-based methods for identifying fly specimen because of identifying all life stages of carrion flies. In this study, we sequenced a part of mitochondrial cytochrome oxodase subunit I (COI) for each five blow fly species [Hemipyrellia ligurriens, Lucilia illustris, Phaenicia sericata, Chrysomya. megacephala, Chrysomya pinguis] collected from the rural and urban regions in Korea, and compared 400 nucleotides of one species with those of another species. Percent similarity of sequence compared was highest value between Ch. pinguis and Ch. megacephala (97.8%), and lowest one between H. ligurriens and Ch. pinguis(89.2%). Maximun intraspecific variation was observed in L. illustris (0.5%). In conclusion, the experimental results indicate that sequence analyses of more necrophagous flies collected from various regions of Korea should be performed to construct a database of mitochondrial CO I of necrophagous fly species.
Criminals ; Cytochromes* ; Diptera* ; DNA, Mitochondrial ; Electron Transport Complex IV* ; Humans ; Insects ; Korea* ; Nucleotides ; Sequence Analysis

Recently many forensic scientists are trying to use the DNA 'barcode' region (upstream portion of mitochondrial cytochrome oxidase subunit I) to identify the species of forensically important fly species. We have analyzed to compare their sequences of the 'barcode' region for twelve blow fly species[A. grahami, C.lata, C. vicina, H.ligurriens, L. ampullaceal, L. Caesar, L. illustris, P. sericata, P. regina, T. calliphoroides, C. megacephala, C. pinguis] collected from the rural and urban regions in Korea. Intra- and interspecies sequence divergences were calculated as 0~0.9% and 0.9~11.4%, respectively. Phylogenetic trees were drawn with Mega 3.1 and Network 4.20 programs. The result illustrates that each genus is grouped as monophyletic group except for T. calliphoroides and all the same species were monophyletic group. This suggests that the 'Barcode' region of COI gene could be a marker for identification of necrophagous blow fly species. But the two closely related species, L.illustris and L.caesar show little differences from each other. Therefore more individuals of these species should be examined for population study.
Diptera* ; DNA ; DNA, Mitochondrial* ; Electron Transport Complex IV ; Korea*

Current influenza virus vaccines are based on strain-specific surface glycoprotein hemagglutinin (HA) antigens and effective only when the predicted vaccine strains and circulating viruses are well-matched. The current strategy of influenza vaccination does not prevent the pandemic outbreaks and protection efficacy is reduced or ineffective if mutant strains emerge. It is of high priority to develop effective vaccines and vaccination strategies conferring a broad range of cross protection. The extracellular domain of M2 (M2e) is highly conserved among human influenza A viruses and has been utilized to develop new vaccines inducing cross protection against different subtypes of influenza A virus. However, immune mechanisms of cross protection by M2e-based vaccines still remain to be fully elucidated. Here, we review immune correlates and mechanisms conferring cross protection by M2e-based vaccines. Molecular and cellular immune components that are known to be involved in M2 immune-mediated protection include antibodies, B cells, T cells, alveolar macrophages, Fc receptors, complements, and natural killer cells. Better understanding of protective mechanisms by immune responses induced by M2e vaccination will help facilitate development of broadly cross protective vaccines against influenza A virus.
Antibodies ; B-Lymphocytes ; Complement System Proteins ; Cross Protection ; Disease Outbreaks ; Hemagglutinins ; Influenza A virus ; Influenza Vaccines ; Influenza, Human* ; Killer Cells, Natural ; Macrophages, Alveolar ; Membrane Glycoproteins ; Orthomyxoviridae* ; Pandemics ; Receptors, Fc ; T-Lymphocytes ; Vaccination ; Vaccines*

Pulmonary sequestration is a developmental anomaly of broncho-pulmonary foregut with nonfunctioning parenchymal tissue, which usually supplied by systemic circulation. Pulmonary sequestration is detected by ultrasonography as a homogeneous echogenic mass and also by Doppler blood flow from systemic circulation to the mass. Pulmonary sequestration is classified into intralobar type and extralobar type. Extralobar type accounts for only 15~25% of the cases and it is subdivided into intrathoracic forms, which are most commonly found and extrathoracic type, which includes intraabdominal, retroperitoneal, or mediastinal masses. We report a rare case of prenatal detection of mediastinal mass with a brief review of literatures, which was confirmed to be a pulmonary sequestration by surgical mass excision after birth.
Bronchopulmonary Sequestration ; Parturition ; Ultrasonography, Prenatal

To confirm the effect of 7-valent pneumococcal conjugate vaccine (PCV7), pneumococcal nasopharyngeal (NP) carriage was compared between vaccinated (3 + 1 doses PCV7) and non-vaccinated children. Vaccinated subjects were recruited from highly vaccinated regions (> or = 60%), Seoul and Incheon whereas control subjects were recruited from Jeju Island where vaccination rates are low (< 15%). NP swabs were obtained from 400 children aged 18-59 months. Serotype and antibiotic susceptibility was analyzed. Pneumococcal carriage rate was 18.0% (36/200) and 31.5% (63/200) for the vaccinated and control group, respectively. Among those vaccinated, 41.7% (15/36) of the serotypes were vaccine-related type (VRT: 6A, 6C, 19A) with the most common serotype 6C. The next common type was non-typable/non-capsule 30.6% (11/36) followed by non-vaccine type 16.7% (6/36) and vaccine type (VT) serotypes were found in only 11.1% (4/36). In contrast, 52.4% (33/63) of the isolates in the control group were VT. Resistance rates for penicillin and erythromycin were lower in the vaccine group (vaccine vs control; penicillin 45.2% vs 71.4%, erythromycin 74.2% vs 90.5%, P < 0.05). Multi-drug resistance was also lower in vaccinated subjects (vaccine vs control; 45.2% vs 69.8%, P < 0.05). PCV7 reduces carriage in VT which leads to replacement of pneumococci by antibiotic susceptible VRT or non-vaccine type strains.
Adult ; Carrier State/*immunology/prevention & control ; Child ; *Child Day Care Centers ; Child, Preschool ; Humans ; *Immunization ; Infant ; Male ; Microbial Sensitivity Tests ; Nasopharynx ; Pneumococcal Infections/*epidemiology/immunology/*prevention & control ; Pneumococcal Vaccines/*administration & dosage ; Prospective Studies ; Republic of Korea/epidemiology ; Serotyping ; Streptococcus pneumoniae/*isolation & purification