PURPOSE: To evaluate the ocular results and refractive errors in children with developmental delay and to determine the significance of ophthalmologic screening in children. METHODS: The present study was conducted with children who visited the development delay clinic of National Health Insurance Corporation Ilsan hospital in Goyang, Korea. Primary evaluation included external eye examination, pupil reflex, and ocular movement test with focal light, and secondary evaluation included slit-lamp examination, fundus examination, cycloplegic refraction, and lacrimal drainage test if necessary. RESULTS: Out of 89 subjects included in the study, 61.8% had ocular abnormalities other than refractive errors, and the two most common results included strabismus and epiblepharon, with occurrence rates of 24.7% and 22.5%, respectively. Among the 60 subjects who underwent cycloplegic refraction, 56.6% had refractive errors, with astigmatism (30%) being the most common. Among the 24 subjects who received treatment, four underwent surgical treatment and 20 started wearing glasses. CONCLUSIONS: The present study revealed a high prevalence of ophthalmologic abnormalities in pediatric developmental delay patients, indicating that systemic and comprehensive ophthalmic examination is necessary for these patients.
Astigmatism ; Child ; Drainage ; Eye ; Humans ; Intellectual Disability ; Korea ; Light ; Mass Screening ; National Health Programs ; Prevalence ; Pupil ; Reflex ; Refractive Errors ; Strabismus

Primary diffuse large B-cell lymphoma (DLBCL) of the female genital tract is a rare case. It is hard to diagnose DLBCL of the uterine cervix before surgery because it is often misdiagnosed as cervical myoma or cervical squamous cell carcinoma. Here, we report a case of cervical DLBCL misdiagnosed as a cervical myoma. A 48-year-old premenopausal woman was referred to the gynecology department due to abnormal uterine bleeding with a normal Papanicolaou smear. The initial diagnosis according to ultrasound and computed tomography was a cervical myoma. She had undergone a hysterectomy with bilateral salpingectomy. The final diagnosis was cervical DLBCL and she was referred to the department of hematology for treatment with Rituximab combined chemotherapy. After six courses of chemotherapy, complete remission was reached. At a 2-year follow-up, the patient is alive without interval change.

BACKGROUND: Pneumocystis is difficult to culture or detect in laboratory environments. Its ecology including the timing and method of transmission as well as environmental sources and communicability remain unclear. METHODS: We retrospectively evaluated the pattern and treatment outcome of Pneumocystis jirovecii pneumonia (PCP) in children with acute lymphoblastic leukemia (ALL) who received chemotherapy. RESULTS: A total of 56 patients with ALL were evaluated. While on chemotherapy, all patients received PCP prophylaxis. PCP were found in a total of 6 patients, including definite PCP in 2, probable PCP in 2, and possible PCP in 2 patients. There were no significant differences in sex, age group, National Cancer Institute risk group, or pneumocystis prophylaxis type between PCP and non-PCP groups. However, there was a significant statistical difference in the times of ALL diagnosis. Regarding recent chemotherapy at the time of PCP diagnosis, there were one induction, one consolidation, and four maintenance cases. All PCP patients were treated with high-dose sulfamethoxazole (100 mg/kg/day) and trimethoprim (20 mg/kg/day) intravenously. Five patients survived, while one patient with endotracheal mechanical ventilation therapy died due to respiratory failure in spite of aggressive treatment. CONCLUSION: Pediatric PCP became extremely rare due to routine prophylaxis in clinical practice of pediatric malignancy. Nevertheless, we analyzed patients with acute lymphoblastic leukemia who had received PCP prophylaxis for 14 years, and analyzed the clustered outbreaks of PCP. It is still important to emphasize the need for prophylaxis and to increase the level of attention and isolation under environmental and personal risk factors.
Child ; Compliance ; Diagnosis ; Disease Outbreaks ; Drug Therapy ; Ecology ; Humans ; Methods ; National Cancer Institute (U.S.) ; Pneumocystis jirovecii ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Respiration, Artificial ; Respiratory Insufficiency ; Retrospective Studies ; Risk Factors ; Sulfamethoxazole ; Treatment Outcome ; Trimethoprim

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) is an autosomal recessive inherited disorder form of primordial dwarfism, caused by mutations in the pericentrin gene. The purpose of the study was to examine the clinical and radiological features, physicochemical properties and microstructures of the tooth affected with MOPD II.
The mandibular 2nd molar was collected from the MOPD II patient. Micro-computerized tomography, scanning electron microscopy, energy dispersive spectrometry and Vickers microhardness analysis were performed on the MOPD II and the normal control.
The morphology of the MOPD II tooth appeared to have malformed pulp and root and showed a small size. The mineral density measurement showed that the MOPD II tooth had similar scores in the enamel, but lower scores in the root 1/2 and apical dentin compared to the normal control. The microhardness values were smaller in the cusp enamel, root 1/2 dentin and apical dentin of the MOPD II compared to the normal control.
In this study, the dental characteristics and the physicochemical properties of a tooth affected with MOPD II were analyzed to improve understanding of the oral manifestations of the disease and to assist in proper dental treatment by identifying precautions.

Purpose: Gambling disorder is highly prevalent, and harms individuals, families, interpersonal relationships, and society. However, the efforts to treat and recover from a gambling disorder are insufficient. The purpose of this study was to construct an integrated body of knowledge related to the recovery of gambling disorder, by synthesizing qualitative studies showing the recovery process in gambling. Methods: The qualitative meta-synthesis method was used to search for qualitative studies on recovery from gambling, and the experiences of 213 people of 22 articles were analyzed. Results: The overall theme representing the recovery of a gambling disorder was derived as ‘the journey of becoming the master of my life and growing together’. The process of recovery from a gambling disorder was subdivided into the decision-making phase, life-reconstruction phase, and life-fulfillment phase. The factors that enable as well as hinder recovery are presented in detail. Conclusion It is expected that the results of this study can be used as an empirical basis, for planning gambling-related policies and programs in practice through the experiences of recovering gamblers.

PURPOSE: Predicting the need for surgical intervention among patients with intestinal obstruction is challenging. The delta neutrophil index (DNI) has been suggested as a useful marker of immature granulocytes, which indicate an infection or sepsis. In this study, we evaluated the impact of the DNI as an early predictor of operation among patients with intestinal obstruction. METHODS: A total of 171 patients who were diagnosed with postoperative intestinal obstruction were enrolled in this study. Medical records, including data for the initial CRP level, WBC count, and DNI were reviewed. Receiver operating characteristic (ROC) curves were generated to clarify the optimal DNI cutoff values for predicting an operation. RESULTS: Among the 171 patients, 38 (22.2%) needed surgical intervention. The areas under the initial CRP, WBC, and DNI ROC curves were 0.460, 0.449, and 0.543, respectively. The optimal cutoff value for predicting further surgical intervention according to the initial DNI level was 4.3%. The accuracy of the cutoff value was 74.9%, the sensitivity was 23.7%, and the specificity was 89.5% (positive predictive value, 23.7%; negative predictive value, 89.5%). In the multivariate analysis, initial DNI levels ≥ 4.3% were significantly associated with surgical intervention (odd ratio, 3.092; 95% confidence interval, 1.072–8.918; P = 0.037). CONCLUSION: The initial DNI level in patients with intestinal obstruction may be a useful predictor for determining the need for surgical intervention.
Granulocytes ; Humans ; Intestinal Obstruction* ; Medical Records ; Multivariate Analysis ; Neutrophils* ; ROC Curve ; Sensitivity and Specificity ; Sepsis

As a minimally invasive method, sentinel lymph node biopsy (SLNB) in conjunction with guidance methods is the standard method to determine cancer metastasis in breast. The desired guidance methods for SLNB should be capable of precise SLN localization for accurate diagnosis of micro-metastases at an early stage of cancer progression and thus facilitate reducing the number of SLN biopsies for minimal surgical complications. For this, high sensitivity to the administered dyes, high spatial and contrast resolutions, deep imaging depth, and real-time imaging capability are pivotal requirements. Currently, various methods have been used for SLNB guidance, each with their own advantages and disadvantages, but no methods meet the requirements. In this review, we discuss the conventional SLNB guidance methods in this perspective. In addition, we focus on the role of the PA imaging modality on real-time SLN identification and biopsy guidance. In particular, PA-based hybrid imaging methods for precise SLN identification and efficient biopsy guidance are introduced, and their unique features, advantages, and disadvantages are discussed.
Biopsy* ; Breast ; Coloring Agents ; Contrast Media ; Diagnosis ; Lymph Nodes* ; Methods ; Neoplasm Metastasis ; Optical Imaging ; Sentinel Lymph Node Biopsy ; Ultrasonography

Objectives: . Postinfectious olfactory dysfunction (PIOD) is the most common etiology of olfactory dysfunction, and olfactory training (OT) is an accepted treatment modality for PIOD. Some studies have investigated OT in Korean patients, but they involved odorants unfamiliar to Koreans or had no control group. The aim of this study was to verify the efficacy of OT in PIOD patients, using odorants familiar to Koreans and including a control group. Methods: . We enrolled a total of 104 Korean patients with PIOD over the 3-year study period. All participants were assessed using endoscopy and an olfactory function test at the baseline assessment and 3 months after OT. The olfactory function test was performed using the Korean version of Sniffin’ stick (KVSS) II. Nasal and psychological function was evaluated using a visual analog scale and the Mini-Mental State Examination. OT was performed over a period of 3 months, using five odorants (rose, lemon, cinnamon, orange, and peach). Results: . OT improved olfactory function in approximately 40% of subjects over a period of 12 weeks compared to non-OT subjects. A comparison of changes between the initial and follow-up assessments demonstrated that the OT group had significantly better olfactory results for the total KVSS II, threshold, and identification scores than the non-OT group. The degree of olfactory improvement after OT was affected by the initial score. Conclusion . The effects of OT in patients with PIOD were demonstrated in this study. A meaningful contribution of this study is that Korean patients were tested using odors familiar to them in comparison with a control group.

Primary ciliary dyskinesia (PCD) results in several characteristic clinical symptoms, including chronic pansinusitis, recurrent infections of the respiratory tract, and infertility. Concerning the rhinologic aspect, medical therapy mainly involving a combination of long-term antimicrobial agents and intranasal steroid sprays can control sinusitis in the majority of cases. But, there are no definite treatment guidelines for recalcitrant chronic sinusitis with PCD. Recently, we examined a 28-year-old male with serous otitis effusion, chronic sinusitis, and bronchiectasis, and a 4-year-old female with chronic sinusitis and serous otitis effusion. We confirmed PCD by electron microscopy and endoscopic maxillary mega-antrostomy was performed in both cases for the treatment of chronic sinusitis that was refractory to conservative management.

Purpose: To compare the perinatal outcomes among the majority of physicians who manage pregnancies complicated by gestational diabetes mellitus (GDM), particularly those who require insulin treatment. Methods: We conducted a retrospective study involving 206 singleton pregnant women diagnosed with GDM between January 2017 and September 2022. The study participants were divided into 2 groups according to the majority of physicians (obstetrics vs. endocrinology). We compared the maternal characteristics and perinatal outcomes between the 2 groups and performed a subgroup analysis of preterm birth cases. Results: During the study period, 206 pregnant women were diagnosed with GDM and 36.9% (76 of 206) required insulin treatment. Among the GDM A2 pregnancies, 26 patients visited or consulted endocrinologists, and 50 patients were managed by obstetricians. There were no significant differences in maternal characteristics and perinatal outcomes between the two groups. Eighteen infants were delivered before 37 weeks of gestation (12 in the obstetrician group and 6 in the endocrinologist group). In preterm-delivered patients, the birth weight was heavier in the endocrinology group (median [range], 2.66 [1.98–3.77] vs. 3.71 [2.48–4.17], p=0.025) despite similar gestational age at delivery (median [range], 35.5 [33.1–36.5] vs. 36.0 [34.2–36.6], p=0.511). However, there were no significant differences in perinatal outcomes, including the rate of neonatal hypoglycemia, oxygen treatment and the duration of neonatal intensive care unit admission. Conclusion Our data show that GDM can be managed by obstetricians even in cases requiring insulin treatment.