We evaluated the efficacy of the full-thickness pentagonal wedge resection for localized trichiasis and distichiasis. Fourteen eyes of eleven patients, who were diagnosed to have trichiasis and distichiasis from October 1995 to October 1997 and had more than 10 aberrant cilia that were clustered together, were included in this study. More than 2 months later, we examined clinical symptoms, recurrent aberrant cilia, and complications. There was no recurrence in 11 lids. In 3 lids there were one to three recurrent aberrant cilia around resection margins, and the patients had mild foreign body sensations. In 2 of 3 cases of symptomatic recurrence, symptoms improved after argon laser treatment. Although one case showed recurrence after argon laser treatment, the patient remained asymptomatic. There were no significant complications including postoperative scarring. Therefore, we suggest that the full-thickness pentagonal wedge resection may be simple and effective for the treatment of trichiasis and distichiasis clustered with many aberrant cilia, especially in high risk patients who have potential for corneoconjunctival complications.
Argon ; Cicatrix ; Cilia ; Foreign Bodies ; Humans ; Recurrence ; Sensation ; Trichiasis*

Background: and Purpose: Organic light-emitting diodes (OLEDs) emit less blue light than traditional light-emitting diodes (LEDs), but the effects of OLED light exposure (LE) on melatonin and sleep have not been evaluated. Methods: Twenty-four healthy subjects (age 26.9±5.7 years; including 18 females) with the intermediate chronotype were exposed to three different light conditions [4,000 K 150 lux OLED LE, 4,000 K 150 lux LED LE, and dim light (DL) at <10 lux] for 6.5 h from 17:30 to 24:00, in a random order and with a 1-week interval. Participants entered the unit for the experiment at 16:00, and their daylight was measured by actigraphy from 8:00 to 16:00 during each session. Saliva samples for melatonin were taken every hour from 18:00 to 24:00. Sleep was monitored by polysomnography, and vigilance was evaluated by psychomotor vigilance test upon awakening. Results: Melatonin onset occurred at 21:11±01:24, 21:20±01:19, and 21:36±01:16 in the DL, OLED, and LED conditions, respectively. Melatonin onset was significantly delayed under LED LE compared to DL (p=0.007) but did not differ under OLED LE (p=0.245). Melatonin suppression, sleep parameters, and vigilance were similar among the three light conditions. The accumulated amount of daytime light in each session was negatively correlated with the melatonin onset time under the DL (rho=-0.634, p=0.002) and OLED (rho=-0.447, p=0.029) conditions, not under the LED condition (p=0.129). Conclusions Melatonin onset under OLED LE was not significantly delayed compared to DL.Exposure to sufficient daylight may advance melatonin onset even when a subject is exposed to OLED LE in the evening.

BACKGROUND/AIMS: The natural history of Crohn's disease (CD) is characterized by a remitting and relapsing course and a considerable number of patients ultimately require bowel resection. Moreover, postoperative recurrence is very common. Relatively few studies have investigated the postoperative recurrence of CD in Korea. The aim of the current study was to assess postoperative recurrence rates - both clinical and endoscopic - in CD as well as factors influencing postoperative recurrence. METHODS: Electronic medical records of patients who underwent surgery due to CD were reviewed and analyzed. Patients with incomplete surgical resection, a follow-up period of less than a year, and a history of strictureplasty or perianal surgery were excluded. RESULTS: Of 112 CD patients, 39 patients had history of bowel resection, and 34 patients met the inclusion criteria. Among them, 26 were male (76%) and the mean age of onset was 32.8 years. The mean follow-up period after operation was 65.4 months. Cumulative clinical recurrence rates were 8.8%, 12.5%, and 33.5% at 12, 24, and 48 months, respectively. Use of immunomodulators for prophylaxis was the only predictor of clinical recurrence in univariate analysis (P=0.042). Of 21 patients who had undergone follow-up colonoscopy after surgery, cumulative endoscopic recurrence rates were 33.3%, 42.9%, and 66.1% at 6, 12, and 24 months, respectively. No significant predicting factor for endoscopic recurrence was detected. CONCLUSIONS: Postoperative recurrence rates in Korean patients with CD are high, and endoscopic recurrence rates are comparable to those reported from Western studies. Appropriate medical prophylaxis seems to be important for preventing postoperative recurrence in CD.
Age of Onset ; Colonoscopy ; Crohn Disease* ; Electronic Health Records ; Follow-Up Studies ; Humans ; Immunologic Factors ; Korea ; Male ; Natural History ; Recurrence*

PURPOSE: Results of the Korea National Health Screening Program for Infants and Children, which was launched in November 2007, were evaluated for future research and policy development. METHODS: Data from a total of 2,729,340 cases were analyzed. Five visiting ages, such as 4, 9, 18, 30, and 60 months, were included. Several parameters such as stunting, obesity, and positive rate of developmental screening were also analyzed. Telephone survey was performed in 1,035 users. For the provider survey, 262 doctors participated in our study. RESULTS: The overall participation rate of users was 35.3%. This participation rate showed a decrement tendency to old age and low income. Only 6.9% of users participated in oral screening. Health screening was performed mainly in private clinics (82.6%). The recall rate of 4 months program users at the age of 9 months was 57.3%. The positive rate of screening was 3.1%, and was higher in the low-income group. By telephone survey, users reported that questionnaires were not difficult (94%) and overall satisfaction was good (73%). Longer duration of counseling was related with more satisfied users. Counseling and health education were helpful to users (73.2%). Doctors agreed that this program was helpful to children (98.5%). CONCLUSION: Korea National Health Screening Program for Infants and Children was launched successfully. Participation rate should be improved, and a quality control program needs to be developed. More intensive support following this program for children of low-income families may lead to effective interventions in controlling health inequality. Periodic update of guidelines is also needed.
Child ; Counseling ; Health Education ; Humans ; Infant ; Korea ; Mass Screening ; Obesity ; Policy Making ; Quality Control ; Surveys and Questionnaires ; Socioeconomic Factors ; Telephone

BACKGROUND/AIMS: Patients undergoing cholecystectomy may have small intestinal bacterial overgrowth (SIBO). We investigated the prevalence and characteristics of SIBO in patients with intestinal symptoms following cholecystectomy. METHODS: Sixty-two patients following cholecystectomy, 145 with functional gastrointestinal diseases (FGIDs), and 30 healthy controls undergoing hydrogen (H2)-methane (CH4) glucose breath test (GBT) were included in the study. Before performing GBT, all patients were interrogated using bowel symptom questionnaire. The positivity to GBT indicating the presence of SIBO, gas types and bowel symptoms were surveyed. RESULTS: Post-cholecystectomy patients more often had SIBO as evidenced by a positive (+) GBT than those with FGID and controls (29/62, 46.8% vs 38/145, 26.2% vs 4/30, 13.3%, respectively; P = 0.010). In the gas types, the GBT (H2) + post-cholecystectomy patients was significantly higher than those in FGIDs patients (P = 0.017). Especially, positivity to fasting GBT (H2) among the GBT (H2)+ post-cholecystectomy patients was high, as diagnosed by elevated fasting H2 level. The GBT+ group had higher symptom scores of significance or tendency in abdominal discomfort, bloating, chest discomfort, early satiety, nausea, and tenesmus than those of the GBT negative group. The status of cholecystectomy was the only significant independent factor for predicting SIBO. CONCLUSIONS: The SIBO with high levels of baseline H2 might be the important etiologic factor of upper GI symptoms for post-cholecystectomy patients.
Breath Tests* ; Cholecystectomy ; Fasting ; Gastrointestinal Diseases ; Glucose* ; Humans ; Hydrogen* ; Nausea ; Prevalence ; Thorax

PURPOSE: This study was undertaken to develop directions for research on nursing practice education and also for standardization of contents of Fundamental Nursing Practice (FNP) by identifying and analyzing the present content and inconsistency in FNP textbooks. METHOD: Eleven FNP textbooks published between 2007 and 2013 were selected and itemized nursing contents were compared and analyzed. Nursing professors and practicingnurses prioritized contents identified from an actual condition survey based on theoretical reason and clinical guides for each item. RESULTS: Inconsistencies were found for 34 domains with 219 sub items and of them, 21 domains and 84 items needed to be standardized. Number of items that showed consistency between professors and nurses (ICC > or = .800) was 29 (34.5%) and for complete consistency (ICC=1), 4 (4.8%). Number of items that showed inconsistency between the groups (ICC< .600) was 30 (35.7%) and very low consistency (ICC=0), 10 (11.9%). CONCLUSION: The results indicate a difference between understood validity of content by professors and by nurses and technical differences among FNP textbooks. Therefore confirmation of the items needing to be standardized and differences in understanding content by professors and by nurses shows a need for standardization of practice education between course and clinical practice. These results provide basic data for developing standardized form of FNP education.
Education* ; Education, Nursing ; Nursing*

Neuromyelitis optica spectrum disorder (NMOSD) is a rare inflammatory demyelinating disease. Anti-aquaporin-4 antibodies serve as a specific biomarker, while other factors including antecedent infection may also play a role in the development of NMOSD. Abnormal cerebrospinal fluid (CSF) findings such as leukocytosis with concentration >50/mm3 are one of the characteristics of NMOSD, but these were not specific for identifying other infective neurological diseases. Here we describe a rare case of NMOSD with CSF findings suggestive of bacterial meningomyelitis.

Purpose: Mycoplasma pneumoniae pneumonia (MP) is a major cause of community-acquired pneumonia (CAP) in children and is associated with extrapulmonary manifestations (EPM). The incidence and risk factors for EPM in children are unknown. Methods: This was a retrospective study involving 65,243 pediatric patients with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Medical records were reviewed to collect information regarding the clinical characteristics, radiological results, and laboratory findings. Logistic regression with multivariate analysis was performed to evaluate the risk factors associated with EPM in MP. Results: The incidence of EPM was 23.9%, including elevation of liver enzymes (18.1%), mucocutaneous manifestations (4.4%), proteinuria (4.1%), cardiovascular and neurological manifestations (0.4%), hematologic manifestations (0.2%), and arthritis (0.2%). Statistical analysis showed that mucocutaneous manifestations significantly increased with elevated alanine aminotransferase (adjusted odds ratio [aOR], 3.623; 95% confidence interval [CI], 1.933-6.790) and atopic sensitization (aOR, 2.973; 95% CI, 1.615–5.475) and decreased with respiratory virus coinfection (aOR, 0.273; 95% CI, 0.084–0.887). Elevated liver enzymes were significantly associated with elevated lactate dehydrogenase (aOR, 3.055; 95% CI, 2.257–4.137), presence of pleural effusion (aOR, 2.635; 95% CI, 1.767–3.930), and proteinuria with respiratory virus coinfection (aOR, 2.245; 95% CI, 1.113–4.527). Conclusion Approximately 24% of pediatric patients with MP had various EPM. As the risk factors associated with each EPM were different, it is necessary to evaluate the various clinical aspects and findings of MP to predict and prepare for the occurrence of EPM.