Purpose: To report the long-term outcomes of patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO) and to explore the ME incidence and factors associated with ME resolution. Methods: We retrospectively studied patients with ME secondary to CRVO. The visual acuity at baseline was compared to that at the final visit. The incidence and timing of ME resolution during treatment were evaluated and the visual outcomes of patients who did and did not experience ME resolution were compared. We also identified factors predictive of ME resolution. Results: We included 79 patients; the mean follow-up time was 50.1 ± 14.3 months. The mean logarithm of the minimal angle of resolution (logMAR) of visual acuity was 0.94 ± 0.75 at diagnosis and 1.00 ± 0.84 at the final visit (p = 1.000). A logMAR visual loss of 0.3 or greater was noted in 28 patients (35.4%). During follow-up, ME resolution was evident in 40 eyes (50.6%) at a mean of 16.9 ± 17.4 months. Visual improvement was greater in patients who evidenced ME resolution than in those who did not (p < 0.001). The ME resolution rate was higher in patients younger than 60 years (p = 0.039) and in those who lacked subretinal fluid at diagnosis (p < 0.001). Conclusions In patients with ME secondary to CRVO, the risk of long-term recurrent ME was higher in older patients and those evidencing subretinal fluid at diagnosis indicating that such patients require close follow-up and aggressive treatment.

PURPOSE: To evaluate the duration of therapy in amblyopic children with anisometropia and/or strabismus who had been successfully treated with a best corrected visual acuity (BCVA) of 1.0. METHODS: The duration of amblyopic treatment was compared according to the cause of amblyopia (anisometropia, strabismus, combined), the initial BCVA of amblyopic eye, the age at treatment, and the prediction of a further duration of treatment needed. RESULTS: The mean age of amblyopic treatment in 66 amblyopic children with anisometropia and strabismus was 5.4 years and the mean duration of treatment to gain BCVA of 1.0 was 15.9 months. The duration of treatment was longer in children with initially poorer BCVA and in younger aged children than in older aged children at diagnosis. However, there was no statistical significance according to the cause of amblyopia. In occlusion therapy, the patching time from the initial BCVA to 1.0 was not statistically different from the patching time from the midpoint VA (between the initial visual acuity and 1.0) to 1.0. CONCLUSIONS: The duration of treatment to gain a VA of 1.0 was dependent on the degree of the initial BCVA in the amblyopic eye and the age at treatment. In occlusion therapy, the duration of further treatment to gain a BCVA of 1.0 was necessary as much as the duration to gain a midpoint VA from the initial BCVA.
Aged ; Amblyopia ; Anisometropia ; Child ; Eye ; Humans ; Strabismus ; Visual Acuity

Purpose: To evaluate the long-term clinical outcomes of vitrectomy with internal limiting membrane (ILM) removal for patients with macular hole retinal detachment (MHRD). Methods: We retrospectively reviewed the medical records of patients with MHRD who underwent vitrectomy with ILM removal. The incidence of retinal re-attachment and MH closure at 1 month were calculated. Factors associated with RD recurrence were investigated. Visual acuity before surgery was compared to that at the final visit. Results: Forty-two eyes were included; the mean follow-up period was 38.5 ± 19.1 months. Twenty-three eyes received gas injections and 19 silicone oil injections. Retinal re-attachment occurred in 41 (97.6%). Type 1 closure was noted in 21 eyes (51.2%) and type 2 in 20 (48.8%). Recurrent RD was noted in five eyes (14.6%) within 3 months of initial surgery. Type 2 closure was a risk factor for recurrence (p = 0.021). The logarithm of the minimum angle of resolution best-corrected visual acuity improved significantly from 1.79 ± 0.79 before surgery to 1.30 ± 0.75 after surgery (p < 0.001). Conclusions Retinal re-attachment was noted in most patients and the MH closed in approximately half of all patients after vitrectomy with ILM removal to treat MHRD. RD did not recur later than 3 months after initial surgery. Further efforts to increase the rate of type 1 closure are required.

OBJECTIVES: This study aimed to evaluate the mental health status of the children of psychiatric patients in order to plan for the resources that may be necessary to help these children achieve their full potential. METHODS: Forty-eight children (age 9–18) whose parents were registered in 5 community mental health centers located in Seoul were recruited. Tests assessing 3 psychological domains were conducted: 1) cognition: Korean version of Learning Disability Evaluation Scale, Comprehensive Attention Test, 2) parent reported emotion and behavior: Korean Child Behavior Checklist, Korean attention-deficit hyperactivity disorder Rating Scale, and 3) self-reported emotion and behavior: Korean Beck's Depression Inventory-II/Children's Depression Inventory-II, Korean Youth Self Report). We defined the children as having a high risk of developing mental health problems if their test scores were over the cut-off levels in 2 or more of the 3 domains assessed. RESULTS: Twelve (25%) children were classified as having a high risk of developing mental health issues. 20 (41.6%) children scored above the cut-off in only one of the domains. CONCLUSION: Our results suggest that the children of psychiatric patients might be vulnerable to mental illness and need early prevention or interven-tions for the sake of their mental health.
Adolescent ; Checklist ; Child Behavior ; Child* ; Cognition ; Community Mental Health Centers ; Depression ; Humans ; Learning Disorders ; Mass Screening* ; Mental Health* ; Parents* ; Seoul

Epithelioid angiomyolipoma (EAML) of liver is a rare neoplasm. Hepatic EAML is often misdiagnosed as other neoplasms such as hepatocellular carcinoma due to non-specific clinical and radiologic features. The morphologic features under microscope and immunohistochemistry staining profile are important in the diagnosis EAML. Here, we report a case of 52-year-old man who found 1.2 cm mass in liver by routine checkup. On the impression of hepatocellular carcinoma, lateral sectionectomy of the liver was done. Microscopically, the tumor is composed of predominant epithelioid cells with vascular component and foamy cells. These cells were positive for HMB45, MelanA, and smooth muscle actin and negative for epithelial membrane antigen. The final diagnosis was hepatic EAML.
Actins ; Angiomyolipoma* ; Carcinoma, Hepatocellular ; Diagnosis ; Epithelioid Cells ; Humans ; Immunohistochemistry ; Liver* ; MART-1 Antigen ; Middle Aged ; Mucin-1 ; Muscle, Smooth ; Perivascular Epithelioid Cell Neoplasms

PURPOSE: The aim of this study was to verify the effects of daily 2% chlorhexidine gluconate (CHG) bathing on the acquisition of multidrug-resistant organisms (MDRO) and healthcare-associated infection (HAI) in a medical intensive care unit (MICU). METHODS: The study was a randomized controlled group posttest only design, involving 91 patients in MICU at a tertiary hospital (47 patients in the experimental group and 44 patients in the control group). The 2% CHG bathing was performed daily according to bathing protocol to the patients in the experimental group, and traditional bath was performed every three days to those in the control group. Fisher's exact test and χ² test were used to analyze the data. RESULTS: MDRO were found in 6 patients of the experimental group and in 15 patients of the control group. The difference was statistically significant (p=.016). HAI occurred in 2 patients of the experimental group and in 7 patients of the control group. The difference was not statistically significant (p=.084). CONCLUSION: The results confirmed that daily bathing with CHG was effective in reducing the incidence of MDRO acquisition. Therefore, it is expected that daily bathing with CHG will be used as an effective nursing intervention to reduce the incidence of MDRO acquisition.
Baths ; Chlorhexidine ; Critical Care ; Cross Infection ; Drug Resistance, Microbial ; Humans ; Incidence ; Intensive Care Units ; Nursing ; Tertiary Care Centers

Purpose: We report a rare case of allergic contact dermatitis after the use of a non-preservative 0.5% moxifloxacin ophthalmic solution.Case summary: A 60-year-old male presented with bacterial corneal ulceration of the right eye. He was treated with 50 mg/mL of fortified cefazolin and 14 mg/mL of tobramycin that were tapered as the corneal lesion improved after 1 month, and 0.5% moxifloxacin application was started. After 2 weeks of moxifloxacin treatment, the patient developed conjunctival injection, lid swelling, redness, and itching in the right eye. An allergic reaction was suspected and moxifloxacin administration was immediately stopped. The symptoms improved after the administration of oral antihistamines, 0.5% loteprednol eye drops, and steroid combination ointment. Conclusions Patients treated with 0.5% topical moxifloxacin should be monitored for allergic contact dermatitis, even if preservative-free eye drops are used.

It is important to understand the acute and chronic complications of prolonged contact lens use; treatment of acute problems is more effective than treatment of chronic reactions because it is difficult to restore corneal tissue. Contact lens-induced acute red eye (CLARE) is an acute inflammatory reaction of the cornea and conjunctiva triggered by contact lenses. CLARE recurrence is common; differential diagnosis from serious eye diseases that can compromise visual acuity is important. CLARE must be appropriately treated and patients must be educated in terms of safe contact lens wearing and storage.

Purpose: This study aimed to conduct a systematic literature review and meta-analysis of the exercise intervention effects for the prevention of musculoskeletal injuries in military personnel. Methods: Among studies that included military personnel as participants, we identified randomized controlled trials (RCTs) and cluster-RCT studies that used exercise interventions as a method for injury prevention. Exercise encompassed all types of physical activity, and the effect size was determined by the ratio of injuries between groups.Literature searches were conducted with search terms modified to ensure common inclusion of keywords such as “Soldier,” “Injury prevention,” and “Exercise.” For the analysis of potential factors, variables selected for group differentiation included gender, risk of bias, exercise volume, injury location, exercise type, and study design. Results: Among a total of 8,598 search results, 10 papers were finally confirmed. The meta-analysis of all 10 papers showed that there was no statistically significant injury prevention effect, and significant heterogeneity was observed among the studies (incidence rate ratio, 0.82; 95% confidence interval, 0.62–1.09, I2 =83%). Subgroup analysisrevealed a significant 44% reduction in injuries in studies where exercise volume for injury prevention was relatively high. However, no significant injury prevention effects were observed in other potential factors between groups. Conclusion The results of this study suggest that the effectiveness of injury prevention exercises in military settings was not statistically significant. However, through the analysis of potential factors, it was confirmed that increasing the time spent on injury prevention exercises may have a preventive effect on injuries.