Purpose: We aimed to derive insights by analyzing the results of a patient safety awareness survey conducted by the Regional Patient Safety Center of the Korean Medical Association. Methods: Survey questions were developed in three domains: sociodemographic characteristics, patient safety awareness, and patient safety education needs. An online anonymous survey targeting Korean physicians was conducted annually from 2021 to 2023. Chi-square tests were used to verify differences in responses by year and sociodemographic characteristics. Results: A total of 774 physicians participated in the survey over the three-year period. Approximately half of the participants were still assessed to have insufficient knowledge about patient safety, and no clear year-over-year improvement was observed. Additionally, while patient safety incidents appeared common, the proportion of respondents who reported incidents remained around 20%. However, participants showed high levels of agreement or engagement in patient participation activities related to patient safety (over 90%), with 60% having previously received patient safety-related education, and nearly 90% expressing willingness to participate in future education. The findings also highlighted a particular urgency in improving patient safety awareness among clinic-based physicians. Conclusion Promoting awareness of patient safety incident reporting methods and encouraging clinic-based physicians to report incidents should be prioritized. The study’s findings will provide a foundation for more effectively fostering physician engagement in patient safety improvement activities.

Purpose: To confirm the clinical features of hemicentral retinal vein occlusion and identify predictors of visual outcomes. Methods: A retrospective analysis was conducted on patients diagnosed with hemicentral retinal vein occlusion between January 2018 and December 2022 and followed for more than 6 months. Patients underwent intravitreal injections as necessary for intraretinal edema. Visual acuity, central macular thickness, ellipsoid zone damage, and the location of inner retinal layer edema were assessed. Patients were categorized into groups A and group B based on the visual acuity at 6 months. Results: In total, 20 eyes were followed, with 15 eyes observed for up to 12 months. Seven patients (35.0%) had diabetes and 11 (55.0%) had hypertension. There was a correlation between poor vision at 6 months and hypertension (p = 0.033). The visual acuity of all patients improved from a logMAR of 0.96 at the initial visit to a logMAR of 0.35 at 6 months (p = 0.005). In the group with good initial visual acuity, there were no significant changes in visual acuity during the follow-up period (p = 0.444). The group with good visual acuity at 6 months had a lower degree of photoreceptor ellipsoid zone disruption compared to the group with poor initial vision, indicating a normal structure (p = 0.015). Conclusions During follow-up of patients with hemicentral retinal vein occlusion, overall visual acuity improved over time. Patients with good initial acuity maintained it. Favorable visual outcomes can be expected if the ellipsoid zone has a normal structure at the time of the first examination.

Purpose: We report a case of bilateral nasal and temporal four-site scleromalacia following cosmetic conjunctivectomy, successfully managed with simultaneous restoration surgery at all four sites using autologous tragal perichondrium and preserved scleral graft.Case summary: A 56-year-old woman who underwent cosmetic conjunctivectomy on both eyes 15 years earlier, presented with intermittent eye pain. Examination revealed scleromalacia with calcium plaques in all four nasal and temporal scleral areas. The most extensive avascular area was in the nasal region of the right eye, and the most prominent uveal exposure was in the nasal area of the left eye. Considering the lesion and exposure sizes of the avascular zone and uvea exposure, preserved sclera was transplanted to the temporal and nasal areas of the right eye, while autologous tragal perichondrium was transplanted to the nasal area of the left eye. Tenon's capsule vessels were fixed with pedicle flaps in all four surgical areas for vascularization. Frozen amniotic membrane was transplanted in the nasal area of the left eye, where the conjunctival defect was substantial, and in the lateral area of the left eye, where no graft was used. The conjunctival epithelium was closed using autologous conjunctival flaps in all four areas. Post-surgery, successful engraftment and vascularization of the graft materials were observed in both eyes. Conclusions Even with multiple areas of scleromalacia in both eyes, successful results can be achieved during simultaneous surgery if an appropriate graft material is selected and the surgery is performed utilizing principles of tissue restoration.

Purpose: To evaluate the clinical efficacy of intense pulsed light (IPL) therapy combined with meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD) caused by glaucoma eye drops. Methods: This study included 20 patients (aged 18-85 years) who were using glaucoma eye drops and exhibited signs of MGD. Participants underwent four sessions of IPL therapy at 3-week intervals, each followed by MGX. Evaluative measures included the Ocular Surface Disease Index (OSDI), best-corrected visual acuity, Schirmer's test, tear break-up time (TBUT), corneal fluorescein staining score (CFS), lid margin abnormalities, meibomian gland expressibility (MGE), meibum quality, lipid layer thickness (LLT), and meiboscore. These assessments were conducted before and after each treatment. Results: After treatment, significant improvements were observed across all measured parameters, including OSDI, Schirmer's test, TBUT, CFS, lid margin abnormalities, MGE, meibum quality, LLT, and meiboscore. Conclusions IPL therapy combined with MGX was effective in improving ocular surface and eyelid abnormalities among patients with MGD induced by glaucoma eye drops. Our findings support the use of IPL and MGX as safe and effective adjunct therapies for these patients.

Intervertebral disc degeneration is associated with diverse spine diseases, including spinal stenosis, facet arthropathy, and disc herniation, which have socio-economic effects. A normal intervertebral disc has consistency and homeostasis, consisting of annulus fibrosus, nucleus pulposus, notochordal cells, nucleus pulposus cells, and an endplate with an immune privilege. On the other hand, when the degenerative process has pathologic causes, the inflammatory reaction could lead to nerve sprouting and vascularization into the tissue. Histopathologically, the pathologic process involves the degradation of the extracellular matrix, apoptosis and necrosis of nucleus pulposus cells, inhibition of chondrogenic differentiation, disruption of endplate chondrogenic cells, and other processes. Various approaches for managing disc degeneration have been reported. Among them, mesenchymal stem cells (MSCs) have been regarded as representative trials. In vitro and animal studies with MSCs have reported some promising outcomes in terms of inflammatory modulation and regeneration, but several limitations have been pointed out, including the issues of graft rejection and survival. Because the paracrine mechanism would be a main therapeutic factor of MSCs, extracellular vesicles (EVs), one of the factors released from MSCs, have been considered a promising source for regenerative medicine. EVs possess nucleic acids, functional proteins, and inflammation-related factors, playing a significant role in the inflammatory reaction and regeneration. The current review article discusses the pathophysiology of disc degeneration, outcomes of conventional MSCs and EVs, and current limitations and future perspectives on EV therapeutics.

Accessory breast tissue can appear along the mammary ridge, extending from the axilla to the groin, with the axilla being the most common site. Malignancies arising in accessory breast tissue are rare, representing approximately 0.3%–0.6% of all breast cancer cases.When evaluating accessory breasts, it is essential to apply the same management strategies used for conventionally positioned breasts. This report presents a case of ductal carcinoma in situ originating from accessory breast tissue in the axilla of a 55-year-old woman. The diagnosis was established through a comprehensive assessment involving mammography, ultrasound, and magnetic resonance imaging. Since the axillary accessory breast tissue wasn’t initially included in the routine mammography, we added an axillary tail view to evaluate the extent and morphology of malignant microcalcifications.