PURPOSE: We evaluated cultured specimens from silicone tubes removed from patients with congenital nasolacrimal duct obstruction and determined the antibiotic sensitivities of the specimens. METHODS: This study included 26 eyes of 22 patients who had received endonasal silicone tube intubation for congenital nasolacrimal duct obstruction. The removed silicone tubes were divided into canaliculus, lacrimal sac, nasolacrimal duct and nasal cavity parts according to insertion state. Then, bacteria and fungus cultures were performed and their antibiotic sensitivity was tested. RESULTS: Bacteria culture rate was 80.8% in the canaliculus and the lacrimal sac, and 88.5% in the lacrimal duct, and the nasal cavity, which was not significantly different according to insertion site. Fungus culture rate was significantly higher in the nasal cavity than in the nasolacrimal duct and in the nasolacrimal duct than in the lacrimal sac and the canaliculus (p-value < 0.05). The species of cultured Gram-positive bacteria were in the following order: Staphylococcus aureus, Streptococcus pneumonia and coagulase negative Staphylococcus. Common species of cultured Gram-negative bacteria were Pseudomonas and Serratia marcescens. All six species of cultured fungi were Candida. Among 12 Staphylococcus aureus cultured, eight species showed resistance to methicillin (MRSA). In all patients, the symptoms and the signs of nasolacrimal duct obstruction improved after the tube removal. CONCLUSIONS: Bacterial and fungal infection of the silicone tube in patients with congenital nasolacrimal duct obstruction does not appear to affect directly the outcome of silicone tube intubation. Further studies of bacterium and fungi in the nasolacrimal duct before silicone tube intubation are needed for determining the infection causing nasolacrimal duct obstruction.
Bacteria ; Candida ; Coagulase ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Intubation ; Methicillin ; Nasal Cavity ; Nasolacrimal Duct* ; Pneumonia ; Pseudomonas ; Serratia marcescens ; Silicones* ; Staphylococcus ; Staphylococcus aureus ; Streptococcus

Thyroid hormone plays a critical role in fetal growth and development, and thyroid dysfunction during pregnancy is associated with several adverse outcomes, such as miscarriage and preterm birth. In this review, we introduce and explain three major changes in the revised Korean Thyroid Association (KTA) guidelines for the diagnosis and management of thyroid disease during pregnancy: first, the normal range of thyroid-stimulating hormone (TSH) during pregnancy; second, the treatment of subclinical hypothyroidism; and third, the management of euthyroid pregnant women with positive thyroid autoantibodies. The revised KTA guidelines adopt 4.0 mIU/L as the upper limit of TSH in the first trimester. A TSH level between 4.0 and 10.0 mIU/L, combined with free thyroxine (T4) within the normal range, is defined as subclinical hypothyroidism, and a TSH level over 10 mIU/L is defined as overt hypothyroidism regardless of the free T4 level. Levothyroxine treatment is recommended when the TSH level is higher than 4 mIU/L in subclinical hypothyroidism, regardless of thyroid peroxidase antibody positivity. However, thyroid hormone therapy to prevent miscarriage is not recommended in thyroid autoantibody-positive women with normal thyroid function.

PURPOSE: To report the clinical effect of an eyelid stretching exercise in 8 cases of overcorrected congenital ptosis after levator resection and present a literature review. CASE SUMMARY: Eyelid stretching exercise was performed by pushing the margin of the upper eyelid down. If margin reflex distance 1 (MRD1) asymmetry was larger than 1.5 mm compared with the other eyelid after the stretching exercise for 2 weeks, the exercise was extended for 1 more week. This study included 8 eyes of 8 patients who performed eyelid stretching exercise for 2 weeks when overcorrected 1 week after undergoing levator resection. We compared preoperative MRD1 and postoperative MRD1s for 1 month. Overcorrection was corrected satisfactorily in all patients with bilateral symmetry with eyelid stretching exercise for 2 weeks. Additional exercise did not affect MRD1. CONCLUSIONS: In congenital ptosis overcorrected after levator resection, medical treatment including eyelid stretching exercise could be considered before undergoing a secondary operation. Eyelid stretching exercise can be effective when performed early before fibrous tissue bonds are too firm.
Eyelids* ; Humans ; Reflex

No abstract available.
Pregnancy*

The levels of ergothioneine (ERG), which have been shown to act as an excellent antioxidant, were determined in both fruiting bodies and mycelia of various mushroom species. We found that ERG accumulated at different levels in fruiting bodies of mushrooms and showed up to a 92.3-fold difference between mushrooms. We also found that ERG accumulated at higher levels in mycelia than in fruiting bodies of economically important mushroom species such as Ganoderma neo-japonicum, G. applanatum and Paecilomyces tenuipes. The addition of 2 mM methionine (Met) to mycelial culture medium increased the ERG contents in most mushroom species tested, indicating that Met is a good additive to enhance the ERG levels in a variety of mushroom species. Taking these results into consideration, we suggest that the addition of Met to the mycelial culture medium is an efficient way to enhance the antioxidant properties in economically important mushroom species.
Agaricales ; Ergothioneine ; Fruit ; Ganoderma ; Methionine ; Paecilomyces

Background: This study aimed to investigate the changes of incidence and treatment of choice for hyperthyroidism from 2003 to 2018 and explore the treatment-related complications and concomitant comorbidities in South Korea using data from the National Health Insurance Service. Methods: This is a retrospective observational study. Hyperthyroidism was defined as a case having two or more diagnostic codes of thyrotoxicosis, with antithyroid drug intake for more than 6 months. Results: The average age-standardized incidence of hyperthyroidism from 2003 to 2018 was 42.23 and 105.13 per 100,000 men and women, respectively. In 2003 to 2004, hyperthyroidism was most often diagnosed in patients in their 50s, but in 2017 to 2018, people were most often diagnosed in their 60s. During the entire period, about 93.7% of hyperthyroidism patients were prescribed with antithyroid drugs, and meanwhile, the annual rates of ablation therapy decrease from 7.68% in 2008 to 4.56% in 2018. Antithyroid drug-related adverse events, mainly agranulocytosis and acute hepatitis, as well as complications of hyperthyroidism such as atrial fibrillation or flutter, osteoporosis, and fractures, occurred more often in younger patients. Conclusion In Korea, hyperthyroidism occurred about 2.5 times more in women than in men, and antithyroid drugs were most preferred as the first-line treatment. Compared to the general population, hyperthyroid patients may have a higher risk of atrial fibrillation or flutter, osteoporosis, and fractures at a younger age.

This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4%) were mothers. Among them 89.6% were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36%), followed by 28% from Kyung Gi Province, and 20% were from the Kyung Sang area. Among 8,261 callers, 72.8% were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5%) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3%), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25% and 23.3% respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3% with diaper rash being the second highest among the skin problems. About 80% of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.
Caregivers ; Child ; Child Care ; Child Rearing ; Child Health* ; Child* ; Constipation ; Counseling* ; Dermatitis, Atopic ; Diaper Rash ; Female ; Growth and Development ; Humans ; Immunization ; Male ; Mothers ; Nursing ; Parents ; Psychology ; Seoul ; Skin ; Social Welfare ; Telephone* ; Vomiting

Pedunculated hepatocellular carcinoma (P-HCC) can be defined as a carcinoma protruding from the liver with or without a pedicle. Cases of P-HCC showing extrahepatic growth are very rare. P-HCC constitutes 0.2-4.2% of all HCC cases in Japan and Taiwan, but few cases in Korea have been reported. A 67-year-old female patient was admitted to our hospital with a 6-month history of epigastric discomfort. Examination identified an abdominal mass in the left upper quadrant, and abdominal computed tomography revealed a huge mass adjacent to the fundus of the stomach. We diagnosed this mass as a gastrointestinal stromal tumor because of its size and site. However, postoperative histopathological findings showed that the mass was HCC. Here, we report this case and review the relevant medical literature.
Aged ; Carcinoma, Hepatocellular ; Female ; Gastrointestinal Stromal Tumors ; Humans ; Japan ; Korea ; Liver ; Stomach ; Taiwan

Pedunculated hepatocellular carcinoma (P-HCC) can be defined as a carcinoma protruding from the liver with or without a pedicle. Cases of P-HCC showing extrahepatic growth are very rare. P-HCC constitutes 0.2-4.2% of all HCC cases in Japan and Taiwan, but few cases in Korea have been reported. A 67-year-old female patient was admitted to our hospital with a 6-month history of epigastric discomfort. Examination identified an abdominal mass in the left upper quadrant, and abdominal computed tomography revealed a huge mass adjacent to the fundus of the stomach. We diagnosed this mass as a gastrointestinal stromal tumor because of its size and site. However, postoperative histopathological findings showed that the mass was HCC. Here, we report this case and review the relevant medical literature.
Aged ; Carcinoma, Hepatocellular ; Female ; Gastrointestinal Stromal Tumors ; Humans ; Japan ; Korea ; Liver ; Stomach ; Taiwan

OBJECTIVE: To determine whether the presence of Y-chromosome microdeletion affects the outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) program. METHODS: Fourteen couples with microdeletion in azoospermic factor (AZF)c region who attempted IVF/ICSI or cryopreserved and thawed embryo transfer cycles were enrolled. All of the men showed severe oligoasthenoteratoazoospermia (OATS) or azoospermia. As a control, 12 couples with OATS or azoospermia and having normal Y-chromosome were included. Both groups were divided into two subgroups by sperm source used in ICSI such as those who underwent testicular sperm extraction (TESE) and those used ejaculate sperm. We retrospectively analyzed our database in respect to the IVF outcomes. The outcome measures were mean number of good quality embryos, fertilization rates, implantation rates, beta-hCG positive rates, early pregnancy loss and live birth rates. RESULTS: Mean number of good quality embryos, implantation rates, beta-hCG positive rates, early pregnancy loss rates and live birth rates were not significantly different between Y-chromosome microdeletion and control groups. But, fertilization rates in the Y-chromosome microdeletion group (61.1%) was significantly lower than that of control group (79.8%, p=0.003). Also, the subgroup underwent TESE and having AZFc microdeletion showed significantly lower fertilization rates (52.9%) than the subgroup underwent TESE and having normal Y-chromosome (79.5%, p=0.008). Otherwise, in the subgroups used ejaculate sperm, fertilization rates were showed tendency toward lower in couples having Y-chromosome microdeletion than couples with normal Y-chromosome. (65.5% versus 79.9%, p=0.082). But, there was no significance statistically. CONCLUSIONS: In IVF/ICSI cycles using TESE sperm, presence of Y-chromosome microdeletion may adversely affect to fertilization ability of injected sperm. But, in cases of ejaculate sperm available for ICSI, IVF outcome was not affected by presence of Y-chromosome AZFc microdeletion. However, more larger scaled prospective study was needed to support our results.
Avena ; Azoospermia ; Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro* ; Humans ; Live Birth ; Male ; Outcome Assessment (Health Care) ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Y Chromosome*