PURPOSE: To evaluate the influence of a silicone tube on tear drainage in patients with a healed rhinostomy site after dacryocystorhinostomy. METHODS: The subjects of the present study included the patients for whom the removal of a silicone tube was performed after dacryocystorhinostomy for acquired nasolacrimal duct obstruction. The silicone tube was removed after the rhinostomy site was completely healed. The tear drainage function was evaluated using the fluorescein dye disappearance test at the following 3 time points: immediately before, immediately after, and 1 month after silicone tube removal. In addition, a Schirmer test was performed and tear break-up time was measured at each time point. To study the correlation between the measured values and subjective tearing symptoms, self-report questionnaires were given to each patient at his/her last visit. RESULTS: The 3 measured values showed no statistical difference between the 3 time points, immediately before, immediately after, and 1 month after silicone tube removal. When the patients were divided into groups according to their subjective symptomatic changes after silicone tube removal, no group showed statistically significant difference in the 3 measured values before, between, and after silicone tube removal. CONCLUSIONS: In patients with a healed rhinostomy site after dacryocystorhinostomy, the removal of the silicone tube did not induce a change of tear drainage function. Therefore, based on the results from the present study, a silicone tube may not have influence on tear drainage functions.
Dacryocystorhinostomy ; Drainage ; Fluorescein ; Humans ; Nasolacrimal Duct ; Surveys and Questionnaires ; Silicones ; Tears

PURPOSE: To investigate the role of gangliosides in the differentiation of orbital fibroblasts into adipocytes, a component in the pathogenesis of Graves' ophthalmopathy. METHODS: Orbital tissues were obtained during orbital surgery for subjects without Graves' ophthalmopathy or other inflammatory orbital disease, and orbital fibroblasts were primarily cultured from each obtained tissue. Morphological examination of orbital fibroblasts was performed after treatment with commercially available gangliosides mixture (Gmix) comprised of several subtypes. To determine the effect of Gmix on the differentiation of orbital fibroblasts into adipocytes and the differentiation-related genes, Oil Red-O staining and RT-PCR were performed. RESULTS: The treatment with Gmix induced the morphological changes, which at least in part were explained with the differentiation of orbital fibroblasts into adipocytes in accordance with the increase of mRNA level of genes known to be related to adipogenesis, whereas dermal fibroblasts and preadipocytes were irresponsive to the same treatment. CONCLUSIONS: The results from the present study suggest gangliosides may have a role in pathologic mechanisms of Graves' ophthalmopathy by the induction of differentiation of orbital fibroblasts into adipocytes.
Adipocytes ; Adipogenesis ; Fibroblasts ; Gangliosides ; Orbit ; Orbital Diseases ; RNA, Messenger

PURPOSE: This study develop a Video Recording-Based Standardized Handoff (VRSH) program at shift change for ward nurses.METHOD: The study was conducted in five medical, three surgical, and one comprehensive nursing care service wards affiliated with a secondary general hospital. In this methodological study, the VRSH program was developed between April and December, 2017. It is noted that 65 nurses who were involved in the VRSH program participated in this study.RESULTS: In line with the modified Situation, Background, Assessment, Recommendation tool, the VRSH program consisted of three phases. In the VRSH program, the average time for handoff duration was 3–5 minutes per patient. More than 90% of the ward nurses were satisfied with the VRSH program since it benefited them by reducing overtime work and improving the performance, as well as effective communication, of nurses. The content analysis of nurses' VRSH program experience, revealed three categories and eight sub-categories.CONCLUSION: This study provides evidence that the VRSH program improves effective nursing performance and, the handoff communication and relationships between nurses. Future studies on large sample sizes and multiple settings are required to substantially evaluate the impact of the VRSH program on clinical outcomes.
Feasibility Studies ; Hospitals, General ; Humans ; Methods ; Nursing ; Nursing Care ; Patient Handoff ; Pilot Projects ; Sample Size ; Video Recording

OBJECTIVES: The reproductive history of women has been suggested to have a possible influence on the risk of osteoporotic fractures. The purpose of this study was to assess the association between reproductive history and hip fractures in the elderly women. METHODS: The study subjects were drawn from women members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, whose reproductive histories were available, and who were beneficiaries of the Korea Medical Insurance Corporation (KMIC) in 1993 and lived in Busan city, Korea. The information on reproductive histories, and possible confounders, were collected from mailed questionnaires. Potential hip fracture cases were collected from the claims data obtained between 1993 and 1998, with a hospital survey conducted to confirm the final diagnoses. Rate ratios and their 95% confidence intervals, were calculated using a Cox's proportional hazard model. RESUJLTS: Following up 5,219 women for 6 years, 51 cases were confirmed with hip fractures. When adjusted for age, weight and physical activity, the rate ratio of hip fractures in women who had given birth three or more times was 0.56 (95% CI: 0.25 - 1.25), compared with those who had given birth two or less times. When adjusted for age, number of births, weight and physical activity, the rate ratio in women who first gave birth when younger than 22 years was 0.60 (95% CI: 0.34 - 1.08) compared with those who had giving birth at 22 years or older. CONCLUSIONS: According to these findings, an early age when first giving birth might decrease the risk of hip fractures in elderly Korean women.
Aged* ; Busan ; Cohort Studies* ; Diagnosis ; Female ; Hip Fractures ; Hip* ; Humans ; Insurance ; Korea* ; Motor Activity ; Osteoporotic Fractures ; Parturition ; Postal Service ; Proportional Hazards Models ; Surveys and Questionnaires ; Reproductive History*

OBJECTIVES: The reproductive history of women has been suggested to have a possible influence on the risk of osteoporotic fractures. The purpose of this study was to assess the association between reproductive history and hip fractures in the elderly women. METHODS: The study subjects were drawn from women members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, whose reproductive histories were available, and who were beneficiaries of the Korea Medical Insurance Corporation (KMIC) in 1993 and lived in Busan city, Korea. The information on reproductive histories, and possible confounders, were collected from mailed questionnaires. Potential hip fracture cases were collected from the claims data obtained between 1993 and 1998, with a hospital survey conducted to confirm the final diagnoses. Rate ratios and their 95% confidence intervals, were calculated using a Cox's proportional hazard model. RESUJLTS: Following up 5,219 women for 6 years, 51 cases were confirmed with hip fractures. When adjusted for age, weight and physical activity, the rate ratio of hip fractures in women who had given birth three or more times was 0.56 (95% CI: 0.25 - 1.25), compared with those who had given birth two or less times. When adjusted for age, number of births, weight and physical activity, the rate ratio in women who first gave birth when younger than 22 years was 0.60 (95% CI: 0.34 - 1.08) compared with those who had giving birth at 22 years or older. CONCLUSIONS: According to these findings, an early age when first giving birth might decrease the risk of hip fractures in elderly Korean women.
Aged* ; Busan ; Cohort Studies* ; Diagnosis ; Female ; Hip Fractures ; Hip* ; Humans ; Insurance ; Korea* ; Motor Activity ; Osteoporotic Fractures ; Parturition ; Postal Service ; Proportional Hazards Models ; Surveys and Questionnaires ; Reproductive History*

Osteopetrosis refers to a group of genetic skeletal disorders characterized by osteosclerosis and fragile bones. Osteopetrosis can be classified into autosomal dominant, autosomal recessive, or X-linked forms, which might differ in clinical characteristics and disease severity. Autosomal recessive osteopetrosis, also known as malignant osteopetrosis, has an earlier onset, more serious clinical symptoms, and is usually fatal. We encountered a 1-day-old girl who was born full-term via vaginal delivery, which was complicated by meconium-stained amniotic fluid, cephalo-pelvic disproportion, and nuchal cord. Routine neonatal care was provided, in addition to blood tests and chest radiography to screen for sepsis, as well as skull radiography to rule out head injuries. Initial blood tests revealed hypocalcemia, which persisted on follow-up tests the next day. Radiographic examinations revealed diffusely increased bone density and a "space alien" appearance of the skull. Based on radiographic and laboratory findings, the infantile form of osteopetrosis was suspected and genetic testing for identification of the responsible gene. Eventually, a heterozygous mutation of the T cell immune regulator 1, ATPase H+ transporting V0 subunit a3 (TCIRG1) gene (c.292C>T) was identified, making this the first reported case of neonatal-onset malignant osteopetrosis with TCIRG1 mutation in South Korea. Early-onset hypocalcemia is common and usually results from prematurity, fetal growth restriction, maternal diabetes, perinatal asphyxia, and physiologic hypoparathyroidism. However, if hypocalcemia persists, we recommend considering 'infantile of osteopetrosis' as a rare cause of neonatal hypocalcemia and performing radiographic examinations to establish the diagnosis.

Osteopetrosis refers to a group of genetic skeletal disorders characterized by osteosclerosis and fragile bones. Osteopetrosis can be classified into autosomal dominant, autosomal recessive, or X-linked forms, which might differ in clinical characteristics and disease severity. Autosomal recessive osteopetrosis, also known as malignant osteopetrosis, has an earlier onset, more serious clinical symptoms, and is usually fatal. We encountered a 1-day-old girl who was born full-term via vaginal delivery, which was complicated by meconium-stained amniotic fluid, cephalo-pelvic disproportion, and nuchal cord. Routine neonatal care was provided, in addition to blood tests and chest radiography to screen for sepsis, as well as skull radiography to rule out head injuries. Initial blood tests revealed hypocalcemia, which persisted on follow-up tests the next day. Radiographic examinations revealed diffusely increased bone density and a "space alien" appearance of the skull. Based on radiographic and laboratory findings, the infantile form of osteopetrosis was suspected and genetic testing for identification of the responsible gene. Eventually, a heterozygous mutation of the T cell immune regulator 1, ATPase H+ transporting V0 subunit a3 (TCIRG1) gene (c.292C>T) was identified, making this the first reported case of neonatal-onset malignant osteopetrosis with TCIRG1 mutation in South Korea. Early-onset hypocalcemia is common and usually results from prematurity, fetal growth restriction, maternal diabetes, perinatal asphyxia, and physiologic hypoparathyroidism. However, if hypocalcemia persists, we recommend considering 'infantile of osteopetrosis' as a rare cause of neonatal hypocalcemia and performing radiographic examinations to establish the diagnosis.

OBJECTIVE: We aimed to describe the imaging findings of multidetector CT coronary angiography (MDCTA) in cases of vasospastic angina (VA) and to determine the accuracy of MDCTA in the identification of VA as compared with invasive coronary angiography with an ergonovine provocation test (CAG with an EG test). MATERIALS AND METHODS: Fifty-three patients with clinically suspected VA were enrolled in this study. Two radiologists analyzed the stenosis degree, presence or absence of plaque, plaque composition, and a remodeling index of the related-segment in CAG with an EG test, which were used as a gold standard. We evaluated the diagnostic performances of MDCTA by comparing the MDCTA findings with those of CAG with an EG test. RESULTS: Among the 25 patients with positive CAG with an EG test, all 12 patients with significant stenosis showed no definite plaque with the negative arterial remodeling. Of the six patients with insignificant stenosis, three (50%) had non-calcified plaque (NCP), two (33%) had mixed plaque, and one (17%) had calcified plaque. When the criteria for significant stenosis with negative remodeling but no definite evidence of plaque as a characteristic finding of MDCTA were used, results showed sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) of 48%, 100%, 100%, and 68%, respectively. CONCLUSION: Significant stenosis with negative remodeling, but no definite evidence of plaque, is the characteristic finding on MDCTA of VA. Cardiac MDCTA shows good diagnostic performance with high specificity and PPV as compared with CAG with an EG test.
Angina Pectoris/*radiography ; Chi-Square Distribution ; Comorbidity ; Contrast Media/diagnostic use ; Coronary Angiography/*methods ; Electrocardiography ; Ergonovine/diagnostic use ; Female ; Humans ; Iopamidol/analogs & derivatives/diagnostic use ; Male ; Middle Aged ; Oxytocics/diagnostic use ; Predictive Value of Tests ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods

Erdheim-Chester disease is a rare non-Langerhans-cell histiocytosis with bone and organ involvement. A 76-year-old man presented with low back pain and a history of visits for exertional dyspnea. We diagnosed him with anemia of chronic disease, cytopenia related to chronic illness, chronic renal failure due to hypertension, and hypothyroidism. However, we could not determine a definite cause or explanation for the cytopenia. Multiple osteosclerotic axial skeleton lesions and axillary lymph node enlargement were detected by computed tomography. Bone marrow biopsy revealed histiocytic infiltration, which was CD68-positive and CD1a-negative. This report describes an unusual presentation of Erdheim-Chester disease involving the bone marrow, axial skeleton, and lymph nodes.
Aged ; Anemia ; Biopsy ; Bone Marrow* ; Chronic Disease ; Dyspnea ; Erdheim-Chester Disease* ; Histiocytosis, Non-Langerhans-Cell ; Humans ; Hypertension ; Hypothyroidism ; Kidney Failure, Chronic ; Low Back Pain ; Lymph Nodes* ; Skeleton*