PURPOSE: To report a case of fibrotic obstruction of scleral orifice in Ex-PRESS shunt. CASE SUMMARY: A 57-year-old male presented with elevated intraocular pressure in his left eye. In the past, laser photocoagulation was performed at a local clinic due to retinal venous occlusion in his left eye. During observation, he was transferred to our hospital due to uncontrolled intraocular pressure despite antiglaucoma medications. He was diagnosed with neovascular glaucoma in the left eye. Since intravitreal injection of anti-vascular endothelial growth factor with maximal medical therapy did not lower the intraocular pressure, an Ex-PRESS shunt device was implanted. Two weeks postoperatively, the bleb was flat and diffuse with shallow anterior chamber and intraocular pressure was below 5 mm Hg. Therefore, we performed scleral flap revision and intraocular pressure was sustained between 10 and 15 mm Hg. Two months postoperatively, the patient experienced high intraocular pressure and no elevated bleb, thus we performed bleb revision. During the surgery, although we removed fibrotic adhesions between the conjunctiva and episclera using a 30-gauge needle, aqueous outflow was not observed. Therefore, we opened the scleral flap and found the scleral orifice of the Ex-PRESS shunt was obstructed by fibrous scar tissue. After scar tissue removal and achieving aqueous outflow through the scleral opening, intraocular pressure decreased to a satisfactory level. CONCLUSIONS: In patients with elevated intraocular pressure after implantation of the Ex-PRESS shunt, the scleral opening of the Ex-PRESS shunt should be examined for obstruction.
Anterior Chamber ; Blister ; Cicatrix ; Conjunctiva ; Endothelial Growth Factors ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Light Coagulation ; Male ; Middle Aged ; Needles ; Retinaldehyde

BACKGROUND: The risk for a hand injury was increased according to industrial structure and lifestyle change. This study investigated the post traumatic stress (PTS) and related factors in some hand replantation patients. METHODS: Total 150 hand replantation patients in one hospital were selected using convenience sampling methods. General characteristics of patients, characteristics of injured hand, self-esteem and PTS were collected using self-reported questionnaires. And clinical characteristics of injured hand were obtained from a review of medical records. Descriptive analysis, t-test, ANOVA and multiple regression analysis were performed to determine the associated factors with the score of PTS. RESULTS: Among 150 patients, 80% were male and 94% had a job. The mean score of PTS was 22.2±16.9. In simple analysis, PTS score were associated with smoking status, injury day of the week, pain score and self-esteem. Finally, the subjects who injured in weekdays had significantly higher PTS score compared to subjects who injured in weekend (β=0.185, P=0.021) and pain score was positively associated with PTS score (β=0.181, P=0.027) in multiple regression analysis. CONCLUSIONS: Injury day of the week and pain score were associated with PTS score in some hand replantation patients. Considering these results will help to management and improve quality of life of hand replantation patients.
Amputation ; Hand Injuries ; Hand* ; Humans ; Life Style ; Male ; Medical Records ; Quality of Life ; Replantation* ; Risk Factors ; Smoke ; Smoking

The purpose of this study was to develop a dental communication course in dental hygiene schools that included theory, practice, and skill for effective dental communication. Thirty-six senior dental hygiene students in a dental hygiene school took a dental communication course and responded to a questionnaire. The instrument used in the study was a modified form of Kim's communication skill self-assessment sheet. The self-assessment questionnaire about communication competencies was administered before and after the class, and the difference between scores at each time point was analyzed using the Wilcoxon signed rank sum test. Among seven elements of dental communication competencies, the competency of “information gathering” was significantly improved (p=0.008). Students' scores on perception of the importance (p=0.019) and necessity (0.016) of a communication course significantly increased after the course. Competencies in communication are essential requirement for dental hygienists. This study showed the possibility of communication skill training. An objective evaluation tool regarding students' communication competencies should be developed. Further studies with larger samples size are needed to develop a standardized comprehensive communication course in dental hygiene schools.
Curriculum ; Dental Hygienists ; Health Communication ; Health Education ; Humans ; Learning* ; Oral Hygiene* ; Self-Assessment

We describe a 28-year old man in otherwise apparently good health, in whom pain in his left knee joint caused by avascular necrosis led to a diagnosis of polyarteritis nodosa (PAN). The angiogram showed multiple microaneurysmal and thrombotic lesions, notably in the renal, mesenteric and tibial arteries. A skin biopsy of the upper dermis of the left thigh with an erythematous skin rash showed the infiltration of mononuclear leukocytes in the perivascular area. During hospitalization, he was diagnosed with chronic hepatitis B, and was treated with lamivudine, and corticosteroid, azathioprine to control the PAN. The knee joint pain improved progressively, and the patient could walk normally after several months. This case is an unusual presentation because the initial manifestation of PAN was avascular necrosis.
Azathioprine ; Biopsy ; Dermis ; Exanthema ; Hepatitis B, Chronic ; Hospitalization ; Humans ; Knee Joint ; Lamivudine ; Leukocytes, Mononuclear ; Necrosis ; Osteonecrosis ; Polyarteritis Nodosa ; Skin ; Thigh ; Tibial Arteries

OBJECTIVE: This study was performed to identify associations between the practice of health behaviors and awareness of metabolic syndrome (MetS) among adults aged 19 to 64 years in the Gwangju-Jeonnam area. METHODS: This study utilized data from the 2010 Community Health Survey (CHS). Health behaviors considered in this study were smoking, alcohol drinking, physical activity, low-salt diet, and perception of stress. The index for the health behaviors was calculated as the sum of the practice of each health behavior (range: 0-5). The analysis was weighted with a complex sampling design, and the chi-square test and multiple logistic regression analysis were used to identify the association between the practice of health behaviors and awareness of MetS. RESULTS: A total of 19.8% of the population were aware of MetS. The perception of MetS was statistically significantly associated with healthy behaviors, including nonsmoking (aOR = 1.33, 95% CI = 1.14-1.56), non-high-risk drinking (aOR = 1.54, 95% CI = 1.27-1.88), engagement in physical activity (aOR = 1.48, 95% CI = 1.28-1.72), and a low-salt diet (aOR = 1.30, 95% CI = 1.13-1.51). The ORs of the perception of MetS were significantly higher in patients with a health behavior index of 2 to 3 (aOR = 1.64, 95% CI = 1.01-2.66) and in those with an index of > or =4 (aOR = 2.47, 95% CI = 1.51-4.04) than in those with an index of 0. Among all health behaviors, physical activity had the highest OR for the perception of MetS (aOR = 1.50, 95% CI = 1.29-1.74). CONCLUSIONS: This study revealed associations between health behaviors, especially physical activity, and awareness of MetS. Therefore, integrated health promotion programs may be needed to enhance awareness of MetS and to effectively prevent MetS and non-communicable diseases.
Adult* ; Alcohol Drinking ; Diet, Sodium-Restricted ; Drinking ; Health Behavior* ; Health Promotion ; Health Surveys* ; Humans ; Logistic Models ; Motor Activity ; Smoke ; Smoking

Objective: This study aimed to investigate relation between empathic response of care workers and specificity of autobio-graphic memory of the elderly living alone. Methods: An interview of autobiographical memory was conducted on 66 physically and mentally healthy elderly people living alone in the community. The transcript was used to evaluate the empathic responses of the care workers and to classify thespecificity of the autobiographical memory into four categories: episodic, categoric, semantic, and error. Logistic regression was used for investigation relation between empathic response of care workers and specificity of autobiographic memory of the elder-ly living alone. Results: More than half of the elderly reported specific autobiographical memories, and the interviewers showed a high level of empathic response when the elderly reported specific memories. Episodic and categoric autobiographical memory had a high empathic response of interviewer, and semantic memory or error type memory had a low empathic response. Empathy enhance-ment program experience showed not significantly association with empathic response of interviewer. Conclusion Further research is needed on interview techniques that can easily and conveniently talk about specific autobio-graphical memories.

Purpose: We used the Bayley Scales of Infant and Toddler Development (BSID)-III to analyze the incidence and risk factors of developmental delay in very-low-birth-weight infants without severe brain lesions. We further examined the correlation between the cumulative dexamethasone dose and developmental assessment results. Methods: We retrospectively analyzed data of preterm infants (birth weight <1,500 g) admitted to our neonatal intensive care unit between January 2014 to December 2020. The BSID-III scores obtained between the corrected ages of 12 and 24 months and after 24 months were analyzed. Developmental delay was defined as a composite score of <85 for the cognition, language, and motor domains. Univariate and multivariate analyses of developmental delay risk factors and developmental changes from the first to second BSID-III were performed. Correlations between the accumulated dexamethasone dose used for bronchopulmonary dysplasia (BPD) and the first and second test scores were analyzed. Results: Seventy-one and thirty-six infants completed the first and second tests, respectively. In both tests, developmental delay was most commonly observed in the language domain (26.8%, 47.2%). In multivariate analysis, mild BPD was identified as a developmental delay risk factor (P<0.05), whereas prenatal steroid use reduced the developmental delay risk (P<0.05). All domain scores were lower in the second test than in the first test. The cognition and language domain scores in the second test decreased with increasing cumulative dexamethasone doses. Conclusion Very-low-birth-weight infants typically experience language delay, which can persist as they age.

Purpose: Since premature infants are sensitive to the changes in blood glucose levels and body temperature, maintaining these parameters is important to avoid the risk of infections. The authors implemented the Golden Hour protocol (GHP) that aims to close the final incubator within one hour of birth by implementing early treatment steps for premature infants after birth, such as maintaining body temperature, securing airway, and rapidly administering glucose fluid and prophylactic antibiotics by securing breathing and rapid blood vessels. This study investigated the effect of GHP application on the short- and long-term clinical outcomes. Methods: We retrospectively analyzed the medical records between 2017 and 2018 before GHP application and between 2019 and 2020 after GHP application in preterm infants aged 24 weeks or older and those aged less than 33 weeks who were admitted to the neonatal intensive care unit. Results: Overall, 117 GHP patients and 81 patients without GHP were compared and analyzed. Peripheral vascularization time and prophylactic antibiotic administration time were shortened in the GHP-treated group (P=0.007 and P=0.008). In the short-term results, the GHP-treated group showed reduced hypothermia upon arrival at the neonatal intensive care unit (P=0.002), and the blood glucose level at 1 hour of hospitalization was higher (P=0.012). Furthermore, the incidence of neonatal necrotizing enteritis decreased (P=0.043). As a long-term result, the incidence of BPD was reduced (P=0.004). Conclusion We confirmed that applying GHP improved short- and long-term clinical outcomes in premature infants aged <33 weeks age of gestation, and we expect to improve the treatment quality by actively using it for postnatal treatment.

Staphylococcus aureus is able to utilize efficiently transferrin-bound iron as an iron source, whereas other staphylococci are not. The reason for this difference remains unclear. We compared the activity of siderophore-mediated iron-uptake systems among S. aureus, S. epidermidis, and S. saprophyticus. S. aureus was more susceptible to streptonigrin than the other two staphylococci. S. aureus was able to utilize efficiently transferrin-bound iron in proportion to the level of iron-saturation and produced siderophores in an inverse relation to iron-saturation. In contrast to S. aureus, S. epidermidis and S. saprophyticus were able to utilize only holotransferrin (HT; about 80% iron- saturated) and produced siderophores only in media containing HT. Moreover, they utilized HT less efficiently than S. aureus, though they produced greater amount of siderophores than S. aureus in media containing HT. The ability of the equivalent siderophores per se to capture iron from HT was not significantly different among the three species. Nevertheless, the siderophores from S. aureus stimulated the growth of the staphylococci to a greater degree than did the siderophores from S. epidermidis and S. saprophyticus. The siderophores from S. epidermidis and S. saprophyticus also stimulated the growth of S. aureus to a greater degree than those of the original bacteria which produced them. This indicates that S. aureus possesses a greater ability to produce more-efficient siderophores responding to very low iron-availability, as well as a greater ability to utilize iron-siderophore complexes, than the other two staphylococci. This explains in part the higher virulence of S. aureus compared to other staphylococci.
Bacteria ; Iron* ; Siderophores ; Staphylococcus aureus ; Streptonigrin ; Transferrin ; Virulence

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*