Ocular inflammation from various causes may have similar clinical presentation thus careful clinical evaluations are mandatory particularly when the disease appear to be resistant to treatment. This paper reports a case of ocular lymphoma which was initially treated as Vogt Koyanagi Harada disease at a different centre. A 65-year-old Sudanese man complained of gradual worsening left eye vision. Careful ocular and slit lamp examination revealed a conjunctival lesion with choroidal infiltration as well as exudative retinal detachment. Computed tomography scan (CT scan) showed left eye axial proptosis, and a homogenous enhancing mass at the posterior coat of the globe. Tissue biopsy of the conjunctival lesion revealed marginal Zone B cell (MALT type), low grade, non-Hodgkin’s lymphoma. AS the ocular signs and symptoms progressed, chemotherapy was initiated. The proptosis, exudative retinal detachment, disc hyperemia and swelling improved after chemotherapy. The post treatment CT scan showed reduction of the posterior ocular coat mass. The possibility of malignant lymphoma should be considered in patients with resistant uveitis despite administration of corticosteroid. Ocular lymphoma is an indolent tumour with good prognosis. Careful ocular examination, adequate imaging studies followed by early surgical biopsy will contribute to early diagnosis.
Uveomeningoencephalitic Syndrome

PURPOSE: To investigate the degree and sources of stress which fathers of infants in NICU experience. METHOD: Eighty-five fathers of NICU infants at 5 university hospitals in Seoul volunteered to complete the Parental Stressor Scale for NICU (PSS: NICU) from September 1, to October 15, 2002. RESULTS: Total perceived stress was 3.50+/-0.76. The highest score were in Parental Role Alteration (3.76+/-0.83) and Appearance and Behavior (3.65+/-1.04). The total perceived stress score (PSS), correlated significantly with method (t=3.50, p=.01), and route (F=5.30, p=.00) of feeding. Light & Sound correlated significantly with birth weight (F=3.39, p=.02), medical diagnosis(F=2.30, p=.03), plan of operation(t=2.50, p=.01), operation (t=3.80, p=.02), method (F=4.90, p=.003), and route (F=4.70, p=.00) of feeding. Infant Appearance and Behavior correlated significantly with birth weight (F=5.12, p=.01), plan of operation (t=2.50, p=.01), method (F=3.50, p=.01), and route (F=7.80, p=.00) of feeding. Parental Role Alteration correlated significantly with care of incubator (t=-.68, p=.03), method of feeding (F=2.80, p=.04) and education level of father (F=3.00, p=.05). CONCLUSION: Father with NICU infants were concerned mostly with parental role alteration and infant appearance. Nursing intervention should include fathers of NICU infants.
Birth Weight ; Education ; Fathers* ; Hospitals, University ; Humans ; Incubators ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal* ; Nursing ; Parents ; Seoul ; Child Health

PURPOSE: Topiramate(TPM) is a new anticonvulsant with multiple action mechanisms which should theoretically represent a wide therapeutic spectrum. However, there is still little clinical experience of its use in Asian children with epilepsy. METHODS: The patients were total 96 children who were treated with more than 2 anticonvulsants but poorly controlled seizure activity. TPM was given as add-on therapy and evaluated the efficacy and adverse events prospectively. This study consisted of 8 weeks of baseline phase, 10- 16 weeks titration phase, and 8 weeks of stabilization phase. Clinical efficacy was classified into 4 groups : disappearance, marked improvement, improvement, no improvement. RESULTS: When TPM was prescribed, a response of >50% reductions in seizure attacks was seen in 90.6% of cases(95.5% of partial type epilepsy) and disappearance was seen in 67.7% of cases (83.3% of generalized type epilepsy). Concommitent with the larger number of anticonvulsants a longer duration of epilepsy and more frequent seizure attack was showed more lower disappearance rate of seizure attack. Adverse event weight loss(9.4%), somnolence(7.3%), dizziness(5.2%), skin rash, decreased cognitive function, nocturia(3.1%) and headache(2.1%) were noted, but were mostly not serious. CONCLUSION: TPM seems to be a promising new broad-spectrum anticonvulsant, which is efficacious and safe in children with intractable epilepsy.
Anticonvulsants ; Asian Continental Ancestry Group ; Child* ; Epilepsy* ; Exanthema ; Humans ; Prospective Studies ; Seizures

No abstract available.

Polypoidal choroidal vasculopathy (PCV) is a retinal disorder characterized by aneurismal polypoidal lesions in choroidal vasculature. PCV appears to preferentially affect pigmented individuals and is considerably high among Asians. Most reports on patterns of PCV around Asia are based on a homogenous race (e.g. Chinese, Japanese) and very few descriptions from a multiracial population like those seen in Malaysia. The present study aimed to describe the demographic features, clinical and investigative characteristics of PCV in a multiracial group at Universiti Kebangsaaan Malaysia Medical Centre (UKMMC). Ninety one eyes of 86 PCV patients, comprising of Chinese (65.1%), Malays (31.4%), Indians (2.3%) and Eurasian (1.2%) were retrospectively reviewed. All underwent complete ophthalmic examination and investigations. Mean patient age was 70.4 years with a male preponderance (59.3%), and mostly unilateral presentation (94.1%). The logMAR mean presenting visual acuity was 0.78 ± 0.64. Polypoidal vascular lesions were located generally within the macula area (86.8%), manifesting mainly as submacular hemorrhage (59.3%). Interestingly a number of eyes (43.9%) had associated drusen. Optical coherence tomography largely demonstrated exudative changes (75.9%) and almost all patients (97.7%) had loss of external limiting membrane (ELM) and IS/OS interface. On indocyanine green angiography, majority of eyes had multiple polyps (82.4%) with ‘cluster’ (58.2%) being the commonest configuration. In conclusion, although the patterns of PCV in UKMMC were mainly similar to other Asian patients, a number of our patients had associated drusen. This indicates that PCV in our population could be a variant of neovascular age related macular degeneration and not solely idiopathic in nature.
Retinaldehyde ; Choroid

PURPOSE: This study attempts to examine the extent to which competencies were identified in a Korean community nursing practice based on the 11 core competencies required by US health nurses. METHODS: This was a descriptive research study, and the subjects of this study were 11 students who were in a four-year nursing course. Data were collected by means of a questionnaire from October 19 to November 22, 2016. RESULTS: Core competencies in total were practiced in 60.0% to 98.5% of schools in Korea. Among these, competencies corresponding to the practice level of ‘high’ were identified as ‘communicating effectively with community nursing subjects and colleagues, and accepting various personal characteristics without criticism or prejudice’. On the other hand, competencies corresponding to the practice level of ‘low’ were identified as ‘to comply with social justice, public good, public health principles, and leadership in a community nursing practice’. CONCLUSION: This study can be used as a resource to categorize the competence of nursing students expected in the field of community nursing. Based on a careful review of core competencies with low practice, it is necessary to seek specific practical strategies to strengthen these competencies in the future.
Community Health Nursing* ; Hand ; Humans ; Korea ; Leadership ; Mental Competency ; Nurses, Public Health* ; Nursing ; Public Health Nursing ; Public Health* ; Social Justice ; Students, Nursing

PURPOSE: This study was done to investigate factors associated with depression and quality of life (QoL) among the community-dwelling elderly. METHODS: This study used a descriptive correlational research design. The subjects were 730 elders aged over 65 living in D district of Daegu. Data were collected using questionnaires for 30 days in April, 2007. The research instruments utilized in this study were a physical function scale of long-term care insurance system, Geriatric Depression Scale Short Form Korea Version (GDSSF-K), and Korean Quality of Life Scale (KoQoLs). The collected data were analyzed by descriptive statistics, t-test, ANOVA, Duncan, stepwise multiple regression, and Spearman correlation. RESULTS: The mean age of the subjects was 72.6, and 68.8% and 57.9% of subjects were, respectively, female and living alone. 12.3% of variance in depression was explained by age, education, economic status, subjective health, alcohol consumption, condition of teeth, and fall experience. 18.2% of variance in QoL was explained by economic status, number of diseases, condition of teeth, incontinence, paralysis, and IADL. Economic status and condition of teeth were contributing factors to depression and QoL of the elderly. CONCLUSION: Findings of this study may be useful in understanding the health status of the community-dwelling elderly and developing more regionally specific health promotion strategies.
Aged ; Alcohol Drinking ; Daegu ; Depression* ; Education ; Female ; Health Promotion ; Humans ; Insurance, Long-Term Care ; Korea ; Paralysis ; Quality of Life* ; Research Design ; Tooth ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify the prevalence of cognitive impairment, behavioral problems, and the state of mental health for elderly Korean people who have been institutionalized. METHODS: A cross-sectional, nation-wide survey was performed using an anonymous questionnaire. The participants in this study were 2,521 institutionalized elderly Korean people. A proportional stratified random sampling method was employed. RESULTS: 1) Elders admitted to subacute hospitals and long term care (LTC) facilities showed a higher level of cognitive impairment compared to elders admitted to acute care hospitals. 2) Elders confined in LTC facilities showed a higher level of behavioral problems compared to elders in acute or subacute hospitals. 3) Elders admitted to subacute hospitals and LTC facilities showed more serious mental health problems, such as depression or suicidal ideation, compared to elders in acute care hospitals. CONCLUSION: The results of this study indicate that the severity of cognitive-behavioral or mental health problems do not match well with type of care setting. Therefore, health personnel working with elderly people should be provided guidance on detection and management of cognitive-behavioral and mental health problems. The necessity of a decision support system for eligibility and placement in long-term care is also discussed.
Aged ; Aged, 80 and over ; Cognition Disorders/*epidemiology ; Cross-Sectional Studies ; Demography ; Female ; Homes for the Aged ; Hospitals ; Humans ; *Institutionalization ; Long-Term Care ; Male ; Mental Disorders/*epidemiology ; *Mental Health ; Nursing Homes ; Questionnaires

No abstract available.
Blood Glucose* ; Calcium* ; Humans ; Hypocalcemia* ; Hypoglycemia* ; Incidence* ; Infant, Newborn*

PURPOSE: To evaluate the clinical features and treatment outcomes of smartphone overusers with acute acquired comitant esotropia. METHODS: We retrospectively reviewed the medical records of patients ≥ 15 years of age who used a smartphone for > 4 hours a day for > 1 year, and who were diagnosed with acute acquired comitant esotropia from May 2011 to January 2016. We analyzed sex, age at the time of manifestation and duration of esotropia, refractive error, deviated angle at the first and final visits, and the results of refraining from smartphone use, use of the Fresnel prism, and surgery for esotropia. RESULTS: A total of 13 patients were studied, including 8 males and 5 females. The mean age at development of esotropia was 22.7 ± 9.7 years. The mean duration of esotropia before the first visit was 28.0 ± 33.0 months, and the mean follow-up period was 16.4 ± 16.4 months. The mean angle of esotropia was 21.8 ± 7.0 prism diopters (PD) at distance and 22.2 ± 7.9 PD at near. There were eight myopic patients; the other patients were emmetropia. The esotropia of all patients did not improve after refraining from smartphone use. There was no improvement in five patients who were wearing the Fresnel prism for ≥ 4 months. A total of six patients were treated with bilateral medial rectus recession; only one patient remained orthotropic at postoperative 6 months, three patients were undercorrected, and two had a recurrence. CONCLUSIONS: Esotropia persisted after refraining from smartphone use or wearing a Fresnel prism in acute acquired comitant esotropia patients who were smartphone overusers, and the surgical prognosis of these patients was relatively poor.
Emmetropia ; Esotropia ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Prognosis ; Recurrence ; Refractive Errors ; Retrospective Studies ; Smartphone