There has been a growing concern and subsequent interest surrounding numerous reproductive toxic agents found in various working and non-working environments. Meanwhile, there have been many efforts in medical fields such as toxicology and epidemiology applying experimental studies to elucidate reproductive toxic agents’ characterization and health effects. However, there remains insufficient research data and inadequate evidence in humans. Adverse reproductive outcomes vary from transient, moderate health effects to severely detrimental consequences, such as permanent infertility or childhood cancer of one’s offspring. Furthermore, upon exposure to toxic agents, the latent period before reproductive health effects are observed is relatively short compared to other occupational diseases (e.g., occupational cancer); instant action is required once exposure to reproductive toxic agents is detected. Therefore, it is very important for workers and healthcare professionals to know about the reproductive toxic agents they are likely to be exposed to. In this review, we discuss the general epidemiology of reproductive health in Korea, and the information regarding these reproductive toxic agents.

PURPOSE: We report a case of hemorrhagic lymphangiectasia of the conjunctiva with a 360° connected circumference, which recovered spontaneously.CASE SUMMARY: A 44-year-old female patient presented with congestion of the right eye 1 day prior to her visit. There was no history of any systemic disease or trauma, but she had experienced relapses of the same episode three times before the visit. There were no accompanying symptoms such as decreased vision or pain. Blood analysis, orbital computed tomography, and angiographic findings showed no remarkable finding. Slit lamp examination showed circumferential lymphatic dilatation extending 360° under the conjunctiva of the eye at a distance of about 6 mm behind the limbus of the right eye, which was accompanied by intralymphatic bleeding. Irregular local lymphatic dilatations were observed on the bulbar conjunctiva at 4 and 8 o'clock of the left eye. The bleeding spontaneously resolved in about 2 weeks, but the translucent enlarged lymphatic vessels were still observed on slit lamp examination and anterior segment optical coherence tomography.CONCLUSIONS: This is the first reported case of hemorrhagic lymphangiectasia involving 360° of the bulbar conjunctiva in Republic of Korea.

This study explored the experiences of pregnant women with depressed mood participating ina group cognitive behavioral therapy (CBT) program using video communication, based on Beck’s cognitive theory.Methods: The participants were six pregnant women out of 13 women who had participated in an 8-session group CBT program using video communication for women with depressed mood (EdinburghPostnatal Depression score of ≥9). Data were collected from February 20 through March 25, 2021. Indepth individual interviews were conducted through a video conferencing platform at 1 month post-baseline. Thematic analysis was done.Results: Three themes, 10 subthemes, and 38 concepts were derived from experiences of participating inthe 4-week group CBT program (twice a week). The first theme, entitled “continuing realization” hadsubthemes of “a negative and instable self,” “a selfish judgment that excludes others,” and “a strong beliefin self-control.” The second theme, entitled “attempt to change for restoration” had subthemes of “shift torational thinking,” “freedom from suppressed beliefs,” “tolerance of other people,” and “courage for self-expression.” The third theme, entitled “departure for a positive life,” had subthemes of “emotional healing,”“faith in oneself,” and “reestablishing the criteria for happiness.”Conclusion: Pregnant women with depressed mood expressed that continuing realizations and attemptsto change supported their transition toward a positive direction of healing. Thus, they were able to changetheir distorted thinking into rational thinking through CBT using video communication. These findingssupport the use of group CBT using video communication with pregnant women who have depressedmood.

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%–58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%–33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as “preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee,” and 19.7% were “preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time.” These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.
Education ; Education, Nursing ; Hospitals, General ; Joints ; Long-Term Care ; Nursing ; Preceptorship ; Tertiary Care Centers

PURPOSE: To report the clinical manifestations and computed tomography (CT) findings of patients with a trapdoor type medial orbital wall blowout fracture.METHODS: From March 2009 to October 2016, the clinical records and computed tomography findings of patients who underwent surgical treatment for a trapdoor type medial orbital wall blowout fracture were retrospectively analyzed.RESULTS: A total of eight patients (six males and two females) were enrolled with a combined mean age of 14.4 years. Clinical manifestations were eyeball movement limitation (abduction and adduction) and ocular motility pain (eight patients, 100%), diplopia (seven patients, 87.5%), and nausea and vomiting (four patients, 50%). On CT, the distance from the orbital apex to the fracture site was an average of 22.0 mm and occurred in the middle position of the entire wall. Two patients had missed rectus completely dislocated into the ethmoid sinus through the fracture gap and six patients had definite involvement in the fracture gap and edema of the medial rectus muscle. The medial rectus muscle cross-sectional area was 47.7 mm² which was edematous compared to the contralateral eye (40.1 mm²). Orbital wall reconstruction was performed an average of 4.1 days after the injury. In all patients with oculocardiac reflex-like nausea and vomiting immediately improved after surgery. Six out of eight patients who had eyeball movement limitations (abduction and adduction) preoperatively showed adduction limitation after surgery. The eyeball movement limitation and diplopia disappeared 11.7 days and 46.7 days after surgery, respectively.CONCLUSIONS: Patients with trapdoor type medial wall blowout fracture showed characteristic computed tomographic findings and clinical manifestations such as eyeball movement limitation, ocular motility pain, diplopia, and oculocardiac reflex. An understanding of clinical findings and quick surgical treatment are therefore required. The type of eyeball movement limitation was abduction and adduction limitation preoperatively and adduction limitation postoperatively.
Diplopia ; Edema ; Ethmoid Sinus ; Humans ; Male ; Nausea ; Orbit ; Reflex, Oculocardiac ; Retrospective Studies ; Vomiting

Purpose: To report a case of actinomycosis infection originating in the orbitonasal cavity that quickly invaded the cerebrum.Case summary: A-57-year-old male with a history of right tooth extraction 7 days before the first visit presented with right eyelid swelling and pain that had developed 4 days prior to the visit and had become increasingly worse. The best-corrected visual acuity was light perception. The intraocular pressure of the patient was 37 mmHg in the right eye. Eyelid abscess, subconjunctival hemorrhage, and severe chemosis was observed. Orbital computed tomography showed multiple air pockets and enhancing soft tissue along the periorbital, maxillary, and ethmoid sinus. Emergent endoscopic sinus surgery, lateral canthotomy, and intravenous antifungal treatment were performed due to suspicion of mucormycosis infection. Two days after treatment, exenteration combined with otolaryngology and neurosurgery were performed, as brain magnetic resonance imaging scans indicated that intraorbital lesions had invaded the dura and frontal sinus. On Day 8 of treatment, Actinomyces odontolyticus was identified and intravenous Ampicillin was administered. Despite systemic antibiotic treatment, the infection could not be controlled. The patient died 28 days after treatment due to persistent intracranial hemorrhage and brain edema. Conclusions For patients with severe eyelid swelling with a history of tooth extraction, actinomycosis infection should be considered. Delays in diagnosis and treatment of this infection could lead to serious consequences.

Purpose: To report a case of actinomycosis infection originating in the orbitonasal cavity that quickly invaded the cerebrum.Case summary: A-57-year-old male with a history of right tooth extraction 7 days before the first visit presented with right eyelid swelling and pain that had developed 4 days prior to the visit and had become increasingly worse. The best-corrected visual acuity was light perception. The intraocular pressure of the patient was 37 mmHg in the right eye. Eyelid abscess, subconjunctival hemorrhage, and severe chemosis was observed. Orbital computed tomography showed multiple air pockets and enhancing soft tissue along the periorbital, maxillary, and ethmoid sinus. Emergent endoscopic sinus surgery, lateral canthotomy, and intravenous antifungal treatment were performed due to suspicion of mucormycosis infection. Two days after treatment, exenteration combined with otolaryngology and neurosurgery were performed, as brain magnetic resonance imaging scans indicated that intraorbital lesions had invaded the dura and frontal sinus. On Day 8 of treatment, Actinomyces odontolyticus was identified and intravenous Ampicillin was administered. Despite systemic antibiotic treatment, the infection could not be controlled. The patient died 28 days after treatment due to persistent intracranial hemorrhage and brain edema. Conclusions For patients with severe eyelid swelling with a history of tooth extraction, actinomycosis infection should be considered. Delays in diagnosis and treatment of this infection could lead to serious consequences.

The prevalence of metabolic syndrome (MetS) in Korea has been increasing in adults, as well as in adolescents. Recently the prevalence of MetS in children has been reported to strongly link that of MetS in parents. Families are known to share similar food environment so that eating habits of parents closely resemble that of the children's. Therefore, the aim of this study to examine metabolic risk factors and dietary intake in children by with respect to mother's metabolic syndrome, based on the data from Korean National Health and Nutrition Examination Survey (KNHANES) 2007-2010. Using the household variable and the eldest child per household, 1,341 pairs of mothers and children were selected. The mothers were defined by MetS criteria, and then the children were classified into the following three groups in accordance to the mothers' MetS; children whose mothers had none, 1-2, and 3 or more components of MetS. All dietary data were evaluated using the data from a food frequency questionnaire. The mean age was 42.6 +/- 4.2 years for the mothers, and 14.9 +/- 2.0 years for the children. Children whose mothers had 3 or more components of MetS showed a significantly higher prevalence of overweight and higher level of fasting triglyceride; conversely, they showed a lower level of serum HDL-cholesterol compared to the other two groups. Regarding an agreement of food consumption between the mothers and children, most food groups showed high agreement, except in the category of beverages. Regarding the dietary habits and family meals, children whose mothers had 3 or more components of MetS were more likely to skip breakfast and less likely to have family meals at breakfast or snack. In conclusion, the children's metabolic risk factors and dietary factors were different with respect to the status of mothers' MetS. Further studies are necessary to examine the causal effect of family environment in children's health status.
Adolescent* ; Adult ; Beverages ; Breakfast ; Child* ; Eating ; Family Characteristics ; Fasting ; Food Habits ; Humans ; Korea ; Meals ; Mothers ; Nutrition Surveys* ; Overweight ; Parents ; Prevalence ; Surveys and Questionnaires ; Risk Factors* ; Snacks ; Triglycerides

BACKGROUND: Valdecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor. It is effective in the treatment of rheumatoid arthritis, osteoarthritis, primary dysmenorrhea, and postoperative pain. Two kinds of sodium currents, tetrodotoxin-sensitive (TTX-S) and tetrodotoxin-resistant (TTX-R), are expressed in the dorsal root ganglia (DRG). Both sodium currents are implicated in the formation of normal and abnormal pain. METHODS: The effects of valdecoxib on sodium currents in rat DRG neurons were investigated using the whole-cell variation of the patch-clamp technique. RESULTS: Valdecoxib suppressed two types of sodium currents in a dose-dependent manner, without altering the activation and inactivation kinetics of either current type. It shifted the activation voltage toward a depolarizing direction and the steady-state inactivation voltage toward a hyperpolarizing direction, and suppressed resting channels to similar extents in both types of sodium currents. Valdecoxib slowed the recovery of both sodium currents from inactivation, and suppressed them in a frequency-dependent manner. CONCLUSIONS: The results suggest that valdecoxib may produce analgesic effects through the inhibition of sodium currents in sensory neurons as well as COX-2.
Analgesia ; Animals ; Arthritis, Rheumatoid ; Cyclooxygenase 2 ; Diagnosis-Related Groups ; Dysmenorrhea ; Female ; Ganglia, Spinal ; Kinetics ; Neurons ; Osteoarthritis ; Pain, Postoperative ; Patch-Clamp Techniques ; Rats ; Sensory Receptor Cells* ; Sodium Channels ; Sodium* ; Tetrodotoxin

A 70-year-old man was transferred to our center due to severe epigastric and back pain with the impression of a ruptured thoracic aortic aneurysm. Six months previously, he had undergone insertion of stent graft into the descending thoracic aorta at another hospital. The findings of the computed tomographic scan suggested a rapidly growing malignant mediastinal tumor rather than a ruptured aneurysm. Exploratory thoracotomy confirmed the diagnosis and the tumor was resected along with the portion of the aorta contained in it. This exemplary case should raise the concern against overzealous application of endovascular aortic repair.
Aged ; Aneurysm ; Aneurysm, Ruptured ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Back Pain ; Diagnostic Errors ; Humans ; Sarcoma ; Stents ; Thoracotomy ; Transplants