PURPOSE: To describe a case of Wyburn-Mason Syndrome, which is a rare phakomatosis, and its associated optical coherence tomography findings. CASE SUMMARY: A 5-year-old boy was referred to our clinic for decreased vision in his right eye. He had nevus flammeus on his right forehead, upper eyelid, and cheek. His best corrected visual acuity was hand motion in the right eye, in which a relative afferent pupillary defect was noted. Fundus examination of the right eye showed marked dilation and tortuosity of retinal vessels, which could not be discriminated between arteries and veins on the posterior pole. Optical coherence tomography showed multiple large intraretinal vessels without involvement of the internal limiting membrane. Cerebral angiography revealed arteriovenous malformations (AVMs) and feeder vessels from the internal carotid artery to the ophthalmic artery, extending to the ethmoidal artery in the nasal cavity. CONCLUSIONS: Wyburn-Mason syndrome is a rare phakomatoses and shows unique retinal AVM. Misdiagnosis or undertreatment of Wyburn-Mason syndrome can lead to serious complications. Patients with facial nevus flammeus should undergo thorough ocular examinations to rule out this disorder. Optical coherence tomography is a useful method for understanding structural features of retinal vascular malformations in Wyburn-Mason syndrome.
Arteries ; Arteriovenous Malformations ; Carotid Artery, Internal ; Cerebral Angiography ; Cheek ; Child, Preschool ; Diagnostic Errors ; Eyelids ; Forehead ; Hand ; Humans ; Male ; Membranes ; Methods ; Nasal Cavity ; Neurocutaneous Syndromes ; Nevus* ; Ophthalmic Artery ; Port-Wine Stain* ; Pupil Disorders ; Retinal Vessels ; Retinaldehyde ; Tomography, Optical Coherence* ; Vascular Malformations ; Veins ; Visual Acuity

PURPOSE: To compare the safety and efficacy of cataract surgery using nasal clear corneal incision (CCI) versus superior or temporal CCIs in Korean patients. METHODS: A retrospective comparative study was conducted. Patients underwent cataract surgery using CCI performed by 3 surgeons between January 2012 and December 2013.The patients were divided into the following 3 groups based on CCI direction: nasal CCIs (group I), superior CCIs (Group II), and temporal CCIs (Group III). To assess usability, surgically induced astigmatism (SIA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), keratometry reading, and refractive errors at baseline and 1 month after surgery were compared. Operation times were compared between groups. To assess safety, intraoperative complications and wound stability were compared. RESULTS: A total of 1,374 eyes (Group I, 283 eyes; Group II, 587 eyes; Group III, 504 eyes) were included in the present study. The SIA was not significantly different among the 3 groups. The postoperative mean BCVA, IOP, keratometry reading and spherical equivalent as well as the mean operation times were not significantly different between the 3 groups (14.04 ± 3.79 vs. 13.80 ± 3.27 vs. 13.80 ± 3.70; p = 0.473). The rate of intraocular complications and incidence of corneal wound suture were not significantly different between the 3 groups (1.7% vs. 3.2% vs. 2.3%; p = 0.378). CONCLUSIONS: The safety and efficacy of cataract surgery using nasal CCI were not significantly different compared with the use of temporal or superior CCI. Our results showed that cataract surgery using nasal CCI can be performed safely and conveniently in Korean patients.
Astigmatism ; Cataract* ; Humans ; Incidence ; Intraocular Pressure ; Intraoperative Complications ; Refractive Errors ; Retrospective Studies ; Surgeons ; Sutures ; Visual Acuity ; Wounds and Injuries

OBJECTIVES: The author investigated the relationship between the environmental tobacco smoke exposure during mid-pregnancy and early childhood and neurobehavioral outcomes of preschool children and if there is any effect of the genetic polymorphism of glutathione S-transferase (GST) M1 and T1 on this relationship. METHODS: The participants were the pregnant women (week 24-28) who visited the obstetrics and gynecology department (between 2001 and 2004). They had been evaluated for their sociodemographic data including direct and environmental tobacco smoke exposure history and the urine specimen had been sampled for the measurement of cotinine. The offsprings' urine specimen and blood sampling had been done and the socioeconomic data including the environmental tobacco smoke exposure history was evaluated at age 3. The cotinine level of urine specimen was measured and GST polymorphism was analyzed. The offsprings completed Korean-Childhood Behavioral Check List (K-CBCL) at age 4-5. RESULTS: The environmental tobacco smoke exposure during mid-pregnancy based on urine cotinine level has a significant association with increased total score and externalizing problem score of K-CBCL (p<0.05). The environmental tobacco smoke exposure based on urine cotinine level at age 3 is associated increased total score, externalizing problem score and internalizing problem score of K-CBCL with no statistical significance. The environmental tobacco smoke exposure after controlling for tobacco smoke exposure during pregnancy, however, is significantly associated with the increased externalizing problem scores (p=0.04). The environmental tobacco smoke exposure is associated with increased total score, externalizing problem score and internalizing problem score of K-CBCL with GSTM1 null type or GSTT1 null type at age 3 although there was no statistical significance. CONCLUSION: The environmental tobacco smoking exposure during pregnancy and at early childhood is associated with childhood behavioral problems. The clinical implication of this study is that it is important to avoid the environmental tobacco smoke exposure during pregnancy and early childhood and to monitor the possible emergence of behavioral problems of children.
Child ; Child, Preschool ; Cotinine ; Female ; Glutathione ; Glutathione Transferase ; Gynecology ; Humans ; Obstetrics ; Organothiophosphorus Compounds ; Polymorphism, Genetic ; Pregnancy ; Pregnant Women ; Smoke ; Smoking ; Tobacco

PURPOSE: The purpose of this study was to explore the monitoring experience of nursing students and to suggest considerations when developing mentoring programs. METHODS: This qualitative study was conducted by online surveys and individual interviews with 7 nursing students who participated in the health promotion program as mentors. Data were analyzed using qualitative content analysis to identify motives for participating in mentoring and to explore their changes through mentoring. RESULTS: The results were as follows: Motives for participating were ‘inquisitiveness about children’, ‘interest in mentoring activities’ and ‘curiosity about research’. Recognition of mentor roles were ‘actively involved guide’, ‘exemplary role model’ and ‘empathetic emotional supporter’. Changes through mentoring experiences were revealed by ‘understanding the characteristics of children’, ‘improvement of interaction ability with children’, ‘understanding self and changes’ and ‘recognition of excellence in forest activities’. CONCLUSION: Nursing students had opportunities to learn the characteristics of general children and to understand themselves through natural interaction. Participation in mentoring has the potential to be a creative educational method of field learning as a form of service learning.
Child ; Forests ; Health Promotion* ; Humans ; Learning ; Mentors* ; Methods ; Nursing* ; Qualitative Research ; Students, Nursing*

Tegoprazan is a novel potassium-competitive acid blocker that treats gastric acid-related diseases. Clarithromycin was widely used as one of various regimens for eradicating Helicobacter pylori. This study compared the pharmacokinetic and safety profile of tegoprazan and clarithromycin between combination therapy and monotherapy to evaluate the potential drug-drug interaction. An open-label, randomized, 6-sequence, 3-period crossover study was conducted in 24 healthy subjects. According to the assigned sequence, the subject was administered the assigned treatment during 5 days in each period. PK parameters of tegoprazan and clarithromycin administered in combination were compared with those of the respective monotherapies. The co-administration of tegoprazan with clarithromycin increased maximum steady-state plasma concentration (C ss,max ) and area under the plasma concentration-time curve in dosing interval at steady-state (AUC ss,tau ) of tegoprazan (1.6-fold in C ss,max and 2.5-fold in AUC ss,tau ) and M1 (2.0-fold in C ss,max , 2.5-fold in AUC ss,tau ) than tegoprazan alone. The C ss,max and AUC sss,tau of 14-hydroxyclarithromycin increased 1.8- and 2.0-fold in co-administration, respectively. The AUC ss.tau of clarithromycin was slightly increased in co-administration, but C ss,max was not changed. Combination of tegoprazan and clarithromycin and those of the respective monotherapies were tolerated in 24 healthy subjects. There may exist drug interaction that lead to reciprocal increase in plasma drug concentrations when tegoprazan and clarithromycin were administrated in combination and no safety concerns were raised. It is suggested that an in-depth analysis of the concentrationresponse relationship is necessary to determine whether these concentration changes warrant clinical action.

PURPOSE: A soft tissue sarcoma (STS) is a rare type of cancer, accounting for 1% of adult solid cancers. The aim of the present study is to determine the incidence of localized and advanced STS in Korean patients, their treatment patterns, and the survival of patients by disease status. MATERIALS AND METHODS: The STS patient cohort was defined using National Health Insurance Service medical data from 2002 to 2015. Incidence, distribution, anatomical location of tumors, survival rates (Kaplan-Meyer survival function) and treatment patterns were analyzed by applying different algorithms to the STS cohort containing localized and advanced STS cases. RESULTS: A total of 7,813 patients were diagnosed with STS from 2007 to 2014, 4,307 were localized STS and 3,506 advanced STS cases. The total incidence of STS was 2.49 per 100,000 person- years: 1.37 per 100,000 person-years for localized STS and 1.12 per 100,000 person-years for advanced STS. The 5-year survival rate after diagnosis was 56.4% for all STS, 82.4% for localized, and 27.2% for advanced STS. Half of the advanced STS patients (49.98%) received anthracycline-containing chemotherapy as initial treatment after diagnosis. CONCLUSION: This study provides insights into localized and advanced STS epidemiology, treatment patterns and outcomes in Korea, which could be used as fundamental data in improving clinical outcomes of STS patients in the future.
Adult ; Cohort Studies ; Diagnosis ; Drug Therapy ; Epidemiology ; Humans ; Incidence ; Korea ; National Health Programs ; Sarcoma ; Survival Rate