Purpose: We sought to investigate the temporal changes of eyelid height after phenylephrine instillation in Korean patients with and without ptosis to determine the time points of the first and maximum reactions. Methods: The phenylephrine test was performed on 16 eyes of 12 ptotic patients (group I) and 24 eyes of 12 normal control subjects (group II) in our hospital between September 2017 and March 2018. One drop of 2.5% phenylephrine was instilled and the marginal reflex distance 1 (MRD1) was measured at 15 seconds before instillation and the following time points after instillation: at 15-second intervals for the initial 5 minutes and at 5-minute intervals until a total of 20 minutes was reached (i.e., at 10, 15, and 20 minutes). Results: In group I patients, the first reaction appeared at 5 minutes (p = 0.034), while the maximum eyelid height after the first reaction was reached at 15 minutes (p = 0.025) and was maintained until 20 minutes. In group II subjects, the first reaction appeared at 5 minutes (p = 0.034), while the maximum eyelid height was reached at 10 minutes (p = 0.015) and was maintained until 20 minutes. There was no significant difference in the response of eyelid height based on time (p = 0.122) between the two groups. Conclusions Our analysis of phenylephrine test results in Korean ptotic patients revealed a significant increase occurred in the eyelid height after 5 minutes; meanwhile, the maximum eyelid height was reached at 15 minutes and was maintained until 20 minutes after instillation.

PURPOSE: To evaluate the incidence and risk factors for ocular hypertension (OHT) in traumatic hyphema within 7 days after trauma. METHODS: A retrospective case series study of 265 traumatic hyphema inpatients from 2010–2016. OHT was defined as intraocular pressure (IOP) that exceeded 21 mmHg using two consecutive measurements by a Goldmann applanation tonometer within 7 days after trauma. The subjects were divided into two groups (OHT group and non-OHT group). Age, sex, best-corrected visual acuity (BCVA), IOP, hyphema grade, presence of systemic disease, and past history of glaucoma were compared between the two groups. RESULTS: Of the 265 patients, 95 (35.8%) developed OHT after traumatic hyphema. Of those 95 patients, 70 (73.7%) developed OHT within 1 day after trauma; 18 (18.9%) developed OHT 2–3 days after trauma; and 7 (7.4%) developed OHT 4–7 days after trauma. Compared to the non-OHT group, the OHT group had a lower visual acuity (p = 0.018) and higher IOP (p < 0.001). In addition. if the hyphema grade was higher the incidence of OHT was significantly higher (p = 0.017). Using multivariate logistic regression analysis, the BCVA (p = 0.045) and hyphema grade (p = 0.006) were associated with the incidence of OHT in traumatic hyphema within 7 days after trauma. CONCLUSIONS: The incidence of OHT in traumatic hyphema within 7 days after trauma was 35.8%. The BCVA and hyphema grade were associated with the incidence of OHT within 7 days after trauma.
Glaucoma ; Humans ; Hyphema ; Incidence ; Inpatients ; Intraocular Pressure ; Logistic Models ; Ocular Hypertension ; Retrospective Studies ; Risk Factors ; Visual Acuity

PURPOSE: To investigate the relationship between peripheral retinal degeneration including retinal tear and character of floater and flash in patients with symptoms. METHODS: A retrospective review of 56 patients who visited Dong-A University Hospital with the symptoms of vitreous floaters and flash between July 2017 and March 2018 was performed using medical records. All patients completed a questionnaire detailing their symptoms include duration of symptoms, characters, floaters with flash and associated another visual symptom (e.g., headache, whiteout) had been performed full ophthalmic examination. RESULTS: A total of 56 eyes were included in this study, including 22 eyes (39.3%) of retinal breaks and peripheral retinal degeneration and 34 eyes (60.7%) of no peripheral retinal degeneration. Univariated analysis showed that the onset of symptoms within 1 week, multiple floaters particularly for the number from 2 to 5, and existence of posterior vitreous detachment are meaningful factor. Laser photocoagulation was performed in patients with peripheral retinal degeneration including retinal tears requiring treatment. No additional breaks were observed in all patients during the 6-month follow-up. CONCLUSIONS Patients with floaters and flash should be thoroughly asked with regard to the onset and number of floaters, and if the onset of symptom is within one week or patients feel multiple floaters, thorough peripheral fundus examination to find peripheral retinal degeneration including retinal tears should be needed.

The development of a multiplex polymerase chain reaction (PCR) method for rapid and accurate detection and typing of herpes simplex virus type 1 (HSV-1), and type-2 (HSV-2), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) is very important for clinical diagnosis to allow the deliver of therapy as early as possible. Large scale amplifications by multiplex PCR of viral DNA can lower the cost and time for viral diagnosis. In this study, therefore sensitive quadruplex PCR was achieved by optimizing parameters such as primers, and 1.5 mM magnesium and 200 uM dNTPs concentrations. The concentrations of HSV-1, HSV-2, CMV and EBV primers were 0.5, 0.3, 0.25 and 0.25 pmoles, respectively. Optimal annealing temperature was 54 degrees C. Employing these conditions, we could detect 10 copies of reconstructed template plasmid DNA, which were cloned to vectors containing target sequences of viral DNA. PCR products of 271 bp for HSV-1, 231 bp for HSV-2, 368 bp for CMV, and 326 bp for EBV were separated on 5.0% polyacrylamide gel electrophoresis and confirmed by direct sequencing. The present study showed that the quadruplex PCR assay described herein has potential application in clinical diagnosis, when rapid, accurate detection and typing of viruses HSV-1, HSV-2, CMV or EBV are necessary.
Cytomegalovirus/classification/*isolation & purification ; Herpesvirus 1, Human/classification/*isolation & purification ; Herpesvirus 2, Human/classification/*isolation & purification ; Herpesvirus 4, Human/classification/*isolation & purification ; Human ; *Polymerase Chain Reaction/methods ; Sensitivity and Specificity ; Support, Non-U.S. Gov't

BACKGROUND: This study was purposed to identify the knowledge and performance level of the infection control guidelines and to improve their performance level of infection control for those nurses who care patients directly. METHODS: This study was based on the survey questionnaires about infection control guidelines with the total 626 nurses in Seoul and Kyunggi areas for the period between May 26, 2003 and July 14, 2003. RESULTS: The average knowledge level of infection control was 0.84 +/-0.07 (score range 0-1) and the average performance level of the infection control was 4.44+/-10.27 (score range 0-5). The correlation between knowledge and performance of the infection control showed positive correlation (r=.39; P<.001). The knowledge and performance level of the 'Prevention of the central catheter infection' were higher than other infection control guidelines. The performance levels of the 'Prevention of the surgical site infection' were lower than other infection control guidelines. The correlation between knowledge and performance of the 'Prevention of the nosocomial pneumonia' (r=.389; P<.001). 'Prevention of the urinary tract infection' (r=.325; P<.001), 'Prevention of the central catheter infection (r=.290; P<.001) and 'Intravascular infection control' (r=.446; P<.001) showed positive correlation. CONCLUSION: The study demonstrated that the nurses' knowledge and performance of infection control guidelines showed positive correlation. So the education on the infection control is required indispensably and it would contribute to reduce the hospital infection rate by performing the right treatment on the infection control with the basis of accurate knowledge.
Catheters ; Cross Infection ; Education ; Gyeonggi-do ; Humans ; Infection Control* ; Seoul ; Urinary Tract ; Surveys and Questionnaires

The resistance to recombinant human erythropoietin (r-HuEPO) in patients with chronic renal failure can develop in conditions such as iron deficiency, chronic bleeding, or chronic inflammatory disease. Recently, there have been several case reports of pure red cell aplasia due to antibody production to r-HuEPO in chronic hemodialysis patients. A 59-year old female undergoing chronic hemodialysis responded well to r-HuEPO for 6 years. But, a rapidly progressive anemia was then noted which was unresponsive to maximal doses of r-HuEPO and the patient became transfusion-dependent. Bone marrow examination showed absence of red cell precursors. A detailed search for the cause of this pure red cell aplasia was unrevealing. We conclude that although very rare, pure red cell aplasia should be considered in evaluating chronic hemodialysis patients with erythropoietin-resistant anemia.
Anemia* ; Antibody Formation ; Bone Marrow Examination ; Erythropoietin ; Female ; Hemorrhage ; Humans ; Iron ; Kidney Failure, Chronic ; Middle Aged ; Red-Cell Aplasia, Pure* ; Renal Dialysis*

PURPOSE: An epidemiologic study of childhood cancer would provide useful information on cancer etiology and development of management guidelines. MATERIALS AND METHODS: Data from the Korea National Cancer Incidence Database were used to examine the incidence and survival of cancer in patients aged 0-14 years. Patients were grouped according to the International Classification of Childhood Cancer, 3rd edition. Age-specific and age-standardized incidences per million and estimated annual percentage change (APC) were calculated by sex and age. Five-year relative survival was calculated for four periods from 1993 to 2011. RESULTS: The study comprised 15,113 patients with malignant neoplasms. Age-standardized incidence rates for all cancers were 134.9 per million children in 1999-2011 and 144.0 and 124.9 per million for males and females, respectively (M/F ratio, 1.2; p < 0.05). The highest incidences were observed for 'leukemias, myeloproliferative diseases, and myelodysplastic diseases' (group I) (46.4), 'central nervous system neoplasms' (group III) (18.3), and 'lymphomas and reticuloendothelial neoplasms' (group II) (13.4). Age-standardized incidence increased from 117.9 in 1999 to 155.3 in 2011, with an APC of 2.4% (95% confidence interval, 2.1 to 2.7). There was a significant increase of APC in 'neuroblastoma and other peripheral nervous cell tumors' (group IV) (5.6%) and 'other malignant epithelial neoplasms and malignant melanomas' (group XI) (5.6%). The 5-year relative survival rate for all childhood cancers improved significantly from 56.2% (1993-1995) to 78.2% (2007-2011) (males, 56.7% to 77.7%; females, 55.5% to 78.8%). CONCLUSION: This study provides reliable information on incidence and survival trends for childhood cancer in Korea.
Carcinoma ; Child ; Classification ; Epidemiologic Studies ; Female ; Humans ; Incidence* ; Korea* ; Male ; Nervous System ; Survival Rate

C-Terminal carboxyl methylation of a human placental 23 kDa protein catalyzed by membrane-associated methyltransferase has been investigated. The 23 kDa protein substrate methylated was partially purified by DEAE-Sephacel, hydroxyapatite and Sephadex G-100 gel filtration chromatographies. The substrate protein was eluted on Sephadex G-100 gel filtration chromatography as a protein of about 29 kDa. In the absence of Mg2+, the methylation was stimulated by guanine nucleotides (GTP, GDP and GTPgammaS), but in the presence of Mg2+, only GTPgammaS stimulated the methylation which was similar to the effect on the G25K/rhoGDI complex. AFC, an inhibitor of C-terminal carboxyl methylation, inhibited the methylation of human placental 23 kDa protein. These results suggests that the substrate is a small G protein different from the G25K and is methylated on C-terminal isoprenylated cysteine residue. This was also confirmed by vapor phase analysis. The methylated substrate protein was redistributed to membrane after in vitro methylation, suggesting that the methylation of this protein is important for the redistribution of the 23 kDa small G protein for its putative role in intracellular signaling.
Cysteine/metabolism* ; Female ; GTP-Binding Proteins/metabolism* ; Guanine Nucleotides/pharmacology ; Human ; Methylation ; Placenta/metabolism* ; Placenta/enzymology ; Pregnancy ; Pregnancy Proteins/metabolism* ; Protein Methyltransferases/metabolism*

PURPOSE: A phase II study of vinorelbine and ifosfamide combination chemotherapy in patients with advanced or recurrent non-small cell lung cancer (NSCLC) was conducted to assess response rate, response duration, and toxicites. MATERIALS AND METHODS: Patients with advanced NSCLC who had no prior systemic chemotherapy were eligible. They have no central nervous system metastasis and recurrent or progressive disease after surgery or radiotherapy. Each cycle consisted of vinorelbine 25 mg/m' i.v. days 1 & 8, and ifosfamide 2 g/m i.v. days 1, 2 & 3 with Mesna and treatments were repeated every 21 days. RESULTS: Forty patients with advanced or recurrent NSCLC were treated at multi center between March, 1997 and March, 1998. Six patients were not evaluable because five patients refused therapy after the first course and one patient was protocol violation. Of 34 evaluable patients, objective responses were seen in 11 (32.4%) patients (CR 0%, PR 32.4%). The median duration of response was 16.4 weeks. The median overall survival was 9.5 months. The toicities of this regimen were acceptable without treatment related toxic death. CONCLUSION: We concluded that combination regimen of vinorelbine and ifosfamide was effective and tolerable in the treatment of advanced non-small cell lung cancer.
Carcinoma, Non-Small-Cell Lung ; Central Nervous System ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Ifosfamide* ; Mesna ; Neoplasm Metastasis ; Radiotherapy ; Small Cell Lung Carcinoma*

Congenital abnormalities of the coronary arteries are found in 0.6% to 1.3% of patients in coronary angiography. Dual left anterior descending coronary artery (LAD) is a rare coronary anomaly and is incidentally detected during coronary angiography. We report a case of a 65-year-old female with a rare coronary anomaly who was diagnosed with dual LAD via coronary computed tomography and coronary angiography. The imaging studies revealed dual LAD originating from the left main stem and right coronary sinus. These angiographic findings were considered to be consistent with the type IV variety of dual LAD by Spindola-Franco classification. Recognition of dual LAD is important to prevent errors of interpretation of the coronary angiogram and for optimal surgery.
Aged ; Classification ; Congenital Abnormalities ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessel Anomalies ; Coronary Vessels* ; Female ; Humans