PURPOSE: This study evaluated the clinical outcomes of transcanalicular laser-assisted dacryocystorhinostomy (TCL-DCR) using a diode laser in patients with nasolacrimal duct obstruction (NLDO). METHODS: A total of 71 patients (76 eyes) who underwent TCL-DCR between May 2004 and April 2010 were analyzed. The functional and anatomic success rates were evaluated and the causes of failure were analyzed. RESULTS: The anatomic and functional success rates in primary TCL-DCR were 73.9% (51 of 69 eyes) and 62.3% (43 of 69), respectively. The causes of failure were membranous obstruction in 50.0% of the cases, granuloma formation in 38.9%, synechia formation in 5.6%, and canalicular stenosis in 5.6%. The anatomic and functional success rates were both 42.9% (3 of 7eyes) after TCL-DCR revision. CONCLUSIONS: The success rate of TCL-DCR is relatively comparable to that of conventional surgery. Additionally, the advantages of the procedure are its minimal invasiveness and convenience in an outpatient setting, suggesting that TCL-DCR may be an effective procedure for primary and secondary NLDO.
Constriction, Pathologic ; Dacryocystorhinostomy ; Granuloma ; Humans ; Lasers, Semiconductor ; Nasolacrimal Duct ; Outpatients

OBJECTIVE: The purpose of this study is to investigate the effects of spouse support and conflict on the depression in older adults, and also to explore whether there are any differences between men and women in these effects. METHODS: The participants of this study were normal and married older adults who participated in the first wave of Korean Social Life, Health, and Aging Project. Participants consisted of 221 men and 210 women. The effects of support and conflict in spousal and other relationships on depression were analyzed using hierarchical regression analysis, separately in men and women. RESULTS: In the men group, the spouse conflict was especially influential in depression. More spouse conflict resulted in greater depression among men. In the women group, however, support from individuals other than spouse (kin support and friends support) had significant effects on depression. Less support received from individuals other than spouse was associated with higher levels of depression among women. CONCLUSION: The results of this study suggest that the quality of spousal and other relationships is related to depression in older adults. Moreover, there is a gender difference in the effect of support and conflict experienced in the relationship.
Adult* ; Aging ; Depression* ; Female ; Friends ; Humans ; Male ; Spouses*

Purpose: To investigate the postoperative changes in diplopia and evaluate factors that affect diplopia after isolated inferior orbital wall fracture. Methods: A retrospective study was conducted on 200 patients who underwent reconstruction surgery for isolated inferior orbital wall fracture between March 2001 and December 2020. Diplopia was categorized into peripheral, central, and full-degree types based on the history and binocular single vision. The natural course of diplopia was analyzed pre-operatively and at 1 day, 6 weeks, and 6 months postoperatively. We analyzed the orbital computed tomography images to determine fracture size (small, medium, or large), fracture site (anterior, middle, posterior, or mixed), extraocular muscle (EOM) size (swelling or deformity), EOM site (incarcerated or prolapsed), and EOM tenting. Results: Diplopia was seen in 144 out of 200 patients (72.0%) before surgery; peripheral diplopia was seen in 57 patients (39.6%), central diplopia in 46 (24.3%), and full-degree diplopia in 20 (13.9%). Pre-operative diplopia differed according to the pre-operative limitation of range of motion (LOM) (p < 0.001) and EOM site (p = 0.022). Pre-operative diplopia type differed according to the LOM direction (p = 0.018) and EOM size (p = 0.020). Diplopia persisted in 33 patients (16.5%) 6 months after the surgery. Recovery was faster in patients with peripheral diplopia compared to those with central or full-degree diplopia. Conclusions The presence of diplopia was associated with the pre-operative LOM and EOM site but the type of diplopia was associated with LOM direction and EOM size. These factors can be used to predict the progression of diplopia in patients with isolated inferior orbital wall fracture.

Purpose: To investigate the effect of botulinum A toxin (BTXA) chemodenervation in paralytic strabismus patients without surgical correction. Methods: A retrospective chart review of 51 patients who were diagnosed as paralytic strabismus and underwent BTXA chemodenervation was performed. The patients were divided into four groups according to the cause of paralytic strabismus of vasculopathy, neoplasm, trauma, and idiopathic. They were also divided into two groups of early and late treatment according to the initiation time of BTXA chemodenervation after the onset of strabismus (3 months), and of the initial strabismus type of exotropia and esotropia. We investigated the changes of angle of deviation and diplopia after BTXA chemodenervation. Results: The average deviation of angles decreased by 25.2 prism diopter (PD) (35.1 to 9.9 PD) in total patients, and the overall success rate was 64.7% (33 by 51), and the there was no statistically significant difference in success rate between each group divided by the cause of paralytic strabismus. According to the treatment timing, the deviation of the angle decreased by 28.0 PD (36.8 to 8.8 PD) in the early treatment group, and 21.3 PD (33.5 to 12.2 PD) in late treatment group at the time of the last postinjective follow-up. According to the initial strabismus type, the average angle of deviation decreased by 20.3 PD (35.6 to 15.3 PD) in exotropia group by cranial nerve 3 palsy, and 24.4 PD (32.5 to 8.1 PD) in esotropia by cranial nerve 6 palsy. Conclusions BTXA chemodenervation reduced the angle of deviation and the number of patients with diplopia regardless of the cause of paralytic strabismus. Early BTXA chemodenervation can be considered as the first treatment of choice in paralytic strabismus, especially in esotropia patients.

Purpose: To evaluate the postoperative stereopsis changes in strabismus patients over 10 years of age after surgical correction. Methods: We reviewed, retrospectively, the medical records of 193 patients (99 men and 94 women) who underwent strabismus surgery from March 2002 to August 2019 at our hospital. Patients were classified into an exotropia group, an esotropia group, or a combined strabismus group (having horizontal and vertical strabismus simultaneously), according to their strabismus type. These groups were further divided into three groups based on pre-operative stereopsis findings classified as poor (above 4,000 seconds [s] of arc), fair (between 4,000 to 100 s of arc), or good (below 100 s of arc). The stereopsis conditions before and after surgery were compared. Results: Overall, the stereopsis of patients over 10 years of age who underwent surgery improved from 2.45 ± 0.69 logarcsec to 2.85 ± 0.58 logarcsec (p < 0.001) after surgery regardless of strabismus type. Stereopsis in exotropia patients was 2.33 ± 0.71 logarcsec before surgery and improved to 2.15 ± 0.56 logarcsec (p < 0.001) after surgery. Stereopsis in esotropia patients was 0.85 ± 0.58 logarcsec before surgery and 2.48 ± 0.11 logarcsec after surgery (p = 0.002). Stereopsis of combined strabismus patients was 2.44 ± 0.76 logarcsec before surgery versus 2.20 ± 0.54 logarcsec after surgery (p = 0.133). The degree of stereopsis improvement was highest for the esotropia, group followed by the combined strabismus, and exotropia groups. Conclusions Surgical correction of various types of strabismus may be helpful for binocular function in patients over 10 years of age.

Purpose: To evaluate the postoperative stereopsis changes in strabismus patients over 10 years of age after surgical correction. Methods: We reviewed, retrospectively, the medical records of 193 patients (99 men and 94 women) who underwent strabismus surgery from March 2002 to August 2019 at our hospital. Patients were classified into an exotropia group, an esotropia group, or a combined strabismus group (having horizontal and vertical strabismus simultaneously), according to their strabismus type. These groups were further divided into three groups based on pre-operative stereopsis findings classified as poor (above 4,000 seconds [s] of arc), fair (between 4,000 to 100 s of arc), or good (below 100 s of arc). The stereopsis conditions before and after surgery were compared. Results: Overall, the stereopsis of patients over 10 years of age who underwent surgery improved from 2.45 ± 0.69 logarcsec to 2.85 ± 0.58 logarcsec (p < 0.001) after surgery regardless of strabismus type. Stereopsis in exotropia patients was 2.33 ± 0.71 logarcsec before surgery and improved to 2.15 ± 0.56 logarcsec (p < 0.001) after surgery. Stereopsis in esotropia patients was 0.85 ± 0.58 logarcsec before surgery and 2.48 ± 0.11 logarcsec after surgery (p = 0.002). Stereopsis of combined strabismus patients was 2.44 ± 0.76 logarcsec before surgery versus 2.20 ± 0.54 logarcsec after surgery (p = 0.133). The degree of stereopsis improvement was highest for the esotropia, group followed by the combined strabismus, and exotropia groups. Conclusions Surgical correction of various types of strabismus may be helpful for binocular function in patients over 10 years of age.

Lynch syndrome is also called Hereditary nonpolyposis colorectal cancer (HNPCC). It is characterized by a risk of colorectal cancer and other cancers of the endometrium, ovary, stomach, small intestine etc. The increased risk is due to inherited mutations that impaired DNA mismatch repair. Two to three percentage of colon cancer is caused by Lynch syndrome. A family history of colon cancer occurs at a young age. We experienced one case of Lynch syndrome who had had stomach cancer, endometrial cancer and colon cancer recently. Hence we report this case with a brief review of literature.
Colonic Neoplasms ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Intestine, Small ; Ovary ; Stomach ; Stomach Neoplasms

Purpose: This quasi-experimental single group study aimed to confirm the effects of discharge education using a systematic discharge education program on anxiety and parenting confidence in mothers of premature babies. Methods: This study conducted discharge education for 3 to 5 days prior to the discharge of 29 mothers of premature babies born in the neonatal intensive care unit. Data were collected between April 1, 2021, to June 30, 2021, and were examined. The hypotheses were analyzed using the Wilcoxon signed-rank test. Results: Discharge education using a systematic discharge education program was effective in increasing the parenting confidence of mothers with premature babies (z=-3.839, p<0.001). However, it was not effective in reducing anxiety (z=-1.712, p=0.087). Conclusion The effects of the systematic discharge education program development and discharge education systematized discharge nursing education, reduced mothers’ anxiety in raising premature babies at home after discharge, and contributed to improving parenting confidence.

Sirtuin 3 (SIRT3), a well-known mitochondrial deacetylase, is involved in mitochondrial function and metabolism under various stress conditions. In this study, we found that the expression of SIRT3 was markedly increased by oxidative stress in dopaminergic neuronal cells. In addition, SIRT3 overexpression enhanced mitochondrial activity in differentiated SH-SY5Y cells. We also showed that SIRT3 overexpression attenuated rotenoneor H2 O2 -induced toxicity in differentiated SH-SY5Y cells (human dopaminergic cell line). We further found that knockdown of SIRT3 enhanced rotenone- or H2 O2 -induced toxicity in differentiated SH-SY5Y cells. Moreover, overexpression of SIRT3 mitigated cell death caused by LPS/IFN-γ stimulation in astrocytes. We also found that the rotenone treatment increases the level of SIRT3 in Drosophila brain. We observed that downregulation of sirt2 (Drosophila homologue of SIRT3) significantly accelerated the rotenone-induced toxicity in flies. Taken together, these findings suggest that the overexpression of SIRT3 mitigates oxidative stress-induced cell death and mitochondrial dysfunction in dopaminergic neurons and astrocytes.

Purpose: This study analyzes the clinical results of SNUCONE AF+II® (SNUCONE Implant) implants placed in the edentulous region to determine the implant survival rate and the marginal bone healing pattern in the healing process. Materials and Methods: Two hundred forty implants placed in 131 patients with SNUCONE AF+II® implant system from January 1, 2014 to December 31, 2014 at Cheongju Hankook General Hospital were followed up for 5 years.Result: We evaluated 240 SNUCONE AF+II® implants of 131 patients from January 1, 2014 to December 31, 2014 at Cheongju Hankook General Hospital, and the results are as following: 1) Three implants were failed out of 240 implants of 131 patients and the survival rate was 98.75%. 2) The marginal bone resorption was 0.95±1.84 mm for 4 years after prosthesis placement, showing favorable result. Conclusion Although long-term cumulative evaluations and studies should be performed in the future, SNUCONE AF+II® implants show high cumulative survival and low marginal bone resorption according to the results of this study, which believed to give outstanding result in various dental implant procedure.