Purpose: To report a biopsy-proven case of granulomatosis with polyangiitis (GPA) who visited for red eye and discomfort. We detected papillary thyroid cancer by a whole-body scan.Case summary: A 56-year-old female presented to our clinic with hyperemia and discomfort in the right eye for the past 1 month. The visual acuity was 0.9 in the right eye. Congestion and chemosis of the right conjunctiva were observed by slit-lamp microscopy. There was a firm, erythematous, tender mass near the right nasolacrimal duct. Impairment of adduction and infraduction and proptosis were observed. Radiologically, a 3.6 × 2.6 × 1.2 cm right orbital mass was seen in the intraorbital extraconal space, invading the right nasolacrimal duct and nasal cavity. Pathologic and supplementary investigations showed granulomatous, c-anti-neutrophil cytoplasmic antibodies (ANCA)-positive inflammation in the mass. The patient was diagnosed with GPA. Whole-body computed tomography and positron emission tomography-computed tomography revealed multiple lesions in the right orbit, nasal cavity, mediastinum, retropubic area, and left thyroid gland. Thyroid ultrasonography and biopsy led to a diagnosis of papillary carcinoma with lymph node metastasis. Topical and systemic steroids and rituximab injection were administered, and total thyroidectomy with bilateral central lymph node dissection was performed. This led to improvements in proptosis and limitation of extraocular movement. Conclusions GPA is a rare disease that may initially present with ocular symptoms. It can be associated with malignancies even in the absence of immunosuppression. Patients with ocular problems suspected of having GPA should undergo autoimmune antibody testing, including ANCA and tissue biopsy.

PURPOSE: The purpose of this study is to explore the perceptions of obesity and management behaviors of obese adolescents and their families in Korea. METHOD: Nine adolescents with moderate-degree obesity and of four their mothers of them were investigated using semi-structured interviews. RESULT: The perceptions of obesity was classified into four domains and obesity management behaviors was classified into three domains. The domains regarding the perceptions of obesity include definitions of obesity(a danger signal of health status, deviation status, symbols of growth), causes of obesity(out of balance), opinions about their obesity(contempt, negative preconception, superiority) and changes on thought and attitudes owing to obesity(shrinkage, repulsion, sustaining losses, decreased activity, decreased self-confidence, defensive behaviors). The domains regarding obesity management behaviors include attitude about the management of obesity(not having priority, optimistic view, ardent wish), management behaviors for correcting obesity(encouraging physical activity, control of diet, gathering information, trial of diet control), attitudes about performing the management behaviors for correcting obesity(inconsistency, non-autonomy, conflict). CONCLUSION: This study helps to enhance the understanding of the perception of obesity and management behaviors of obese adolescents and their families. Futhermore, based on this understanding, effective and appropriate heath management programs can be planned and conducted.
Adolescent* ; Diet ; Humans ; Korea* ; Methods ; Mothers ; Motor Activity ; Obesity*

PURPOSE: The purpose of this study is to identify how regular stimulation affects apnea of a premature infant. METHOD: This study was used a within-subjects design with repeated measure using GEE (General Estimating Equation) and had been conducted from July 1, 2003 to March 12, 2004. The subjects consisted of 11 apneic premature infants who had showed apnea more than twice for 12 hours. A regularly vibrating test lung was provided to the subjects to find how regular stimulation affects apnea. RESULT: From the result of regular stimulation for apneic premature infants, both the lowest SaO2 and the lowest heart rate at experimental period were found to be increased significantly. However, the decreased frequency of the apnea cases was not statistically effective. CONCLUSION: These findings indicate that regular stimulation for apneic premature infants could be effective on increasing both SaO2 and heart rate. Therefore, we suggest regular stimulation to be used clinically to heal apnea of premature infants.
Apnea* ; Heart Rate ; Humans ; Infant, Newborn ; Infant, Premature ; Lung ; Child Health

OBJECTIVE: To evaluate the effect of the Whirlpool hydrotherapy on pain and anxiety in chronic myofascial pain syndrome (MPS) patients, compared to the conventional hydrocollator pack therapy. METHODS: Forty-one subjects who have MPS in the upper trapezius muscles without depression were recruited. The patients were randomly assigned into two groups: the whirlpool therapy group whose bodies were immersed in a whirlpool bath at 34degrees C-36degrees C for 30 minutes; the hydrocollator group who took a 30-minute application of a standard hot hydrocollator pack. Patients in both groups received therapy three days a week for 2 weeks and underwent several evaluations at baseline and after treatment. The variables we analyzed during evaluations were as follows: the primary outcome we considered was pain severity using a visual analogue scale. And the secondary outcomes examined included anxiety using the Korean version of the Beck Anxiety Inventory and quality of life (QoL) using the Korean version of the World Health Organization QoL Assessment, Brief Form. All follow-up values were compared with the baseline values. RESULTS: The baseline parameters did not show significant differences between two groups. And after 2-week treatment, both groups revealed significant improvement in anxiety levels and QoL, as well as in pain. However, the improvement on pain (p=0.002) and anxiety (p=0.010) was significantly greater in the whirlpool group, compared to the hydrocollator group. CONCLUSION: The whirlpool hydrotherapy can be used as a more effective therapeutic method to reduce pain and anxiety in chronic MPS patients without depression.
Anxiety ; Depression ; Follow-Up Studies ; Humans ; Hydrotherapy ; Muscles ; Myofascial Pain Syndromes ; Quality of Life ; World Health Organization

Purpose: To assess changes in the tear film and delayed tear drainage after upper or lower, or combined upper and lower, punctal occlusion using dissolvable polydioxanone plugs in patients with dry eye. Methods: In total, 40 dry eye patients (80 eyes) were enrolled: four groups of 10 (20 eyes) with no, lower, upper, and lower and upper punctal occlusions. Dissolvable polydioxanone plugs were placed. The tear break-up time (tBUT) and the tear meniscus height (TMH) were measured, and the Schirmer I test and dye disappearance test (DDT) were performed at baseline and 2 weeks after the procedure. Results: Compared to the control group, all three test groups exhibited significant changes in the tBUT, the DDT test, and the TMH after polydioxanone plug placement (all p < 0.05). The group with both upper and lower punctal occlusions exhibited more delayed tear drainage than the other test groups. A lower punctal occlusion significantly delayed tear drainage to a greater extent than did an upper punctal occlusion (p = 0.010). Conclusions In dry eye patients, a polydioxanone plug improved the tBUT and TMH, and the DDT score. The tear drainage delay increased in the order: both, lower, and upper punctal occlusion(s).

PURPOSE: The exercise status in patients with rheumatoid arthritis, associations between exercise behavior and personal factors, and associations between exercise behavior and exercise-specific cognitions and their effects were assessed. METHOD: Four hundred thirty nine outpatients with rheumatoid arthritis were studied. The exercise status was measured by a single item. The intensity was multiplied by the frequency and duration of each exercise. The product of these intensity values for all exercises was defined as exercise behavior. Based on the Pender's revised health promotion model, exercise benefit, barrier, self-efficacy, enjoyment and social support were chosen as exercise specific cognitions and affect variables. Path analysis was used to identify the predictors of exercise behavior. Results: Compared to the duration before being diagnosed, the number of subjects who exercised regularly increased after being diagnosed. However over half of the subjects refrain from any sort of exercise and the type of exercise is very limited. Among the variables, exercise barrier, self-efficacy, and social support were found to be significant predictors of exercise behavior, and only previous exercise experience was found to be significant predictors of all behavior specific cognitions and affect variables. CONCLUSION: These findings suggest that studies should explore exercise behaviors and strategies to emphasize the cognitive-motivational messages to promote exercise behaviors.
Arthritis, Rheumatoid* ; Exercise ; Health Promotion ; Humans ; Outpatients

Early detection and intervention is critical in improving prognosis of developmental disorders. Developmental delay can have many different causes and the clinical features of developmental delay are diverse according to its etiologic causes and severity. The vast and rapid growth of the child's neurobehavioral repertoire from birth through adolescence requires the physician's abundant experience, knowledge, and understanding of development. Here, we summarize instruments for use in neurodevelopmental assessment of infants and toddlers, focusing on motor development, which is the most frequent complaint listed in the developmental clinic.
Adolescent ; Humans ; Infant ; Parturition ; Prognosis

PURPOSE: The purpose of this study was to figure out emotional labor, healthy lifestyle, needs for health services of flight attendants and the relationships among needs for health services according to various characteristics of flight attendants. METHODS: The participants of this study were 140 flight attendants who work on major and low cost airlines. Data were collected through a questionnaire from 2017 .Jan.~2017. Feb. Data were subsequently analyzed using the SPSS 21 Program. RESULTS: The score of emotional labor was 3.76 surface acting was 3.75 and deep acting was 3.77. The average of healthy lifestyle was 2.41, and the highest was 3.13 of personal relationship and the lowest was 1.91 of eating habits. There is a positive correlation between emotional labor-deep acting and healthy lifestyle. Flight attendants demand health services for physical exercise, stress and emotional labor management, healthy eating habits, emergency treatment, prevention of fatigue, cancer screening, sexual harassment prevention, sex education and etc. CONCLUSION: These results show that flight attendants need to various interventions for improving healthy lifestyle and reducing emotional labor. It is necessary to develop customized health promotion program suited to their job and general characteristics.
Early Detection of Cancer ; Eating ; Emergency Treatment ; Exercise ; Fatigue ; Health Promotion ; Health Services ; Health Services Needs and Demand ; Humans ; Life Style ; Sex Education ; Sexual Harassment

PURPOSE: The purpose of this study was to figure out emotional labor, healthy lifestyle, needs for health services of flight attendants and the relationships among needs for health services according to various characteristics of flight attendants. METHODS: The participants of this study were 140 flight attendants who work on major and low cost airlines. Data were collected through a questionnaire from 2017 .Jan.~2017. Feb. Data were subsequently analyzed using the SPSS 21 Program. RESULTS: The score of emotional labor was 3.76 surface acting was 3.75 and deep acting was 3.77. The average of healthy lifestyle was 2.41, and the highest was 3.13 of personal relationship and the lowest was 1.91 of eating habits. There is a positive correlation between emotional labor-deep acting and healthy lifestyle. Flight attendants demand health services for physical exercise, stress and emotional labor management, healthy eating habits, emergency treatment, prevention of fatigue, cancer screening, sexual harassment prevention, sex education and etc. CONCLUSION These results show that flight attendants need to various interventions for improving healthy lifestyle and reducing emotional labor. It is necessary to develop customized health promotion program suited to their job and general characteristics.

Purpose: To determine the clinical outcomes after exchange of diffractive multifocal intraocular lenses (IOLs) with monofocal IOLs for patients who complained of dysphotopsia after cataract surgery. Methods: We exchanged the IOLs of patients who visited our clinic complaining that dysphotopsia had not improved after they underwent phacoemulsification and diffractive multifocal IOL implants in local eye clinics. We evaluated the corrected distance visual acuity (CDVA) before and after operation, the type of preoperative dysphotopsia, postoperative dysphotopsia status, patient satisfaction, and all complications. Results: We enrolled 35 eyes of 27 patients and observed them for 5.7 ± 3.6 months. After 1 month, the CDVA significantly (p < 0.001) improved from 0.131 ± 0.131 logarithm of the minimal angle resolution (logMAR) preoperatively to 0.0328 ± 0.0900 logMAR postoperatively. Patient satisfaction graded on a scale from 1 (very dissatisfied) to 5 (excellent) significantly (p < 0.001) increased from 1.17 ± 0.382 preoperatively to 4.09 ± 0.818 postoperatively. No vision-threatening complications developed. Postoperative cystoid macular edema developed in one eye but resolved after intravitreal bevacizumab (Avastin®, Genetech, Inc, San Francisco, CA, USA) injections. Conclusions IOL exchange surgery relatively safely improves the vision of patients suffering from dysphotopsia attributable to the characteristics of diffractive multifocal IOLs.