Overhanging bleb after trabeculectomy is a late complication which can cause visual disturbance, ocular pain and even be a risk factor of late endophthalmitis. When it fails to be managed with conservative and less invasive treatment, the bleb is to be excised surgically. In this case, the shortage of conjunctiva in the course of partial excision of the bleb was successfully managed by human amniotic membrane transplantation. Amniotic membrane is avascular tissue with thick basement membrane and rich stroma, and it can supply the conjunctiva with basement membrane and growth factors. We report the usefulness of amniotic membrane transplantation as a temporary substitute of conjunctiva and a source of stroma for its growth in the excision of overhanging bleb.
Amnion* ; Basement Membrane ; Blister* ; Conjunctiva ; Endophthalmitis ; Humans* ; Intercellular Signaling Peptides and Proteins ; Risk Factors ; Trabeculectomy

PURPOSE: This study was conducted to identify the effects of cardiopulmonary resuscitation (CPR) practice education on CPR knowledge, attitude, confidence, learning satisfaction and performance of the personal assistants for the disabled. METHODS: This is a quasi-experimental study with a non-equivalent control group. The participants were 62 personal assistants for the disabled. Thirty-one subjects were assigned to an experimental group and the remaining subjects were assigned to a control group. The date collected were analyzed using the IBM SPSS Statistics 20.0 program by descriptive statistics, χ2-test, Fisher's exact test, and t-test. RESULTS: CPR practice education was found to have a meaningful effect on CPR knowledge (p<.001), learning satisfaction (p<.001), and performance (p<.001) of the personal assistants for the disabled. CONCLUSION: Considering these results, it would be useful to develop CPR practice curriculum to enhance CPR knowledge, attitude, confidence, learning satisfaction and performance of the personal assistants for the disabled.
Cardiopulmonary Resuscitation* ; Curriculum ; Education* ; Humans ; Learning ; Non-Randomized Controlled Trials as Topic

PURPOSE: This research was conducted to identify the effects of providing support programs to families of elderly with dementia on family empowerment and attitudes toward dementia. METHODS: A nonequivalent control group pre- and post-test design was used. Participants were 49 family caregivers, experimental (24) and control (25), recruited from families through a dementia support center in Y district. This program implemented Haearim, a support program for family caregivers of demented elders developed by the National Institute of Dementia in 2016. Outcome measures were empowerment and attitudes toward to dementia. Data were analyzed with a χ2-test, independent t-test, Fisher's exact probability test, paired t-test, and repeated measures ANOVA with SPSS/PC version 20.0. RESULTS: Family empowerment (F=6.84, p=.002) and family caregivers' attitudes (F=16.48, p < .001) toward dementia in the experimental group improved significantly more than that of the control group after intervention. CONCLUSION: Results indicate that support programs for families of elderly with dementia are effective in positively changing empowerment and attitudes toward dementia among family caregivers.
Aged ; Caregivers ; Dementia ; Humans ; Outcome Assessment (Health Care) ; Power (Psychology)

PURPOSE: To evaluate the clinical manifestations of adverse drug reactions (ADRs) of parenteral nutrition (PN) use in Korea. METHODS: The Korean Adverse Event Reporting System (KAERS) database records in 2015 on PN-treated patients were used. ADRs classified as “certain,”“probable,” and “possible” based on the WHO-Uppsala Monitoring Centre criteria were analyzed. RESULTS: In total, 21,436 ADRs from 2,346 patients were included for analysis. The mean patient age was 57.1 years and the mean number of ADRs per patient was 9.1. ADRs were reported frequently with amino acids solutions (682 events, 40.8%), followed by combinations products (519 events, 31.1%), and fat emulsions (363 events, 21.7%). The frequent ADRs were gastrointestinal (507 events, 30.3%), skin (343 events, 20.5%), general disorders (239 events, 14.3%), and central/peripheral nervous system disorders (165 events, 9.9%). The common clinical symptoms were nausea (321 events, 19.2%), vomiting (105 events, 6.3%), and vein pain (102 events, 6.1%). Serious ADRs accounted for 220 patients (9.4%) and dyspnea was the most frequent clinical manifestation. CONCLUSION: This study analyzed the KAERS data in 2015 from patients treated with PN and revealed gastrointestinal and skin disorders to be the leading ADRs.
Amino Acids ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Emulsions ; Humans ; Korea* ; Nausea ; Nervous System Diseases ; Parenteral Nutrition* ; Skin ; Veins ; Vomiting

Late bleb leak after trabeculectomy is a serious and intractable complication and its frequency is increasing as antimetabolites are used in the surgery. Various modalities have been challenged in the treatment of late bleb leak but the results have not been satisfactory.Amniotic membrane is avascular tissue with thick basement membrane and rich stroma, and it can modulate wound.As it does not express HLA, it doesn t induce graft rejection. With the use of these characteristics of amniotic membrane, we report a case in which late bleb leak after trabeculectomy with MMC was successfully treated with amniotic membrane transplantation maintaining bleb function.
Amnion* ; Antimetabolites ; Basement Membrane ; Blister* ; Graft Rejection ; Humans* ; Membranes ; Trabeculectomy

Sclerosing pseudotumor of the orbit is a unique clinico-pathological entity which is characterized by an insidious, chronic and progressive fibrosing process damaging orbital structures.As this entity forms immunologically mediated fibrosis even in early phase and frequently involves orbital apex and adjacent intracranial structures, it can cause severe ocular symptoms, visual impairments and even can threaten the life. We report clinical characteristics of nine biopsy-proven cases of sclerosing pseudotumor of the orbit.Five cases out of them have shown clinical improvement with combined therapeutic approach of surgical debulking, systemic steroids therapy, radiation therapy, and immunosuppressive therapy. We believe that prompt diagnosis through biopsy, early introduction of radiation therapy and immunosuppressive therapy are the most rational, currently available treatment for sclerosing pseudotumor of the orbit.
Biopsy ; Diagnosis ; Fibrosis ; Orbit* ; Steroids ; Vision Disorders

OBJECTIVES: The objective of the study was to determine patient's views of the effects of internet health information on the doctor-patient relationship. METHODS: Online survey with 26 items was conducted which was developed by revising the questionnaire of Direct-to-Consumer Advertising to accommodate to the internet health information. Members of the active online patients communities were solicited by e-mail. RESULTS: Most of them gave an affirmative answer on Internet Health Information saying that it makes them get advice from doctor with self-confidence, follow their doctor's direction well, get more medical treatment after retrieving the information and so on. By contrast, physicians perceived that internet health information may have variety of negative effects according to the preceding research. CONCLUSIONS: There are the differences of perspectives between physicians and patients. Therefore it will be necessary to make the experts' intervention in the provision of internet health information, which will have good effects on quality of care, doctor-patient relationship, and health service utilization.
Electronic Mail ; Health Services ; Humans ; Internet ; Surveys and Questionnaires

PURPOSE: To report a case where bilateral malignant retrobulbar lymphoma was diagnosed after repetitive intraocular lens dislocation to the anterior chamber. CASE SUMMARY: An 85-year-old male with a history of stroke who had undergone cataract surgery 10 years ago at another hospital presented with repeated intraocular lens (IOL) dislocations of both eyes into the anterior chamber. He had previously undergone IOL scleral fixation once in his left eye and twice in his right eye, but IOL dislocation was still repeatedly occurring. The best-corrected visual acuity was 0.4 in both eyes. Hertel exophthalmetry was 20 mm in his right eye and 18 mm in his left eye. Painless limitation of motion at supraduction was observed in the right eye. Funduscopy showed newly appeared choroidal folding in the right eye, so orbital computed tomography (CT) with contrast was performed. The CT scans showed bilateral homogenously enhancing retrobulbar masses. Biopsy of the masses showed a MALToma. After radiation therapy, the choroidal folds resolved and exophthalmetry improved to 10 mm in both eyes. No additional IOL dislocation occurred. During 2.5 years of follow-up, there was no evidence of recurrence or distant metastasis of the MALToma. CONCLUSIONS: Orbital lymphomas can cause lid edema, exophthalmos, strabismus, and diplopia, and can be diagnosed with imaging modalities such as CT. Final diagnosis involves biopsy and radiation therapy or chemotherapy. If IOL dislocation occurs repeatedly, it may result from an increase in retrobulbar pressure, and concurrent choroidal folding using funduscopy is strongly recommended for imaging to check for the presence of retrobulbar masses.
Aged, 80 and over ; Anterior Chamber ; Biopsy ; Cataract ; Choroid ; Diagnosis ; Diplopia ; Dislocations* ; Drug Therapy ; Edema ; Exophthalmos ; Follow-Up Studies ; Humans ; Lenses, Intraocular* ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Male ; Neoplasm Metastasis ; Orbit ; Recurrence ; Strabismus ; Stroke ; Tomography, X-Ray Computed ; Visual Acuity

Background: and Purpose: Subjective cognitive decline (SCD) refers to the self-perception of cognitive decline with normal performance on objective neuropsychological tests. SCD, which is the first help-seeking stage and the last stage before the clinical disease stage, can be considered to be the most appropriate time for prevention and treatment. This study aimed to compare characteristics between the amyloid positive and amyloid negative groups of SCD patients. Methods: A cohort study to identify predictors for the clinical progression to mild cognitive impairment (MCI) or dementia from subjective cognitive decline (CoSCo) study is a multicenter, prospective observational study conducted in the Republic of Korea. In total, 120 people aged 60 years or above who presented with a complaint of persistent cognitive decline were selected, and various risk factors were measured among these participants.Continuous variables were analyzed using the Wilcoxon rank-sum test, and categorical variables were analyzed using the χ2 test or Fisher’s exact test. Logistic regression models were used to assess the predictors of amyloid positivity. Results: The multivariate logistic regression model indicated that amyloid positivity on PET was related to a lack of hypertension, atrophy of the left temporal lateral and entorhinal cortex, low body mass index, low waist circumference, less body and visceral fat, fast gait speed, and the presence of the apolipoprotein E ε4 allele in amnestic SCD patients. Conclusions The CoSCo study is still in progress, and the authors aim to identify the risk factors that are related to the progression of MCI or dementia in amnestic SCD patients through a two-year follow-up longitudinal study.

Background: and Purpose: Early detection of subjective cognitive decline (SCD) due to Alzheimer’s disease (AD) is important for clinical research and effective prevention and management. This study examined if quantitative electroencephalography (qEEG) could be used for early detection of AD in SCD. Methods: Participants with SCD from 6 dementia clinics in Korea were enrolled.18 F-florbetaben brain amyloid positron emission tomography (PET) was conducted for all the participants. qEEG was performed to measure power spectrum and source cortical activity. Results: The present study included 95 participants aged over 65 years, including 26 amyloid PET (+) and 69 amyloid PET (−). In participants with amyloid PET (+), relative power at delta band was higher in frontal (p=0.025), parietal (p=0.005), and occipital (p=0.022) areas even after adjusting for age, sex, and education. Source activities of alpha 1 band were significantly decreased in the bilateral fusiform and inferior temporal areas, whereas those of delta band were increased in the bilateral cuneus, pericalcarine, lingual, lateral occipital, precuneus, posterior cingulate, and isthmus areas. There were increased connections between bilateral precuneus areas but decreased connections between left rostral middle frontal area and bilateral frontal poles at delta band in participants with amyloid PET (+) showed. At alpha 1 band, there were decreased connections between bilateral entorhinal areas after adjusting for covariates. Conclusions SCD participants with amyloid PET (+) showed increased delta and decreased alpha 1 activity. qEEG is a potential means for predicting amyloid pathology in SCD. Further longitudinal studies are needed to confirm these findings.