Purpose: To report a case of spontaneous closure of a chronic recurrent full-thickness macular hole (FTMH) in a previously vitrectomized eye.Case summary: A 58-year-old female who underwent vitrectomy for the treatment of a rhegmatogenous retinal detachment (RRD) on the right eye 2 years ago complaint of decreased vision on the same eye. The best corrected visual acuity (BCVA) was 0.2. The fundus photograph and optical coherence tomography revealed a FTMH with perifoveal cystoid macular edema (CME). While surgical treatment for the macular hole (MH) was scheduled, the spontaneous closure of MH was observed with resolution of CME. BCVA improved to 0.5. During the long-term follow-up periods, FTMH with CME recurred 2 times or more. In all events, the hole was spontaneously closed in 1 month, accompanied with resolution of CME. Conclusions A FTMH with CME developed 3 times for 11 years following RRD repair, which was spontaneously closed with CME resolution in a month. In case of chronic recurrent FTMH in vitrectomized eye, it would be better to determine surgical treatment after closely monitoring changes in hole and CME.

Purpose: To report a case of spontaneous closure of a chronic recurrent full-thickness macular hole (FTMH) in a previously vitrectomized eye.Case summary: A 58-year-old female who underwent vitrectomy for the treatment of a rhegmatogenous retinal detachment (RRD) on the right eye 2 years ago complaint of decreased vision on the same eye. The best corrected visual acuity (BCVA) was 0.2. The fundus photograph and optical coherence tomography revealed a FTMH with perifoveal cystoid macular edema (CME). While surgical treatment for the macular hole (MH) was scheduled, the spontaneous closure of MH was observed with resolution of CME. BCVA improved to 0.5. During the long-term follow-up periods, FTMH with CME recurred 2 times or more. In all events, the hole was spontaneously closed in 1 month, accompanied with resolution of CME. Conclusions A FTMH with CME developed 3 times for 11 years following RRD repair, which was spontaneously closed with CME resolution in a month. In case of chronic recurrent FTMH in vitrectomized eye, it would be better to determine surgical treatment after closely monitoring changes in hole and CME.

Purpose: To report a case of spontaneous closure of a chronic recurrent full-thickness macular hole (FTMH) in a previously vitrectomized eye.Case summary: A 58-year-old female who underwent vitrectomy for the treatment of a rhegmatogenous retinal detachment (RRD) on the right eye 2 years ago complaint of decreased vision on the same eye. The best corrected visual acuity (BCVA) was 0.2. The fundus photograph and optical coherence tomography revealed a FTMH with perifoveal cystoid macular edema (CME). While surgical treatment for the macular hole (MH) was scheduled, the spontaneous closure of MH was observed with resolution of CME. BCVA improved to 0.5. During the long-term follow-up periods, FTMH with CME recurred 2 times or more. In all events, the hole was spontaneously closed in 1 month, accompanied with resolution of CME. Conclusions A FTMH with CME developed 3 times for 11 years following RRD repair, which was spontaneously closed with CME resolution in a month. In case of chronic recurrent FTMH in vitrectomized eye, it would be better to determine surgical treatment after closely monitoring changes in hole and CME.

Purpose: To report a case of spontaneous closure of a chronic recurrent full-thickness macular hole (FTMH) in a previously vitrectomized eye.Case summary: A 58-year-old female who underwent vitrectomy for the treatment of a rhegmatogenous retinal detachment (RRD) on the right eye 2 years ago complaint of decreased vision on the same eye. The best corrected visual acuity (BCVA) was 0.2. The fundus photograph and optical coherence tomography revealed a FTMH with perifoveal cystoid macular edema (CME). While surgical treatment for the macular hole (MH) was scheduled, the spontaneous closure of MH was observed with resolution of CME. BCVA improved to 0.5. During the long-term follow-up periods, FTMH with CME recurred 2 times or more. In all events, the hole was spontaneously closed in 1 month, accompanied with resolution of CME. Conclusions A FTMH with CME developed 3 times for 11 years following RRD repair, which was spontaneously closed with CME resolution in a month. In case of chronic recurrent FTMH in vitrectomized eye, it would be better to determine surgical treatment after closely monitoring changes in hole and CME.

Selective serotonin reuptake inhibitors are commonly prescribed drugs for the treatment of depression in the patients with diabetes. Here, we report a case of paroxetineinduced severe recurrent hypoglycemia that developed in a 35-year-old woman with poorly controlled type 2 diabetes complicated by diabetic nephropathy and neuropathy. She discontinued her daily insulin therapy 2 months after the introduction of paroxetine, but hypoglycemic events were sustained. After discontinuation of paroxetine, no more hypoglycemic events occurred.
Adult ; Depression ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Female ; Humans ; Hypoglycemia* ; Insulin ; Paroxetine ; Serotonin Uptake Inhibitors

Objective: To investigate the correlation between videofluoroscopic swallowing study (VFSS) and radionuclide salivagram findings in chronic brain-injured patients with dysphagia. Methods: Medical records of chronic brain-injured patients who underwent radionuclide salivagram and VFSS were retrospectively analyzed. Patients were divided into two groups according to salivagram findings. Differences in patient characteristics and clinical factors, including Mini-Mental State Examination (MMSE), Modified Barthel Index (MBI), Functional Ambulatory Category (FAC), feeding method, tracheostomy state, and VFSS findings between the two groups were investigated. Results: A total of 124 patients were included in this study. There were no significant differences in MMSE, MBI, FAC, feeding method, and presence of tracheostomy between the two groups. However, the incidence of aspiration pneumonia history was significantly higher in the positive salivagram group. The Functional Dysphagia Scale (FDS) was significantly associated with positive salivagram findings, especially in the pharyngeal phase. A multivariate logistic regression analysis showed that laryngeal elevation and epiglottic closure was statistically significant FDS parameter in predicting salivary aspiration on a salivagram (odds ratio=1.100; 95% confidence interval, 1.017–1.190; p=0.018). The receiver operating characteristic (ROC) curve of FDS in the pharyngeal phase showed that an optimum sensitivity and specificity of 55.1% and 65.4%, respectively, when the cut-off value was 39. Conclusion In chronic brain-injured patients, inappropriate laryngeal elevation and epiglottic closure is predictive variable for salivary aspiration. Therefore, performing a radionuclide salivagram in patients with FDS of 39 or less in the pharyngeal phase for prevents aspiration pneumonia from salivary aspiration.

Objective: To investigate the correlation between videofluoroscopic swallowing study (VFSS) and radionuclide salivagram findings in chronic brain-injured patients with dysphagia. Methods: Medical records of chronic brain-injured patients who underwent radionuclide salivagram and VFSS were retrospectively analyzed. Patients were divided into two groups according to salivagram findings. Differences in patient characteristics and clinical factors, including Mini-Mental State Examination (MMSE), Modified Barthel Index (MBI), Functional Ambulatory Category (FAC), feeding method, tracheostomy state, and VFSS findings between the two groups were investigated. Results: A total of 124 patients were included in this study. There were no significant differences in MMSE, MBI, FAC, feeding method, and presence of tracheostomy between the two groups. However, the incidence of aspiration pneumonia history was significantly higher in the positive salivagram group. The Functional Dysphagia Scale (FDS) was significantly associated with positive salivagram findings, especially in the pharyngeal phase. A multivariate logistic regression analysis showed that laryngeal elevation and epiglottic closure was statistically significant FDS parameter in predicting salivary aspiration on a salivagram (odds ratio=1.100; 95% confidence interval, 1.017–1.190; p=0.018). The receiver operating characteristic (ROC) curve of FDS in the pharyngeal phase showed that an optimum sensitivity and specificity of 55.1% and 65.4%, respectively, when the cut-off value was 39. Conclusion In chronic brain-injured patients, inappropriate laryngeal elevation and epiglottic closure is predictive variable for salivary aspiration. Therefore, performing a radionuclide salivagram in patients with FDS of 39 or less in the pharyngeal phase for prevents aspiration pneumonia from salivary aspiration.

Background: Dental diseases are common in dogs and cats, and accurate measurements of dentoalveolar structure are important for planning of treatment. The information that the comparison computed tomography (CT) with dental radiography (DTR) is not yet reported in veterinary medicine. Objectives: The purpose of this study was to compare the DTR with CT of dentoalveolar structures in healthy dogs and cats, and to evaluate the CT images of 2 different slice thicknesses (0.5 and 1.0 mm). Methods: We included 6 dogs (2 Maltese and 1 Spitz, Beagle, Pomeranian, mixed, 1 to 8 years, 4 castrated males, and 2 spayed female) and 6 cats (6 domestic short hair, 8 months to 3 years, 4 castrated male, and 2 spayed female) in this study. We measured the pulp cavity to tooth width ratio (P/T ratio) and periodontal space of maxillary and mandibular canine teeth, maxillary fourth premolar, mandibular first molar, maxillary third premolar and mandibular fourth premolar. Results: P/T ratio and periodontal space in the overall dentition of both dogs and cats were smaller in DTR compared to CT. In addition, CT images at 1.0 mm slice thickness was generally measured to be greater than the images at 0.5 mm slice thickness. Conclusions The results indicate that CT with thin slice thickness provides more accurate information on the dentoalveolar structures. Additional DTR, therefore, may not be required for evaluating dental structure in small-sized dogs and cats.

Background: The existing literature has comprehensively examined the benefits of specialized wound-care services and multidisciplinary team care. However, information on the development and integration of wound-dressing teams for patients who do not require specialized wound care is scarce. Therefore, the present study aimed to elucidate the benefits of a wound-dressing team by reporting our experiences with the establishment of a wounddressing team. Methods: The wound-dressing team was established at Korea University Guro Hospital.Between July 2018 and June 2022, 180,872 cases were managed for wounds at the wounddressing team. The data were analyzed to assess the types of wounds and their outcomes.In addition, questionnaires assessing the satisfaction with the service were administered to patients, ward nurses, residents/internists, and team members. Results: Regarding the wound type, 80,297 (45.3%) were catheter-related, while 48,036 (27.1%), 26,056 (14.7%), and 20,739 (11.7%) were pressure ulcers, dirty wounds, and simple wounds, respectively. In the satisfaction survey, the scores of the patient, ward nurse, dressing team nurse, and physician groups were 8.9, 8.1, 8.2, and 9.1, respectively.Additionally, 136 dressing-related complications (0.08%) were reported. Conclusion The wound dressing team can enhance satisfaction among patients and healthcare providers with low complications. Our findings may provide a potential framework for establishing similar service models.

Purpose: This study’s aim was to confirm the importance and performance of the clinical practice of nurses working in the general wards of a tertiary hospital and to analyze their educational needs. Methods: The study employed a descriptive research design, and a self-reported questionnaire was developed and used for nurses in a tertiary hospital. Data were collected from July 22 to July 29, 2022, analyzed by an independent t-test, paired t-test, and one-way ANOVA for the importance and performance of each clinical nursing practice according to general characteristics, and then a post hoc verification was performed by Scheffé’s test. An Importance-Performance Analysis and Borich needs assessment model were used to analyze clinical nursing education needs. Results: Clinical nursing practice performance showed a significant difference according to length of total clinical career, time working in current department, and preceptor experience. According to the results of the Importance-Performance Analysis, neurological evaluation, and nursing intervention, artificial respirator and high-flow oxygen inhalation nursing, chemotherapy, emergency nursing, and cardiopulmonary resuscitation were identified as belonging to the “concentrate here” quadrant. All these items ranked in the top 10 in the Borich needs assessment model. Conclusion Based on these results, the current education system should be reviewed, and short and long term education strategies based on educational needs should be established to strengthen the competence of nurses.