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Churg-Strauss Syndrome*

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PURPOSE: To evaluate the relationship between the lesions of the MEWDS, retinal dysfunction and the cause of decreased visual acuity. METHODS: A patient with a medical history, retinal finding, and the fluorescein angiographic findings consistent with the diagnosis of MEWDS is described. Full field ERG and mfERG were performed and the results was analyzed to find the relationship the visual acuity and the fluorescein angiographic findings. RESULTS: mfERG of the involved eye shows diffuse depression of the amplitude accentuated by focal areas of steep depression thought to correspond to white spot and full field ERG shows generalized depressed signal. The mfERG abnormalities seen at the presentation resolved with the resolution of visual symptoms after 1 month. CONCLUSIONS: The major symptoms of the patient is due to the decreased retinal function and the mfERG is seem to be the useful and safe tool for evaluation of the retinal function and the relationship between the symptoms and the white dots.
Dental Caries ; Depression ; Diagnosis ; Fluorescein ; Humans ; Retinaldehyde ; Visual Acuity

PURPOSE: To evaluate the effects of simvastatin on the catalase expression in human retinal pigment epithelium. METHODS: Retinal pigment epithelial (RPE) cells were incubated for 6 hours and 24 hours with various concentrations of simvastatin. In addition, RPE cells were incubated with 200 microM of H2O2 and various concentrations of simvastatin. After incubation, real-time polymerase chain reaction (PCR) was performed to examine the catalase messenger ribonucleic acid (mRNA) expression and a catalase assay was performed to examine the catalase activity in RPE. Intracellular reactive oxygen species (ROS) was measured using a fluorescence activated cell sorter (FACS). RESULTS: Simvastatin increased the amount of catalase mRNA and catalase activity at 10 microM in RPE cells. Under oxidative stress (200 microM of H2O2), 2.5 microM of simvastatin increased the catalase mRNA expression and 5 microM of simvastatin increased catalase activity in RPE cells. In addition, simvastatin reduced free radical formation but this effect was diminished in the presence of an irreversible catalase inhibitor, 3-amino-1,2,4-triazole (3-AT). CONCLUSIONS: Simvastatin exhibits anti-oxidative effects by inducing the catalase expression in human RPE cells. This anti-oxidative effect may be beneficial for preventing age-related macular degeneration induced by oxidative stress.
Amitrole ; Catalase* ; Epithelial Cells* ; Fluorescence ; Humans ; Macular Degeneration ; Oxidative Stress ; Reactive Oxygen Species ; Real-Time Polymerase Chain Reaction ; Retinal Pigment Epithelium ; Retinaldehyde* ; RNA ; RNA, Messenger ; Simvastatin*

OBJECTIVES: There are emerging evidences suggest that the development of tardive dyskinesia (TD) is related to the oxidative stress, excitotoxicity, and immune activation. The purpose of this study is to investigate whether single-nucleotide polymorphisms (SNPs) of tumor necrosis factor (TNF)-alpha genes are associated with the susceptibility of TD and schizophrenia. METHODS: We investigated two hundred and eighty Korean schizophrenic patients. The schizophrenic participants consisted of patients with (n=105) and without (n=175) TD who were matched for antipsychotic drug exposure and other relevant variables. The TNF-alpha gene -308G/A SNPs were analyzed by polymerase chain reaction (PCR)-based methods. RESULTS: The frequencies of genotype (chi2=0.33, p=0.848) of the TNF-alpha gene -308 G/A SNP did not differ significantly between schizophrenic patients with and without TD. The difference of allele frequencies (chi2=0.28, p=0.594) of the TNF-alpha gene between the schizophrenic patients with and without TD were not significant. CONCLUSION: These results suggest that the TNF-alpha gene -308 G/A SNPs are not associated with TD and schizophrenia in a Korean population. Further association studies of TD with other candidate genes for cytokines would help us understand the pathophysiological mechanisms of TD.
Cytokines ; Gene Frequency ; Genotype ; Humans ; Movement Disorders ; Oxidative Stress ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Schizophrenia ; Tumor Necrosis Factor-alpha

PURPOSE: To compare the clinical characteristics and laboratory finding between adenoviral and group A streptococcal (GAS) pharyngitis. METHODS: A retrospective review of medical records was performed in the patients with adenovirus infection among those who were admitted for febrile respiratory disease from January 2011 to July 2013 and GAS pharyngitis among those who visited for symptoms of scarlet fever from August 2006 to July 2013. RESULTS: 179 patients (AV1 group) were diagnosed with adenoviral pharyngitis and 37 (AV2 group) of these patients had adenovirus single infection. 26 patients (GAS group) were diagnosed with scarlet fever. Adenoviral infection (AV2 group) developed in younger patients compared to GAS group (2.8+/-2.1 years vs. 5.4+/-1.8 years, P=0.000). Total durations of fever and admission were longer in AV2 (6.3+/-2.6 days vs. 3.3+/-1.9 days, P=0.000; 4.1+/-1.2 days vs. 1.9+/-1.8 days, P=0.000, respectively). WBC counts were higher in AV2 (11,449+/-5,680 cells/mm2 vs. 6,722+/-6,941 cells/mm2, P=0.000). CRP was not significantly different between AV2 and GAS group (3.8+/-3.2 mg/dL vs. 5.2+/-5.1 mg/dL, P=0.368). No difference was found between two groups in the percentage of antibiotics use (91.9% vs. 100%, P=0.261). CONCLUSION: Clinical characteristics and measures of inflammation in the laboratory findings were similar between adenoviral and GAS pharyngitis group. It is necessary to conduct the test for respiratory virus and bacteria in early stage to differentiate in the pharyngitis patients with leukocytosis and elevation of CRP level.
Adenoviridae ; Adenoviridae Infections ; Anti-Bacterial Agents ; Bacteria ; Child* ; Fever ; Humans ; Inflammation ; Leukocytosis ; Medical Records ; Pharyngitis* ; Retrospective Studies ; Scarlet Fever

Purpose: To compare the visual outcomes and corneal aberrations between wavefront-optimized (WFO) and corneal wavefront-guided (WFG) photorefractive keratectomy (PRK) in low to moderate myopia. Methods: Twenty-seven eyes treated with WFO and 29 eyes treated with WFG PRK using a Schwind Amaris 750S Excimer laser were included after 6 months of postoperative follow-up. Uncorrected distance visual acuity, corrected distance visual acuity, refractive errors, corneal higher-order aberrations (HOA) and corneal thickness obtained using a Scheimpflug system, and central ablation depth and volume were evaluated during the preoperative period and again at the postoperative 6-month visits. Results: Postoperatively, uncorrected distance visual acuity, corrected distance visual acuity, manifest spherical equivalent, and refractive astigmatism were improved in both groups, and there was no statistically significant difference between the two groups. There was no significant difference in safety, efficacy, or predictability of the refractive outcome. Postoperative total corneal HOA root mean square (RMS), coma RMS, and spherical aberration were significantly increased in both groups. Among these, only spherical aberration showed a significant difference between the two groups, with greater increase in the WFO group at 6 months postoperatively. The changes in corneal HOA RMS and spherical aberration were smaller in the WFG group, and this benefit was marked in eyes with high HOA RMS (≥0.4 μm) and spherical aberration (≥0.2 μm). Even though ablation volume in the WFG group was much larger than that of the WFO group, there was no significant difference in postoperative central and peripheral corneal thickness between the two groups. Conclusions Both WFO and WFG PRK using a Schwind Amaris 750S laser for low to moderate myopia were safe and effective at improving visual and refractive outcomes. However, WFG PRK induced fewer spherical aberrations than WFO PRK and may be more advantageous for eyes with high HOA root mean square or spherical aberration.

PURPOSE: The purpose of this study was to develop a sexual abuse prevention education program for elementary school students. METHODS: Orem's Self-Care Theory (1995) and Seels & Richey's ADDIE model (1994) for developing learning materials were applied to develop this program. RESULTS: The development progress of the program consisted of 5 distinct phases: analysis, design, development, implementation, and evaluation. The contents was classified into 6 categories: the definition of sexual abuse, how to deal with sexual abuse, the situational reaction, areas with a high risk for sexual abuse, related organizations, and a wrap-up quiz. The app was easily accessible for elementary school students. CONCLUSION: A sexual abuse prevention program using a hybrid app may be an effective way to reach elementary students, and further research for children of various ages is required.
Child ; Child Abuse, Sexual ; Education ; Health Education ; Humans ; Learning ; Mobile Applications ; School Health Services ; Self Care ; Sex Offenses

A pressure sore, such as quadriplegia, is developed in patients who have been idle in bed for a long time, particularly in the spinal cord. The treatment is particularly difficult in cases of multiple recurrent sores, osteomyelitis with pathologic fractures, other underlying conditions such as diabetes mellitus, immuno-suppression, or radiotherapy. Over the last 20 years, the development and popularization of rectus abdominis flap have significantly increased for reconstruction of a wide variety of difficult clinical problems. From March 2000 to Dec 2001, 6 neurologically impaired patients underwent reconstruction of chronic pressure sores utilizing an inferiorly based rectus abdominis musculocutaneous flap. Postoperative follow-up ranged from 6 to 15 months. The average thickness of rectus abdominis muscle in quadriplegic patient is less than half of that in healthy patient. In most cases, mild venous congestions are developed, but these were resolved by medical treatment. All wounds have healed without any significant complications such as flap loss, infection, hernia, and sepsis. In conclusion, rectus abdominis muscle for these reconstructions provides a simple, reliable solution to often difficult reconstructive problem. We recommended this highly viable, versatile and reliable flap as one to be considered in planning the reconstruction of the quadriplegia patient with pressure sores when other local and regional flaps are unavailable.
Diabetes Mellitus ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Fractures, Spontaneous ; Hernia ; Humans ; Myocutaneous Flap ; Osteomyelitis ; Pressure Ulcer* ; Quadriplegia* ; Radiotherapy ; Rectus Abdominis* ; Sepsis ; Spinal Cord ; Wounds and Injuries

Congenital macrostomia is a result of defective union between the mandibular and maxillary processes and it is a rare deformity seen in every 100 to 300 facial clefts. Ohnizuka1`classified macrostomia into two groups as congenital and posttraumatic. We experienced two cases of acquired macrostomia due to NOMA sequelae(58/F:Lt & 51/F:Rt) and one case of congenital macrostomia (3 months/M:Rt). Many plastic surgeons have developed surgical procedures for repair of this congenital macrostomia. Among them, McCarthy6,11 described the classic commissuroplasty. We could repaired 1 case of congenital macrostomia and two cases of acquired macrostomia due to NOMA sequelae using modified technique of McCarthy,s classic commissuroplasty. McCarthy described new oral commissure 2-3mm laterally for prevention of postoperative contraction, orbicularis oris muscle transposition to restore labial function and a z- plasty cutaneous closure. But some author raise an objection to new oral commissure 2-3mm laterally, and they made new oral commissure at same distance of opposite side normal commissure. And so, we designed the new oral commissure moved 1mm laterally comparing to original commissuroplasty in a congenital case for the prevention of displacement. In cases of acquired macrostomia due to NOMA sequelae, we reconstructed new oral commissure like congenital case, moved 1mm laterally. Orbicularis oris muscle transposition could not be possible because of destruction of muscle, adhesion and atrophy. And so we dissected muscle and just sutured side by side. Acquired macrostomia following NOMA sequelae manifsted facial deformity variably, and reconstruction of the facial deformity is difficult by using simple approach. Other variable reconstructive procedures were needed with commissuroplasty as like Washio flap, rotation advancement flap, bone graft and free radial forarm flap, etc. Postoperative results were relatively good. We propose that macrostomia due to NOMA sequelae must add to Ohnizuka classification of acquired macrostomia.
Atrophy ; Classification ; Congenital Abnormalities ; Macrostomia* ; Noma ; Transplants