PURPOSE: To evaluate the long-term changes in spherical equivalent (SE) refractive error and astigmatism in patients after spectacle use. METHODS: A total of 103 patients with refractive error without strabismus and amblyopia who received at least 3 years of follow-up after using spectacles were included in this study. Patients were divided into groups according to the age at which spectacles were used (<4 years, ≥4 to <7 years, ≥7 years), the initial degree of SE refractive error (<−0.50 diopter [D], −0.50 to +0.75 D, >+0.75 D), and the initial degree of astigmatism (<1.00 D, 1.00 to 3.00 D, ≥ 3.00 D). Changes in the SE refractive error and astigmatism were compared between these groups using mixed linear models.. RESULTS: Patients were followed up for a mean of 9.1 ± 1.6 years. An overall negative shift in SE refractive error and an increasing tendency in astigmatism during follow-up were noted regardless of the age at which spectacles were used (p < 0.001). The myopic group showed the largest negative shift in SE and the largest increase in astigmatism (p < 0.001, p = 0.02 respectively). The low and moderate astigmatism groups were more likely to have significant increases in astigmatism (p < 0.001). CONCLUSIONS: Patients with refractive error showed a negative shift in SE and an increasing tendency in astigmatism regardless of the age at which spectacles were used. Changes in SE and astigmatism may be influenced by the initial degree of SE, and the initial degree of astigmatism may influence changes in astigmatism.
Amblyopia ; Astigmatism ; Eyeglasses ; Follow-Up Studies ; Humans ; Linear Models ; Refractive Errors* ; Strabismus

Objective of this study was to compare the color stability, mechanical and chemical properties of three different types of temporary crown resins. Commercially available powder-liquid (Group PL), light-cured (Group LC) and auto-mix syringe (Group AM) types' temporary crown resins were used as experimental groups for each of the evaluation. All the test groups were evaluated after 1 day and 7 days of immersion in various staining solutions. The colors of all groups before and after storage in the staining solutions were measured by a spectrophotometer based on CIE Lab system, and the color differences (ΔE(*)) thereby calculated. Micro hardness test was performed before water storage and aging after 7 days at 37 ℃. In addition, flexural strength, water sorption and solubility tests were performed according to international standard, ISO 10477. All experimental groups showed significant color change in staining solutions when compared to those stored in the control solution (distilled water) (p<0.05). Group PL showed the least color change among the three groups followed by Group AM (p<0.05). This tendency was observed after 7 days of immersion. In terms of the micro hardness test, Group PL showed the highest value among the three groups followed by Group AM (p<0.05). Additionally, the flexural strength decreased in the following order: AM > PL > LC (p<0.05). Water sorption and solubility increased in the following order: AM < PL < LC (p<0.05). The results of this study would provide useful information when choosing temporary crown resin types in various clinical situations.
Aging ; Crowns ; Hardness Tests ; Immersion ; Solubility ; Syringes ; Water

PURPOSE: The prescription drug list for primary treatment by community health practitioners has been maintained for 30 years without any modification. Thus, this study will suggest an improvement scheme of prescription drug list for primary health care posts through an analysis of drug use in those posts. METHODS: A questionnaire survey was implemented with community health practitioners from April to June in 2012. A total of 1,249 copies were analyzed. As for the databases of drug use in the integrated information, a total of 154,229 diagnoses selected in the method of stratified cluster sampling from 39 primary health care posts'data were analyzed. We consulted some experts about the prescription medication list, and referred to the medication information on-line home page for up-to-date drug information. RESULTS: This study ultimately suggests 77 prescription drug items for primary health care posts by eliminating 35 items and replacing 1 item from the original list, and adding 4 items to it. CONCLUSION: This study will provide basic data for revising the prescription drug list in primary health care posts by periodically reflecting adverse effects in the existing drugs, demographic and environmental changes, and development of new drugs.
Coat Protein Complex I ; Prescriptions ; Primary Health Care ; Rural Health ; Surveys and Questionnaires

The Prototheca species is achlorophyllic algae and rarely causes human infection. Human protothecosis presents clinically as a cutaneous infection, olecranon bursitis, and disseminated systemic disease. We report a case of human cutaneous protothecosis involving the left wrist. A 68-year-old man presented with an ill-defined erythematous lesion with crust at the dorsal aspect of his left wrist. A punch biopsy was performed to reveal the histologic features of granulomatous inflammation with necrosis at the upper dermis, containing Prototheca organisms, of which, the characteristic features were highlighted by special staining. Through a molecular study, the Prototheca zopfii species was identified.
Aged ; Biopsy ; Bursitis ; Dermis ; Humans* ; Inflammation ; Necrosis ; Olecranon Process ; Prototheca ; Wrist

PURPOSE: This study investigated the factors of C. sinensis infection among the residents in vicinity of the Nakdong River and the infection status of fishes in the stream with C. sinensis maetacercaria. METHODS: Selected five regions of the Nakdong River and collected freshwater fishes from the stream to examine their metacercarial infections; and studied the status and causes of C. sinensis infection in 552 residents living within 5 kilometers from the river. RESULTS: Among the 552 residents studied, 13.8% were infected with C. sinensis, and among 379 freshwater fishes of 20 species collected from the five regions, 41 fishes of 8 species were infected with C. sinensis metacercaria. CONCLUSION: In order to prevent human C. sinensis infection and transition to chronic liver ions, we need to develop and apply good programs such as continuous health education, personal hygiene improvement, active medical treatment for those infected with C. sinensis, and residents' voluntarily stop of eating freshwater fishes in the raw state.
Clonorchiasis* ; Clonorchis sinensis ; Eating ; Fishes ; Fresh Water ; Health Education ; Humans ; Hygiene ; Ions ; Liver ; Rivers

Objective: : We attempted to compare the incidence of pyogenic spondylitis (PS) and tuberculous spondylitis (TS) between 2007 and 2016. Furthermore, we investigated the patients who underwent surgery in 2016 compared to that in 2007. Methods: : We used a nationwide database managed by the Korean National Health Insurance Service (NHIS) in 2007 and 2016. Total 9655 patients with a newly diagnosis of PS or TS were enrolled in PS or TS group. Among them, 1721 patients underwent either fusion or decompression surgery. We analyzed demographic distribution of patients according to gender and age and year of diagnosis. Results: : Comparing between 2007 and 2016, the incidence of PS has increased in 2016 than in 2007 (4874 vs. 2431, p<0.0001). Conversely, declination of incidence of TS was discovered in 2016 compared to 2007 (594 vs. 1756, p<0.0001). Females showed predominance over males regarding both PS and TS (5228 vs. 4427, p<0.0001). Among them, the number of PS patients who underwent surgery increased significantly in 2016 relative to that in 2007 (979 vs. 592, p<0.0001). Conclusion : This nationwide study suggests that PS may increase and TS may decrease in Korea. In addition, demand for surgery regarding PS may increase.

BACKGROUND/AIMS: The ballooning time in endoscopic papillary large balloon dilation (EPLBD) remains controversial. The aim of this study was to evaluate the significance of the ballooning time comparing an immediate balloon deflation method with a conventional ballooning time of > 45 seconds. METHODS: Between January 2010 and December 2010, 126 patients with bile duct stones treated with EPLBD and endoscopic sphincterotomy were divided according to the ballooning time: the immediate deflation group (n=56) and the conventional inflation group (ballooning time 45s to < 60s) (n=70). RESULTS: The overall success rate and the success rate of the first attempt of ERCP (endoscopic retrograde cholangio-pancreatography) were 96.4% (54/56) and 80.4% (45/56) in the immediate group and 97.1% (68/70) and 77.1% (54/70) in the conventional inflation group. There were no statistically significant differences in the overall success and the first attempt of ERCP success rate (p=0.99, p=0.66). The frequency of mechanical lithotripsy was 0% in the immediate deflation group and 7.1% in the conventional inflation group (p=0.065). Complications occurred in 3.6% (2/56) patients in the immediate deflation group and 8.6% (4/70) patients in the conventional inflation group (p=0.298). CONCLUSIONS: The ballooning time in EPLBD does not affect the outcomes of the treatment for bile duct stones. And the feasibility of the immediate deflation method in EPLBD is acceptable.
Bile Ducts* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Humans ; Inflation, Economic ; Lithotripsy ; Sphincterotomy, Endoscopic

PURPOSE: This study was performed to identify job competencies and needs for job education perceived by new community health practitioners. METHODS: This study used a qualitative research design. Eight new community health practitioners participated in this study. Data were collected through in-depth interviews and analyzed using content analysis. RESULTS: Five job competencies were identified in this study, including primary care, public health management, interpersonal relationship, teaching and counseling, and leadership. The contents of job education that they needed were management of major symptoms and chronic diseases, understanding and prescription of medications, emergency responses and care, management of endemic diseases, planning and management of public health programs, writing official documentsand computer works, and leadership training. The learning methods they preferred were connecting theory and practice, situation- or case-based learning, skill- or practice-based learning, and increased opportunities of clinical practice. CONCLUSION: The findings of this study provided the direction of job education for new community health practitioners. Job education for new community health practitioners needs to consider the job competencies and educational needs identified in this study.
Chronic Disease ; Counseling ; Education ; Emergencies ; Endemic Diseases ; Leadership ; Learning ; Needs Assessment ; Prescriptions ; Primary Health Care ; Professional Competence ; Public Health ; Qualitative Research ; Writing

OBJECTIVES: The extracapsular spread (ECS) of metastatic lymph nodes is associated with aggressive tumor behavior, and is regarded as a major risk factor for local recurrence in patients with head and neck squamous cell carcinoma. However, the significance of ECS of metastatic lymph nodes has not been well established in well-differentiated thyroid carcinoma. The purpose of this study was to examine this question. METHODS: A retrospective review was performed of 335 patients with papillary thyroid carcinoma who underwent total thyroidectomy with lymph node dissection from April 2001 to December 2009. We analyzed various clinical characteristics, pathologic factors, and the size, number, and ECS of foci in metastatic lymph nodes. RESULTS: On pathologic review, 201 of the patients (56.6%) had lymph node metastasis. This was significantly related to age and tumor size. ECS was noted in 64 of these 201 patients (31.8%), and was significantly related to male gender, tumor size, presence of extrathyroidal extension, metastatic lymph node size, and focus size. Recurrence occurred in 13 patients (3.9%), and the presence of ECS was significantly related to recurrence. CONCLUSION: ECS of metastatic lymph nodes is an important prognostic factor for loco-regional recurrence in papillary thyroid carcinoma.
Carcinoma, Squamous Cell ; Head ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neck ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND: Developing predictive markers for hepatocellular carcinoma (HCC) is important, because many patients experience recurrence and metastasis. Epithelial to mesenchymal transition (EMT) is a developmental process that plays an important role during embryogenesis and also during cancer metastasis. Paired-related homeobox protein 1 (Prrx-1) is an EMT inducer that has recently been introduced, and its prognostic significance in HCC is largely unknown. METHODS: Tissue microarray was constructed using surgically resected primary HCCs from 244 cases. Immunohistochemical staining of E-cadherin and Prrx-1 was performed. The correlation between E-cadherin loss and Prrx-1 expression, as well as other clinicopathologic factors, was evaluated. RESULTS: E-cadherin expression was decreased in 96 cases (39.4%). Loss of E-cadherin correlated with a higher recurrence rate (p < .001) but was not correlated with patient's survival. Thirty-two cases (13.3%) showed at least focal nuclear Prrx-1 immunoreactivity while all non-neoplastic livers (n = 22) were negative. Prrx-1 expression was not associated with E-cadherin loss, survival or recurrence rates, pathologic factors, or the Ki-67 labeling index. Twenty tumors that were positive for E-cadherin and Prrx-1 had significantly higher nuclear grades than the rest of the cohort (p = .037). In Cox proportional hazard models, E-cadherin loss and large vessel invasion were independent prognostic factors for shorter disease-free survival. Cirrhosis and high Ki-67 index (> 40%) were independent prognostic factors for shorter overall survival. CONCLUSIONS: Prrx-1 was expressed in small portions of HCCs but not in normal livers. Additional studies with a large number of Prrx-1-positive cases are required to confirm the results of this study.
Cadherins* ; Carcinoma, Hepatocellular* ; Cohort Studies ; Disease-Free Survival ; Embryonic Development ; Epithelial-Mesenchymal Transition ; Female ; Fibrosis ; Genes, Homeobox ; Humans ; Liver ; Neoplasm Metastasis ; Pregnancy ; Proportional Hazards Models ; Recurrence