PURPOSE: To investigate the changes in intraocular pressure (IOP) and associated systemic factors over 7 years in a healthy Korean population. METHODS: This longitudinal study included healthy subjects with no history of ocular disease and who had been receiving health examinations seven years apart at the Konkuk University Medical Center, Healthcare Center. The participants completed lifestyle questionnaires and underwent general health examinations (blood pressure, height and weight, and blood biochemical tests) and ocular examinations including noncontact tonometry and fundus photography. Subjects with abnormal fundus photography findings and ocular hypertension were excluded. Changes in IOP and systemic factors over 7 years were analyzed. RESULTS: Of 524 possible subjects, 469 were enrolled (55 subjects were excluded: 50 due to abnormal fundus photography and 5 for missing data). The left eye was analyzed in all patients. In all subjects, initial IOP (mean 14.50 ± 3.14 mmHg) was not significantly different from final IOP (14.72 ± 3.38 mmHg) (paired t-test, p = 0.074). In male patients, the final IOP was significantly higher than the initial IOP (paired t-test, p = 0.035). Lifestyle questionnaire variables were associated with a final IOP that was significantly higher than the initial IOP (smokers, alcohol drinkers and less exercisers, paired t-test; p = 0.014, 0.010 and 0.024, respectively). A linear mixed-effects model analysis showed that the change in IOP was negatively associated with age, but this was not statistically significant. Changes in systolic blood pressure (SBP), body mass index (BMI), total cholesterol (T.Chol) and low density lipoprotein (LDL) were positively correlated with change in IOP. CONCLUSIONS: A linear mixed-model analysis showed IOP decreased with age but this was not statistically significant. Changes in SBP, BMI, T.Chol and LDL were significantly positively correlated with change in IOP.
Academic Medical Centers ; Blood Pressure ; Body Mass Index ; Cholesterol ; Delivery of Health Care ; Healthy Volunteers ; Humans ; Intraocular Pressure* ; Life Style ; Lipoproteins ; Longitudinal Studies* ; Male ; Manometry ; Ocular Hypertension ; Photography

Purpose: To investigate the impact of uncomplicated cataract surgery on the measurement of Bruch’s membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer thickness (RNFLT) using spectral domain optical coherence tomography (SD-OCT) in primary open-angle glaucoma (POAG) patients. Methods: This retrospective study included 63 eyes of 63 patients, including 32 POAG eyes and 31 normal eyes who underwent uneventful cataract surgery and follow-up for at least 6 months. Using SD-OCT, BMO-MRW and RNFLT were measured preoperatively and postoperatively at 6 months. Paired t-test was used to compare intraocular pressure (IOP), BMO-MRW, RNFLT, and image quality before and after surgery. These parameters and their changes were compared between POAG and normal groups. Univariate and multivariate linear regression analyses were performed to determine the factors associated with the postoperative change (Δ) in RNFLT and BMO-MRW. Results: BMO-MRW and RNFLT were significantly increased and IOP was decreased after phacoemulsification in both groups (p < 0.001, respectively). The ΔRNFLT was significantly greater in POAG eyes compared with the normal eyes (p < 0.001). The ΔRNFLT was associated with the postoperative IOP reduction and glaucoma diagnosis (p < 0.001 and p = 0.001, respectively). In the normal group, only the ΔIOP had a significant influence on the ΔRNFLT (p = 0.003), but in the POAG group, not only the ΔIOP (p = 0.044) but also preoperative visual field mean deviation (p = 0.029) showed a significant influence. The ΔBMO-MRW showed no difference between POAG and normal eyes. Conclusions The postoperative increase of RNFLT was significantly greater in the POAG group, and the postoperative increase of RNFLT was associated with the preoperative visual field mean deviation and ΔIOP in POAG eyes and with the ΔIOP in normal eyes. Our results imply that RNFLT is more affected than BMO-MRW in POAG eyes compared to normal eyes by cataract surgery.

PURPOSE: This study was performed to identify the levels of paclitaxel-containing chemotherapy-induced peripheral neuropathy (CIPN) in relation to quality of life (QOL) in patients with breast cancer. METHODS: A total of 82 breast cancer patients with CIPN participated in this study. Data were collected through self-reported questionnaires containing three instruments by the European Organization for Research and Treatment of Cancer (EORTC), such as QLQ-C30 for health-related QOL, QLQ-BR23 for breast cancer-related QOL, and QLQ-CIPN20 for CIPN. Scores from all three instruments were transformed into 0 to 100 scale. Data were analyzed using SPSS/WIN20 with descriptive statistics and Pearson's correlations. RESULTS: The mean score for each subscale of health-related QOL was 46.14 for global health status, 62.43 for functional scale, and 31.29 for symptom scale. The mean score for each subscale of breast cancer-related QOL was 56.55 for the functional scale and 42.06 for the symptom scale. Also, the CIPN's mean score on the sensory scale was 30.42, 24.03 on the motor scale, and 22.70 on the autonomic scale. There were significant moderate correlations between QOLs and CIPN (r ranged from -.37 to .65). CONCLUSION: There is a need to develop interventions for breast cancer patients to enhance their quality of life and to alleviate chemotherapy-induced peripheral neuropathy.
Breast Neoplasms* ; Breast* ; Humans ; Peripheral Nervous System Diseases* ; Quality of Life* ; Surveys and Questionnaires

Schwannomas are benign tumors that arise from the neural sheath of Schwann cells. Renal schwannomas are extremely rare and are commonly misdiagnosed as renal cell carcinoma, which typically results in a radical nephrectomy. We present a case of a renal schwannoma that mimics a renal pelvis tumor.
Carcinoma, Renal Cell ; Kidney ; Kidney Pelvis ; Nephrectomy ; Neurilemmoma ; Schwann Cells

Purpose: To investigate the safety of single and combined use of epinephrine and indocyanine green during cataract surgery by evaluating the effects on corneal endothelial cells. Methods: From January 2017 to October 2021, 121 patients (132 eyes) who underwent cataract surgery were enrolled. Patients were divided into 4 groups: epinephrine (n = 20), indocyanine green (n = 49), epinephrine and indocyanine green combination (n = 12), and control (n = 51). Retrospective medical chart findings and endothelial cell count change data were compared among study groups before and after operation. Results: Endothelial cell count change (△ECC) decreased for all groups; however, a significant difference among groups was not observed (p = 0.822). Univariate linear regression showed that △ECC was associated with postoperative hexagonality, nuclear sclerosis grade, ultrasound time, and cumulative dissipated energy (beta = -0.216, 0.254, 0.368, 0.351 and p = 0.013, p = 0.003, p < 0.001, p < 0.001). Multivariate linear regression showed that △ECC was associated with postoperative hexagonality and ultrasound time (beta = -0.215, 0.367, p = 0.010, p < 0.001). Conclusions Factors closely associated with postoperative endothelial cell loss were postoperative hexagonality and ultrasound time. No significant damage to the corneal endothelium was observed when epinephrine and indocyanine green were used alone or in combination. Thus, these agents appear safe for use in this context.

Sheehans syndrome is a known complication of pregnancy, It was described as a syndrome of hypopituitarysm due to acute ischemic necrosis of the anterior pituitary gland secondary to severe postpartum bleeding and shock. The neurophysis is usually preserved. But it can be involved in severe cases manifesting as diabetes insipidus. Because of its rare coexistence with Sheehans syndrome, diabetes insipidus is seldom recognized as a potential postpartum complication. The report describes a patient who developed Sheehans syndrome and diabetes insipidus immediately following delivery. Diabetes insipidus resolved spontaneously after 15 months, while panhypopituitarysm is persistent.
Diabetes Insipidus ; Hemorrhage ; Humans ; Hypopituitarism ; Necrosis ; Pituitary Gland, Anterior ; Postpartum Hemorrhage ; Postpartum Period ; Pregnancy ; Shock

Carcinoma ex pleomorphic adenoma is an uncommon malignant salivary gland tumor that arises from a longstanding pleomorphic adenoma. The carcinomatous component of carcinoma ex pleomorphic adenoma can possess virtually any histologic subtype of salivary gland cancer. We experienced a case of a 61-year-old patient who presented with a right parotid mass that was initially palpated 20 years ago, with a sudden increase in size in the last few months. Radiological and cytological findings from fine needle aspiration biopsy could not exclude malignancy. Total parotidectomy and selective neck dissection were performed for treatment, and carcinoma ex pleomorphic adenoma with mixed carcinoma components of salivary duct carcinoma and myoepithelial carcinoma was diagnosed. After receiving postoperative radiation of 6000 cGy over 6 weeks, there has been no recurrence up to the 18-month follow-up. We report this rare case of carcinoma ex pleomorphic adenoma with mixed malignancy subtypes, accompanied by a review of literature.

Purpose: This study evaluated whether patient activation and nurse trust mediate the relationship between a person-centered climate and patient satisfaction in cancer patients. Methods: A total of 179 participants, who were admitted in a tertiary hospital of J city, were surveyed in a cross-sectional study. Data were collected from March 1 to June 10, 2023. The descriptive statistics and mediating effects were analyzed using SPSS/WIN 25.0 and PROCESS macro program. Results: A person-centered climate directly affected patient satisfaction (direct effect=0.21, p<.001; direct effect=0.34, p<.001). Patient activation had a mediating effect between a person-centered climate and patient satisfaction (indirect effect=0.31, 95% Boot confidence interval=0.24~0.39). Nurse trust had a mediating effect between a person-centered climate and patient satisfaction (indirect effect=0.19, 95% Boot confidence interval=0.10~0.27). Conclusion This indicates the importance of developing a person-centered climate, patient activation and nurse trust to improve satisfaction for cancer patients. Therefore, it is necessary to assess the level of trust in nurses to improve and strengthen trust in them and to develop various program to focus on patient activation in cancer patients.

CCL5/regulated on activation, normal T expressed and secreted production (RANTES) is a principal CC chemokine, and can activate macrophages and Th1 lymphocytes, however, little is known about the CCL5 profiles associated with active tuberculosis (TB). In this study, we investigated the production of CCL5 by the peripheral blood mononuclear cells (PBMCs) of patients with active pulmonary TB after stimulation with Triton X-100 soluble proteins (TSP) or the 30-kDa antigen. The profiles of cytokines/chemokines [CXCL8/interleukin (IL)-8, IL-12 p40, and interferon (IFN)-gamma] were also examined by PBMCs from TB patients, and compared with those obtained from healthy tuberculin reactors (HTR). Concordant with earlier studies, IFN-gamma production was significantly depressed in the PBMCs from TB patients compared with those from HTR. In addition, the CCL5, but not CXCL8, levels in the PBMCs from TB patients were significantly depressed after stimulation for 18 hr compared to those in the PBMCs from HTRs. The CCL5 release was not significantly correlated with the release of IFN-gamma in the cells from TB patients and HTRs. Further, inhibitor studies show that the 30-kDa- or TSP-induced CCL5 mRNA expression is sensitive to inhibitors of mitogen-activated protein kinase kinase (MEK) 1/2 and Janus kinase (JAK) 2, but not p38, pathway activation, suggesting a MEK1/2- or JAK2-based mechanism is responsible for modulating of the CCL5 expression in human PBMCs. Collectively, these data suggest that TB patients show depressed production of CCL5 secretion, which can be modulated by MEK- and JAK2-based transcriptional regulatory mechanisms, in response to the mycobacterial antigens.
Corynebacterium ; Humans ; Interferon-gamma ; Interferons ; Interleukin-12 ; Lymphocytes ; Macrophages ; Octoxynol ; Phosphotransferases ; Protein Kinases ; Proteins ; RNA, Messenger ; Tuberculin ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. METHODS: We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. RESULTS: Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 (500-403,300)/microL. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were 53.5+/-18.7%. CONCLUSION: Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.
Biopsy ; Bone Marrow ; Breast Neoplasms ; Female ; Genes, p16 ; Genes, Tumor Suppressor ; Humans ; Leukemia ; Male ; Phosphorylation ; Phosphotransferases ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Risk Factors ; Survival Rate ; T-Lymphocytes