Purpose: Radiotherapy is used to reduce the risk of breast cancer recurrence after surgery, but it is a potential cause of secondary cancer. We validated the risk of secondary cancer in primary breast cancer who received radiotherapy compared with those who did not from a matched cohort using a large-scale observational study of the Observational Health Data Sciences and Informatics (OHDSI) data network. Materials and Methods: A retrospective comparative cohort study using propensity score-matched cohorts was performed using two Observational Medical Outcome Partnership common data model databases, from tertiary general hospitals in South Korea. Among female patients who underwent surgery after the diagnosis of breast cancer, the risk of secondary primary malignant occurrence after 1:1 matching was analyzed. Results: Among 27,078 patients with breast cancer, there was no significant difference in the risk of secondary cancer following radiotherapy in 4,426 patients after 1:1 propensity-score matching. Further, there were no significant differences in the sensitivity analysis according to age, latency period, and number of radiation treatments. Conclusion There was no difference in the risk of secondary cancer in the patients diagnosed with breast cancer depending on whether or not radiotherapy was performed after surgery. In the future, it is necessary to analyze including data generated during cancer treatment.

Purpose: We derived optimal formulae permitting effective lens position (ELP) for patients differing in terms of their preoperative axial lengths as revealed by partial coherence interferometry. Methods: We included 736 eyes from 736 patients who underwent conventional cataract surgery at Yeouido St. Mary’s Hospital. The preoperative axial length (AL), corneal power (CP), and anterior chamber depth (ACD) measured via partial coherence interferometry served as independent variables for ELP prediction. The 736 eyes were divided into seven groups differing by 1.0-mm intervals in terms of the preoperative axial length. We sought correlations between the independent variables and the ELP, and defined the combinations that best predicted the ELPs of the seven groups. Results: The CP correlated significantly with the ELP for eyes with AL between 22.0 and 25.0 mm (all p < 0.01) and the ACD correlated significantly with the ELP for eyes with AL between 23.0 and 26.0 mm (all p < 0.01). Although a regression equation featuring all of the AL, ACD, and CP best predicted the ELP for the total of 736 eyes (p < 0.001), the optimal combination varied by the preoperative AL. Conclusions The effects of CP, ACD, and AL on ELP vary by the preoperative AL. The optimal combination of preoperative variables predicting ELP thus varies as that parameter changes.

Purpose: To report a case of secondary Descemet membrane endothelial keratoplasty (DMEK) for graft failure after primary DMEK.Case summary: A 47-year-old female underwent primary DMEK in her left eye with a diagnosis of Fuchs’ endothelial dystrophy. At 6 weeks later, corneal stromal edema with epithelial and subepithelial bullae was first observed. From that point on, the condition of the cornea and the visual acuity continued to degrade. After 7 months, a second DMEK procedure (i.e., a repeat DMEK) for graft failure was performed successfully without any complications. Since the second procedure, the cornea has been clear, and the best-corrected visual acuity has remained at 0.6 for 8 months. Conclusions To manage graft failure after primary DMEK, we performed a second DMEK procedure. The removal of the previous graft was easy, and there were no complications. Thus, repeat DMEK may be a feasible procedure.

Purpose: We derived optimal formulae permitting effective lens position (ELP) for patients differing in terms of their preoperative axial lengths as revealed by partial coherence interferometry. Methods: We included 736 eyes from 736 patients who underwent conventional cataract surgery at Yeouido St. Mary’s Hospital. The preoperative axial length (AL), corneal power (CP), and anterior chamber depth (ACD) measured via partial coherence interferometry served as independent variables for ELP prediction. The 736 eyes were divided into seven groups differing by 1.0-mm intervals in terms of the preoperative axial length. We sought correlations between the independent variables and the ELP, and defined the combinations that best predicted the ELPs of the seven groups. Results: The CP correlated significantly with the ELP for eyes with AL between 22.0 and 25.0 mm (all p < 0.01) and the ACD correlated significantly with the ELP for eyes with AL between 23.0 and 26.0 mm (all p < 0.01). Although a regression equation featuring all of the AL, ACD, and CP best predicted the ELP for the total of 736 eyes (p < 0.001), the optimal combination varied by the preoperative AL. Conclusions The effects of CP, ACD, and AL on ELP vary by the preoperative AL. The optimal combination of preoperative variables predicting ELP thus varies as that parameter changes.

Purpose: To report a case of secondary Descemet membrane endothelial keratoplasty (DMEK) for graft failure after primary DMEK.Case summary: A 47-year-old female underwent primary DMEK in her left eye with a diagnosis of Fuchs’ endothelial dystrophy. At 6 weeks later, corneal stromal edema with epithelial and subepithelial bullae was first observed. From that point on, the condition of the cornea and the visual acuity continued to degrade. After 7 months, a second DMEK procedure (i.e., a repeat DMEK) for graft failure was performed successfully without any complications. Since the second procedure, the cornea has been clear, and the best-corrected visual acuity has remained at 0.6 for 8 months. Conclusions To manage graft failure after primary DMEK, we performed a second DMEK procedure. The removal of the previous graft was easy, and there were no complications. Thus, repeat DMEK may be a feasible procedure.

BACKGROUND: Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. METHODS: Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). RESULTS: In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. CONCLUSION: We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.
Atherosclerosis* ; Body Mass Index ; Carotid Arteries ; Carotid Intima-Media Thickness ; Coronary Angiography ; Coronary Vessels ; Humans ; Hypertension ; Logistic Models ; Risk Factors* ; Ultrasonography

OBJECTIVES: This study used representative national survey data of Korean workers to estimate the occupational injury rate and to identify factors associated with occupational injuries. METHODS: We analyzed data from the fourth Korea National Health and Nutrition Examination Survey conducted from 2007 to 2009 using the Complex Samples Frequencies procedure of the SPSS to estimate the occupational injury rate. Complex Samples Logistic Regression was performed to calculate a nationally representative odds ratios that reflects the likelihood of specific individual attributes and job characteristics being associated with occupational injuries. We did this while controlling for relevant covariates. RESULTS: It was estimated that 3.5% of Korean workers have suffered at least one occupational injury and 1.9% of full-time employed workers have suffered occupational injuries which required more than 4 days of absence during the year. After adjustment for confounding variables, the experience of occupational injuries was related to several job characteristics, including exposure to hazards such as: air pollutants (OR=1.40; 95%CI: 1.05~1.85), noise (OR=1.31; 95%CI: 1.01~1.70), biological hazards (OR=1.60; 95%CI: 1.13~2.28), a difficult physical environment (OR=1.79; 95%CI: 1.33~2.41), and difficult ergonomic work (e.g. work involving awkward posture or heavy lifting) (OR=1.49; 95%CI: 1.11~2.00). CONCLUSIONS: Using national survey data from the Korea National Health and Nutrition Examination Survey to estimate the occupational injury rate and to identify predictors of work-related injuries has several advantages. Futhermore, these results suggest that a hazardous work environment is associated with occupational injury.
Air Pollutants ; Confounding Factors (Epidemiology) ; Korea ; Logistic Models ; Noise ; Nutrition Surveys ; Occupational Injuries ; Occupations ; Odds Ratio ; Posture ; Risk Factors

No abstract available.
Echocardiography ; Thrombosis

OBJECTIVES: The purpose of this study was to identify current status of sickness absence and early leaves from work as a result of work-related musculoskeletal symptoms. METHOD: From January to December in 2007, 4,975 workers were recruited into this study and surveyed over this time period; workers came from 116 small and medium sized companies in Incheon. Among the study populations, only those who met the NIOSH criteria for work-related musculoskeletal symptoms on each symptom locations were included in the final analysis. The survey used a structured self-administered questionnaire, which asked questions about musculoskeletal symptoms regarding locations, sickness absences and early leaves from work. Other information gathered from participants included sociodemographical characteristics, and work-related characteristics. RESULTS: The rates of sickness absences and early leaves in each symptom locations were highest (14.9%) among workers with waist symptoms. Men had higher rates of sickness absences and early leaves form work than women; manufacturing workers had higher rates of sickness absences and early leaves form work than office workers. After confounding variables that had significant difference in univariate analysis on each symptom locations were adjusted, the odds ratios for sickness absence and early leaves divided by pain intensity were 4.361(neck), 4.140(shoulder), 3.151(arm/wrist), 3.085(leg/foot), and 2.731(waist), respectively; these differences were statistically significant. CONCLUSIONS: The rates of sickness absence and early leaves in each work-related musculoskeletal symptom locations were highest among workers with waist symptoms, and the intensity of pain was identified to have a considerable effect on the rates of sickness absences and early leaves. Based on these results, we think that there are needs to be early interventions on workers with waist symptoms.
Confounding Factors (Epidemiology) ; Early Intervention (Education) ; Humans ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Odds Ratio ; Porphyrins ; Questionnaires

PURPOSE: We report a case of ophthalmic artery occlusion with third nerve paresis in the left eye due to acute occlusion of the left ICA. CASE SUMMARY: A 37-year-old man visited our emergency room with "black out" in the left eye, headache, and nausea. The corrected visual acuity was 20/25 in the right eye, and hand motion in the left eye. In the left eye, a relative afferent papillary defect was noted, with an intraocular pressure of six mmHg. Twenty prisms of exotropia in the primary position was observed, and ocular motor examination revealed limitations of supraduction, infraduction, and adduction in the left eye, suggesting third nerve palsy of the left eye. Fundus examination revealed a pale retina in the macula of the left eye. Brain MRI demonstrated multifocal faint low densities in the left caudate nucleus as well as the frontal and parietal lobes. CT angiography and four-vessel angiography demonstrated complete occlusion in the proximal part of the left internal carotid artery ICA.
Adult ; Angiography ; Brain ; Carotid Artery, Internal ; Caudate Nucleus ; Emergencies ; Exotropia ; Eye ; Hand ; Headache ; Humans ; Intraocular Pressure ; Nausea ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Ophthalmic Artery ; Paresis ; Parietal Lobe ; Retina ; Visual Acuity