Publications by authors named "Eun Kyoung Lee"

163 Publications

The Value of Capsule Thickness on Breast Ultrasound as an Indicator of the Severity of Capsular Contracture and Its Correlation with the Baker Classification.

Aesthetic Plast Surg 2021 Aug 30. Epub 2021 Aug 30.

Vievis NAMUH Hospital, Seoul, Korea.

Background: We conducted this study to explore the value of the capsule thickness as an indicator of the severity of capsular contracture (CC) alternatively to the Baker classification system in patients who were treated with an implant-based augmentation mammaplasty.

Methods: A total of 117 eligible patients (202 breasts) were included in the current study. We measured the capsule thickness using ultrasound and histologic examination in association with the Baker grades I, II, III and IV. Then, we analysed agreement of the capsule thickness between the two methods using an intra-correlation coefficient (ICC 2,1) with 95% confidence intervals (CIs). The CC of Baker grades II, III and IV (105 breasts), for which the capsule thickness could be measured using US, served as Model 1. Moreover, Model 1 including the CC of Baker grades I (97 breasts) served as Model 2.

Results: The capsule thickness was measured as 0.58 ± 0.11 (0.4-0.8) mm, 1.07 ± 0.16 (0.8-1.31) mm and 1.89 ± 0.55 (1-4.1) mm on ultrasound in association with Baker grades II, III and IV, respectively. In addition, it was also measured as 0.28 ± 0.07 (0.09-0.41) mm, 0.58 ± 0.08 (0.42-0.75) mm, 1.06 ± 0.14 (0.79-1.34) mm and 2.13 ± 1.14 (1.38-6.98) mm on histologic examination in association with Baker grades I, II, III and IV, respectively. In Model 1 and 2, the ICC was calculated as 0.942 (95%CI 0.914-0.961) and 0.955 (95%CI 0.940-0.966), respectively. The cut-off values between the Baker grades I-II, II-III and III-IV were calculated as 0. mm, 0.8 mm and 1.2 mm, respectively.

Conclusions: In conclusion, the capsule thickness might be used as an indicator of the severity of CC alternatively to the Baker classification system. But further studies are warranted to establish our results.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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http://dx.doi.org/10.1007/s00266-021-02544-5DOI Listing
August 2021

Role of Ultra-widefield Imaging in the evaluation of Long-term change of highly myopic fundus.

Acta Ophthalmol 2021 Aug 17. Epub 2021 Aug 17.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To evaluate the impact of posterior staphyloma identified using ultra-widefield fundus imaging on the long-term progression of myopic maculopathy in highly myopic patients.

Methods: In this observational cohort study, highly myopic patients who were followed up for at least 5 years using ultra-widefield fundus imaging were analysed for fundus abnormalities and the progression of myopic maculopathy based on the International Meta-analysis of Pathologic Myopia classification.

Results: This study included 390 eyes (210 patients) with the mean follow-up period of 69.2 ± 7.5 months (range, 60-88). Posterior staphyloma was identified in 198 eyes (50.8%) in the baseline ultra-widefield fundus images. The border of staphyloma was not identified within 50° view circle corresponding to conventional fundus photography in 42 eyes (21.2%) with staphyloma, most of that were wide macular type. Progression of myopic maculopathy during follow-up was observed in 202 eyes (51.8%), and eyes with staphyloma were more likely to show progression compared to those without (142/198 [71.7%] versus 60/192 [31.3%]; p < 0.001). In multivariable regression analysis, the presence of posterior staphyloma was an independent risk factor for the progression of myopic maculopathy (p = 0.005). One or more peripheral retinal lesions were observed in 302 eyes (77.4%) and 321 eyes (82.3%) in the baseline and final ultra-widefield fundus images, respectively.

Conclusion: Posterior staphyloma was associated with the long-term progression of myopic maculopathy. With a wider field of view, ultra-widefield fundus imaging is useful for identifying the posterior staphyloma and monitoring the progression of myopic maculopathy in highly myopic patients.
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http://dx.doi.org/10.1111/aos.15009DOI Listing
August 2021

Impact of kidney transplantation on the risk of retinal vein occlusion in end-stage renal disease.

Sci Rep 2021 Jun 2;11(1):11583. Epub 2021 Jun 2.

Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

It has been known that retinal vein occlusion (RVO) is associated with chronic kidney disease, especially end-stage renal disease (ESRD). However, little is known about the effect of kidney transplantation (KT) on RVO incidence in ESRD patients. This study aimed to compare the incidence of RVO in KT recipients (n = 10,498), matched ESRD patients (n = 10,498), and healthy controls (HCs, n = 10,498), using a long-term population-based cohort. The incidence of RVO was 2.74, 5.68, and 1.02 per 1000 patient-years, for the KT group, the ESRD group, and the HCs group, respectively. Adjusted hazard ratios for RVO development compared to the HCs group, were 1.53 and 3.21, in the KT group and the ESRD group, respectively. In the KT group, multivariable regression analysis indicated that an age over 50, a Charlson Comorbidity Index score over 4, and a history of desensitization therapy were associated with an increased risk of RVO. In summary, KT recipients have a lower risk for development of RVO than ESRD patients treated with dialysis. However, the risk is still higher compared to healthy people who have normal kidney functions.
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http://dx.doi.org/10.1038/s41598-021-90765-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8172893PMC
June 2021

Intraocular Foreign Body: Diagnostic Protocols and Treatment Strategies in Ocular Trauma Patients.

J Clin Med 2021 Apr 25;10(9). Epub 2021 Apr 25.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Korea.

Intraocular foreign bodies (IOFBs) are critical ophthalmic emergencies that require urgent diagnosis and treatment to prevent blindness or globe loss. This study aimed to examine the various clinical presentations of IOFBs, determine the prognostic factors for final visual outcomes, establish diagnostic protocols, and update treatment strategies for patients with IOFBs. We retrospectively reviewed patients with IOFBs between 2005 and 2019. The mean age of the patients was 46.7 years, and the most common mechanism of injury was hammering (32.7%). The most common location of IOFBs was the retina and choroid (57.7%), and the IOFBs were mainly metal (76.9%). Multivariate regression analysis showed that poor final visual outcomes (<20/200) were associated with posterior segment IOFBs (odds ratio (OR) = 11.556, = 0.033) and retinal detachment (OR = 4.781, = 0.034). Diagnosing a retained IOFB is essential for establishing the management of patients with ocular trauma. To identify IOFBs, ocular imaging modalities, including computed tomography or ultrasonography, should be considered. Different strategies should be employed during the surgical removal of IOFBs depending on the material, location, and size of the IOFB.
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http://dx.doi.org/10.3390/jcm10091861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8123265PMC
April 2021

Health Surveillance of Penguins in the Barton Peninsula on King George Island, Antarctica.

J Wildl Dis 2021 Jul;57(3):612-617

Avian Disease Research Division, Animal and Plant Quarantine Agency, 177, Hyeoksin 8-ro, Gimcheon-si, Gyeongsangbuk-do 39660, Republic of Korea.

Samples from 29 adult Gentoo (Pygoscelis papua), Chinstrap (Pygoscelis antarcticus), and Adélie Penguins (Pygoscelis adeliae) at the King Sejong Station on Nar̢ ebski Point, King George Island, Antarctica, were investigated to detect antibodies to avian influenza, Newcastle disease virus, infectious bursal disease virus, infectious bronchitis virus, Mycoplasma, and Salmonella. Antibodies were identified from one Gentoo Penguin and one Chinstrap Penguin against infectious bronchitis virus; from one Gentoo Penguin against Newcastle disease virus; from one Gentoo Penguin against Mycoplasma synoviae; and from two Chinstrap Penguins against Salmonella pullorum. Thirty-three dead penguin chicks were collected from the breeding colony for necropsy, histopathological examination, and polymerase chain reaction. Pulmonary hemorrhage and congestion were the main necropsy findings.
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http://dx.doi.org/10.7589/2019-10-257DOI Listing
July 2021

Decreased choroidal and scleral thicknesses in highly myopic eyes with posterior staphyloma.

Sci Rep 2021 Apr 12;11(1):7987. Epub 2021 Apr 12.

Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.

In this cross-sectional study, we investigated choroidal thickness (CT) and scleral thickness (ST) in highly myopic eyes and their associations with ocular factors. Patients underwent widefield swept-source optical coherence tomography (OCT) to measure the CT and ST at the subfovea and 3000 μm superior, inferior, temporal, and nasal to the fovea and macular curvature. A total of 237 eyes (154 patients) were included. At all five measurement points, thinner CTs and STs were associated with longer axial lengths (r = - 0.548 to - 0.357, all P < 0.001) and greater macular curvatures (r = - 0.542 to - 0.305, all P < 0.001). The CT and ST were significantly thinner in eyes with posterior staphyloma than in those without at all measurement points (all P ≤ 0.006) but did not differ between eyes with the wide macular and narrow macular type of staphyloma. Eyes with myopic maculopathy of category ≥ 3 according to the International Meta-Analysis for Pathologic Myopia classification had significantly thinner CTs and STs than those with category ≤ 2 (all P ≤ 0.005). In highly myopic eyes, a decrease in the CT and ST was more pronounced in eyes with more structural changes, such as longer axial length, steeper macular curvature, and the presence of posterior staphyloma.
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http://dx.doi.org/10.1038/s41598-021-87065-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041899PMC
April 2021

Multiple Reassortants of H5N8 Clade 2.3.4.4b Highly Pathogenic Avian Influenza Viruses Detected in South Korea during the Winter of 2020-2021.

Viruses 2021 03 16;13(3). Epub 2021 Mar 16.

Avian Influenza Research & Diagnostic Division, Animal and Plant Quarantine Agency, 177 Hyeoksin 8-ro, Gimcheon-si 39660, Gyeongsangbuk-do, Korea.

During October 2020-January 2021, we isolated a total of 67 highly pathogenic avian influenza (HPAI) H5N8 viruses from wild birds and outbreaks in poultry in South Korea. We sequenced the isolates and performed phylogenetic analysis of complete genome sequences to determine the origin, evolution, and spread patterns of these viruses. Phylogenetic analysis of the hemagglutinin (HA) gene showed that all the isolates belong to H5 clade 2.3.4.4 subgroup B (2.3.4.4b) and form two distinct genetic clusters, G1 and G2. The cluster G1 was closely related to the 2.3.4.4b H5N8 HPAI viruses detected in Europe in early 2020, while the cluster G2 had a close genetic relationship with the 2.3.4.4b H5N8 viruses that circulated in Europe in late 2020. A total of seven distinct genotypes were identified, including five novel reassortants carrying internal genes of low pathogenic avian influenza viruses. Our Bayesian discrete trait phylodynamic analysis between host types suggests that the viruses initially disseminated from migratory waterfowl to domestic duck farms in South Korea. Subsequently, domestic duck farms most likely contributed to the transmission of HPAI viruses to chicken and minor poultry farms, highlighting the need for enhanced, high levels of biosecurity measures at domestic duck farms to effectively prevent the introduction and spread of HPAI.
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http://dx.doi.org/10.3390/v13030490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001867PMC
March 2021

Genetic characterization of H9N2 avian influenza virus previously unrecognized in Korea.

J Vet Sci 2021 Mar;22(2):e21

Avian Influenza Research & Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon 39660, Korea.

In this study, we describe the isolation and characterization of previously unreported Y280-lineage H9N2 viruses from two live bird markets in Korea in June 2020. Genetic analysis revealed that they were distinct from previous H9N2 viruses circulating in Korea and had highest homology to A/chicken/Shandong/1844/2019(H9N2) viruses. Their genetic constellation showed they belonged to genotype S, which is the predominant genotype in China since 2010, where genotype S viruses have infected humans and acted as internal gene donors to H5 and H7 zoonotic influenza viruses. Active surveillance and control measures need to be enhanced to protect the poultry industry and public health.
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http://dx.doi.org/10.4142/jvs.2021.22.e21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007441PMC
March 2021

Whole-exome sequencing in 168 Korean patients with inherited retinal degeneration.

BMC Med Genomics 2021 03 10;14(1):74. Epub 2021 Mar 10.

Retinal Degeneration Research Lab, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.

Background: To date, no genetic analysis of inherited retinal disease (IRD) using whole-exome sequencing (WES) has been conducted in a large-scale Korean cohort. The aim of this study was to characterise the genetic profile of IRD patients in Korea using WES.

Methods: We performed comprehensive molecular testing in 168 unrelated Korean IRD patients using WES. The potential pathogenicity of candidate variants was assessed using the American College of Medical Genetics and Genomics and the Association for Molecular Pathology variant interpretation guidelines, in silico prediction tools, published literature, and compatibility with known phenotypes or inheritance patterns.

Results: Causative variants were detected in 86/168 (51.2%) IRD patients, including 58/107 (54.2%) with retinitis pigmentosa, 7/15 (46.7%) with cone and cone-rod dystrophy, 2/3 (66.6%) with Usher syndrome, 1/2 (50.0%) with congenital stationary night blindness, 2/2 (100.0%) with Leber congenital amaurosis, 1/1 (100.0%) with Bietti crystalline dystrophy, 1/1 (100.0%) with Joubert syndrome, 9/10 (90.0%) with Stargardt macular dystrophy, 1/10 (10.0%) with vitelliform macular dystrophy, 1/11 (9.1%) with other forms of macular dystrophy, and 3/4 (75.0%) with choroideraemia. USH2A, ABCA4, and EYS were the most common causative genes associated with IRD. For retinitis pigmentosa, variants of USH2A and EYS were the most common causative gene mutations.

Conclusions: This study demonstrated the distribution of causative genetic mutations in Korean IRD patients. The data will serve as a reference for future genetic screening and development of treatment modalities for Korean IRD patients.
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http://dx.doi.org/10.1186/s12920-021-00874-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7945660PMC
March 2021

Telemedicine and the Use of Korean Medicine for Patients With COVID-19 in South Korea: Observational Study.

JMIR Public Health Surveill 2021 01 19;7(1):e20236. Epub 2021 Jan 19.

Research Institute of Korean Medicine Policy, The Association of Korean Medicine, Seoul, Republic of Korea.

Background: COVID-19 was first reported in Wuhan, China, in December 2019, and it has since spread worldwide. The Association of Korean Medicine (AKOM) established the COVID-19 telemedicine center of Korean medicine (KM telemedicine center) in Daegu and Seoul.

Objective: The aim of this study was to describe the results of the KM telemedicine center and the clinical possibility of using herbal medicines for COVID-19.

Methods: All procedures were conducted by voice call following standardized guidelines. The students in the reception group obtained informed consent from participants and they collected basic information. Subsequently, Korean Medicine doctors assessed COVID-19-related symptoms and prescribed the appropriate herbal medicine according to the KM telemedicine guidelines. The data of patients who completed the program by June 30, 2020, were analyzed.

Results: From March 9 to June 30, 2020, 2324 patients participated in and completed the KM telemedicine program. Kyung-Ok-Ko (n=2285) was the most prescribed herbal medicine, and Qingfei Paidu decoction (I and II, n=2053) was the second most prescribed. All COVID-19-related symptoms (headache, chills, sputum, dry cough, sore throat, fatigue, muscle pain, rhinorrhea, nasal congestion, dyspnea, chest tightness, diarrhea, and loss of appetite) improved after treatment (P<.001).

Conclusions: The KM telemedicine center has provided medical service to 10.8% of all patients with COVID-19 in South Korea (as of June 30, 2020), and it is still in operation. We hope that this study will help to establish a better health care system to overcome COVID-19.
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http://dx.doi.org/10.2196/20236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817255PMC
January 2021

Pigmented Paravenous Chorioretinal Atrophy: Clinical Spectrum and Multimodal Imaging Characteristics.

Am J Ophthalmol 2021 04 16;224:120-132. Epub 2020 Dec 16.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address:

Purpose: To investigate the clinical findings and natural course of patients with pigmented paravenous chorioretinal atrophy (PPCRA) using multimodal imaging.

Design: Retrospective, observational case series.

Methods: We reviewed the records of consecutive patients diagnosed with PPCRA at a single center and assessed serial fundus photographs, fundus autofluorescence (FAF), and spectral-domain optical coherence tomography images. Electrophysiological findings and visual field analysis were also reviewed.

Results: The study included 50 eyes in 25 patients. The mean age of the population was 51.6 ± 14.6 years. Nine patients (36.0%) were asymptomatic and 9 (36.0%) complained of nyctalopia. We divided fundus appearance into one of 3 groups: paravenous (58.0%), focal (16.0%), and confluent (26.0%). Of the 50 eyes, macular involvement was present in 13 eyes (26.0%). Fifteen patients (60.0%) demonstrated a symmetric fundus appearance, whereas 10 (40.0%) had marked asymmetry. Eight eyes (16.0%) exhibited apparent changes in fundus findings, over a mean follow-up period of 8.8 years. FAF imaging was most sensitive to evaluate the extent of lesions. Sixteen eyes (44.4%) showed progressive visual field loss during the follow-up period. Most patients maintained stable vision, and 36 eyes (72.0%) had a final visual acuity of 20/50 or better. Nevertheless, some eyes with macular involvement experienced severe deterioration in vision. Electrophysiological data were variable, and interocular asymmetry was common (45.8%).

Conclusions: PPCRA can present with a more variable expressivity than previously described. Multimodal imaging can provide insights into its clinical characteristics to facilitate the diagnosis, classification, and follow-up of these patients.
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http://dx.doi.org/10.1016/j.ajo.2020.12.010DOI Listing
April 2021

Antioxidative Effects of Ascorbic Acid and Astaxanthin on ARPE-19 Cells in an Oxidative Stress Model.

Antioxidants (Basel) 2020 Sep 6;9(9). Epub 2020 Sep 6.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Korea.

Oxidative stress has been implicated as critical pathogenic factors contributing to the etiology of diabetic retinopathy and other retinal diseases. This study investigated antioxidative effect of ascorbic acid and astaxanthin on ARPE-19 cells within an oxidative stress model induced by common biological sources of reactive oxygen species (ROS). Hydrogen peroxide (HO) at concentrations of 0.1-0.8 mM and 20-100 mJ/cm of ultraviolet B (UVB) were treated to ARPE-19 cells. Cell viability and intracellular ROS level changes were measured. With the sublethal and lethal dose of each inducers, 0-750 μM of ascorbic acid and 0-40 μM of astaxanthin were treated to examine antioxidative effect on the model. Ascorbic acid at concentrations of 500 and 750 μM increased the cell viability not only in the UVB model but also in the HO model, but 20 and 40 μM of astaxanthin only did so in the UVB model. The combination of ascorbic acid and astaxanthin showed better antioxidative effect compared to each drug alone, suggesting a synergistic effect.
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http://dx.doi.org/10.3390/antiox9090833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556018PMC
September 2020

Clinical Course and Outcomes of 3,060 Patients with Coronavirus Disease 2019 in Korea, January-May 2020.

J Korean Med Sci 2020 Aug 3;35(30):e280. Epub 2020 Aug 3.

Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Background: The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea.

Methods: Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation.

Results: The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3-4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5-7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50-59, 60-69, 70-79, and ≥ 80 years of age, respectively.

Conclusion: In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.
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http://dx.doi.org/10.3346/jkms.2020.35.e280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402927PMC
August 2020

Genetic characteristics and pathogenesis of H5 low pathogenic avian influenza viruses from wild birds and domestic ducks in South Korea.

Sci Rep 2020 07 22;10(1):12151. Epub 2020 Jul 22.

Avian Influenza Research and Diagnostic Division, Animal and Plant Quarantine Agency, 177 Hyeoksin 8-ro, Gimcheon-si, Gyeongsangbuk-do, 39660, Republic of Korea.

H5 and H7 subtypes of low pathogenic avian influenza viruses (LPAIVs) can mutate to highly pathogenic forms and are therefore subject to stringent controls. We characterized H5 LPAIVs isolated from wild-bird habitats and duck farms in South Korea from 2010 to 2017. Through nationwide active surveillance for AIVs, 59 H5 LPAIVs were isolated from wild-bird habitats (a mean annual rate of 5.3% of AIV isolations). In 2015, one LPAI H5N3 strain was isolated on a duck farm. Phylogenetic analysis revealed that the hemagglutinin (HA) gene of H5 isolates belonged to the Eurasian lineage, classified into three subgroups (HA-II, HA-III, and HA-IV). The H5 LPAIVs of the HA-III and HA-IV subgroups appeared in 2015 and 2017 in unusually high proportions (13.1% and 14.4%, respectively). In gene-constellation analysis, H5 LPAIVs isolated from 2015 to 2017 constituted ≥ 35 distinct genotypes, representing high levels of genetic diversity. Representative strains of three HA subgroups replicated restrictively in specific-pathogen-free chickens. Among the 11 isolates that were tested, 10 infected and replicated in mice without prior adaptation. The frequency of recent H5 LPAIV isolates with high genetic diversity indicates the importance of continued surveillance in both wild birds and poultry to monitor genetic and pathobiological changes.
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http://dx.doi.org/10.1038/s41598-020-68720-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376034PMC
July 2020

Diagnostic Accuracy and Confidence of [18F] FDG PET/MRI in comparison with PET or MRI alone in Head and Neck Cancer.

Sci Rep 2020 06 11;10(1):9490. Epub 2020 Jun 11.

Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

The usefulness of PET/MRI in head and neck malignancy has not been fully elucidated. The purpose of our study was to evaluate the diagnostic accuracy and confidence of PET/MRI in comparison with PET or MRI alone. This study included 73 consecutive patients who underwent [18F] FDG PET/MRI in head and neck under the suspicion of malignancy. A neuroradiologist and a nuclear medicine specialist reviewed MRI and PET images, respectively and independently, followed by a consensus review of PET/MRI one month later. For 134 lesions, accuracy and confidence were compared among PET, MRI, and PET/MRI. For lesion base, PET/MRI had a sensitivity of 85.7%, a specificity of 89.1%, a PPV of 89.6%, a negative predictive value of 85.1%, and an accuracy of 87.3%. AUCs of PET/MRI per lesion (0.926) and per patient (0.934) for diagnosing malignancy were higher than PET (0.847 and 0.747, respectively) or MRI (0.836 and 0.798, respectively) alone (P < 0.05). More than 80% of the cases (111/134) showed diagnostic concordance between PET and MRI. PPV of PET/MRI was higher in malignant concordant cases (93.2%, 55/59) than in discordant cases (62.5%, 5/8) (p = 0.040). Confident scoring rate in malignant concordant cases was higher on PET/MRI (96.6%, 57/59) than on MRI (76.3%, 45/59) (p = 0.003). In conclusion, compared with PET or MRI alone, PET/MRI presents better diagnostic performance in accuracy and confidence for diagnosis of malignancy. PET/MRI is useful in patients with head and neck cancer.
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http://dx.doi.org/10.1038/s41598-020-66506-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289810PMC
June 2020

Acromioplasty rates in patients with shoulder disorders with and without acupuncture treatment: a retrospective propensity score-matched cohort study.

Acupunct Med 2020 08 20;38(4):255-263. Epub 2020 Apr 20.

Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.

Objective: This retrospective propensity score-matched cohort study aimed to examine the frequency of acromioplasty among patients with shoulder disorders receiving and not receiving acupuncture, based on Korea National Health Insurance Service-National Sample Cohort (NHIS-NSC) data.

Methods: We included cases of high-frequency shoulder disorders-adhesive capsulitis, rotator cuff syndrome, shoulder impingement syndrome, and sprain and strain of the shoulder joint-stratified from the Korea NHIS-NSC database between 2002 and 2013; cases were classified into two groups based on a history of acupuncture treatment performed at least twice within 6 weeks (acupuncture group:  = 111,561; control group:  = 71,340). We examined propensity scores and hazard ratios (HRs) for the frequency of acromioplasty, within 2 years of the first treatment or first examination in the acupuncture and control groups, respectively; cumulative survival rates were estimated using Kaplan-Meier survival analysis.

Results: Following propensity score matching, no differences were observed between the acupuncture and control groups for variables including sex, age, income and the Charlson comorbidity index. In addition, the incidence rates of acromioplasty within 2 years were lower in the acupuncture group than in the control group (HR 0.264; 95% confidence interval 0.224-0.311). Based on differences in sensitivity analyses for the numbers of acupuncture sessions and treatment duration, the frequency of acromioplasty within 2 years was lower in the acupuncture group than in the control group.

Conclusion: This study found that the frequency of acromioplasty was reduced in patients with shoulder disorders who had been treated with acupuncture. Although the findings need to be verified by prospective randomized clinical trials, these results imply that acupuncture may be effective at reducing the incidence rate of shoulder surgery.
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http://dx.doi.org/10.1177/0964528419895529DOI Listing
August 2020

Foveal Microvascular Structures in Eyes with Silicone Oil Tamponade for Rhegmatogenous Retinal Detachment: A Swept-source Optical Coherence Tomography Angiography Study.

Sci Rep 2020 02 13;10(1):2555. Epub 2020 Feb 13.

Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea.

Silicone oil (SO) is widely used as a long-term intravitreal tamponading agent for rhegmatogenous retinal detachment (RRD) repair. This study investigated the structural changes of the foveal microvasculature using optical coherence tomography angiography (OCTA) in patients with RRD treated with vitrectomy and SO tamponade. Thirty-eight patients with unilateral RRD who were treated with vitrectomy and SO tamponade and were followed up for ≥3 months after SO removal were included. En face OCTA images were obtained and foveal avascular zone (FAZ) area and vascular density (VD) were compared between study eyes and unaffected contralateral eyes. The FAZ area in deep capillary plexus (DCP) was larger (P < 0.001) and the VD in DCP was lower (P = 0.022) in the study eyes than in the fellow eyes. The duration of SO tamponade was significantly correlated with the enlargement of FAZ area (P = 0.034) and reduction of VD in DCP (P = 0.015). These changes could reflect vascular insufficiency in eyes with SO tamponade and may represent a potential explanation for the pathogenesis of retinal thinning and unexplained visual loss.
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http://dx.doi.org/10.1038/s41598-020-59504-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018724PMC
February 2020

Nursing stress factors affecting turnover intention among hospital nurses.

Int J Nurs Pract 2020 Dec 29;26(6):e12819. Epub 2020 Jan 29.

College of Nursing, Gachon University, Incheon, Republic of Korea.

Aims: This study aimed to identify the nursing stress factors, which affect turnover intention in hospital nurses.

Background: Nursing stress is known to be an important predictor of turnover intention in nurses. Although nurses experience various sources of stress across work environments, cultures, and generations, little is known about the stress factors affecting turnover intention in nurses.

Design: A descriptive cross-sectional design was employed.

Methods: A total of 329 nurses were recruited through convenience sampling from 27 hospitals in South Korea. Data were collected from May to November 2018 using a questionnaire.

Results: Among the stress factors, stress from patients and their families, workload stress, stress from conflicts with supervisors, and stress from conflicts with peers were associated with turnover intention in hospital nurses. These variables explained 40.0% of the variance in turnover intention among hospital nurses.

Conclusions: Stress from interpersonal relationships with patients and their families, supervisors, and peers may have a considerable impact on turnover intention. To reduce nursing turnover intention, coping strategies to reduce stress from patients and their families should be established. It is necessary to provide programmes that foster interpersonal relationship skills in the workplace. Nurse managers may encourage communication among nurses to establish positive relationships.
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http://dx.doi.org/10.1111/ijn.12819DOI Listing
December 2020

The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study.

BMC Musculoskelet Disord 2019 Dec 29;20(1):631. Epub 2019 Dec 29.

Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.

Background: Patients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. Therefore, this study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data.

Methods: A total of 12,375 TMD patients from the Korean National Health Insurance Review and Assessment database were analyzed. Controls were selected using propensity score-matching. The McNemar test, chi-square test, and paired t-test were used to compare the prevalence and severity of spinal pain between cases and matched controls. Logistic regression and linear regression models were used to analyze factors affecting the prevalence and severity of spinal pain in patients with TMD.

Results: The annual period prevalence of TMD was 1.1%. The prevalence was higher in younger individuals than in individuals of other ages and was higher in women than in men. The medical expenditure for TMD per person was $86. Among TMD patients, 2.5% underwent surgical procedures and 0.3% were hospitalized. The prevalence of spinal pain in patients with TMD was 48%, whereas that in the control group was 34%. Increased severity of TMD was associated with an increased probability of spinal pain. The medical expenditure, mean number of visits, and lengths of treatment for spinal pain were greater for patients with TMD than for controls ($136 vs. $81, 4.8 days vs. 2.7 days, 5.5 days vs. 3.3 days). Higher TMD grade was associated with greater differences in average medical expenditure, number of visits, and lengths of treatment for spinal pain between cases and controls. Additionally, for women, living in a rural area and having an older age and more severe TMD were associated with a greater probability of spinal pain and higher medical expenditure related to spinal pain.

Conclusion: A strong association was observed between the presence of TMD and the presence of spinal pain. The association became stronger as the severity of TMD increased, indicating a positive correlation between the severity of TMD and spinal pain.
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http://dx.doi.org/10.1186/s12891-019-3003-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935481PMC
December 2019

Changes in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial.

Minerva Anestesiol 2020 05 4;86(5):507-517. Epub 2019 Dec 4.

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea -

Background: The aim of intraoperative fluid therapy is to avoid both hypovolemia and hypervolemia; however, the patient's exact volume status is difficult to determine during surgery. Fluid optimization guided by stroke volume variation (SVV) has been widely used in patients undergoing major open abdominal surgery. The aim of this study was to evaluate the changes in plasma volume before and after surgery following SVV-guided fluid therapy.

Methods: Patients were randomly allocated into one of two groups according to the SVV criteria for fluid administration during surgery. In the fixed SVV fluid strategy group, fluid was administered to maintain the SVV below 13%. In the individual SVV group, individual SVV values of each patient were maintained until the end of surgery. Plasma volume, body weight, and extracellular water (ECW) were measured before and after surgery. Plasma volume was estimated using the indocyanine green dilution technique.

Results: A total of 118 patients were included. Median (25-75%) plasma volumes in the preoperative and postoperative period were 2.46 (2.20-2.88) L and 2.69 (2.33-3.12) L for the fixed SVV group (N.=57, P=0.133), respectively, and 2.56 (2.23-2.90) L and 2.89 (2.48-3.19) L for the individual SVV group (N.=61, P<0.001), respectively.

Conclusions: Fluid administration during surgery to maintain SVV below 13% was effective for maintaining the preoperative plasma volume until the end of surgery in patients undergoing major open stomach or colorectal surgery. This result supports the validity of SVV-guided fluid therapy, which maintains the SVV value below 13%, in terms of maintaining patient volume status.
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http://dx.doi.org/10.23736/S0375-9393.19.13952-1DOI Listing
May 2020

Imaging findings of pneumonia: emphasis on CT findings between immunocompromised and immunocompetent patients.

Acta Radiol 2020 Jul 7;61(7):903-909. Epub 2019 Nov 7.

Department of Radiology, Veterans Health Service Medical Center, Seoul, Republic of Korea.

Background: () is a globally emerging, rare, waterborne, aerobic, gram-negative, multiple-drug-resistant organism, most commonly associated with respiratory tract infection in humans. Computed tomography (CT) findings in patients with pneumonia are rarely reported.

Purpose: To compare CT findings between immunocompromised and immunocompetent patients, and to determine characteristic imaging findings of pneumonia.

Material And Methods: CT findings of eight immunocompromised and 29 immunocompetent patients with proven pneumonia were reviewed retrospectively. Different patterns of CT abnormalities between immunocompromised and immunocompetent patients were compared by Fisher's exact test.

Results: Patchy ground-glass opacities (GGOs) were the most common CT findings, present in 36 (97.3%) of the 37 patients. Among the patients with patchy GGOs, consolidation was seen in 29 (78.4%) patients, and centrilobular nodules were noted in 15 (40.5%) patients. The transaxial distribution of the parenchymal abnormalities was predominantly randomly distributed in 30 (81.1%) cases. Regarding longitudinal plane involvement, the predominant zonal distributions were the diffuse distribution (n=23, 62.2%) and the lower lung zone (n=14, 37.8%). None of the patients showed upper lung zone predominance. The proportion of patients with parenchymal CT findings or associated findings in the immunocompromised patients was not significantly different from that of the immunocompetent patients. However, lower lung zone predominance on the longitudinal plane was significantly more common in immunocompetent patients than in immunocompromised patients (14/29 vs. 0/8, =0.015). And diffuse distribution of parenchymal abnormalities on a longitudinal plane was significantly more frequent in immunocompromised patients than in immunocompetent patients (8/8 vs. 15/29, =0.015).

Conclusion: The most common CT patterns of pneumonia in immunocompromised and immunocompetent patients were patchy GGOs and consolidation. However, in immunocompetent patients, parenchymal abnormalities were more predominately distributed in lower lung zone than in immunocompromised patients; and in immunocompromised patients, parenchymal abnormalities were more diffusely distributed than in immunocompetent patients.
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http://dx.doi.org/10.1177/0284185119885117DOI Listing
July 2020

A telomerase-derived peptide vaccine inhibits laser-induced choroidal neovascularization in a rat model.

Transl Res 2020 02 5;216:30-42. Epub 2019 Oct 5.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address:

GV1001, a novel peptide derived from human telomerase reverse transcriptase, reportedly has anticancer and anti-inflammatory effects. Choroidal neovascularization (CNV) is a complex pathogenic process that involves angiogenesis, inflammation, cellular immunity, and other factors. This study was aimed at investigating the effect of GV1001 on laser-induced CNV in a rat model. Brown Norway rats were subcutaneously administered GV1001 (0.1 nM, 1 nM, and 10 nM) daily, beginning 3 days prior, and ending 14 days after laser photocoagulation. Optical coherence tomography, fluorescein angiography, choroidal flat mount, and histologic analysis were performed to analyze CNV. The protein level of IκB-α and nuclear translocation of nuclear factor κB (NF-κB) was analyzed via immunohistochemistry of p65. Multiplex immunoassay was performed to evaluate the interleukin (IL)-1β, IL-6, vascular endothelial growth factor (VEGF), monocyte chemotactic protein-1, and tumor necrosis factor-α levels. The GV1001-treated group had significantly lower CNV thickness, smaller CNV area, and lower proportion of CNV lesions with clinically significant fluorescein leakage than vehicle-treated group. GV1001 treatment inhibited IκB-α degradation and NF-κB p65 nuclear translocation. At 1 nM concentration, GV1001 had highest inhibitory effect on CNV and NF-κB signaling activation; moreover, it suppressed the levels of IL-1β, IL-6, and VEGF significantly. The present study demonstrates that GV1001 treatment led to significant suppression of laser-induced CNV, alongside inhibition of inflammatory processes including NF-κB activation and subsequent upregulation of proinflammatory cytokines. Therefore, this provides molecular evidence of potential validity of GV1001 treatment as a therapeutic strategy for neovascular age-related macular degeneration.
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http://dx.doi.org/10.1016/j.trsl.2019.10.001DOI Listing
February 2020

Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study.

Int J Environ Res Public Health 2019 10 24;16(21). Epub 2019 Oct 24.

Department of Nursing, College of Medicine, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Korea.

The environment of health organizations can determine healthcare quality and patient safety. Longer working hours can be associated with nurses' health status and care quality, as well as work-related hazards. However, little is known about the association of hospital nurses' working hours and patient safety competencies with adverse nurse outcomes. In this cross-sectional descriptive study, convenience sampling was employed to recruit 380 nurses from three tertiary care hospitals in South Korea. Data were collected using structured questionnaires from May to June 2016. Hierarchical linear regression analysis was used to identify the association of working hours and patient competencies with adverse nurse outcomes among 364 participants selected for analysis. Most nurses worked over 40 h/week. Working hours ( = 0.202, < 0.001) had the strongest association with adverse nurse outcomes. Low perceived patient safety competencies ( = -0.179, = 0.001) and frequently reporting patient safety accidents ( = 0.146, = 0.018) were also correlated with adverse nurse outcomes. Nursing leaders should encourage work cultures where working overtime is discouraged and patient safety competencies are prioritized. Further, healthcare managers must formulate policies that secure nurses' rights. The potential association of overtime with nurse and patient outcomes needs further exploration.
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http://dx.doi.org/10.3390/ijerph16214083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862320PMC
October 2019

Morphological characteristics of ocular toxoplasmosis and its regression pattern on swept-source optical coherence tomography angiography: a case report.

BMC Ophthalmol 2019 Sep 5;19(1):199. Epub 2019 Sep 5.

Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Republic of Korea.

Background: To report the successful treatment of ocular toxoplasmosis and present the use of multimodal imaging to describe the changes in ocular toxoplasmic lesions subsequent to treatment.

Case Presentation: A 73-year-old female visited the clinic with decreased visual acuity in the left eye. Fundus examination showed severe vitreous haze with yellow-white infiltrates near the foveal center. Spectral-domain optical coherence tomography (SD-OCT) revealed disorganization of the retinal structure with markedly thickened choroid beneath the active lesion. Highly elevated serum titers of IgG antibodies against Toxoplasma gondii were observed. Topical and systemic steroids with oral Bactrim were administered after a diagnosis of ocular toxoplasmosis was made. After improvement in the severity of vitritis, structural en face swept-source optical coherence tomography (SS-OCT) imaging demonstrated diffuse choroidal dilation with many collateral vascular branches surrounding the active lesion. Eight intravitreal injections of clindamycin (1 mg/0.1 ml) were administered at 1- to 2-week intervals along with systemic antibiotics and steroids. After the treatment, the toxoplasmic lesion resolved to an atrophic chorioretinal scar. Dilated choroidal vessel size was normalized and collateral vascular branches were markedly constricted on structural en face SS-OCT images.

Conclusions: This is the first detailed report on the morphological changes in the choroidal vasculature surrounding ocular toxoplasmic lesions that were characterized using SS-OCT-A imaging. Multimodal imaging with SS-OCT-A can be valuable in clinical diagnosis as well as in clarifying the mechanism of choroidal structural changes in ocular toxoplasmosis.
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http://dx.doi.org/10.1186/s12886-019-1209-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729000PMC
September 2019

Outcomes of Anti-vascular Endothelial Growth Factor Treatment for Foveal Serous Retinal Detachment Associated with Inferior Staphyloma.

Korean J Ophthalmol 2019 Jun;33(3):228-237

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) treatment of eyes with foveal serous retinal detachment (SRD) associated with inferior staphyloma and to investigate choroidal thickness changes following anti-VEGF therapy.

Methods: In this observational case series, eyes with inferior staphyloma accompanied by foveal SRD were treated with a single intravitreal anti-VEGF injection, followed by further injections as needed. Changes in height and width of subretinal fluid (SRF) and visual acuity after treatment were assessed. Choroidal thickness was measured at the subfovea, 1.5 mm superior and inferior to the fovea using enhanced depth imaging optical coherence tomography at baseline and 1 month after initial anti-VEGF therapy.

Results: Six eyes from six patients were included. One month after the initial injection, the mean SRF height and width had decreased significantly from 112.5 ± 40.1 to 44.5 ± 48.7 μm ( = 0.046) and from 1,401.8 ± 627.3 to 690.7 ± 634.7 μm ( = 0.028), respectively. Mean choroidal thickness at the superior point decreased from 218.7 ± 59.3 to 200.5 ± 61.0 μm ( = 0.046). SRF resolved completely in three of the six eyes (50%) with a mean of 6.8 ± 5.9 injections (range, 1 to 15). All eyes experienced at least one recurrence of exudation, at a mean interval of 4.8 months. Mean visual acuity improvement was 0.17 logarithm of the minimum angle of resolution units at a mean of 28.7 months follow-up.

Conclusions: Anti-VEGF therapy resulted in an SRF decrease and modest visual improvement in eyes with foveal SRD associated with inferior staphyloma. Reduction in superior choroidal thickness appeared to contribute to the clinical improvements that were observed.
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http://dx.doi.org/10.3341/kjo.2018.0125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557795PMC
June 2019

Pathogenicity of clade 2.3.4.4 H5N6 highly pathogenic avian influenza virus in three chicken breeds from South Korea in 2016/2017.

J Vet Sci 2019 May;20(3):e27

Laboratory of Pathology, College of Veterinary Medicine, Chonbuk National University, Iksan 54596, Korea.

In 2016, novel H5N6 highly pathogenic avian influenza virus emerged in Korea. During the outbreak, the virus caused the largest culling, especially in brown chicken lines. We determined the pathogenicity and transmissibility of the virus in 2 white chicken lines of the specific pathogen-free chickens, broilers and brown chicken line of Korean native chicken (KNC). A KNC had a longer virus shedding period and longer mean death time than others. Our study showed that this characteristic in the KNC might have contributed to a farm-to-farm transmission of the brown chicken farms.
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http://dx.doi.org/10.4142/jvs.2019.20.e27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538517PMC
May 2019

Anatomical configurations of vitreomacular traction syndrome: influence on clinical course and surgical outcomes.

Graefes Arch Clin Exp Ophthalmol 2019 Aug 18;257(8):1631-1639. Epub 2019 May 18.

Department of Ophthalmology, Chung-Ang University Hospital, #102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea.

Purpose: To develop a new classification system for vitreomacular traction (VMT) syndrome according to spectral-domain optical coherence tomography (SD-OCT) imaging and to investigate the clinical course of VMT patients.

Methods: This study included 68 eyes of 68 consecutive patients who were followed with observation or treated with vitrectomy for idiopathic VMT. Eyes were classified into one of three groups according to SD-OCT findings: group A (foveal pseudocyst, which was defined as the formation of cystoid cavity located in the inner part of the central fovea along with foveal thickening), group B (parafoveal retinoschisis, which was defined as intraretinal cysts or clefts along with no apparent foveal thickening), and group C (outer retinal dehiscence at the fovea, which is sometimes accompanied by foveal thinning). The minimum required follow-up period was 1 year. Clinical course and anatomical and functional outcomes were compared among the groups.

Results: Twenty-seven eyes (39.7%) were included in group A, 22 eyes (32.4%) were included in group B, and 19 eyes (27.9%) were included in group C. Among the 24 eyes that were managed by observation, a significantly larger percentage of patients in group A (6/10 [60%]) exhibited more spontaneous resolution of VMT compared with those in groups B (9.1%) or C (0%) (P = 0.010). In the 44 eyes that were managed with vitrectomy, a significantly larger percentage of patients in group C (4/16 [25%]) experienced subsequent full-thickness macular hole development following vitrectomy compared with those in groups B (0%) or C (0%) (P = 0.014). The percentage of patients with photoreceptor inner segment/outer segment disruption was significantly reduced in group A after vitrectomy, with group C exhibiting the lowest recovery rate. Postoperatively, group A experienced a significantly better visual outcome than group C (P = 0.021).

Conclusions: A novel configuration system offering insight into the clinical course of VMT is proposed. According to this system, anatomical and functional outcomes were favorable in group A and worse in group C.
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http://dx.doi.org/10.1007/s00417-019-04352-9DOI Listing
August 2019

COMPARISON OF VISUAL/ANATOMICAL OUTCOMES AND RECURRENCE RATE BETWEEN ORAL SPIRONOLACTONE AND PHOTODYNAMIC THERAPY FOR NONRESOLVING CENTRAL SEROUS CHORIORETINOPATHY.

Retina 2020 Jun;40(6):1191-1199

Department of Ophthalmology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

Purpose: To compare long-term visual/anatomical outcomes and recurrence rate between oral spironolactone (SPRL) treatment and half-dose photodynamic therapy for nonresolving central serous chorioretinopathy.

Methods: This retrospective, interventional, comparative study included 50 nonresolving central serous chorioretinopathy patients who had exhibited subretinal fluid (SRF) accumulation for >3 months. Of the 50 patients, 26 (26 eyes) received oral SPRL treatment and 24 (24 eyes) received half-dose photodynamic therapy. Best-corrected visual acuity, central subfield thickness, SRF height, and subfoveal choroidal thickness were compared between groups at 1, 2, 3, 6, and 12 months after treatment by using repeated-measures analysis of variance.

Results: After treatment, best-corrected visual acuity, central subfield thickness, and SRF height significantly improved in both groups, compared with baseline. There were no significant differences in best-corrected visual acuity, central subfield thickness, or SRF height between the two groups, with the exception of 3 and 12 months of follow-up for central subfield thickness (P = 0.016 and P = 0.028, respectively) and 3 months of follow-up for SRF height (P = 0.039). However, recurrence was more likely to occur in the oral SPRL group than in the half-dose photodynamic therapy group (P = 0.002).

Conclusion: Oral SPRL treatment for nonresolving central serous chorioretinopathy showed good long-term visual/anatomical outcomes, compared with half-dose photodynamic therapy. However, recurrence was more likely to occur when using oral SPRL.
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http://dx.doi.org/10.1097/IAE.0000000000002507DOI Listing
June 2020

Predictive Factors of Duration of Continuous Renal Replacement Therapy in Acute Kidney Injury Survivors.

Shock 2019 12;52(6):598-603

Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

The factors influencing continuous renal replacement therapy (CRRT) duration for critically ill patients with acute kidney injury (AKI) are unclear. Therefore, we investigated the clinical factors that could influence the duration of CRRT for AKI survivors. In this retrospective observational study, the medical records of all hospital survivors who required CRRT for AKI in intensive care units were analyzed. The CRRT duration (median, 6 days) was categorized as short-duration CRRT (≤ 6 days, n = 65) and long-duration CRRT (> 6 days, n = 59), according to the median CRRT duration. A urine output of less than 0.5 mL/kg/h (adjusted odds ratio [OR], 3.4; P = 0.010), mechanical ventilation use (adjusted OR, 7.9; P = 0.001), and extracorporeal membrane oxygenation (ECMO) use (adjusted OR, 6.5; P = 0.010) were independent predictors of long-duration CRRT, whereas serum creatinine and neutrophil gelatinase-associated lipocalin were not significant predictors. A clinical model demonstrated a good discriminatory ability to predict long-duration CRRT (area under the curve, 0.84; 95% confidence interval, 0.76-0.90). The urine output immediately before CRRT initiation and factors associated with disease severity significantly affected the duration of CRRT. Simultaneously considering the urine output, mechanical ventilation use, and ECMO use predicted CRRT duration in AKI survivors.
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http://dx.doi.org/10.1097/SHK.0000000000001328DOI Listing
December 2019

Different pathogenicity of two strains of clade 2.3.4.4c H5N6 highly pathogenic avian influenza viruses bearing different PA and NS gene in domestic ducks.

Virology 2019 04 15;530:11-18. Epub 2019 Jan 15.

Avian Disease Laboratory, College of Veterinary Medicine, Konkuk University, 120 Neungdongro, Gwangjingu, Seoul 05029, Republic of Korea. Electronic address:

H5Nx clade 2.3.4.4 highly pathogenic avian influenza viruses (HPAIVs) have been disseminated to wide geographic regions since 2014. In 2016, five distinct genotypes (C-1 to C-5) of clade 2.3.4.4c H5N6 HPAIVs were detected in South Korea. In this study, we evaluated the pathogenicity, susceptibility to infection, and transmissibility of the two strains representing the C-1 and C-4 genotypes of the H5N6 viruses, which have different PA and NS gene, in domestic ducks. Although the susceptibility to infection of domestic ducks to the two strains was similar, the C-4 genotype virus induced higher mortality in ducks than C-1 genotype virus. A higher titer of viral shedding were detected in ducks challenged with the C-4 genotype virus compared with the C-1 genotype virus. These results indicated that the reassortment of HPAIVs with prevailing low pathogenic avian influenza viruses could effect on the pathogenicity in ducks.
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http://dx.doi.org/10.1016/j.virol.2019.01.016DOI Listing
April 2019
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