A 64-year-old man complained of difficulty with far vision in the right eye after blunt trauma by his hand during sleep. He had undergone uneventful phacoemulsification and intraocular lens (IOL) implantation of both eyes one week before the event. On slit lamp examination, the anterior chamber was shallow compared to postoperative one day or the left eye. After mydriasis, IOL position was perfect, within the capsulorrhexis margin, and no haptics were protruded. SE of his right eye was −4.00 diopter after trauma, although spherical equivalent (SE) of both eyes was near emmetropia one day after cataract surgery. We decided on IOL reposition or exchange. Intraoperatively, we pushed the IOL posteriorly; the IOL was vaulted posteriorly, as expected. After surgery, his SE was +0.25 with the same diopter IOL. We report the case on the possibility of 4-point haptic IOL vaulting anteriorly by blunt trauma within the capsular bag. Se presenta el caso de un varón de 64 años con dificultad en visión lejana en el ojo derecho tras tratamiento contuso con su propia mano durante el sueño. Se había sometido sin incidentes a una facoemulsificación y a un implante de lentes intraoculares en ambos ojos una semana antes del suceso. En el examen de la lámpara de hendidura la cámara anterior se mostraba plana en comparación al día siguiente a la operación así como en comparación al ojo izquierdo. Tras la midriasis, la posición de la lente intraocular era perfecta dentro del margen de la capsulorrhexis, sin sobresalir los hápticos. El equivalente esférico de su ojo derecho era de -4,00 dioptrías tras el traumatismo, aunque el equivalente esférico de ambos ojos era casi emetrópico al día siguiente de la cirugía de catarata. Se optó por la reposición o cambio de la lente intraocular. Intraoperatoriamente la lente intraocular fue empujada posterioremente, y dicha lente se posicionó posteriormente, según lo previsto. Tras la cirugía, el equivalente esférico era de +0,25 empleando la misma potencia de lente intraocular. En este caso se reporta la posibilidad de un desplazamiento anterior de una lente intraocular con hápticos de 4 puntos, debido a un traumatismo contuso dentro del saco capsular.
Abstract Retinoid X receptors (RXRs) are nuclear receptors for retinoids that play a critical role in the regulation of growth and differentiation in normal and tumor cells. Deregulation of RXR expression has been reported in non-small cell lung cancer (NSCLC); however, the mechanism underlying the impaired expression of RXRs in lung cancer is not known. Aberrant methylation of promoter CpG islands is known to be a major mechanism for inactivation of tumor suppressor genes. We investigated the methylation status of the RXR genes in 139 surgically-resected NSCLCs and correlated the results with the clinicopathologic characteristics of the patients. Methylation in the tumors was detected at RXRα (5.7%), RXRβ (4.3%), and RXRγ (23.7%). RT-PCR analysis showed that RXRγ methylation correlates with mRNA expression. Methylation of the RXRγ gene was not significantly associated with the prognosis of patients; however, when the patients are categorized by smoking status, the effect of RXRγ methylation on prognosis was significantly different between never- and ever-smokers (P = 0.003 [test for homogeneity]); specifically, RXRγ methylation was associated with a significantly worse survival in never-smokers, whereas it exhibited a better survival outcome in ever-smokers, although not statistically significant. This finding suggests that methylation-associated down-regulation of the RXRγ gene may play a differential role in the carcinogenesis of NSCLCs according to smoking status, but further studies are needed to confirm this. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4935.
Osteochondral fracture is an often painful, usually unilateral condition that occurs in young adults in which a segment of articular cartilage and an attached fragment of subchondral bone become partially or completely separated from the underlying bone. Accurate diagnosis of osteochondral fracture of the talus, mainly caused by trauma, is difficult because osteochondral lesion is not detected easily on the roentgenographic examination. Osteochondral fracture is intraarticular fracture, thus operative approach and fixation is technically difficult and requires considerable expertise to work. Authors treated 5 patients who had osteochondral fracture of talus, with subchondral bone curettage through percutaneous extraarticular transtalar approach under the C-arm guide without arthrotomy in three cases of minimally detached or elevated osteochondral fragment. And two cases of partially detached osteochondral fragment treated by bone peg fixation with arthrotomy. We obtained good functional results at the follow-up of a mean of 1 year and 5 months. We believe that the subchondral curettage and bone peg fixation are excellent treatment methods for osteochondral fracture of the talus.
Background : Osteopenia has been recognized as one of the potential complications of chronic liver disease. However, its correlation with hepatits B virus (HBV) carriage has not been reported. Thus this study was aimed to clarify the relationship between osteopenia and HBV carriage. Methods : Bone density was measured in 192 HBV carrier women and 200 healthy women in the following sites: the lumbar spine and three sites of the proximal femur (the neck, Ward's triangle, greater trochanter) by dual-photon absorptiometry. Liver function tests (AST, ALT, Albumin, GGT, and ALP) were also performed. Results : The levels of the bone density measured at the four sites were significantly correlated with each other (r=0.34 to 0.99, P
본 연구는 공무원들의 스트레스나 피로수준과 같은 사회심리적 건강상태가 그들의 직급, 근무경력 등의 직업관련 특성이나 업무요구도, 업무자율성, 직장 내에서의 사회적 지지와 같은 직무스트레스 내용에 의해 영향을 받고 있는지를 구조방정식모형을 통하여 검토하고자 시도하였다. 연구대상은 대전광역시의 5개 정부 공공기관에 근무하는 일반 사무직 행정공무원 805명이었으며, 자료 수집은 2009년 10월 1일부터 11월 30일까지의 기간 동안에 표준화된 자기기입식 설문지(self-administered questionnaire)를 사용하여 실시하였다. 연구결과, 공무원들의 스트레스 및 피로수준은 직급, 근무경력, 업무만족도, 업무자율성, 상사의 지지도 및 동료의 지지도와는 유의한 음의 상관관계를 나타낸 반면, 년 간 결근일수, 업무요구도와는 유의한 양의 상관관계를 나타내었다. 구조방정식모형 분석 결과 연구대상자들의 직무스트레스 요인은 직업관련 특성 요인보다 사회심리적 건강상태에 더 큰 영향을 미쳤으며, 직무스트레스가 높을수록 사회심리적 건강상태를 나타내는 스트레스와 피로수준을 높여주는 것으로 나타났다. 한편, 직업관련 특성의 인지정도가 높을수록 직무스트레스 요인을 감소시키는 효과가 있는 것으로 나타났다. 따라서 공무원들의 스트레스나 피로를 감소시키기기 위해서는 직업관련 특성에 따른 직무내용의 개선을 위한 프로그램의 개발 및 시행이 필요할 것으로 생각된다. The effects of job related factors on psychosocial health status were examined by taking job stress into account. The self-administered questionnaires were performed, during the period between Oct. 1st, 2009 and Nov. 30th, 2009, to 805 individuals in the service of general administration located in Daejeon City. Causal relationships between job related factors, job stress, and, psychosocial health status were examined by structural equation model. The main finding as follows: For correlations of such indices of psychosocial health status as PWI and MFS with various studied items, all of these two indices were found to be in a negative correlation with the job position, job career, satisfaction in job life, autonomy of job, supervisors support and coworkers support, whereas in positive correlation with the experience of sick absence per year and job demand. With the analysis of structural equation model, the degree of job stress factors was more influential on the level of psychosocial health status than job related factors in such a manner as that the greater the job stress, while the lower the job related factors, the higher the psychosocial health status(PWI and MFS). Moreover, it was found to have the inter-relational effects that the greater the job related factors, the lower the job stress factors. Thus the effective strategy for stress and fatigue symptoms reduction among governmental employees requires additional programs focusing on innovated job specifications.
Endotension is an unpredictable late complication of endovascular aortic aneurysm repair (EVAR). This case report will discuss the successful treatment of enlarged aneurysmal sac due to endotension using the relining technique. An 81-year-old male complained of nondecreasing huge aneurysm sac. He had undergone EVAR for infrarenal abdominal aortic aneurysm 7 years prior and no endoleak was found through follow-up. Initially computed tomography-guided sac aspiration was tried, but in vain, Relining using the double barrel technique and tubular endograft for modular diconnection, which was unexpectedly found in the original endograft, were performed sucessfully. During follow-up after the relining procedure, the size of aneurysm sac continued to decrease in size. The relining technique is effective mothod for treating endotension.
Abstract Multiple pregnancies are prone to gestational diabetes mellitus (GDM). This study investigated the association between pregravid liver enzyme levels and the development of GDM in a twin pregnancy. Women who had the National Health Screening Examination and delivered their twin babies within one year were enrolled. Pregravid liver enzyme levels were divided into high and low level. Risks for developing GDM by high levels of liver enzymes were analyzed, in subgroups by pregravid obesity or metabolic syndrome. Among the 4348 twin pregnancies, 369 women (8.5%) developed GDM not requiring insulin treatment (GDM − IT), and 119 women (2.7%) developed GDM requiring insulin treatment(GDM + IT). High levels of pregravid GGT and ALT were related to risks of GDM + IT not only in women with obesity or metabolic syndrome (odds ratio[OR] 6.348, 95% confidence interval [CI] 2.579–15.624 and OR 6.879, 95% CI 2.232–21.204, respectively), but also in women without obesity (OR 3.05, 95% CI 1.565–5.946) or without metabolic syndrome (OR 3.338, 95% CI 1.86–5.992), compared to in women with low levels of those. However, there were no significant associations in the pregravid ALT and GGT levels and risks for development of GDM − IT, unrelated to pregravid obesity or metabolic syndrome. Therefore, this study suggests that women with high levels of pregravid GGT and ALT need to recognize their increased risk of GDM + IT, regardless of pregravid obesity or MetS, when they get pregnant twin.
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