A Study on the Relationship between Dietary Patterns and the Subjective Stress Perception of Korean Adult Men: Based on the Korean National Health and Nutrition Examination Survey, 2014∼2016

This study was conducted to identify the major dietary patterns of Korean adult men and to examine the relationship between subjective stress perception and these dietary patterns using data from the 2014∼2016 Korean National Health and Nutrition Examination Survey (KNHANES). Of the 23,080 total subjects, adult men between the ages of 19 and 64 who did not take the questionnaire or answer the questions relating to depression, and cases where the daily energy intake was less than 500 kcal or more than 5,000 kcal in the Food Frequency Questionnaire were excluded. This left a total of 3,464 subjects who were included in the final analysis. We performed a factor analysis based on the yearly mean intake frequency of 41 food groups to identify the major dietary patterns. Three major dietary patterns were identified (factor loading ＞0.3), including the ‘Healthy pattern’, ‘Processed meat pattern’, and the ‘Alcohol pattern’. The ‘Healthy pattern’ was characterized by higher intake of beans, tofu, vegetable, fish, and fruits. The ‘Processed meat pattern’ was characterized by high consumption of processed meats and instant foods. The ‘Alcohol pattern’ was characterized by a higher intake of alcohol. As a response to the subject's subjective perception of stress, the most answered 'a little' according to age, marital status, occupation, income, residential area, smoking status, drinking status, and exercise status. People whose diets followed the ‘Processed meat’ and ‘Alcohol’ patterns had significantly higher scores on subjective stress perception compared to people following the ’Healthy pattern’.To manage subjective stress, it is more effective to maintain health by relieving stress through a healthy method that combines healthy eating and exercise rather than following an unhealthy diet as characterized by the ‘processed meat’ and ‘alcohol’ dietary patterns.

Improvement of Skin Photoaging by Polysaccharide Extract Derived from Tremella fuciformis (White Jelly Mushroom)

Chronic ultraviolet (UV) radiation causes photoaging, which represents skin damage, disrupts skin barrier function, and promotes wrinkle formation. We investigated that the polysaccharide extract of an edible basidiomycetous white jelly mushroom, Tremella fuciformis, (TF-Glucan ® ) exhibited statistically photoprotective activity by inhibiting matrix metalloproteases (MMPs) and increasing collagen synthesis, and an antiinflammatory activity by inhibiting nitric oxide and pro-inflammatory cytokines at the concentrations of less than 1000 μg/ml, which is not cytotoxic (p < 0.05). Additionally, TF-Glucan ® increased the expression of involucrin and filaggrin to prevent the disruption of UVB-induced barrier function (p < 0.05). TF-Glucan ® was assessed as a safe material by the human primary skin irritation (1, 3, 5%), human repeated insult patch test (no sensitization at 5%), 3T3 NRU phototoxicity assay (no phototoxicity, PIF < 2, MPE < 0.1), eye irritation test test by BCOP (no category, IVIS ≤ 3) and local lymph node assay (negative at 10, 25, 50%) for identifying potential skin sensitizing. These results suggest that TF-Glucan ® may be useful as an anti-photoaging ingredient for developing cosmeceuticals.

Arteritic Anterior Ischemic Optic Neuropathy Associated with Giant-Cell Arteritis in Korean Patients: A Retrospective Single-Center Analysis and Review of the Literature

BACKGROUND AND PURPOSE: The aim of this study is to report the relative incidence of arteritic anterior ischemic optic neuropathy (AAION) associated with giant-cell arteritis (GCA) in a single-center and evaluate the clinical features of AAION in Korean patients. METHODS: The medical records of patients with presumed AION who visited our hospital from January 2013 to August 2018 were examined retrospectively. The patients were divided into two groups: AAION associated with GCA, and non AION (NAION). We additionally reviewed the literature and identified all cases of AAION in Korean and Caucasian patients. We evaluated the clinical data including the initial and final best-corrected visual acuities, fundus photographs, visual field tests, fluorescein angiography, and contrast-enhanced MRI, and compared the data with those for Caucasian patients in the literature. RESULTS: Of the 142 patients with presumed AION, 3 (2.1%) were diagnosed with AAION and 139 (97.9%) were diagnosed with NAION. Seven Korean patients with AAION associated with GCA were identified in our data and the literature review. We found no difference in any clinical features other than laterality: four of the seven Korean patients had bilateral involvement. Moreover, the optic nerve sheath was enhanced in two of our Korean patients. CONCLUSIONS: AAION associated with GCA is a very rare condition compared to NAION in Korea. However, GCA should be considered in all cases of ischemic optic neuropathy because AAION is associated with poor visual outcome, and sometimes presents bilaterally.

Orbital Lymphoma Presenting with Inferior Rectus Palsy

No abstract available.

Clinical Reasoning: A 38-year-old Man Presented with Headache and Diplopia

No abstract available.

Cogan Syndrome Accompanied with Meningitis / 대한평형의학회지

Cogan syndrome is a rare inflammatory disease characterized by intraocular inflammation and vestibulo-auditory dysfunction. The exact etiology of Cogan syndrome is still unknown, but is currently thought to be an autoimmune disease. Cogan syndrome can be accompanied with various conditions including fever, arthritis, skin rash, aortitis, central or peripheral nerve system involvement, lymphadenopathy, splenomegaly and diarrhea. We report a case of Cogan syndrome accompanied with meningitis.

A Case of Orbital Chondroma

PURPOSE: To report a case of orbital chondroma. CASE SUMMARY: A 15-year-old male presented with an 8-month history of left hypertropia. The best-corrected visual acuity was 20/20 in both eyes. The exophthalmometry showed no exophthalmos, with 13 mm in both eyes. There was a hard palpable mass at the superonasal orbit of the left eye. Orbital computed tomography showed a heterogenous soft tissue shadow at the superonasal orbit of the left eye, and orbital magnetic resonance imaging revealed a 25 × 16 × 20 mm well-defined mass with low signal intensity in the T1-weighted image, high signal intensity in the T2-weighted image, and heterogenous enhancement in the contrast enhanced T1-weighted image. The mass was surgically removed with anterior orbitotomy. A 27 × 17 mm well-capsulated lobular mass was found, and histopathological examination revealed hyaline cartilage and chondrocyte. The mass was diagnosed as a chondroma. CONCLUSIONS: A chondroma is a benign tumor, which usually occurs in long bones and the small bones of the hands and feet. It is very rare in the facial and pelvic bones. The sites of chondroma occurring in the head and neck include the ethmoid sinus and maxilla, but it is extremely rare in the orbit.

Opsoclonus-Myoclonus Syndrome Associated with Scrub Typhus / 대한평형의학회지

Scrub typhus is an infective acute febrile disorder caused by the intracellular parasite Orientia tsutsugamushi. Neurological manifestations of scrub typhus are meningoencephalitis, cerebellitis, transverse myelitis, papilledema, and cranial nerve palsy. However, opsoclonus-myoclonus syndrome associated with scrub typhus has been rarely reported. A 59-year-old man developed vertigo, nausea, vomiting, and imbalance following scrub typhus infection for eight days. Examination showed eschar at the axilla, decreased mentality, and opsoclonus-myoclonus syndrome. Video-oculography disclosed opsoclonus with an amplitude of 15°–20° and a frequency of 6–8 Hz. The serum antibody titers to Orientia tsutsugamushi were 1:5,120, and cerebrospinal fluid analysis revealed pleocytosis. Brain magnetic resonance imaging was normal. Neurological symptoms and signs completely improved by systemic steroid and antibiotics treatment. Various mechanisms including direct disseminating inflammation or indirect immune modulation may give rise to neurological complications following scrub typhus.

Second-Eye Refractive Error Depending on the Reflection Rate of First-Eye Refractive Error in Cataract Surgeries

PURPOSE: To evaluate the reflection rate of the first eye in order to minimize the real refractive error in the second eye in bilateral consecutive cataract surgeries. METHODS: A retrospective analysis was performed with 248 patients who underwent bilateral sequential uncomplicated phacoemulsification and posterior chamber intraocular lens implantation. Predicted spherical equivalent was compared with postoperative spherical equivalent, and the range of real refractive error was analyzed by calculating the reflection rate of the first eye. RESULTS: When the difference between predicted spherical equivalent and postoperative spherical equivalent was greater than 0.5 D as calculated with the formula of Sanders-Retzlaff-Kraff Theoretical (SRK)-T and SRK II, application of 50-60%, 40-50% of the difference of the first eye was high probability to reduce the second-eye real refractive error (75%, 100%). CONCLUSIONS: Application of 40-60% of the real refractive error in the first-eye can minimize the real refractive error in the second-eye in bilateral sequential cataract surgeries.

Episodic Ataxias: Clinical and Genetic Features

Episodic ataxia (EA) is a clinically heterogeneous group of disorders that are characterized by recurrent spells of truncal ataxia and incoordination lasting minutes to hours. Most have an autosomal dominant inheritance pattern. To date, 8 subtypes have been defined according to clinical and genetic characteristics, and five genes are known to be linked to EAs. Both EA1 and EA2, which are caused by mutations in KCNA1 and CACNA1A, account for the majority of EA, but many patients with no identified mutations still exhibit EA-like clinical features. Furthermore, genetically confirmed EAs have mostly been identified in Caucasian families. In this article, we review the current knowledge on the clinical and genetic characteristics of EAs. Additionally, we summarize the phenotypic features of the genetically confirmed EA2 families in Korea.

Occipital Lobe Epilepsy with Hemicrania Epileptica

No abstract available.

Genetic Approach of Dizziness / 대한평형의학회지

Patients with recurrent vertigo/dizziness or unsteadiness are a heterogeneous group of complex disorders affecting the peripheral and central vestibular system. They represent a diagnostic challenge for the clinicians, and their genetic basis is largely not known. However, there are some cerebellar and vestibular disorders with a strong genetic background, such as episodic ataxia, spinocerebellar ataxia, vestibular migraine, Meniere's disease, and autosomal dominant nonsyndromic deafness. Furthermore, recent advances in next generation sequencing technique are increasing the number of novel genes associated with cerebellar and vestibular disorders. In this article, we have summarized clinical and molecular genetics findings in neuro-otology.

Efficacy of Plasma Exchange Therapy for Steroid-Unresponsive Neuromyelitis Optica

PURPOSE: To report the therapeutic efficacy of plasma exchange therapy on steroid-unresponsive neuromyelitisoptica (NMO) patients. CASE SUMMARY: Three patients who had not achieved improvement of visual acuity and visual field after high steroid pulse therapy after optic neuritis visited our clinic with decreasing visual acuity combined with eye pain in the other eye. All patients were diagnosed as neuromyelitisoptica (NMO) based on the presence of NMO-IgG antibody and optic nerve enhancing in contrast-enhanced orbital magnetic resonance imaging (MRI). Recurrent optic neuritis was observed. Steroid pulse retreatment was started but visual acuity was not improved in all patients. The patients received plasma exchange therapy, followed by immune suppression therapy. All patients showed improved visual acuity and restored visual field promptly without recurrence of neuromyelitisoptica. CONCLUSIONS: In case of steroid-unresponsive neuromyelitisoptica, plasma exchange should be promptly considered as the treatment of choice.

Clinical Manifestations and Treatment of Idiopathic Optic Perineuritis

PURPOSE: To investigate the clinical and radiologic manifestations of idiopathic optic perineuritis (OPN), and to evaluate the outcomes of steroid treatment for OPN. METHODS: We reviewed the medical records and radiologic findings of 10 patients (13 eyes) who were diagnosed with OPN and treated with steroid. RESULTS: The mean age was 56.5 +/- 9.3 years (range, 35-77 years) and the sex ratio was equal. The main complaint was decrease in visual acuity combined with ocular pain during extraocular eye movement in 9 patients. The median visual acuity at the first visit was 0.2 (HM-0.8) and the relative afferent papillary defect was observed in 12 eyes. Additionally, combined orbital diseases included posterior scleritis in 1 eye and myositis in 1 eye. Orbit magnetic resonance imaging (MRI) scans demonstrated intraorbital optic nerve sheath enhancement in all patients, occasionally with orbital fat involvement. All patients demonstrated improved visual acuity after high-dose oral steroid therapy (6 patients) or intravenous (IV) pulse steroid therapy (4 patients). Relapse occurred in 4 patients during steroid tapering. CONCLUSIONS: The population in this study was composed predominantly of patients with OPN in their 50's. The primary symptom of OPN was visual acuity decrease combined with ocular pain during extraocular eye movement. Radiologically, orbit MRI scans demonstrated intraorbital optic nerve sheath enhancement. The patients in this study demonstrated good responses to steroid treatment, but clinicians must be aware of the high recurrence rate during steroid tapering in this condition. A combination of clinical and radiologic findings was helpful to diagnose OPN.

Multiple Cerebral Infarction in Cogan's Syndrome / 대한평형의학회지

Cogan's syndrome is a rare chronic inflammatory disease Characterized by non-syphilitic keratitis and vestibuloauditory dysfunction. Although the precise pathogenesis of Cogan's syndrome is unknown, it is thought to develop from vasculitis involving multiple organ system. It can be accompanied with various systemic diseases including arthritis, lymphadenopathy, splenomegaly, and aortitis with insufficiency. We report a case of typical Cogan's syndrome with multiple cerebral infarctions.

Cerebellar Control of Saccades / 대한임상신경생리학회지

Saccades are rapid eye movements that shift the line of sight between successive points of fixation. The cerebellum calibrates saccadic amplitude (dorsal vermis and fastigial nucleus) and the saccadic pulse-step match (flocculus) for optimal visuo-ocular motor behavior. Based on electrophysiology and the pharmacological inactivation studies, early activity in one fastigial nucleus could be important for accelerating the eyes at the beginning of a saccade, and the later activity in the other fastigial nucleus could be critical for stopping the eye on target, which is controlled by inhibitory projection from the dorsal vermis. The cerebellum could monitor a corollary discharge of the saccadic command and terminate the eye movement when it is calculated to be on target. The fastigial nucleus and dorsal vermis also participate in the adaptive control of saccadic accuracy.

Recurrent Vertigo in Vestibular Schwannoma Responsive to Oxcarbazepine / 대한평형의학회지

Vestibular schwannoma (VS) are benign neoplasms that arise from Schwann cells of the eighth cranial nerve. Although progressive unilateral hearing loss with dizziness or disequilibrium provides a high suspicion index of VS, vertigo is the symptom causing the most pronounced negative effect on quality of life in patients with VS. We report a 55-year-old woman with recurrent paroxysmal vertigo and hyperventilation-induced nystagmus due to VS, which improved by oxcarbazepine treatment. We suggest that episodic vertigo in VS may be ascribed to the ectopic paroxysmal neuronal discharge from the partially demyelinated vestibular nerve due to tumor compression.

Isolated Body Lateropulsion as a Presenting Symptom of Lateral Medullary Infarction / 대한평형의학회지

Body lateropulsion is a common manifestation of lateral medullary infarction (LMI), and usually associated with vertigo, limb ataxia, sensory disturbance, and Horner's syndrome. However, isolated body lateropulsion as a presenting symptom of LMI is rare, and the responsible lesion for lateropulsion remains uncertain. We report a 71-year-old woman who showed isolated body lateropulsion as a presenting symptom of LMI. Ipsilateral body lateropulsion in our patient may be ascribed to the involvement of the ascending dorsal spinocerebellar tract rather than the descending lateral vestibulospinal tract, which runs more ventromedially.

A Case of Bilateral Horizontal Semicircular Canal Dysplasia with Normal Cochlea: Three Dimensional Volume Rendering Image Using MR CISS Sequence / 대한평형의학회지

Congenital inner ear malformations are frequently found in patients with sensorineural hearing loss, but isolated vestibular anomalies with normal cochlear development have been rarely reported. We report a 20-year-old man with recurrent dizziness and disequlibrium without hearing impairment. Neuro-otological evaluations showed a left peripheral vestibulopathy with normal hearing function. Three dimensional volume rendering image using magnetic resonance constructive interference in steady state sequence demonstrated isolated vestibular anomalies involving bilateral horizontal semicircular canals. Isolated vestibular anomalies might not be as rare as previously thought among patients with recurrent dizziness, and should be carefully evaluated through various imaging techniques.

Differential Immunohistological Features of Inflammatory Myopathies and Dysferlinopathy

This study was performed in order to characterize the types of the infiltrating cells, and the expression profiles of major histocompatibility complex (MHC) class I and membrane attack complex (MAC) in patients with inflammatory myopathies and dysferlinopathy. Immunohistochemical stains were performed using monoclonal antibodies against several inflammatory cell types, MHC class I, and MAC in muscles from inflammatory myopathies and dysferlinopathy. There was significant difference in the types of infiltrating cells between polymyositis (PM), dermatomyositis (DM), and dysferlinopathy, including significantly high CD4+/CD8+ T cell ratio and B/T cell ratio in DM. In dysferlinopathy, CD4+ T cells were the most abundant and the proportions of infiltrating cell types were similar to those of DM. MHC class I was expressed in muscle fibers of PM and DM regardless of the presence of inflammatory infiltrates. MAC was expressed in necrotic fibers and vessels of PM and DM. One patient with early stage DM had a MAC deposits on endomysial capillaries. In dysferlinopathy, MAC deposit was also observed on the sarcolemma of nonnecrotic fibers. The analysis of inflammatory cells, MHC class I expressions and MAC deposits may help to differentiate dysferlinopathy from idiopathic inflammatory myopathy.