Purpose: To report recurrent idiopathic choroidal neovascularization (CNV) in an adolescent.Case summary: A 14-year-old male presented with reduced vision in the right eye, 3 weeks in duration. His best-corrected visual acuity (BCVA) was 0.2. He lacked any medical or ocular history, any family history of retinal disease, and any trauma history. Autorefraction yielded a spherical equivalent of -4.75 diopters. Neither posterior staphyloma nor myopic macular degeneration was apparent in a fundus photograph. However, the photograph revealed a greyish foveal lesion with a subretinal hemorrhage, but was otherwise unremarkable. Optical coherence tomography and fluorescein angiography revealed foveal CNV with a subretinal hemorrhage and fluid. As no feature known to cause CNV was apparent, we diagnosed idiopathic CNV and prescribed right-eye intravitreal ranibizumab injections. After treatment, the BCVA became 1.0, but the CNV continued to recur; he has received 26 intravitreal ranibizumab injections over the last 47 months. Conclusions Most idiopathic CNVs in adolescents are well-treated with fewer injections. However, CNV can continue to recur; multiple intravitreal injections and careful monitoring may be required.

Purpose: The results of the Hahn Chun Suk color test (Hahn test) and the Farnsworth-Munsell D-15 test (D-15 test) were compared in patients with acute optic neuritis. Methods: Patients with acute optic neuritis evaluated using both the Hahn and D-15 tests in the acute phase and 2 months later were evaluated. The results of the acute phase tests were compared. Correlations were sought between color deficiency and all of visual acuity, the visual field index (VFI), and the severity of optic disc edema. Changes in the test results 2 months later were also evaluated and correlated with other visual functions. Results: Twenty-seven eyes of 22 patients were enrolled. The mean patient age was 49.4 years and the logarithm of the minimum angle of resolution visual acuity 0.5. In the acute phase, the perception number was 10.06 in the Hahn test. On the D-15 test, the ‘strong’ grade predominated (40.7%). The concordance rates of severity and type were 55.6 and 54.5% between the two tests. In 9 of 12 eyes exhibiting inconsistent severity, the D-15 test afforded better results than did the Hahn test. A significant positive correlation was evident between the Hahn test results and visual acuity (r = 0.560, p = 0.002). The mean deviation (MD) and the VFI also correlated with the results of the Hahn test (r = -0.432, p = 0.027 for the MD; r = -0.517, p = 0.007 for the VFI). The D-15 test results correlated only with visual acuity (r = 0.476, p = 0.012). After 2 months, the results of both tests correlated significantly only with visual acuity. Conclusions In the acute phase, the concordances of the Hahn and D-15 test results were 55.6% in terms of severity and 54.5% in terms of type. The Hahn test results correlated with the visual acuity and VFI. In contrast, the D-15 test results correlated with visual acuity only.

ESWL has become the most widely advocated procedure for urinary calculi because of its minimal invasiveness and high effectiveness. Unfortunately, so far most urologist use push-up or push-down technique in the treatment of mid ureter stone with ESWL. Herein, we tried in situ ESWL with ultrasonographic targeting system (Lithostar ultra, Siemens Co., Germany) in 74 mid ureter stone patients. We could target the stone in 71 out of 74 patients (71/74, 95.6%) in semilateral position in the patients with upper half of mid ureter stone or in supine position in the patients with lower half of mid ureter stone The stone was successfully removed in sixty eight patients and the success rate was 9l.1% (68/ 74). The number of treatment session was 1 to 5 (mean 1.3+/-0.8) and the duration was 20-150 minutes (mean 46.4+/-19.7 minutes). Complications were gross hematuria in 5 cases(7.0%), severe colicky pain in 2 cases (2.8%). In conclusion, we think in situ ESWL with ultrasonographic targeting system is a recommendable treatment of modality in mid ureter stone patients.
Abdominal Pain ; Hematuria ; Humans ; Supine Position ; Ureter* ; Urinary Calculi

PURPOSE: The purpose of this study was to identify the influence of nurses' emotional intelligence and communication within the organization on teamwork in Armed Forces hospitals. METHODS: This study employed a cross-sectional design with a convenience sample of 195 nurses from five Armed Forces hospitals in Korea. Data were collected through a self-administered questionnaire from August 7 to 23, 2017 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. The SPSS/WIN 21.0 program was used for all analyses. RESULTS: The degree of teamwork was 5.03±0.73, with scores ranging from 1 to 7. Emotional intelligence and communication within the organization were positively correlated with teamwork. Specifically, communication within the organization (β=.60, p < .001), the intensive care unit (β=.21, p=.001), and the medical general ward (β=.17, p=.010) were identified as factors influencing teamwork. This model explained 51% of the variance in teamwork, and it was statistically significant (F=35.09, p < .001). CONCLUSION: These results imply the need to develop an approach including communication within the organization to improve teamwork among nurses in Armed Forces hospitals.
Arm ; Emotional Intelligence ; Intensive Care Units ; Korea ; Patients' Rooms

PURPOSE: The purpose of this study was to identify the influence of nurses' emotional intelligence and communication within the organization on teamwork in Armed Forces hospitals. METHODS: This study employed a cross-sectional design with a convenience sample of 195 nurses from five Armed Forces hospitals in Korea. Data were collected through a self-administered questionnaire from August 7 to 23, 2017 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. The SPSS/WIN 21.0 program was used for all analyses. RESULTS: The degree of teamwork was 5.03±0.73, with scores ranging from 1 to 7. Emotional intelligence and communication within the organization were positively correlated with teamwork. Specifically, communication within the organization (β=.60, p < .001), the intensive care unit (β=.21, p=.001), and the medical general ward (β=.17, p=.010) were identified as factors influencing teamwork. This model explained 51% of the variance in teamwork, and it was statistically significant (F=35.09, p < .001). CONCLUSION These results imply the need to develop an approach including communication within the organization to improve teamwork among nurses in Armed Forces hospitals.

Objective: Peripheral vertigo is one of the most common causes of the emergency department (ED) visits. It can impair balance and might predispose patients to injuries after discharge. The purpose of this study was to determine whether peripheral vertigo is associated with an increased risk of trauma. Methods: This matched-cohort study used the nationally representative dataset of de-identified claim information of 1 million randomly sampled individuals from a real Korean population, from 2002 to 2013. The exposure cohort included patients who visited EDs for new-onset peripheral vertigo without prior or concurrent injury. Each patient was randomly matched to five unexposed individuals (also without previous injury) by incidence density sampling. The primary outcome was a new injury within 1 year. The secondary outcomes were various injury subtypes. The time-dependent effect of the exposure was modeled using the extended Cox model. Age, sex, comorbidities, and household income level were included as covariates. Results: A total of 776 and 3,880 individuals were included as the exposure and comparison cohorts, respectively. The risks of trunk injury and upper extremity injury were significantly higher in the exposure cohort. Extended Cox models with multivariable adjustment showed significantly increased risk for up to 1 year, with the first 1-month; 1 month to 3 months; and 3 months to 1 year hazard ratios of 5.23 (95% confidence interval [CI], 2.83–9.64); 1.50 (95% CI, 1.02–2.20); and 1.37 (95% CI, 1.11–1.68), respectively. Conclusion Patients visiting EDs for acute peripheral vertigo are at a higher risk of a new injury for up to a year.

PURPOSE: The aim of this study was to determine whether or not the 1-hour pad test demonstrates the objective severity of female stress urinary incontinence. MATERIALS AND METHODS: One hundred eighteen female patients with stress urinary incontinence symptom were prospectively evaluated with a 1-hour pad test as recommended by the International Continent Society and they also underwent videourodynamics to determine the ALPP. The patients were divided into 2 groups by the ALPP: group A (n=94) was the low leak point pressure group (ALPP< or=100cmH2O), and group B (n=24) was the high leak point pressure group (ALPP>100cmH2O or no leakage). A pad gain < or=2g was considered a negative pad test. Student's t-test was done to evaluate the difference of urine leakage between the two groups. RESULTS: The mean amount of urine leakage measured by the 1-hour pad test for groups A and B were 53.4+/-47.2 and 50.9+/-53.9g, respectively, and there was no statistically significant differences between two groups (p=0.839). Eighteen (15.2%) women did not leak during the ALPP measurement and 6 (5.1%) women had a negative pad test. Among the 18 women with no leakage on the ALPP, 15 had a positive pad test and 3 had a negative pad test. Among the 6 women with a negative pad test, 3 had leakage and 3 had no leakage during the ALPP measurement. One hundred fifteen patients received an operation for stress urinary incontinence. The three patients who had no leak on the ALPP and who also had a negative pad test did not receive the operation. CONCLUSIONS: These data suggest that the 1-hour pad test did not demonstrate the objective severity of stress urinary incontinence. However, the 1-hour pad test was more sensitive to demonstrate leakage than the ALPP; therefore, in the case of no leakage during the ALPP measurement, the 1-hour pad test is needed to check the leakage.
Female ; Humans ; Incontinence Pads ; Prospective Studies ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

In this paper, we reviewed domestic and foreign cases and evaluation methods for validation of sleep products for development of the domestic sleep industry. Foreign companies and organizations are trying to verify products relatively systematically for demonstration purposes, but they are using different methods depending on the institution, and standardized validation guidelines have not been established. In Korea, there has been little evaluation including objective verification for sleep products. Sleep-wake evaluation for validation of sleep products requires expert evaluation of the product and of the product effectiveness by users, and subjective and objective sleep-wake evaluations and circadian rhythm evaluation methods can be used. For more accurate verification, experimental designs such as randomization method, control product utilization method, and cross-experiment design can be used.

In this paper, we reviewed domestic and foreign cases and evaluation methods for validation of sleep products for development of the domestic sleep industry. Foreign companies and organizations are trying to verify products relatively systematically for demonstration purposes, but they are using different methods depending on the institution, and standardized validation guidelines have not been established. In Korea, there has been little evaluation including objective verification for sleep products. Sleep-wake evaluation for validation of sleep products requires expert evaluation of the product and of the product effectiveness by users, and subjective and objective sleep-wake evaluations and circadian rhythm evaluation methods can be used. For more accurate verification, experimental designs such as randomization method, control product utilization method, and cross-experiment design can be used.

PURPOSE: Because of the disappointing long-term results of transvaginal bladder neck suspension surgery for anatomical incontinence (AI), a pubovaginal sling, which was formerly operated for sphincteric incontinence (SI), was used to treat AI. The results of the pubovaginal sling for treating AI and the risk factors that affect the result were evaluated. MATERIALS AND MTHODS: A total 39 women with AI underwent a pubovaginal fascial sling using a strip of autologous rectus muscle fascia. The urethral sphincteric function was assessed by measuring the Valsalva leak point pressure. Fifteen patients has type I and 24 patients type II stress incontinence. The results of the pubovaginal sling were compared with those of 51 women who received the Raz precedure. The risk factors for the pubovaginal fascial sling were evaluated. RESULTS: The success rate of an autologous pubovaginal sling (95.6%) at mean follow-up period of (21 months) was significantly higher than that of the Raz bladder neck suspension (80.4%) during the same follow-up period (p<0.05). The success rate of the Raz procedure - 80.4%, 70.8% and 60.7% at 21, 36, 72 months - was decreased after months. The predictive factors for the pubovaginal sling - the number of deliveries, history of hystectomy, the type of stress incontinence, cystocele, urge incontinence, and age - had no significant effect on the success rate of the pubovaginal sling (p<0.05). CONCLUSIONS: A pubovaginal fascial sling may be an effective surgical treatment not only for treating sphincteric incontinence but also anatomical incontinence.
Cystocele ; Fascia ; Female* ; Follow-Up Studies ; Humans ; Neck ; Risk Factors* ; Urethra ; Urinary Bladder ; Urinary Incontinence, Urge