Purpose: To evaluate the reliability, validity, and usability of a mobile phone app that captures facial images to identify strabismus. Methods: We enrolled patients who visited our pediatric strabismus clinic and provided consent for participation in the study. The facial photographs of the patients were automatically captured by the app. The app used the photographs to identify ocular misalignment based on the comparison of the positions of the corneal reflex and limbus of both eyes. The results from the app were compared to the physician’s diagnosis. Intraclass correlation coefficients were used to assess the test-retest and interrater reliability of the app. Additionally, the guardians captured photographs of the patients through this app for 1 month at home to evaluate the frequency of manifest exotropia at home. And the results were compared to those of other strabismus control scales. Results: A total of 103 patients were enrolled and 10 patients were enrolled for the home control test. Based on the physician’s diagnosis, the sensitivity, specificity, positive predictive value, and negative predictive value of the app were 74.6%, 87.5%, 90.4%, and 68.6%, respectively. The interclass correlation coefficients for inter-rater and test-retest reliability were 0.801 (p = 0.011) and 0.828 (p < 0.001), respectively. The frequency of intermittent exotropia recorded by the app at home showed a strong positive correlation with other control scales (rho > 0.770, p = 0.009). Conclusions This mobile phone app is easily accessible and useful for the rapid determination and recording of strabismus, particularly in uncooperative patients. Also, this app may be used as a reliable indicator of the frequency of manifest strabismus at home.

PURPOSE: The purpose of this study was to identify effects of fatigue, depression and anxiety on quality of life in pregnant women with preterm labor. METHODS: With a survey design, data were collected from 138 mothers who were admitted at a hospital in Seoul, between June 2014 and September 2015. Instruments used to collect the data for the study were: Fatigue Continuum Form, Depression anxiety stress scale (DASS-21) and maternal postpartum quality of life (MAPP-QOL). RESULTS: The mean fatigue score was 68.30 with 50.7% of women being depressed and 79.7% of the 138 women being anxious. The mean quality of life was 18.92 with quality of life being associated with fatigue, depression and anxiety. Depression and fatigue explained 26% of the variance in quality of life. CONCLUSION: Depression and fatigue adversely affected women's quality of life. It is important to address appropriate management of depression and fatigue in order to improve quality of life in pregnant women with preterm labor.
Anxiety* ; Depression* ; Fatigue* ; Female ; Humans ; Mothers ; Obstetric Labor, Premature* ; Postpartum Period ; Pregnancy ; Pregnant Women* ; Quality of Life* ; Seoul

Mostly of the sudden deaths, except in-hospital death and death within 48 hours of discharge, are declared in the emergency department by emergency physician. The purpose of this study is to review the protocol of cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest by understanding the cause of sudden death from autopsy results. A retrospective analysis was performed by 48 months of medical records from emergency department of a tertiary hospital. The analysis was made from the patient group which gone through autopsy in the main office of National Institute of Scientific Investigation. In the emergency department, 1913 patients were declared death and 43 patients have received autopsy and 19 (1.0%) were natural death. 14 partients received CPR in the natural death group, and 13 were specified as cardiovascular disease. Result of this study represents the importance of prehospital CPR in case of unexpected cardiac arrest patients. However to generalize this result, all dead patients must go through autopsies for medical purpose which the frequency alse should be increased.
Autopsy ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Death, Sudden ; Emergencies ; Heart Arrest ; Humans ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Retrospective Studies ; Tertiary Care Centers

PURPOSE: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. METHODS: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. RESULTS: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70% of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury (38.0+/-18.56 vs. 34.5+/-33.68 days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. CONCLUSION: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.
Abscess ; Accidents, Traffic ; Decision Making ; Drainage ; Early Diagnosis ; Electronic Health Records ; Humans ; Length of Stay ; Neck ; Pancreas ; Shock, Septic

BACKGROUND: We describe the characteristics of malpractice claims related to central venous catheterization and identify causes and potential preventability of such claims. METHODS: A retrospective study was performed by reviewing records at Lawnb and Lx CD-rom. The records on closed malpractice claim related to central venous catheterization were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the factors associated with a successful defense. RESULTS: Twelve closed claim cases, related to central venous cathetertization were reviewed in the data for malpractice. Catheter-related complications were pneumothorax, hemothorax, cardiac tamponade, pyothorax, hematoma due to arterial puncture, pseudoaneurysm. Almost cases resulted in indemnity payment and verdict for patient. CONCLUSIONS: Although malpractice claims related to central venous catheterization were uncommon, they resulted in high rate and amount of indemnity payments. In pediatric patient, catheterization should be performed with attention. Clinicians should consider the underlying disease of patients and do any pretreatment if needed. Post-procedural radiologic confirmation can improve patient outcome and is also associated with decreased indemnity risk. Informed consent is also important.
Aneurysm, False ; Cardiac Tamponade ; Catheterization ; Catheterization, Central Venous* ; Catheters ; CD-ROM ; Central Venous Catheters* ; Empyema, Pleural ; Hematoma ; Hemothorax ; Humans ; Informed Consent ; Malpractice ; Pneumothorax ; Punctures ; Retrospective Studies

Purpose: Approximately 90% of the medical institutions in Korea are located in cities, so there is a disparity in medical resource distribution between urban and rural areas. In order to establish an equal healthcare system, it is necessary to understand the distribution and treatments offered by medical institutions and to investigate access to these facilities. In the present study, we investigated medical institutions offering ophthalmic examinations for children in Korea. Methods: The presence or absence of regional eye clinics and ophthalmologists in public health centers, public health offices, and military medical facilities were investigated in different cities and counties. In addition, the population status and ophthalmic facilities in vulnerable areas were investigated. Results: In the second quarter of 2021, there were 1,658 regional eye clinics in Korea located in Seoul, Gyeonggi, Busan, and Daegu, respectively. There were a total of 3,610 ophthalmologists in Seoul, Gyeonggi, Busan, and Daegu, respectively. Among the 250 counties, 20 did not have eye clinics while 13 did not have an ophthalmologist. The average time required to reach the closest eye examination center was 48.0 ± 38.1 minutes by car and 75.1 ± 40.0 minutes by public transportation. The total population in vulnerable areas was 558,336, including 28,358 children under the age of 10 years. Conclusions The present study identified vulnerable areas for eye examinations. Based on the findings, it is necessary to establish a healthcare system with improved accessibility, equity, and efficiency considering the importance of ophthalmic examinations in children and the elderly.

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.