PURPOSE: The purpose of this study was to explore the therapeutic communication experience of nurses in psychiatric wards.METHODS: Data were collected from 9 mental health nurses working at psychiatric wards in three university hospitals in Seoul and Gyeongju, South Korea. The study involved in-depth individual interviews, which were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.RESULTS: Therapeutic communication experiences of psychiatric ward nurses were categorized into 4 categories, 12 subcategories, and 24 codes. The four categories were ‘therapeutic communication practiced as a nurse’, ‘therapeutic communication delivered to patients’, ‘power revealed between patients and nurses’, and ‘environment surrounding therapeutic communication’. The twelve subcategories were ‘approaching with interest’, ‘with all one's heart and soul’, ‘learning and grow from peers’, ‘understanding the true meaning of mental health nursing’, ‘boosting in strength’, ‘providing a sense of security’, ‘formation of rapport’, ‘lead to recovery’, ‘variability of interaction’, ‘powerful energy originating from sparklet’, ‘lack of physical time’, and ‘absence of supervision’.CONCLUSION: The results of this study indicate the need to develop and apply therapeutic communication interventions for psychiatric nurses. Supervision is needed to promote therapeutic communication among psychiatric nurses and requires institutional support.
Gyeongsangbuk-do ; Heart ; Hospitals, University ; Humans ; Korea ; Mental Health ; Organization and Administration ; Psychiatric Nursing ; Qualitative Research ; Seoul

Purpose: We investigated the the effect of wearing a loose mask on tear-film break-up time using cross-sectional and experimental methods. Methods: This was a comparative analysis of non-invasive tear-film break-up time (NIBUT) after wearing no mask, loose mask, and tight mask for 10 minutes each in 60 eyes with or without dry eye syndrome. NIBUT measurements were performed using a keratograph. Results: The NIBUT values were 7.53 ± 0.83 seconds, 6.19 ± 0.78 seconds, and 7.36 ± 0.68 seconds for the no mask, loose mask, and tight mask groups, respectively. There was no significant difference between the no mask and tight mask groups (ρ-value = 0.517), but the loose mask group had a significantly reduced NIBUT compared with the other groups (ρ-value = 0.013 and 0.022, respectively). Conclusions Wearing a loose mask reduced the tear-film break-up time regardless of the presence or absence of dry eyes and may cause or worsen dry eye symptoms.

Purpose: To report two cases of cataract that progressed after COVID-19 mRNA vaccination.Case summary: Two patients visited our clinic with decreased visual acuity in the left eye that began after mRNA vaccine. A 40-year-old man visited our hospital with decreased visual acuity in the left eye that developed 1 week after injection of the second dose of mRNA-1273 (Moderna ® ,Cambridge, UK). A 40-year-old woman visited our clinic with decreased visual acuity in the left eye that occurred on day 46 after the injection of the third dose of BNT162b2 (Pfizer ® , New York, NY, USA). Neither case had any relevant ophthalmic history, and there was no clear optic neuropathy or retinopathy on fundus examination. After phacoemulsification and intraocular lens implantation, the best-corrected visual acuity improved, and intraocular pressure has remained stable. Conclusions The possibility of cataract development or progression after COVID-19 mRNA vaccine injection should be considered.

Purpose: This study evaluated the efficacy and safety of subconjunctival bevacizumab injection after primary pterygium surgery. Methods: We performed a conjunctivo-limbal autograft after pterygium resection in 136 eyes of 128 patients with primary pterygium between December 2019 and July 2021. A subconjunctival bevacizumab injection of 2.5 mg (0.1 mL) was administered in the bevacizumab group but not in the control group (54 eyes of 48 patients). We compared pterygium recurrence rates between the two groups at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months after surgery. Results: Pterygium recurrence occurred in one eye (1.21%) in the bevacizumab group and five eyes (9.25%) in the control group. Additionally, fibrovascular tissue proliferation was suppressed in the bevacizumab group and no postoperative complications were observed. Conclusions Pterygium recurrence occurred in one eye (1.21%) in the bevacizumab group and five eyes (9.25%) in the control group. Additionally, fibrovascular tissue proliferation was suppressed in the bevacizumab group and no postoperative complications were observed.

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the clinical value of preoperative planning via computer simulation by comparing preoperative and postoperative measurements of a patient with ankylosing spondylitis. SUMMARY OF LITERATURE REVIEW: Ankylosing spondylitis is a disorder that results in a spinal deformity because chronic inflammation at the ligament attachment sites triggers ossification; it causes round fixed kyphosis. This causes limitations in not only everyday life but also social interaction because it is impossible for patients to face forward. Therefore, surgical correction is necessary. MATERIALS AND METHODS: We analyzed 38 patients (41 instances) who underwent correctional osteotomy between June 2007 and March 2014 to treat kyphosis caused by ankylosing spondylitis. We chose the appropriate operation site on the basis of preoperative simulations of osteotomy and the site for pre- and postoperative radiological evaluations conducted from the lateral view in a standing position. For the clinical evaluation, Bath Ankylosing Spondylitis Function Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Hospital Anxiety and Depression Survey (HADS), and Health Locus of Control Form C Questionnaire (HLC-C) were used. RESULTS: The mean sagittal vertical axis (SVA) was improved from 123.4 mm to 66.1 mm, the mean thoracic kyphosis angle (TKA) changed from 42.2degrees to 40.1degrees, and the mean lumbar lordosis angle (LLA) improved from 16.0degrees to 28.5degrees. The correlation coefficients between the preoperative predictive value and the postoperative radiographic measurement were 0.43, 0.93, and 0.87, which were all statistically significant. CONCLUSIONS: By comparing the preoperative measurement with the postoperative radiologic score, we found that the two were correlated and that the clinical assessment improved on the basis of the visualization. Therefore, preoperative simulation of patients with ankylosing spondylitis along with a kyphotic deformity is thought to be clinically effective.
Animals ; Anxiety ; Axis, Cervical Vertebra ; Baths ; Computer Simulation ; Congenital Abnormalities ; Depression ; Humans ; Inflammation ; Internal-External Control ; Interpersonal Relations ; Kyphosis ; Ligaments ; Lordosis ; Osteotomy* ; Surveys and Questionnaires ; Retrospective Studies ; Spondylitis, Ankylosing*

Proximal junctional kyphosis (PJK) is a common radiographic finding after long spinal fusion. A number of studies on the causes, risk factors, prevention, and treatment of PJK have been conducted. However, no clear definition of PJK has been established. In this paper, we aimed to clarify the diagnosis, prevention, and treatment of PJK by reviewing relevant papers that have been published to date. A literature search was conducted on PubMed using "proximal junctional", "proximal junctional kyphosis", and "proximal junctional failure" as search keywords. Only studies that were published in English were included in this study. The incidence of PJK ranges from 5% to 46%, and it has been reported that 66% of cases occur 3 months after surgery and approximately 80% occur within 18 months. A number of studies have reported that there is no significantly different clinical outcome between PJK patients and non-PJK patients. One study showed that PJK patients expressed more pain than non-PJK patients. However, recent studies focused on proximal junctional failure (PJF), which is accepted as a severe form of PJK. PJF showed significant adverse impact in clinical aspect such as pain, neurologic deficit, ambulatory difficulties, and social isolation. Numerous previous studies have identified various risk factors and reported on the treatment and prevention of PJK. Based on these studies, we determined the clinical significance and impact of PJK. In addition, it is important to find a strategic approach to the proper treatment of PJK.
Diagnosis* ; Epidemiology ; Humans ; Incidence ; Kyphosis* ; Neurologic Manifestations ; Risk Factors ; Social Isolation ; Spinal Fusion

STUDY DESIGN: Case report. OBJECTIVES: To report a case of progressive kyphotic deformity after spinal fusion in a patient with diffuse idiopathic skeletal hyperostosis (DISH). SUMMARY OF LITERATURE REVIEW: DISH is characterized by spinal and peripheral enthesopathy, and is a completely different disease from ankylosing spondylitis (AS). Though DISH can be associated with thoracic kyphosis, no reports have described a progressive thoracolumbar kyphotic deformity after spinal fusion surgery in a DISH patient. MATERIALS AND METHODS: A 47-year-old male presented with pain in the thoracolumbar region. After excluding the possibility of AS and confirming the diagnosis of DISH, we performed spinal fusion for the treatment of a T11-T12 flexion-distraction injury. The kyphotic deformity was found to be aggravated after the first operation, and we then performed corrective osteotomy and additional spinal fusion. Results: The kyphotic deformity of the patient was corrected after the second operation. RESULTS: The kyphotic deformity of the patient was corrected after the second operation. CONCLUSIONS: In DISH patients in whom AS must be excluded in the differential diagnosis, a kyphotic deformity can become aggravated despite spinal fusion surgery, so regular and continuous follow-up is required.
Congenital Abnormalities* ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Kyphosis ; Male ; Middle Aged ; Osteotomy ; Rheumatic Diseases ; Spinal Fusion* ; Spondylitis, Ankylosing

Huntington's disease is a neurodegenerative disorder with an autosomal dominant inheritance pattern. Patients with Huntington's disease show an increased risk of aspiration pneumonia when the pharyngeal muscle is invaded. We report a case of advanced-stage Huntington's disease in which the patient received right middle lobectomy for a lung abscess caused by repeated aspiration. The best lung isolation technique has not yet been established in these patients. We successfully performed selective lobar isolation of the right lower and middle lobes using a double lumen tube and a Fogarty embolectomy catheter.
Catheters* ; Embolectomy ; Humans ; Huntington Disease ; Inheritance Patterns ; Lung ; Lung Abscess ; Neurodegenerative Diseases ; One-Lung Ventilation ; Pharyngeal Muscles ; Pneumonia, Aspiration

STUDY DESIGN: Retrospective study. OBJECTIVES: To compare serum vitamin D levels in elderly patients with or without osteoporotic spinal compression fractures (OSCFs) and to identify relationships between the serum vitamin D level and other variables, such as age, bone mineral density (BMD), and bone turnover markers (osteocalcin and C-telopeptide). SUMMARY OF LITERATURE REVIEW: Vitamin D plays a key role in calcium metabolism in the bone tissue. Vitamin D deficiency can lead to decreased BMD and an increased risk of falls and of osteoporotic fractures. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 95 elderly patients (≥60 years) with OSCFs (fracture group) and 118 subjects who had been diagnosed with osteoporosis without OSCFs (control group). Serum vitamin D levels were contrasted between the two groups taking into account other factors such as patient age, sex, and seasonal variations. For all the patients, we also evaluated the correlation between the vitamin D level and the patient age, BMD, and bone turnover markers. RESULTS: The mean of the serum 25(OH) vitamin D3 levels was significantly lower in the fracture group than in the control group. There were significant differences in the 25(OH) vitamin D3 levels in autumn. In all patients, the mean serum 25(OH) vitamin D3 levels were the highest in autumn and the lowest in spring. Furthermore, the mean serum 25(OH) vitamin D3 levels were significantly correlated with patient age and BMD. CONCLUSIONS: A low serum vitamin D level might be a risk factor of OSCFs in elderly patients.
Aged ; Bone and Bones ; Bone Density ; Calcitriol ; Calcium ; Case-Control Studies* ; Cholecalciferol ; Fractures, Compression ; Humans ; Medical Records ; Metabolism ; Osteoporosis ; Osteoporotic Fractures ; Retrospective Studies ; Risk Factors ; Seasons ; Spinal Fractures ; Spine* ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of intradural disc herniation (IDH) around conus medullaris. SUMMARY OF LITERATURE REVIEW: IDH is rare with an incidence of less than 1% of all lumbar disc herniations. It is important to differentiate IDH from other condition with accurate diagnosis and subsequent surgical treatment. IDH has a higher risk of neurologic deficit, like conus medullaris syndrome and cauda equina syndrome. MATERIALS AND METHODS: A 62 year-old male was affected by lumbar back pain radiating to the anterolateral aspect of the right thigh for 5 days. MRI showed a mass that existed on the anterior portion of the conus medullaris. We performed partial laminectomy at the L1-L2level. The mass located anteriorly in the intradural space was eliminated after durotomy by a posterior approach. RESULTS: We confirmed the IDH for histopathology. CONCLUSIONS: IDH usually needs accurate differential diagnosis. Preoperative MRI scans are necessary to differentiate IDH from other intradural lesions. The confirmative diagnosis can be done only in the operative field.
Back Pain ; Conus Snail ; Diagnosis ; Diagnosis, Differential ; Humans ; Incidence ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Polyradiculopathy ; Spinal Cord Compression ; Thigh