Purpose: To evaluate changes in central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) after phacovitrectomy over a 2-year period in idiopathic epiretinal membrane (ERM) patients. Methods: The records of 52 idiopathic ERM patients (52 eyes) who underwent phacovitrectomy, without recurrence of the condition over a 2-year follow-up period, were reviewed retrospectively. Changes in CMT and SFCT, as measured by optical coherence tomography, were analyzed and compared with those of a normal control group over a 2-year period. Results: The mean preoperative CMT and SFCT were 425.67 ± 84.67 and 257.56 ± 90.13 μm, respectively. Postoperative CMT was reduced significantly to 372.17 ± 45.26 μm at 1 year and 363.15 ± 47.35 μm at 2 years (p < 0.001). SFCT at 1 and 2 years postoperatively was significantly reduced to 238.85 ± 84.85 and 230.31 ± 87.95 μm, respectively (p < 0.001). In the control group, there was no significant change in CMT; however, the SFCT decreased by 11.09 ± 22.36 μm during the 2-year follow-up (p = 0.007). In contrast, in the patient group, CMT and SFCT decreased by 62.52 ± 71.45 and 27.25 ± 41.97 μm, respectively, showing a significant difference from the control group (p < 0.001 and p = 0.043, respectively). Both before surgery and at 1 year postoperatively, the thinner the CMT, the better the best-corrected visual acuity (BCVA) (p = 0.010 and p = 0.018, respectively). A better postoperative BCVA at 2 years was associated with a thinner CMT and better BCVA before surgery (p < 0.001 and p < 0.001, respectively). Conclusions Following a phacovitrectomy procedure, ERM patients showed significant reductions in both the CMT and SFCT at the 2-year follow-up.

PURPOSE: The purpose of this study was to review and synthesize the existing literature on the experience of nursing students in simulation. METHODS: A systematic review was undertaken using meta-ethnography. Eight databases were searched up to January 2014 for peer-reviewed studies, written in Korean and English, that reported primary data, used identifiable and interpretative qualitative methods, and offered a valuable contribution to the synthesis. RESULTS: Nine studies were identified, with quality appraisal undertaken. Three key concepts were generated: ambivalence of simulation practice, learning by reflection, and building up of the competency as a future nurse. Six sub-concepts emerged: double sidedness of simulation setting; feeling ambivalence of simulation; learning from others; learning from self-reflection; improvement of confidence by role experience; and internalization of nursing knowledge. A line of argument has been developed based on the themes generated. CONCLUSION: The findings from this qualitative synthesis and other related literature indicated the importance of capability of educator and extension of the simulation system to facilitate effective simulation-based education.
Education ; Humans ; Learning ; Nursing ; Students, Nursing

Purpose: The purpose of this study was to investigate the influence of e-health literacy in patients with chronic diseases on their healthcare provider-patient communication. Methods: The participants were 184 patients with chronic illnesses admitted to a general hospital. Using a structured-questionnaire, data were collected from December 1 to 31, 2018.Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple linear regression with IBM SPSS/WIN 22.0. Results: Healthcare provider-patient communication was positively correlated with e-health literacy (r=.87, p <.001). Factors influencing healthcare provider-patient communication were e-health literacy (β=.87, p <.001), subjective health statues (β=.17, p =.011), health concerns (β=-.15, p <.001), number of questions during the hospital treatment (β=.14, p=.003), and education (β=-.14, p =.048). The input variables explained 70.8% of healthcare provider-patient communication. Conclusion The results of this study suggest that healthcare providers should provide reliable online health information to patients and encourage health-oriented attitudes in order to communicate about health information that patients obtained from online.

Purpose: To report a case of papillophlebitis treated with an intravitreal bevacizumab injection in an adolescent patient.Case summary: A 15-year-old female with no medical history presented with a 3-day history of blurred vision and a floating sensation. The initial visual acuity (VA) was 0.0 logarithm of minimal angle of resolution (logMAR) in the left eye. A fundus examination revealed a blurry disc margin, peripapillary hemorrhage, and venous engorgement. Optical coherence tomography indicated subretinal fluid (SRF) accumulation. Both color vision and pupillary reactions were normal in bilateral eyes. Blood tests revealed no significant abnormalities. Brain magnetic resonance imaging (MRI) showed mild focal papillitis, but the patient did not report eye movement pain or discomfort. The diagnosis was papillophlebitis; however, high-dose steroid treatment was not initiated due to the absence of a significant decrease in VA. A single injection of intravitreal bevacizumab was administered to address the SRF. At the 9-month follow-up, VA remained at 0.0 logMAR, and the retina demonstrated anatomical stabilization after complete absorption of the SRF without recurrence. Conclusions Papillophlebitis can manifest during adolescence. Treatment of a 15-year-old patient with intravitreal bevacizumab obviated the need for high-dose steroid therapy and produced favorable outcomes, including preservation of VA and anatomical stabilization of the retina.

PURPOSE: The objective of this retrospective study was to identify predictive factors for the complete pathologic response and tumor downstaging after preoperative concurrent chemoradiotherapy for locally advanced rectal cancer. MATERIALS AND METHODS: Between the years 2000 and 2008, 39 patients with newly diagnosed rectal cancer without prior evidence of distant metastasis received preoperative concurrent chemoradiotherapy followed by surgery. The median radiation dose was 50.4 Gy (range, 45~59.4 Gy). Thirty-eight patients received concurrent infusional 5-fluorouracil and leucovorin, while one patient received oral capecitabine twice daily during radiotherapy. RESULTS: A complete pathologic response (CR) was demonstrated in 12 of 39 patients (31%), while T-downstaging was observed in 24 of 39 patients (63%). N-downstaging was observed in 18 of 28 patients (64%), with a positive node in the CT scan or ultrasound. Two patients with clinical negative nodes were observed in surgical specimens. The results from a univariate analysis indicated that the tumor circumferential extent was less than 50% (p=0.031). Moreover, the length of the tumor was less than 5 cm (p=0.004), while the post-treatment carcinoembryonic antigen (CEA) levels were less than or equal to 3.0 ng/mL (p=0.015) and were significantly associated with high pathologic CR rates. The univariate analysis also indicated that the adenocarcinoma (p=0.045) and radiation dose greater than or equal to 50 Gy (p=0.021) were significantly associated with high T-downstaging, while a radiotherapy duration of less than or equal to 42 days (p=0.018) was significantly associated with N-downstaging. The results from the multivariate analysis indicated that the lesser circumferential extent of the tumor (hazard ratio [HR], 0.150; p=0.028) and shorter tumor length (HR, 0.084; p=0.005) independently predicted a higher pathologic CR. The multivariate analysis also indicated that a higher radiation dose was significantly associated with higher T-downstaging (HR, 0.115; p=0.025), while the shorter duration of radiotherapy was significantly associated with higher N-downstaging (HR, 0.028; p=0.010). CONCLUSION: The circumferential extent of the tumor and its length was a predictor for the pathologic CR, while radiation dose and duration of radiotherapy were predictors for tumor downstaging. Hence, these factors may be used to predict outcomes for patients and to develop further treatment guidelines for high-risk patients.
Adenocarcinoma ; Chemoradiotherapy ; Neoplasm Metastasis ; Rectal Neoplasms

PURPOSE: To determine the possible effects of chronic exposure of low dose benzalkonium chloride (BAK) on trabecular meshwork cells, and to characterize the pathways involved in the effects. METHODS: Trabecular meshwork cells were treated with 0.0005%, 0.00075%, 0.001%, and 0.0025% BAK for 10 minutes; then, the cells were transferred to a new medium for 24 hours. This process was repeated three times. Cell survival was assessed using the MTT assay to determine the non-apoptotic BAK concentration. Senescence-associated (SA)-β-gal staining was performed to compare quantitatively the cellular senescence of BAK-treated cells with the control group. Cells treated with BAK were analyzed by western blot to determine whether the expressions of cell cycle regulators were affected. RESULTS: Two concentrations (0.0005% and 0.00075%) showed persistent cell viability and were chosen for further experiments. After SA-β-gal staining, cells treated with 0.0005% and 0.00075% BAK showed 28% (± 2.08), 37% (± 2.08) increases in cellular senescence expression, respectively, when compared with control cells (p < 0.05). To identify the molecular pathways involved in cell cycle arrest via BAK, western blot analysis was performed on trabecular meshwork cells, resulting in decreased expressions of cyclin E/CDK2, and increased expressions of the upper stream control molecules, p53 and p21. CONCLUSIONS: Chronic exposure to low dose BAK accelerated cell senescence through cell cycle arrest. Because senescent cells of the trabecular meshwork can inhibit its outflow pathway function and ultimately worsen the glaucomatous process, long-term usage of topical glaucoma medications containing BAK should be conducted with caution.
Aging ; Benzalkonium Compounds ; Blotting, Western ; Cell Aging ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Survival ; Cyclins ; Glaucoma ; Rivers ; Trabecular Meshwork

Three Stener-like lesions of the metacarpophalangeal joint of the fingers and a rupture of the first dorsal interosseous muscle mimicking the lesion in the index finger were observed. Two cases in the little fingers had a true Stener's lesion. In one case in the index finger, the ruptured ligament was retracted and located under the intact sagittal band, which was also observed by preoperative magnetic resonance imaging (MRI). Rupture of the first dorsal interosseous muscle was misdiagnosed preoperatively as a Stener's lesion in the index finger by ultrasonography. MRI should be an essential differential diagnostic exam for collateral ligament ruptures of the metacarpophalangeal joint of the fingers.
Collateral Ligaments ; Fingers* ; Ligaments ; Magnetic Resonance Imaging ; Metacarpophalangeal Joint* ; Rupture ; Ultrasonography

OBJECTIVES: Radiation therapy has multiple roles in the treatment of meningioma although surgery remains the primary treatment of choice. In this retrospective study, we report the results of radiation therapy for meningioma as definitive, postoperative or salvage therapies. METHODS: Seventeen patients diagnosed with meningioma were treated with radiation therapy in our institute from May 2000 to October 2009. Radiation therapies were performed as definitive therapies in 8 patients, as postoperative therapies in 5 and as salvage therapies in 4. Nine patients received stereotactic radiosurgery (SRS), 2 patients fractionated stereotactic radiotherapy (FSRT), and 5 patients 3-dimensional conformal radiotherapy (3DCRT). Radiation dose were 12 to 20 Gy for SRS, 36 Gy in 9 fractions for FSRT and 50.4 Gy in 28 fractions for 3DCRT. Follow-up imaging study of computed tomography or magnetic resonance imaging was performed at 6 to 12 months intervals and neurologic exam was performed with an interval less than 6 months. RESULTS: The median follow-up duration was 38 months (range, 12 to 85 months). Tumor progression after radiation therapy developed in one patient. The reduction of tumor volume measured on follow-up images were more than 20% in 4 patients and minimal change of tumor volume less than 20% were observed in 12 patients. Peritumoral edema developed in 4 patients and disappeared without any treatment. One patient had radiation necrosis. CONCLUSION: Our experience is consistent with the current understanding that radiotherapy is as an effective and safe treatment modality for meningiomas when the tumor cannot be resected completely or when recurred after surgery.
Brain Edema ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Radiosurgery ; Radiotherapy* ; Radiotherapy, Conformal ; Retrospective Studies ; Salvage Therapy ; Tomography, X-Ray Computed ; Tumor Burden

Confirming the direct link between neural circuit activity and animal behavior has been a principal aim of neuroscience. The genetically encoded calcium indicator (GECI), which binds to calcium ions and emits fluorescence visualizing intracellular calcium concentration, enables detection of in vivo neuronal firing activity. Various GECIs have been developed and can be chosen for diverse purposes. These GECI-based signals can be acquired by several tools including two-photon microscopy and microendoscopy for precise or wide imaging at cellular to synaptic levels. In addition, the images from GECI signals can be analyzed with open source codes including constrained non-negative matrix factorization for endoscopy data (CNMF_E) and miniscope 1-photon-based calcium imaging signal extraction pipeline (MIN1PIPE), and considering parameters of the imaged brain regions (e.g., diameter or shape of soma or the resolution of recorded images), the real-time activity of each cell can be acquired and linked with animal behaviors. As a result, GECI signal analysis can be a powerful tool for revealing the functions of neuronal circuits related to specific behaviors.
Animals ; Behavior, Animal ; Brain ; Calcium Channels ; Calcium ; Carisoprodol ; Endoscopy ; Fires ; Fluorescence ; Ions ; Microscopy ; Neuronal Calcium-Sensor Proteins ; Neurons ; Neurosciences ; Statistics as Topic

Purpose: This study was conducted to explore the relationships among new nurses’ meaning of work, organizational commitment, professional self-image, and retention intention through path analysis. Methods: The participants were 872 nurses with less than a year of clinical experience working at general or tertiary hospitals over 500 beds in Korea. The data were collected using structured questionnaires from May 15, 2021 to June 28, 2021, and analysis was conducted using SPSS/WIN 22.0 and AMOS 21.0 programs. Results: Retention intention was explained by meaning of work, organizational commitment, and professional self-image, its explanatory power was 46.5%. The mediating effect of professional self-image was found on the relationship between meaning of work and retention intention. Conclusion To encourage the retention intention among new nurses, an environment where new nurses can set a high value on the meaning of work and sense of accomplishment should be created, and a strategy to improve organizational commitment and professional self-image should be established.