Orthokeratology is the way to correct the myopia or astigmatism by flattening or the central cornea with specialty lenses. The range of correction is from − 2.50 to − 4.00 diopters after 10 days of fitting. The designs is constructed with flat base curve radius, steep reverse curve, flat alignment curve, and peripheral curve. This multi-cuve design enabled the orthokeratology lenses to stay on the cornea stably and effectively. Recently, the application of orthokeratology is extending to hyperopia and presbyopia. In the future, the amount of correction and the application of orthokeratology will increase more and more.
Astigmatism ; Cornea ; Hyperopia ; Myopia ; Presbyopia ; Prescriptions* ; Radius

OBJECTIVE: This study aims to develop the web-interface creator, which automatically changes the Case Report Form(CRF) web page when the protocol developer in any clinical study revises the ontology of CRF. METHODS: This study established the conceptual model of CRF on oriental and western medicine, and developed ontologies. A program was developed to produce online-based a input form through the parser that generates automatically HTML script from OWL. RESULTS: The CRF applied in this study is a draft through consensus of experts for stroke research at the Korea Institute of Oriental Medicine. The ontology of CRF consisted of Label, ControlType and Value classes and hasControl, hasValue and hasSymptoms properties. The Label is the class of question items groups, so it could have CRF questionnaire instances. The ControlType is the class that expresses controls such as checkbox, text, etc in the HTML script. The Value class represents selections for each items. Finally, the HTML script was created by XSL transformation from the OWL script. CONCLUSION: Online-based automatic interface creation, which enables immediate coping with the continuous change in the medical knowledge system, assures reduced time requirement.
Consensus ; Korea ; Medicine, East Asian Traditional* ; Strigiformes ; Stroke

Milwaukee shoulder syndrome (MSS) is a rare disease in which joints are destroyed and occurs mainly in elderly women. We describe rapidly progressive MSS with complete destruction of the shoulder joint within 2 months. An 80-year-old woman visited the outpatient clinic with shoulder pain for 2 weeks. rotator cuff tear arthropathy was diagnosed, and nonsteroidal anti-inflammatory drugs were prescribed. Two months later, her shoulder pain worsened without trauma. Shoulder swelling and tenderness, and arm lifting inability were observed. Complete humeral head disruption was observed by radiography. We diagnosed MSS based on the presence of serohematic and noninflammatory joint effusion, periarticular calcific deposits, and rapid joint destruction, and initiated conservative treatment. When initially treating elderly patients with shoulder arthropathy, it is advisable to perform short-term follow-up and to consider the possibility of crystal-induced arthropathy.
Aged ; Aged, 80 and over ; Ambulatory Care Facilities ; Arm ; Female ; Follow-Up Studies ; Humans ; Humeral Head ; Joints ; Lifting ; Radiography ; Rare Diseases ; Rotator Cuff ; Shoulder Joint ; Shoulder Pain ; Shoulder ; Tears

Background: and purpose: The anti-aging standard forest healing program (ASFHP), which uses forest therapy, was reported to be effective in improving psychological, physical, and cognitive functions. However, there are several challenges to directly visiting the forest. This study aimed to investigate the impact of multi-session ASFHP with forest visit on the mental and physical health of the older people with visits to forest facilities and compared them with those of the same program conducted indoors. Methods: Individuals aged over 70 years with concerns about cognitive decline were recruited at dementia relief centers and divided into control and experimental groups. A total of 33 people were administered ASFHP under the supervision of a forest therapy instructor. The control group stayed indoors, while the experimental group visited a forest healing center and repeated the program 20 weeks. Results: The multiple-session ASFHP positively affected cognitive impairment screening test (CIST) total scores (p=0.002), memory (p=0.014), Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status total scores (p<0.001), immediate recall (p=0.001), visuospatial/construction (p<0.001), language (p<0.001), forest healing standard questionnaire total scores (p=0.002), and cognitive function (p=0.019), regardless of location. The forest visits during the ASFHP showed positive effects on orientation (p=0.035), delayed recall (p=0.042), emotional stability (p=0.032), physical activity (p=0.005), and health (p=0.022). The CIST scores of the memory domain were the strongest indicator of the multiple-session ASFHP effects. Conclusions The 20-week multi-session ASFHP with forest visit showed effects on cognitive improvement and physical and emotional stability compared to indoor education.

Atherosclerosis and its complications are often reported in patients with connective tissue diseases (CTDs) showing chronic inflammation. Traditional cardiovascular risk factors do not account for accelerated atherosclerosis in patients with CTDs. Inflammation, although non-traditional, is considered one of the risk factors for endothelial dysfunction, atrial stiffness, and atherosclerosis. Therefore, it is essential to evaluate other risk factors for cardiovascular disease (CVD) in patients with CTDs. The interest in pulse wave analysis (PWA) is growing because of its predictive value for CVD. The arterial pressure waveform is a composite of an incidental wave produced by a ventricular contraction and a reflected wave. The wave reflection can be quantified using the augmentation index (AIx); it is defined as the difference between the inflection and peak systolic pressure, and expressed as a percentage of the pulse pressure. The PWA is represented by AIx. Risk score systems, such as the Framingham scoring system, were correlated with AIx. Many studies have analyzed the ability of the AIx to predict the CAD severity in the general population. In patients with CTDs, the AIx was found to increase compared to a healthy control group. The AIx was related to the activity of CTDs. The treatment for inflammation appeared to improve the AIx in some CTDs. Although more studies will be needed to obtain conclusive evidence, AIx is expected to be a prognostic factor or a risk factor for CVD in patients with CTDs.
Arterial Pressure ; Atherosclerosis ; Blood Pressure ; Cardiovascular Diseases ; Connective Tissue Diseases* ; Connective Tissue* ; Humans ; Inflammation ; Pulse Wave Analysis ; Risk Factors

OBJECTIVES: The purpose of this study was firstly to introduce a Participatory Action-Oriented Training (PAOT) program for the prevention of work-related musculoskeletal diseases (WRMSDs) in Small and Medium sized Enterprises in the Gumi Industrial Zone, and secondly to assess its effect. METHODS: Two PAOT workshops to prevent WRMSDs were conducted with 39 volunteer participants from 10 companies selected (on a first-come, first-served basis) among 200 small- or medium-sized enterprises in Gumi. These companies had been provided with mandatory occupational health management agency services for Small and Medium sized Enterprises by an occupational medicine clinic. Each workshop consisted of 6 technical sessions and one closing ceremony. At the 1st session, the principles of each action checklist item were explained and an on-site checklist exercise was carried out. The 2nd to 5th sessions presented good example pictures on 4 subjects: material storage and handling, working environment, work organization and work-related welfare. Group discussions were carried out by the participants. In the final 6th session on the implementation of improvement, each participant was asked to present 6 action plans, 3 short-term and 3 long-term, for their own workplace improvement. RESULTS: Overall, the participants worked out 47 real action plans, 27 short-term and 20 long-term, for improvement of their own workplaces. Three to 6 months after the workshops, through in-person visits to each company, it was confirmed that more than half of these 47 plans had been completed; 25 plans (53.2%) had been completed as planned, 8 (17.0%) were in processing, and 14 (29.8%) had not yet been put into practice. CONCLUSIONS: The study findings confirmed that the PAOT program holds strong potential as an intervention method to prevent WRMSDs in Small and Medium sized Enterprises, although the final results have not been fully assessed yet.
Checklist ; Education ; Gyeongsangbuk-do ; Musculoskeletal Diseases ; Occupational Health ; Occupational Medicine ; Volunteers

Arterial thoracic outlet syndrome (TOS) causes ischemic symptoms; it is the rarest type, occurring in 5% of all TOS cases. This paper is a case report of a 38-year-old male patient diagnosed with arterial TOS, displaying symptoms of acute critical limb ischemia caused by thromboembolism. Brachial artery of the patient has been diffusely damaged by repeated occurrence of thromboembolism. It was thought to be not enough only decompression of subclavian artery to relieve the symptoms of hand ischemia; therefore, bypass surgery using reversed great saphenous vein was performed.
Adult ; Brachial Artery ; Decompression ; Extremities ; Hand ; Humans ; Ischemia ; Male ; Saphenous Vein ; Subclavian Artery ; Thoracic Outlet Syndrome* ; Thromboembolism ; Vascular Grafting

BACKGROUND: Upper limb ischemia is less common than lower limb ischemia, and relatively few cases have been reported. This paper reviews the epidemiology, etiology, and clinical characteristics of upper limb ischemia and analyzes the factors affecting functional sequelae after treatment. METHODS: The records of 35 patients with acute and chronic upper limb ischemia who underwent treatment from January 2007 to December 2012 were retrospectively reviewed. RESULTS: The median age was 55.03 years, and the number of male patients was 24 (68.6%). The most common etiology was embolism of cardiac origin, followed by thrombosis with secondary trauma, and the brachial artery was the most common location for a lesion causing obstruction. Computed tomography angiography was the first-line diagnostic tool in our center. Twenty-eight operations were performed, and conservative therapy was implemented in seven cases. Five deaths (14.3%) occurred during follow-up. Twenty patients (57.1%) complained of functional sequelae after treatment. Functional sequelae were found to be more likely in patients with a longer duration of symptoms (odds ratio, 1.251; p=0.046) and higher lactate dehydrogenase (LDH) levels (odds ratio, 1.001; p=0.031). CONCLUSION: An increased duration of symptoms and higher initial serum LDH levels were associated with the more frequent occurrence of functional sequelae. The prognosis of upper limb ischemia is associated with prompt and proper treatment and can also be predicted by initial serum LDH levels.
Angiography ; Brachial Artery ; Embolism ; Epidemiology ; Follow-Up Studies ; Humans ; Ischemia* ; L-Lactate Dehydrogenase ; Lower Extremity ; Male ; Prognosis ; Retrospective Studies ; Thrombosis ; Upper Extremity*

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease of unknown etiology, which affects skins, joints and other parts of body. Retinopathies associated SLE occur in 3.3% to 28% of cases, the incidence rising with the severity of systemic disease, and generally are found late in the disease. The most common findings described are cotton wool spots, retinal hemorrhages, and optic disc edema. We report two cases of SLE who had retinopathies as early manifestation of disease.
Edema ; Incidence ; Joints ; Lupus Erythematosus, Systemic* ; Retinal Hemorrhage ; Retinal Vasculitis ; Retinaldehyde* ; Skin ; Wool

PURPOSE: Opioid-based intravenous patient-controlled analgesia (IV-PCA) is a popular method of postoperative analgesia, but many patients suffer from PCA-related complications. We hypothesized that PCA was not essential in patients undergoing major abdominal surgery by minimal invasive approach. METHODS: Between February 2013 and August 2013, 297 patients undergoing laparoscopic surgery for colorectal cancer were included in this retrospective comparative study. The PCA group received conventional opioid-based PCA postoperatively, and the non-PCA group received intravenous anti-inflammatory drugs (Tramadol) as necessary. Patients reported their postoperative pain using a subjective visual analogue scale (VAS). The PCA-related adverse effects and frequency of rescue analgesia were evaluated, and the recovery rates were measured. RESULTS: Patients in the PCA group experienced less postoperative pain on days 4 and 5 after surgery than those in the non-PCA group (mean [SD] VAS: day 4, 6.2 [0.3] vs. 7.0 [0.3], P = 0.010; and day 5, 5.1 [0.2] vs. 5.5 [0.2], P = 0.030, respectively). Fewer patients in the non-PCA group required additional parenteral analgesia (41 of 93 patients vs. 53 of 75 patients, respectively), and none in the non-PCA group required rescue PCA postoperatively. The incidence of postoperative nausea and vomiting was significantly higher in the non-PCA group than in the PCA group (P < 0.001). The mean (range) length of hospital stay was shorter in the non-PCA group (7.9 [6-10] days vs. 8.7 [7-16] days, respectively, P = 0.03). CONCLUSION: Our Results suggest that IV-PCA may not be necessary in selected patients those who underwent minimal invasive surgery for colorectal cancer.
Analgesia ; Analgesia, Patient-Controlled* ; Colorectal Neoplasms* ; Humans ; Incidence ; Laparoscopy* ; Length of Stay ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Retrospective Studies