PURPOSE: To investigate the accuracy of Orbscan system in measuring corneal thickness before refractive surgery, the authors conducted a comparative study of Orbscan system and ultrasonic pachymeter in their agreement and repeatability. METHODS: 84 patients (168 eyes) who were examined between December, 2000 and March, 2001 were divided into two groups: those who exceeded -6.00 D, and those who did not. Orbscan and ultrasonic pachymeter were employed. Correlation and regression were analyzed to assess their agreement. The repeatability was measured by analyzing mean, standard deviation, and 95% confidence interval of each method. RESULTS: The average central corneal thickness was 542.3+/-34.2micro meter by Orbscan system, and 528.6+/-29.7micro meter by ultrasonic pachymeter. Correlation coefficient was nearly 1 between them, and therefore we obtained statistically significant linear regression equation. In the analysis of repeatability, 95% confidence interval of Orbscan system was -17.2micro meter~+11.8micro meter which was superior to the interval of ultrasonic pachymeter (-23.2micro meter~+14.4micro meter). CONCLUSION: Orbscan system measurements of corneal thickness was greater than ultrasonic pachymeter measurements by 9 to 19 m. Because Orbscan system also showed superiority in repeatability, it may be a useful method in the clinical field.
Humans ; Linear Models ; Refractive Surgical Procedures ; Ultrasonics

PURPOSE: This study was conducted to assess the effects of lights-out at nighttime on body weight, physiological variables, and behavioral status in premature infants and to provide basic data for applying lights-out at night time in premature infants. METHODS: Premature infants of over 32 weeks' corrected age were included in this study (January 2015-June 2015), and were allocated to two groups according to the lights-out at night for 5 hours: study group and control group. Lights-out was applied to the study group from midnight for five hours in a quiet environment. RESULTS: Fifty-two infants were included in the study: 26 in the study group and 26 in the control group. Growth rates of body weight, height, and head circumference were higher in the study group compared to the control group, but there were no statistical differences. In the physiological variables, heart rate decreased by 6.9 beats per minute in the study group, but it increased by 2.7 beats per minute in the control group (P<0.0001) during applied 5 hours at night. Anderson Behavioral State Score decreased in the study group compared to the control group (P=0.042). CONCLUSION: Lights-out at night decreased the heart rate and made the behavioral status more stable. To understand the effects of lights-out on long-term growth and development of premature infants at the highest risk of delayed growth and development, further studies with a larger number of premature infants are needed.
Body Weight* ; Circadian Rhythm ; Growth and Development ; Head ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature*

OBJECTiVE We investigate the effects of multiple attempts of embryo transfer because of retained embryos in the catheter and of contaminated mucus on the transferred catheter. MATERiALS AND METHODS: We respectively analysed data between November 1998 and August 2002 from 305 patients of 369 cycles who underwent iVF-ET. Of these patients, 47 patients of 50 cycles (Group 2) were required multiple trial of embryo transfer. They were compared with an age-matched control groups (Group 1) with female factor infertility. Pearson's c2 and Fisher's tests were used to compare proportions between discrete variables. Non-categorical data were compared using t-test. Statistical significance was set at p<0.05. RESULTS: Embryos were significantly more likely to be retained when catheter was contaminated with mucus (Group 1: 22.4%; Group 2: 44.0%). The clinical pregnancy rates, however, for the contaminated mucus or not, were 46.8%, 43.5% respectively. There was no significant difference clinical pregnancy rate between those who had all their embryos transferred at the first attempt (45.4%) and those who required more than one attempt (48.0%). CONCLUSiONS: Contaminated mucus in the catheter is associated with failed embryo transferred at the first attempt. Embryo transfers, however, that are repeated attempts do not adversely affect pregnancy rates following iVF-ET.
Catheters ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization* ; Humans ; Infertility ; Mucus* ; Pregnancy Rate* ; Pregnancy*

Multiple pulmonary nodules were found in a 71-year-old Korean female patient with cutaneous squamous cell carcinoma during diagnostic work-up. A presumptive diagnosis of metastases was made and percutaneous fine needle aspiration cytology was undertaken. Finally, pathological examination of the tissue revealed granulomatous inflammation with cryptococcal infection. The patient received 6 months of antifungal treatment with fluconazole and her chest radiographic findings were improved after the treatment. She is now under clinical follow-up. Recognition that pulmonary cryptococcal infection can mimic metastasis is important in reaching the correct diagnosis and in determining the correct treatment.
Aged ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell* ; Cryptococcosis* ; Cryptococcus ; Diagnosis ; Female ; Fluconazole ; Follow-Up Studies ; Humans ; Inflammation ; Multiple Pulmonary Nodules ; Neoplasm Metastasis* ; Radiography, Thoracic

Coccidioidomycosis is a systemic infection caused by inhalation of airborne spores of Coccidioides immitis, a fungus found in soil in the southwestern area of United States and in parts of Mexico and South America. Although its human infection has not been reported infrequently in nonendemic areas, it has rarely been done in Korea since first report of a case of systemic coccidioidomycosis with cutaneous lesions. The patient was a 32-year-old male with granulating cutaneous nodules on left side of upper back for 1 month. Three months ago, he had stayed at northern area of Mexico for 2 months with mild transient upper respiratory symptoms during his stay. After he returned to Korea, cervical lymphadenopathy and skin lesions developed. He had also respiratory symptoms such as chest discomfort and mild chest pain and chest X-ray revealed a solitary nodule. The cutaneous nodules of walnut size were removed surgically and he was recieved daily oral medication of itraconazole 400 mg for 10 months showing good clinical response. Even though lung nodule was not disappeared in radiological exam, repeated CT guided biopsy and fungal tissue culture of lung nodule were undertaken with no growth throughout 10 months. After 10 months itraconazole therapy, there was no evidence of clinical relapse and no change on chest film for following 16 months. We report a case of disseminated coccidioidomycosis involving lung, skin and lymph node simmultaneously and successfully treated with both surgical excision and systemic antifungal therapy.
Adult ; Biopsy ; Chest Pain ; Coccidioides ; Coccidioidomycosis* ; Fungi ; Humans ; Inhalation ; Itraconazole ; Juglans ; Korea ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Male ; Mexico ; Recurrence ; Skin ; Soil ; South America ; Spores ; Thorax ; United States

Incidence of nontuberculous mycobacterium (NTM) pulmonary disease is increasing with the wider recognition and development of diagnostic technology. Mycobacterium kansasii is the second most common pathogen of NTM pulmonary disease in human immunodeficiency virus (HIV)-infected patients. However in Korea, the incidence of M. kansasii pulmonary disease is relatively low, and there has been no report of M. kansasii pulmonary disease with bronchial involvement in HIV patients, to the best of our knowledge. We report a case of M. kansasii pulmonary disease presenting with endobronchial lesions in an HIV-infected patient complaining of chronic cough with bilateral enlargements of hilar lymph nodes on chest X-ray.
Bronchial Diseases ; Cough ; HIV ; Humans ; Incidence ; Korea ; Lung Diseases* ; Lymph Nodes ; Mycobacterium kansasii* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Thorax

A 35-year-old male patient with heart and renal failure and pneumonia was transferred to our department due to recurrent cardiac standstill with syncope. He had been diagnosed as and treated for MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) syndrome for the past 3 years. Electrocardiography (ECG) showed the Wolff-Parkinson-White pattern, and an echocardiogram showed hypertrophic cardiomyopathy. He developed syncopal attacks intermittently, and ECG monitoring showed intermittent bradycardia. His Holter monitoring showed several episodes of 5-16 seconds of sinus arrest. We conducted an electrophysiological study to evaluate the arrhythmia. During atrial and ventricular extra-stimuli, cardiac standstill developed several times, and the duration of pauses varied from 2.5 to 5.5 seconds. Abrupt asystolic events also developed accompanying syncopal attacks that were not related to the extra-stimuli. We decided to implant a permanent pacemaker. The patient's syncopal episodes disappeared after implantation of a DDD type pacemaker.
Acidosis, Lactic ; Arrhythmias, Cardiac ; Bradycardia ; Cardiomyopathy, Hypertrophic ; Dichlorodiphenyldichloroethane ; Electrocardiography ; Electrocardiography, Ambulatory ; Heart ; Humans ; Male ; MELAS Syndrome ; Muscular Diseases ; Pacemaker, Artificial ; Pneumonia ; Renal Insufficiency ; Sinus Arrest, Cardiac ; Syncope

Cryptococcosis is an invasive fungal infection, which is more common in immunocompromised patients. However, pulmonary cryptococcosis can occur in immunocompetent patients and should be considered on a differential diagnosis for nodular or mass-like lesions in chest radiograph. Recently, we experienced a patient with pulmonary cryptococcosis, successfully treated with oral fluconazole therapy. A 74-year-old female patient was referred for an evaluation of abnormal images, a large consolidative mass with multiple nodular consolidations and small nodules that mimics primary lung cancer with multiple lung to lung metastases. Computed tomography-guided lung biopsy confirmed the diagnosis of pulmonary cryptococcosis. The follow-up image taken after 4 months with oral fluconazole treatment showed marked improvement.
Aged ; Biopsy ; Cryptococcosis ; Diagnosis, Differential ; Female ; Fluconazole ; Follow-Up Studies ; Humans ; Immunocompromised Host ; Lung ; Lung Neoplasms ; Multiple Pulmonary Nodules ; Neoplasm Metastasis ; Thorax

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.
Actinomycosis* ; Communicable Diseases ; Cough ; Empyema* ; Fever ; Fibrosis ; Humans ; Infusions, Intravenous ; Lung ; Middle Aged ; Necrosis ; Penicillin G ; Pleural Effusion ; Sulfur ; Tomography, X-Ray Computed

OBJECTIVES: This cross-sectional study investigated the relationship between job stress and psychosocial stress among nurses at a university hospital in Incheon, Korea. METHODS: A questionnaire survey was administered to 476 nurses, of which 320 (67.2%) questionnaires were returned and 299 (62.8%) were regarded as containing reliable data for analyses. A structured self-reported questionnaire was used to assess each respondent's sociodemographics, sleep quality, physical burden, job stress and psychosocial stress. Seven domains of occupational stress (e.g., Job demand, Insufficient job control, Interpersonal conflict, Job insecurity, Lack of reward, Organizational system and Occupational climates) according to the Korean Occupational Stress Scale (KOSS) were used and psychosocial stress was measured using Dr. Chang's PWI-SF (Psychosocial Well-being Index-Short Form). We estimated the relation of job stress to psychosocial stress using univariate and logistic regression analyses. RESULTS: The logistic regression analyses indicated that the groups with high stress in 'Insufficient job control' (OR=2.67, 95% C.I.=1.37-5.23), 'Interpersonal conflict' (OR=2.32, 95% C.I.=1.19-4.51), 'Job insecurity' (OR=2.51, 95% C.I.=1.17-5.36), 'Organizational system' (OR=2.80, 95% C.I.=1.39-5.63), and 'Lack of reward' (OR=2.98, 95% C.I.=1.55-5.74) were more likely to experience high psychosocial stress. CONCLUSIONS: Our results tend to suggest that job stress is associated with psychosocial stress. The importance of job stress should be acknowledged and stress management programs need to be instigated to minimize the psychosocial stress caused by job stress.
Cross-Sectional Studies ; Incheon ; Korea ; Logistic Models ; Questionnaires ; Reward