PURPOSE: To evaluate the refractive predictability of a partial coherence interferometry (PCI) biometry device (IOL Master(R)) for cataract surgery and to investigate factors that may affect it. METHODS: Retrospective review of 209 eyes from 151 patients that had undergone preoperative PCI biometry and an uneventful phacoemulsification cataract surgery with posterior chamber intraocular lens (IOL) implantation was conducted. Prediction error defined as the intended refraction minus the postoperative refraction in spherical equivalent (SE) and the absolute error were analyzed according to IOL calculation formulas, patient characteristics, preoperative visual acuity (VA) and refraction, posterior subcapsular cataract (PSC), signal-to-noise ratio (SNR), and axial length (AL). RESULTS: The overall refractive predictability of the PCI device was good. Generally, the SRK/T formula performed better than the SRK-II formula. Refractive predictability was slightly worse in eyes with > or =+2.0 diopters (D) of preoperative SE (with both SRK-II and SRK/T) and in eyes with an AL< or =23.0 mm (only with SRK-II. No other factors significantly affected the refractive predictability of the PCI, although poor VA, dense PSC, and poor SNR were closely interrelated. CONCLUSIONS: The SRK/T formula performed significantly better than the SRK-II formula. Eyes with an AL< or =23.0 mm were associated with significantly greater hyperopic shifts in postoperative refraction with the SRK-II formula, but not with the SRK/T formula. A preoperative SE> or =+2.0D was related to a significantly greater hyperopic shift in postoperative refraction. With proper verification of measured data and a suitable IOL calculation formula, good refractive predictability is expected from PCI biometry regardless of patient characteristics, preoperative VA, SNR, PSC, and AL.
Aged ; Aged, 80 and over ; Female ; Humans ; Interferometry/*methods ; Lens Implantation, Intraocular ; *Lenses, Intraocular ; Light ; Male ; Phacoemulsification/*methods ; *Refraction, Ocular ; Refractive Errors/*diagnosis/physiopathology ; Reproducibility of Results ; Retrospective Studies ; Visual Acuity

PURPOSE: The purpose of the study was to identify levels of anxiety, stress hormone, lymphocytes, and neutrophils of the nursing students before an examination and to examine effects of social support on those variables related to taking examinations. METHODS: Thirty eight healthy nursing students participated. They completed the questionnaire including state anxiety, test anxiety (VAS scale) and social support two weeks before the exam and again just before the exam. Simultaneously, a venous sample for ACTH, cortisol, lymphocytes & neutrophils count was drawn by a trained nurse. Descriptive statistics, paired t-test, student t-test, and Pearson's correlation with SPSS/WIN 14.0 were used to analyze the data. RESULTS: Test anxiety scores and cortisol level on the exam day showed a significant increment compared with those on the non-exam day. The participants with higher levels of total social support scores showed significantly lower state anxiety on the exam day than those with lower levels of total social support scores. CONCLUSION: These data indicate a possible alteration in cortisol responsiveness to academic stress in nursing students. Social support would play an important role in modulation of academic stress.
Adrenocorticotropic Hormone ; Anxiety ; Humans ; Hydrocortisone ; Lymphocytes ; Neutrophils ; Students, Nursing ; Surveys and Questionnaires

PURPOSE: Authors develop a unified structural model that defines multirelationships between systematic factors causing excessive use of smartphones and the corresponding results. METHODS: A survey was conducted with adolescents who live in Seoul, Pusan, Gangneung, Donghae, and Samcheok from February to March 2016. Authors used SPSS, version 22.0, and AMOS, version 22.0, to analyze the survey results at a .05 significance level. To investigate demographic characteristics of the participants and their variations, descriptive analysis was used. The maximum likelihood estimate method was adopted to verify the fitness of the hypothetical model and the hypotheses therein. Authors used χ² statistics, goodness-of-fit index, adjusted goodness-of-fit index, comparative fit index, normed fit index, incremental fit index, root mean square residual, and root mean square error of approximation to verify the fitness of our structural model. RESULTS: (1) The proposed structural model demonstrated a fine fitness level. (2) The proposed structural model could describe the excessive use of a smartphone with 88.6% accuracy. (3) The absence of the family function and relationship between friends, impulsiveness, and low self-esteem were confirmed as key factors that cause an excessive use of smartphones. (4) Furthermore, impulsiveness and low self-esteem are closely related to the absence of family functions and relations between friends by 68.3% and 54.4%, respectively. CONCLUSION: Authors suggest that nursing intervention programs from various angles are required to reduce adolescents' excessive use of smartphones. For example, family communication programs would be helpful for both parents and children. Consultant programs about relationships with friends would also be helpful.
Adolescent ; Busan ; Child ; Consultants ; Friends ; Gangwon-do ; Humans ; Impulsive Behavior ; Likelihood Functions ; Methods ; Models, Structural ; Nursing ; Parents ; Self Concept ; Seoul ; Smartphone*

Since the coronavirus disease 2019 outbreak, telemedicine has become an important means of providing medical care worldwide. This study aims to highlight the implications of establishing telemedicine policies in Korea. Japan’s telemedicine policies were reviewed from the time of the first trial to the present official allowance.Current Concepts: Since telemedicine demonstration work began in 1971, telemedicine in Japan has advanced in four stages. The first stage was the operation of a remote regional comprehensive medical information system from 1971 to 1997. The second stage was when telemedicine was officially institutionalized from 1997 to 2018. The third stage was the time of expansion of telemedicine, from the announcement of the “Guidelines for the Implementation of Proper Online Care” in 2018 to when online first-time examinations were temporarily allowed in 2020. The fourth stage began in 2021 when the “Permanent Establishment of Special Cases for Online Care” was announced, and telemedicine has been officially allowed to supplement face-to-face care. Telemedicine usage was estimated to be about 53.65 million in 2021, and the total number of treatments in Japan in 2021 was estimated to be about 1.32 billion, accounting for about 4.1% of medical care.Discussion and Conclusion: For the Korean government to establish telemedicine, it needs to be promoted step by step through discussions with the medical community. Also, an appropriate medical remuneration system needs to be prepared along with guidelines reflecting the opinions of the medical community to secure the safety of telemedicine.

PURPOSE: To assess the clinical and functional outcome of the patients who underwent percutaneous vertebroplasty with bone cement for the osteoporotic compression fracture and who had been followed up for minimum 1 year. MATERIALS AND METHODS: Among 110 patients who had been undergone percutaneous vertebroplasty with bone cement for osteoporotic compression fracture in Gangneung Asan Hospital from January 2001 to August 2002, 75 patients who had been followed up for more than 1 year were selected. And retrospectively, we analyzed the clinical and radiographic finding of 1 year, 2 year and 3 year follow-up. The patients were divided into 3 groups, the first group who have follow-up period of the from 1 to 2 years had 75 patients, the second group who the from 2 to 3 years, 49 patients, and the third group who the more than 3 years, 20 patients. We graded the clinical results to excellent, good, normal, fair and poor. Also, we assessed the height of vertebral body, the adjacent vertebral body fracture and the leakage of bone cement. RESULTS: 74 patients (98.6%) had the excellent or good results postoperatively. 69 patients (92%) of the first group, 46 patients (93.8%) of the second group and 16 patients (80%) of the third group had excellent or good results at last follow-up. There was no statistical correlation of each groups (p>0.05). In first group, the average height of body was 71.1% preoperatively, 73.5% postoperatively and 73.5% at follow-up. In second group, 71.5%, 75.5%, and 73.1%. In third group, 71.2%, 78.0% and 77.8%. There was no significant statistical correlation of each groups (p>0.05). 47cases (38.8%) had some leakage of cement immediate postoperatively. In 4 cases (7 vertebra), there were adjacent vertebral body fractures. CONCLUSION: Based on the results of our study, percutaneous vertebroplasty is a useful method in the treatment for the osteoporotic compression fracture of vertebra body.
Chungcheongnam-do ; Follow-Up Studies* ; Fractures, Compression* ; Gangwon-do ; Humans ; Retrospective Studies ; Spine ; Vertebroplasty*

Objective: The purpose of this study is to report the activities of Disaster Medical Assistance Team and national emergency medical center in the fire at a women’s hospital on December 14, 2019, and to suggest an improvement plan for the special disastrous situation. Methods: We reviewed the transfer records of national emergency medical center, medical records of regional emergency medical center, and records of each patient’s prognosis of the women’s hospital, retrospectively. Triage of casualties was conducted according to SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) method. Results: The fire was extinguished early and there was no victim with significant carbon monoxide intoxication. Among 228 casualties, there were 143 patients of the women’s hospital. Two patients were classified as immediate, 55 patients including pregnant women, newborns, and mothers were classified as delayed, and 171 casualties including newborns and mothers were classified as minimal. Among 66 newborns, 40 newborns were transferred to the regional Emergency Medical Center, and a second triage was conducted by doctors there. Conclusion Although there was no significant victim, physically and socially susceptible people such as pregnant women, newborns, and mothers were included in this accident. We recommend establishing a standard of disaster response for special population and improving our capability at a national level.

PURPOSE: In-hospital cardiopulmonary resuscitation (CPR) is often performed on patients lying on a bed or stretcher, which involves using a step stool. However, as current CPR training uses mannequins placed on a floor, the quality of CPR in simulated cardiac arrest scenarios on a stretcher versus the floor were analyzed. METHODS: This study was performed during the Objective Structured Clinical Examination (OSCE) for sixth grade medical students. The students were trained using Basic Life Support (BLS) guidelines given by the American Heart Association (AHA) in 2010. Simulated CPR was performed in the 1 rescuer-mode (30:2 compression to ventilation ratio) for 5 cycles, while either standing atop a step stool beside the stretcher or kneeling on the floor, and the position order was randomized. The OSCE score and variables related to CPR quality were compared. RESULTS: Among the 59 students enrolled, 47 students were included for analysis. No significant difference in OSCE scores was found between the groups that performed CPR on a stretcher versus the floor (89.4+/-9.1 vs. 88.1+/-8.4, respectively, p=0.610). In addition, variables related to CPR quality did not differ between the groups that performed CPR on a stretcher versus the floor (following results listed respectively): correct compression rate (%) (54.8+/-42.3 vs. 70.0+/-34.9, p=0.185); compression rate (n/min) (127+/-11.3 vs. 126+/-13.3, p=0.792); correct depth (%) (69.8+/-40.6 vs. 78.6+/-33.6, p=0.429); mean compression depth (mm) (51.1+/-7.2 vs. 53.0+/-6.0, p= 0.337); correct release (%) (99.3+/-2.9 vs. 99.1+/-3.0, p=0.875); correct hand position (%) (83.2+/-32.3 vs. 86.7+/-27.5, p=0.694); total hands off time (sec.) (79.9+/-19.5 vs. 70.4+/-15.6, p=0.077). CONCLUSION: Medical students effectively perform CPR on a stretcher or the floor. Thus, current CPR training methods appear adequate and may be maintained.
American Heart Association ; Cardiopulmonary Resuscitation ; Clinical Competence ; Deception ; Education, Medical ; Hand ; Heart Arrest ; Humans ; Manikins ; Methods ; Students, Medical ; Thorax* ; Ventilation

PURPOSE: This study was performed to evaluate Korean nurses' knowledge about hereditary colorectal cancer (HCRC). METHODS: A modified 15-item HCRC knowledge questionnaire was developed based on previous research. One hundred and forty-eight nurses have completed the questionnaire from February to April, 2011. RESULTS: The average score of nurses' knowledge was 11.25+/-1.54. Ninety-seven percent of nurses knew about colonoscopy check up schedule and family pedigree. However, only 20% of nurses knew about the rate of passing on mutation genes to offspring and risk of developing CRC among carriers. Only 13.5% of nurses had previous genetic education experiences. Working in oncology units, taking care of CRC patients, and participating in genetic education were not associated with nurses' HCRC knowledge. CONCLUSION: Various factors influence nurses' knowledge about HCRC. Repeated study with larger national sample of nurses is recommended to identify the factors affecting nurses' knowledge level in order to develop efficient genetic education programs for HCRC patients and their families by nurses.
Appointments and Schedules ; Colonoscopy ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis ; Humans ; Pedigree ; Surveys and Questionnaires

Purpose: To compare the results of lacrimal syringing performed in clinical practice and under general anesthesia, and the clinical efficacy of lacrimal syringing under general anesthesia before endoscopic dacryocystorhinostomy and dacryoscintigraphy. Methods: The study included 148 eyes of 82 patients who underwent endoscopic dacryocystorhinostomy and silicone tube intubation from August 2018 to April 2019. The patients were examined with lacrimal syringing in clinical practice and re‐examined under general anesthesia. Based on the change in lacrimal syringing, the patients were assigned to inconsistent and consistent groups. The inconsistent group was subclassified into complete (‘regurgitation’ of lacrimal syringing changes to a ‘passage’ pattern) and partial improvement groups (the degree of regurgitation improves under general anesthesia). Results: Twenty (13.5%) eyes showed inconsistent results of lacrimal syringing performed in clinical practice and under general anesthesia; all showed improved passage under general anesthesia. The surgical results did not differ significantly (p = 0.336) between the consistent and inconsistent groups, but did between the complete and partial improvement groups (p < 0.01). Conclusions Lacrimal syringing under general anesthesia may enable an accurate preoperative diagnosis of the degree of obstruction. The combined results of dacryoscintigraphy and lacrimal syringing performed in clinical practice and under general anesthesia allow surgeons to evaluate the lacrimal drainage anatomy precisely and may be useful for predicting the functional success of endoscopic dacryocystorhinostomy.

Melittin-induced pain model has been known to be very useful for the study of pain mechanism. Melittin-induced nociceptive responses are reported to be modulated by the changes in the activity of excitatory amino acid receptor, calcium channel, spinal serotonin receptor and extracellular signaling-regulated kinase. The present study was undertaken to investigate the role of cyclooxygenase (COX) in the melittin-induced nociception. Changes in mechanical threshold, flinchings and paw thickness were measured before and after intraplantar injection of melittin in the rat hind paw. Also studied were the effects of intraperitonealy administered diclofenac (25 mg & 50 mg/kg), piroxicam (10 mg & 20 mg/kg) and meloxicam (10 mg & 20 mg/kg) on the melittin-induced nociceptions. Intraplantar injection of melittin caused marked reduction of mechanical threshold that was dose-dependently attenuated by non-selective COX inhibitor (diclofenac) and selective COX-1 inhibitor (piroxicam), but not by COX-2 inhibitor (meloxicam). Melittin-induced flinchings were strongly suppressed by non-selective COX and COX-1 inhibitor, but not by COX-2 inhibitor. None of the COX inhibitors had inhibitory effects on melittin-induced increase of paw thickness (edema). These experimental findings suggest that COX-1 plays an important role in the melittin-induced nociceptive responses.
Animals ; Calcium Channels ; Cyclooxygenase 1* ; Cyclooxygenase Inhibitors ; Diclofenac ; Melitten ; Nociception ; Phosphotransferases ; Piroxicam ; Prostaglandin-Endoperoxide Synthases ; Rats ; Receptors, Glutamate ; Serotonin