PURPOSE: To evaluate the changes of electroretinographic responses according to the lens opacity type and severity in cataract patients with normal retina. METHODS: Retrospective study was performed on 79 eyes of 79 patients who had undergone electroretinograms (ERG) before cataract surgery. The patients with high myopia, diabetes mellitus, hypertension or glaucoma were excluded. Cataracts were classified using Lens Opacities Classification System III (LOCS III). Whether the ERG results are different according to the location and severity of lens opacity was analyzed. RESULTS: Marked reduction in amplitude and delay in implicit time were observed in mature cataracts. Amplitudes of a- and b-wave were reduced significantly, especially a-wave in maximal combined response and b-wave in rod response (P<0.01). Among the 4 groups, excluding the mature opacity, amplitude was reduced in posterior subcapsular opacity. Implicit times were also delayed, but not significant. CONCLUSIONS: Lens opacity, especially posterior subcapsular opacity affects the ERG results significantly. These findings should be considered in evaluating the retinal abnormalities in patients with cataract.
Cataract* ; Classification ; Diabetes Mellitus ; Glaucoma ; Humans ; Hypertension ; Myopia ; Retina ; Retinaldehyde ; Retrospective Studies

PURPOSE: To evaluate the results of amblyopia on multifocal electroretinogram (mfERG). METHODS: The mfERG procedure was performed on nineteen monocular amblyopic patients (age ranged from 7 to 42 years) using the VERIS(TM) (EDI, San Mateo, CA) system. The central 30 degrees of ocular fundus were stimulated by an array of 103 hexagonal elements for four minutes. The responses of six concentric rings (rings 1 to 6) radiating from the foveal center were averaged, and the latencies and amplitudes of N1, P1 and N2 were compared with the findings of the normal contralateral eyes. The mfERG procedure was recorded again after improvement of vision in one patient (No. 4) who underwent occlusion treatment for one month. RESULTS: There were no significant differences of N1, P1 and N2 latencies between normal contralateral and amblyopic eyes (P>0.05). However, P1 amplitudes of the amblyopic eyes were reduced significantly compared with those of the normal contralateral eyes on rings 1 and 2 (P<0.05). N1 and N2 amplitudes of the amblyopic eyes were also reduced, but not significantly. After the successful occlusion treatment of patient No. 4, the responses of the amblyopic eye were improved but not the level of the contralateral normal eye. CONCLUSIONS: These results suggest that amblyopia may cause some changes in mfERG responses, especially in terms of amplitudes of the central retina. Further investigation is needed to determine whether these results are due to the physiologic change(s) of the amblyopia itself or to fixation instability during the test.
Amblyopia ; Humans ; Retina

PURPOSE: The purpose of this research was to evaluate the application of the Problem-Based Learning(PBL) in nursing with regard to the learning process and learning outcomes. METHOD: PBL modules were provided to the students so that they could identify the nursing problems related to nutrition, regulation, and elimination, and implement appropriate nursing interventions according to the problems. PBL was also used to develop ability to use self-evaluation for nursing intervention outcomes. The modules were developed by the authors for the course, Nursing 1(3 credits) at Y university, and used during one semester, March to June 2003. Evaluation of the learning process and learning outcomes was done by self-report questionnaires and a semi-structured self-report developed by the authors. RESULT: The PBL evaluation included role of the facilitators, group work process, and self-directed learning attitude. The students evaluated the facilitator's role positively in fostering positive interactions and cooperative study among students and stimulating students to apply various problem-solving strategies. Students evaluated their own group work performances as a good opportunity to improve their group work participation, contribution, cooperation, and leadership through the PBL session. Their responsibility for their own learning and develop self-directed learning attitudes to connect present learning to long-term goals. CONCLUSION: Critical thinking, problem solving skills, self-directed learning and group work accomplishments in undergraduate student nurses were fostered and improved through the PBL program.
Diagnostic Self Evaluation ; Foster Home Care ; Humans ; Leadership ; Learning ; Nursing* ; Problem Solving ; Problem-Based Learning* ; Thinking ; Child Health ; Surveys and Questionnaires

The formation of advanced glycation end products (AGEs) has been considered to be a potential causative factor of injury to lens epithelial cells (LECs). Damage of LECs is believed to contribute to cataract formation. The purpose of this study was to investigate the cytotoxic effect of AGEs on LECs both in vitro and in vivo. We examined the accumulation of argpyrimidine, a methylglyoxal-derived AGE, and the expression of apoptosis-related molecules including nuclear factor-kappaB (NF-kappaB), Bax, and Bcl-2 in the human LEC line HLE-B3 and in cataractous lenses of Zucker diabetic fatty (ZDF) rats, an animal model of type 2 diabetes. In cataractous lenses from twenty-one-week-old ZDF rats, LEC apoptosis was markedly increased, and the accumulation of argpyrimidine as well as subsequent activation of NF-kappaB in LECs were significantly enhanced. The ratio of Bax to Bcl-2 protein levels was also increased. In addition, the accumulation of argpyrimidine triggered apoptosis in methylglyoxal-treated HLE-B3 cells. However, the presence of pyridoxamine (an AGEs inhibitor) and pyrrolidine dithiocarbamate (a NF-kappaB inhibitor) prevented apoptosis in HLE-B3 cells through the inhibition of argpyrimidine formation and the blockage of NF-kappaB nuclear translocalization, respectively. These results suggest that the cellular accumulation of argpyrimidine in LECs is NF-kappaB-dependent and pro-apoptotic.
Animals ; Apoptosis/*drug effects ; Cell Line ; Epithelial Cells/*cytology/*drug effects ; Glycosylation End Products, Advanced/*pharmacology ; Lens, Crystalline/*cytology ; Male ; Ornithine/*analogs & derivatives/pharmacology ; Pyrimidines/*pharmacology ; Pyruvaldehyde/*chemistry ; Rats

OBJECTIVE: To investigate the neuroanatomical correlation of conduction aphasia by analyzing neuroimage data of patients who were diagnosed as conduction aphasia after stroke. METHOD: Nine patients with conduction aphasia after stroke were retrospectively reviewed with their medical records. Language functions of patients were assessed by Korean-version Western Aphasia Battery (K-WAB). Stroke lesions were assessed by brain computed tomography or magnetic resonance images taken within 1 month after onset of stroke. RESULTS: The stroke subtypes were cerebral infarction in 5 patients and intracranial hemorrhage in 4 patients. The lesions were located in left hemisphere in 8 subjects and right hemisphere in 1 subject. The left hemispheric lesion were located in the insula and superior temporal lobe in 3, the inferior parietal lobe in 2, the corona radiate in 1, the basal ganglia in 1 patient and both corona radiata and basal ganglia in 1. The right hemispheric lesion was located in the inferior parietal and superior temporal lobe. CONCLUSION: 6 of 9 patients with conduction aphasia had brain lesions in the path of arcuate fasciculus in the left hemisphere, however, 3 of 9 patients showed other brain lesions. These findings suggested that conduction aphasia could be caused by heterogeneous brain lesions. The characteristic features of conduction aphasia according to diverse brain lesions may need further investigation.

The clinical practice guideline for the stroke rehabilitation was formulated through both extensive review of published literature and consensus meeting of the specialists. The purposes of this study were to provide optimum practical guideline for acute and subacute stroke rehabilitation and to enhance the quality of stroke rehabilitation team in Korea. This guideline contains evidences and recommendations on the organization of post-stroke rehabilitation team, timing, evaluation, and intensity of rehabilitation, detailed management of dysphagia, neurogenic bladder and bowel, movement, shoulder problem, cognition, neglect, language, mood and complications commonly encountered in the acute and subacute period of stroke rehabilitation. Clinicians who are working in the field of stroke rehabilitation can adopt this guideline for their practice and give the feedback for further revision.

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization