PURPOSE: We report two patients diagnosed with a sinus thrombosis with papillary edema. CASE SUMMARY: Case 1 was a 27-year-old male who presented with complaints of headache and vomiting for 2 months and blurred vision in both eyes. The best-corrected visual acuity (BCVA) was 1.0 in the right eye and 1.0 in the left eye. A visual field (VF) examination revealed a binocular peripheral VF defect and optical coherence tomography (OCT) and a fundus examination indicated optic disc swelling in both eyes. Brain magnetic resonance imaging (MRI) showed no specific finding but magnetic resonance venography revealed filling defect signs in the transverse sinus and a cerebrospinal fluid examination indicated elevated intracranial pressure (ICP). Case 2 was a 54-year-old female who came to our hospital with suspicion of bilateral optic disc swelling. The BCVA was 0.9 in the right eye and 1.0 in the left eye. A VF examination revealed an inferior-temporal VF defect and blind spot enlargement in the right eye. OCT and a fundus examination showed optic disc swelling in both eyes. Brain MRI showed no specific finding but magnetic resonance venography revealed a decrease in blood flow in the transverse sinus, sigmoid sinus. A cerebrospinal fluid examination indicated elevated ICP. CONCLUSIONS: In the case of optic disc swelling in both eyes, a secondary cause of ICP elevation and the possibility of optic disc swelling due to sinus thrombosis should be considered, and brain MRI and venography are needed to distinguish these possibilities.
Adult ; Brain ; Cerebrospinal Fluid ; Colon, Sigmoid ; Edema ; Female ; Headache ; Humans ; Intracranial Hypertension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Optic Disk ; Optic Nerve Diseases ; Papilledema ; Phlebography ; Sinus Thrombosis, Intracranial ; Telescopes ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields ; Vomiting

"Background: In using the Double-lumen tube (DLT), knowing the minimum bronchial cuff volume (MCV) for an effective air-tight seal will be useful; to provide a collapse of the lung; and to avoid pressure damage. The aims of the present study are thus three-fold: to measure the MCV; to measure the diameter of left main bronchus (LMBD); and to prove any relationships between two parameters. METHODS: One hundred men and forty women who needed intubation of left-sided DLT were enrolled in this study. 37 Fr DLTs were used in male patients, and 35 Fr DLTs were used in female patients. We evaluated the MCV by air bubble method and measured the LMBD in chest PA. We also evaluated the pressure/volume characteristics of the bronchial cuffs by control inflator. RESULTS: 29 patients of 100 patients (29%) exhibited persistent air leakage in 2.5 ml cuff volume in male patients (group of MCV >2.5). On the contrary, 18 patients of 40 patients (45%) did not require any cuff volume in female patients (group of MCV 0). The mean LMBD were 13.23 1.45 mm in male and 11.09 0.96 mm in female. There were significant positive correlations between MCV and LMBD in both sex and their respective correlation coefficients were 0.264 (P=0.008) in male and 0.484 (P=0.002) in female. The equations of linear regression were: LMBD = 12.394 0.429xMCV in male, LMBD = 10.725 0.438xMCV in female. CONCLUSIONS: The MCV of the brochial cuffs in left-sided DLTs has significant relationships with the LMBD measured in chest PA.
Bronchi ; Female ; Humans ; Intubation ; Linear Models ; Lung ; Male ; Thorax

PURPOSE: To investigate the function of the fellow eye in patients with unilateral nonarteritic anterior ischemic optic neuropathy (NAION). METHODS: From 2009 to March 2018, 18 patients with NAION who underwent bilateral visual field examinations and follow-up visits at least two times were enrolled in this study. Initial visual acuity, final visual acuity, degree of visual field defects, the cup-disc (C/D) ratio of the fellow eye, and the presence or absence of cardiovascular disease was retrospectively analyzed using medical records. RESULTS: The fellow eye mean best-corrected visual acuity was 0.03 ± 0.53 (logMAR) and the mean visual field defect was −4.68 ± 3.65 dB in 18 eyes of patients with unilateral NAION (p = 0.007 and p = 0.001, respectively). The C/D ratios were divided into two groups: > 0.3 and < 0.3. The visual field defect was improved significantly from −4.92 dB to −2.37 dB in the group with optic disc ratios < 0.3 (p = 0.013). When the changes in visual field defects were analyzed according to the presence or absence of cardiovascular disease, the visual field defects were improved from −5.65 dB to −4.49 dB in patients with cardiovascular disease, and improved from −3.69 dB to −1.46 dB in patients without cardiovascular disease (p = 0.025 and p = 0.021, respectively). CONCLUSIONS: In patients with unilateral NAION, reduced function in the fellow eye may appear temporarily, so a visual field examination should be performed in both eyes. The possibility of incipient NAION should be considered in patients with visual field abnormalities in the fellow eye.
Cardiovascular Diseases ; Follow-Up Studies ; Humans ; Medical Records ; Optic Neuropathy, Ischemic ; Retrospective Studies ; Visual Acuity ; Visual Fields

Objective: An association between increased erythrocyte mean corpuscular volume (MCV) and treatment response in patients with inflammatory arthritis receiving methotrexate (MTX) has been reported. We investigated the frequency of red blood cell (RBC) macrocytosis and its clinical implications regarding the initiation of biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in patients starting MTX for rheumatoid arthritis (RA). Methods: RBC macrocytosis (MCV >100 fL) and clinical characteristics were retrospectively examined in 1,156 patients starting MTX for RA. Multivariable logistic regression analyses were performed to identify the independent predictors of RBC macrocytosis. The initiation of b/tsDMARDs was assessed using a multivariable Cox proportional hazards regression model. Results: RBC macrocytosis was observed in 21.6% of RA patients over 35 [8, 89] months following MTX initiation and was persistent in 63.6% of the patients during MTX treatment. Anemia coexisted in only 20.0% of the patients with RBC macrocytosis.The occurrence of RBC macrocytosis was independently associated with age, MTX dose, and concomitant use of sulfasalazine or leflunomide (all p<0.001). A higher dose of MTX and double- or triple-DMARDs therapy were more frequently used in the group with RBC macrocytosis than in the group with normal MCV. Patients experiencing RBC macrocytosis were more likely to use b/ tsDMARDs (hazard ratio: 1.45 [95% confidence interval: 1.13, 1.87], p=0.003). Conclusion RBC macrocytosis was possibly associated with the use of b/tsDMARD and could be a supplementary marker for assessing MTX resistance.

Objective: An association between increased erythrocyte mean corpuscular volume (MCV) and treatment response in patients with inflammatory arthritis receiving methotrexate (MTX) has been reported. We investigated the frequency of red blood cell (RBC) macrocytosis and its clinical implications regarding the initiation of biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in patients starting MTX for rheumatoid arthritis (RA). Methods: RBC macrocytosis (MCV >100 fL) and clinical characteristics were retrospectively examined in 1,156 patients starting MTX for RA. Multivariable logistic regression analyses were performed to identify the independent predictors of RBC macrocytosis. The initiation of b/tsDMARDs was assessed using a multivariable Cox proportional hazards regression model. Results: RBC macrocytosis was observed in 21.6% of RA patients over 35 [8, 89] months following MTX initiation and was persistent in 63.6% of the patients during MTX treatment. Anemia coexisted in only 20.0% of the patients with RBC macrocytosis.The occurrence of RBC macrocytosis was independently associated with age, MTX dose, and concomitant use of sulfasalazine or leflunomide (all p<0.001). A higher dose of MTX and double- or triple-DMARDs therapy were more frequently used in the group with RBC macrocytosis than in the group with normal MCV. Patients experiencing RBC macrocytosis were more likely to use b/ tsDMARDs (hazard ratio: 1.45 [95% confidence interval: 1.13, 1.87], p=0.003). Conclusion RBC macrocytosis was possibly associated with the use of b/tsDMARD and could be a supplementary marker for assessing MTX resistance.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.

Objective: An association between increased erythrocyte mean corpuscular volume (MCV) and treatment response in patients with inflammatory arthritis receiving methotrexate (MTX) has been reported. We investigated the frequency of red blood cell (RBC) macrocytosis and its clinical implications regarding the initiation of biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in patients starting MTX for rheumatoid arthritis (RA). Methods: RBC macrocytosis (MCV >100 fL) and clinical characteristics were retrospectively examined in 1,156 patients starting MTX for RA. Multivariable logistic regression analyses were performed to identify the independent predictors of RBC macrocytosis. The initiation of b/tsDMARDs was assessed using a multivariable Cox proportional hazards regression model. Results: RBC macrocytosis was observed in 21.6% of RA patients over 35 [8, 89] months following MTX initiation and was persistent in 63.6% of the patients during MTX treatment. Anemia coexisted in only 20.0% of the patients with RBC macrocytosis.The occurrence of RBC macrocytosis was independently associated with age, MTX dose, and concomitant use of sulfasalazine or leflunomide (all p<0.001). A higher dose of MTX and double- or triple-DMARDs therapy were more frequently used in the group with RBC macrocytosis than in the group with normal MCV. Patients experiencing RBC macrocytosis were more likely to use b/ tsDMARDs (hazard ratio: 1.45 [95% confidence interval: 1.13, 1.87], p=0.003). Conclusion RBC macrocytosis was possibly associated with the use of b/tsDMARD and could be a supplementary marker for assessing MTX resistance.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.