We performed scleral grafting with autogenous temporalis fascia and autogenous conjunctiva in 32 patients (32 eyes) in scleral necrosis after pterygium excision. The average age of patients was 54.3 years (range, 38 to 74 years). Nine of them were male and twenty-three were female. The intervals between pterygium excision and scleral necrosis were from 2 months to 23 years (mean, 6.2 years). After the mean follow-up 6.6 months, in 29 eyes graft was stably adhered but in three eyes graft was melted. Conjunctival wound dehiscence and conjunctival necrosis were noticed in three eyes and one eye respectively. There were no cases showing significant difference between the preoperative and the postoperative visual acuity and intraocular pressure. Autogenous temporalis fascia appears to be a good alternative to homologous sclera for scleral reinforcement.
Conjunctiva ; Fascia* ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Male ; Necrosis* ; Pterygium* ; Sclera ; Transplants* ; Visual Acuity ; Wounds and Injuries

Anesthesia, General ; Hemorrhage ; Humans ; Incidence ; Palatine Tonsil ; Postoperative Hemorrhage ; Tonsillectomy

We conducted experimental studies to evaluate the possibility of Dacron patch for artificial sclera and to gain basic data for practical approach. Forty eyes of twenty rabbits were randomly assigned to experimental or control eye in both eyes. The lamellar-thickness scleral resection was performed and followed by implantation of Dacron and homologous scleral patch respectively. We examined them after one, two, four and 12 weeks. Grossly adhesion of Dacron patch was stable after four weeks. Histologically Dacron graft evoked an outer capsule and a well-vascularized granulomatous foreign body reaction. There were fibrous and vascular ingrowth securety anchored graft to bed and adhesion was uniform and firm throughout the tissue. Attachment of homolgous graft to bed was poor after 1 week but stable after two weeks. Dacron patch appears to be a good alternative to homologous sclera for scleral reinforcement.
Fibroblasts ; Foreign-Body Reaction ; Polyethylene Terephthalates* ; Rabbits ; Sclera ; Transplants*

PURPOSE: The purpose of this study was to provide fundamental data to develop an educational program for the development of nurses' core competences, and to improve the curriculum in nursing education institutions. METHODS: This study, based on a descriptive survey, was conducted with 1,019 nurses working in a tertiary hospital in Seoul. Among 47 core nursing practice items, core nursing practices as perceived by the participants and relevant educational requirements were measured on a four-point scale. The collected data were analyzed using descriptive statistics for the mean and standard deviation, one way ANOVA, and Duncan test as post-hoc test. RESULTS: Regarding the core nursing practice perceived as by the nurses, there were statistically significant differences in 43 out of 47 items according to nursing unit, and in 15 items according to clinical career. Regarding the educational requirements for core nursing practice, there were also statistically significant difference for the same items as perception differences according to nursing unit and clinical career. CONCLUSION: The results of this study suggest further study on the development of educational programs to advance the clinical expertise of nurses and for the development of curriculum reflecting the actual conditions and requirements in clinical nursing practice fields.
Curriculum ; Education, Nursing ; Needs Assessment ; Nursing Stations ; Nursing* ; Nursing, Private Duty ; Seoul ; Tertiary Care Centers*

Pseudohypoxic brain swelling (PHBS) is known to be an uncommon event that may occur during and following an uneventful brain surgery, when negative suction drainage is used. The cerebrospinal fluid loss related to suction drainage can evoke intracranial hypotension that progress to PHBS. The main presentations of PHBS are sudden unexpected circulatory collapses, such as severe bradycardia, hypotension, cardiac arrest, consciousness deterioration and diffuse brain swelling as seen with brain computerized tomography (CT). We present a stuporous 22-year-old patient who underwent cranioplasty under general anesthesia. The entire course of the general anesthesia and operation progressed favorably. However, the time of scalp suture completion, sudden bradycardia and hypotension occurred, followed by cardiac arrest immediately after initiation of subgaleal and epidural suction drainage. After successful resuscitation, the comatose patient was transferred to the neurosurgical intensive care unit and PHBS was confirmed using brain CT.
Anesthesia, General ; Bradycardia ; Brain Edema* ; Brain* ; Cerebrospinal Fluid ; Coma ; Consciousness ; Heart Arrest* ; Humans ; Hypotension ; Intensive Care Units ; Intracranial Hypotension* ; Resuscitation ; Scalp ; Shock ; Stupor ; Suction* ; Sutures ; Young Adult

PURPOSE: To evaluate the refractive outcomes of small incision lenticule extraction (SMILE) in high myopia patients compared with mild to moderate myopia patients. METHODS: This study included 332 eyes of 166 myopic patients treated with SMILE using Visumax 500 kHz femtosecond laser. Treated eyes were divided into 2 groups according to preoperative spherical equivalent (SE): mild to moderate myopia (A group, <-6.0 D) and high myopia (B group, > or =-6.0 D). Follow-up visits were at 1 day, 1 week, 1 month, 3 months, and 6 months. The outcome measures included uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BDVA), postoperative SE, efficacy index, safety index and predictability. RESULTS: Preoperative SE was -4.85 +/- 0.86 D in the A group and -7.70 +/- 1.0 D in the B group. No differences were observed between -0.04 +/- 0.29 D in the A group and -0.30 +/- 0.37 D in the B group at 6 months postoperatively (p = 0.062). At 6 months postoperatively, 98.3% and 97.3% had UDVA of 20/25 or better in the A group and B group, respectively. In the A group, 97.3% and 100% were within +/-0.5 D and +/-1.0 D of intended correction and in the B group, 91.7% and 96.9% were within +/-0.5 D and +/-1.0 D, respectively. Efficacy indices were 1.02 +/- 0.19 in the A group and 0.99 +/- 0.18 in the B group. Safety indices were 1.16 +/- 0.16 in the A group and 1.14 +/- 0.16 in the B group. The efficacy and safety indices were not significantly different between the A and B groups at 6 months postoperatively (p = 0.09, p = 0.695, respectively). CONCLUSIONS: This study showed that SMILE is effective and safe for correcting high myopia as well as mild to moderate myopia.
Follow-Up Studies ; Humans ; Myopia* ; Outcome Assessment (Health Care) ; Visual Acuity

OBJECTIVES: This study was conducted to investigate the status and need for nutrition and dietary life education among nutrition teachers at schools. These characteristics were analyzed if they were different between elementary schools and middle-high schools. METHODS: Subjects were 151 nutrition teachers from 70 elementary schools, 41 middle schools and 40 high schools in 17 cities nationwide selected by two-stage stratified cluster sampling process. Survey questionnaires included the items on general characteristics, status and need assessment for nutrition and dietary life education. Chi-square test or t-test was used for data analysis by school groups. RESULTS: Nutrition education was implemented at 65.7% of elementary schools and 51.9% of middle-high schools. Nutrition education was mainly performed in 'discretionary activities·extracurricular activities' at elementary school and through 'newsletters, school homepage, foodservice bulletin board' at middle-high school (p<0.001). The most needed topic for nutrition education in nutrition teachers was 'healthy dietary habits and table manners' and this was not significantly different by school groups. Responses on adequate frequency (p<0.01), methods used for nutrition education (p<001), materials for nutrition education (p<0.001), information sources for nutrition education (p<0.001) were significantly different by school groups. Major tasks for activating nutrition education included 'securing the time for implementing nutrition education by reducing work loads' and 'developing standardized nutrition education materials' in schools. CONCLUSIONS: Nutrition education at schools might be activated by improving working conditions of nutrition teachers and developing the practical programs that reflect the needs of nutrition teachers.
Adolescent ; Child ; Education* ; Food Habits ; Humans ; Needs Assessment ; Statistics as Topic

We describe herein a case of life-threatening hypoglycemia due to spurious elevation of glucose concentration during the administration of ascorbic acid in a type 2 diabetic patient. A 31-year-old female was admitted for proliferative diabetic retinopathy treatment and prescribed high dose ascorbic acid. During hospitalization, she suddenly lost her consciousness and her glucose concentration was 291 mg/dL, measured using self-monitoring blood glucose (SMBG) device, while venous blood glucose concentration was 12 mg/dL. After intravenous injection of 50% glucose solution, the patient became alert. We reasoned that glucose measurement by SMBG device was interfered by ascorbic acid. Physicians should be aware of this interference; high dose ascorbic acid may cause spurious elevation of glucose concentration when measuring with SMBG devices.
Adult ; Ascorbic Acid/administration & dosage/adverse effects/contraindications/*therapeutic use ; Blood Glucose ; Blood Glucose Self-Monitoring/instrumentation/standards ; Diabetes Mellitus, Type 2/blood/drug therapy ; Female ; Humans ; Hypoglycemia/*diagnosis ; Renal Dialysis

BACKGROUND: It is valuable to find the potential activity of regulating the excessive mucin secretion by the compounds derived from various medicinal plants. We investigated whether aqueous extract of the root bark of Morus alba L. (AMA), kuwanon E, kuwanon G, mulberrofuran G, and morusin significantly affect the secretion and production of airway mucin using in vivo and in vitro experimental models. METHODS: Effect of AMA was examined on hypersecretion of airway mucin in sulfur dioxide-induced acute bronchitis in rats. Confluent NCI-H292 cells were pretreated with ethanolic extract, kuwanon E, kuwanon G, mulberrofuran G, or morusin for 30 minutes and then stimulated with phorbol 12-myristate 13-acetate (PMA) for 24 hours. The MUC5AC mucin secretion and production were measured by enzyme-linked immunosorbent assay. RESULTS: AMA stimulated the secretion of airway mucin in sulfur dioxide-induced bronchitis rat model; aqueous extract, ethanolic extract, kuwanon E, kuwanon G, mulberrofuran G and morusin inhibited the production of MUC5AC mucin induced by PMA from NCI-H292 cells, respectively. CONCLUSION: These results suggest that extract of the root bark and the natural products derived from Morus alba L. can regulate the secretion and production of airway mucin and, at least in part, explains the folk use of extract of Morus alba L. as mucoregulators in diverse inflammatory pulmonary diseases.
Animals ; Biological Products* ; Bronchitis ; Enzyme-Linked Immunosorbent Assay ; Ethanol ; Lung Diseases ; Models, Animal ; Models, Theoretical ; Morus* ; Mucins* ; Plants, Medicinal ; Rats ; Sulfur

OBJECTIVES: There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. METHODS: To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n=60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n=57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. RESULTS: The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. CONCLUSIONS: This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.
Terminal Care/economics/*utilization ; *Social Class ; Patient Admission/statistics & numerical data ; *Neoplasms/economics/epidemiology/therapy ; Middle Aged ; Male ; Korea/epidemiology ; Humans ; Health Services/economics/*utilization ; Health Expenditures/*statistics & numerical data/trends ; Educational Status ; Death Certificates ; Aged ; Adult