We examined the incidence of anti-Ro antibodies with sera from 60 Korean patients with systemic lupus erythematosus(SLE) by double immunodiffusion. Among these 60 sera tested, 31(51.7%) showed evident immunoprecipitations against Ro antigen on the Ouchterlony plates. Several recent studies indieate that the anti-Ro antibody occurs much less frequently in Occidental lupus patients(around 30%) than in Japanese lupus patients (50%). These data may be suggestive that the racial or ethnic baekground might be an important factor determining the serological, and perhaps the clinical features of SLE.
Antibodies* ; Asian Continental Ancestry Group ; Humans ; Immunodiffusion ; Incidence* ; Lupus Erythematosus, Systemic

BACKGROUND: The NMDA receptor mediates wind-up and long-term potentiation in the responses of cells to prolonged stimuli; thus we postulated that the induction and maintenance of sensitization would be affected by the timing of epidural ketamine administration under epidural anesthesia. METHODS: Sixty patients undergoing elective cesarian section were randomly and equally assigned to one of three groups. 20 ml of 2% lidocaine and 2 mg morphine with epinephrine was injected to all patients epidurally through an indwelling catheter inserted at the L2-3 interspace. Before surgical incision, the patients in group 1 were given 3 ml saline, while the patients in group 2 were given 30 mg ketamine. In group 3, patients were injected with 30 mg ketamine after peritoneal closure. An additional 2 mg morphine was injected into all patients 24 h after surgery. The analgesic effects were assessed and side effects were also evaluated. RESULTS: VAS of group 3 at 3 24 h was lower than in the group 1, and at 6 24 h it was lower than in the group 2. The number of patients using additional analgesics in group 3 was lower than in the other groups. The incidence of nausea and vomiting was higher in the group 1 than in the other groups, but dizzness was higher in the groups 2 and 3 than in the control group. CONCLUSIONS: Preoperative administration of epidural ketamine is less effective in reducing postoperative pain than when given after peritoneal closure, especially under epidural anesthesia with local anesthetics.
Analgesia* ; Analgesics ; Anesthesia, Epidural* ; Anesthetics, Local ; Catheters, Indwelling ; Epinephrine ; Humans ; Incidence ; Ketamine* ; Lidocaine ; Long-Term Potentiation ; Morphine ; N-Methylaspartate ; Nausea ; Pain, Postoperative ; Vomiting

BACKGROUND: The NMDA receptor mediates wind-up and long-term potentiation in the responses of cells to prolonged stimuli; thus we postulated that the induction and maintenance of sensitization would be affected by the timing of epidural ketamine administration under epidural anesthesia. METHODS: Sixty patients undergoing elective cesarian section were randomly and equally assigned to one of three groups. 20 ml of 2% lidocaine and 2 mg morphine with epinephrine was injected to all patients epidurally through an indwelling catheter inserted at the L2-3 interspace. Before surgical incision, the patients in group 1 were given 3 ml saline, while the patients in group 2 were given 30 mg ketamine. In group 3, patients were injected with 30 mg ketamine after peritoneal closure. An additional 2 mg morphine was injected into all patients 24 h after surgery. The analgesic effects were assessed and side effects were also evaluated. RESULTS: VAS of group 3 at 3 24 h was lower than in the group 1, and at 6 24 h it was lower than in the group 2. The number of patients using additional analgesics in group 3 was lower than in the other groups. The incidence of nausea and vomiting was higher in the group 1 than in the other groups, but dizzness was higher in the groups 2 and 3 than in the control group. CONCLUSIONS: Preoperative administration of epidural ketamine is less effective in reducing postoperative pain than when given after peritoneal closure, especially under epidural anesthesia with local anesthetics.
Analgesia* ; Analgesics ; Anesthesia, Epidural* ; Anesthetics, Local ; Catheters, Indwelling ; Epinephrine ; Humans ; Incidence ; Ketamine* ; Lidocaine ; Long-Term Potentiation ; Morphine ; N-Methylaspartate ; Nausea ; Pain, Postoperative ; Vomiting

Kawasaki disease is an acute febrile vasculitis that occurs predominantly in young children under 5- years-old. The patients present generally with a high spiking fever that is unresponsive to antibiotics and lasts for more than five days at least. Prolonged fever has been shown to be a risk factor in the development of coronary artery disease. It seems to be certain that infectious agents are associated with the pathogenesis of Kawasaki disease. The differential diagnosis of Kawasaki disease must rule out infectious diseases including scarlet fever, toxic shock syndrome, measles, and so on. This is very important for adequate treatment and prevention of cardiac complications of Kawasaki disease. We experienced a 25-month-old boy who had high fever and pneumonic consolidation in the right middle and lower lobe of the lung that was considered as mycoplasma pneumonia on admission and developed coronary artery aneurysmal dilatation during treatment with roxythromycin.
Aneurysm ; Anti-Bacterial Agents ; Child ; Child, Preschool ; Communicable Diseases ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis, Differential ; Dilatation ; Fever ; Humans ; Lung ; Male ; Measles ; Mucocutaneous Lymph Node Syndrome* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Risk Factors ; Scarlet Fever ; Shock, Septic ; Vasculitis

PURPOSE: To evaluate clinical features of patients who have experienced decreased exodeviation after refractive error correction. METHODS: Thirty-four patients who experienced decreased exodeviation after refractive error correction between 2003 and 2010 were evaluated. Visual acuity, refractive errors, reported age at onset, duration of wearing glasses, stereopsis, and function of fusion were evaluated. RESULTS: The present study included 34 patients with intermittent exotropia. Before correcting refractive errors, the mean visual acuity was 0.34 +/- 0.27 for the right eye and 0.37 +/- 0.27 for the left eye according to log MAR. After refractive error correction, mean visual acuity improved to 0.12 +/- 0.11 for the right eye and 0.11 +/- 0.11 for the left eye according to log MAR. Before correcting refractive errors, the amount of deviation was 18.1 +/- 7.4 PD at near and 13.5 +/- 8.4 PD at far. However, after correcting refractive errors, the amount of deviation decreased to 5.8 +/- 8.6 PD at near and 4.5 +/- 7.6 PD at far (p < 0.05). CONCLUSIONS: The clinical characteristics of children who have decreased exodeviation after correcting refractive errors is shown by a greater amount of deviation at near than at distance and good fusional vergence and stereoacuity. Because correcting refractive errors by wearing appropriate glasses can decrease exodeviation, the authors of the present study recommend correcting refractive errors as the initial management for exotropia.
Child ; Depth Perception ; Exotropia ; Eye ; Eyeglasses ; Glass ; Humans ; Myopia ; Refractive Errors ; Visual Acuity

PURPOSE: The purpose of this study was to identify the relationship between the satisfaction with clinical practice and clinical performance ability by types of self-directed learning ability of nursing students. METHODS: This was a triangular study that was conducted to understand clinical performance ability. The subjects were 260 junior and senior students from a university in P city. The data were collected from April 22 to December 30, 2015. Data were collected by Q-card, Q-block an assessment tool, a structured self-reporting survey and a questionnaire. RESULTS: We classified the self-directed learning abilities into four types: Type 1: a self-reflective person; Type 2: a person who prepares for the future; Type 3: a person with a sense of responsibility and obligation; and Type 4: an enthusiastic learner. We found that clinical performance ability was higher for Type 4 than Type 3. We found that clinical performance satisfaction with clinical practice was also higher for the Type 4 individual than a Type 3 person. CONCLUSION: To improve students' clinical performance ability, we need plans and support to lead students toward becoming an ‘enthusiastic learner’ type of person with self-directed learning ability. It is necessary to increase students' satisfaction with clinical practice.
Clinical Competence* ; Humans ; Learning* ; Nursing* ; Students, Nursing*

PURPOSE: To evaluate the efficacy and safety of customized orbital decompression surgery combined with eyelid surgery or strabismus surgery for mild to moderate thyroid-associated ophthalmopathy (TAO). METHODS: Twenty-seven consecutive subjects who were treated surgically for proptosis with disfigurement or diplopia after medical therapy from September 2009 to July 2012 were included in the analysis. Customized orbital decompression surgery with correction of eyelid retraction and extraocular movement disorders was simultaneously performed. The patients had a minimum preoperative period of 3 months of stable range of ocular motility and eyelid position. All patients had inactive TAO and were euthyroid at the time of operation. Preoperative and postoperative examinations, including vision, margin reflex distance, Hertel exophthalmometry, ocular motility, visual fields, Goldmann perimetry, and subject assessment of the procedure, were performed in all patients. Data were analyzed using paired t-test (PASW Statistics ver. 18.0). RESULTS: Forty-nine decompressions were performed on 27 subjects (16 females, 11 males; mean age, 36.6 +/- 11.6 years). Twenty-two patients underwent bilateral operations; five required only unilateral orbital decompression. An average proptosis of 15.6 +/- 2.2 mm (p = 0.00) was achieved, with a mean preoperative Hertel measurement of 17.6 +/- 2.2 mm. Ocular motility was corrected through recession of the extraocular muscle in three cases, and no new-onset diplopia or aggravated diplopia was noted. The binocular single vision field increased in all patients. Eyelid retraction correction surgery was simultaneously performed in the same surgical session in 10 of 49 cases, and strabismus and eyelid retraction surgery were performed in the same surgical session in two cases. Margin reflex distance decreased from a preoperative average of 4.3 +/- 0.8 to 3.8 +/- 0.5 mm postoperatively. CONCLUSIONS: The customized orbital decompression procedure decreased proptosis and improved diplopia, in a range comparable to those achieved through more stepwise techniques, and had favorable cosmetic results when combined with eyelid surgery or strabismus surgery for mild to moderate TAO.
Adolescent ; Adult ; Decompression, Surgical/*methods ; Exophthalmos/*surgery ; Eye Movements/physiology ; Eyelids/*surgery ; Female ; Graves Ophthalmopathy/*surgery ; Humans ; Male ; Middle Aged ; Oculomotor Muscles/surgery ; *Ophthalmologic Surgical Procedures ; Orbit/*surgery ; Retrospective Studies ; Strabismus/*surgery ; Visual Field Tests ; Visual Fields/physiology

It is widely accepted that the shape and structure of bone are closely related to the activity of attached muscle. Numerous clinical and animal experimental studies indicated the significant effects of masticatory muscle function on maxillofacial morphology. Recently, the development of ultrasonography has spread throughout different fields of medicine. In the clinical examinations, ultrasonography is a convenient, inexpensive technique to apply with accurate and reliable results. The aim of this study is to assess the thickness of the masseter muscle and its correlation to maxillofacial skeleton by examining 35 male and 15 female dental students at Kangnung National University. The masseter muscle thickness of the subjects were measured by ultrasonographic scanning with a 7.5MHz linear probe, and their maxillofacial morphology were investigated by lateral cephalometric radiographs. The relationship between the masseter muscle thickness and maxillofacial morphology of normal adult was statistically analyzed, and the following results were obtained. 1. The average thickness of male masseter muscle was 13.8+/-1.71mm in the relaxed state and 14.8+/-1.77mm at maximal clenching state, while that of female was 11.6+/-1.58mm and 12.4+/-1.47mm, respectively. Ethnic difference in thickness of the masseter muscle and maxillofacial skeleton was found when the results of many researchers were compared with those of this study. 2. The thickness of the masseter muscle in both sexes increased significantly at maximal clenching state than in relaxed state(P<0.05). 3. The masseter muscle thickness of male was greater than that of female both in the relaxed state and maximal clenching states(P<0.05). 4. In males, the thickness of the masseter muscle was negatively correlated with the mandibular plane angle and positively correlated with the mandibular ramus height and anterior cranial base length(P<0.05). It may suggest that the male with thicker masseter muscle has smaller facial divergence. 5. No significant correlation was found between the masseter muscle thickness and maxillofacial morphology in females(P<0.05).
Adult* ; Animal Experimentation ; Female ; Humans ; Male ; Masseter Muscle* ; Masticatory Muscles ; Skeleton ; Skull Base ; Students, Dental ; Ultrasonography

Background: To implement medication management service in Korean nursing home (NH), medication review tool for residents in Korean long-term care facilities was developed. This prospective pilot study aimed to verify the applicability of this newly developed tool and to evaluate the drug related problems (DRPs) identified by pharmacists’ medication review in NH setting. Methods: This study was carried out in two NHs in Korea. The elderly residents (65 or older) using 5 or more medications were eligible. Pharmacists conducted medication review and identified the DRPs and potentially inappropriate medications (PIMs) based on the newly developed tool. Results: Among 43 NH residents, 27 residents agreed to participate. The median age was 87 and about 55.6% of them were taking 10 or more medications. Pharmacists identified a total of 37 PIMs in 18 NH residents (66.7%) and 54 DRPs in 22 residents (81.5%). The most frequent PIM was general-PIM (26 cases) followed by PIM under specific diseases or conditions (7 cases). Out of 77 items contained in the tool, 15 items were detected in study participants. ‘Continued use or regular daily use of hypnotics’ was the most highly detected item (9 cases) followed by ‘multiple prescriptions within each class of hypnotics/sedatives’ (5 cases). Among 54 DRPs identified, pharmacist intervened 39 cases (72.2%) and interventions were accepted in 18 cases (46.1%). Conclusion This pilot study demonstrated that newly developed tool is feasible for the nursing home residents. However, further studies with larger population are warranted.

Purpose: This study was conducted to determine the factors affecting a hypothetical model of testing for general hospital nurses’ job embeddedness. Methods: Data were collected from August 20 to September 19, 2021, by a self-administered questionnaire answered by 428 general hospital nurses. The data were analyzed by SPSS and AMOS. Results: Nine of the hypothetical model’s 12 hypotheses were supported by the data collected from all participants. The test results indicate that ego resilience, subjective career success, and recovery experience from job stress directly affect participants’ job embeddedness. Nurses’ work environments were reported to affect ego resilience and subjective career success, while at the same time ego resilience and subjective career success affected the participants’ job embeddedness. Work-life balance was found to affect ego resilience and ego resilience affected subjective career success, and at the same time subjective career success directly affected participants’ recovery experiences from job stress and job embeddedness. Of these variables, subjective career success had the strongest direct effect on participants’ job embeddedness. Work-life balance affected the participants’ recovery experiences from job stress, and their recovery experiences from job stress were found to directly affect job embeddedness. Conclusion These results suggest that different management strategies to enhance hospital nurses’ job embeddedness should address nurses’ ego resilience, subjective career success, and recovery experiences from job stress.