PURPOSE: To evaluate the accuracy of predicting refractive outcomes of swept-source optical coherence tomography based biometry (ARGOS; Movu Inc., Santa Clara, CA, USA) in nuclear cataracts. METHODS: A total of 107 eyes (107 nuclear cataract patients) were analyzed. Subjects were divided into three groups according to the maximum nuclear density of Pentacam HR (A, lower tertile; B, medium tertile; C, upper tertile). The keratometry and axial length measured by IOLMaster (Carl Zeiss Meditec, Jena, Germany) and ARGOS systems were compared for each group. The correlation between maximum nuclear density and axial length difference readings from the two instruments was evaluated. The mean absolute error between the predicted refraction and 2-month post-operative refraction was compared. RESULTS: The maximum nuclear densities were 28.31 ± 7.30, 51.37 ± 7.82, and 88.63 ± 11.23 for groups A, B, and C, respectively. The axial length measured by ARGOS was significantly longer than that obtained using IOLMaster for groups B and C (respectively, p = 0.035, p < 0.001). A significantly positive correlation was found between the maximum nuclear density and axial length difference of the two devices (p < 0.001). Mean absolute errors were not significantly different between IOLMaster and ARGOS in group A. However, in groups B and C, the mean absolute error using ARGOS (0.31 ± 0.22 D and 0.32 ± 0.20 D, respectively) was significantly lower than that of IOLMaster (0.43 ± 0.21 D and 0.50 ± 0.26 D, respectively) (Group B, p = 0.027; Group C, p = 0.001). CONCLUSIONS: Even in dense nuclear cataracts, accurate refractive outcome prediction was possible using swept-source optical coherence tomography based biometry.
Biometry ; Cataract ; Lenses, Intraocular ; Reading ; Tomography, Optical Coherence

PURPOSE: This study was conducted to comprehensively investigate nursing students' experience of their first encounter with death of a patient during clinical practice. METHODS: This study took place from January 27 through March 6, 2012 with eight female senior nursing students enrolled at Pusan National University located in Y city who have experienced patient death. We collected their experience of their first death encounter during their clinical rotation by asking, "What is your first experience of patient's death during the clinical practice?" Husserl's phenomenological approach was applied in this study. RESULTS: In this study, 17 themes, 15 clusters of themes and eight categories were derived. The categories included "Desire to avoid the reality of death", "Powerlessness", "Anticipation for recovery shifted to fear of death", "Various interpretations of death", "Limitations in their nursing practice", "Resentment of lack of nurses", "Longing to better understand death", and "Motivation for inner growth". CONCLUSION: Through their first encounter with death of a patient, nursing students experienced various emotions and viewed their role as hospice caregiver by projecting themselves as fully trained nurses in future. Participants considered terminal care as a part of nursing care. The result of this study indicates the need to include education of death in the nursing school curriculum.
Busan ; Caregivers ; Curriculum ; Education ; Female ; Hospices ; Humans ; Nursing Care ; Nursing* ; Schools, Nursing ; Students, Nursing ; Terminal Care

Symptomatic neuromas after amputation can be troublesome to treat and make it difficult to properly fit a brace. Surgical management is required when conservative management such as prosthetic socket modification or local injections fail. However, small cutaneous nerves adhere to adjacent soft tissue and they are difficult to locate. The authors suggest that ultrasonography guided tattoo localization using a charcoal suspension is useful to find a visually indistinguishable neuroma.

PURPOSE: To assess the degree of agreement of two rotating Scheimpflug cameras, Galilei G6 and Pentacam HR, in measuring corneal refractive power (K), anterior chamber depth (ACD), and central corneal thickness (CCT). METHODS: Measurement agreement was assessed in 40 eyes of 40 outpatients at our hospital. Measurements of anterior and posterior corneal refractive power (K), ACD, and CCT were compared between the Galilei G6 and Pentacam HR. RESULTS: For Galilei G6 (4 mm), Pentacam HR (3 mm) and Pentacam HR (4 mm), the anterior corneal refractive powers (K) were 44.35 ± 1.38 D, 44.09 ± 1.32 D, and 44.12 ± 1.35 D, respectively, and the posterior corneal refractive powers (K) were 6.39 ± 0.23 D, 6.45 ± 0.23 D, 6.45 ± 0.22 D. The differences in the results were statistically significant. The average ACD measurements using Galilei G6 and Pentacam HR were 3.26 ± 0.42 mm and 3.17 ± 0.42 mm, respectively, and the average CCT measurements were 556.65 ± 30.12 µm and 553.78 ± 29.42 µm. The differences in the measurements were statistically significant. In addition, ACD 95% limits of agreement (LoA) between Galilei G6 and Pentacam HR were in the range of -0.14~0.32 mm, and CCT 95% LoA were in the range of -12.54~18.29 µm. CONCLUSIONS: There were significant differences in measurements of anterior and posterior corneal refractive power (K), ACD, and CCT between the two cameras. Agreement analysis suggests that Galilei G6 and Pentacam HR should not be used interchangeably.
Anterior Chamber ; Humans ; Loa ; Outpatients

PURPOSE: To assess the degree of agreement of two rotating Scheimpflug cameras, Galilei G6 and Pentacam HR, in measuring corneal refractive power (K), anterior chamber depth (ACD), and central corneal thickness (CCT). METHODS: Measurement agreement was assessed in 40 eyes of 40 outpatients at our hospital. Measurements of anterior and posterior corneal refractive power (K), ACD, and CCT were compared between the Galilei G6 and Pentacam HR. RESULTS: For Galilei G6 (4 mm), Pentacam HR (3 mm) and Pentacam HR (4 mm), the anterior corneal refractive powers (K) were 44.35 ± 1.38 D, 44.09 ± 1.32 D, and 44.12 ± 1.35 D, respectively, and the posterior corneal refractive powers (K) were 6.39 ± 0.23 D, 6.45 ± 0.23 D, 6.45 ± 0.22 D. The differences in the results were statistically significant. The average ACD measurements using Galilei G6 and Pentacam HR were 3.26 ± 0.42 mm and 3.17 ± 0.42 mm, respectively, and the average CCT measurements were 556.65 ± 30.12 µm and 553.78 ± 29.42 µm. The differences in the measurements were statistically significant. In addition, ACD 95% limits of agreement (LoA) between Galilei G6 and Pentacam HR were in the range of -0.14~0.32 mm, and CCT 95% LoA were in the range of -12.54~18.29 µm. CONCLUSIONS: There were significant differences in measurements of anterior and posterior corneal refractive power (K), ACD, and CCT between the two cameras. Agreement analysis suggests that Galilei G6 and Pentacam HR should not be used interchangeably.
Anterior Chamber ; Humans ; Loa ; Outpatients

Objectives: This study aimed to examine the correlations between the regional characteristics of counties in Gangwon Province, Republic of Korea and the ratio of intracounty to extracounty sources of coronavirus disease 2019 (COVID-19) infection. Methods: The region of the infectious contact was analysed for each COVID-19 case reported in Gangwon Province between February 22, 2020 and February 7, 2022. The population, population density, area, the proportion of urban residents, the proportion of older adults (>65 years), financial independence, and the number of adjacent counties were assessed for each of the 18 counties in Gangwon Province. Correlation coefficients between regional characteristics and the ratio of intracounty to extracounty infections were calculated. Results: In total, 19,645 cases were included in this study. The population, population density, proportion of older adults, and proportion of urban residents were significantly correlated with the ratio of intracounty to extracounty infections. A stratified analysis with an age cut-point of 65 years showed that the proportion of older adults had a significant negative correlation with the ratio of intracounty to extracounty infections. In other words, the proportions of extracounty infections were higher in countries with higher proportions of older adults. Conclusion Regions with ageing populations should carefully observe trends in infectious disease outbreaks in other regions to prevent possible transmission.

Purpose: To determine the efficacy of immediate pars plana vitrectomy as the primary treatment for acute endophthalmitis in patients with a visual acuity (VA) of hand motion (HM) or better. Methods: A total of 149 patients who were referred to a single center for acute endophthalmitis after cataract surgery over the 13-year study period were retrospectively analyzed. Only patients presenting with a VA of at least HM were included. Patients were initially treated with either primary vitrectomy or intravitreal antibiotic injection alone, and their visual outcomes and reintervention rates after initial treatment were compared. Results: There was no significant difference in the proportion of good (final VA ≥20 / 40) and poor (VA ≤ counting finger) visual outcomes between the groups. However, subgroup analysis of patients with a VA of HM (92 eyes) showed that the incidence of reintervention (14 of 72 eyes [19.4%] vs. 9 of 20 eyes [45.0%]) and poor visual outcomes (10 of 72 eyes [13.9%] vs. 8 of 20 eyes [40.0%]) were lower after prompt vitrectomy than after intravitreal antibiotic injection alone (p = 0.019 and p = 0.022, respectively). For those with a VA of at least counting finger, no significant difference was observed between the groups. Conclusions For patients with endophthalmitis presenting with a VA of HM, performing a prompt vitrectomy reduced the incidence of reintervention and poor visual outcomes than the administration of intravitreal antibiotics alone. Our results suggest that primary vitrectomy for patients with endophthalmitis presenting with a VA of HM could be more beneficial than intravitreal antibiotic injection alone.

BACKGROUND AND OBJECTIVES: Parapharyngeal infections are rare but they cause life-threatening complications such as mediastinitis, rupture or aneurysm of the internal carotid artery, internal jugular vein thrombophlebitis. So, until now, the recommended treatment of parapharyngeal abscess is early open surgical drainage. The purpose of this study is to review the clinical course and outcome of treatment in parapharyngeal abscess according to method of treatment. MATERIALS AND METHOD: A retrospective study was peformed on 34 cases with parapharyngeal abscess in patients admitted for deep neck infection during a 8-year period from June 1994 to January 2003. All had contrast-enhanced computed tomography (CT) imaging and had confirmation of an abscess in parapharyngeal space. RESULTS: All patients were treated with intravenous antibiotics, 19 cases (conservative group) were treated with antibiotics only or needle aspiration, 15 cases (surgical group) were treated with intraoral or external drainage. The mean period of hospitalization was 8.2 days in conservative group and 11.6 days in surgical group. There was no complication except the mediastinitis in one case of conservative group. Five patients required tracheotomy because of severe dyspnea. CONCLUSION: Neck CT scan is useful diagnostic tool to detect and establish treatment plan of parapharyngeal abscess. Parapharyngeal abscess may, in some cases, respond to antibiotics, become localized to parapharyngeal space and treated conservatively with no need for early open surgical drainage.
Abscess* ; Aneurysm ; Anti-Bacterial Agents ; Carotid Artery, Internal ; Drainage ; Dyspnea ; Hospitalization ; Humans ; Jugular Veins ; Mediastinitis ; Neck ; Needles ; Retrospective Studies ; Rupture ; Thrombophlebitis ; Tomography, X-Ray Computed ; Tracheotomy

PURPOSE: Clinical use of cardiopulmonary exercise tests (CPETs) is increasing in elderly patients with cardiovascular (CV) diseases. However, data on Korean populations are limited. In this study, we aimed to examine the characteristics and safety of CPET in an elderly Korean population with CV disease. MATERIALS AND METHODS: We retrospectively analyzed records of 1485 patients (older than 65 years in age, with various underlying CV diseases) who underwent CPET. All CPET was performed using the modified Bruce ramp protocol. RESULTS: The mean age of patients was 71.6±4.7 years with 63.9% being men, 567 patients aged 60–65 years, 818 patients aged 70–79 years, and 100 patients aged 80–89 years. The mean respiratory exchange ratio was 1.09±0.14. During CPET, three adverse cardiovascular events occurred (total 0.20%), all ventricular tachycardia. All subjects showed an average exercise capacity of 21.3±5.5 mL/kg/min at peak VO2 and 6.1±1.6 metabolic equivalents of task, and men showed better exercise capacity than women on most CEPT parameters. A significant difference was seen in peak oxygen uptake according to age group (65–69 years, 22.9±5.8; 70–79 years, 20.7±5.1; 80–89 years, 17.0±4.5 mL/kg/min, p<0.001). The most common causes for CPET termination were dyspnea (64.8%) and leg pain (24.3%), with higher incidence of leg pain in octogenarians compared to other age groups (65–69 years, 22.4%; 70–79 years, 24.6%; 80–89 years, 32.0%, p<0.001). CONCLUSION: CPET was relatively a safe and useful modality to assess exercise capacity, even in an elderly Korean population with underlying CV diseases.
Aged ; Aged, 80 and over ; Architectural Accessibility ; Cardiovascular Diseases ; Dyspnea ; Exercise Test ; Female ; Humans ; Incidence ; Korea ; Leg ; Male ; Metabolic Equivalent ; Oxygen ; Retrospective Studies ; Tachycardia, Ventricular

Background: As the importance of the esthetic function of teeth increases, the use of esthetic restoration materials and whitening treatment are increasing. The purpose of this study was to investigate the color change of esthetic restoration materials upon using staining and whitening toothpaste. Methods: Light curing (LC) packable composite resin, LC flowable resin, LC glass ionomer (GI), and self-curing GI specimens were colored in coffee or curry for three hours a day for seven days. After that, regular toothpaste, whitening toothpaste containing hydrogen peroxide, and whitening toothpaste containing activated charcoal were applied for three minutes three times a day for two weeks. Luminosity (L), chromaticity a (a), and chromaticity b (b) were measured using a spectrophotometer once a week. Results: In the coffee-colored group, the change in L2 *a2 *b2 (E2 ) with time was significant (p=0.004), there was no difference for different toothpaste types (p=0.646), and there was significant difference (p＜0.001) for different esthetic restorative materials.The change of E2 in the curry-colored group was significant only for different esthetic restorative materials (p＜0.001). In the coffee-colored group, the L, a, and b values of the light-curing GI showed greater change than other materials after staining and one week after whitening, turning dark, red, and yellow. In the curry-colored group, L did not differ for different materials and times, and a and b showed the greatest difference in light-curing GI after staining and one and two weeks after whitening. Conclusion The use of whitening toothpaste for two weeks was not different from the use of general toothpaste in the removal of staining or whitening. Since light-curing GI is the most vulnerable to coloration, it is recommended that coloring by food chromogen should be explained in advance, before using light-curing GI for teeth restoration.