Purpose: To characterize perioperative changes in posterior corneal curvature (PCC) following pterygium excision using anterior segment (AS) swept-source optical coherence tomography (SS-OCT), and to identify the critical threshold of horizontal invasion length (HIL) predicting significant PCC alterations. Methods: This retrospective cohort study included 85 eyes of 77 patients with primary nasal pterygium. PCC parameters, including posterior keratometry (K) average, posterior steep K, posterior flat K and posterior corneal astigmatism, were measured preoperatively and postoperatively using AS SS-OCT (Anterion). Perioperative PCC changes were analyzed in relation to HIL and postoperative duration. Subgroup analyses were performed to identify the HIL cutoff value associated with statistically significant changes in posterior K average. Results: Significant postoperative flattening was observed in both posterior K average (from –6.27 ± 0.24 to –6.23 ± 0.23 diopters [D], p < 0.001) and posterior flat K (from –6.14 ± 0.23 to –6.09 ± 0.23 D, p < 0.001), accompanied by a significant increase in posterior corneal astigmatism (from –0.25 ± 0.12 to –0.29 ± 0.17 D, p = 0.003). The magnitude of posterior flattening showed a significant positive correlation with HIL (r = 0.384, p < 0.001) but was not correlated with postoperative duration (p = 0.428). In subgroup analysis, eyes with HIL ≥3.5 mm exhibited a significant change in posterior K average (p < 0.001), whereas those with HIL <3.0 mm and HIL <3.5 mm showed no significant change (p = 0.065 and p = 0.443, respectively). Conclusions Pterygium excision leads to significant posterior corneal flattening proportional to HIL, with 3.5 mm identified as a clinically relevant cutoff. Although the refractive impact may be subtle, surgeons should be aware of these posterior corneal changes as a consistent morphological response, especially in eyes with HIL ≥3.5 mm.

OBJECTIVES: A Womans University College of Medicine faces curriculum reform in 2020. To determine what reforms are needed in the premedical curriculum, a needs assessment was conducted.METHODS: This study utilizes qualitative study method. A focus group interview was conducted with four students who completed premedical courses from November to December 2018. Interviews were conducted in two groups by grade level, and each interview was recorded. After transcribing the recorded contents, four researchers analyzed the data using conventional content analysis.RESULTS: Students chose A Womans University College of Medicine considering their future careers as female medical professionals and other considerations such as scholarships. The students expected diverse experiences, exchanges with students in different departments, and fusion of medicine with other fields during their premedical years. Overall, these expectations were met during the course, but individual needs for customized education, such as liberal arts, were unmet. In general, students' attitudes toward premedical courses were very motivated and they actively used resources provided by the university.CONCLUSION: Qualitative research can provide a better understanding of quantitative data, such as a student survey performed to prepare for curriculum reform. Based on this understanding, the curriculum will be reformed to reflect the educational needs of students, to motivate students and to provide satisfactory education.
Curriculum ; Education ; Education, Medical ; Fellowships and Scholarships ; Female ; Focus Groups ; Humans ; Methods ; Needs Assessment ; Program Evaluation ; Qualitative Research ; Students, Premedical

BACKGROUND: Terminally ill cancer patients suffer from refractory symptoms, and the last option of treatment is to consider sedatives. However, due to concerns that sedation may shorten survival time, some people prefer not to take sedatives. The purpose of this study was to investigate the effects of sedative administration on survival time among terminally ill cancer patients.METHODS: Two hundreds and thirty-seven patients who were hospitalized to the hospice care unit of public hospitals in Seoul from January, 2015 to March, 2016 were analyzed retrospectively. The univariate and multivariate Cox's proportional hazard regression model was used to determine independent factors related to survival time.RESULTS: The usage of sedation was necessary because the incidence of insomnia was 61.4% in the lorazepam only group, and the incidence of delirium was highest in the haloperidol group and the haloperidol with lorazepam group. Interestingly, multivariate analysis showed that male (HR, 1.766; P < 0.001), decreased consciousness (HR, 1.803; P=0.003), anorexia (HR, 1.506; P=0.012), resting dyspnea (HR, 1.757; P < 0.001), elevated serum bilirubin (HR, 1.657; P=0.001), and the haloperidol with lorazepam group (HR, 0.535, P < 0.001) were each significantly associated with survival time. Furthermore, patients in the haloperidol with lorazepam group survived longer than patients with no such medications.CONCLUSION: There is no evidence that treatment with sedative medication shortens the survival time of patients with terminally ill cancer with refractory symptoms.
Anorexia ; Bilirubin ; Consciousness ; Delirium ; Dyspnea ; Haloperidol ; Hospice Care ; Hospices ; Hospitals, Public ; Humans ; Hypnotics and Sedatives ; Incidence ; Lorazepam ; Male ; Multivariate Analysis ; Palliative Care ; Retrospective Studies ; Seoul ; Sleep Initiation and Maintenance Disorders ; Terminally Ill

BACKGROUND: Physical activity is an important factor for preventing osteoporosis. This study aimed to investigate the association of work- and leisure-time physical activities with osteoporosis in postmenopausal women.METHODS: Data were obtained from the Korea National Health and Nutritional Examination Survey 2015–2016. A total of 2,885 postmenopausal women were included in the analysis. The subjects were divided into 3 groups according to the intensity of the work- and leisure-time physical activities. T-test, chi-square test, and multivariable logistic regression analysis were used.RESULTS: No association was found between work-time physical activity and osteoporosis prevalence. However, a dose-response relationship was found in case of leisure-time physical activity. People with leisure-time physical activity of at least >1,000 MET-min/week showed lower prevalence of osteoporosis.CONCLUSION: An appropriate level of leisure-time physical activity should be recommended to prevent and treat osteoporosis.
Female ; Humans ; Korea ; Leisure Activities ; Logistic Models ; Motor Activity ; Nutrition Surveys ; Osteoporosis ; Prevalence

BACKGROUND: We investigated the associations between mineral metabolism parameters and mortality to identify optimal targets in Korean hemodialysis patients. METHODS: Among hemodialysis patients registered in the end-stage renal disease registry of the Korean Society of Nephrology between March 2012 and June 2017, those with serum calcium, phosphorus, and intact parathyroid hormone (iPTH) measured at enrollment were included. Association of serum levels of calcium, phosphorus, and iPTH with all-cause mortality was analyzed. RESULTS: Among 21,433 enrolled patients, 3,135 (14.6%) died during 24.8 ± 14.5 months of follow-up. After multivariable adjustment, patients in the first quintile of corrected calcium were associated with lower mortality (hazard ratio [HR], 0.84; 95% confidence interval [95% CI], 0.71–0.99; P = 0.003), while those in the fifth quintile were associated with higher mortality (HR, 1.39; 95% CI, 1.20–1.61; P < 0.001) compared with those in the third quintile. For phosphorus, only the lowest quintile was significantly associated with increased mortality (HR, 1.24; 95% CI, 1.08–1.43; P = 0.003). The lowest (HR, 1.18; 95% CI, 1.02–1.36; P = 0.026) and highest quintiles of iPTH (HR, 1.24; 95% CI, 1.05–1.46; P = 0.013) were associated with increased mortality. For target counts achieved according to the Kidney Disease Outcomes Quality Initiative guideline, patients who did not achieve any mineral parameter targets hadhigher mortality than those who achieved all three targets (HR, 1.37; 95% CI, 1.12–1.67; P = 0.003). CONCLUSION: In Korean hemodialysis patients, high serum calcium, low phosphorus, and high and low iPTH levels were associated with increased all-cause mortality.
Calcium ; Follow-Up Studies ; Humans ; Kidney Diseases ; Kidney Failure, Chronic* ; Metabolism ; Miners* ; Mortality* ; Nephrology ; Parathyroid Hormone ; Phosphorus ; Renal Dialysis*

Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.
Aged ; Alzheimer Disease ; Anemia, Iron-Deficiency ; Biopsy ; Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Diagnosis ; Foreign Bodies ; Hemoptysis ; Humans ; Inflammation* ; Iron ; Korea ; Necrosis ; Nervous System Diseases ; Parkinsonian Disorders ; Reflex ; Respiratory Aspiration ; Stroke ; Tablets

BACKGROUND: The purpose of this study was to examine the association between resting heart rate (RHR), the risk factors and prevalences of metabolic syndrome (MetS) and type 2 diabetes (T2D) in Korean adults. METHODS: A cross sectional analysis was performed on data from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES V) using frequency analysis, analysis of covariance (ANCOVA), and logistic regression. Participants were stratified according to RHR into 5 groups; <60 bpm, 60-69 bpm, 70-79 bpm, 80-89 bpm, and > or =90 bpm. RESULTS: The results show that risk factors of MetS and T2D increased as RHR increased. Compared to those with a RHR of <60 bpm, the prevalence of MetS increased in those with RHR of 60-69 bpm, 70-79 bpm, 80-89 bpm and > or =90 bpm by 1.46 (95% confidence interval [CI] 1.03-2.08), 2.05 (95% CI, 1.42-2.96), 2.34 (95% CI, 1.57-3.48), and 2.34 (95% CI, 1.23-4.47), respectively. Similarly, compared to those with a RHR of <60 bpm, the prevalence of T2D increased in those with RHR of 60-69 bpm, 70-79 bpm, 80-89 bpm, and > or =90 bpm by 1.01 (95% CI, 0.72-1.41), 1.44 (95% CI, 1.02-2.05), 1.83 (95% CI, 1.25-2.68), and 2.40 (95% CI, 1.30-4.44), respectively. CONCLUSION: In conclusion, RHR was significantly associated with risk factors and prevalences of MetS and T2D. This study suggests that RHR is associated with MetS and T2D and can be used to predict such diseases.
Adult ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Heart Rate ; Heart ; Humans ; Korea ; Logistic Models ; Nutrition Surveys ; Prevalence ; Risk Factors

BACKGROUND: The association between daily protein intake and osteoporosis is still controversial and only a few studies have explored the issue in Korea. This study investigated the relationship between daily protein intake and the prevalence of osteoporosis in Korean adults. METHODS: This study analyzed data extracted from the Korean National Health and Nutrition Examination Survey 4. Participants were aged 19 years or older and had never been treated for osteoporosis. The percentage of calories coming from protein intake was assessed by 24-hour recall method, and participants were divided into three groups according to recommended daily dietary protein intake as a proportion of total daily calories (i.e., <10%, 10%-20%, and >20%). A lumbar or femur neck bone mineral density T-score less than -2.5 was indicative of the presence osteoporosis. The influence of daily protein intake on the prevalence of osteoporosis was analyzed. RESULTS: In both sexes, the group with the highest protein intake had significantly lower odds of developing lumber osteoporosis when compared to the group with the lowest protein intake, after adjusting for associated factors (females: odds ratio [OR], 0.618; 95% confidence interval [CI], 0.610 to 0.626; P for trend <0.001; males: OR, 0.695; 95% CI, 0.685 to 0.705; P for trend <0.001). CONCLUSION: Sufficient daily protein intake lowered the prevalence of osteoporosis in Korean adults. Further prospective studies are necessary to verify the preventive effect of adequate protein intake on osteoporosis.
Adult ; Aged ; Bone Density ; Dietary Proteins ; Femur Neck ; Humans ; Korea ; Nutrition Surveys ; Odds Ratio ; Osteoporosis ; Prevalence ; Proteins

PURPOSE: This study aims to compare and investigate the differences in beliefs with regard to the cause of illnesses, medial skepticism, and attitudes toward medical care between medical, Oriental medical, and nonmedical students. METHODS: To this end, we used a structured questionnaire and collected self-reported data from a sample of 667 respondents. RESULTS: First, their beliefs on the causes of illness were markedly different, depending on their specialty. Compared with students from other specialties, Oriental medical students ranked host factors, environmental factors, and natural factors as the highest causes of illness. -the former group regarded supernatural factors as a more influential cause of illnesses compared with the latter. Among Oriental medical students and nonmedical students-who were also subdivided into the aforementioned groups-the upper-grade group regarded host factors as a higher cause of illness than the lower-grade group. Second, Medical skepticism also differed depending on specialty. Compared with the medical students, Oriental medical students were more likely to have high confidence in "overcoming illnesses", "home remedies", "self-decision in treatments", and "understanding their own health". In subdividing medical and Oriental medical students according to grade we observed that the senior group had more confidence in home remedies than the junior group. Third, In an analysis of the students attitudes toward medical care, we found that nonmedical students had the highest score in the "care-oriented" and "cure-oriented" attitude categories. In the overall results, the care-oriented category ranked highest for the nonmedical students, followed by Oriental medical students and medical students; the cure-oriented category ranked highest for nonmedical students, followed by medical students and then Oriental medical students. CONCLUSION: Based on our results, we conclude that these differences between specialties should be reflected in medical curricula to bridge the gap between patients and doctors in medical education with regard to the causes of illness and attitudes toward medical care.
Curriculum ; Surveys and Questionnaires ; Education, Medical ; Humans ; Medicine, Traditional ; Students, Medical

PURPOSE: This study aims to compare and investigate the differences in beliefs with regard to the cause of illnesses, medial skepticism, and attitudes toward medical care between medical, Oriental medical, and nonmedical students. METHODS: To this end, we used a structured questionnaire and collected self-reported data from a sample of 667 respondents. RESULTS: First, their beliefs on the causes of illness were markedly different, depending on their specialty. Compared with students from other specialties, Oriental medical students ranked host factors, environmental factors, and natural factors as the highest causes of illness. -the former group regarded supernatural factors as a more influential cause of illnesses compared with the latter. Among Oriental medical students and nonmedical students-who were also subdivided into the aforementioned groups-the upper-grade group regarded host factors as a higher cause of illness than the lower-grade group. Second, Medical skepticism also differed depending on specialty. Compared with the medical students, Oriental medical students were more likely to have high confidence in "overcoming illnesses", "home remedies", "self-decision in treatments", and "understanding their own health". In subdividing medical and Oriental medical students according to grade we observed that the senior group had more confidence in home remedies than the junior group. Third, In an analysis of the students attitudes toward medical care, we found that nonmedical students had the highest score in the "care-oriented" and "cure-oriented" attitude categories. In the overall results, the care-oriented category ranked highest for the nonmedical students, followed by Oriental medical students and medical students; the cure-oriented category ranked highest for nonmedical students, followed by medical students and then Oriental medical students. CONCLUSION: Based on our results, we conclude that these differences between specialties should be reflected in medical curricula to bridge the gap between patients and doctors in medical education with regard to the causes of illness and attitudes toward medical care.
Curriculum ; Surveys and Questionnaires ; Education, Medical ; Humans ; Medicine, Traditional ; Students, Medical