Purpose: To determine subjective symptoms and medical history of patients with intermittent exotropia in a large study population. Methods: The Korean Intermittent Exotropia Multicenter Study (KIEMS) is a nationwide, observational, cross-sectional, multicenter study conducted by the Korean Association for Pediatric Ophthalmology and Strabismus including 5,385 patients with intermittent exotropia. Subjective symptoms and medical history of patients with intermittent exotropia were extracted by a comprehensive survey based on a self-administered questionnaire according to the study protocol of the KIEMS. Results: The mean age of symptom onset was 5.5 years. The most common symptom reported in patients with intermittent exotropia was photophobia (52.1%), followed by diplopia at near fixation (7.3%) and distance fixation (6.2%). Preterm birth was found in 8.8%, and 4.1% had perinatal complications. A family history of strabismus was present in 14.9%, and 5.5% of patients had a family member who underwent strabismus surgery. Conclusions The KIEMS is one of the largest clinical studies on intermittent exotropia. Intermittent exotropia frequently caused photophobia and diplopia, and patients with a family history was not uncommon.

Purpose: Trocar-site burns occurring during laparoscopic surgery have been reported in various cases, and several efforts to reduce them are underway. This study aimed to analyze the effect of capacitive coupling on trocar site by observing electrical and histological changes for electrical skin burn injury. Methods: To measure the electrical changes relating to capacitive coupling, the temperature, current, voltage, and impedance around the trocar were measured when an open circuit and a closed circuit were formed using insulation intact instruments and repeated after insulation failure. After the experiment, the tissue around the trocar was collected, and microscopic examination was performed. Results: When open circuits were formed with the intact insulation, the impedance was significantly reduced compared to the cases of closed circuits (142.0 Ω vs. 109.3 Ω, p = 0.040). When the power was 30 W and there was insulation failure, no significant difference was measured between the open circuit and the closed circuit (147.7 Ω vs. 130.7 Ω, p = 0.103). Collagen hyalinization, nuclear fragmentation, and coagulation necrosis suggesting burns were observed in the skin biopsy at the trocar insertion site. Conclusion This study demonstrated that even with a plastic trocar and electrosurgical instruments that have intact insulation, if an open circuit is formed, capacitive coupling increases, and trocar-site burn can occur. When using electrocautery, careful manipulation must be taken to avoid creating an open circuit to prevent capacitive coupling related to electrical skin burn.

Purpose: This study aimed to identify the effect of integrated nursing using cognicise and neurofeedback on cognition and ⍺ waves among elderly individuals. Methods: This quasi-experimental single group pretest-posttest study included 29 Korean adults aged 65 years or older who participated at a senior welfare center in Y city from February to May 2019. Each integrated nursing session consisted of cognicise (10 minutes) and neurofeedback (20 minutes). Subjects participated twice a week for 10 weeks. Structured questionnaires to assess participants' general characteristics and the Korean version of the Mini-Mental Status Examination for Dementia Screening (K-MMSE-DS) were applied. Alpha waves were measured using BrainMaster. Results: Following the integrated nursing program, alpha waves improved in F3 (t=2.41, p=.023), C3 (t=3.00, p=.006), C4 (t=2.60, p=.015), P3 (t=2.43, p=.022), O1 (t=2.30, p=.029), T3 (t=3.05, p=.005), T4 (t=2.28, p=.030), T5 (t=2.91, p=.007), Fz (t=2.30, p=.029), Cz (t=2.73, p=.011), and Pz (t=2.23, p=.034). Most subjects experienced improvement in concentration after participating in the intervention. Conclusion This study provides evidence for the use of a neuroscientific approach including brain wave measurement to improve cognitive health among community-living elderly people.

Although various studies on predictive markers in the use of PD-1/PD-L1 inhibitors are in progress, only PD-L1 expression levels in tumor tissues are currently used. In the present study, we investigated whether baseline serum levels of IL-6 can predict the treatment response of patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1/PD-L1 inhibitors. In our cohort of 125 NSCLC patients, the objective response rate (ORR) and disease control rate (DCR) were significantly higher in those with low IL-6 (<13.1 pg/ml) than those with high IL-6 (ORR 33.9% vs. 11.1%, p=0.003; DCR 80.6% vs. 34.9%, p<0.001). The median progression-free survival was 6.3 months (95% confidence interval [CI], 3.9–8.7) in the low IL-6 group, significantly longer than in the high IL-6 group (1.9 months, 95% CI, 1.6–2.2, p<0.001). The median overall survival in the low IL-6 group was significantly longer than in the high IL-6 group (not reached vs. 7.4 months, 95% CI, 4.8–10.0). Thus, baseline serum IL-6 levels could be a potential biomarker for predicting the efficacy and survival benefit of PD-1/PD-L1 inhibitors in NSCLC.

PURPOSE: To investigate the clinical features and surgical outcomes of rhegmatogenous retinal detachment (RRD) requiring surgery according to age. METHODS: Medical records of patients who underwent surgery for primary RRD between January 2008 and March 2016 were reviewed retrospectively. Patients were classified into two groups according to age at diagnosis: the under-40 group and the over-40 group. The two groups were compared in terms of demographic features, ocular manifestation, operating methods, primary anatomical success rate, and visual outcome. RESULTS: One hundred and forty-four eyes from 144 patients were included. Mean subject age was 48.6 ± 16.9 years old. The under-40 group involved 42 eyes from 42 patients, and the over-40 group included 102 eyes from 102 patients. Symptom duration was shorter in the under-40 group compared to the over-40 group (7.6 ± 10.7 days vs. 14.5 ± 24.4 days; p = 0.029). Proliferative vitreoretinopathy (PVR) occurred more frequently in the under-40 group (40.0% vs. 17.4%, p = 0.007) than in the over-40 group. The anatomical success rate of primary surgery was significantly different between the two groups; 78.6% in the under-40 group and 91.2% in the over-40 group (p = 0.038). Preoperative PVR increased the rate of anatomical failure (40.0% vs. 6.2%, p < 0.001). The visual outcomes were not significantly different between the two groups. CONCLUSIONS: RRD is combined with PVR more frequently in young patients than in old patients, which increases the failure rate of primary re-attachment surgery.
Diagnosis ; Humans ; Medical Records ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Vitrectomy ; Vitreoretinopathy, Proliferative

OBJECTIVES: This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. METHODS: A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. RESULTS: The satisfaction surveys in all three periods showed similar results for patients (4.46+/-0.70 point) and healthcare practitioners, including nurses (3.82+/-0.62 point) and physicians (3.60+/-0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. CONCLUSIONS: The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage.
Blood Glucose ; Blood Pressure ; Compliance ; Cost-Benefit Analysis ; Delivery of Health Care ; Diabetes Mellitus ; Gangwon-do* ; Hemoglobin A, Glycosylated ; Humans ; Hypertension ; Korea* ; Life Style ; Patient Compliance ; Patient Satisfaction ; Rural Health Services ; Telemedicine*

OBJECTIVES: The objective of this study was to develop a new device that provides a simple, noninvasive method of measuring accurate lesion size while using an endoscope. METHODS: We developed a rigid laryngoscope with a built-in laser-ruler using a one-light emitting diode and an acrylic plate. The invention incorporates a built-in laser diode that projects an auto-parallel beam into the optical path of the rigid laryngoscope to form two spots in the field of view. RESULTS: While the interspot distance remains consistent despite changes in focal plane, magnification, or viewing angle of the laryngoscope, projection to an uneven surface introduces certain variations in the shape, and size of the spots, and the distance between the two spots. CONCLUSION: The device enables a laryngologist to easily measure the distance between landmarks, as well as the change in real size, and the progressive change of vocal fold lesions in an outpatient setting.
Enzyme Multiplied Immunoassay Technique ; Humans ; Inventions ; Laryngoscopes ; Outpatients ; Vocal Cords ; Natural Resources

PURPOSE: The purpose of this study was to survey the college students' perception of cancer risks, cancer related health behavior, and perception of cancer occurrence possibility before and after age 40. METHODS: The subjects were 771 college students who were conveniently selected from two colleges in the Gyeonggi Province. Data were analyzed using SPSS WIN 12.0. RESULTS: The mean score of cancer risk perception was 3.8. The highest score item was 'smoking may cause cancer'. The mean score of cancer related health behavior was 3.0. The highest score item was 'take bath or shower'. Student felt that possibility of developing cancer before age 40 was 20.1% and that after age 40 was 36.2%. The perception of cancer risks was significantly different between male and female, and the health behavior was significantly different between age groups. There were weak relationships between the perception of cancer risks and cancer related health behavior. CONCLUSION: College students' perception of cancer risks was mostly good, but their behavior to reduce the risks did not match the degree of perception. Students recognized that after age 40 has a higher risk of developing cancer, therefore, intervention on behavioral modification to reduce cancer risks would be beneficial.
Baths ; Female ; Health Behavior ; Humans ; Male

PURPOSE: To evaluate the efficacy of Flexible intramedullary pin fixation in pediatric forearm diaphyseal fractures. MATERIALS AND METHODS: In this retrospective study, we reviewed 15 cases of forearm diaphyseal fractures operated using flexible intra-medullary nail fixation technique between January 2000 and December 2004. Of these 15 children, there were 11 boys and 4 girls with an average age of 11.6 years (range, 7~15 years). The implants were introduced in the distal radius and proximal ulna in all patients. An average duration of fixation was 5.3 months in the radius, 4.7 months in the ulna. After operation, all patient were applied with a long arm cast and the duration of immobilization was 5.2 weeks (range, 4~6 weeks) on average. RESULTS: All fractures in this series healed with normal range of supination (average 80.0) and pronation (average, 71.6 degrees). Average operation time including anesthesia was 123 minutes and hospital stay was 5.4 days. Time to union was 8.4 weeks on average. Range of motion and functional results were satisfactory in all cases. There were one case of incomplete ulnar nerve injury and two cases of refracture which were treated conservatively without any permanent complication. CONCLUSION: Flexible intramedullary pin fixation technique is a good method in case of unstable displaced fracture and difficult or failed closed treatment.
Anesthesia ; Arm ; Child* ; Female ; Forearm* ; Fractures, Bone* ; Humans ; Immobilization ; Length of Stay ; Pronation ; Radius ; Range of Motion, Articular ; Reference Values ; Retrospective Studies ; Supination ; Ulna ; Ulnar Nerve

A 28-year-old woman was admitted due to fever, dyspnea, hematuria and acute renal insufficiency. 1 months ago, she had been diagnosed as having ventricular septal defect with mild dyspnea and chronic cough. Infective endocarditis (IE) was diagnosed by clinical findings including vegetation in echocardiography. A blood culture drawn during the hospitalization grew streptococcus sanguis. A renal biopsy showed IE-induced crescentic glomerulonephritis (GN). Antibiotic treatment alone was effective for fever, but not for gross hematuria and renal insufficiency. After the initiation of plasmapheresis, gross hematuria and acute renal insufficiency was dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment infective endocarditis-induced crescent GN.
Acute Kidney Injury ; Adult ; Biopsy ; Cough ; Dyspnea ; Echocardiography ; Endocarditis* ; Female ; Fever ; Glomerulonephritis* ; Heart Septal Defects, Ventricular ; Hematuria ; Hospitalization ; Humans ; Plasmapheresis* ; Renal Insufficiency ; Streptococcus sanguis