Purpose: To compare the structural features of the optic nerve head (ONH) in moderate glaucoma patients with single-hemispheric and bi-hemispheric visual field (VF) defects. Methods: Patients with open-angle glaucoma (OAG) and a VF mean deviation between -6 and -12 dB were retrospectively enrolled. Based on VF defect patterns, eyes were classified into two groups: those with single-hemispheric VF defects and those with bi-hemispheric VF defects. Structural features analyzed included Bruch’s membrane opening area, lamina cribrosa (LC) thickness, temporal β-zone parapapillary atrophy with and without Bruch's membrane (βPPA+BM, βPPA-BM, respectively), and peripapillary retinal nerve fiber layer thickness using spectral-domain optical coherence tomography. Results: Out of 137 eyes from 124 patients, 80 eyes had single-hemispheric VF defects and 57 eyes had bi-hemispheric VF defects. The bi-hemispheric group exhibited longer axial length (p = 0.038), thinner central corneal thickness (p = 0.003), thinner LC (p < 0.001), and larger temporal βPPA+BM (p = 0.002) compared to the single-hemispheric group. Conclusions Among Korean OAG patients with moderate VF defects, those with bi-hemispheric VF defects showed more structurally vulnerable optic discs characterized by longer axial lengths, thinner central corneal thickness, thinner LC, and larger β PPA+BM compared to those with single-hemispheric VF defects. These findings underline the importance of evaluating ONH structures in monitoring glaucoma progression particularly in patients with extensive VF damage.

Objective: : Deciphering the anatomy of posterior communicating artery (PCoA) aneurysms in relation to surrounding structures is essential to determine adjuvant surgical procedures. However, it is difficult to predict surgical structures through preoperative imaging studies. We aimed to present anatomical structures using preoperative high-resolution three-dimensional proton densityweighted turbo spin-echo magnetic resonance (PDMR) imaging with simple classification. Methods: : From January 2020 to April 2022, 30 patients underwent PDMR before microsurgical clipping for unruptured PCoA aneurysms in a single tertiary institute. We retrospectively reviewed the radiographic images and operative data of these patients. The structural relationship described by PDMR and intraoperative findings were compared. Subsequently, we classified aneurysms into two groups and analyzed the rate of adjuvant surgical procedures and contact with the surrounding structures. Results: : Correlations between preoperative PDMR predictions and actual intraoperative findings for PCoA aneurysm contact to the oculomotor nerve, temporal uncus, and anterior petroclinoid fold (APCF) reported a diagnostic accuracy of 0.90, 0.87, and 0.90, respectively. In 12 patients (40.0%), an aneurysm dome was located on the plane of the oculomotor triangle and was classified as the infratentorial type. Compared to the supratentorial type PCoA aneurysm, adjuvant procedures were required more frequently (66.7% vs. 22.2%, p=0.024) for infratentorial type PCoA aneurysm clipping. Conclusion : Preoperative PCoA aneurysm categorization using PDMR can be helpful for predicting surgical complexity and planning of microsurgical clipping.

This report provides a detailed description of the methodology for ophthalmic examinations according to the Korea National Health and Nutrition Examination Survey (KNHANES) VII and VIII (from 2017 to 2021). The KNHANES is a nationwide survey which has been performed since 1998 in representatives of whole Korean population. During the KNHANES VII and VIII, in addition to the ophthalmic questionnaire, intraocular pressure measurement, visual field test, auto refractometry, axial length and optical coherence tomography measurements were included. This new survey will provide not only provide normative and pathologic ophthalmic data including intraocular pressure, refractive error, axial length, visual field and precise measurement of anterior segment, macula and optic nerve with optical coherence tomography, but also a more accurate diagnosis for major adult blindness diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, and other ocular diseases, for the national Korean population.

Background: Close reading is used in medical education to improve doctors’ listening, empathy and relationship-building ability, but no method for close reading has been suggested yet. In order to efficiently use close reading in medical education, it is essential to present concrete methods of close reading. Methods: The development of the Close Reading methods is based on the basic principles of text interpretation, resources of knowledge in the evaluation process and the theory of variation analysis presented by Lucius-Hoene and Deppermann. Results: The basic principles of text interpretation include data-orientedness, reconstructive attitude, prerequisites for meaningfulness, multilevel consideration, sequence analysis and contextuality, circularity and coherence, explicativity and argumentativity. As knowledge resources there is everyday knowledge, ethographic-historical knowledge, knowledge about linguistic-communicative phenomena, theoretical knowledge. Variation analysis includes substitution, deletion, permutation, insertion. Conclusion The basic principle of text interpretation is worth using as guidelines for text interpretation that readers of close reading should pay attention to. Knowledge resources can be used as the resources and argument for text interpretation. And the Variation analysis can be used to verify the validity of the close reading results. All of these can also be used for teachers in assessing and providing feedback to learners.

This report provides a detailed description of the methodology for ophthalmic examinations according to the Korea National Health and Nutrition Examination Survey (KNHANES) VII and VIII (from 2017 to 2021). The KNHANES is a nationwide survey which has been performed since 1998 in representatives of whole Korean population. During the KNHANES VII and VIII, in addition to the ophthalmic questionnaire, intraocular pressure measurement, visual field test, auto refractometry, axial length and optical coherence tomography measurements were included. This new survey will provide not only provide normative and pathologic ophthalmic data including intraocular pressure, refractive error, axial length, visual field and precise measurement of anterior segment, macula and optic nerve with optical coherence tomography, but also a more accurate diagnosis for major adult blindness diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, and other ocular diseases, for the national Korean population.

PURPOSE: Optic nerve head surface depression in patients with glaucoma has been previously reported. We quantitatively compared the mean optic disc cup surface depth between glaucoma-like disc (GLD) patients with large cup-to-disc ratios and primary open-angle glaucoma (POAG) patients. METHODS: A total of 40 eyes of 40 patients with GLD and 40 eyes of 40 patients with POAG were included in this study. All patients had an average cup-to-disc ratio of 0.7–0.8. The optic disc area, mean cup-to-disc ratio, and mean optic disc cup volume were measured using spectral domain optical coherence tomography (Cirrus™ HD-OCT; Carl Zeiss Meditec, Inc., Dublin, CA, USA). The mean optic disc cup surface depth was calculated using the formula: (mean optic disc cup volume/[optic disc area × mean cup-to-disc ratio2]) − 200 µm. RESULTS: The mean ages of patients were 61.18 ± 11.83 and 59.65 ± 11.69 years for the GLD and POAG groups, respectively. The average cup-to-disc ratios were 0.74 ± 0.03 and 0.75 ± 0.03 for the GLD and POAG groups, respectively, but no significant difference was observed between the two groups. The mean optic disc cup surface depths were 144.74 ± 82.78 µm and 199.53 ± 90.26 µm for the GLD and POAG groups, respectively, and the difference between the two groups was statistically significant (p = 0.006, t-test). CONCLUSIONS: POAG patients showed a significantly greater mean optic disc cup surface depth compared to GLD patients with a similar mean cup-to-disc ratio. Based on the results of spectral domain optical coherence tomography, confirming the mean optic disc cup surface depth is expected to provide additional information to distinguish GLD from POAG patients.
Depression ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Optic Disk ; Tomography, Optical Coherence

PURPOSE: This study aimed to examine the effects of interpersonal relationship ability, job stress, and stress coping type on the turnover intention of nurses in the early stage of their careers. METHODS: Data were collected from 136 early stage nurses from two general hospitals and one tertiary hospital in Chungbuk province. An early stage nurse was defined as the nurse with a work experience of 3 to 36 months. The collected data were analyzed using independent t-test, one-way ANOVA, Mann-Whitney U test, Person's correlation coefficient, and stepwise multiple regression. RESULTS: It was seen that turnover intention had a negative correlation with interpersonal competency (r=-.20, p=.020) and a positive correlation with job stress (r=.56, p < .001). Job stress due to work over load, inadequate compensation and working environment, interpersonal relationship ability, and length of clinical career were significant factors influencing turnover intention (p < .05). These variables explained for 50.4% of the variance in turnover intention. CONCLUSION: It is necessary to develop an interpersonal relationship ability improvement program to decrease turnover intention among early stage nurses by helping them to successfully adapt to their job. Moreover, it is important to bring about continuous improvements in terms of provision of adequate workload and appropriate rewards, and creation of a suitable work environment to reduce the job stress of early stage nurses.
Adaptation, Psychological ; Chungcheongbuk-do ; Compensation and Redress ; Hospitals, General ; Intention ; Interpersonal Relations ; Reward ; Tertiary Care Centers

No abstract available.

PURPOSE: This study aimed to examine the effects of interpersonal relationship ability, job stress, and stress coping type on the turnover intention of nurses in the early stage of their careers. METHODS: Data were collected from 136 early stage nurses from two general hospitals and one tertiary hospital in Chungbuk province. An early stage nurse was defined as the nurse with a work experience of 3 to 36 months. The collected data were analyzed using independent t-test, one-way ANOVA, Mann-Whitney U test, Person's correlation coefficient, and stepwise multiple regression. RESULTS: It was seen that turnover intention had a negative correlation with interpersonal competency (r=-.20, p=.020) and a positive correlation with job stress (r=.56, p < .001). Job stress due to work over load, inadequate compensation and working environment, interpersonal relationship ability, and length of clinical career were significant factors influencing turnover intention (p < .05). These variables explained for 50.4% of the variance in turnover intention. CONCLUSION It is necessary to develop an interpersonal relationship ability improvement program to decrease turnover intention among early stage nurses by helping them to successfully adapt to their job. Moreover, it is important to bring about continuous improvements in terms of provision of adequate workload and appropriate rewards, and creation of a suitable work environment to reduce the job stress of early stage nurses.

OBJECTIVE: This retrospective case series study of the effectiveness of electroconvulsive therapy (ECT) augmentation on clozapine-resistant schizophrenia was conducted by EMR review. METHODS: Clozapine-resistance was defined as persistent psychotic symptoms despite at least 12 weeks of clozapine administration with blood levels over 350 ng/mL in order to rule out pseudo-resistance. Seven in-patients who were taking clozapine and treated with ECT were selected. We analyzed the psychopathology and subscales changed by ECT. RESULTS: The average number of ECT sessions was 13.4 (±4.6). Total Positive and Negative Syndrome Scale (PANSS) score was significantly reduced by 17.9 (±12.8) points (p=0.0384) on average, which represented a reduction of 25.5% (±14.3). 71.4% (5/7) of patients were identified as clinical remission, with at least a 20% reduction in PANSS score. PANSS reduction was associated with number of ECT sessions, stimulus level in the final session, and blood clozapine levels before ECT. However, the negative subscale on the PANSS were not reduced by ECT in any patient. We did not observe any persistent adverse cognitive effects. CONCLUSION: This study supports that ECT augmentation on clozapine-resistant schizophrenia reveals clinically effective and safe. Further research should be done involving a larger number of patients to investigate the effectiveness of clozapine/ECT combination therapy.
Clozapine ; Electroconvulsive Therapy* ; Humans ; Psychopathology ; Retrospective Studies ; Schizophrenia*