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Influence of Different Diagnostic Criteria on Frequency of Convergence Insufficiency (진단기준 차이가 폭주부족의 빈도에 미치는 영향)

  • Yu, Dong-Sik;Cho, Hyun Gug;Moon, Byeong-Yeon
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.3
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    • pp.235-242
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    • 2016
  • Purpose: This study was to investigate whether the application of different diagnostic criteria affected the frequency of convergence insufficiency (CI). Methods: Eighty one subjects with mean age of 22.54 years (20 to 27 years) were evaluated. Binocularity tests after refraction were performed as the following tests: near point of convergence (NPC) with an accommodative target, phoria using von Graefe method, positive fusional vergence (PFV) with a phoropter. Subjects with CI were diagnosed when exophoria (exo) was greater at near than at distance ($exo{\geq}4{\Delta}$, or >$6{\Delta}$), fusional vergence was $PFV{\leq}11{\Delta}$ for blur, $PFV{\leq}15{\Delta}$ for break, Sheard's or Percival's criterion, and NPC was $NPC{\geq}6cm$, ${\geq}7.5cm$ or >10 cm. Results: Frequency of CI with one diagnostic criterion was ranged from 6.2% to 77.8%, and was overestimated or underestimated according to criteria. It was reduced to the range of 6.2% to 43.2% with diagnostic criteria more than two, especially to the range of 24.7% to 28.4% with lower variability in diagnostic criteria including phoria and Sheard's criterion. There were high relationship between total score of signs and phoria score (r = 0.772, p<0.001), and measured phoria and Sheard's criterion (r = -0.654, p<0.001), but NPC had a high variability and a weak or no significant relationship with other diagnostic criteria. Results suggested $exo{\geq}4{\Delta}$, Sheard's criterion and $NPC{\geq}7.5cm$ for diagnostic criteria of signs and sequence for CI. Conclusions: Frequency of CI is likely to be over- and underestimated with diagnostic criteria. Cutoff values and procedures for phoria, Sheard's criterion and NPC as clinical signs should be suggested definitely in diagnosis associated with CI.

Evaluation of Fibrosis in Liver Cirrhosis by Superparamagnetic Iron Oxide (SPIO)-Enhanced MR Imaging: Does the Radiological Non-Invasive Fibrosis Index Correlate with the Laboratory Non-Invasive Fibrosis Index? (Superparamagnetic Iron Oxide-Enhanced MRI를 이용한 간섬유화의 평가: 영상의학적 비침습적 간섬유화 지표가 AST/혈소판 비와 상관 관계가 있는가?)

  • Kim, Shin-Kee;Lee, Chang-Hee;Kim, Kyeong-Ah;Choi, Jae-Woong;Lee, Jong-Mee;Park, Cheol-Min
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.115-122
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    • 2008
  • Purpose : To evaluate the correlation between the radiological non-invasive hepatic fibrosis index (RNHFI), as determined by SPIO-enhanced MRI, and the laboratory non-invasive hepatic fibrosis index. Materials and Methods : Patients (99 total: 61 men and 38 women; mean age: 58 years) who underwent SPIO-enhanced MRI (1.5T) during 5 years included. These patients were subdivided into a liver cirrhosis group (LCG) and a non-liver cirrhosis group (non-LCG). Using PACS view, we measured the RNHFI (mean standard deviation of hepatic signal intensity (SD), noise-corrected coefficient of variation (CV)) of three ROIs in the liver parenchyma by SPIO-enhanced MRI. The laboratory non-invasive hepatic fibrosis index (AST-platelet ratio index (APRI)) of all patients was calculated from the laboratory data. We compared the RNHFI and APRI of LCG with those of non-LC group using Student's t-test. A bivariate correlation was performed to investigate the relationship between the RNHFI and APRI in the LCG. Results : For the LCG, mean values of SD and CV by SPIO-enhanced MRI were $10.3{\pm}3.7$ and $0.19{\pm}0.08$, respectively. For the non-LCG, mean values of SD and CV were $6.5{\pm}1.6$ and $0.08{\pm}0.05$, respectively. The mean APRI of the LCG and the non- LCG were $2.04{\pm}1.7$ and $0.32{\pm}0.32$, respectively. The RNHFI and APRI were significantly different between both groups (p<0.05). For the LCG, the bivariate correlation between SD and APRI revealed a statistically significant positive correlation (r=0.5, p<0.001). In both groups, there was no statistically significant correlation between CV and APRI. Conclusion: A measurement of SD can be a simple and useful method for the evaluation of hepatic fibrosis.

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A Study on the Job Satisfaction and Quality of Life in Dental Hygienists (치과위생사들의 직무만족과 삶의 질에 관한 연구)

  • Kim, Young-Kyung
    • Journal of Korean society of Dental Hygiene
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    • v.3 no.2
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    • pp.127-141
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    • 2003
  • The present study conducted a survey on the correlation between job satisfaction of dental hygienists and their workplace satisfaction and quality of life. A total of 249 surveys eligible among all the collected surveys were used in the analysis. The survey consisted of 61 items; 35 items were about self-evaluations of their satisfaction with their tasks, occupation, and workplace, as well as the degree of self-affirmation and their family-related satisfaction; the rests were 26 WHOQOL-BREF items investigating the quality of life. Collected data were processed using the SPSS Ver. 10.0 calculating the reliability with the frequency, percentage, and Cronbach's ${\alpha}$. Besides, one-way ANOVA and linear regression analysis examined the correlation between the variables. The conclusion is as follows: 1. By Age: Job satisfaction and family-related satisfaction were highest in the subjects aged 30 or older($3.5377{\pm}0.6891$ at pF0.05 and $4.1789{\pm}0.5431$ at pF0.05, respectively), though the differences were not statistically significant). Workplace satisfaction and self-affirmation were also highest in those aged 30 or order($3.5753{\pm}0.4210$ at pE0.05 and $3.9695{\pm}0.4616$ at pE0.05, respectively). The differences were statistically significant. Quality of life was also highest in those aged 30 or older($3.4095{\pm}0.3529$, pF0.05). 2. By Types of Dental Institutions: Job satisfaction and workplace satisfaction were highest in the subjects who worked at the dental department in a general hospital($3.7431{\pm}0.5940$ at pF0.05 and $3.6615{\pm}0.4602$ at pF0.05. respectively), though without statistical significance. Self-affirmation was highest in those working in university hospitals($3.773{\pm}0.7151$, pF0.05), while family-related satisfaction was highest, though without statistical significance, in those working at the dental department in general hospitals($4.2500{\pm}0.5528$, pF0.05), who also showed highest quality of life with statistical significance($3.4046{\pm}0.4155$, pE0.05). 3. By Years at Work: The subjects who had worked as a dental hygienist for 12 years or more showed highest satisfaction or scores in all the variables investigated: job satisfaction($3.9326{\pm}0.6673$, pE0.05): workplace satisfaction($3.8316{\pm}0.4342$, pE0.05): self-affirmation($4.2000{\pm}0.4551$, pE0.05); family-related satisfaction($4.3778{\pm}0.4692$, pF0.5): and quality of life($3.5235{\pm}0.4323$, pF0.05). All but quality of life showed a difference with statistical significance. 4. Correlation between Quality of Life and Overall Job Satisfaction: Quality of life doesn't have a correlation with the subjects' satisfaction with their occupation or with their self-affirmation, while it does have a correlation with workplace satisfaction and family-related satisfaction(F=15.983, Sig=0.000, $R^2$=0.209). Besides, workplace satisfaction has a significant correlation with all the variables: job satisfaction, self-affirmation, family-related satisfaction, and quality of life(F=38.563, Sig=0.000, $R^2$=0.389). The above result shows that workplace satisfaction has a high correlation with job satisfaction, self-affirmation, family-related satisfaction and with quality of life. Consequently, to enhance satisfaction of dental hygienists with their workplace, it would be important to promote their autonomy and make desirable wokplace environments so that they can work efficiently with pride for their job.

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Analysis of Stress Response of Domestic Chicken Breeds for the Development of a New Synthetic Parent Stock (국산 종계 개발을 위한 토종 계통들의 스트레스 반응 정도 분석)

  • Sohn, Sea Hwan;Cho, Eun Jung;Park, Ji Ae;Hong, Young Ho;Kim, Chong Dae
    • Korean Journal of Poultry Science
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    • v.42 no.2
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    • pp.157-167
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    • 2015
  • We compared the degrees of stress response of 12 domestic purebred chicken strains that have been bred at National Institute of Animal Science, RDA, Korea since 1980. As a physiological marker of stress response, the expression levels of heat shock protein (HSP)-70, HSP-$90{\alpha}$, HSP-$90{\beta}$, hydroxyl-3-methyl-glutaryl coenzyme A reductase (HMGCR) genes and telomere length were measured by quantitative real-time polymerase chain reaction using the lymphocytes of 1,101 chickens. There was significant difference in HSP-70, HSP-$90{\alpha}$, HMGCR expression and telomere length among the strains. There was also significant difference in HSP-$90{\alpha}$, HSP-$90{\beta}$, and HMGCR expression between male and female chickens. Different age groups of chicken exhibited different expression levels of HSP-70, HSP-$90{\alpha}$ and telomere length. The results of the HSPs expression level suggested that, the strains of R, L and Y were highly resistant to stress, whereas the strains of S, O and W were susceptible to stress. Although the statistical differences in some of HSPs gene expression existed between genders, the HSP expression results varied in different strains that some opposed to the others, and there might be interaction between strains and genders, which conclude that there was no difference in stress response between male and female chickens. Moreover, despite of significant difference in some of HSPs expression level, it was considered that there was no difference in stress response between ages due to the inconsistent trends among HSP markers.

CT Simulation Technique for Craniospinal Irradiation in Supine Position (전산화단층촬영모의치료장치를 이용한 배와위 두개척수 방사선치료 계획)

  • Lee, Suk;Kim, Yong-Bae;Kwon, Soo-Il;Chu, Sung-Sil;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.165-171
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    • 2002
  • Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

Percutaneous Cardiopulmonary Support (PCPS) for Patients with Cardioppulmonary Bypass Weaning Failure during Open Heart Surgery (개심술 중 심폐기 이탈에 실패한 환자에게 적용한 경피적 심폐순환 보조장치)

  • Ryu, Kyoung-Min;Park, Seong-Sik;Seo, Pil-Won;Ryu, Jae-Wook;Kim, Seok-Kon
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.604-609
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    • 2009
  • Background: Recently, percutaneous cardiopulmonary support (PCPS) has been widely used to rescue patients in cardiogenic shock or cardiac arrest. However, patients with cardiopulmonary bypass (CPB) weaning failure during open heart surgery still have very poor outcomes after PCPS. We investigated clinical results and prognostic factors for patients who underwent PCPS during open heart surgery. Material and Method: From January 2005 to December 2008, 10 patients with CPB weaning failure during open heart surgery underwent PCPS using the CAPIOX emergency bypass system ($EBS^{(R)}$, Terumo Inc, Tokyo, Japan). We retrospectively reviewed the medical records of those 10 patients. Result: The average age of the patients was $60.2{\pm}16.5$ years (range, $19{\sim}77$ years). The mean supporting time was $48.7{\pm}64.7$ hours (range, $4{\sim}210$ hours). Of the 10 patients, 6(60%) were successfully weaned from the PCPS While 5 (50%) were able to be discharged from the hospital. Complications were noted in 5 patients (50%). In univariate analysis, long aortic cross clamp time during surgery, mediastinal bleeding during PCPS and high level of Troponin-I before PCPS were significant risk factors. All of the discharged patients are still surviving $34{\pm}8.6$ months (range, $23{\sim}48$ months) post-operatively. Conclusion: The use of PCPS for CPB weaning failure during open heart surgery can improve the prognosis. More experience and additional clinical studies are necessary to improve survival and decrease complications.

Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities (비대성심근증 환자의 이완기능평가: 승모판과 폐정맥 유속을 측정한 위상차 MRI의 이용)

  • Kim, Eun Young;Choe, Yeon Hyeon;Kim, Sung Mok;Lee, Sang-Chol;Chang, Sung-A;Oh, Jae K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.314-322
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    • 2014
  • Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.

Radiation Adaptive Response Induced by I-131 Therapy in Patients with Differentiated Thyroid Cancer (분화 갑상선암 환자에서 I-131 치료에 의해 유도되는 방사선적응반응)

  • Li, Ming-Hao;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.2
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    • pp.83-88
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    • 2001
  • Purpose: The purpose of this study was to ascertain whether radiation adaptive response could be induced by high dose I-131 therapy in patients with differentiated thyroid cancer. Materials and Methods: Lymphocytes from 21 patients (7 males, 14 females, mean age $55{\pm}12$ years) were collected before and after administration of 5,550 MBq (150 mCi) I-131. They were exposed to a challenge dose of 1 Gy gamma rays using a Cs-137 cell irradiator. The number of ring-form (R) and dicentric (D) chromosomes was counted under the light microscope, and used to calculate the frequency of chromosomal aberration. Ydr, which was defined as the sum of R and D divided by the total number of counted lymphocytes. Results: Ydr in patients before I-131 therapy ($0.09{\pm}0.01$) was not different from that of controls ($0.08{\pm}0.01$). Ydr was significantly increased to $0.13{\pm}0.02$ (p<0.0001) after I-131 therapy. Increase of Ydr after the challenge irradiation of 1 Gy was significantly lower in patients after I-131 therapy than before I-131 therapy ($0.17{\pm}0.03\;vs\;0.21{\pm}0.02$, p<0.0001). Cycloheximide (CHM), an inhibitor of protein synthesis, abolished this effect. Ydr after CHM ($0.20{\pm}0.01$) was significantly higher than Ydr after I-131 therapy ($0.17{\pm}0.03$, p<0.0001), but was not different from Ydr before I-131 therapy ($0.21{\pm}0.02$).Conclusion: High dose I-131 therapy induces an adaptive response in peripheral lymphocytes of patients with well-differentiated thyroid cancer, which is associated with protein synthesis.

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The Relationship between Perceived Stress and the Ways of Coping in the Elderly (노인의 지각된 스트레스와 대처방법과의 관계)

  • Hong, Min-Ju;Lee, Myung-Hwa
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.1
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    • pp.26-39
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    • 2003
  • The elderly can experience a lot of stressful events and the stress acts as a various fluent that affects a well-being level, the self-contentment of lives, and the achievements by themselves. Also, the elderly are different from the young in many unexpressed stress and have diverse copings for perceived stress. Moreover, they mainly seem to use a problem-focused coping and an emotion-focused coping. To use whatever copings is to improve the quality of life in the old period and very important fact to achieve their ends. The purpose of this study was to investigate the relationship between Perceived Stress and the Ways of Coping in the Elderly and to gain the baseline data for development of nursing intervention program for improve to the quality of life in the elderly. The design of this study was a correlational study. The subjects of this study consisted of 230 of the elderly living in Pusan. The data was collected from 1st July. to 1st September, 2002. The instruments used for this study were 'Perceived Stress Scale(20items, 5point. scale)' developed by Kang In(1990) and translated by Lee young-ja(1999), and its reliability is Cronbach's ${\alpha}=.89$. 'Coping Scale(30items, 4point. scale, 14 items about a problem-focused coping, 16 items about an emotion-focused coping, 4 points scale) developed by Lazarus & Folkman(1984) and translated by Yang Young-hee(1998). The reliability of this study is Cronbach's ${\alpha}=.90$. The data was analyzed by the SPSS WIN 10.0 program using frequency, percentage, mean, standard deviation, t-test, ANOVA & Scheffe test and Pearson's correlation coefficient. The results of this study were as follows; 1. The mean score of perceived stress was $31.75{\pm}10.23$(Min 20, Max 100), which the item mean score was $1.59{\pm}.51$(Min 1, Max 5). 2. The number of subjects in a problem-focused coping was 72(31.3%), the number of subjects in an emotion-focused coping was 158(68.7%) 3. There were statistically significant positive correlation between perceived stress and problem-focused coping method and the more emotion-focoused coping method.(r=.180, r= .209, P< .05). It means the more stress, the more problem-focused coping method and the more emotion-focused coping method. 4. There was significant difference the score of perceived stress according to sex (F=-5.057, P=.000)marital status, (F=-2.909, P=.004), economic level, (F=10.243, P=.000), paticipated meeting, (F=9.346, P=.000), perceived health status(F=5.117, P=.007). 5. There was significant difference the score of problem-focused coping method according to age(F=14.200, P=.000), marital status (F=2.432, P=.0160), economic level (F=14.410, P=.000), monthly income, (F=8.300. P=.000), income resource (F=10.235, P=.000), educational level (F=15.222, P=.000), occupation (F=1.544, P=.041), paticipated meeting (F=4.936, P=.008), perceived health status(F=5.655, P=.004). And there was significant difference the score of emotion-focused coping method according to monthly income(F=4.781, P=.009), income resource(F=2.930, P=.035), educational level(F=6.101, P=.003), religionF=2.698, P=.032), paticipated meetings(F=7.285, P=.001). As a result of the study, the elderly had a bit less stress and the two-thirds of the elderly used the emotion-focused coping. Thus, the more perceived stress, the more problem-focused coping method and the more emotion-focused coping method. Accordingly, to improve the quality of life of the elderly, there needs and applies a nursing intervention program that relieves the stress and use effective coping method.

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Urine endothelin-1 as a Biomarker for Urinary Tract Infections in Children (Urine endothelin-1의 소아 요로 감염 환아에서의 진단적 유용성)

  • Kee, Hyung Min;Yi, Dae Yong;Yun, Ki Wook;Lim, In Seok;Ha, Tae-Seon
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.36-41
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    • 2014
  • Purpose: Urinary tract infections (UTIs) are the most common source of bacterial infections in infants and young children. Accurate diagnosis and treatment is important because of their association with renal scarring, which can lead to complications. Urine endothelin-1 (ET-1) is the major renal isoform produced and released by renal mesangial cells in response to glomerular injury. This study aimed to investigate whether urinary levels of ET-1 can be used as a biomarker for UTI diagnosis. Method: We conducted a prospective study using medical records of 70 patients below the age of 18 years, who visited Chung-Ang University Hospital from July 2012 to July 2013. We classified the patients into the UTI and control groups based on urine culture studies. The UTI group was further divided into upper and lower UTI groups using 99m-Technetium dimercaptosuccinic acid scintigraphy. Urine ET-1 was measured using enzyme linked immunosorbent assay with 0.3 mL urine. Results: The UTI and control groups were comprised of 45 and 25 patients, respectively. Mean urine ET-1 levels were significantly higher in the UTI group than in the control group ($1.41{\pm}0.35$ pg/mL vs. $0.33{\pm}0.07$ pg/mL, P =0.04). There was no significance difference in the quantitative value between the upper and lower UTI groups (P =0.552). There was no correlation between urine ET-1 and serum C-reactive protein (Pearson correlation [R]=0.24), urine ET-1 and serum white blood cell count (R=0.19). Conclusion: Our study suggests that urine ET-1 can be used for early diagnosis of UTI in children.