• Title/Summary/Keyword: Acuity

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A Case of Cytomegalovirus Retinitis during Maintenance Chemotherapy for Acute Leukemia

  • Ahn, Bin;Song, Seungha;Han, Mi Seon;Oh, Baek Lok;Choi, Jae Hong;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.27 no.3
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    • pp.198-204
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    • 2020
  • Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy. Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

Analysis of Astigmatism in Korean Adults from 20 to 29 Yesrs Old (20세부터 29세까지 한국인 성인 난시 분석)

  • Kim, Douk-Hoon;Park, Sang-Youl
    • Journal of Korean Clinical Health Science
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    • v.9 no.1
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    • pp.1478-1485
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    • 2021
  • Purpose. To analysis of astigmatism in Korean adults from 20 to 29 years old. Methods. From January 2019 to February 2020, one hundred two subjects were performed in refraction test using the Auto-Refractometry. Results. In the type of astigmatism based on refractive error, the male's right eye was 4.26% simple myopic astigmatism and 95.74% complex myopic astigmatism, and the left eye was 2.22% simple myopic astigmatism and 97.78% complex myopic astigmatism. However, in the female's right eye, simple myopic astigmatism was 2.27%, complex myopic astigmatism was 97.73%, and left eye was simple myopic astigmatism was 2.17%, complex myopic astigmatism was 97.83%. The types of astigmatism in men and women similar to other. The mean refractive astigmatism values were -0.922±-0.798 diopter and -0.877±-0.707 diopter for male right and left eye, and -0.765±-0.599 diopter and -0.853±-0.586 diopter for female. On the other hand, the refraction values of the right and left eyes of men and women have statistical significance(p=0.000). The mean power comparative between refractive astigmatism and corneal astigmatism power were -0.186±-0.745 diopter, -1.091±-0.589 diopter in male and -1.140±-0.593 diopter, -1.140±-0.534 diopter in female. Therefore, the mean power values of the refractive astigmatism and corneal astigmatism of men and women were statistical significance(p=0.000). At the 0.75 diopter or more, which can have clinical symptoms of astigmatism power, males have 60.86% and 72.09% of the right and left eyes, and females have 47,64% and 60.10% of the right and left eyes. At 0.75 diopter or more, which can have clinical symptoms of corneal astigmatism power, males have 68.75% and 74% of the right and left eyes, and females have 86.50% and 82.35% of the right and left eyes. In the type of astigmatism axis, both men and women had a high frequency of the rule astigmatism. However, men had a high frequency of against-the-rule astigmatism and women showed a high frequency of oblique astigmatism. Conclusions. In this study, the complex myopic astigmatism and with-the rule astigmatism was the most common of all subjects. However, there was a statistical significance between right and left eyes of all subjects. The corneal astigmatism was higher refractive values in both males and females than refractive astigmatism. This study suggests that the analysis of the astigmatism can provide the useful diagnosis information for the correction of visual acuity.

Quality of Life and Its Related Factors Among Metropolitan-dwelling Older Adults (도시지역 재택 고령자의 삶의 질(Quality of Life) 및 관련요인)

  • Ham, Seok-Pil;Kim, Beom-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.5
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    • pp.411-422
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    • 2021
  • The purpose of this study is to examine the relationships between quality of life and demographic characteristics and health-related behavioral characteristics, and their relevance to variables that represent health conditions among metropolitan-dwelling older adults. The study subjects were 380 senior citizens aged 65 or older living in the D metropolitan area, and data collection was conducted by visiting them for interviews in June 2019. A binomial logistic regression analysis was performed to examine the relationship between independent variables (demographic characteristics, health-related behavioral characteristics, health condition variables) and the dependent variable (quality of life) while controlling for gender and age. As a result, the factors related to quality of life for those surveyed were education level, spousal status, living status, bear for living expenses, average monthly allowance, satisfaction with daily life, evaluation of sleep quality, smoking and eating habits, amount of regular exercise, hobbies, subjective health status, physical disability (if any), hearing ability, visual acuity, mastication ability, urinary incontinence (present or not), and amnesia. The above results suggest that quality of life for the elderly living in urban areas is significantly related to variables that indicate demographic characteristics, health-related behavioral characteristics, and health condition.

Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision (각막절개 위치와 크기에 따른 난시교정인공수정체의 난시교정의 정확성)

  • Park, Wookyung;Kim, Man Soo;Kim, Eun Chul
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.2
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    • pp.126-134
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    • 2019
  • Purpose: To assess the accuracy of toric intraocular lens (IOL) implantation by the location and size of the corneal incision. Methods: We retrospectively reviewed the medical records of 98 patients (98 eyes) who underwent phacoemulsification with toric IOL implantation from January 2014 to March 2017. The patients were divided into two groups: group 1 got an incision of the superior side of the cornea (n = 54) and group 2 received an incision on the temporal side of the eye (n = 44). For both groups, incisions were made at their steep corneal astigmatism axises. Each group was further divided into subgroups for whom different sized blades were employed (2.75 vs. 2.2 mm widths). We measured the refractive index and autokeratometric parameters. We postoperatively assessed residual astigmatism and any reduction thereof. Results: In both groups, uncorrected and best-corrected visual acuity, refraction cylinder astigmatism, and autokeratometric astigmatism improved statistically. Between two groups, corneal astigmatism decrease was not significant. Residual astigmatism also showed no significant differences between the two. Patients in both groups treated using 2.75 mm wide blades exhibited greater increases in corneal astigmatism. Conclusions: During cataract surgery, precise correction of astigmatism via toric IOL implantation is possible when surgically induced astigmatism is minimized by careful choice of the location and size of the corneal incision.

Endophthalmitis after Removal of an Intralenticular Foreign Body in Place without Symptoms for 20 Years (20년 동안 증상없이 잔존한 수정체 내 이물제거 후 발생한 안내염)

  • Choi, Young;Eom, Youngsub;Choi, Soo Youn;Lee, Bo Young;Kim, Eun Jee;Kang, Su-Yeon;Song, Jong Suk;Kim, Hyo Myung
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.5
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    • pp.480-485
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    • 2019
  • Purpose: We report a case of postoperative endophthalmitis in the cataract patient, associated with removal of an intralenticular foreign body that had remained in place without symptoms for 20 years. Case summary: A 45-year-old male visited our outpatient clinic complaining of gradual visual loss in his right eye over the past 3 months. In slit-lamp examinations, anterior capsular opacification, nuclear sclerosis, and posterior subcapsular opacity were observed in the right eye. Twenty years before, a tiny metallic projectile had hit his right eye, but slit-lamp examination at the time of injury did not reveal any intraocular foreign body. We decided to undergo cataract surgery. During phacoemulsification, a metallic foreign body was found in the lens and safely removed; then an intraocular lens was implanted. As hypopyon was evident 3 days later, we injected intravitreal antibiotics and applied fortified antibiotic eye drops to the right eye. The anterior chamber inflammation improved and the best-corrected visual acuity recovered to 1.0. Conclusions: Surgeon should be aware of that endophthalmitis could develop after cataract surgery with removal of an intralenticular foreign body that had been in place for 20 years. But did not trigger inflammation or cause any symptoms as the cataract progressed.

Efficacy of Statins on BMB or Fracture Risk in Postmenopausal Women (스타틴이 폐경기 여성의 골밀도 혹은 골절위험에 미치는 효과 -보고된 임상연구결과 분석을 중심으로-)

  • Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.86-91
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    • 2006
  • There are 3 different hypotheses on how statins may affect bones, through promoting bone formation, inhibiting bone resorption or through anti-inflammatory effect. In the 3 cross-sectional studies above, one showed increase BMD at hip and spine, one showed increase BMD only at mid-forearm and one showed that the risk reduction in fractures is not explained by the changes in BMD however, all 3 studies showed a decrease in risk of fracture associated with statins. In the 2 prospective cohort studies, one showed the use of statins was not associated with BMD at any skeletal site or decreasing the risk of fracture, and the other showed statins except pravastatin decreased in risk of vertebrate fracture but not affecting lumbar spine BMD. All of case-control studies indicated reduction in fracture risk but did not provide any data regarding BMD. 2 of the randomized, controlled studies showed no significant reduction in fracture risk as well as statins' effects on BMD. Finally, one longitudinal study showed statin use reduced fracture risk and increased BMD. Among the conflicting results shown above, even when statin use was shown to increase BMD, it does not seem to account for the reduction in fracture risk. There may be different ways that statins affect bone other than those hypotheses proposed above. Many studies seem to agree that pravastatin does not have any effect on bone. Some studies suggested that the reason statins did not achieve clinically significant increases in BMD in some studies, is due to the low affinity of statins on bone; statins are designed to act in the liver therefore their effective concentration in extrahepatic tissue is low. The limitations to those studies discussed above. Many studies did not account for the change of lifestyle while subjects' were on statins. Increases in weight bearing exercise and changes in diet might affect BMD and thus reduce risk of fractures. Mental alertness and vision acuity might prevent falls from occurring; many statin-users in the studies were young so the risk of fractures from falls would be decreased. Almost all of the studies failed exclude patients with neurological problems. During study periods, many subjects may have been started on drugs for diseases that usually occur with aging which could cause drowsiness and lead to falls. The sample sizes used in some of the trials were small and the duration of treatment and follow up might not have been long enough to see clinically relevant results.

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Factors Related to Poor School Performance of Elementary School Children (국민학교아동의 학습부진에 관련된 요인)

  • Park, Jung-Han;Kim, Gui-Yeon;Her, Kyu-Sook;Lee, Ju-Young;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.4 s.44
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    • pp.628-649
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    • 1993
  • This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

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A Study on Accounting for Nursing Cost by Korean Diagnosis Related Groups (K - DRGs) (종합병원(綜合病院)의 간호행위양상(看護行爲樣相)에 따른 간호원가(看護原價) 산정(算定)에 관(關)한 연구(硏究))

  • Oh, Hyo-Sook
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.5-46
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    • 1989
  • The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

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A Study for the Refractive Error on the Basis of Their Glasses Power (안경도수를 근거로 한 굴절이상에 관한 연구)

  • Jung, Han-Sub;Hong, Dong-Gyun;Park, Sang-An
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.431-437
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    • 2004
  • This research reviewed the objects of 384 persons (male:86, female:298) from 6 to 50 years old visited the S. Optical shop at Mokpo over two times from Mar. 2002 to Feb. 2004. We obtained the following results by analyzing the visual acuity prescription to keeping at S. Optical shop. 1. The abnormal refraction eyes were 191 persons(49.74%) for simple myopia, 2 persons(0.52%) for myopic simple astigmatism, 180 persons(46.88%) for myopic compound astigmatism, and 1 person(0.26%) for simple hyperopia, 2 persons(0.52%) for hyperopic simple astigmatism, 8 persons(2.08%) for hyperopic compound astigmatism, respectively. 2. Classifying of correction power for 373 persons (male:84, female:289) myopia, so that showed 166 persons(male:36, female) between $$0.25D{\leq_-}2.00D$$, 194 persons(male:46, female:148) between $$2.25D{\leq_-}6.00D$$, 13 persons(male:2, female:11) for over 6.250 respectively. 3. According to the kinds of 192 persons astigmatism subjects(male:53, female:148), direct astigmatism was 145 persons(male:32, female:113), oblique astigmatism 33 persons (male:12, female:21), reverse astigmatism 14 persons(male:5, female:9). 4. The variation of spherical power for myopia showed 299 persons(male:71, female:228) between $$0.00D{\leq_-}0.50D$$, 64 persons(male:11, female:53) between $$0.51D{\leq_-}1.00D$$, 9 persons(male:2, female:7) between $$1.01D{\leq_-}1.50D$$, 1 person(male:0, female:1) between $$1.51D{\leq_-}2.00D$$ variation respectively. Hyperopia showed 8 persons(male:1, female:7) between $$0.00D{\leq_-}0.50D$$, 3 persons(male:1, female:2) between $$0.51D{\leq_-}1.00D$$ variation respectively. 5. The variation of astigmatism power showed 181 persons(male:48 female:113) between $$0.00D{\leq_-}0.25D$$, 25 persons(male:9, female:16) between $$0.26D{\leq_-}0.50D$$, 6 persons(male:0, female:6) between $$0.51D{\leq_-}0.75D$$ astigmatism variation respectively.

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Analysis of Binocular Abnormality by Eyeball Motion in Ametropia (비정시의 안구운동에 의한 양안시 이상 분석)

  • Seong, Jeong-Sub
    • Journal of Korean Ophthalmic Optics Society
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    • v.10 no.3
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    • pp.205-213
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    • 2005
  • To evaluate the reliability of binocular vision measurements by phorometry. 90 students volunteered to participate in this study. 25 subjects were males, and 65 were females, they ranged in ages from 21 to 30 years. All subjects had normal ocular and systematic health, and all of them had at least 1.0 visual acuity with their best correction. At negative relative convergence(NRC) measurement in distance, the percentage of subjects is included in expected value(blur point/break point/recovery point) was 78%/61%/67%, divergence excess(DE) was 9%/31%/33%, and divergence insufficience(DI) was 13%/8%/9%, respectively. And positive relative convergence(PRC) measurement, includes expected value was 20%/46%/39%, convergence excess(CE) was 22%/14%/16%, and convergence insufficience(CI) was 35%/40%/45%. AC/A ratios of 42 subjects were normal. 38 were low, and the rest of them high. A low AC/A ratio is usually the result of a small vergence response in relation to accommodation. Negative relative convergence(NRC) at near, includes expected value was 26%/29%/44%, divergence excess(DE) was 61%/33%/24%, and divergence insufficience(DI) was 3%/38%/32%. And PRC at near, includes expected value was 33%/40%/31%, convergence excess(CE) was 61%/23%/42%, and convergence insufficience(CI) was 6%/37%/27%. For the near point of convergence(NPC) test, 58% of their subjects had a break of ${\leq}8cm$ with the accommodative target. In case of NRA(PRA) measurement, the expected value was 41%(33%). Accommodative insufficiency (AI) was 33%(43%), and accommodative excess(AE) was 26%(24%), respectively. AE was related to respectively low values of NRA. AI and CE are associated with high value of NRA, and the dysfunction of convergence excess combined with AE was related to a normal-high values of NRA. PRA in AI was related to a low value, wheres the dysfunction are associated with high values of PRA.

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