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Aided Distance Visual Acuity and Refractive Error Changes by Using Smartphone (스마트폰 사용이 원거리 교정시력과 굴절 이상 변화에 미치는 영향)

  • Kim, Bong-Hwan;Han, Sun-Hee;Shin, Young Gul;Kim, Da Yeong;Park, Jin Young;Sin, Won Chul;Yoon, Jeong Ho
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.3
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    • pp.305-309
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    • 2012
  • Purpose:This study was conducted to research any effect on aided distance visual acuity and refractive error changes by using smartphone at near for long term. Methods: 20($20.6{\pm}0.9$ years) young adults subjects with no ocular diseases, over 0.8 of aided distance visual acuity, normal amplitude of accommodation and normal accommodative facility agreed to participate in this study. The subjects were divided into two group, Group 1 (15 cm fixation distance) included 10 subjects and Group 2(40 cm fixation distance) included 10 subjects. Aided distance visual acuity and refractive error were measured before and after using smartphone for 30 minutes by auto-chart project (CP-1000, Dongyang, Korea), phoropter (VT-20, Dongyang, Korea), auto refractor-keratometer (MRK-3100, Huvitz, Korea). After then, the subjects looked at distance with wearing spectacles. Refractive error was measured at 5 minutes, 10 minutes, and 15 minutes later, respectively. Results: After using smartphone at 15 cm for 30 minutes, there was statistically significant reduction of aided distance visual acuity (p=0.030) and increasing myopia (p=0.001). The increased myopia was not statistically significant after 5 minutes rest (p${\geq}$0.464). However there was no statistically significant changes in aided distance visual acuity (p=0.163) and refractive error (p=0.077) after using smartphone at 40 cm for 30 minutes. Conclusions: It is recommend to keep 40 cm off the smartphone from eyes to avoid any aided distance visual acuity and refractive error changes. If smartphone is used closer than 40 cm, a rest for 5 minutes is also recommend after every 30 minutes use with smartphone to avoid any aided distance visual acuity and refractive error changes.

A Comparison of the Contact Areas between Cornea and RGP Lenses by Fitting Status (피팅 상태에 따른 RGP 렌즈와 각막과의 간극 비교)

  • Park, Eun Hye;Kim, So Ra;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.3
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    • pp.255-264
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    • 2012
  • Purpose: In this study, the effect of lens fitting status on the contact area between spherical/aspherical RGP lens and the cornea having different astigmatic degree and corneal type was investigated for guiding the proper selection of RGP lens. Methods: Spherical and aspherical RGP lenses were applied on ninety eyes $(25.12{\pm}3.52years)$ having with-the-rule astigmatism by different fitting status. Then, their central, mid-peripheral and peripheral areas of fluorescein pattern were calculated and compared for the quantitative evaluation of the contact area between spherical/aspherical RGP lens. Results: The central and peripheral areas with the alignment fitting was significant different based on lens design. However, the central area didn't show any significant difference by lens design and corneal type when fitted in steep or flat. When analyzed by the corneal shape, both lenses with alignment and flat fitting had significant difference in central and peripheral areas. However, the central, mid-peripheral and peripheral areas with steep fitting didn't show the difference by corneal types. When analyzed by the astigmatic degree, the central and peripheral areas with alignment fitting changed proportionally to the increase of corneal astigmatism regardless of corneal shape. With steep and flat fitting, however, the central, mid-peripheral and/or peripheral areas in round- and symmetric bowtie-typed corneas showed the conflicting result when compared to those of alignment fitting when analyzed by the astigmatic degree. Conclusions: In this study, it was confirmed that the contact areas of cornea and RGP lens fitted steep and flat status were largely affected by the corneal type and corneal astigmatism rather than RGP lens fitted in alignment status. Also, this result commonly occurred in both spherical and aspherical RGP lenses.

A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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The Stability Appraisement on Cultural Property Material with the Replacing Fumigation Gas of Methyl Bromide (Methyl Bromide를 대체하는 훈증 가스의 문화재 재질 안정성 평가)

  • Kang, Dai-Ill
    • Journal of Conservation Science
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    • v.25 no.3
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    • pp.283-291
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    • 2009
  • Methyl Bromide that was used as fumigation gas turned out to be the substance of destroying the ozone layer. For that reason, at the Montreal Protocol in 1987 the use of methyl bromide was forbidden starting 2005 in the advanced country. Also according to the 2007 Bali Protocolly methyl bromide is expected to be forbidden and therefore the purpose of this study is to find out the effects of substitution fumigation gas (Ethylene Oxide+HFC 134a, Methyl Iodide, Cyanogen and Argon) on the metal(silver, copper and iron), wood(oregon pine), pigment(yellow, red, blue, white and black), textile(hemp, ramie, jute, silk1 and silk2 / indigo, safflower and cork) and paper. After the fumigation test, ethylene oxide+HFC 134a did not have changes in the weight and color of the material itself before and after the experiment. On exterior alteration, color change occurred partly on paper and metal. Also, in most materials color change extent was 0.5 to 1.5 on the average and showed scanty difference. The materials after the fumigation test with methyl iodide did not show weight changes after the test. However, color changes more than 1.0 was shown in most of the materials especially in dyed textile material. In blue pigment, the discoloration on the surface could be seen by naked eyes. Fumigation test with cyanogen gas did not show weight changes and discoloration is more than 1.5 before and after the test. The weight changes of test materials with the argon gas was decreased about 3 to 6%. It can be observed that discoloration on paper was generated. Color changes can be seen on jute dyed with safflower and cork for two weeks with argon gas and the extent was 6.3 and 6.0.

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3-D Conformal Radiotherapy for CNS Using CT Simulation (입체조준장치를 이용한 중추신경계의 방사선 입체조형치료 계획)

  • 추성실;조광환;이창걸
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.90-98
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    • 2003
  • Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

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The Associated Factors with Xerostomia in Patients with Systemic Diseases (일부 전신질환자에서 구강건조증의 관련요인 분석)

  • Kim, Sun-Ju;Choi, Jun-Seon
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.386-392
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    • 2013
  • The purpose of this study was to evaluate the factors related to xerostomia in patients with systemic diseases, and the results were analyzed through t-test, ANOVA, and multiple linear regression analysis. There were 62 respondents (56.9%) who reported dry mouth and the season of the most severe dry mouth was reported to be the highest during winter. According to the analysis made in the relationship of xerostomia with the awareness of general health and health behavior, the group that understood their own health poorly, had more than two kinds of diseases, and had been administered more than two kinds of daily medication showed higher xerostomia. Also, those who experienced desperation, had high dryness in other parts of the body, and heavy snoring were more aware of xerostomia (p<0.05). According to the analysis made in the relationship between xerostomia and awareness of oral health state, the group that understood their oral health poorly and had pain in the oral mucous membrane and halitosis was more aware of xerostomia (p<0.05). According to the analysis made in the relationship between quality of life and xerostomia, the group that showed high level of problem in daily living and stress and were self-conscious and felt tense due to halitosis reported more xerostomia (p<0.05). Finally, xerostomia was most correlated with consciousness of the eyes of others due to halitosis followed by the number of transferred systemic diseases and stress level. Based on such results, xerostomia was understood to be an obstacle in maintaining favorable social life and health. Since xerostomia was shown to be related to the number of transferred systemic diseases, the dental professions are asked to further improve their understanding not only on oral health but also systemic diseases. Therefore, these efforts are expected to prevent xerostomia and reduce various complications caused by xerostomia.

Analysis of Quorum Sensing-Related Phenotypes of Pseudomonas aeruginosa Clinical Isolates (녹농균 임상균주의 쿼럼 센싱 관련 표현형 분석)

  • Jung, Kyung-Ju;Choi, Yu-Sang;Ha, Chang-Wan;Shin, Jeong-Hwan;Lee, Joon-Hee
    • Korean Journal of Microbiology
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    • v.46 no.3
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    • pp.240-247
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    • 2010
  • Pseudomonas aeruginosa is a Gram (-) opportunistic human pathogen causing a wide variety of infections on lung, urinary tract, eyes, and burn wound sites and quorum sensing (QS), a cell density-sensing mechanism plays an essential role in Pseudomonas pathogenesis. In order to investigate the importance of QS in the Pseudomonas infections of Korean patients, we isolated 189 clinical strains of P. aeruginosa from the patients in Pusan Paik Hospital, Busan, South Korea. The QS signal production of these clinical isolates was measured by signal diffusion assay on solid media using reporter strains. While most clinical strains (79.4%) produced the QS signals as similar level as a wild type strain, PAO1 did, where LasR, the initial QS signal sensor-regulator was fully activated, a minority of them (4.2%) produced much less QS signals at the level to which LasR failed to respond. Similarly, while 72.5% of the clinical isolates produced QS signals enough to activate QscR, an another QS signal sensor-regulator, some few of them (9%) produced the QS signals at much lower level where QscR was not activated. For further analysis, we selected 74 clinical strains that were obtained from the patients under suspicion of Pseudomonas infection and investigated the total protease activity that is considered important for virulence. Interestingly, significant portion of them showed very low protease activity (44.6%) or no detectable protease activity (12.2%). When the biofilm-forming ability that is considered very important in chronic infection was examined, most isolates showed lower biofilm-forming activity than PAO1. Similarly, significant portion of clinical isolates showed reduced motility (reduced swarming activity in 51.4% and reduced twitching activity in 41.9%), or non-detectable motility (swarming-negative in 28.4% and twitching-negative in 28.4%). Our result showed that the clinical isolates that produced QS signals at the similar level to wild type could have significantly reduced activities in the protease production, biofilm formation, and motility, and some clinical isolates had unique patterns of motility, biofilm formation, and protease production that are not correlated to their QS activity.

The clinical study of Myasthenia Gravis (중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究))

  • Chae, Byung-Yoon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.190-211
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    • 1996
  • Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

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The Effects of Corneal Type and Corneal Astigmatism on Tear Volume between Rigid Gas Permeable Lens and the Cornea (각막형상 및 각막난시도가 RGP렌즈와 각막사이의 눈물양에 미치는 영향)

  • Kim, Jihye;Kim, So Ra;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.2
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    • pp.141-150
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    • 2015
  • Purpose: In the present study, a difference in tear volume between the cornea and the rigid gas permeable (RGP) lens relative to corneal shape and corneal astigmatism was investigated by the alignment fitting status of spherical and aspherical RGP lenses. Methods: Spherical and aspherical RGP lenses were fitted with alignment in 77 subjects (135 eyes) who were in their 20~30s. Tear volume stained with fluorescein was qualitatively analyzed by dividing cornea into center, mid-peripheral and peripheral parts. Results: For the spherical RGP lens fitting, tear volume differences were found in each part in all corneal types. For the aspherical RGP lens fitting, tear volume differences were in each corneal part in symmetric bow tie- and asymmetric bow tie-type corneas. However, the tear was equally distributed from the center to the peripheral part in round- and oval-type corneas. In the group with corneal astigmatism lower than 1.25 D, tear volume between center and peripheral parts, and mid-peripheral and peripheral parts, was different when a spherical RGP lens was fitted. However, tear volume in each part was not different in the group with corneal astigmatism over 1.50 D. Moreover, the tear volumes of the central and mid-peripheral parts were proportionally increased with increasing corneal astigmatism in both spherical and aspherical RGP lenses. Furthermore, aspherical RGP lenses showed greater increments than spherical RGP lenses. Conclusions: The results revealed that the difference in tear volume between aspherical RGP lens and cornea was less than spherical RGP lens, and the difference in tear volume varied according to corneal shape and astigmatism. In addition, the method of measuring relative tear volume between RGP lens and cornea that was established in the present study can be used to evaluate tear volume between contact lens and cornea.

Effect of Visual Sensory Improvement by Amblyopia Treatment on Improvement of Ocular Functions (약시 치료에 의한 시감각 개선이 안기능 향상에 미치는 효과)

  • Kim, Jae-Do
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.4
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    • pp.551-555
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    • 2014
  • Purpose: This study is to investigate if the improvement of visual sensory (VS) by amblyopia treatment affects the ocular functions in refractive errors, accommodative errors and phoria at distance and near. Methods: 10 subjects (17 eyes, mean age of $10.7{\pm}2.9$ years) who treated amblyopia completely, were participated for this study. Refractive errors, accommodative errors, and distance and near phoria were compared between before and after treatments of amblyopia. Refractive errors and accommodative errors at 40 cm were measured using openfield auto-refractor (NVision-5001, Shin Nippon, Japan) and using monocular estimated method (MEM) respectively. Phoria was determined at 3 m for distance and at 40 cm for near using Howell phoria card, cover test or Maddox rod. Results: Mean corrected visual acuity (CVA) significantly increased from $0.46{\pm}0.11$ (decimal notation) for before amblyopia treatment to a level of $1.03{\pm}0.13$ for after amblyopia treatment (p < 0.001). For spherical refractive error, hyperopia significantly decreased from $+2.29{\pm}0.86D$ to a level of $+1.1{\pm}2.38D$ (p < 0.05) but astigmatism did not significantly change; $-1.80{\pm}1.41D$ for before treatment and $-1.65{\pm}1.30D$D for after treatment (p > 0.05). Accommodative error significantly decreased from accommodative lag of $+1.1{\pm}0.75D$ to a level of $+0.5{\pm}0.59D$ (accommodative lag) (p < 0.05). Distance phoria significantly changed from eso $2.9{\pm}6.17PD$ (prism diopters) to a level of eso $0.2{\pm}3.49PD$ (p < 0.05), and near phoria also significantly changed from eso $0.4{\pm}2.32PD$ to level of exo $2{\pm}4.9PD$ (p < 0.05). There was a high correlation (r = 0.88, p < 0.001) between improvement of visual acuity and decrease of accommodative lag. Conclusions: Hyperopic refractive error decreased with improvement of CVA or VS by amblyopia treatment. And the improvement of VS by amblyopia treatment also improved accommodative error, and changed phoria coupled with accommodation.