Effects of the Integrated Stress Management Program on Stress and Depression in Psychiatric Inpatients / 정신간호학회지

PURPOSE: The purpose of this study was to test the effects on stress and depression by developing and implementing an integrated stress management program for inpatients in the psychiatric closed ward. METHODS: The study was a one-group pretest-posttest design. A total of 36 patients in the closed ward participated in this study. Data were collected through self-report questionnaires to measure hospital stress and depression. Data were analyzed by using t-tests and one-way ANOVA with SPSS/WIN 21.0. RESULTS: Integrated stress management program was designed based on Lazarus and Folkman stress-appraisal-coping model. Total of eight 1-hour sessions were delivered for four weeks in the group. There were significant differences in the inpatient stress scores before and after the intervention. However, the integrated stress management program showed some reduction in depression but did not show signifiant differences statistically. CONCLUSION: Our study findings confirm that the use of the integrated stress management program can reduce stress of the patients, that enable them to stabilize their minds at hospitalization. However, further study is needed to confirm the effects on depression. Thus, it would be beneficial to provide psychiatric nursing intervention tailored to psychiatric patients' symptoms, especially for reducing inpatient stress.

Clinical Characteristics of Intraorbital Foreign Bodies: Our Experience with 14 Cases

PURPOSE: To evaluate the clinical characteristics of intraorbital foreign bodies as well as the treatment outcomes. METHODS: This was a noncomparative interventional case series. Clinical data and radiographic images were gathered via retrospective chart reviews of 14 patients who underwent surgical removal of intraorbital foreign bodies by an oculoplastic surgeon at the Asan Medical Center, Seoul, Korea between July 2012 and November 2015. RESULTS: The mean age of patients was 45.1 years and 13 patients (92.9%) were male. There were 9 metallic; 3 nonmetallic, inorganic; and 2 organic intraorbital foreign bodies in this series. The most common orbital complication was orbital wall fracture (8, 57.1%), and one patient had orbital cellulitis associated with a wooden foreign body. Six patients (42.9%) underwent surgical removal of foreign bodies in a delayed setting, and 4 of them needed surgery to allow for the brain magnetic resonance image tests to evaluate neurologic problems. There were 6 patients (42.9%) who had a postoperative corrected visual acuity worse than 20/200, and all of them had poor visual acuity at the time of injury due to associated eyeball or optic nerve injuries. Four patients (28.6%) had eyeball movement limitations from the initial trauma, but only 1 patient had persistent limitations postoperatively. There were no other complications associated with surgical removal. CONCLUSIONS: The majority of patients with intraorbital foreign bodies were male who had periorbital traumas. The most common foreign body was metal, and orbital wall fractures were common. The poor visual prognosis was related to the eyeball or optic nerve injuries from the initial trauma. The urgent surgical removal should be performed for organic foreign bodies or associated orbital/ocular injuries. Metallic foreign bodies may also be considered for removal to allow for possible brain magnetic resonance image evaluations in the future.

Current Trends in the Management of Thyroid Ophthalmopathy / 한양의대학술지

Thyroid ophthalmopathy (TO) is an autoimmune inflammatory disorder involving the orbit characterized by inflammation and swelling of the extraocular muscles and an increase in orbital fat and connective tissue. Despite extensive research, TO continues to be a difficult condition for the patient to cope with and for the clinician to treat. Current treatments consist of systemic immunosuppression, orbital irradiation, and surgery. It is promising for patient refractory to conventional therapy that pathogenesis of TO at molecular level which advance development of new therapies targeting cellular immunity are now better understood. Future therapies targeting immune system or specific molecules are under investigation and show promise for the future. This review will describe current trends in the management of TO, from well-established therapies such as glucocorticoids, orbital irradiation and orbital decompression to more innovative therapies targeting immune system or specific molecules involved in TO pathogenesis.

Normative Data of Videonystagmography in Young Healthy Adults under 40 Years Old

PURPOSE: The purpose of this study was to establish a set of normative data values for saccade movements using videonystagmography and to evaluate the effects of manual correction on this data. METHODS: We examined 25 healthy subjects (9 men and 16 women). All tests were carried out by one well-instructed physician. Errors such as the wrong detection of the inflection point, missing movement, and prediction occurred during some tests. Thus, the same physician manually corrected the data by deleting error data from row results. RESULTS: We established a set of normative data for horizontal saccade movements (amplitude size 15 and 30 degrees) for mean peak velocity, latency, and accuracy. Manual correction only impacted latency and accuracy at 30 degrees horizontal, which is likely related to possible errors during the test. CONCLUSIONS: The present study provides clinically useful videonystagmography-based normative data for clinicians regarding saccade movements in Korean individuals.

Influence of Image Compression on the Interpretation of Optical Coherence Tomography in Diabetic Macular Edema

PURPOSE: To evaluate the influence of image compression on optical coherence tomography (OCT) images in eyes with diabetic macular edema (DME). METHODS: Twenty eyes of 30 patients diagnosed with DME were included in this retrospective observational case series. Horizontal OCT scans centered at the center of the fovea were conducted using spectral-domain OCT (Spectral OCT/SLO(R)). The images were exported to Tag Image File Format (TIFF) and then transformed to 10, 5, and 1 quality of Joint Photographic Experts Group (JPEG) format using Photoshop. OCT images were taken before and after intravitreal bevacizumab injection. The presence of intraretinal fluid, foveolar detachment, and photoreceptor inner segment/outer segment (IS/OS) disruption were evaluated in each image. RESULTS: The mean (+/- standard deviation) size of TIFF images and 10, 5 and 1 quality JPEG images were 1712.0, 183.3 +/- 6.8, 90.9 +/- 4.3, 42.8 +/- 1.4 kilobytes (KB), respectively, before the injection and 1712.0, 189.5 +/- 9.1, 94.9 +/- 5.6, 43.4 +/- 1.8 KB, respectively, after the injection. The presence of intraretinal fluid, foveolar detachment, and photoreceptor IS/OS disruption identified in TIFF images was also identified in the compressed JPEG images. CONCLUSIONS: Quality of retinal OCT image did not influence the estimation of DME despite the JPEG image being compressed to approximately 1/40 of the original TIFF image size.

Using ImageJ to Evaluate Optic Disc Pallor in Traumatic Optic Neuropathy

PURPOSE: To evaluate optic disc pallor using ImageJ in traumatic optic neuropathy (TON). METHODS: This study examined unilateral TON patients. The optic disc was divided into 4 quadrants (temporal, superior, nasal, and inferior), consistent with the quadrants on optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness maps. Optic disc photography was performed and disc pallor was quantified using gray scale photographic images imported into ImageJ software. The correlation between optic disc pallor and RNFL thickness was examined in each quadrant. RESULTS: A total of 35 patients (31 male, 4 female) were enrolled in the study. The mean participant age was 34.8 +/- 15.0 years (range, 5 to 63 years). Overall RNFL thickness decreased in 6 patients, with thinning most often occurring in the inferior quadrant (28 of 35 eyes). There was a significant correlation between optic disc pallor and RNFL thickness (superior, rho = -0.358, p = 0.04; inferior, rho = -0.345, p = 0.04; nasal, rho = -0.417, p = 0.01; temporal, rho = -0.390, p = 0.02). The highest level of correspondence between disc pallor and RNFL thickness values outside of the normative 95th percentiles was 39.3% and occurred in the inferior quadrant. CONCLUSIONS: Optic disc pallor in TON was quantified with ImageJ and was significantly correlated with RNFL thickness abnormalities. Thus, ImageJ evaluations of disc pallor may be useful for evaluating RNFL thinning, as verified by OCT RNFL analyses.

Causes and Treatments of Entropion and Ectropion in Adults

PURPOSE: To evaluate the causes and treatments of entropion and ectropion in adults. METHODS: A retrospective review was performed of 397 patients (490 eyes) with entropion and 109 patients (138 eyes) with ectropion who underwent corrective surgery at Kim's Eye Hospital from January 2009 to December 2012. RESULTS: The surgical correction of entropion was 3.5 times greater than that of ectropion. The causes of entropion were classified as senile (98.4%), cicatricial (1.4%) and spastic (0.2%). The causes of ectropion were classified as cicatricial (60.1%), paralytic (23.2%) and senile (16.7%). CONCLUSIONS: The main causes of entropion and ectropion were senile and cicatricial, respectively. Specifically, senile entropion was more common than senile ectropion, which is considered to be related to the lid anatomy of Asian patients.