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Purpose@#The aim of this descriptive study was to identify the factors influencing depression risk among South Korean nursing students. @*Methods@#The data were collected from nursing students attending two universities through web-based questionnaires that surveyed them about depression, academic stress, social network service (SNS) addiction tendency, and upward social comparison from August 22 to September 4, 2021. The collected data from 196 nursing students were analyzed by t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple linear regression. @*Results@#The mean score of depression (using CES-D Korean version) among nursing students was 13.91, which denotes probable depression. Concerning the variance with regard to depression among nursing students, 20.2% was explained by clinical practice period, academic stress, and upward social comparison. @*Conclusion@#Programs to relieve academic stress and depression should be developed in a simple way and systematically provided at the organizational level so that nursing students secure sufficient support during the initial and continuing period of clinical practicums. Concomitantly, an attempt to reduce the upward social comparison should be highly considered.
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Purpose@#To compare the diagnostic accuracy of differentiating polypoidal choroidal vasculopathy (PCV) from exudative age-related macular degeneration (AMD), using color fundus photography (CFP), optical coherence tomography (OCT), and swept-source OCT angiography (SS-OCTA) without using indocyanine green angiography (ICGA). @*Methods@#Treatment-naive eyes with exudative AMD that underwent CFP, OCT, SS-OCTA, and ICGA imaging before treatment were identified. Images of each patient were categorized into two sets (set A, CFP + OCT; set B, CFP + SS-OCTA). In set B, both the en face and cross-sectional B scans were analyzed. Each set was reviewed by two graders, and it was determined whether the presumed diagnosis was PCV. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for the diagnosis of PCV were assessed for each set by comparing diagnoses that included ICGA. The number of polypoidal lesions in each set was calculated and compared to ICGA. @*Results@#A total of 94 eyes from 94 patients with AMD were included in the study, of which 66.0% were male, and the mean age was 71.8 ± 9.0 years. The PCV diagnosis rate using ICGA was 45.7%. The sensitivity was 0.88 for set A and 0.93 for set B, while the specificity was 0.94 for set A and 0.96 for set B. The AUC was 0.90 (95% confidence interval [CI], 0.83–0.97) for set A and 0.96 (95% CI, 0.90–1.00) for set B. Set A detected 1.28 ± 0.91 polypoidal lesions, while set B detected 1.47 ± 1.01; ICGA showed 1.51 ± 0.86. @*Conclusions@#This study highlights that, without using ICGA, both CFP combined with OCT and CFP combined with SS-OCTA demonstrate high sensitivity, specificity, and AUC in diagnosing PCV. It is evident that SS-OCTA contributes to enhancing sensitivity, specificity, and AUC for PCV diagnosis.
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Purpose@#We investigated the effect of preoperative administration of analgesics and sedatives on pain levels during silicone tube intubation conducted under local anesthesia in patients with acquired nasolacrimal duct stenosis. @*Methods@#We retrospectively reviewed the medical records from 121 patients at the ophthalmology department of our hospital from July 2016 to May 2022. In total, 71 patients were administered acetaminophen and diazepam orally, while the remaining 50 were not. Postoperative pain (measured using the visual analogue scale [VAS] score [0 = no pain, 10 = severe pain] immediately after operation), operative duration, and improvement in epiphora symptoms were compared between the two groups. @*Results@#The premedication group had significantly lower VAS scores than the non-premedication group (5.23 ± 2.75 vs. 6.34 ± 2.33, p = 0.02). It also had a notably shorter (p < 0.01) operation duration and higher subjective improvement rate of epiphora symptoms. However, premedication did not influence the tube retention period post-surgery (p = 0.86). @*Conclusions@#The administration of analgesics and sedatives prior to silicone tube intubation effectively mitigates operative pain and reduces operation duration. Furthermore, it may help improve postoperative epiphora symptoms.
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Purpose@#This study aimed to compare the intraoperative and postoperative outcomes between robotic and laparoscopic transperitoneal adrenalectomies. @*Methods@#In this retrospective study, 93 patients underwent adrenalectomy using 2 surgical modalities: 45 patients underwent adrenalectomy using the da Vinci Xi system (robotic group), and 48 patients using laparoscopic devices (laparoscopic group). We compared the operation time, intraoperative bleeding, and hospital stay according to the surgical modality and tumor characteristics. @*Results@#There were no significant differences in the operative time (P = 0.827), hospital stay (P = 0.177), and intraoperative bleeding (P = 0.174) between the groups. However, the robotic group showed a lower coefficient of variation in total operative time than that of the laparoscopic group (100.6 ± 23.3 minutes vs. 101.9±32.7 minutes, 0.230 vs. 0.321). When divided into 2 subgroups based on the tumor size (3 cm had a shorter operative time than that of the laparoscopic group (P = 0.032). The robotic group also had fewer cases of intraoperative bleeding (P = 0.034). @*Conclusions@#Compared to the laparoscopic transperitoneal adrenalectomy, the robotic one achieved a lower deviation in total operative time and showed less bleeding and a shorter operative time, especially for tumors sized >3 cm.
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Background@#In psoriasis treatment, not all body regions improve simultaneously after clinical interventions. @*Objective@#This study was aimed at evaluating clinical responses across body regions, which may differentially influence patient treatment plans. @*Methods@#This prospective, observational, and multi-center study was conducted in Koreans who adhered to ustekinumab treatment based on criteria per local label and reimbursement guidelines. A total of 581 were included in this analysis. @*Results@#The mean (±standard deviation) psoriasis area severity index (PASI) score at baseline, age, disease duration, and body surface area (%) were 18.9±9.69, 44.2±13.29 years, 11.3±9.65 years, and 27.8±17.83, respectively. Across the head and neck, upper extremities, trunk, and lower extremities, the correlation between the PASI sub-scores for the upper and lower extremities was the highest (r=0.680). The mean PASI sub-score for the lower extremities was the highest at baseline. PASI90 and PASI100 scores were the highest for the head and neck region, indicating the highest response rates, while those for the lower extremities were consistently low at all visits. @*Conclusion@#We found differences in regional ustekinumab responses, with the lower extremities being the most difficult to treat. These findings should be considered in psoriasis treatment.
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Purpose@#To evaluate the difference in each retinal layer thickness in central retinal vein occlusion (CRVO) with resolved macular edema after intravitreal antivascular endothelial growth factor injection and normal contralateral eyes.. @*Methods@#Patients with ischemic and nonischemic CRVO whose macular edema resolved after intravitreal antivascular endothelial growth factor injections and did not recur for at least 6 months, and a normal contralateral eye were enrolled. Each retinal layer thickness between CRVO and normal contralateral eyes was compared according to Early Treatment Diabetic Retinopathy Study subfields using spectral domain optical coherence tomography. @*Results@#The thicknesses of outer nuclear layer, photoreceptor layer, and retinal pigment epithelium in central ring, ganglion cell layer, inner plexiform layer, outer nuclear layer, and photoreceptor layer in the inner ring, and ganglion cell layer in the outer ring of CRVO eyes were significantly thinner than those of normal contralateral eyes (all p < 0.05). Whereas, inner nuclear layer and outer plexiform layer thicknesses in central ring of CRVO eyes were 23.86 ± 8.8 and 25.76 ± 7.6 μm, respectively, which was significantly thicker than those of normal contralateral eyes (19.52 ± 7.7 and 22.76 ± 6.5 μm; p = 0.019 and p = 0.043, respectively). Additionally, the mean best-corrected visual acuity of CRVO eyes were significantly correlated with photoreceptor layer thickness in central ring (p = 0.005). @*Conclusions@#In CRVO eyes with resolved macular edema, the outer retinal layers were thinner as well as inner retinal layers, whereas inner plexiform layer and outer nuclear layer were thicker than normal fellow eyes. Additionally, photoreceptor layer thickness in foveal area had a significant impact on visual acuity in CRVO.
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Purpose@#To analyze topographic progression of geographic atrophy with different concentric circles centered on the fovea in correlation with decrease of visual acuity. @*Methods@#We retrospectively analyzed 36 eyes of 26 patients diagnosed with geographic atrophy and followed at least 1 year. One millimeter circular area at the foveal center were defined as zone 1, and doughnut shape areas from between 1 and 2 mm to between 5 and 6 mm were defined as zone 2 to 6. Then, changes of geographic atrophy area in each zone were measured with semi-automatic software. Correlation analysis and regression analysis were performed to determine the relationship between changes in visual acuity and atrophic area in each zone. @*Results@#Mean age was 76.9 years and follow-up period were 3.38 years. The mean atrophic area increased from 8.09 to 16.34 mm2 and visual acuity decreased from 0.39 to 0.69 on logarithm of the minimal angle of resolution. Mean change of total geographic atrophy area was not significantly correlated with visual acuity decrease. While geographic atrophy progression within zone 1, 2, and 3 showed significant causal relationship with decrease of visual acuity (all, p < 0.05). @*Conclusions@#In contrast to the total geographic atrophy area, progression of geographic atrophy in parafoveal area was significantly correlated with decrease of visual acuity.
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Purpose@#At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. @*Methods@#A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. @*Results@#In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decisionmaking process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). @*Conclusion@#Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.
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This study compared the job satisfaction and job importance of school dietitians according to various school types in Sejong. One hundred and twenty-six school dietitians working in kindergartens (n=36), elementary schools (n=42), middle schools (n=22), and high schools (n=26) participated in this questionnaire survey. The subjects were divided into four groups according to the school types. Half of the subjects were over 41 years of age, with 64.3% graduating from graduate school. The percentage of nutrition teachers was the highest in middle schools at 95.4%, followed by the elementary school at 90.5% and high school at 73.1%, whereas 100% of the kindergarten dietitians were not nutrition teachers (P＜0.001). The percentage of the running status of nutrition education classes/activities was lowest in kindergartens (P＜0.001). The job satisfaction score in the job itself area was significantly lower in kindergartens and high schools than in middle schools (P＜0.01). The satisfaction scores of human relationships, working environment, personnel evaluation, and welfare did not differ significantly among the schools. As for the Job importance, the scores of nutrition counseling were significantly lower in middle school than in elementary and high schools (P＜0.05). In cooking and distribution management, high schools were less important than other school levels (P＜0.05). These findings highlight the need for the placement of nutrition teachers in kindergarten to promote nutrition education, the reduction of workload for school dietitiansutrition teachers and additional placement of dietitians by the appropriate workload such as the number of people and meals to serve.
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Purpose@#This study aimed to explore the lived experiences of breastfeeding women with gestational diabetes and to understand the meaning of breastfeeding for them and its encompassing context. @*Methods@#Qualitative data were collected by interviewing 15 mothers with gestational diabetes. The transcript data from 5 focus group interviews and 2 individual interviews were analyzed using thematic analysis. @*Results@#A core theme and 10 sub-themes emerged. The core theme that emerged was "the maternal commitment enabled for a limited time a way to compensate for guilt." Because mothers had to control their blood sugar levels before childbirth, they were worried about whether it would harm the newborn baby and thus searched for dietary information. After the babies were born and separated from their mothers, they were free from gestational diabetes. Mothers then felt guilty about their unhealthy bodies when they were pregnant. This regret provides a motivational context for breastfeeding. However, the mothers realized that breastfeeding requires commitment and dedication and that they need breastfeeding support, such as being provided practical help. @*Conclusion@#The results showed that the breastfeeding intention of women with gestational diabetes might originate from their feelings of guilt. Therefore, an integrated breastfeeding program that combines the empathetic support of women with similar experiences and that shares practical information from experts should be implemented in a structured and systematic way.
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Purpose@#Endoscopic breast surgery for patients with breast cancer was introduced for its superior cosmetic outcomes; it was initially studied in the field of breast-conserving surgery and, more recently, in robotic-assisted nipple-sparing mastectomy (NSM). The main purpose of this study was to investigate the feasibility and safety of endoscopic NSM (E-NSM) in patients with breast cancer by comparing E-NSM and conventional NSM (C-NSM). @*Methods@#Between May 2017 and October 2020, we retrieved the records of 45 patients who underwent NSM with permanent silicone implants and divided them into the E-NSM group (20 patients) and the C-NSM group (25 patients), depending on the use of the endoscopic device.We also analyzed demographic information, pathology, operative time, and complications. @*Results@#No significant differences were observed between the 2 groups based on demographic information, postoperative pathological data, mean length of hospital stay, and total number of complications. The mean preparation time for surgery was comparable between both groups. Compared to the C-NSM group, the E-NSM group had a significantly longer mean operative time and, subsequently, a significantly longer mean total operative time and number of complications. @*Conclusion@#The results showed that E-NSM was feasible and safe with a more inconspicuous incision in patients with breast cancer.
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This study compared the job satisfaction and job importance of school dietitians according to various school types in Sejong. One hundred and twenty-six school dietitians working in kindergartens (n=36), elementary schools (n=42), middle schools (n=22), and high schools (n=26) participated in this questionnaire survey. The subjects were divided into four groups according to the school types. Half of the subjects were over 41 years of age, with 64.3% graduating from graduate school. The percentage of nutrition teachers was the highest in middle schools at 95.4%, followed by the elementary school at 90.5% and high school at 73.1%, whereas 100% of the kindergarten dietitians were not nutrition teachers (P＜0.001). The percentage of the running status of nutrition education classes/activities was lowest in kindergartens (P＜0.001). The job satisfaction score in the job itself area was significantly lower in kindergartens and high schools than in middle schools (P＜0.01). The satisfaction scores of human relationships, working environment, personnel evaluation, and welfare did not differ significantly among the schools. As for the Job importance, the scores of nutrition counseling were significantly lower in middle school than in elementary and high schools (P＜0.05). In cooking and distribution management, high schools were less important than other school levels (P＜0.05). These findings highlight the need for the placement of nutrition teachers in kindergarten to promote nutrition education, the reduction of workload for school dietitiansutrition teachers and additional placement of dietitians by the appropriate workload such as the number of people and meals to serve.
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Purpose@#This study aimed to explore the lived experiences of breastfeeding women with gestational diabetes and to understand the meaning of breastfeeding for them and its encompassing context. @*Methods@#Qualitative data were collected by interviewing 15 mothers with gestational diabetes. The transcript data from 5 focus group interviews and 2 individual interviews were analyzed using thematic analysis. @*Results@#A core theme and 10 sub-themes emerged. The core theme that emerged was "the maternal commitment enabled for a limited time a way to compensate for guilt." Because mothers had to control their blood sugar levels before childbirth, they were worried about whether it would harm the newborn baby and thus searched for dietary information. After the babies were born and separated from their mothers, they were free from gestational diabetes. Mothers then felt guilty about their unhealthy bodies when they were pregnant. This regret provides a motivational context for breastfeeding. However, the mothers realized that breastfeeding requires commitment and dedication and that they need breastfeeding support, such as being provided practical help. @*Conclusion@#The results showed that the breastfeeding intention of women with gestational diabetes might originate from their feelings of guilt. Therefore, an integrated breastfeeding program that combines the empathetic support of women with similar experiences and that shares practical information from experts should be implemented in a structured and systematic way.
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Purpose@#Endoscopic breast surgery for patients with breast cancer was introduced for its superior cosmetic outcomes; it was initially studied in the field of breast-conserving surgery and, more recently, in robotic-assisted nipple-sparing mastectomy (NSM). The main purpose of this study was to investigate the feasibility and safety of endoscopic NSM (E-NSM) in patients with breast cancer by comparing E-NSM and conventional NSM (C-NSM). @*Methods@#Between May 2017 and October 2020, we retrieved the records of 45 patients who underwent NSM with permanent silicone implants and divided them into the E-NSM group (20 patients) and the C-NSM group (25 patients), depending on the use of the endoscopic device.We also analyzed demographic information, pathology, operative time, and complications. @*Results@#No significant differences were observed between the 2 groups based on demographic information, postoperative pathological data, mean length of hospital stay, and total number of complications. The mean preparation time for surgery was comparable between both groups. Compared to the C-NSM group, the E-NSM group had a significantly longer mean operative time and, subsequently, a significantly longer mean total operative time and number of complications. @*Conclusion@#The results showed that E-NSM was feasible and safe with a more inconspicuous incision in patients with breast cancer.
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Purpose@#To investigate the oxidative damage and changes of retinas by blue light through zebrafish and to confirm the protective effect of polyphenol on retina cells using grape seed-derived polyphenols. @*Methods@#To induce oxidative damage and changes of the retina by blue light, blue light LED (10,000 Lux, 480 nm) was added to the zebrafish grown in the dark room after pretreating polyphenols derived from grape seed at various concentrations (0, 0.1, 1, 10 μg/mL, respectively) for 4 days. Changes in retinal thickness and numbers of outer nuclear layer nuclei through hematoxylin & eosin staining were evaluated. @*Results@#Photoreceptor layer thickness of blue light exposed group was significantly thinner than the group without blue light (108.1 ± 27.7 μm vs 41.1 ± 17.0 μm). As pretreated polyphenol concentration increased, photoreceptor layer thickness was increased (41.1 ± 17.0, 56.3 ± 18.6, 90.7 ± 23.7, 99.1 ± 23.1 μm, p < 0.05), and damage to outer nuclear layer nuclei was also decreased. @*Conclusions@#Exposure to blue light is an important factor for increasing oxidative stress in the retina. Grape seed-derived polyphenols have been shown to protect photoreceptor cells and retinal pigment epithelial cells from oxidative stress. This suggests that the antioxidant effect of polyphenol compounds may help suppress the progression of retinal diseases associated with oxidative stress such as age-related macular degeneration.
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Purpose@#The purpose of this study was to evaluate the machining precision and the marginal and internal fit of single restorations fabricated with three types of lithium disilicate ceramic blocks and to evaluate the correlation. @*Materials and methods@#Single restorations were designed using a CAD software program. The crown designed model file was extracted from the CAD software program. Three types of lithium disilicate blocks (Rosetta; HASS, IPS e.max CAD; Ivoclar vivadent, VITA Suprinity; VITA) were milled using a milling machine. For the fabrication of the crown scanned model file, the intaglio surface of the restoration was digitized using a contact scanner. Then, using the three-dimensional inspection software (Geomagic control X; 3D Systems), the process of the overlap of the crown designed model and the scanned model and 3-dimensional analysis was conducted. In addition, the marginal and internal fit of the crowns was evaluated by a silicone replication method. The difference among three types of single ceramic crown was analyzed using a Kruskal-Wallis H test, and Spearman correlation analysis was performed to analyze the correlation between machining precision and fitness (α=.05) @*Results@#There was a significant difference in the machining precision and the marginal and internal fit according to the type of ceramic block (P<.001). In addition, the machining precision and the marginal and internal fit were positively correlated (P<.001). @*Conclusion@#The marginal fit of crowns fabricated according to the types of ceramic blocks was within the clinically acceptable range (< 120 µm), so it can be regarded as appropriate machining precision applicable to all clinical as aspects in terms of the marginal fit.
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PURPOSE@#The present study aimed to evaluate the accuracy of a desktop scanner and intraoral scanners based on the volumetric dimensions of a complete arch. @*MATERIALS AND METHODS@#Seven reference models were fabricated based on the volumetric dimensions of complete arch (70%, 80%, 90%, 100%, 110%, 120%, and 130%). The reference models were digitized using an industrial scanner (Solutionix C500; MEDIT) for the fabrication of a computer-aided design (CAD) reference model (CRM). The reference models were digitized using three intraoral scanners (CS3600, Trios3, and i500) and one desktop scanner (E1) to fabricate a CAD test model (CTM). CRM and CTM were then superimposed using inspection software, and 3D analysis was conducted. For statistical analysis, one-way analysis of variance was used to verify the difference in accuracy based on the volumetric dimensions of the complete arch and the accuracy based on the scanners, and the differences among the groups were analyzed using the Tukey HSD test as a post-hoc test (α=.05). @*RESULTS@#The three different scanners showed a significant difference in accuracy based on the volumetric dimensions of the complete arch (P<.05), but the desktop scanner did not show a significant difference in accuracy based on the volumetric dimensions of the complete arch (P=.808). @*CONCLUSION@#The accuracy of the intraoral scanners was dependent on the volumetric dimensions of the complete arch, but the volumetric dimensions of the complete arch had no effect on the accuracy of the desktop scanner. Additionally, depending on the type of intraoral scanners, the accuracy differed according to the volumetric dimensions of the complete arch.
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Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning.Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.
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Purpose@#Using two types of electronic apex locators, this study aimed to investigate the differences in accuracy according to the evaluator and equipment. @*Materials and Methods@#Artificial teeth of the lower first premolars and two mandibular acrylic models (A and B) were used in this study. In the artificial teeth, the pulp chamber was opened and the access cavity was prepared.Using calibrated digital Vernier calipers, the distance from the top of the cavity and the root apex was measured to assess the actual distance between two artificial teeth. The evaluation was conducted by 20 dentists, and each evaluator repeated measurements for each electronic apex locator five times. The difference between the actual distance from the top of the cavity to the root apex and the distance measured using electronic measuring equipment was compared. For statistical analysis, the Friedman test the Mann–Whitney U-test were conducted and the differences between groups were analyzed (α=0.05).Result: As for the accuracy of measurement according to the two types of electronic apex locators, the value of the measurement error was 0.4753 mm in Dentaport ZX and 0.3321 mm in E-Cube Plus. Moreover, electronic apex locators Dentaport ZX and E-Cube Plus showed statistically significant differences (P<0.05). As for the difference in the accuracy of the two types of electronic apex locators according to the evaluator, the resulting values differed depending on the evaluator and showed a statistically significant difference (P<0.001). @*Conclusion@#Electronic apex locator E-Cube Plus showed higher accuracy than did Dentaport ZX. Nevertheless, both types of electronic apex locators showed 100% accuracy in finding the region within root apex ±0.5 mm zone. Fur-thermore, according to the evaluator, the two electronic apex locators showed different resulting values.
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Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning.Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.