• Journal of Trauma and Injury
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• v.21 no.1
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• pp.28-35
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• 2008

Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.3
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• pp.79-87
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• 2008

Purpose: This study measured Y-intercept that means a fixation disparity, X-intercept that means a associated phoria and slope of a fixation disparity curve (FDC), which are variables of dissociated phoria and the FDC. We searched for the result value and examined the direction, distribution pattern and a variable that give an most affect on dissociated phoria and the FDC at distance and near. Also this study examined that there were statistically significant differences between distance and near, comparing the result value. Methods: We measured the dissociated phoria and the fixation disparity for 51 subjects at distance and near in June, 2007. All subjects ranged from 20 to 25 years of age (average 21.72${\pm}$1.88 years old) and had no eye disease. At distance the dissociated phoria measured with the distance MIM card (muscle imbalance measure card, Bernell co., USA), and the fixation disparity measured with the modified Mallett Far Unit (Bernell co., USA). At near the dissociated phoria measured with the near MIM card (muscle imbalance measure card, Bernell co., USA), and the fixation disparity measured with the Wesson fixation disparity card (American Optical co., USA). Results: The percentage distribution of types of fixation disparity curves was that at distance prevalence of Type I (74.6%) was the highest, followed by Type IV (17.6%) and Type II (3.9%), Type III (3.9%) and that at near prevalence of Type I (53.0%) was the highest, followed by Type III (29.4%), Type IV (13.7%) and Type II (3.9%). 2. There were significantly correlation in dissociated phoria, fixation disparity (Y-intercept) and associated phoria (X-intercept). 3. The fixation disparity at distance was most affected by associated phoria (X-intercept) (p=0.000). The distance dissociated phoria was most affected by fixation disparity (Y-intercept) (p=0.342), but the influence was weak. 4. The fixation disparity at near was most affected by associated phoria (X-intercept) (p=0.000). The near also dissociated phoria was most affected by associated phoria (X-intercept) (p=0.009). The result that compared the each variables with the same variables at distance and near had statistically significant on paired t-test for among dissociated phoria (t=7.529, p=0.000), X-intercept (t=5.860, p=0.000), the Y-intercept (t=4.640, p=0.000) but slope of the FDC did not differ significant (t=1.336 p=0.188). Conclusions: Relationship of fixation disparity and Heterophoria had close correlation at distance and near.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.3
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• pp.65-71
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• 2008

Purpose: This paper studied the effect of eyes on the comparison between the distance optical centers problem of dispensing reading glasses made by optician and finished reading glasses in the current market. Methods: The method of this study has been measured by eleven different categories from +1.00D to +4.00D. This study also separated into three groups by their optical frame size and measured optical center point (O.C) and optical center height (O.H) with 200 peoples of man and females over 40 years old without ocular disease living in Gwang-san gu, Gwang-Ju city. Results: As a result, optical center point ranged from 57 mm to 80 mm and it turned to be most common range is from 61 mm to 65 mm (64.6%). Moreover, the optical center height ranged from 1 mm to 8mm and most common ranged (23%) were 4 mm. In other words, finished reading glasses have irregular optical ranges. After observing 200 people who are over 40 years old men and women, result shows that more than 75.5% (151 people) currently use finished reading glasses. Survey of 151 people, most common error between the finished reading glasses's O.C and the wearers P.D were 4 mm (45%). Furthermore, the most common error between the finished reading glassses's O.H and the wearers O.H ranged from 3 mm to 4 mm. Astonishingly, the entire 151 people who wear finished reading glasses appeal that they feel tiredness on their eyes when they wear finished reading glasses. 53 people (35%) claimed that they feel tiredness on their eyes after 10 to 20 minutes wearing finished reading glasses. Base on the research, We conducted more experiment to find the value of prism of optical centers err because it will tell us whether the finished reading glasses are good enough to wear or not. We multiplied diopter by the difference between finished reading glasses's O.C. and wearer's P.D. Consequently, We found out that the finished reading glasses counter to the German RAL-RG 915 policy. And We also found that it is relative to the diopter of lenses. In conclusion, based on the researched that wearing finished reading glasses have a dangerous factor for our vision. Therefore optician must need to recommend correctly made dispensing reading glasses based on the optical center point.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.4
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• pp.25-30
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• 2008

Purpose: In this paper, we have analyzed the problems of the Oh's report which is used to the basic data for supply and demand of medical technicians and studied a proposal for improvement to control system and supply and demand of korean optometrists. Methods: We have analyzed errors of Oh's report including supply and demand for medical technicians and management policy, expecting number for future optician, inaccurate estimation by limited data (employment rate, retirement rate, mortality rate) and an incorrect method of measurement for future supply and demand. Results: Oh's report showed the 18% error for estimation of supply which exclude the irregular entrance students. The estimation of supply was calculated by graduation rate 62.6% (college and University of Technology are 78.9% and 85.98% respectively), employment rate 65.8% (the average employment between 2002 and 2007 is 73.96%) and retirement rate is 2.3% (the retirement of pharmacists is 1.3%) but it showed the significant differences to objective data. For estimate the suitable ratio of optometrists to the population, the ratio use of medical facilities by an age group was used, and suggested spectacle wearers 1,280 persons (populations 2,928 persons) per optometrist but the different from reference of Germany (4,706 persons), America (1,789 persons) and Korea (1,825 persons/an optometrist) are applied to estimation on supply. This report applied the low employment rate and argued that maintain the present situation, but claimed that utilize unemployment persons. The above result has induced double weighting effect on estimation of supply. Conclusions: To solve the related problems of supply and demand, we have to make a search for exact data and optimum application model, have to take an example of nation similar job category as Germany and the research result of the job satisfaction into consideration. After we get the integrated research result, we must carried out the policy with fairness and balance for the estimation of supply and demand. Therefore exact research is required prior to beginning policy establishment, government and related group have to make a clear long-term plan and permanent organization for medical technician to establish supply and demand of medical technician.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.4
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• pp.51-58
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• 2008

Purpose: This study was assessed to investigate adverse effect induced by overuse of disposable soft contact lenses (CL). Methods: Three disposable lenses (etafilcon A, hilabilcon A, and nelfilcon A) were applied to 19 normal subjects free from any eye diseases for either a single day or variable periods by when subjects complained any discomforts. On the first and last days, localizations of lens' center on corneal surface and blink rates were recorded at every case. Results: Among CL wearers, 10.5% and 47.4% of total subjects quit wearing on the second day and third day, respectively. The case of stopping disposable lens wear was continuously increased with extended hour of lens application. On fourth day, 70.2% of CL wearers reported severe discomforts such as redness, dryness, irritation, pain and blurred vision. When subjects stopped CL wear, decentration of lens from the center of cornea was observed when it compared to the case of single usage of disposable CL. Also about 80% of total subjects showed increased blink rate when CL were worn for more than 2 days. These changes in lens centration and blink rate were consistantly shown regardless of lens types. Conclusions: Blurred vision and acute/chronic discomforts could occur to CL wearers by decentration of lens and increased blink rate when CL were overused more than 2 days even the numbers of two parameters measured in this study were variable by each subject or lens types. Therefore, consideration of individual characteristics and lens types is critical to prevent adverse effects may induced by overusage of disposable lens.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.3
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• pp.1-6
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• 2008

Purpose: Plastic optical monomer materials having ultra high refractive index have an income of the whole quantity from advanced nations to domestic companies which are related to plastic optical lens. It is necessary to develop novel plastic optical lens materials in order to overcome a FTA provision and revitalize a stagnating optical lens industry in the interior optical lens industries. The new plastic optical lens materials against the substitution effect of income should be gradually demanded. This work will be synthesized novel super high refractive monomer resin materials of urethane lens series and studied the properties of optical lens using it. Methods: ETS-4 (2-(2-mercaptoethylthio)-3-{2-[3-mercapto-2-(2-mercaptoethylthio)propyl thio]ethylthio}propane -1-thiol), which is optical lens monomer resin having super high refractive index, was synthesized and identified its structure and property by elemental analysis, EI-MS, TGA, FT-IR spectroscopy, $^1H$ and $^{13}C$ NMR spectroscopies. After mixing evenly from mixed monomer resin and diisocyanate series, it was casting in glass mold. After thermal curing, the obtained optical lenses were measured and compared with the refractive index and Abbe number for studies of their optical properties. Results: We have synthesized the novel ultra high refractive index monomer resin, ETS-4, and have identified its structure and property by elemental analysis, EI-MS, TGA, FT-IR spectroscopy, $^1H$ and $^{13}C$ NMR spectroscopies. The existence of three isomers for EST-4 was identified by $^{13}C$ NMR spectroscopy. The refractive index ($N_d$ at $25^{\circ}C$) of monomer resin in liquid state obtained from the Abbe refractometer was 1.647. The refractive indexes of raw plastic optical lenses prepared from the mixed ETS-4 monomer and diisocyanate series were in the range of 1.656~1.680. Conclusions: Novel super high refractive index plastic optical lens monomer was synthesized and analysed, the optical lenses prepared using it were colorless transparency and excellent properties. It is of utility for the industrialization.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.3
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• pp.13-17
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• 2008

Purpose: The aim of the study is to provide for prospects of Department of Ophthalmic Optics. Methods: This study surveyed on notion in sunder of the frist grade 100 people, second grade 100 people, third grade 100 people in the third educational system of Department of Ophthalmic Optics. Results: 1. Recognition of beforehand information for Department of Ophthalmic Optic were investigated the highest rate at frist grade 40 people(40%) by ordinary, at second grade 42 people(42%) by ordinary and at third grade 34 people(34%) by low. 2. Goodness of fit of register for a course and content for Department of Ophthalmic Optic were investigated the highest rate at frist grade 54 people(54%) by ordinary, at second grade 51 people(51%) and at third grade 47 people(47%) by suitableness. 3. Satisfaction of choice for Department of Ophthalmic Optics were investigated the highest rate at frist grade 43 people(43%) by high, at second grade 45 people(45%) by ordinary and at third grade 41 people(41%) by high. 4. Consideration of instruction for Department of Ophthalmic Optic were investigated the highest rate at frist grade 55 people(55%), at second grade 60 people(60%) and at third grade 49 people (49%) by good. 5. Relationship of friend in Department of Ophthalmic Optics were investigated the highest rate at frist grade 40 people(40%), at second grade 50 people(50%) and at third grade 51 people(51%) by good. 6. Relationship a senior-younger men in Department of Ophthalmic Optics were investigated the highest rate at frist grade 47 people(47%), at second grade 50 people(50%) and at third grade 41 people(41%) by ordinary. 7. Prospects of future for Department Ophthalmic Optics were investigated the highest rate at frist grade 47 people (47%), at second grade 50 people(50%) and at third grade 45 people(45%) by ordinary. 8. Affairs after graduation of Department of Ophthalmic Optics were investigated the highest rate at frist grade 60 people(60%), at second grade 68 people(68%) and at third grade 66 people(66%) by optical shop. Conclusions: Satisfaction of choice for Department and Prospects of future for Department were investigated to be good as a whole.

• Neonatal Medicine
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• v.15 no.1
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• pp.32-37
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• 2008

Purpose : Perinatal asphyxia is an important cause of neonatal mortality and subsequent lifelong neurodevelopmental handicaps. Although many treatment strategies have been tested, there is currently no clinically effective treatment to prevent or reduce the harmful effects of hypoxia and ischemia in humans. In the clinical setting, maternal hyperthermia induces adverse effects on the neonatal brain, but recent studies have shown that hyperthermic pretreatment (PT) plays some role in hypoxic-ischemic (HI) injuries of the developing brain. The present study investigated the effect of hyperthermic PT on HI brain injuries in newborn rats. Methods : HI was produced in 7-day-old neonatal rats by unilateral common carotid artery ligation, followed by hypoxia with 8% oxygen at $38^{\circ}C$ for 2 hours. Twenty-four hours before HI, one-half of the pups were exposed to a $40^{\circ}C$ environment for 2 hours. The severity of the brain injury was assessed 7 days after the HI. Results : Hyperthermic PT reduced the gross and histopathologic findings of brain injury from 64.7 to 31.2% (P<0.05). There were no differences in location and severity of injury between the pretreated and control brains. Conclusion : These findings indicate that hyperthermic PT provides neuroprotective benefits on HI in the developing brain. Also, these findings suggest maternal hyperthermia may have protective effect on perinatal HI brain injuries.

• Neonatal Medicine
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• v.15 no.1
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• pp.80-83
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• 2008

Purpose : Inguinal hernias are common in children and sometimes are associated with dangerous complications, such as incarceration. There are no established management guidelines for ovarian hernias. We have reviewed the clinical course of ovarian hernias in infants. Methods : We reviewed the medical records of female infants diagnosed with ovarian hernias by ultrasonogram at Kwandong University College of Medicine, Cheil General Hospital, and the Women's Healthcare Center between March 2001 and August 2007. We analyzed the patients gestational age, birth weight, age at the time of detection of the inguinal mass, the patients chief complaints, operative time, post-operative complications, and ultrasonographic findings. Results : Eight female infants had ovarian hernias, four of whom were born prematurely. Seven infants had left-sided ovarian hernias, and one infant had a right-sided ovarian hernia. Five infants underwent surgery and there were no postoperative complications or recurrences. Three girls did not have surgery, and the ovarian hernias regressed spontaneously, with no recurrences or complications. The regression time of inguinal masses ranged from 70-161 days after birth. Conclusion : Physical examination to detect movable masses within the labium major in premature female infants is important because the incidence of premature inguinal hernias is much higher than in term infants. No rational medical treatment plans for female ovarian hernias have been published to date. We cared for three girls with spontaneous regression of ovarian hernias. Pediatricians should be aware whether emergent surgery for ovarian hernias is indicated.

• Neonatal Medicine
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• v.15 no.1
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• pp.44-53
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• 2008

Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.