ABSTRACT
PURPOSE: To assess the relationship between eye position and anesthesia depth using the bispectral index (BIS) value, a parameter derived from electroencephalography data. METHODS: We investigated the relationship between BIS value and eye position in 32 children who underwent surgery for epiblepharon under general anesthesia. BIS values were recorded continuously throughout the procedure (from induction to awakening). Eye positions were video-recorded and analyzed after surgery. The vertical position of each eye was scored according to its height in relation to the medial canthus. An eye position in which the upper eyelid covered one-third of the cornea was defined as a significant ocular elevation. RESULTS: The BIS value correlated inversely with the end-tidal concentration of each anesthetic agent, whereas it correlated positively with the eye elevation score (eye position = 0.014 × BIS + 0.699, p = 0.011). The mean eye position score was significantly greater in patients whose BIS values were over 65. Eleven patients (34.4%) had significant ocular elevation; their mean concurrent BIS value was 61.6. Two of these patients had elevation during surgery and 9 had elevation during emergence from anesthesia. CONCLUSIONS: We found that high BIS values were correlated with low levels of anesthetic concentration and high eye position, suggesting that BIS monitoring may be useful for predicting eye position during anesthesia. Particular attention must be given to eye position during ophthalmic surgery. Anesthesia depth can be maintained by assuring that the BIS value remains below 65.
Subject(s)
Child , Humans , Anesthesia , Anesthesia, General , Cornea , Electroencephalography , Electrophysiology , Eyelids , Lacrimal ApparatusABSTRACT
PURPOSE@#This review aimed to integrate the results of studies related to job embeddedness of clinical nurses and suggest directions for future research.@*METHODS@#A search for relevant studies was conducted using six databases according to the predetermined index terms “nurse†and “job embeddedness.†A total of 28 studies that met the inclusion criteria were selected and analyzed.@*RESULTS@#The definition of job embeddedness was consistent in the articles, but the terms, scope, and use of tools to determine job embeddedness were not. In addition, no article suggested a theoretical framework. In all the studies except one, the tool used to measure job embeddedness was one revised from Mitchell et al. (2001). In 15 articles, a negative correlation was found between job turnover and turnover intention. Job embeddedness was also found to be associated with nurses' work environment, organizational citizenship behavior, and organizational commitment, and it had a positive impact on these variables.@*CONCLUSION@#Job embeddedness can be used as a major variable to explain nurses's turnover intention. Job embeddedness is multidimensional, and a theoretical framework is needed to explain the job embeddedness of clinical nurses. Tools specific to Korea should be developed to measure the job embeddedness of Korean clinical nurses.
ABSTRACT
PURPOSE: This review aimed to integrate the results of studies related to job embeddedness of clinical nurses and suggest directions for future research. METHODS: A search for relevant studies was conducted using six databases according to the predetermined index terms “nurse” and “job embeddedness.” A total of 28 studies that met the inclusion criteria were selected and analyzed. RESULTS: The definition of job embeddedness was consistent in the articles, but the terms, scope, and use of tools to determine job embeddedness were not. In addition, no article suggested a theoretical framework. In all the studies except one, the tool used to measure job embeddedness was one revised from Mitchell et al. (2001). In 15 articles, a negative correlation was found between job turnover and turnover intention. Job embeddedness was also found to be associated with nurses' work environment, organizational citizenship behavior, and organizational commitment, and it had a positive impact on these variables. CONCLUSION: Job embeddedness can be used as a major variable to explain nurses's turnover intention. Job embeddedness is multidimensional, and a theoretical framework is needed to explain the job embeddedness of clinical nurses. Tools specific to Korea should be developed to measure the job embeddedness of Korean clinical nurses.
Subject(s)
Intention , KoreaABSTRACT
PURPOSE: To present cases of toxoplasmic retinochoroiditis (TRC) treated successfully with intravitreal clindamycin injection. CASE SUMMARY: (Case 1) A 41-year-old man presented with blurred left eye vision for several months. The patient had a large chorioretinal scar with infiltrations at the boundaries, and fluorescein angiography (FA) showed active retinochoroiditis. Antitoxoplasmosis (antiTX) immunoglobulin G (IgG) was positive, and the patient was started on antiTX medication. Despite several weeks of treatment with maximum doses of antiTx, the TRC progressed and visual acuity worsened. Pars plana vitrectomy (PPV) with intravitreal clindamycin injection (1.0 mg/0.1 ml) was performed, and an additional injection was given 4 weeks later. Six weeks after the second injection, TRC wascompletely resolved with 20/20 vision. (Case 2) A 67-year-old man presented with decreased left eye vision for 1 year. Fundus examinations showed vitreous opacity and epiretinal membranes. The FA revealed retinochoroiditis and the antiTX IgG titer was elevated. The presumed diagnosis was TRC, and oral medications of trimethoprim-sulfamethoxazole, clindamycin, and prednisolone was administered. Inflammation began to improve however, as the patient was not tolerating systemic antiTx medications, an intravitreal injection of clindamycin (1.0 mg/0.1 ml) was administered with PPV. The patientdiscontinued oral medication after surgery, and the inflammation resolved 5 weeks later. CONCLUSIONS: Intravitreal clindamycin injections may be an additional treatment option for TRC in patients who are unable to tolerate systemic therapy or whose disease progresses despite systemic therapy.
Subject(s)
Adult , Aged , Humans , Cicatrix , Clindamycin , Epiretinal Membrane , Eye , Fluorescein Angiography , Immunoglobulin G , Inflammation , Intravitreal Injections , Prednisolone , Trimethoprim, Sulfamethoxazole Drug Combination , Vision, Ocular , Visual Acuity , VitrectomyABSTRACT
PURPOSE: To report a case of non-arteritic anterior ischemic optic neuropathy after bilateral selective neck dissection. CASE SUMMARY: A 48-year-old man presented with a visual field defect in his right eye 11 days after bilateral selective neck dissection. His corrected visual acuity in the right eye was 20/20; fundus photographs revealed a segmental optic disc swelling in the superior half of the right eye, and the Humphrey visual field test showed an inferior altitudinal defect in the right eye, corresponding to the disc swelling. The fluorescein angiography revealed a delayed filling on the superior half of the optic disc in the right eye. The diagnosis was non-arteritic anterior ischemic optic neuropathy. Orbital and brain MRIs showed an increase in caliber of the right optic nerve, but no other mass or enhanced lesion was noted. After 3 months, the patient's visual acuity and visual field were maintained, but segmental atrophy developed on the superior half of the right optic disc. CONCLUSIONS: With the risk factors of ischemic optic neuropathy, the possibility of postoperative visual impairment or field defect should be considered after a selective head and neck surgery.
Subject(s)
Humans , Middle Aged , Atrophy , Brain , Eye , Fluorescein Angiography , Head , Neck , Neck Dissection , Optic Nerve , Optic Neuropathy, Ischemic , Orbit , Risk Factors , Vision Disorders , Visual Acuity , Visual Field Tests , Visual FieldsABSTRACT
PURPOSE: To investigate the relationships between preoperative factors and intraocular pressure (IOP) reduction after phacoemulsification in normal, open-angle glaucoma (OAG) and angle-closure glaucoma (ACG) patients. METHODS: IOP was measured before and 3 months after cataract surgery in 30 normal, 24 OAG and 31 ACG patients. The relationship between IOP reduction after cataract surgery and preoperative parameters including anterior chamber depth (ACD), axial length (AL), preoperative IOP/ACD ratio (PD ratio), preoperative IOP/AL ratio (PL ratio) were investigated in the 3 groups. RESULTS: Significant IOP reduction was observed in all 3 groups after surgery (paired sample t-test; p < 0.05), and IOP reduction was correlated with preoperative IOP level in all 3 groups (Pearson's correlation; p < 0.05). Other preoperative parameters such as ACD and AL were not correlated with IOP reduction, and PD ratio was significantly correlated with IOP reduction only in the OAG group (Pearson's correlation; p < 0.001). PL ratio was significantly correlated with IOP reduction in all 3 groups (Pearson's correlation; p < 0.05) and showed the best sensitivity and specificity to predict significant reduction in IOP after cataract surgery among parameters including preoperative IOP, PD ratio and PL ratio. CONCLUSIONS: PL ratio was significantly correlated with IOP reduction after cataract surgery in all 3 groups and showed a higher predictive value for IOP reduction in the OAG group than in the other groups.