PURPOSE: To evaluate the clinical manifestations of double elevator palsy and describe the surgery outcomes in patients. METHODS: We performed a retrospective chart review of all patients who were treated surgically for double elevator palsy between 1999 and 2012 at Yonsei University, Severance Hospital in Seoul, Korea. RESULTS: Overall, 15 subjects (7 males and 8 females) with a mean age of 14.6 years (range, 3-40 years) underwent their first surgery during the study period. All patients received inferior rectus recession as a primary procedure. Nine patients (60.0%) underwent a secondary procedure which included 4 cases of horizontal muscle transposition, 2 cases of correction of exotropia, and 3 cases of correction of hypotropia and exotropia simultaneously. The mean preoperative hypotropia was decreased from 29.9 +/- 8.4 prism diopter (PD) to 4.7 +/- 5.3 PD postoperatively. Mean follow-up period was 40.9 +/- 48.2 months. Seven patients (46.7%) underwent eyelid surgery for true ptosis. At last follow-up, a majority of patients showed mild or no amblyopia. CONCLUSIONS: Primary inferior rectus recession and additive secondary horizontal muscle transposition surgery was effective in treatment of double elevator palsy. The clinical manifestations and surgical outcomes of monocular elevation deficiency in the present study can help in the treatment of Korean patients.
Amblyopia ; Elevators and Escalators* ; Exotropia ; Eyelids ; Follow-Up Studies ; Humans ; Korea ; Male ; Paralysis* ; Retrospective Studies ; Seoul

The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (l)Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3parts, that is, occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was slightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of occupational Medicine(18.2%), several kinds of Medical College Journal(17.0%), The Korean Journal occupational Health(15.l%), The Korean Journal of preventive Medicine(15.l%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(l8.2%), occupational organization 3(9.1%) and occupational health delivery system l(3.0%). of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was l85(71.l%), followed by women worker, white color workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (l) study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.
Classification* ; Surveys and Questionnaires ; Disease Management ; Education ; Epidemiology ; Female ; Humans ; Korea* ; Male ; Occupational Health Services ; Occupational Health*

No abstract available.
Leptospira interrogans* ; Leptospira*

OBJECTIVES: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. METHODS: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. RESULTS: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. CONCLUSIONS: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.
Aged* ; Dementia* ; Education ; Female ; Gangwon-do ; Humans ; Pain Measurement ; Pain Threshold*

No abstract available.
Arteriovenous Fistula ; Lower Extremity

The goal of this study was to analyze the effects of genistein, a widely used tyrosine kinase inhibitor, on cloned Shaw-type K+ currents, Kv3.1 which were stably expressed in Chinese hamster ovary (CHO) cells, using the whole-cell configuration of patch-clamp techniques. In whole-cell recordings, genistein at external concentrations from 10 to 100 micrometer accelerated the rate of inactivation of Kv3.1 currents, thereby concentration-dependently reducing the current at the end of depolarizing pulse with an IC50 value of 15.71+/-0.67 micrometer and a Hill coefficient of 3.28+/-0.35 (n=5). The time constant of activation at a 300 ms depolarizing test pulses from -80 mV to +40 mV was 1.01+/-0.04 ms and 0.90+/-0.05 ms (n=9) under control conditions and in the presence of 20 micrometer genistein, respectively, indicating that the activation kinetics was not significantly modified by genistein. Genistein (20 micrometer) slowed the deactivation of the tail current elicited upon repolarization to -40 mV, thus inducing a crossover phenomenon. These results suggest that drug unbinding is required before Kv3.1 channels can close. Genistein-induced block was voltage-dependent, increasing in the voltage range (-20 mV~0 mV) for channel opening, suggesting an open channel interaction. Genistein (20 micrometer) produced use-dependent block of Kv3.1 at a stimulation frequency of 1 Hz. The voltage dependence of steady-state inactivation of Kv3.1 was not changed by 20 micrometer genistein. Our results indicate that genistein blocks directly Kv3.1 currents in concentration-, voltage-, time-dependent manners and the action of genistein on Kv3.1 is independent of tyrosine kinase inhibition.
Animals ; Clone Cells ; Cricetinae ; Cricetulus ; Female ; Genistein* ; Inhibitory Concentration 50 ; Kinetics ; Ovary ; Patch-Clamp Techniques ; Protein-Tyrosine Kinases* ; Tyrosine*

BACKGROUND: Hyperlipidemia has been known as an independent risk factor in the develop-ment of coronary artery disease. This study was carried out to compare nutrient intakes, smo-king status, antioxidant vitamins, and plasma lipids in patients with coronary heart disease (CHD) and in normal healthy subjects among Korean population in Taegu. Possible causes of this dis-ease in patients are discussed. METHODS: Anthropometric assessments included mean intakes of nutrients, and the levels of plasma lipids (apolipoprotein [Apo] A - I, Lipoprotein [Lp] [a]), and antioxidant vitamins (such as vitamins A and E) were measured in female and male subjects with CHD against healthy con-trols. RESULTS: Dietary cholesterol and fat intakes were significantly higher in CHD groups in men and women. Total plasma cholesterol, LDL-C, triglyceride, thiobarbituric acid reactive subst-ance (TBARS), atherogenic index and Lp (a) levels were significantly higher in CHD patients than in the normal group in both men and women. Apo A-I, HDL-C and vitamin E levels were lower in CHD patients than in the normal group. The number of smokers was higher in CHD patients than in the normal group in both sexes of subjects. CONCLUSION: High fat and high cholesterol intakes seemed to be a major factor for the hyperlipidemia in the CHD patients. Their abnormal lipoprotein profile, which appeared in pati-ent plasma, corresponded well to dietary intake patterns. However, long term studies are need-ed to investigate the effects of smoking on lipid metabolism in CHD patients among the Korean population.
Apolipoprotein A-I ; Cholesterol ; Cholesterol, Dietary ; Coronary Artery Disease ; Coronary Disease* ; Daegu ; Female ; Humans ; Hyperlipidemias ; Lipid Metabolism ; Lipid Peroxidation ; Lipoprotein(a)* ; Lipoproteins* ; Male ; Plasma* ; Risk Factors ; Smoke* ; Smoking* ; Triglycerides ; Vitamin A ; Vitamin E ; Vitamins

PURPOSE: To examine the relationship between injury severity and patterns of associated injury in spinal fracture. MATERIALS AND METHODS: From March 2004 to March 2010, a retrospective study was conducted on 291 patients who had undergone surgeries due to spinal fractures. Spinal fractures were categorized as upper cervical, lower cervical, thoracic, thoracolumbar, and lumbar region, and the severity of fracture was measured using the Abbreviated Injury Scale and Injury Severity Score (ISS). We evaluated the correlation between the fracture site and the incidence and injury severity of the associated injury, and compared the neurologic damage according to the presence/absence of the associated injury. RESULTS: Spinal fracture occurred in the thoracic (43.5%) and lower cervical (30.0%) levels, and associated injury developed in 134 patients (47%). The area of associated injury was in the extremity (41.2%), thorax (25.5%), head, neck, and face (21.9%). Lower cervical fracture (34.5%) had a lower prevalence than thoracic (81%) and lumbar fracture (61%). The average ISS of the associated injury was 17.14 for the thoracic fracture, 12.30 for the lower cervical fracture, 8.7 for the thoracolumbar fracture and 5.69 for the lumbar fracture. Neurologic damage was highly frequent in the lower cervical fracture and included 54 patients (62.1%) and was less frequent in the upper cervical fracture, which included 7 patients (17.9%) (p=0.032). CONCLUSION: Although the associated injury was less frequent in the lower cervical spine among the spinal fractures that underwent surgical treatment, there was a high risk of neurologic damage in the case of associated injury; therefore, there is a need to pay special attention to patients that suffer damage in this area. In addition, since the degree of the associated injury in the thoracic and lower cervical fracture is significant, an appropriate management strategy for the associated injury must be considered.
Abbreviated Injury Scale ; Extremities ; Head ; Humans ; Incidence ; Injury Severity Score ; Lumbosacral Region ; Multiple Trauma ; Neck ; Prevalence ; Retrospective Studies ; Spinal Fractures ; Spine ; Thorax

OBJECTIVE: To determine whether there is correlation between serum concentrations of lipoproteins (VLDL, HDL, LDL) and development of preedampsia. METHODS: The authors measured serum concentrations of lipoproteins(VLDL, HDL, LDL) and lipids(which are major components of lipoproteins) in 12 preeclamptic women admitted to Sanggye Paik Hospital, Inje University from March 1999 to August 1999 and 12 normal pregnant women matched in age, weight, parity and gestational age. RESULTS: The first, the values of median and range of VLDL are higher in preeclamptic women than in normal pregnant women(preeclamptic women : 244mg/dL & 124-521mg/dL, normal pregnant women : 149mg/dL & 68-308mg/dL, p=0.0005). But there are no difierences in serum concentrations of HDL(high-density lipoprotein) and LDL(low-density lipoprotein) between two groups. The second, the values of median and range of triglyceride and free fatty acids are higher in preedamptic women than in normal pregnant women(preeclamptic women : triglycerides : 305.5mg/dL & 231-545mg/dL, free fatty acids : 1,333mmol/L & 842- 1523mmol/L, normal pregnant women,: triglycerides : 239mg/dL & 151-414mg/dL, free fatty acids : 806.5mmol/L & 314-1517mmol/L, p=0.019 in triglycerides and p=0.033 in free Fatty acids). But the serum concentrations of cholesterol are similar in two groups. CONCLUSIONS: Overall, the results of this study showed the serum concentrations of VLDL, triglycerides and free fatty acids are significantly higher in preeclamptic women than in normal pregnant women. So, the high serum concentration of VLDL is thought to be important in the pathogenesis of preeclampsia. In the next study, the prospective analysis will be necessary to identify whether serum concentration of VLDL is abnormaUy high in early gestational pregnant women who are destined to preeclamsia. Also, the measurement of pI 5.6 isoelectric form of albumin which is suggested to prevent VLDL toxicity will be necessary.
Cholesterol ; Fatty Acids, Nonesterified ; Female ; Gestational Age ; Humans ; Lipoproteins* ; Parity ; Pre-Eclampsia* ; Pregnant Women ; Triglycerides

BACKGROUND/AIMS: Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. MATERIALS AND METHODS: Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = 5 log10 copies/ml. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. RESULTS: Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < 5 log(10) copies/ml or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log(10) copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. CONCLUSIONS: Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.
Alanine Transaminase ; DNA ; Drug Resistance ; Guanine ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Korea ; Medical Records ; Polymerase Chain Reaction ; Retrospective Studies