BACKGROUND: It is well-known that a decline in the prevalence of smoking among physicians has preceded a decline in the general population. For the purpose of finding out the reason for lower smoking rate in Korean medical doctors than that of general population whether it is due to knowledge of toxicity related to smoking perceived as health professionals or as the only leader group in society this study was investigated. We selected lawyers as a representative of other professional groups. We investigated smoking rate, habits and attitudes towards smoking in Korean lawyers and compared the smoking rate and attitudes to wards smoking in lawyers with those of medical doctors. METHODS: This study investigates smoking rate, habits and attitudes towards smoking in Korean lawyers. An anonymous self-administered postal survey was used. One-third of registered lawyers were sampled according to stratified random sampling. Among 1,401 target population, 463 (38.3%) responded. RESULTS: Among male lawyers, 38.0% were current smokers, 38.9% were ex-smokers and 23.1% were non-smokers, while 7.7% were ex-smokers and 92.3% were non-smokers among female lawyers. The direct age-adjusted smoking rate among Korean male lawyers was 42.1%. CONCLUSION: In comparison of the direct age-adjusted smoking rate among male lawyers, medical doctors and general population in Korea, the rate in lawyers was 42.1%, medical doctors 34.9%, and general population 67.6%. The smoking rate of lawyers was found to be higher than that of medical doctors, but considerably lower than that of general population. In comparison of the attitudes towards smoking between lawyers and medical doctors, the lawyers were found to have a lower level of support in questions of the knowledge about the harmful effects of smoking and smoking bans on health than medical doctors.
Anonyms and Pseudonyms ; Female ; Health Occupations ; Health Services Needs and Demand ; Humans ; Korea* ; Lawyers* ; Male ; Prevalence ; Smoke* ; Smoking*

No abstract available.
Child* ; Humans ; Scrub Typhus*

A 54-year-old male patient was seen in clinic for ocular pain and decreased vision in the right eye with duration of two days. He underwent a cataract operation for his right eye 12 years ago, then a sclera-fixated secondary intraocular implantation and pars plana vitrectomy three years ago due to intraocular lens dislocation. At the initial visit, his visual acuity was restricted to the perception of hand motion. An edematous cornea, cells, flare with hypopyon, and exposed suture material at were observed at the six o'clock direction by slit lamp. Vitreous opacity was noted from B-scan ultrasonography. The patient was diagnosed with late-onset endophthalmitis and an intravitreal cocktail injection was done. On the next day, the hypopyon was aggravated, and therefore a pars plana vitrectomy was performed. A vitreous culture tested positive for Citrobacter koseri. After 12 weeks, the best corrected visual acuity of the right eye improved to 0.7 and a fundus examination revealed a relatively normal optic disc and retinal vasculature. We herein report the first case of endophthalmitis caused by Citrobacter koseri in Korea. Exposed suture material was suspected as the source of infection in this case and prompt surgical intervention resulted in a relatively good visual outcome.
Anti-Bacterial Agents/administration & dosage ; Cataract Extraction/adverse effects ; Citrobacter koseri/*isolation & purification ; Diagnosis, Differential ; Endophthalmitis/diagnosis/*microbiology/therapy ; Enterobacteriaceae Infections/diagnosis/*microbiology/therapy ; Eye Infections, Bacterial/diagnosis/*microbiology/therapy ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Lens Implantation, Intraocular/*adverse effects ; Male ; Microscopy, Acoustic ; Middle Aged ; Surgical Wound Infection/diagnosis/*microbiology/therapy ; Sutures/adverse effects/microbiology ; Visual Acuity ; Vitrectomy ; Vitreous Body/*microbiology

PURPOSE: To report a case of massive spontaneous suprachoroidal hemorrhage in a middle-aged female with heavy alcohol consumption. CASE SUMMARY: A 48-year-old female with a history of heavy alcohol consumption developed a massive spontaneous suprachoroidal hemorrhage in the right eye. Fundus examination and B-scan ultrasonography of the right eye revealed a hemorrhagic choroidal detachment with kissing choroidal sign. On systemic evaluation, she was diagnosed with alcohol-induced hepatitis, diabetes, and diabetic nephropathy. We performed trans-scleral drainage of the suprachoroidal hemorrhage, trans pars plana vitrectomy and silicone oil injection in her right eye. CONCLUSIONS: To our knowledge, this is the first case report of massive spontaneous suprachoroidal hemorrhage in a patient with heavy alcohol intake.
Alcohol Drinking* ; Choroid ; Diabetic Nephropathies ; Drainage ; Female ; Hemorrhage* ; Hepatitis ; Humans ; Middle Aged ; Silicone Oils ; Ultrasonography ; Vitrectomy

PURPOSE: To evaluate the accuracy of intraocular lens (IOL) power estimation and the factors associated with outcome in eyes undergoing combined phacovitrectomy for proliferative diabetic retinopathy. METHODS: We performed a retrospective case review of 39 consecutive patients (44 eyes) that underwent phacovitrectomy for proliferative diabetic retinopathy. Axial lengths were measured using ultrasound (A-scan) and/or optical biometry (IOL Master). Achieved and predicted refractions were compared to calculate the mean postoperative refractive prediction error (ME) and the mean absolute prediction error (MAE). Systemic conditions of patients and several preoperative and postoperative factors related to the postoperative refraction were analyzed. RESULTS: The ME of 44 eyes were -0.23 +/- 0.52 diopters (D) and -0.23 +/- 0.47 D after 3 and 6 months, respectively (range, -1.40~+0.79 D). There was no statistically significant difference in the refractive outcomes between the refractive errors (p = 0.959). The MAEs were 0.45 +/- 0.35 D and 0.40 +/- 0.33 D after 3 and 6 months, respectively with no statistical significant difference between the results (p = 0.196). When comparing ME in the 20 eyes that achieved both results, ultrasound was more accurate than optical biometry (p = 0.002, 0.002). The factors associated with more inaccurate ME and MAE after phacovitrectomy were diabetic nephropathy and neovascular glaucoma. CONCLUSIONS: Combined phacovitrectomy in proliferative diabetic retinopathy showed small biometric errors within the tolerable range in most cases. Patients with neovascular glaucoma and diabetic nephropathy had more inaccurate postoperative refractive power. Both optical biometry and ultrasound should be used to estimate axial lengths for improving the accuracy of IOL power calculation.
Biometry ; Diabetic Nephropathies ; Diabetic Retinopathy* ; Glaucoma, Neovascular ; Humans ; Lenses, Intraocular* ; Refractive Errors ; Retrospective Studies ; Ultrasonography

Purpose: We report the first case of bilateral paracentral acute middle maculopathy (PAMM) after severe headache in a Korean patient.Case summary: A 43-year-old woman with herniation of a lumbar disk visited the emergency room with a 5-day history of headache and bilateral visual disturbance. She experienced a severe headache, facial fever, and partial visual field defects in both eyes. There were no neurologic symptoms, related acute brain disease or lesions on brain/orbit magnetic resonance imaging.Her best corrected visual acuity was 0.8 (right eye) and 0.5 (left eye), which was lower than. There were no relative afferent pupillary defects, color deficits, or any ocular movement disorder. Her intraocular pressures were normal, but a Humphrey visual field test identified multiple atypical scotomas in both eyes. Ophthalmoscopic examination revealed multiple light gray exudates with unclear margins surrounding the maculas of both eyes. Spectral domain optical coherence tomography (SD-OCT) showed some localized hyper-reflective lesions located in the inner plexiform, inner nuclear, and outer plexiform layers. On optical coherence tomography angiography (OCTA) examination, there was a normal choriocapillaris and a reduction of the inner retinal capillary plexus corresponding to the lesions in the fundus examination. Fluorescent angiography revealed early localized nonperfusion areas and a late leak in the same lesions. In addition, there was delayed filling of the peripheral retina and a late leak. Conclusions It is important to consider PAMM in patients who show sudden visual loss or visual field defects and SD-OCT and OCTA may assist in the diagnosis.

PURPOSE: To evaluate the usefulness of OCT retinal mapping in determining the configuration of a vitreomacular adhesion and selecting a meridian for entry into the subhyaloid space in patients with vitreomacular traction syndrome. METHODS: Six consecutive patients (6 eyes) with vitreomacular traction syndrome underwent vitrectomy with peeling of posterior hyaloid. Ocular coherence tomography (OCT) retinal mapping was performed preoperatively. Access to the subhyaloid space was made by creating an opening with a 25 gauge needle at a location where the detached posterior hyaloid membrane was farthest from the retinal surface. The location was selected based on six preoperative meridional OCT scans. The posterior hyaloid was then gently peeled off in a circular fashion around the fovea with a micropick. Visual acuity and foveal thicknesses were measured before the operation and 3 months afterwards. RESULTS: After the operation, visual acuity improved and central macular thicknesses were reduced significantly in all six patients. The best corrected visual acuity improved from 0.4 to 0.75 with a mean increase by 3.5 lines on a Snellen chart 3 months after the operation. The mean foveal thickness was reduced from 406 micrometer to 241 micrometer. The restoration of foveal pit was observed in five patients. Neither intraoperative nor postoperative complications were observed during the follow up period. CONCLUSIONS: An OCT retinal mapping program is a valuable diagnostic tool in understanding the configuration of vitreomacular adhesion and planning the surgical approach for operating on vitreomacular traction syndrome.
Aged ; Eye Diseases/diagnosis/etiology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Retinal Diseases/diagnosis/etiology/*surgery ; Syndrome ; Tissue Adhesions/etiology/surgery ; *Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy/*methods ; Vitreous Body/pathology/*surgery ; Vitreous Detachment/complications

BACKGROUND: Tracheal intubation is accompanied by varing degrees of sympathetic stimulation as reflected by increases in heart rate, and blood pressure and several clinical trials to reduce the effects on blood pressure and heart rate by pharmacologic agents such as and blockers, calcicum channel blockers, narcotics and lidocaine, have been reported. METHODS: To evaluate the effect of fentanyl, lidocaine, esmolol on the hemodynamic changes induced by intubation, we administered thiopental 5 mg/kg only (group 1, n=12), fentanyl 2 g/kg with thiopental 5 mg/kg (group 2, n=12), lidocaine 1 mg/kg with thiopental 5 mg/kg group 3, n=12) or esmolol 0.5 mg/kg with thiopental 5 mg/kg (group 4, n=12) for induction of anesthesia, and measured heart rate, systolic blood pressure, diastolic blood pressure, mean arteiral pressure, and rate-pressure products (RPP) before induction, after induction, after intubation and at 1, 2, 3, and 5 minutes after intubation. RESULTS: There was a significant increase in heart rate, systolic blood pressure and RPP after intubation and 1 min after intubation in all groups, but in group 2, group 3 and group 4, the cardiovascular responses were more attenuated compared to group 1. CONCLUSION: The preintubation intravenous injection of fentanyl, lidocaine and esmolol may offer important roles in the hemodynamically unstable patients because it attenuate cardiovascular responses with intubation.
Anesthesia ; Blood Pressure ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Injections, Intravenous ; Intubation ; Lidocaine* ; Narcotics ; Thiopental

A 60-year-old male was referred to the ophthalmologic clinic with aggravated anterior uveitis and corneal edema despite the use of topical and systemic steroids. He had undergone cataract surgery in both eyes 15 years previous. Slit lamp examinations revealed a retained lens fragment in the inferior angle of the anterior chamber, with severe corneal edema and mild anterior uveitis. The corneal edema and uveitis subsided following surgical extraction of the lens fragment. That a retained lens fragment caused symptomatic anterior uveitis with corneal edema 15 years after an uneventful cataract surgery is unique. A retained lens fragment should be considered as one of the causes of anterior uveitis in a pseudophakic patient.
Cataract Extraction/*adverse effects ; Corneal Edema/*etiology/*pathology ; Humans ; Lens, Crystalline/*pathology/surgery ; Male ; Middle Aged ; Postoperative Complications/pathology/surgery ; Pseudophakia/pathology ; Reoperation ; Severity of Illness Index ; Uveitis, Anterior/*etiology/*pathology

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate the familial correlation and heritability of the LDL cholesterol level through a segregation analysis. SUBJECTS AND METHODS: This study was based on the data from 9,884 Korean individuals, ascertained as pedigrees, who had participated in the 1998 and 2001 Korean National Health & Nutrition Examination Survey. The subjects of the segregation analysis were 3,613 Korean with more than five family members. RESULTS: The LDL cholesterol level revealed a strong familial correlation among spouses, parental-offspring and siblings; a low correlation with spouses, but a high correlation with parental-offspring and siblings. The heritability of the LDL cholesterol level was 37.3%, when controlled for age, age2, gender, age x gender, waist circumference, smoking, alcohol drinking, exercise and education. After the segregation analysis, models of the major gene effects were rejected in the general population. However, the Mendelian dominant and co-dominant models were found in high risk families. CONCLUSION: In conclusion, the randomly ascertained Korean families of this study showed strong familial aggregation in the LDL cholesterol level. This suggested that variations in the level of LDL cholesterol may be influenced by a major gene effect.
Alcohol Drinking ; Cholesterol, LDL ; Education ; Humans ; Siblings ; Smoke ; Smoking ; Spouses ; Waist Circumference