OBJECTIVE AND METHODS: To determine correlations among ambulatory renin activity, ambulatory blood pressure and microalbumin excretion rate, 66 Korean essential hypertensives were studied after 4 week wash-out period. The ambulatory blood pressure was monitored every 30 minutes and mean BP were calculated automatically. Urinary microalbumin excretion rate(UAER) and ambulatory plasma renin activity(aPRA) collected at mid-day were measured by radioimmunoassays. Subjectives were divided into 2 groups by aPRA value(2ng/ml/hr). RESULT: 14 cases were high renin group and 52 cases low renin group. The mean BP were 148.83/94.69mmHg in low renin group, and 146.57/98.07mmHg in high-renin group without difference. UAER were not different also between both groups. 23.07%(4/14) of non-dippers were included in high renin group and 25.58%(12/52) in low renin group without statistical difference. The aPRA was significantly related to UAER and systolic and diastolic mean blood pressure. Also UAER was related significantly to day mean blood pressures. CONCLUSION: Thus aPRA is thought to be a meaningful indicator to predict hypertensive renal target organ damage as well as blood pressure measured with 24-hr ABPM.
Blood Pressure* ; Hypertension* ; Plasma* ; Radioimmunoassay ; Renin*

As for the goal of medical education, it is generally accepted that it should provide the medical students with the ability to practice primary care. However, the medical education has been markedly dependent on the lecture and general hospital-based clerkship in Korea. This survey was conducted on the senior medical students (N = 209) who has been through with the entire curriculum of Seoul National University to assess the degree of satisfaction with the medical education and the ability to practice primary care. We analyzed the useful answers of the 164 objectives. The mean age of the objectives was 24.2+/-1.0 years. The results were as follows : 1. The proportion of the students who answered that he (or she) was satisfied with the medical education was 30.5% (N = 50) and that of the unsatisfied was 54.3% (N = 89). 2. The proportion of the students who answered that he (or she) has ever practiced the suture of simple laceration was 11% (N = 18). 3. The proportion of the students who answered that he (or she) could not manage the acute diarrhea of children was 63.8% (N = 104). 4. The proportion of the students who answered that he (or she) could not manage the upper respiratory tract infection of adult was 29.3% (N = 48).
Adult ; Child ; Curriculum ; Diarrhea ; Education, Medical* ; Humans ; Korea ; Lacerations ; Primary Health Care ; Respiratory Tract Infections ; Seoul* ; Students, Medical ; Sutures ; Surveys and Questionnaires

PURPOSE: To research the advantage of using calcium plaque scissors in conjunctival flap surgery for calcified scleromalacia after cosmetic conjunctivectomy. METHODS: We analyzed 55 eyes that had undergone conjunctival flap surgery for calcified scleromalacia occurring after cosmetic conjunctivectomy. Surgical blade was used in 30 eyes (Group 1) and calcium plaque scissors in 25 eyes (Group 2). Time after conjunctivectomy, plaque size, operation time and visual acuity before and after the flap surgery were analyzed and compared. Additionally, necessity of additional scleral surgery was evaluated. Optical coherence tomography (OCT) of the sclera was performed both pre- and postoperatively and the results were compared. RESULTS: An average of 3.9 +/- 1.0 years elapsed until conjunctival flap surgery and follow-up time was 5.2 +/- 3.8 months. Post conjunctivectomy time and plaque size were similar in both groups (p = 0.87 and 0.49, respectively). The surgery time in Group 2 was shorter than in Group 1 (17.5 +/- 6.3 minutes and 21.9 +/- 8.5 minutes, respectively, p = 0.20). Uncorrected visual acuity was similar in both groups before and after conjunctival flap surgery (p = 0.53 and p = 0.20, respectively). In Group 1, one sclera transplantation and three Ologen(TM) insertion surgeries were performed as an additional scleral surgery. Based on OCT, calcium plaque scissors were confirmed as a new surgical tool for calcium plaque removal with minimal scleral damage. CONCLUSIONS: Using calcium plaque scissors when performing conjunctival flap surgery for calcium plaque removal that occurred after cosmetic conjunctivectomy reduces the necessity of an additional scleral surgery and surgery time.
Calcium* ; Follow-Up Studies ; Sclera ; Tomography, Optical Coherence ; Visual Acuity

The effect of betaxolol and dipivefrin on microcirculation of peripapil lary reina and optic disc in normal tension glaucoma was assessed. Betaxolol, selective beta-1 blocker, was known to improve the blood flow of retrobulbar arteries, and dipivefrin was known to decrease the flow of ciliary body. Total subjects were 29 normal tension glaucoma patients; 18 subjects with no previous IOP reducing eye drops during 4 weeks were assigned for betaxolol group, and 11 subjects with using timolol for dipivefrin group. The intraocular pressure was significantly reduced after instillation in betaxolol group(p<0.01), and in dipivefrin group(p<0.05). But systemic blood pressure and pulse rate were not changed after instillations in both groups. Blood flow, volume, velocity of optic disc and peripapillary retina of betaxolol group and dipivafrin group were not significantly changed. From the above results, we concluded that betaxolol and dipiverin with timolol did not influenced the microcirculation of peripapillary retina and opit disc.
Arteries ; Betaxolol* ; Blood Pressure ; Ciliary Body ; Heart Rate ; Humans ; Intraocular Pressure ; Low Tension Glaucoma* ; Microcirculation ; Ophthalmic Solutions ; Optic Disk* ; Optic Nerve* ; Retina ; Retinaldehyde* ; Timolol

Remained lens epithelial cells after the cataract surgery can cause anterior and posterior capsular opacity and other complications from the postoperative anterior chamber inflammation. The removal of lens epithelial cells(LEC) during the cataract surgery is important clinically. We measured the degree of the anterior chamber inflammation after the removal of LEC in 360 degree and the removal of LEC in 180 degree. The anterior chamber inflammation was measured by flare-cell meter postoperatively the 1st day, 4th day, 1st week, 2nd week, 3rd week, 4th week, and 3rd month, and compared the results with the anterior chamber inflammation after the cataract surgery without the removal of LEC. There were no significant differencies among the groups before the 2nd week. The degree of inflammation was decreased significantly in the groups postoperatively compared to the group in which LEC were not removed. And the inflammation was lower significantly in the group of the 360 degree removal than the group of 180 degree removal after the 2nd week postoperatively. We conclude that LEC removal in cataract surgery decreased the anterior chamber inflammation significantly after the 2nd week postoperatively.
Anterior Chamber* ; Cataract Extraction ; Cataract* ; Epithelial Cells* ; Inflammation*

PURPOSE: To assess the preemptive analgesic effect of topical NSAIDs (0.5% ketorolac tromethamine, Acular) as postoperative pain relief in patients undergoing LASEK. METHODS: A prospective, randomized, placebo-controlled, paired eye study was performed. Patients undergoing LASEK were randomized to receive 0.5% ketorolac in one eye and 0.3% ofloxacin (placebo) in the contralateral eye at 30 minutes, 20 minutes, or ten minutes prior to LASEK. Pain was assessed using a visual analog scale of 0 to 10 in each eye 6, 12, 24, 36, 48 and 72 hours after surgery. Patients were also asked to assess the levels of glare, tearing and irritation using a visual analog scale from 0 to 10. RESULTS: A total of 62 eyes from 31 patients were enrolled in the present study. The mean postoperative pain score in the NSAID group was significantly lower than that in the placebo group at postoperative hours 6 (2.35 versus 4.97), 12 (2.52 versus 5.16), and 24 (3.84 versus 4.94) (p < 0.05). The mean postoperative pain score after 36 and 48hours was also lower in the NSAID group than in the placebo group, but the differences were not statistically significant (p > 0.05). Patients reported significantly less tearing and irritation in the NSAID-administered eye compared to those in the placebo eye after LASEK (p < 0.05). CONCLUSIONS: Preemptive administration of topical NSAIDs before LASEK was effective in reducing acute postoperative pain. Preemptive analgesia with topical NSAIDs may be a valuable treatment option for controlling postoperative pain following ocular surgery.
Analgesia ; Anti-Inflammatory Agents, Non-Steroidal ; Eye ; Glare ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Ketorolac ; Ketorolac Tromethamine ; Ofloxacin ; Pain, Postoperative ; Prospective Studies

The changes of higher-order aberrations (HOAs) after bilateral lateral rectus muscle recession were evaluated. Forty eyes of 20 children were enrolled and their wavefront information was assessed until postoperative 3 months. Even though the root mean square (RMS) of total aberration was not changed, the RMS of HOA was transiently increased at postoperative 1 week and returned to baseline level after 1 month. Among individual Zernike coefficient, secondary astigmatism, quadrafoil, secondary coma, secondary trefoil, and pentafoil showed similar tendency with the RMS of HOA. However, coma, trefoil, and spherical aberration were not changed. Regarding recession amount, it did not correlate with any Zernike coefficient. In summary, our data imply that the HOAs are transiently increased after lateral rectus recession surgery. These results are in collusion with previous reports that strabismus surgery induced transient corneal astigmatism.
Adolescent ; Astigmatism/*etiology ; Child ; Child, Preschool ; Exotropia/*surgery ; Female ; Humans ; Male ; Postoperative Care ; *Postoperative Complications/epidemiology/pathology ; Vision Tests

No abstract available.
Hospitals, Community* ; Humans

OBJECTIVE: The most common operation in gynecology is hysterectomy. To compare the indications, patient characteristics and clinical outcome, complication between total abdominal hysterectomy (TAH) and vaginal total hysterectomy (TVH), laparoscopically assisted vaginal hysterectomy (LAVH). METHODS: This study was designed to analyze 147 patients of TAH (Group I) from January 2003 to September 2003, 48 patients of TVH (Group II), 108 patients of LAVH (Group III) at Eulji medical center of obstetrics and gynecology from January 2002 to September 2003. We analyzed the result with patient characteristics, parity, medical disease, history of previous operation, indication of hysterectomy, uterine weight, concurrent surgical procedure, operation time, bleeding amount, complication and length of hospital stay. Uterine prolapse was excluded in the analysis of this study. RESULTS: Patient characteristics, parity, medical disease were no differences. Number of previous operation were 63 cases (42.9%) in TAH group, 10 cases (20.8%) in TVH group, 43 cases (39.8%) in LAVH group, and the most common of operation was tubal ligation in three gropups. Most common indication of hysterectomy was uterine leiomyoma. The mean uterine weight was 374.31 +/- 250.26 gm in TAH group, 187.70 +/- 109.62 gm in TVH group and 203.26 +/- 94.92 gm in LAVH group. The mean operation time was 89.61 +/- 25.24 min in TAH group, 73.39 +/- 21.80 min in TVH group and 96.18 +/- 27.98 min in LAVH group. Postoperative complication was observed 60 cases (40.8%) in TAH group, 8 cases (16.7%) in TVH group, 19 cases (17.6%) in LAVH group. Most common complication was bleeding and required transfusion (TAH 32 cases (21.8%), TVH 3 cases (6.3%), LAVH 10 cases (9.3%)). CONCLUSION: LAVH and TVH present superior result in terms of complication when compared with TAH. LAVH and TVH have advantage of lower morbidity, less pain, shorter hospital stay and convalescence. LAVH should be considered when the vaginal approach is unfeasible, showing clear advantages over abdominal hysterectomy.
Bleeding Time ; Convalescence ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Leiomyoma ; Length of Stay ; Obstetrics ; Parity ; Postoperative Complications ; Sterilization, Tubal ; Uterine Prolapse