The methodological and statistical validity of 382 original articles published in the Journal of the Korean Medical Association, from January 1980 to December 1989 was reviewed by the author-devised c heck list consisting of 21 items (14 items for methodological validity and 7 items for methodology, and of 297 articles using statistical analyses a total of 290 articles (97.6%) were found to contain at least one error in statistical methods used. The mean and standard deviation of 'validity score of one article', defined as the total number of valid items devided by the total number of applicable items and then multiplied by 100, were 43.8 and 15.2, respectively. The distribution of validity score was as follows ; over 60 (57 articles, 14.9%), 30 to 59 (266 articles, 69.6%), and under 30 (59 articles, 15.5%). The proportion of articles, of which validity score was over 60, was significantly higher in descriptive study (19.4%) than in analytic study (8.4%, p = 0.003). Also the articles of over 60 in validity score were more frequent in survey (15.9%) than in experiment (8.2%), and in cross-sectional study (16.8%) than in longitudinal study (10.6%), but this finding was not statistically significant. The averaged validity score of two year period was highest in 1984-1955 (50.24), and lowest in 1986-1987 (38.85). There was no significant time trend of the averaged validity score over 10 years(p>0.1). These results suggest that medical articles published in Korea, 1980-1989, were short of their expected quality, and there have been no evidence of improvement with time. It is concluded that a basic training in biostatistical methods in the medical postgraduates and residencies, more consultation of medical investigators with statistician or other experts, and careful review by someone knowledgeable in biostatistics or research design before accepting a manuscript are needed. In addition, refutation should be allowed for the controversial point through the journal.
Biostatistics ; Cross-Sectional Studies ; Humans ; Internship and Residency ; Korea* ; Longitudinal Studies ; Research Design ; Research Personnel

It is necessary for medical readers or reviewers to assess critically the methodological and statistical validity of medical articles before accepting their results or conclusion. The authors develope d a validity-assessing checklist of 21 items. Among them 14 items for methodological validity included the followings : clear statement of research hypothesis or specific aims, suitable focus, definition of study population (or subjects), eligibility criteria, exclusion criteria, appropriateness of samples, description of methods in detail, desconclusion of accuracy, description of reliability, presence of control, susceptability bias, performance bias, detection bias, transfer bias. The last 5 items are applicable only to analytic study. And 7 errors to statistical validity : incomplete description of basic data, statistical test performed yet not defined, incomplete description of power or confidence interval, inadequate description of measures of central tendency or dispersion, incorrect analysis, multiplicity on hypothesis testing, unwarranted conclusion. The first 3 items are 'errors of omission', and the other are 'errors of commission'. The authors suggest the checklist be very helpful, but not perfect. Critical mind is needed, which enables someone to distinguish minor errors from major fallacies.
Bias (Epidemiology) ; Checklist*

Esthetics ; Facial Bones ; Malocclusion ; Mastication ; Orthognathic Surgery

PURPOSE: To investigate the clinical characteristics of retinopathy associated with systemic lupus erythematosus (SLE) and its risk factors. METHODS: Medical records of patients who were diagnosed with SLE were reviewed retrospectively. The presence of retinal hemorrhage, vasculitis and a cotton wool patch were regarded as lupus retinopathy, but concomitant diabetic retinopathy and hypertensive retinopathy were excluded from the study. The correlation between the development of lupus retinopathy and the presence of positive autoantibodies was also investigated. RESULTS: Ocular morbidity was found in 173 of 260 (66%) SLE patients. Retinopathy was detected in 52 eyes of 33 patients (12%), which included 36 eyes of 21 patients (63%) with classic retinopathy and 11 eyes of 10 patients (30%) with vaso-occlusive retinopathy. The presence of classic retinopathy coincided with the flare-up of lupus activity and completely resolved without visual impairment. However, vaso-occlusive retinopathy was not related with lupus activity, and resulted in significant visual impairments of 20/200 or less in six eyes of five patients. The disease activity of lupus assessed by the maximum SLE disease activity index was higher in patients with retinopathy (p<0.05), and the prevalence of antiphospholipid antibody was higher in patients with vaso-occlusive retinopathy than in patients with classic retinopathy (66.7% vs. 37.5%, p<0.05). CONCLUSIONS: Vaso-occlusive retinopathy in SLE can result in permanent visual impairment. Patients with high SLE activity or positive anti-phospholipid antibodies have a high possibility of developing SLE retinopathy and should be referred for ophthalmologic examination.
Antibodies ; Antibodies, Antiphospholipid ; Autoantibodies ; Diabetic Retinopathy ; Eye ; Humans ; Hypertensive Retinopathy ; Lupus Erythematosus, Systemic ; Medical Records ; Prevalence ; Retinal Hemorrhage ; Retrospective Studies ; Risk Factors ; Vasculitis ; Vision Disorders ; Wool

PURPOSE: To investigate the clinical characteristics of retinopathy associated with systemic lupus erythematosus (SLE) and its risk factors. METHODS: Medical records of patients who were diagnosed with SLE were reviewed retrospectively. The presence of retinal hemorrhage, vasculitis and a cotton wool patch were regarded as lupus retinopathy, but concomitant diabetic retinopathy and hypertensive retinopathy were excluded from the study. The correlation between the development of lupus retinopathy and the presence of positive autoantibodies was also investigated. RESULTS: Ocular morbidity was found in 173 of 260 (66%) SLE patients. Retinopathy was detected in 52 eyes of 33 patients (12%), which included 36 eyes of 21 patients (63%) with classic retinopathy and 11 eyes of 10 patients (30%) with vaso-occlusive retinopathy. The presence of classic retinopathy coincided with the flare-up of lupus activity and completely resolved without visual impairment. However, vaso-occlusive retinopathy was not related with lupus activity, and resulted in significant visual impairments of 20/200 or less in six eyes of five patients. The disease activity of lupus assessed by the maximum SLE disease activity index was higher in patients with retinopathy (p<0.05), and the prevalence of antiphospholipid antibody was higher in patients with vaso-occlusive retinopathy than in patients with classic retinopathy (66.7% vs. 37.5%, p<0.05). CONCLUSIONS: Vaso-occlusive retinopathy in SLE can result in permanent visual impairment. Patients with high SLE activity or positive anti-phospholipid antibodies have a high possibility of developing SLE retinopathy and should be referred for ophthalmologic examination.
Antibodies ; Antibodies, Antiphospholipid ; Autoantibodies ; Diabetic Retinopathy ; Eye ; Humans ; Hypertensive Retinopathy ; Lupus Erythematosus, Systemic ; Medical Records ; Prevalence ; Retinal Hemorrhage ; Retrospective Studies ; Risk Factors ; Vasculitis ; Vision Disorders ; Wool

Retinitis pigmentosa (RP) is the most common hereditary retinal disorder and is characterized by progressive retinal degeneration and decline in vision. RP comprises a heterogeneous group of disorders caused by various genetic variants. Since the first discovery of the causal mutation in the RHO gene using positional cloning, numerous mutations have been detected in more than 60 loci and 50 genes. However, causal genes have not been discovered in about 50% of cases. We attempt here to review the strategies to identify causal alleles of retinitis pigmentosa. These include conventional methods as well as state-of-the-art technologies based on next-generation sequencing.
Alleles ; Clone Cells ; Cloning, Organism ; Retinal Degeneration ; Retinaldehyde ; Retinitis ; Retinitis Pigmentosa ; Vision, Ocular

STUDY DESIGN: A retrospective study OBJECTIVES: To examine the influence of cervical spondylosis on an acute cervical spinal cord injury. SUMMARY OF LITERATURE REVIEW: There are no reports on the relationship between cervical spondylosis and acute cervical spinal cord injuries. MATERIALS AND METHODS: Twenty six patients who underwent operative treatment for acute cervical injuries with spinal cord injury were evaluated. The mean age and follow-up period was 58 years and 2.2 years, respectively. The evaluation was performed by examining the causes of the injuries, and the classification of fractures according to the presence of cervical spondylosis. This study compared the degrees of postoperative neurological recovery with motor index score in the groups with and without cervical spondylosis. RESULTS: Cervical cord injuries were more prevalent in the group 60 years and older; 17 cases vs. 9 cases in the group under 60 years. Eleven (65%) and 6 (35%) cases in the group 60 years and older had sustained a high and low energy injury, respectively. In contrast, mostly high energy injuries (8 in 9 cases) were encountered in the group under 60 years of age. A low energy injury could cause a acute cervical cord injury in the group 60 years and older, who also had cervical spondylosis. In those cases, previous cervical spondylosis might be one of the etiologic factors. CONCLUSIONS: The cases with cervical spondylosis in the group 60 years and older tended to show incomplete cord injury and good postoperative neurological recovery when they had sustained cervical cord injuries.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Cord ; Spinal Cord Injuries ; Spondylosis

Tuberculous epididymitis mimics nonspecific chronic epididymitis in every way and the diagnosis is rather difficult in case of no systemic involvement. We performed fine needle aspiration on 4 cases or chronic epididymitis with unknown etiology and examined cytologically and microbiologically. Out or 4 cases 3 were proven tuberculosis and the other one was turned out nonspecific chronic inflammation. We concluded that the fine needle aspiration of the epididymis is a simple and convenient diagnostic procedure when the diagnosis is doubtful.
Biopsy, Fine-Needle* ; Biopsy, Needle ; Diagnosis ; Diagnosis, Differential* ; Epididymis ; Epididymitis* ; Inflammation ; Male ; Tuberculosis

PURPOSE: To investigate the clinical characteristics and visual outcome of cytomegalovirus retinitis in Korean patients with acquired immunodeficiency syndrome (AIDS) in the highly active antiretroviral therapy (HAART) era. METHODS: The medical records of 252 patients from Seoul National University Hospital who were diagnosed with AIDS between 2003 and 2006 were reviewed retrospectively. In addition, 15 patients (19 eyes) Having cytomegalovirus (CMV) retinitis with a minimum follow-up period of more than a year were included. Visual acuity, immune status, involved retinal area, and bilaterality were analyzed. RESULTS: All patients were treated with the HAART regimen and an anticytomegaloviral agent with the exception of two patients. In all patients, immune recovery developed and retinitis was inactivated. Moderate (< or = 0.4) and severe (< or = 0.1) visual loss developed in 10 (52%) eyes and 9 (47%) eyes, respectively. Retinal detachment and involvement of posterior pole accounted for more than 80% (8 out of 10) of moderate, and 88% (8 out of 9) of severe visual loss. Patients with bilateral retinitis were more likely to develop retinal detachment and visual loss. Delayed immune recovery was associated with moderate visual loss. CONCLUSIONS: Posterior pole involvement and retinal detachment were the major cause of visual loss in CMV retinitis in AIDS patients. Bilateral involvement and delayed immune recovery were related to retinal detachment and a poor visual outcome.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Eye ; Follow-Up Studies ; Humans ; Medical Records ; Retinal Detachment ; Retinaldehyde ; Retinitis ; Retrospective Studies ; Visual Acuity

Purpose: To assess the safety and efficacy of selective retina therapy (SRT) using a Q-switched neodymium-doped yttrium lithium fluoride laser with feedback systems in patients with idiopathic central serous chorioretinopathy (CSC). Methods: This randomized clinical trial enrolled patients having at least 3-month symptom of CSC. From month 3 visit, all subjects in both groups were eligible for SRT retreatment if they showed persistent or recurrent subretinal fluid (SRF). The primary outcome was complete resolution of SRF by optical coherence tomography at 3 months after treatment. The secondary outcomes were changes in SRF, central macular thickness (CMT) and best-corrected visual acuity at the 1-, 3-, and 6-month examinations. Results: Sixty-eight CSC patients were included (SRT, 31; control, 37). After 1 and 3 months, complete resolution of SRF was achieved in 25.8% and 54.8% of SRT group and 17.6% and 35.1% of controls. The differences were not statistically significant (p = 0.424 and p = 0.142, respectively). However, mixed model for repeated measures analyses showed that the reduction of SRF and CMT were observed earlier in SRT group than in the sham group (least squares mean difference, -59.7 µm; 95% confidence interval, -98.2 to -21.2; p = 0.0029; least squares mean difference -67.0 µm; 95% confidence interval, -104.8 to -29.2; p = 0.0007, respectively). Significant reduction of SRF (≥50% reduction from baseline) was more frequently observed in SRT group (80.6%) than the sham group (44.1%) at month 1 (p = 0.007). Early reduction of SRF and CMT was more abundant in SRT group with symptom duration less than 6 months. Treatment related serious adverse events were not observed. Conclusions SRT using a Q-switched neodymium-doped yttrium lithium fluoride laser with feedback system was safe in this trial and effective for early resolution of SRF in the CSC patients. Early intervention with SRT can be a safe alternative for patients with acute symptomatic CSC.