PURPOSE: To evaluate the changes in break-up time (BUT) and corneal sensitivity following LASIK surgery for refractive error correction with presbyopia in patients older than 45 years. METHODS: The authors of the present study measured the BUT and corneal sensitivity of 92 eyes that received LASIK surgery for correcting refractive error with presbyopia. The eyes were divided into groups according to gender and preoperative refractive error before surgery and 1, 3, 6 and 12 months after LASIK. RESULTS: The mean age of patients was 52.01 +/- 5.51 years, and the male to female eye distribution was 31:61. The value of BUT before surgery and 1, 3, 6, and 12 months postoperative was 5.31 +/- 2.03 sec, 4.47 +/- 1.67 sec, 4.04 +/- 1.58 sec, 4.53 +/- 1.51 sec, and 4.87 +/- 1.46 sec, respectively; corneal sensitivity was 56.35 +/- 5.94 mm, 40.07 +/- 14.21 mm, 46.42 +/- 10.41 mm, 50.75 +/- 8.04 mm, and 52.92 +/- 7.51 mm, respectively. BUT was not significantly different relative to refractive error and was significantly shorter in the female group than the male group at 1 month postoperative. Corneal sensation of myopia at 12 months postoperative was statistically higher than at other time points; however, there was no difference between genders. BUT and corneal sensitivity at 12 months postoperative recovered to 91.6% and 93.9% of the preoperative value, respectively. CONCLUSIONS: BUT and corneal sensitivity after LASIK for presbyopia were decreased until 12 months postoperative and recovered slowly, but did not return to preoperative levels.
Eye ; Female ; Humans ; Keratomileusis, Laser In Situ ; Male ; Middle Aged ; Myopia ; Presbyopia ; Refractive Errors ; Sensation ; Tears

OBJECTIVES: The aim of this study was to determine the relationship between the core properties of professional socialization and social status satisfaction, economic reward satisfaction, and subjective class identification. METHODS: Medical knowledge and skill, autonomy, and professional value factors were used as essential properties of professional socialization to determine the association with job satisfaction and subjective class identification. The authors used a self-administered questionnaire survey and collected nationwide data between July and August 2003, with 211 responses used for final analysis. RESULTS: 'Age' and 'trust and respect' were positively associated with social status satisfaction, and 'occupation' was negatively associated. 'Income' and 'trust and respect' were positively related to economic reward satisfaction, and 'practicing for oneself', and 'a sense of duty and attendance' were negatively related. 'Practicing for oneself', 'not believing explanations', and 'a sense of duty and attendance' had a positive relationship with subjective class identification. 'Income', 'knowledge system', 'medical mistakes', 'treating like goods', 'meaning and joy', and 'trust and respect' had a negative relationship. CONCLSIONS: The core property variables of professional socialization had a different relationship with social status satisfaction, economic reward satisfaction and subjective class identification. In particular, many core property variables were associated with subjective class identification positively or negatively. The development of professional socialization would help promote job satisfaction and subjective class identification.
Adult ; Age Factors ; Aged ; Female ; Humans ; Income ; *Job Satisfaction ; Korea ; Male ; Middle Aged ; Physicians/*psychology ; Professional Autonomy ; *Social Class ; Trust

PURPOSE: Sarcoidosis is a noncaseating granulomatous disorder that can affect any organ. In its early phase, sarcoidosis is clinically similar to tuberculosis. We report a case of sarcoidosis diagnosed through ocular and systemic evaluations in a patient who developed multiple conjunctival nodules during antituberculous treatment for nasal mucosal nodules. CASE SUMMARY: A 37-year-old woman who had been on antituberculosis medications for 9 months because of multiple nasal mucosal nodules was referred for conjunctival hyperemia and the multiple nodules. The ocular examination revealed multiple conjunctival nodules in the upper and lower fornices. Biopsy and systemic evaluations were performed. A conjunctival biopsy specimen showed noncaseating granulomatous inflammation compatible with sarcoidosis. Laboratory tests revealed hypercalciuria and increased levels of ACE. Chest computed tomography showed bilateral hilar and mediastinal lymphadenopathy. Subconjunctival steroid injection was done for the conjunctival nodules and systemic steroid treatment was started as well. Complete resolution of conjunctival lesions was obtained. CONCLUSIONS: In cases of chronic, multiple conjunctival and nasal mucosal nodules, sarcoidosis should be considered in the differential diagnosis.
Adult ; Biopsy ; Conjunctiva ; Diagnosis, Differential ; Female ; Humans ; Hypercalciuria ; Hyperemia ; Inflammation ; Lymphatic Diseases ; Nasal Mucosa ; Sarcoidosis ; Thorax ; Tuberculosis

OBJECT: The Composite Scale by Smith et al. has been proposed as an improved measure of momingness-eveningness. This study attempted to endorse that a Korean translation of Composite Scale(KtCS) can be useful to differentiate people according to circadianrhythm types. METHOD: KtCS and Life Habit Questionnaire(LHQ) were administered to 561 university students. LHQ consisted of items questioning sleep habits on weekdays(bedtime, rising time and sleep length), the time of perceived peak alertness(mental and physical), time of perceived peak performance(mental, physical and academic), and quality of academic performance during the morning, afternoon and evening. Subjects were categorized on the basis of their KtCS scores into evening(I) types, intermediate(I) types, and morning(M) types. The cut-off points for these categories were set at the 10th and 90th percentiles. In addition 7 I-type and 7 M-type subjects were selected from the student population who had participated in the previous survey and then, oral temperature of each subject was taken every hour torn 08 : 00 to 22 : 00. To assess both the internal and the external measurement properties of KtCS, descriptive statistics, reliability and validity were examined. RESULTS: The distribution of KtCS scores was significantly, negatively skewed. The KtCS scores closest to the 10th and 90th percentiles were 26 and 41 respectively. The split-half reliability(. 85), test-retest reliability( .91), and internal consistency(Cronbach alpha, .82) were obtained above the expected. Inter-item correlations were all positive and ranged from .10-.59 with a mean of .25. Item-total correlations varied from .33 to .63 with a mean of .45. Common factor analyses confirmed three factors: preferred times of performance and going to bed, arising time, and morning alertness. The validity of KtCS was further demonstrated through strong relationships between the scale and external criteria.4 discernable difference in oral temperature between the M-type and the type across morning to evening provided additional evidence for validity of the scale. CONCLUSIONS: The results would suggest the possibility that KtCS can be employed as a tool for selection of I-type people or M-type people. It is as yet, however, uncertain that KtCS might be suitable to select people for night shiftwork because the subjects of this study are limited to university students. Therefore, future research among varying types of people are required to endorse this study.
Humans ; Reproducibility of Results

PURPOSE: We compared the preoperative with the postoperative outcomes between tension-free vaginal tape (TVT) and transobturator vaginal tape inside-out(TVT-O) for the surgical treatment of female stress urinary incontinence MATERIALS AND METHODS: From January 2003 to December 2005, 72 women, one is TVT group(n=52) and the other is TVT-O group(n=20), after operation following were assigned. The preoperative and postoperative evaluations analysis and urodynamic study and Korean version of I-QoL, surgical outcomes, complications and uroflowmetry were analysed. RESULTS: All outcomes included the patients`states, incontinence quality of life(I-QoL)(p=0.013), the success rate of the cure(p=0.003) and the rate of the patient satisfaction(p=0.001) were not comparable statistically between two groups and there are no differences and no long-term complications such as bladder perforation or prolonged voiding difficulty. Preoperative and postoperative uroflowmetry was similar between the two groups. Mean operation time(TVT: 15.6 min, TVT-O: 13.2 min) was significantly shorter in TVT-O than in TVT. CONCLUSION: The observation of 1-year following-up shows the equally effectiveness between two groups(TVT and TVT-O) as the surgical treatment of stress urinary incontinence.
Female* ; Humans ; Quality of Life ; Suburethral Slings* ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.
Angioplasty, Balloon ; Arteries ; Edema ; Humans ; Iliac Vein ; Leg ; May-Thurner Syndrome* ; Phlebography ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis

OBJECTIVE: The objective of this study was to evaluate clinical significance of endometrial and corporal extensions of Carcinoma of the uterine cervix. METHODS: The 273 patients with locally advanced cervical cancer who underwent radical hysterectomy after neoadjuvant chemotherapy between Jan 1983 to May 1998 were included in this study and endometrial and corporal extension was examined by pathologic report. Then, clinical characteristics such as age, stage, tumor size, geographic contour, the lymph node and parametrial invasions, recurrence rate, and 5 year-survival rate were compared between extension(n=30) and non-extension(n=243) group. Pearson chi-square test, Fisher's exact test, and Kaplan-mayer survival analysis were used for calculation of statistical significance between two group. p-value less than 0.05 was considered to be clinically significant. RESULTS: The incidence of endometrial and corporal extension in this locally advanced cervical cancer group was 11% (30/273). The endometrial and corporal extension were closely related with advanced stage, larger cervical tumor mass, endophytic type, and pelvic lymph node metastasis. However, 5-year disease free survival rates or 5-year actuarial survival rates did not show statistically significant differences between extension and non-extension group (7S% vs 83% and 81% vs 84%, respectively) CONCLUSION: The endometrial and corporal extension were closely associated to high risk factors of advanced cervical cancer. Though its clinical significance for poor outcome were not proved in this study, prospective study with more patients is needed to clarify its clinical significance.
Cervix Uteri* ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Risk Factors ; Survival Rate ; Uterine Cervical Neoplasms

BACKGROUND: Pneumonia is a common medical complication after acute stroke, and makes a considerable influence on the prognosis. It is potentially preventable or treatable if early recognized. Thus, the identification of which patients are at risk for the development of pneumonia is clinically significant. METHODS: A total of 240 patients with an acute stroke who were consecutively admitted to a Seoul National University Hospital were studied. The following prognostic factors were accounted for in the statistical analyses: age, sex, hypertension, diabetes, cardiac disease, smoking, recurrent stroke, NIHSS, modified Rankin scale (mRS), the presence of dysphagia, blood pressure, body temperature, white blood cell count, blood sugar, fibrinogen, Levin tube insertion, Foley catheter insertion, and subtype of stroke. RESULTS: Pneumonia was diagnosed in 36 (17.0%) patients during the acute stage of stroke, particularly within 2 weeks. Average admission stay of patients with pneumonia was 38.7 days, whereas it was 19.3 days for those without pneumonia. By multivariate analysis, Levin tube insertion, body temperature, recurrent stroke, and mRS were significant predictor of pneumonia development. Forty percent of patients with four or five points of mRS developed pneumonia, compared to 6% in less than four points. CONCLUSIONS: Our results show that the patients who have Levin tube, high mRS, or recurrent stroke tend to develop pneumonia after acute stroke. It is important for early detection and prevention of pneumonia in patients with high mRS.
Blood Glucose ; Blood Pressure ; Body Temperature ; Catheters ; Deglutition Disorders ; Fibrinogen ; Heart Diseases ; Humans ; Hypertension ; Leukocyte Count ; Multivariate Analysis ; Pneumonia* ; Prognosis ; Seoul ; Smoke ; Smoking ; Stroke*

Using KAIS 0.15 Telsla resistive magnetic imaging system, ECG gated magnetic resonance (MR) image of variouscardiovascular disease was obtained in 10 patients. The findings of MR image of the cardiovascular disesase wereanlaysed and the results were as follows: 1. In 6 cases of acquired and congenital cardiac disease, there were 2cases of myocardial infarction, 1 case of mitral stenosis and 3 cases of corrected transpossition of greatvessels. The others were 3 cases of aortic disease and 1 case of pericardial effusion with lymphoma. 2. Myocardialthinning left ventricular aneurysm were detected in MR images of myocardial infarction. The left atrium was welldelineated and enlarged in the case of mitral stenosis. And segmental analysis was possible in the cases ofcorrected transposition since all cardiac structures were well delineated anatomically. 3. In aortic disease, thefindings of MR image were enlarged lumen, compressed cardic chambers in ascending aortic aneurysm, intimal flap,enhanced false lumen in dissecting aneurysm and irregular narrowing of aorta with arterial obstruction inTakayasu's arteritis. 4. Pericardial effusion revealed a conspicuous contrast with neighboring meidastinal fat andcardiac wall due to it low signal encircling cardiac wall. 5. ECG gated MR image is an accurate non-invasive imaging modality for the diagnosis of cardiovascular disease and better results of its clinical application areexpected in the futher development in the imaging system and more clinical experiences.
Aneurysm ; Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm ; Aortic Diseases ; Arteritis ; Cardiovascular Diseases ; Diagnosis ; Electrocardiography ; Heart Atria ; Heart Diseases ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Mitral Valve Stenosis ; Myocardial Infarction ; Pericardial Effusion