We perfomed this study to evaluate the incidence of the oculocardiac reflex(OCR) and its difference relative to each extraocular muscles. In addition, preventive methods for oculocardiac reflex were also evaluated. From Febrary 1997 to January 1998, we examined the occurrence of the OCR of 65 patients who underwent strabismus surgery in 123 extraocular muscles under the general anesthesia. Those who showed severe OCR were prepared with retrobulbar injection of 1% lidocaine 2cc or 1% intravenous atropine and observed wheather OCR was prevented. The overall incidence of the OCR was 66.2% and there was no significant difference between the incidence in both eyes(p>0.999). The incidence in each of the extraocular muscles did not show statistically significance when the patients were prepared with preoperative intramuscular atropine(p=0.018). The incidence after intraoperative retrobulbar injection or intravenous atropine was decreased to 27.3% but was not statistically significant(p=0.34).
Anesthesia, General ; Atropine ; Humans ; Incidence ; Lidocaine ; Muscles ; Reflex, Oculocardiac* ; Strabismus*

STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

The objective of this study is to measure eosinophil count and Eosinophil Cationic Protein (ECP) levels of tears and sera in patients with acute allergic conjunctivitis and normal subjects and to assess the correlation of this mediator with allergic conjuctivitis and the clinical usefulness. Seventeen subjects were selected on the basis of clinical manifestation, history, skin prick test, total IgE. Serum IgE and eosinophil count were increased in 10patients, and eosinophilia in conjunctival epithelium were present in 11subjects. ECP in tears were increased in patients significantly (12.0+/-8.0 vs 3.9+/-3.8ng/ml,p=0.01), but not in serum (52.5+/-43.1 vs 28.3+/-25.9ng/ml). There was significant relationship beween serum and tear eosinophil count(p=0.004,r=0.66). But there was no significant correlation between eosinophil count and ECP in serum (p>0.05m r=0.19), and no significant correlation between eosinophil count of conjectival epithelium and tears ECP (p=0.043, r=0.05). In conclusion, ECP in tears may be very important role in allergic conjunctivitis and is more reliable indicatior of diagnosis clinically rather than eosinophil count in tear and conjunctival epithelium.
Child* ; Conjunctivitis, Allergic* ; Diagnosis ; Eosinophil Cationic Protein* ; Eosinophilia ; Eosinophils* ; Epithelium ; Humans ; Immunoglobulin E ; Skin

PURPOSE: Low urinary pH is a risk factor for uric acid stones, and acidic urine has been described as a renal manifestation of the metabolic syndrome. We evaluated the association between metabolic syndrome and urinary pH in adult Korean men who visited a health promotion center. MATERIALS AND METHODS: From 2004 to 2008, a total of 18,513 adult men who visited our health promotion center were enrolled in this study. The relation between urinary pH and various parameters associated with the metabolic syndrome were evaluated. RESULTS: The average age was 45.6 years (range, 18-95 years), and 4987 men (26.9%) were classified as having the metabolic syndrome. The mean urinary pH of the metabolic syndrome group was 5.91, which was significantly lower than that of the normal group (6.08). In univariate and multivariate analysis, body mass index, serum triglyceride, and blood sugar were negatively correlated with urinary pH (p<0.05). In multivariate logistic regression analysis, obesity (body mass index > or =25 kg/m2), hypertriglyceridemia (> or =150 mg/dl), high fasting glucose (> or =110 mg/dl), and low high-density lipoprotein cholesterol (<45 mg/dl) were the significant factors that predicted low urinary pH (< or =5.5). CONCLUSIONS: Metabolic syndrome was related to lower urinary pH in ostensively healthy adult Korean men. Further studies are needed to elucidate the exact mechanism responsible for the lower urinary pH in individuals with the metabolic syndrome.
Adult ; Blood Glucose ; Body Mass Index ; Cholesterol ; Fasting ; Glucose ; Health Promotion ; Humans ; Hydrogen-Ion Concentration ; Hypertriglyceridemia ; Lipoproteins ; Logistic Models ; Male ; Metabolic Syndrome X ; Multivariate Analysis ; Obesity ; Risk Factors ; Uric Acid ; Urinalysis

BACKGROUND/AIMS: Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea. METHODS: We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals. RESULTS: Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%–94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios. CONCLUSIONS: The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea.
Colonoscopy ; Colorectal Neoplasms ; Endoscopy ; Korea ; Quality Improvement ; Surveys and Questionnaires

Paragangliomas are neoplasms that arise from autonomic nervous system-associated paraganglia ; most often, they are benign, but have infrequently been reported to metastasize. Involvement of the spine is rare and is usually intradural at the level of the cauda equina. The authors report one case of metastatic malignant paraganglioma to the spine, which resulted in radiculopathy caused by extradural spinal root compression ; a review of the literature is also provided. Management of the reported patient involved spinal root decompression and spinal stabilization ; long-term symptom-free ambulatory status was maintained. After surgical removal of these tumors, radiation therapy may be an important adjunctive procedure.
Cauda Equina ; Decompression ; Humans ; Neoplasm Metastasis ; Paraganglioma* ; Radiculopathy ; Spinal Nerve Roots* ; Spine

Behcet's disease is a recurrent and multisystemic disorder which usually persists over many years. In 1937 Behcet described a chronic relapsing triple symptom complex of recurrent oral ulceration, genital ulceration and ocular inflammation. Other manifestations of the syndrome include arthritis, cutaneous vasculitis, thrombophlebitis, epididymitis, ulcers of gastrointestinal tract and meningoencephalitis. Recently, a case was experienced involving intestinal Behcet's syndrome with duodenal ulcer bleeding. A 32-year-old male patient was admitted due to hematemesis, and epigastric pain. The patient had ulcers on the oral mucosa, soft palate, external genitalia, and anus. An irregularly marginated ulcer with bleeding was found on the anterior of the duodenal bulb through esophago- gastroduodenoscopic examination. The patient was diagnosed with Behcet's disease and was treated with steroids. In this paper, the case of duodenal bulb involvement of Behcet's disease is reported with a review of relevant literature.
Adult ; Anal Canal ; Arthritis ; Behcet Syndrome ; Duodenal Ulcer* ; Epididymitis ; Gastrointestinal Tract ; Genitalia ; Hematemesis ; Hemorrhage ; Humans ; Inflammation ; Male ; Meningoencephalitis ; Mouth Mucosa ; Oral Ulcer ; Palate, Soft ; Steroids ; Thrombophlebitis ; Ulcer ; Vasculitis

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.
Adenoma, Islet Cell ; Insulinoma* ; Islets of Langerhans ; Laparoscopy ; Pancreas

BACKGROUND: Metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, over- weight and abdominal fat distribution, dyslipidemia and hypertension, is associated with subsequent de- velopment of type 2 diabetes mellitus and cardiovascular disease, especially coronary heart disease. The aim of the study is to assess the relationship between metabolic syndrome and coronary heart disease in elderly greater than 65 years old. METHODS: Eighty two elderly patients greater than 65 years old who underwent coronary angiography were divided into two groups with metabolic syndrome or without metabolic syndrome, and assessed the association with coronary angiographic finding. The metabolic syndrome factors and cardiovascular risk factors of JNC 7 were investigated to assess the relationship with coronary heart disease in elderly. Coronary heart disease was defined as 50% or greater diameter in stenosis of coronary artery in coronary angiography. RESULTS: In elderly patients with metabolic syndrome, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p<0.05) were presented significantly higher than non metabolic syndrome patients. In elderly patients with 3 and more cardiovascular risk factors of JNC 7, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p=0.059) were presented more than the other patients. Diabetes mellitus was related significantly with coronary heart disease(p value 0.044). CONCLUSION: In elderly patients, metabolic syndrome was significantly related with coronary heart disease and diabetes mellitus had strong relationship with coronary heart disease. Metabolic syndrome and cardiovascular risk factors of JNC 7 should be further evaluated to assess the relationship with coronary heart disease in the future.
Abdominal Fat ; Aged* ; Cardiovascular Diseases ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease* ; Coronary Vessels ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Glucose ; Heart ; Humans ; Hypertension ; Insulin ; Metabolism ; Risk Factors

PURPOSE: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. MATERIALS AND METHODS: The subjects were 8 patients (average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. RESULTS: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. CONCLUSION: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.
Bone Transplantation ; Clavicle* ; Follow-Up Studies ; Humans ; Rehabilitation ; Shoulder Joint