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*

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

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 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.

No abstract available.
Adenocarcinoma* ; Cell Line*

PURPOSE: This study is to describe authors'experience on mammographic findings of breast cancer and to know if there is difference between 35 years of age or younger and older groups. MATERIALS AND METHODS: Mammograms of 72 patients with breast cancer detected from January, 1991 to December, 1993 were retrospectively analysed. Mammographic findings were classified into mass only, mass with microcalcifications, microcalcifications only and others. Marginal characteristics of mass were classified into spiculated, poorly marginated and well marginated. Shape of microcalcifications were classified into casting, granular and mixed types. These findings were compared between 35 years of age or younger and older groups. RESULTS: Mammogram showed mass only in 33 patients(46%), mass with microcalcifications in 26 patients (36%), microcalcifications only in seven(10%) and other findings in six(8%). Other findings were architectural distortion, asymmetric high density and incidental breart carcinoma from paraffinoma in one patient respectively, and dense breast in three patients. The margins of the breast mass were spiculated in ten(17%) poorly marginated in 30(51%), well-marginated in 19(32%). Shape of microcalcifications were casting type in 13(40%), granular in 14(42%) and mixed in six(18%) cases. 3 patients had dense breast with which mammography did not demonstrate the lesion. 3 patients without mammographically demonstrable lesions due to dense breasts were under 35 years in age. and there was statistically significant difference between the two groups(p-value<0.05). Microcalcifications only was more common findings in 35 years of age or younger. CONCLUSION: The most important mammographic findings of breast cancer were mass and microcalcifications. Architectural distortion and asymmetric high density were additional findings. In 35 years of age or younger, microcalcifications only was an important finding because mass lesions are frequently masked by dense breast. Thus other imaging modalities, such as ultrasonography, were required.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Masks ; Retrospective Studies ; Ultrasonography

A 5-year-old girl was diagnosed with neurofibromatosis type 2 (NF-2) due to multiple neurofibromas, cafe-au-lait spots, and schwannomas of the brain. During ophthalmologic evaluation, a posterior subcapsular cataract and a gray-green colored subretinal lesion were found in right eye. Fluorescein angiography (FA) revealed a combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). At age 9, she underwent cataract surgery. At this time FA and spectral-domain optical coherence tomography (SD-OCT) were taken. The SD-OCT showed an elevated hyperreflective mass in the retina with prominent attenuation of the inner and outer retina, but minimal attenuation in the photoreceptor layers. The underlying retina appeared to be disorganized and thick (791 microm). This is the first case report of SD-OCT imaging of a CHRRPE associated with NF-2 in a pediatric patient. By using SD-OCT in this patient, we could obtain detailed tumor characteristics, and SD-OCT may be helpful in the diagnosis and management of CHRRPE.
Child, Preschool ; Diagnosis, Differential ; Female ; Hamartoma/complications/*diagnosis ; Humans ; Neurofibromatosis 2/*complications/diagnosis ; Retinal Diseases/complications/*diagnosis ; Retinal Pigment Epithelium/*pathology ; Tomography, Optical Coherence/*methods ; Visual Acuity

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