PURPOSE: We compared the intraocular pressures (IOPs) measured by the Corvis ST (CST), Goldmann applanation tonometer (GAT), and Rebound tonometer (RBT) and correlated the measured IOPs with the corneal center thickness (CCT). METHODS: The IOPs were measured in 34 eyes of 34 normal subjects using the CST, GAT, and RBT by independent examiners. Comparisons between the IOPs measured by the CST and other tonometers were made using paired t-tests and Bland-Altman plots and Pearson's correlation coefficient was used to correlate the measured IOPs with the CCTs. RESULTS: The IOP measured by the CST (C-IOP; 14.57 ± 2.37 mmHg) was significantly higher than that measured by the GAT(13.56 ± 2.25 mmHg) and RBT (13.57 ± 3.26 mmHg) (p < 0.05). The biomechanically corrected C-IOP (C-bIOP; 13.40 ± 2.06mmHg) showed no difference from the GAT-IOP and RBT-IOP (p > 0.50). In analyzing the correlation with CCT, RBT-IOP (R =0.34; p = 0.705) showed a lower correlation than the GAT-IOP (R = 0.49; p < 0.01) and C-IOP (R = 0.48; p < 0.01). The C-bIOP showed no correlation with the CCT (p = 0.74). CONCLUSIONS The IOP measurements using the C-IOP were significantly higher than the RBT-IOP and GAT-IOP but the C-bIOP showed no difference from the RBT-IOP and GAT-IOP. C-IOP, RBT-IOP, and GAT-IOP were significantly correlated with corneal thickness, but there was no correlation between CCT and C-bIOP. C-bIOP may therefore be considered clinically useful.

PURPOSE: In order to investigate the safety of laser-assisted subepithelial keratomileusis (LASEK), corneal endothelial cells before and after the LASEK procedure were evaluated. METHODS: Thirty-six patients (72 eyes) who underwent LASEK between June 2010 and May 2011 were included in the present study. Parameters included corneal endothelial cell density (CD), coefficient of variation of the cell area (CV), and percentage of hexagonal cells (6A) which were all obtained by a specular microscope (Noncon ROBO sp 8000, Konan, Japan) before and 3, 6, and 12 months after LASEK. RESULTS: Preoperative CD was 2952 +/- 352 cells/mm2, and postoperative CD did not significantly change at 3, 6, and 12 months. Preoperative CV and 6A and postoperative CV and 6A at 12 months were not significantly different. Furthermore, correlation between change in corneal endothelial cell and degree of myopia correction was not statistically significant. CONCLUSIONS: LASEK appears to be a safe procedure for corneal endothelial cells over an extended period.
Endothelial Cells ; Endothelium, Corneal ; Humans ; Keratectomy, Subepithelial, Laser-Assisted* ; Myopia

PURPOSE: This study was designed to establish standard guidelines to meet the growing health care needs of adolescents by direct assessment of pediatricians' current practices, attitude and obstacles to the primary care of adolescents. MEHTODS: A questionnaire consisting of 9 questions, including personal characteristics of respondents, current health care practice of adolescents, attitude, obstacles to providing adolescent care, interest in further training, roles of Korean Pediatric Society for adolescent medicine, etc., was completed by 214 pediatricians. RESULTS: Among the respondents, 87.4% were in the 4th or 5th decade of age, and 88.8% of respondents were working for private clicins. More than 60% of respondents were managing patients without age limits. Most of the respondents were interested in adolescent medicine. However, approximately one half of all respondents answered that they could not currently provide satisfactory care to their adolescent patients. Obstacles to providing adolescent care include : their image as "baby doctors", lack of knowledge and skills in adolescent medicine, lack of separate hours for adolescents and concern that parents would object to certain types of care. Among respondents who wanted to further training, many were interested in Continuing Medical Education(CME) course, lecture series, introducing reading lists and publishing textbooks, while others expressed their interest in a newsletter and mini-fellowship. Respondents expected the Korean Pediatric Society to play a role in activating the adolescent medicine as a field for pediatric practice through educating adolescents, pediatricians and advertising via mass media. CONCLUSION: Future policy decisions and medical education must respond to these realities in pediatric practice.
Adolescent Medicine ; Adolescent* ; Surveys and Questionnaires ; Delivery of Health Care* ; Education, Medical ; Humans ; Mass Media ; Parents ; Periodicals as Topic ; Primary Health Care

PURPOSE: Sildenafil citrate was developed to treat angina, but was found to also inhibit PDE in the corpus callosum and is now widely used to treat impotence. We report a case of enlargement of the inferior rectus muscle after sildenafil citrate ingestion. CASE SUMMARY: A 58-year-old male presented with binocular diplopia which started 2 weeks prior. He had no underlying disease. The patient had taken sildenafil citrate on 3 different occasions 2 weeks prior, and 2 days after his first ingestion, his right conjunctiva was injected and binocular diplopia started. On the first visit, he showed 16 PD hypotropia of the right eye with limitation of motion at upgaze. The MRI scan showed enlargement and enhancement of the inferior rectus muscle, and 50 mg of prednisone was prescribed. The amount of hypotropia decreased to 8 PD 2 weeks later. CONCLUSIONS: Enlargement of extraocular muscle caused by sildenafil citrate ingestion has not been reported in Korea, and related mechanisms are yet to be researched. Additional case reports and research are necessary in the future.
Citric Acid ; Conjunctiva ; Corpus Callosum ; Diplopia ; Eating ; Erectile Dysfunction ; Eye ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Muscles ; Myositis ; Piperazines ; Prednisone ; Purines ; Strabismus ; Sulfones ; Telescopes ; Sildenafil Citrate

Pancreatic endocrine tumors are low-to-intermediate-grade neoplasms arising from the pancreatic islets that produce various hormones. These tumors account for a minority of pancreatic tumors and are generally considered functional if they are associated with a hormonal syndrome. Adrenocorticotropic hormone-secreting tumors (ACTHomas) are very rare and require special clinical consideration. Patients with ACTH-secreting tumors usually present with Cushing's syndrome, due to ectopic ACTH production. ACTHomas have a poor prognosis because of early metastasis and difficulty controlling corticosteroid production. We report a 62-year-old male with an ACTH-secreting metastatic pancreatic neuroendocrine tumor, who did not respond to somatostatin analogs and died.
Adrenocorticotropic Hormone ; Cushing Syndrome ; Humans ; Islets of Langerhans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Pancreas ; Prognosis ; Somatostatin

BACKGROUND: Because doxylamine succinate (DS) is an over-the-counter medicine, it can be obtained easily and is frequently used in suicidal attempts. Patients usually recover without serious complications, but occasionally rhabdomyolysis and even death can occur in DS intoxication. In this study, the authors tried to find out the independent predictors of high peak serum CK levels, i.e. probable rhabdomyolysis in DS intoxication. METHODS: The medical records of 41 patients who visited a hospital for DS intoxication from January 1, 2002 to April 30, 2003, were reviewed retrospectively. RESULTS: In the group of DS only, initial occult blood of urine (P=0.003), initial WBC count (P=0.003) and confusion (P=0.007) were the best predictors of the peak serum CK level (2=0.724). In the group of DS with other drugs intoxication, initial creatinine level (P=0.003) and initial occult blood of urine (P=0.007) were the best predictors of the peak serum CK level (r2=0.784). In the cases of rhabdomyolysis patients, the time taken for the CK level to be increased over 1,000 IU/L was 1.9level to be increased over 1,000 IU/L was 1.9+/-0.6 days. CONCLUSION: In DS only intoxication, occult blood in initial urine analysis, initial high WBC count and confusion can be thought of as useful clinical predictors for high peak serum CK level case. In DS with other drugs intoxication, initial creatinine level and initial occult blood of urine can be considered as the best predictors. More than 2 days will be needed for the observation of serious complications in DS intoxication.
Creatinine ; Doxylamine* ; Humans ; Medical Records ; Occult Blood ; Retrospective Studies ; Rhabdomyolysis ; Succinic Acid

Objective: Organic light-emitting diodes (OLEDs) emit less blue light than traditional light-emitting diodes (LEDs), and we previously found that early-night OLED light exposure (LE) delays the melatonin phase by less than LED at a color temperature of 4,000 K. As a follow-up study, we investigated the effects of OLED and LED at a different color temperature (3,000 K) on melatonin profile, sleep, and vigilance. Methods: 24 healthy subjects (27.5±5.1 years) were exposed to three light conditions [OLED, LED, and dim light (DL)] from 17:30 to 24:00, in a random order and with a 1-week interval. Saliva samples for melatonin were taken every hour from 18:00 to 24:00. Polysomnography (PSG) and a psychomotor vigilance test (PVT) were performed. Results: Melatonin onset time was significantly delayed under OLED and LED compared with DL, with no significant difference between OLED and LED. The mean melatonin level at 24:00 under LED was lower than that under DL, but there was no significant difference between OLED LE and DL. The percentage of slow wave sleep (N3) in LED was significantly lower than in OLED. Conclusion Exposure to light in the evening can suppress melatonin secretion late at night and disturb deep sleep, and those effects are slightly worse under LED than OLED.

Objective: Organic light-emitting diodes (OLEDs) emit less blue light than traditional light-emitting diodes (LEDs), and we previously found that early-night OLED light exposure (LE) delays the melatonin phase by less than LED at a color temperature of 4,000 K. As a follow-up study, we investigated the effects of OLED and LED at a different color temperature (3,000 K) on melatonin profile, sleep, and vigilance. Methods: 24 healthy subjects (27.5±5.1 years) were exposed to three light conditions [OLED, LED, and dim light (DL)] from 17:30 to 24:00, in a random order and with a 1-week interval. Saliva samples for melatonin were taken every hour from 18:00 to 24:00. Polysomnography (PSG) and a psychomotor vigilance test (PVT) were performed. Results: Melatonin onset time was significantly delayed under OLED and LED compared with DL, with no significant difference between OLED and LED. The mean melatonin level at 24:00 under LED was lower than that under DL, but there was no significant difference between OLED LE and DL. The percentage of slow wave sleep (N3) in LED was significantly lower than in OLED. Conclusion Exposure to light in the evening can suppress melatonin secretion late at night and disturb deep sleep, and those effects are slightly worse under LED than OLED.

No abstract available.
Heart* ; Pericardial Effusion*

OBJECTIVE: To evaluate efficacy and safety of local injection of potassium chloride (KCl) and methotrexate (MTX) in the treatment of cornual pregnancy. METHODS: We retrospectively reviewed all cases of cornual pregnancy treated conservatively from 2005 through August 2007. Eight cases were identified and two cases were heterotopic interstitial pregnancy. All cases were managed with local injection of KCl or methotrexate under ultrasound guidance and 2 cases were treated with intra-muscular injection of MTX in combination. After the procedure all cases with cardiac activity was confirmed to be aborted by ultrasound. Also serial follow-up sonographic examination and serum beta-hCG measurement were performed. RESULTS: The mean initial beta-hCG level was 53,331.6 mIU/mL and ranged from 14,332 mIU/mL to 125,721 mIU/mL. Mean gestational age was 48.3 days from 40 to 65 days. All cases were aborted successfully and follow up beta-hCG were declined abruptly. Two cases of heterotopic pregnancy resulted in successful deliveries at full term. CONCLUSION: Cornual resection or hysterectomy should no longer be the first line of treatment for hemodynamically stable patients with cornual pregnancy. They can be successfully treated through local injection of MTX or KCl by ultrasound guidance.
Follow-Up Studies ; Gestational Age ; Humans ; Hysterectomy ; Methotrexate ; Potassium ; Potassium Chloride ; Pregnancy ; Pregnancy, Heterotopic ; Retrospective Studies