PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.
Aged ; Anesthesia ; Anterior Chamber ; Conjunctiva ; Cryotherapy ; Female ; Glaucoma ; Humans ; Ischemia* ; Mannitol ; Muscles ; Ophthalmic Artery ; Paracentesis ; Retinal Artery Occlusion ; Retinal Detachment ; Retinal Perforations ; Young Adult

BACKGROUND: Burnout is a common problem for interns and residents. It may be related to medical error, but little is known about this relationship. The purpose of this study was to determine the association between burnout and perceived medical errors among interns and residents. METHODS: The study group consisted of interns and residents working in a university hospital in Busan. Data were provided by 86 (58.5%) of 147 interns and residents. They completed a questionnaire including self-assessment of medical errors, a linear analog self-assessment of overall quality of life (QOL), fatigue, the Epworth Sleepiness Scale (ESS) score, the Maslach Burnout Inventory, and a validated depression screening tool. RESULTS: According to univariate logistic regression analyses, there was an association between perceived medical errors and fatigue (odds ratio [OR], 1.37 per unit increase; 95% confidence interval [CI], 1.12 to 1.69; P < 0.003) and ESS scores (OR, 1.13 per unit increase; 95% CI, 1.03 to 1.23; P < 0.009). Perceived medical errors were also associated with burnout (ORs per 1-unit change; emotional exhaustion OR, 1.07; 95% CI, 1.02 to 1.13; P < 0.005; depersonalization OR, 1.11; 95% CI, 1.02 to 1.21; P < 0.013), a negative depression screen (OR, 0.29; 95% CI, 0.11 to 0.76; P < 0.013), and overall QOL (OR, 0.80; 95% CI, 0.70 to 0.98; P < 0.033). In multivariate logistic regression analyses, an association was identified between perceived medical errors and emotional exhaustion (OR, 1.06; 95% CI, 1.00 to 1.11; P < 0.046) when adjusted for ESS, and depersonalization (OR, 1.01; 95% CI, 1.01 to 1.19; P < 0.04) when adjusted for fatigue. CONCLUSION: Higher levels of burnout among interns and residents were associated with perceived medical errors.
Depersonalization ; Depression ; Fatigue ; Logistic Models ; Mass Screening ; Medical Errors ; Quality of Life ; Self-Assessment

OBJECTIVES: The purpose of this study was to identify the risk factors of metabolic syndrome (MS) and to analyze the relationship between the risk factors of MS and medical cost of major diseases related to MS in Korean workers, according to the scale of the enterprise. METHODS: Data was obtained from annual physical examinations, health insurance qualification and premiums, and health insurance benefits of 4,094,217 male and female workers who underwent medical examinations provided by the National Health Insurance Corporation in 2009. Logistic regression analyses were used to the identify risk factors of MS and multiple regression was used to find factors associated with medical expenditures due to major diseases related to MS. RESULT: The study found that low-income workers were more likely to work in small-scale enterprises. The prevalence rate of MS in males and females, respectively, was 17.2% and 9.4% in small-scale enterprises, 15.9% and 8.9% in medium-scale enterprises, and 15.9% and 5.5% in large-scale enterprises. The risks of MS increased with age, lower income status, and smoking in small-scale enterprise workers. The medical costs increased in workers with old age and past smoking history. There was also a gender difference in the pattern of medical expenditures related to MS. CONCLUSIONS: Health promotion programs to manage metabolic syndrome should be developed to focus on workers who smoke, drink, and do little exercise in small scale enterprises.
Female ; Health Expenditures ; Health Promotion ; Humans ; Insurance, Health ; Korea* ; Logistic Models ; Male ; National Health Programs ; Physical Examination ; Prevalence ; Risk Factors ; Smoke ; Smoking

The Korean Society of Nuclear Medicine (KSNM) is celebrating its 60th anniversary in honor of the nuclear medicine professionals who have dedicated their efforts towards research, academics, and the more comprehensive clinical applications and uses of nuclear imaging modalities. Nuclear cardiology in Korea was at its prime time in the 1990s, but its growth was interrupted by a long pause. Despite the academic and practical challenges, nuclear cardiology in Korea now meets the second leap, attributed to the growth in molecular imaging tailored for many non-coronary diseases and the genuine values of nuclear myocardial perfusion imaging. In this review, we describe the trends, achievements, challenges, and perspectives of nuclear cardiology throughout the 60-year history of the KSNM.

BACKGROUND: This study was conducted to explore the effect of known risk factors, focusing on risk factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, in consideration of interaction among East-Asian women. METHODS: Case-control study with 2,123 cases and 2,121 controls with mammographic density was conducted. Using the mammographic film, breast density was measured using Breast Imaging-Reporting and Data System. To identify the association of selected reproductive factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, stratified analysis was conducted according to breast density groups and interaction effects was assessed. The results were presented with adjusted OR and 95% CIs. RESULTS: Significant interaction effect between age at first birth and breast density on breast cancer (P = 0.048) was observed. Women with age at first birth ≥ 28 years old showed increased breast cancer risk in extremely dense breast group (≥ 75%) (OR = 1.627, 95% CI = 1.190–2.226). However, women with fatty breast (< 50%) and heterogeneously dense breast (50%–75%) did not show an increased association. Age at menarche, age at menopause, number of children, and family history of breast cancer did not show significant interaction with breast cancer and similar risk patterns were observed. CONCLUSIONS: Age at first birth showed significant interaction with breast density on breast cancer risk. Further studies considering biologically plausable model between exposure, intermediate outcomes and breast cancer risk with prospective design need to be undertaken in East Asian women.
Asian Continental Ancestry Group ; Birth Order ; Breast Neoplasms ; Breast ; Case-Control Studies ; Child ; Female ; Humans ; Information Systems ; Menarche ; Menopause ; Prospective Studies ; Reproductive History ; Risk Factors

Malnutrition associated vitamin D deficiency contributes to the calcium loss from bone and results in osteoporosis and osteomalacia at final stage. Osteomalacia is characterized with softening of bone secondary to defective bone mineralization. Here, we report a case of possible osteomalacia caused by prolonged lactation and severe malnutrition in 35-year-old female. She was a housewife and her body mass index was 11.8 kg/m2. She was diagnosed with severe osteoporosis in regular health check-up 2 years ago, but did not take any medication. Nine months ago, she had been treated with anti-tuberculosis medications for 6 month due to active pulmonary tuberculosis. After complete remission of pulmonary tuberculosis, she had lost her appetite severely. Furthermore, she felt gait difficulty and suffered from generalized bone pain. On serologic examination, hypocalcemia, hypophosphatemia, high alkaline phosphatase, low vitamin D3 and high parathyroid hormone level were seen. In the bone mineral density, Z-score from her lumbar spine was -6.5. She was treated with oral calcium and vitamin D3 intramuscularly. After 1 year treatment, she felt significant improvement in bone pain and could walk alone. Also her serum calcium, phosphate and vitamin D3 level are all normalized.
Adult ; Alkaline Phosphatase ; Appetite ; Body Mass Index ; Bone Density* ; Calcification, Physiologic ; Calcium ; Cholecalciferol ; Female ; Gait ; Humans ; Hypocalcemia ; Hypophosphatemia ; Lactation* ; Malnutrition* ; Osteomalacia ; Osteoporosis ; Parathyroid Hormone ; Spine ; Tuberculosis, Pulmonary ; Vitamin D ; Vitamin D Deficiency*

Heterotopic pancreas is an uncommon condition that commonly occurs in the gastrointestinal tract such as the stomach and small bowel. It is defined as the presence of pancreatic tissue outside its usual location and lacking anatomical and vascular continuity with the pancreas. A heterotopic pancreas is usually found incidentally and is mostly silent; however, it rarely causes abdominal pain, weight loss, bleeding, or ileus. A 49-year-old male presented with intermittent abdominal pain for 4 weeks. We report a case with submucosal features of a jejunal heterotopic pancreas with the aid of capsule endoscopy and a histological confirmation through a single port laparoscopic segmental jejunectomy.
Abdominal Pain ; Capsule Endoscopy ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileus ; Jejunum ; Male ; Middle Aged ; Pancreas ; Stomach ; Weight Loss

BACKGROUND: The significance of adiponectin levels in elderly individuals with prediabetes has yet to be determined. Thus, the present study was performed to evaluate the relationships between adiponectin levels and anthropometric variables, body composition parameters, insulin sensitivity, and lipid profiles in elderly prediabetic patients. METHODS: The present study included 120 subjects with prediabetes who were >65 years of age and were selected from among 1,993 subjects enrolled in the Korea Rural Genomic Cohort Study. All subjects underwent a 75 g oral glucose tolerance test and tests for measurement of insulin sensitivity. All diagnoses of prediabetes satisfied the criteria of the American Diabetes Association. RESULTS: Plasma adiponectin levels were lower in elderly prediabetic subjects than elderly subjects with normal glucose tolerance (P<0.01) as well as in elderly prediabetic patients with metabolic syndrome (MetS) than in those without MetS (P<0.02). When the subjects were categorized into two groups according to plasma adiponectin levels, the waist-to-hip ratio and 2-hour insulin levels were significantly lower in individuals with high plasma adiponectin levels than in those with low plasma adiponectin levels. Additionally, the plasma adiponectin levels of elderly prediabetic subject were inversely correlated with body mass index (BMI), waist circumference (WC), waist-to-hip ratio, visceral fat, visceral fat ratio, and 2-hour insulin levels. CONCLUSION: The present findings demonstrated that the major factors correlated with adiponectin levels in elderly prediabetic subjects were BMI, WC, waist-to-hip ratio, visceral fat, visceral fat ratio, and 2-hour insulin levels.
Adiponectin* ; Aged* ; Body Composition ; Body Mass Index ; Cohort Studies ; Diagnosis ; Glucose ; Glucose Tolerance Test ; Humans ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Korea ; Plasma* ; Prediabetic State* ; Waist Circumference ; Waist-Hip Ratio

OBJECTIVES: This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in Korea during 1999-2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014-2018. METHODS: The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by gender and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran’s I with a spatial weight matrix based on adjacency or distance. RESULTS: Regional disparities varied depending on cancer type and gender during the 20-year study period. For men, the regional disparities of stomach, colon and rectum, lung, and liver cancer declined, and those of thyroid and prostate cancer recently decreased, despite an overall increasing incidence. For women, regional disparities in stomach, colon and rectum, lung, liver, and cervical cancer declined, that of thyroid cancer recently decreased, despite an overall increasing incidence, and that of breast cancer steadily increased. In 2014-2018, breast cancer (I, 0.61; 95% confidence interval [CI], 0.53 to 0.70) showed a high probability of cancer clusters in women, and liver cancer (I, 0.48; 95% CI, 0.40 to 0.56) showed a high probability of cancer clusters in men. CONCLUSIONS Disparities in cancer incidence that were not seen at the national level were discovered at the municipal level. These results could provide important directions for planning and implementing local cancer policies.

Purpose: This study aimed to report the projected cancer incidence and mortality for the year 2024 to estimate Korea’s current cancer burden. Materials and Methods: Cancer incidence data from 1999 to 2021 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2022 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and multiplying the projected age-specific rates by the anticipated age-specific population for 2024. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend for prediction. Results: In total, 292,221 new cancer cases and 83,770 cancer deaths are expected to occur in Korea in 2024. The most common cancer site is expected to be the thyroid, followed by the colon and rectum, lung, breast, and stomach. These five cancers are expected to represent 55.7% of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and stomach cancers. Conclusion The age-standardized incidence rates for female breast and prostate cancers are estimated to continue to increase. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.