Purpose: In the present study, we determined the prevalence of obstructive meibomian gland dysfunction (MGD), hyposecretory MGD, grossly normal MG, and hypersecretory MGD in patients with dry eye syndrome using lipid layer thickness (LLT) and MG dropout. Methods: Eighty-eight patients with dry eye syndrome were included in the study. Patients were categorized into four groups according to the LLT and weighted total meiboscore. The proportion of patients in each group was calculated. The age, sex, Ocular Surface Disease Index, LLT, Schirmer, tear film breakup time, cornea stain, weighted total meiboscore, expressibility, and quality of meibum were compared between the four groups. Results: Fifteen eyes (17.0%) had obstructive MGD, two eyes (2.3%) had hyposecretory MGD, 40 eyes (45.5%) had grossly normal MG, and 17 eyes (19.3%) had hypersecretory MGD. The obstructive MGD group was younger than the grossly normal MG group. In obstructive MGD, the ratio of men to women was higher than that of the other groups. However, Ocular Surface Disease Index, Schirmer, tear film breakup time, and corneal stain did not show statistically significant differences between the four groups. The meibum expressibility of the hyposecretoy MGD group was worse than those of the other groups. The meibum expressibility of the hyposecretoy MGD group was poor than those of the obstructive and hypersecretory MGD group. Conclusions This categorization was expected to help determine the best treatment method for dry eye syndrome, according to the MG status.

OBJECTIVE: This study aimed to describe the conceptualization, development, and implementation processes of the newly established Korean Cardiac Arrest Resuscitation Consortium (KoCARC) to improve out-of-hospital cardiac arrest (OHCA) outcomes. METHODS: The KoCARC was established in 2014 by recruiting hospitals willing to participate voluntarily. To enhance professionalism in research, seven research committees, the Epidemiology and Preventive Research Committee, Community Resuscitation Research Committee, Emergency Medical System Resuscitation Research Committee, Hospital Resuscitation Research Committee, Hypothermia and Postresuscitation Care Research Committee, Cardiac Care Resuscitation Committee, and Pediatric Resuscitation Research Committee, were organized under a steering committee. The KoCARC registry was developed with variables incorporated in the currently existing regional OHCA registries and Utstein templates and were collected via a web-based electronic database system. The KoCARC study population comprises patients visiting the participating hospitals who had been treated by the emergency medical system for OHCA presumed to have a cardiac etiology. RESULTS: A total of 62 hospitals volunteered to participate in the KoCARC, which captures 33.0% of the study population in Korea. Web-based data collection started in October 2015, and to date (December 2016), there were 3,187 cases compiled in the registry collected from 32 hospitals. CONCLUSION: The KoCARC is a self-funded, voluntary, hospital-based collaborative research network providing high level evidence in the field of OHCA and resuscitation. This paper will serve as a reference for subsequent KoCARC manuscripts and for data elements collected in the study.
Cardiopulmonary Resuscitation ; Data Collection ; Emergencies ; Epidemiology ; Heart Arrest* ; Humans ; Hypothermia ; Korea ; Out-of-Hospital Cardiac Arrest ; Professionalism ; Registries ; Resuscitation

The poisoning information database (PIDB) provides clinical toxicological information on commonly encountered toxic substances in Korea. The aim of this study was to estimate the coverage rate of the PIDB by comparing the database with the distribution of toxic substances that real poisoning patients presented to 20 emergency departments. Development of the PIDB started in 2007, and the number of toxic substances increased annually from 50 to 470 substances in 2014. We retrospectively reviewed the medical records of patients with toxic exposure who visited 20 emergency departments in Korea from January to December 2013. Identified toxic substances were classified as prescription drug, agricultural chemical, household product, animal or plant, herbal drug, or other. We calculated the coverage rate of the PIDB for both the number of poisoning cases and the kinds of toxic substances. A total of 10,887 cases of intoxication among 8,145 patients was collected. The 470 substances registered in the PIDB covered 89.3% of 8,891 identified cases related to poisoning, while the same substances only covered 45.3% of the 671 kinds of identified toxic substances. According to category, 211 prescription drugs, 58 agricultural chemicals, 28 household products, and 32 animals or plants were not covered by the PIDB. This study suggested that the PIDB covered a large proportion of real poisoning cases in Korea. However, the database should be continuously extended to provide information for even rare toxic substances.
Adolescent ; Adult ; Aged ; Animals ; Animals, Poisonous ; Child ; Child, Preschool ; Databases, Factual ; Drugs, Chinese Herbal/poisoning ; Emergency Service, Hospital ; Female ; Humans ; Infant ; Male ; Middle Aged ; Pesticides/poisoning ; Plants, Medicinal/poisoning ; Poisoning/*epidemiology ; Prescription Drugs/poisoning ; Republic of Korea ; Retrospective Studies ; Young Adult

No abstract available.
Advanced Cardiac Life Support* ; Cardiopulmonary Resuscitation*

The purpose of this study was to investigate the association between body mass index (BMI) and the prevalence of wheeze using nation-wide cross-sectional study in Korean children. Total 50,200 children from 427 elementary schools were randomly selected according to residential areas (metropolitan, provincial, rural, and industrial areas) by the cluster sampling method. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires were used to measure the prevalence of wheeze. Among 31,026 respondents, 25,322 were analyzed. BMI was classified into quartiles based on BMI-for-age percentile. In all residential areas, pets at home and visible mold or moisture were associated with an increased prevalence of wheeze in both genders. However, other living environment factors were not consistently associated among residential areas and gender. Among girls, lowest BMI was negatively associated with prevalence of wheeze and highest BMI was positively associated in all residential areas. In multilevel logistic regression analysis, environmental tobacco smoking exposure, pets at home, visible mold or moisture, and being in the lowest and highest BMI quartile were significantly associated with the prevalence of wheeze in both genders. BMI has become an important risk factor for asthma symptoms among Korean children.
Allergens ; Asthma/*epidemiology ; Body Composition ; *Body Mass Index ; Child ; Cross-Sectional Studies ; *Environmental Exposure ; Female ; Fungi/immunology ; Humans ; Male ; Pets/immunology ; Questionnaires ; Republic of Korea/epidemiology ; *Residence Characteristics ; Tobacco Smoke Pollution ; Water

BACKGROUND/AIMS: Colonoscopy training programs and the minimal experience with colonoscopy required to be considered technically competent are not well established. The aim of this study was to determine the colonoscopy learning curves and factors associated with this difficult procedure at a single center. METHODS: A total of 3,243 colonoscopies were performed by 12 first-year gastroenterology fellows, and various clinical factors were assessed prospectively for 22 months. Acquisition of competence (success rate) was evaluated based on two objective criteria: (i) the adjusted completion rate (>90%) and (ii) cecal intubation time (<20 minutes). RESULTS: The overall success rate in reaching the cecum in less than 20 minutes was 72.8%. The cecal intubation time was 9.34+/-4.13 minutes (mean+/-SD). Trainees' skill at performing cecal intubation in <20 minutes reached the requisite standard of competence after 200 procedures. Cecal intubation time decreased significantly from 11.3 to 9.4 minutes after 100 procedures and improved continuously thereafter. Female patients and advanced patient age (over 60 years) were associated with prolonged cecal intubation time (>20 minutes). Surgery of the uterus and ovaries was significantly correlated with delayed cecal intubation time, but not after sufficient colonoscopy experience. CONCLUSIONS: The minimum number of procedures to reach technical competence was 200. The cecal intubation time was longer in female and older patients.
Cecum ; Colonoscopy ; Female ; Gastroenterology ; Humans ; Intubation ; Learning ; Learning Curve ; Mental Competency ; Ovary ; Prospective Studies ; Uterus

Iliopsoas bursitis is known to occur in relation to hip joint lesions such as osteoarthritis, rheumatoid arthritis, synovial chondromatosis, pigmented villonodular synovitis and rarely osteonecrosis of the femoral head, but femoral nerve palsy due to iliopsoas bursitis is a very rare condition. A patient visited to the emergency room because of anesthesia of the anterior thigh. A mass had developed and this enlarged to 3x5 cm in size after 2 weeks, and this was probably due to progression of osteonecrosis of the femoral head. The patient was finally diagnosed with femoral nerve palsy that was caused by a distended iliopsoas bursa, which was detected by ultrasonography and enhanced MRI. Total hip arthroplasty via the posterior approach was done and the connected iliopsoas bursa was removed. After operation, the anesthesia of the anterior thigh and the motor power were improved. We report here on a case of femoral nerve palsy due to iliopsoas bursitis that was related to osteonecrosis of the femoral head, and we review the relevant medical literature.
Anesthesia ; Arthritis, Rheumatoid ; Arthroplasty ; Bursitis ; Chondromatosis, Synovial ; Emergencies ; Femoral Nerve ; Head ; Hip ; Hip Joint ; Humans ; Osteoarthritis ; Osteonecrosis ; Paralysis ; Synovitis, Pigmented Villonodular ; Thigh

BACKGROUND/AIMS: Proton pump inhibitor (PPI) based triple therapy for Helicobacter pylori eradication has an approximately 20% treatment failure rate. The aim of this study is to examine the clinical factors that influence eradication of H. pylori in patients with peptic ulcers. METHODS: We reviewed the medical records of 597 endoscopy-proven peptic ulcer and H. pylori-positive patients who were treated at our hospital between July 2004 and March 2007. The eradication rate and the effect of age, gender, smoking, alcohol drinking, activity and the location of ulcer and the kind of PPIs were examined. RESULTS: 597 patients were treated with one-week triple therapy (PPI, amoxicillin 1 g, clarithromycin 500 mg all twice daily). The overall eradication rate was 80.2%. Eradication was significantly more successful in the patients with an age under 60, and in patients over 60 and who had a duodenal ulcer (83.2% vs 73.2%, respectively, p=0.005) or a gastric ulcer (82.5% vs 73.6%, respectively, p=0.041). There was no statistically significant difference according to gender, smoking, alcohol, the activity of the ulcer and the kind of PPIs. CONCLUSIONS: An age over 60 and gastric ulcer were associated with a lower H. pylori eradication rate in patients with peptic ulcers. Therefore, H. pylori eradication in old age patients and in patients with gastric ulcer should be managed differently and the treatment duration should be extended or a new treatment regime developed to overcome the lower eradication rate.
Alcohol Drinking ; Amoxicillin ; Clarithromycin ; Duodenal Ulcer ; Helicobacter ; Helicobacter pylori ; Humans ; Medical Records ; Peptic Ulcer ; Proton Pumps ; Smoke ; Smoking ; Stomach Ulcer ; Treatment Failure ; Treatment Outcome ; Ulcer