OBJECTIVE: This study investigated the driving habits of taxi drivers, in order to examine the characteristics of human factors causing traffic accidents and unsafe driving behavior and to determine any relevancy among them. METHOD: Taxi drivers (N=335) answered a questionnaire investigating various measures of human factors, unsafe driving behaviors, and number of traffic accident experiences in the previous year. In factor analysis, the characteristics of human factors were classified into 5 common factors: job, mental health, age, health habit and sleep factor. A contextual mediated model was proposed to distinguish the distal (5 common factors) and proximal (unsafe driving behaviors) factors in predicting traffic accident involvement by hierarchical multiple regression. RESULT: In hierarchical multiple regression, job factor(beta: 0.122), sleep factor (beta: 0.114) and unsafe driving behaviors (beta: 0.018) yielded a direct effect on the rate of traffic accidents. Mental health factor beta: 6.429), job factor (beta: 1.319) and health habit factor(beta: 1.177) yielded a indirect effect on the rate of traffic accidents by unsafe driving behaviors. CONCLUSION: Various human factors co-related by the unique characteristics that exist in the taxi service industry have significant effects on the rate of traffic accidents mediated by unsafe driving behaviors. Therefore a proper countermeasure against these factors should be established in order to effectively reduce the rate of taxi accidents.
Accidents, Traffic* ; Humans* ; Mental Health ; Questionnaires

No abstract available.
Animals ; Rats*

Hyperreflexic bladder is a disease manifested in patients with spinal cord lesions above the sacral segment. The treatments for hyperreflexic bladder are medical therapy, interruption of innervation, argumentation cystoplasty, etc. We treated four hyperreflexic bladder patients with 12% a phenol injection into the subarachnoid space for sacral nerve block. Before treatment the average bladder capacity was about 100 ml, and there was one case of autonomic dysreflexia. After the subarachnoid block the average bladder capacity increased above 300 ml and maximal intravesical pressure decreased below 30cmH2O, autonomic dysreflexia disappeared in one patient. The decreased bladder compliance after nerve block was managed by repetitive bladder overdistention. We suggest that subarachnoid block is easier and more effective than sacral nerve block individually, and is a treatment for hyperreflexic bladder refractory to medical therapy.
Autonomic Dysreflexia ; Compliance ; Humans ; Nerve Block ; Phenol ; Spinal Cord ; Subarachnoid Space ; Urinary Bladder*

No abstract available.
Animals ; Coal* ; Dust* ; Lung* ; Rats* ; Silicon Dioxide*

Cancer screening evaluation will be a important issue in Korea in near future. Bias in cancer screening evaluation is well known by concept, but it is not applied yet using the data from screening program of Korea. So introducing the way how the bias is adjusted will be helpful. This review deals with the type, meaning, the way how the bias is adjusted, and examples. Especially, lead-time bias, length bias and self-selection bias were focused. Adjusting bias is one of the imperative step for epidemiologic analysis. Understanding the background concept and experience using the screening program data will be helpful for estimating the effectiveness of national screening program of Korea.
Bias (Epidemiology) ; Early Detection of Cancer ; Korea ; Mass Screening

PURPOSE: To evaluate the usefulness of external bandage suture for bleb-related management that follows trabeculectomy with mitomycin C. METHODS: External bandage sutures were performed on 10 patients having hypotony maculopathy, persistent low intraocular pressure (IOP) caused by either hyperfiltration or focal leakage, or a persisting large bleb caused by hyperfiltration and who received trabeculectomy using mitomycin C as an adjuvant treatment. The changes in IOP measured before and 4 weeks after the procedure along with complication incidences were evaluated. RESULTS: The mean IOP 4 weeks after the procedure compared with the mean IOP prior to the procedure increased from 5.8 +/- 2.0 mm Hg (3.0-9.0 mm Hg) to 14.1 +/- 8.5 mm Hg (4.0-32.0 mm Hg), with statistical significance (p = 0.008). After the procedure, improvement in visual acuity was observed but without statistical significance. One patient had persistent focal leakage from an avascular bleb and conjunctival advancement with removal of the avascular conjunctiva was performed. CONCLUSIONS: An external bandage suture can be a good alternative for correction of post-trabeculectomy hypotony and severe chemosis with minimal effect on blebs while correcting focal leakage and hyperfiltration.
Bandages ; Blister ; Conjunctiva ; Humans ; Incidence ; Intraocular Pressure ; Mitomycin ; Sutures ; Trabeculectomy ; Visual Acuity

PURPOSE: To report a case of secondary glaucoma and sclerokeratitis after cosmetic eye whitening by regional conjunctivectomy with Mitomycin C application. CASE SUMMARY: A 69 year-old man was referred to our clinic for a left ocular pain and ocular hypertension sustained for 3 months after cosmetic eye whitening by regional conjunctivectomy with Mitomycin C application for chronic conjunctival hyperemia. On first examination, the scleromalacia and large conjunctival epithelium defect in the nasal quadrant of the limbus area and diffuse sclerokeratitis were observed. Conjunctival and episcleral vessel deficit were seen except superior 30% portion in the left eye. The anterior chamber depth in the left eye was very shallow compared to the right eye and cell reaction in the left anterior chamber was detected. Intraocular pressure (IOP) in the left eye was 28 mmHg after Cosopt(R) and 15% mannitol 500 ml use. Glaucomatous cupping was detected. During follow-up, left IOP increased over 40 mmHg despite the maximal medical treatment and the progression of visual field defects was detected, so then left phacoemulsification, Ahmed valve implantation and amnion membrane transplantation were done. After surgery, the conjunctival epithelial defect and sclerokeratitis were improved much and IOP was regulated 20~30 mmHg without medication. Digital massage was done 2 times per day for decreasing IOP and wound remodeling after 1 month. At 3 month after surgery, the conjunctival epithelial defect recurred and scleromalacia was also progressed, so then we performed autoconjunctival flap and amnion membrane transplantation in left eye. The conjunctival epithelial defect were recovered completely, IOP was regulated 24~36 mmHg without medication, and 20~24 mmHg with Cosopt.(R) The compliance of patient is very poor, further management may be needed for IOP control. CONCLUSIONS: Cosmetic eye whitening by regional conjunctivectomy with Mitomycin C application can cause serious complications such as scleromalcia and secondary glaucoma. This case shows that particular care should be taken in order to minimize these complications.
Amnion ; Anterior Chamber ; Compliance ; Cosmetics ; Epithelium ; Eye ; Follow-Up Studies ; Glaucoma ; Glycosaminoglycans ; Humans ; Hyperemia ; Intraocular Pressure ; Mannitol ; Massage ; Membranes ; Mitomycin ; Ocular Hypertension ; Phacoemulsification ; Transplants ; Visual Fields

OBJECTIVE: This study was designed to assess sequential association between right ventricular systolic pressure and cardiothoracic (C/T) ratio of chest radiography in systemic sclerosis (SSc) patients and inferred pulmonary arterial hypertension by increased C/T ratio and right ventricular systolic pressure. METHODS: Twenty-eight consecutive patients with confirmed SSc (22 females, 6 males; mean age 51.1+/-2.1 years), with a mean time of 91.0+/-6.7 months from SSc diagnosis, were prospectively included in the study. C/T ratio was obtained by chest radiography with an interval of two years. The first C/T ratio was taken at diagnosis and second C/T ratio was taken at the time of enrollment. The enrolled subjects were agree to undergo echocardiography and measurement of brain natriuretic peptide. RESULTS: In 24 SSc patients with normal right ventricular systolic pressure, 10 SSc patients had increased C/T ratio, the other four SSc patients with increased right ventricular systolic pressure by echocardiography, had increased C/T ratio all together. In four SSc patients with increased right ventricular systolic pressure, one patient had resting dyspnea, taken cardiac catheterization and confirmed as pulmonary hypertension and the other three patients had no clinical symptoms. The increased right ventricular systolic pressure is related to the increase of C/T ratio (>0.55) in chest radiography (p<0.05) and increased brain natriuretic peptide in blood (p<0.05). CONCLUSION: The increase of C/T ratio (>0.55) in chest radiography was associated with increased right ventricular systolic pressure measured by echocardiography and inferred a role in early detection of asymptomatic pulmonary arterial hypertension in SSc patients.
Blood Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Dyspnea ; Echocardiography ; Female ; Humans ; Hypertension ; Hypertension, Pulmonary ; Male ; Natriuretic Peptide, Brain ; Prospective Studies ; Radiography ; Scleroderma, Systemic* ; Thorax

Chondroblastoma is a benign occurrence bone tumor arising most often in the epiphyses of long bone and its occurance in skull is rare. The authors recently encountered a case of large chondroblastoma occupying middle cranial fossa. The clinical presentation, reoentgenographic appearance, gross and microscopic characteristics, surgical treatment, differential diagnosis, and the rapeutic result are presented. A 27 year old male patient was admitted to the Department of Neurosurgery, Keimyung University Hospital because of progressive diffuse swelling in right temporal area of 4 months duration. In physical examination, nontender, firm, nonmovable diffuse mass in right temporal area and bean sized polypoid mass in the anterior and superior wall of the right external auditory canal were noted. Plain skull X-rays showed lytic defect in the right temporal squama, base of middle cranial fossa, sphenoid ridge, a part of petrous bone and anterior fossa with rather sharp, but not sclerotic margin. Brain CT scan showed a lentiform nonhomogeneous slight high density mass with scattered calcification in the entire middle cranial fossa, and the tumor enhanced slightly. Selective external carotid serial angiogram revealed complete obstruction of external carotid artery just behind the origin of lingual artery without tumor staining. Right temporal craniectomy was performed with nearly total curetting of tumor mass grossly. The histological diagnosis was chondroblastoma. The patient was discharged with good result.
Adult ; Arteries ; Brain ; Carotid Artery, External ; Chondroblastoma* ; Cranial Fossa, Middle* ; Curettage ; Diagnosis ; Diagnosis, Differential ; Ear Canal ; Epiphyses ; Humans ; Male ; Neurosurgery ; Petrous Bone ; Physical Examination ; Skull ; Tomography, X-Ray Computed

OBJECTIVES: Patients with smell loss after craniocerebral trauma are known to have some brain abnormalities, but there was no study to analyze the findings according to the time interval between injury and evaluation. We aimed to identify whether the time interval may influence on the findings in the brain. METHODS: Medical records of 19 patients with posttraumatic olfactory dysfunction were reviewed. All of them underwent a magnetic resonance imaging and olfactory function tests. The patients were divided into early (n=10) and delayed (n=9) groups according to the time interval. RESULTS: Magnetic resonance imaging was taken at a mean time of 2.2 and 59.6 months after trauma in the early and delayed groups, respectively. Abnormal findings in the brain were found in 6 and 8 patients in the early and delayed groups, respectively. The olfactory bulb and orbitofrontal cortex were commonly affected olfactory pathways in both groups. In the early group, the abnormalities were brain tissue defect, hemorrhage, and focal edema whereas tissue defect was the only finding in the delayed group. In the early group, 5 of 6 patients with severe olfactory dysfunction showed brain abnormality while 1 of 4 patients with mild dysfunction had abnormality. In the delayed group, all the patients had severe dysfunction and 8 of 9 patients showed brain abnormality. CONCLUSION: Most patients with traumatic olfactory dysfunction had abnormality in the brain, and brain abnormality might be different according to the timing of evaluation. Furthermore, there might be an association between the severity of olfactory dysfunction and radiological abnormalities.
Brain ; Craniocerebral Trauma ; Edema ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Medical Records ; Olfactory Bulb ; Olfactory Pathways ; Smell