Since the time of Jonathan Hutchinson(1858~63), it has been known that over 90% of cases of diffuse interstitial keratitis occur in syphilitic patients. Interstitial keratitis is due to acquired syphilis in 4% of cases and the other 6% of cases due to tuberculosis, sarcoid, trypanosomiasis, onchocerciasis and other rare infections. After the introduction of penicillin by Mahoney et al. in 1943 for syphilis therapy, syphilis epidemy was sharply decreased throughout the world. However, during the middle 1950's the incidence of syphilis began to increase throughout the world. In Korea. the syphilis incidence has been increased since around 1963-1965 in parallel with the world trends(Kim and Lew 1968). A 6 year old Korean girl has been found to have bilateral acute interstitial keratitis and a positive serological test for syphilis.
Child ; Female ; Humans ; Incidence ; Keratitis* ; Korea ; Onchocerciasis ; Penicillins ; Serologic Tests ; Syphilis ; Syphilis, Congenital* ; Trypanosomiasis ; Tuberculosis

PURPOSE: To evaluate the correlation between diabetic retinopathy (DR) and arteriolosclerosis in patients with NIDDM (non-insulin-dependent diabetes mellitus), to investigate the risk factors of DR, and to assess the change of the correlation according to the risk factors. METHODS: The study subjects were selected from consecutive routine clinical visits by random sampling from July 2002 to June 2003. The patients were divided into two groups according to the presence of DR, and the patients' charts, fundus examination and blood test were retrospectively reviewed. ETDRS (Early Treatment DR Study) classification for DR and Scheie classification for arteriolosclerosis were used. Statistical analysis was conducted with SPSS program (version 10.0). The confidence interval was set to 95%, and the level of significance was set at p=0.05. RESULTS: DR had a statistically significant correlation with arteriolosclerosis, especially according to duration of diabetes mellitus (p<0.05). Risk factors including diabetes mellitus duration, HgA1c level, and LDL (low-density lipoprotein) cholesterol level showed statistically significant difference (p<0.05). CONCLUSIONS: From the result of analysis, DR has a statistically significant correlation with arteriolosclerosis, especially according to the duration of diabetes mellitus. To prevent vision-threatening complications of DR, the degree of arteriolosclerosis as well as risk factors such as diabetes mellitus duration, serum HgA1c level, and LDL (low-density lipoprotein) cholesterol level should be carefully considered and monitored in the evaluation, progression, and treatment of DR.
Arteriolosclerosis* ; Cholesterol ; Classification ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Hematologic Tests ; Humans ; Retrospective Studies ; Risk Factors

OBJECTIVES: This study evaluated the effect of an in-house work-related musculoskeletal disorders (WMSDs) preventive programs in a telephone directory assistance workplace. METHODS: The subjects (N=177) were divided into four groups (nonparticipants, 41; preventive exercise, 31; self-physical therapy, 40; both, 65) by program participation type. The results of WMSDs program were obtained by questionnaire, which consisted of upper extremities'(neck, shoulder, arm, hand) symptom prevalence, self-rating symptom severity, and before-after symptom change between 1995 and 1998 data and workers'satisfaction by program participation. RESULTS: The prevalence of symptoms related WMSDs was only reduced in neck region of nonparticipants, other groups not in significant. The pain scale (5-likert) of each region was significantly decreased in neck, arm and hand of nonparticipants. In other groups, there was no significant change in the prevalence of WMSDs. The change of visual analogue scale was decreased by 21.7% in self-physical therapy group (p=0.043). The subjects mostly were satisfied with this in-house programs. Above all, preventive exercise and both program groups showed content over 80%. CONCLUSIONS: The results of before-after symptoms change was not inconsistent, but subjects were showed high satisfaction about the preventive programs. In attempts to improve the WMSDs related symptoms, the best results will be achieved with ongoing in-house preventive programs practice and periodic outcomes assessments.
Arm ; Hand ; Neck ; Outcome Assessment (Health Care) ; Prevalence ; Shoulder ; Telephone* ; Surveys and Questionnaires

Retinal dysplasia is defined as an abnormal differentiation of the retina with proliferation of its elements into resettes, folds, and gliosis. The clinical presentation is usually bilateral with a variety fo systemic abnormalities. We experienced a case of unilateral retinal dysplasia without systemic abnormalities occurring in a 2-month-old girl who underwent an enucleation of her right eye because of the possibility of retinoblastoma. We reviewed the available literatures regarding this disease.
Female ; Gliosis ; Humans ; Infant ; Retina ; Retinal Dysplasia* ; Retinaldehyde* ; Retinoblastoma

Retinal dysplasia is defined as an abnormal differentiation of the retina with proliferation of its elements into resettes, folds, and gliosis. The clinical presentation is usually bilateral with a variety fo systemic abnormalities. We experienced a case of unilateral retinal dysplasia without systemic abnormalities occurring in a 2-month-old girl who underwent an enucleation of her right eye because of the possibility of retinoblastoma. We reviewed the available literatures regarding this disease.
Female ; Gliosis ; Humans ; Infant ; Retina ; Retinal Dysplasia* ; Retinaldehyde* ; Retinoblastoma

Myasthenia gravis (MG) is an autoimmune-mediated disease characterized by weakness and fatigability due to dysfunction of the neuromuscular junction from antibodies directed against the acetylcholine receptor (AchR). The main considerations for the anesthesiologist are the underlying muscle weakness and interactions with various anesthetic drugs. This includes sensitivity to neuromuscular blocking agents and volatile agents, and the risk of postoperative respiratory failure. We report two cases of transsternal thymectomy for MG under general anesthesia with the use of a bispectral index-monitored total intravenous technique using propofol and remifentanil without muscle relaxants.
Acetylcholine ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics ; Antibodies ; Humans ; Muscle Weakness ; Muscles ; Myasthenia Gravis ; Neuromuscular Blocking Agents ; Neuromuscular Junction ; Piperidines ; Propofol ; Respiratory Insufficiency ; Thymectomy

BACKGROUND/AIMS: Among borderline resectable pancreatic cancer (BRPC), group B BRPC patients have findings that are suggestive but not diagnostic of metastasis. In this study, we attempted to validate whether group B could truly be categorized as a borderline resectable group. METHODS: We placed the BRPC patients into group A or group B. The survival outcomes were compared between the groups. RESULTS: A total of 53 patients with pancreatic adenocarcinoma was classified as either group A or B borderline resectable. In group A, 23 (60.5%) of 38 patients underwent pancreatectomy after concurrent chemoradiotherapy or chemotherapy, but in group B, only five (33.3%) of 15 patients underwent pancreatectomy, mainly because of the progression of suspected distant metastasis. There was a significant difference in overall survival (OS) between group A and B patients (median OS, 21.2 months vs 10.2 months, respectively; p=0.007). Of the patients who underwent pancreatectomy, group B had a higher recurrence rate compared to group A (recurrence rate: 11 of 23 patients [47.8%] vs five of five patients [100%], respectively; p=0.033). CONCLUSIONS: This report is the first to validate the definition of BPRC. Group B had much worse outcomes, and whether group B BRPC can be categorized as BRPC together with group A is questionable.
Adenocarcinoma/classification/mortality/pathology/surgery ; Adult ; Aged ; Aged, 80 and over ; Chemoradiotherapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Pancreatectomy ; Pancreatic Neoplasms/*classification/mortality/pathology/*surgery ; Retrospective Studies ; Treatment Outcome

PURPOSE: It has been stressed that age itself as well as multiple organ failure are important prognostic factors in acute renal failure (ARF) in children. This study was performed to find out the significance of age factor and underlying disease of ARF in children. METHODS: We tried to review 58 pediatric ARF cases, retrospectively, in the pediatric intensive care unit (excluding the neonatal and surgical intensive care unit cases) of the Samsung Seoul Hospital of Sung Kyun Kwan University from Sept., 1994. to Dec., 1996. RESULTS: We classified the enrolled 58 cases into 5 age groups and more than half were younger than 1 year old. As underlying causes, heart and gastrointestinal disease were predominant in less than 1 month of age group. After 1 year of age, intrinsic renal disease was the most common cause (43-50%). Among the renal disease, systemic lupus erythematosus (10-15 year group), hemolytic uremic syndrome (1-10 year group), and obstructive uropathy (less than 1 year age group) were common etiologies. The mortality was the highest (46.7%) in less than 1 year group and lowest (21.4%) in 10-15 year age group. CONCLUSION: The underlying disorders of ARF in children were different among the age group. Among intrinsic renal diseases, hemolytic uremic syndrome was the most common cause. The difference in the mortality was dependent on age and underlying disease.
Acute Kidney Injury* ; Age Factors ; Child* ; Gastrointestinal Diseases ; Heart ; Hemolytic-Uremic Syndrome ; Humans ; Critical Care ; Intensive Care Units ; Lupus Erythematosus, Systemic ; Mortality ; Multiple Organ Failure ; Retrospective Studies ; Seoul

PURPOSE: Pancreatic neuroendocrine tumors (PNET) are a rare subgroup of tumors. For PNETs, the predictive factors for survival and prognosis are not well known. The purpose of our study was to evaluate the predictive factors for survival and disease progression in PNETs. MATERIALS AND METHODS: We retrospectively analyzed 37 patients who were diagnosed with PNET at Severance Hospital between November 2005 and March 2010. Prognostic factors for survival and disease progression were evaluated using the Kaplan-Meier method. RESULTS: The mean age of the patients was 50.0+/-15.0 years. Eight cases (21.6%) were described as functioning tumors and 29 cases (78.4%) as non-functioning tumors. In univariate analysis of clinical factors, patients with liver metastasis (p=0.002), without resection of primary tumors (p=0.002), or American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) stage III/IV (p=0.002) were more likely to demonstrate shorter overall survival (OS). Patients with bile duct or pancreatic duct invasion (p=0.031), sized-lesions larger than 20 mm (p=0.036), liver metastasis (p=0.020), distant metastasis (p=0.005), lymph node metastasis (p=0.009) or without resection of primary tumors (p=0.020) were more likely to demonstrate shorter progression-free survival (PFS). In multivariate analysis of clinical factors, bile duct or pancreatic duct invasion [p=0.010, hazard ratio (HR)=95.046] and tumor location (non-head of pancreas) (p=0.036, HR=7.381) were confirmed as independent factors for predicting shorter PFS. CONCLUSION: Patients with liver metastasis or without resection of primary tumors were more likely to demonstrate shorter OS. Patients with bile duct or pancreatic duct invasion or tumors located at body or tail of pancreas were more likely to demonstrate shorter PFS.
Bile Ducts ; Disease Progression ; Disease-Free Survival ; Humans ; Joints ; Liver ; Lymph Nodes ; Methods ; Multivariate Analysis ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors* ; Pancreas ; Pancreatic Ducts ; Prognosis ; Retrospective Studies ; Tail

A study was conducted to assess the association between musculoskeletal subjective symptoms and the MMPI(Minnesota Multiphasic Personality Inventory) profile. The study subjects were 539 female operators of telecommunication company in Seoul, and were interviewed with subjective symptom questionnaire and MMPI. Results were as follows 1. 77.5% of the study subjects complained subjective symptoms on the shoulder, 73.8% on the neck, 71.8% on the lower back, 67.5% on the arm, 67.2% on the hand, 39.8% on the elbow, respectively. According to NIOSH symptom criteria, 63% complained on the shoulder, 57.4%, 54.6% on the lower back, 53.2% on the hand, 45.9% on the arm, 29.8% on the elbow, respectively. 2. Among the MMPI clinical scales, Hs(Hypochondriasis), Hy(Hystria) and Dep (Depression) scales showed significant differences according to the numbers of subjective symptom(NIOSH criteria), VAS(Visual Analogue Scale), and the experience of sick leave (each by ANOVA, p<0.05). 3. The association between the numbers of subjective symptom site for NIOSH symptom criteria, the personal history of sick leave and the MMPI profile that has more than 70 points in anything of Hs, Dep and Hy scales was showed significantly (each by x(2)-test, p<0.05).
Arm ; Elbow ; Female* ; Hand ; Humans ; MMPI* ; National Institute for Occupational Safety and Health (U.S.) ; Neck ; Questionnaires ; Seoul ; Shoulder ; Sick Leave ; Telecommunications ; Weights and Measures