Purpose: This study aimed to evaluate the surgical outcomes of unilateral medial rectus recession and lateral rectus resection (R&R) for patients with large-angle deviations of acute acquired concomitant esotropia (AACE) without a neurological disease. Further, we have also suggested the surgical dosage of R&R for large-angle deviations of AACE.
Methods: This was a retrospective study of patients with AACE who underwent surgery and followed up after surgery for at least 6 months between September 2016 and March 2020. Among them, patients with ocular deviations of ≥30 prism diopters (PD) who underwent unilateral R&R were included.
Results: Seventeen patients with AACE were enrolled in this study (mean age, 23.5 years; four females). The mean amount of deviation was 40.00 PD at distance and near (range, 30–55 PD). Fifteen patients (88.2%) had myopia. The mean interval between the initial visit and surgery was 7.7 months (range, 4–20 months). All included patients had resolved diplopia after the surgery. Most patients with decreased stereoacuity displayed stereoacuity recovery after surgical treatment. At the final visit (mean follow-up period, 12.8 months), the mean angle of esodeviation was 0.82 PD (range, 6–0 PD) at distance and 0.47 PD (range, 4–0 PD) near. No patient displayed over-correction or adduction limitations in the operated eye.
Conclusions The unilateral R&R procedure presented favorable surgical outcomes for patients with large-angle deviations of AACE. These results and proposed surgical dosage guidelines may be useful for surgeons in planning the surgical treatment of large-angle deviations of AACE.

Purpose: This study aimed to evaluate the surgical outcomes of unilateral medial rectus recession and lateral rectus resection (R&R) for patients with large-angle deviations of acute acquired concomitant esotropia (AACE) without a neurological disease. Further, we have also suggested the surgical dosage of R&R for large-angle deviations of AACE.
Methods: This was a retrospective study of patients with AACE who underwent surgery and followed up after surgery for at least 6 months between September 2016 and March 2020. Among them, patients with ocular deviations of ≥30 prism diopters (PD) who underwent unilateral R&R were included.
Results: Seventeen patients with AACE were enrolled in this study (mean age, 23.5 years; four females). The mean amount of deviation was 40.00 PD at distance and near (range, 30–55 PD). Fifteen patients (88.2%) had myopia. The mean interval between the initial visit and surgery was 7.7 months (range, 4–20 months). All included patients had resolved diplopia after the surgery. Most patients with decreased stereoacuity displayed stereoacuity recovery after surgical treatment. At the final visit (mean follow-up period, 12.8 months), the mean angle of esodeviation was 0.82 PD (range, 6–0 PD) at distance and 0.47 PD (range, 4–0 PD) near. No patient displayed over-correction or adduction limitations in the operated eye.
Conclusions The unilateral R&R procedure presented favorable surgical outcomes for patients with large-angle deviations of AACE. These results and proposed surgical dosage guidelines may be useful for surgeons in planning the surgical treatment of large-angle deviations of AACE.

BACKGROUND: There is a well recognized interlaboratory variation in the results using the polymerase chain reaction(PCR) to detect the IS6110 sequence. The clinical utility of a commercially developed PCR test(Amplicor) in bronchial washings for detecting pulmonary tuberculosis in smear negative patients was evaluated. The sensitivity and specificity of Amplicor was compared with that of an in-house PCR test used for detecting the IS6110 sequence of Mycobacterium tuberculosis(M.tbc) in the bronchial washing fluid. METHODS: 66 patients whose sputum smear for M.tbc were negative or who could not produce any sputum were recruited from January 1999 to July 1999. They all had a bronchoscopy performed to determine if there were signs of hemoptysis, patients who could not cough up sputum, lung lesion that exclude pulmonary tuberculosis. Pulmonary tuberculosis was diagnosed on the basis of a positive culture or a response to anti-tuberculosis therapy. RESULTS: 19 patients with tuberculosis were identified and samples from 16 patients were later confirmed by culture. Bronchial washing for Amplicor PCR revealed a sensitivity, specificity, positive and negative predictive values of 94.7%, 97.9%, 94.7%, 97.9%, respectively. Using IS6110 based PCR, the sensitivity, specificity, positive and negative predictive values were of 73.7%, 87.2%, 70%, 89.1% respectively. CONCLUSION: Bronchial washing for Amplicor PCR proved to be more useful than IS6110 based PCR in rapidly diagnosing smear negative pulmonary pulmoary tuberculosis in patients where tuberculosis was likely to be differential and rapid diagnosis was essential for optimal treatment.
Bronchoscopy ; Cough ; Diagnosis* ; Hemoptysis ; Humans ; Lung ; Mycobacterium ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*

BACKGROUND: The purpose of the study was to investigate prospectively the relation of lipoprotein(a)[Lp(a)],apoproteins and serum lipid parameters to restenosis after percutaneous transluminal coronary angioplasyt(PTCA). METHODS: One hundred and forty-five patients who received successful PTCA were enrolled and their serum levels of lipids, apoproteins and Lp(a) were measured before PTCA. After 6 months of follow-up, the patients were reevaluated for the development of restenosis by coronary angiography, treadmill test or thallium scan. RESULTS: A total 137 patients could be followed. Restenosis occurred in 71 patients(52%). Clinical parameters(e.g. age, sex, hypertension, diabetes, smoking) and angiographic parameters(e.g. lesion site, type and degree of stenosis) were not significantly different between the group without restenosis and the group with restenosis. Lipid parameters and apoproteins were not associated with restenosis. Lp(a) and Lp(a) phenotype analysis showed no significant difference between the two gruops. CONCLUSION: Serum lipid parameters, apoproteins and Lp(a) concentration are not associated with restenosis after PTCA and cannot be used as predictios of restenosis.
Angioplasty, Balloon, Coronary* ; Apoproteins ; Coronary Angiography ; Exercise Test ; Follow-Up Studies ; Humans ; Hypertension ; Lipoprotein(a)* ; Phenotype* ; Prospective Studies ; Thallium

Previously, we reported that glucose-deprived astrocytes are more vulnerable to the cytotoxicity of peroxynitrite, the reaction product of nitric oxide and superoxide anion. The augmented vulnerability of glucose-deprived astrocytes to peroxynitrite cytotoxicity was dependent on their proliferation rate. Inhibition of cell cycle progression has been shown to inhibit the apoptotic cell death occurring in cerebral ischemia-reperfusion. In the present study, we demonstrate that the increased death of glucose-deprived astrocytes by peroxynitrte was largely blocked by the cell cycle phase G2/M transition blocker etoposide. However, the cytoprotective effect of etoposide was not associated with its inhibition of cell cycle progression. Instead, etoposide effectively scavenged peroxynitrite. However, etoposide did not scavenge individual nitric oxide and superoxide anion and it did not prevent the hydrogen peroxide-induced cytotoxicity. The present results indicate that etoposide prevents the toxicity of peroxynitrite in astrocytes by directly scavenging peroxynitrite, not by inhibiting cell cycle progression.
Astrocytes ; Cell Cycle ; Cell Death ; Etoposide ; Hydrogen ; Nitric Oxide ; Peroxynitrous Acid ; Superoxides

Neuroinflammation such as reactive gliosis and microglial activations are important pathological findings of ALS. We present a first autopsy case of ALS in Korea related with neuroinflammatory change. A 67-year-old ALS patient suddenly expired due to accidental head trauma. Gross autopsy finding showed marked atrophic change in spinal cord. Pathological finding include a marked loss of motor neurons, reactive gliosis and microglial infiltrations. These findings suggest neuroinflammation may play a role in pathogenesis of ALS.
Aged ; Amyotrophic Lateral Sclerosis ; Autopsy ; Craniocerebral Trauma ; Gliosis ; Humans ; Korea ; Motor Neurons ; Spinal Cord

BACKGROUND AND PURPOSE: Recently published, evidence-based guidelines should alter the management of amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND). However, the newest recommendations for ALS/MND therapy are not reflected in actual clinical practice. We sought to evaluate the current status of the diagnosis and management of ALS in Korea. METHODS: The Korean ALS/MND research group was organized in 2010, involving more than 50 neurologists from neuromuscular centers in Korea. Participating centers collected data from April to September 2010 on the diagnosis and management of patients with ALS. Data forms from the ALS patient care database, which is a component of the ALS clinical assessment, research, and education program (http://www.outcomes-umassmed.org/ALS/), were modified and used for data collection. RESULTS: In total, 373 sporadic ALS cases from 35 centers were enrolled. The demographic features and clinical findings were similar to those in previous reports from other countries. The mean age at onset was 50-60 years, and a slight male predominance was observed. The enrolled patients predominantly showed focal onset of cervical or lumbosacral symptoms. Only about one-half of the indicated patients (31.4%) received a physician's recommendation for a parenteral gastrostomy, and 18.1% underwent the procedure. Noninvasive ventilation was recommended in 23% of patients, but applied in only 9.5% of them. Tracheostomy was performed in 12.7% of patients. CONCLUSIONS: The demographic and clinical features of the diagnosis and management of ALS in Korea are similar to those reported in other countries; however, supportive management, as recommended in evidence-based guidelines, are not yet widely recommended or performed for patients with ALS in Korea.
Amyotrophic Lateral Sclerosis ; Cross-Sectional Studies ; Gastrostomy ; Humans ; Korea ; Male ; Neurons ; Noninvasive Ventilation ; Palliative Care ; Patient Care ; Tracheostomy

BACKGROUND: No prospective analyses of clinical characteristics and prognostic factors on amyotrophic lateral sclerosis (ALS) have been performed in Korea. METHODS: The prognosis of 227 sporadic ALS patient with El-Escorial-compatible criteria were evaluated using the serial Korean Amyotrophic Lateral Sclerosis Functional Rating Scale-revised (K-ALSFRS-R), and the progression rate of K-ALSFRS-R (DeltaFS=48-ALSFRS-R at the time of diagnosis). Their clinical characteristics and survival times were also analyzed. The endpoint was defined as either time to death or the tracheostomy state. The effects of individual prognostic factors on disease progression were assessed with the Kaplan-Meier life-table method and multivariate Cox proportional regression analysis. The declining ALSFRS-R curve, epidemiological data, and neuropsychological tests were evaluated. RESULTS: Among 331 motor neuron disease (MND) patients, 227 were finally diagnosed as sporadic ALS. The mean age at onset in 227 sporadic ALS patients was 50.7 years (range 19-76 years). Analysis of sequential ALSFRS-R data revealed that a mean DeltaFS of 0.73/month and a high DeltaFS score were related with early death or a tracheostomy state. Neuropsychological testing revealed nonmotor symptoms, and especially cognitive impairment, had developed in half of our patients. CONCLUSIONS: Our data suggest that DeltaFS is valuable parameter for evaluating prognosis and clinical course of ALS patients, and clinical characteristics obtained from this study would be informative data for understanding epidemiology of ALS in Korea.
Amyotrophic Lateral Sclerosis ; Disease Progression ; Humans ; Korea ; Motor Neuron Disease ; Neuropsychological Tests ; Prognosis ; Tracheostomy

OBJECTIVE: This study evaluated the cost for occupational health and safety in manufacturing factories in Korea according to the factory's size and the industrial classification. METHODS: The costs to prevent occupational injuries and promote the general health of the workers were calculated by using the data of The Occupational Safety and Health Survey in Korea in the year of 2005 and the data of the Industrial Accident Compensation Insurance (IACI) premiums at the same factories for the year of 2004. RESULTS: The mean cost per one worker was as follows: 990,000 won for the factory with 5~49 workers, 869,000 won for the factory with 50~299 workers and 1,773,000 won for the factory with more than 300 workers. In the factories with 5~49 workers and 50~299 workers, the premium for the IACI was the largest portion of the cost (62.8% and 52.8%, respectively) and the cost for gear to protect workers from dangerous machineries was the next biggest portion of the cost (20.1% and 19.1%, respectively). The largest portion of the cost in the factories with more than 300 workers was the premium for the IACI (37.5%). CONCLUSIONS: The investment costs to prevent occupational injuries and to promote the general health of the workers were very diverse according to the size of the factories and the industrial classification. To reduce the occupational injuries and to promote the general health of the workers, systematic and continuous approaches to evaluate the investment costs for the occupational health and safety are required.
Accidents, Occupational ; Compensation and Redress ; Health Surveys ; Insurance ; Investments ; Korea ; Occupational Health ; Occupational Injuries ; Occupations

OBJECTIVE: This study evaluated the cost for occupational health and safety in manufacturing factories in Korea according to the factory's size and the industrial classification. METHODS: The costs to prevent occupational injuries and promote the general health of the workers were calculated by using the data of The Occupational Safety and Health Survey in Korea in the year of 2005 and the data of the Industrial Accident Compensation Insurance (IACI) premiums at the same factories for the year of 2004. RESULTS: The mean cost per one worker was as follows: 990,000 won for the factory with 5~49 workers, 869,000 won for the factory with 50~299 workers and 1,773,000 won for the factory with more than 300 workers. In the factories with 5~49 workers and 50~299 workers, the premium for the IACI was the largest portion of the cost (62.8% and 52.8%, respectively) and the cost for gear to protect workers from dangerous machineries was the next biggest portion of the cost (20.1% and 19.1%, respectively). The largest portion of the cost in the factories with more than 300 workers was the premium for the IACI (37.5%). CONCLUSIONS: The investment costs to prevent occupational injuries and to promote the general health of the workers were very diverse according to the size of the factories and the industrial classification. To reduce the occupational injuries and to promote the general health of the workers, systematic and continuous approaches to evaluate the investment costs for the occupational health and safety are required.
Accidents, Occupational ; Compensation and Redress ; Health Surveys ; Insurance ; Investments ; Korea ; Occupational Health ; Occupational Injuries ; Occupations