OBJECTIVE: This study was performed to determine the smoking status and its associated factors in military life among young Korean men to provide date for smoking prevention in military areas as a part of the health promotion program for soldiers. METHODS: 1,033 infantrymen serving in 17 military units, which are located in suburbs of K city, were enrolled in this study. A questionnaire on the soldiers smoking status and other various characteristics was obtained from October 2nd to 12th, 2000. Logistic regression analysis was performed on the various variables in order to determine the factors related to smoking. RESULTS: 1) 830(80.3%) out of 1033 subjects had smoked cigarettes and 759 persons(73.4%) were regular smokers. 2) Among the 734 soldiers who started smoking before their military service, 714 soldiers(97.2%) continued to smoke after, while 45 soldiers(15.0%) among the 299 non-smokers started smoking after joining the army. 3) Through the logistic regression analysis, the education level, specialty in the army, smoking amongst the friends they met before military service, smoking amongst soldiers in the army, dating girl friends, drinking, satisfaction with their army lives and the presence of convenient smoking places at the barracks were significant factors related to the prevalence of smoking in soldiers. CONCLUSION: the factors related with incidence of smoking in the army are the complicated interactions among the individuals personal background, general charcterisitcs of the solider and the special environment in the barracks. Therefore, to improve national soldiers' health, an active non-smoking campaign and education should be pushed to discourage smoking in the barracks.
Drinking ; Education ; Female ; Friends ; Health Promotion ; Humans ; Incidence ; Logistic Models ; Male ; Military Personnel* ; Prevalence ; Smoke* ; Smoking* ; Tobacco Products

Grave's disease is an autoimmune disorder and affects thyroid gland and orbit. Ocular manifestations of this disease, referred to as Grave's ophthalmopathy are caused by deposition of antithyroglobulin immune complexes into extraocular muscles and orbital fats. Consequent increase in volume of orbital contents results in exopthalmos. Severe exopthalmos results in several significant visual consequences as follows: exposure keratitis, diplopia and optic neuropathy. Orbital decompression for Grave's ophthalmopathy has traditionally been performed through either an external or a transantral approach. The advent of intranasal endoscopes allowed for the development of a transnasal approach for medial and inferior orbital wall decompression. Recently, the authors experienced a case of Grave's ophthalmopathy complicated with exposure keratitis and performed endoscopic transnasal orbital decompression, so report this case with a review of literature.
Antigen-Antibody Complex ; Decompression* ; Diplopia ; Endoscopes ; Fats ; Keratitis ; Muscles ; Optic Nerve Diseases ; Orbit* ; Thyroid Gland

BACKGROUND AND OBJECTIVES: A number of studies have documented that the incidence of otitis media with effusion (OME) is greater than 90% in children with cleft palates. The purpose of this study was to evaluate the correlation of OME and mastoid pneumatization in children with cleft palate. SUBJECTS AND METHOD: We studied 175 ears in 95 patients. They were categorized into three groups according to otologic finding:normal children (38 ears), children with OME (89 ears), children with cleft palates (38 ears). The mastoid pnuematization was graded into 5 groups. RESULTS: The masoid pneumatization was relatively good in 76.3% of normal children. The mastoid pneumatization was poor in 40.4% of the children with OME. All children with cleft palate had OME in both ears and their mastoid pneumatizations were very poor, with 16.7% of grade IV and 83.3% of grade V. CONCLUSION: The mastoid pneumatization of children with cleft palate was very poor compared to those without cleft palate. We believe that mastoid pneumatization was influenced by the disease of middle ear and mastoid, environmental factors. Special consideration is needed to deal with otologic problems in children with cleft palate.
Child* ; Cleft Palate* ; Ear ; Ear, Middle ; Humans ; Incidence ; Mastoid ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Temporal Bone*

Objective: The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis. Materials and Methods: We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan–Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors. Results: Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02–6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths. Conclusion Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.

Purpose: This study aimed to investigate the effectiveness of preoperative patient-controlled analgesia(PCA) education program on older patients with spine surgery. Methods: A quasi-experimental research with a non-equivalent control group pretest-posttest design was conducted to investigate the impact of a PCA education program before surgery on postoperative pain, pain knowledge and attitudes, and frequency of additional analgesic use. The sample size for experimental and control group was 55 respectively. Results: The experimental group, which underwent the PCA education program, had lower postoperative pain scores compared to the control group. Furthermore, the experimental group exhibited a higher level of knowledge on PCA (p<.001) and more positive attitudes toward analgesic use (p<.001). While there was a significant difference in the use of opioid analgesics for additional pain relief between two groups (p<.001), there was no significant difference in the use of non-opioid analgesics. Conclusion The implementation of the PCA education program was found to increase knowledge and positive attitudes on the use of PCA. Moreover, it significantly alleviated pain, particularly during physical activity, within initial 48 hours after spinal surgey in older patients. Therefore, the findings of this study supported that the PCA education program could be used as a preoperative intervention to alleviate postoperative pain for older patients with spinal surgery.

Objective: To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. Materials and Methods: This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022.Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (≥ 25% of lung involvement), and typical CT pneumonia. Results: Of 2218 patients (mean age, 69.5 ± 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01– 2.47], P = 0.042; and 3.12 [95% CI, 1.47–6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54–5.67], P = 0.001; and 2.87 [95% CI, 1.50–5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49–32.66], P < 0.001; and 4.18 [95% CI, 1.70–10.25], P = 0.002, respectively). Conclusion Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.

PURPOSE: In order to evaluate the spectrum of mitochondrial DNA (mtDNA) mutations in the patients with suspected Leber's hereditary optic neuropathy (LHON). METHODS: We investigated 14 primary mtDNA mutations at nucleotide positions (nps 3460A, 4160C, 5244A, 9101C, 9804A, 10663C, 11778A, 13730A, 14459A, 14482G, 14484C, 14495G, 14498T, and 14568T) and one common secondary mutation (np15257A) in 82 Korean patients with suspected LHON. RESULTS: Among them, only three kinds of LHON mutations were identified in 60 (73%) of 82 probands, which were comprised of 46 (56%) cases with the 11778A, 13 (16%) with the 14484C, and 1 (1%) with the 3460A. None of the other mtDNA mutations was detected. Of the 60 probands with LHON positive mutations, 19 (32%) had relevant family histories. Heteroplasmy was determined in 2 (4%) of the 46 probands with the 11778A and 1 (8%) of 13 probands with the 14484C. CONCLUSIONS: In conclusion, the 11778A was the most common cause (56%), and higher prevalence of the 14484C and the lower prevalence of the 3460A were characteristic in Korean patients with LHON. Especially, the 3460A had a remarkable racial difference compared with Caucasians. Except 3460A, 11778A, and 14484C, the other mutations screened may not be involved in pathogenesis and not have a synergistic effect on the clinical expression of LHON in Koreans.
Asian Continental Ancestry Group ; DNA, Mitochondrial* ; Humans ; Molecular Biology* ; Optic Atrophy, Hereditary, Leber* ; Prevalence

BACKGROUND AND OBJECTIVES: The CO2 laser is commonly used in the oral cavity and pharyngolaryngeal lesion, since, unlike the conventional scalpel technique, it provides excellent hemostasis and visualization and thus enables the surgeon to operate in a precise manner. Additional advantages include decreased postoperative pain and less swelling. Despite this advantage, several studies have reported impaired wound healing associated with the use of CO2 laser. Fibronectin is a high molecular weight glycoprotein and serves as a substrate for adhesion and migration of cells which repair cell defects together with fibrin. Fibronectin is involved in the generation of reticulin matrix together with the type III collagen. MATERIALS AND METHODS: The histological changes and the expression of fibronectin activities following incision of tongue mucosa by the CO2 laser and the conventional scalpel technique were compared over a period of 7 days in a rat model. RESULTS: A delay was noted in the healing of the CO2 laser wound. Both CO2 laser and scalpel wound expressed fibronectin, soon after wounding. The expression of fibronectin activities in the CO2 laser rose to the maximal level more slowly than the scalpel wound and its degree was weaker. CONCLUSION: Delayed expression in fibronectin may play a role in the delay of the CO2 laser wound healing.
Animals ; Collagen Type III ; Fibrin ; Fibronectins* ; Glycoproteins ; Hemostasis ; Lasers, Gas* ; Models, Animal ; Molecular Weight ; Mouth ; Mucous Membrane ; Pain, Postoperative ; Rats* ; Reticulin ; Tongue* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND AND OBJECTIVES: The tympanosclerosis is an abnormal deposits of collagen materials on the lamina propria of the tympanic membrane or the middle ear mucosa. It usually appears as a whitish plaque on the tympanic membrane through otoscopic examination. The etiology of tympanosclerosis is not known, but there are some theories that attempt to explain the pathogenesis. The aim of this study is to understand the pathogenesis of tympanosclerosis and to find out the methods to minimize the occurrence of tympanosclerosis after ventilation tube insertion. MATERIALS AND METHODS: Otoscopic examination, impedance and pure tone audiometry were performed on 190 patients (306 ears) with serous otitis media, and on those who have undertaken ventilaton tube insertion from 1990 to 1998 at the otolaryngology department in Hanyang University Hospital. Then, the patients' medical and operative records were reviewed and analyzed in view of location and pathogenesis of tympanosclerosis. RESULTS: Incidence rate of tympanosclerosis was 42.5% in non-cleft patients and 61.9% in congenital cleft and palate patients. The rate increased when larger and heavier tube was used and the middle ear fluid was highly viscous. Most common sites for the development of tympanosclerosis were in the posteroinferior and anteroinferior portions of the tympanic membrane. Tympanosclerosis had little effect on hearing but in severe cases, it caused mild degree of hearing loss. CONCLUSION: We consider that tympanosclerosis is an inevitable result of ventilation tube insertion and its pathogenesis is multifactorial. We found that we can minimize the occurrence of tympanosclerosis by using small and light ventilation tubes, and avoid intraoperative bleeding and minimal mechanical trauma on the tympanic membrane by aspiring the middle ear fluid.
Audiometry ; Collagen ; Ear, Middle ; Electric Impedance ; Hearing ; Hearing Loss ; Hemorrhage ; Humans ; Incidence ; Mucous Membrane ; Myringosclerosis* ; Otitis Media with Effusion ; Otolaryngology ; Palate ; Tympanic Membrane ; Ventilation*

Teratomas are embryonal neoplasms that show characteristics from all three germ layers(ectoderm, endoderm, and mesoderm). These tumors are frequently present in infancy and childhood. Teratomas are classified into three groups : mature teratoma, immature teratoma, and teratomas with malignant elements. The histopathologic findings of immature teratoma is primitive neuroepithelial cells compounding pseudostratified tubular formations. The pure immature teratoma accounts for fewer than 1% of all germ cell malignancies. The immature teratomas in nasal cavity are very rare tumor. These tumors are often presented as neonatal respiratory distress, nasal obstruction and epistaxis. We report a case of histologically confirmed immature teratoma in nasal cavity in 48 years old man with review of the literature.
Endoderm ; Epistaxis ; Germ Cells ; Humans ; Middle Aged ; Nasal Cavity* ; Nasal Obstruction ; Neoplasms, Germ Cell and Embryonal ; Neuroepithelial Cells ; Teratoma*