The study was performed retrospectively to compare the results of anterior chamber IOL(Intraocular Lens) implantation and posterior chamber IOL implantation by scleral fixation in cases of inadequate zonular or capsular support during the extracapsular cataract extraction. A total of 27 cases were reviewed of which 11 cases had anterior chamber IOL implantation and 16 cases had posterior chamber IOL implantation by scleral fixation. The follow-up period ranged from two to twenty-four months. Nine of eleven in anterior chamber IOL group and thirteen of sixteen in posterior chamber IOL group had the final corrected vision of 0.5 or better. Vision-threatening complications included two cases of cystoid macular edema in anterior chamber IOL group, whose visual acuity was 0.1 and 0.5, and three cases of vitreous hemorrhage in posterior chamber IOL group, which had little effect on visual outcome The final visual acuity didn't show statistically significant difference between the two groups.
Anterior Chamber* ; Cataract Extraction ; Follow-Up Studies ; Lenses, Intraocular* ; Macular Edema ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage

No abstract available.
External Fixators* ; Foot Deformities* ; Foot*

For young children with scoliosis before growth spurt, suhcutaneous lengthening without fusion was designed by Harrington and modified by Moe and Luque. However, many problems including spontaneous fusion, rod breakage, and hook disloclgement have been ohserved. CotrelDubousset(CD) instrumentation was sometimes used, but it usually resulted in failure due to soft tissue adhesion around the rough surface of ordinary CD rod. We tried to use the smooth CD rod, transvcrse-pedicle clawing on the upper part, and pedicle screw inscrtion on upper and lower part of the curve to reduce the hardware failures. Among 8 patients in whom suhcutaneous lengthening with smooth CD rod was carried out hetween October l992 and Suly 1996. 4 cases perfomed with final spinal fusion were analysed. There were I central core disease, 1 multicore disease and 2 idiopathic scoliosis(infantile and juvenile type). Mean age at the first operation was l0.0(8.8-11.8) years, and the Risser sign was all grade 0 except one with grade 1. Suhcutaneous lengthening was performed every 5 or 6 months Mean lengthening duration was 22(9-39) months and mean age at spinal fusion was 11.7(9.6-13.8) years. Mean Cobb angle decreased from 7ldegrees (55degrees-88degrees) at preoperative stage to 32 (10degrees-59degrees) at the last follow-up. There were 5 complications during 21 operations, and three hardware failures comprised 2 hook dislodgcment and 1 screw pull-out. Crankshaft phenomenon happened in I case who had had a posterior fusion in young age(9.6 years) due to laminar fracture. The suhcutaneous lengthening with smooth CD rod can he another option of treatment for young children with severe scoliosis. prescrving the powth potential of involved vertebrae with few complications.
Animals ; Child* ; Follow-Up Studies ; Hoof and Claw ; Humans ; Myopathy, Central Core ; Scoliosis* ; Spinal Fusion ; Spine ; Tissue Adhesions

PURPOSE: Clostridium difficile (C. difficile)-associated colitis, a known complication of colon and rectal surgery, can increase perioperative morbidity and mortality, leading to increased hospital stay and costs. Several contributing factors, including advanced age, mechanical bowel preparation, and antibiotics, have been implicated in this condition. The purpose of this study was to determine the clinical features of and factors responsible for C. difficile-associated colitis after colorectal cancer surgery. METHODS: The medical records of patients who had undergone elective resection for colorectal cancer from January 2008 to April 2010 were reviewed. Cases that involved procedures such as transanal excision, stoma creation, or emergency operation were excluded from the analysis. RESULTS: Resection with primary anastomosis was performed in 219 patients with colorectal cancer. The rate of postoperative C. difficile-associated colitis was 6.8% in the entire study population. Preoperative metallic stent insertion (P = 0.017) and aged sixty and older (> or = 60, P = 0.025) were identified as risk factors for postoperative C. difficile-associated colitis. There were no significant differences in variables such as preoperative oral non-absorbable antibiotics, site of operation, operation procedure, and duration of prophylactic antibiotics. CONCLUSION: Among the potential causative factors of postoperative C. difficile-associated colitis, preoperative metallic stent insertion and aged sixty and older were identified as risk factors on the basis of our data. Strategies to prevent C. difficile infection should be carried out in patients who have undergone preoperative insertion of a metallic stent and are aged sixty and older years.
Aged ; Anti-Bacterial Agents ; Clostridium ; Clostridium difficile ; Colitis ; Colon ; Colorectal Neoplasms ; Emergencies ; Humans ; Length of Stay ; Medical Records ; Risk Factors ; Stents

PURPOSE: This retrospective study is conducted to evaluate the local response rate, survival rate, median survival times and complication of hyperthermic treatment combined with radiotherapy/chemotherapy in locally advanced inoperable gastric cancer. MATERIALS AND METHODS: One hundred and twenty-seven patients treated with hyperthermia from April, 1992 to December, 1994 were enrolled. Among 127 patients, 13(10.2%) were treated with thermo-radiotherapy(Group I), 4(3.1%) were treated with thermo-radio-chemotherapy(Group II) and 110(86.6%) were treated with thermo-chemotherapy (Group III). Hyperfractionated radiotherapy(135 cGy/fr., 2 times/day) using 6-MV X-ray Linac was delivered with total doses of 40.5~67.5 Gy(median: 45 Gy). Chemotherapy by FI(5-FU+ Interferon) or EAP(Etoposide+ Adriamycin+ Cisplatin) regimens was administered. Hyperthermia using 8-MHz RF(radiofrequency) capacitive heating eqiupment (CANCERMIA GHT-8) was applied with interval of 2 times/week, 40~60 minutes /session within 10~15 minutes following radiation, and was simultaneously done with chemotherapy. The estimation of local response was used computed tomography and endoscopy, and was divided into complete response(CR), partial response(PR), and no response(NR). The survival rate was calculated by Kaplan-Meier method. RESULTS: Overall local response rate(CR+ PR) was 68.5% with 6.3% in CR and 62.2% in PR. The local response rates by treatment modality were 92.3% (CR: 15.4%, PR: 76.9%) in Group I, 100%(CR: 75.0%, PR: 25.0%) in Group II and 64.5%(CR: 2.7%, PR: 61.8%) in Group III. There was statistically significant difference(p=0.0001). The overall 1 and 2 years survival rates with median survival time(MST) were 20.5%, 7.1% with 9 months, respectively. The overall 1 and 2 years survival rates(with MST) by treatment modality were 7.7%, 0%(7 months) in Group I, 50.0%, 0%(9 months) in Group II and 20.9%, 8.2%(6 months) in Group III. There was no statistically significant difference. The incidence of side effect by heating was 3.1%(4 patients) and the most serious side effect was subcutaneous fat necrosis in anterior abdominal wall. CONCLUSION: From this study we concluded that hyperthermic treatment combined with radiotherapy/chemotherapy may increase the local response rate in locally advanced inoperable gastric cancer.
Abdominal Wall ; Drug Therapy ; Endoscopy ; Fever ; Heating ; Hot Temperature ; Humans ; Incidence ; Necrosis ; Retrospective Studies ; Stomach Neoplasms* ; Subcutaneous Fat ; Survival Rate

OBJECTIVES: The goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea. METHODS: The National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database. RESULTS: Of the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%). CONCLUSIONS: The reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.
Angiography ; Angioplasty ; Coronary Vessels ; Diagnosis ; Emergency Service, Hospital ; Hospitalization* ; Humans ; International Classification of Diseases ; Korea ; Myocardial Infarction* ; National Health Programs* ; Vascular Surgical Procedures

STUDY DESIGN: A biomechanical study using the porcine spine. OBJECTIVES: To investigate the efficacy of direct anterior vertebroplasty [Polymethylmetacrylic acid (PMMA) augmentation] with anterior vertebral screw fixation. SUMMARY AND LITERATURE REVIEW: We are not aware of any previous reports that described this technique. MATERIALS AND METHODS: Thirty out of 35 fresh porcine lumbar vertebral bodies (L1-5) were instrumented with single anteriorvertebral screws using different augmentation methods. In group 1 (n=10), the non-augmented group, each vertebral body was pre-drilled and an anterior vertebral screw was inserted unicortically at 90 degrees laterally. In groups 2 (n=10) and 3 (n=10), after the unicortical pre-drilling, 2 ml of PMMA were injected through an 11-gauge bone biopsy needle. The screw was inserted immediately after the cement injection in group 2, and after complete consolidation of the cement in group 3. Axial pullout loads to loosen the screws were measured. Conventional vertebroplasties via bilateral pedicles were performed in the other 5 vertebral bodies, the cement distribution areas of which were compared with the 5 specimens of groups 2 and 3, respectively, using radiomorphometry. The data were analyzed using the Mann-Whitney test. RESULTS: The mean pullout loads were 459+/-111N in group 1, 1510+/-165N in group 2, and 1241+/-189N in group 3. The PMMA augmented anterior vertebral screws (groups 2 and 3) provided more than 100% of an increase in pullout strength compared with non-augmented screws (group 1) (P < 0.001). Among the augmented screws, the screws that were inserted during the consolidation of PMMA (group 2) had a greater resistance against pullout loads than did those that were inserted after complete consolidation (group 3) (P < 0.01). The cement distribution areas after the direct anterior vertebroplasties (groups 2 and 3) was no different than that after conventional posterior vertebroplasties (P > 0.05) CONCLUSIONS: Direct anterior vertebroplasty is another effective augmentation method for anterior vertebral screw fixation. With this technique, we avoided an unnecessary posterior procedure and achieved a more rigid fixation because we could insert the screws during the consolidation of PMMA.
Biopsy ; Needles ; Polymethyl Methacrylate ; Spine ; Vertebroplasty*

PURPOSE: The purpose of this study was to investigate the effects of unilateral pedicle screw fixation on the fusion segment and the superior adjacent segment after one segment lumbar fusion using validated finite element models. MATERIALS AND METHODS: Four L3-4 fusion models were simulated according to the extent of decompression and the method of pedicle screws fixation in L3-4 lumbar fusion. These models included hemi-laminectomy with bilateral pedicle screw fixation in the L3-4 segment (BF-HL model), total laminectomy with bilateral pedicle screw fixation (BF-TL model), hemi-laminectomy with unilateral pedicle screw fixation (UF-HL model), and total laminectomy with unilateral pedicle screw fixation (UF-TL model). In each scenario, intradiscal pressures, annulus stress, and range of motion at the L2-3 and L3-4 segments were analyzed under flexion, extension, lateral bending, and torsional moments. RESULTS: Under four pure moments, the unilateral fixation leads to a reduction in increment of range of motion at the adjacent segment, but larger motions were noted at the fusion segment (L3-4) in the unilateral fixation (UF-HL and UF-TL) models when compared to bilateral fixation. The maximal von Mises stress showed similar patterns to range of motion at both superior adjacent L2-3 segments and fusion segment. CONCLUSION: The current study suggests that unilateral pedicle screw fixation seems to be unable to afford sufficient biomechanical stability in case of bilateral total laminectomy. Conversely, in the case of hemi-laminectomy, unilateral fixation could be an alternative option, which also has potential benefit to reduce the stress of the adjacent segment.
Biomechanical Phenomena ; *Computer Simulation ; Humans ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; *Models, Anatomic ; *Pedicle Screws ; *Range of Motion, Articular ; Software ; Spinal Fusion ; Stress, Mechanical

PURPOSE: The prevalence of vesicoureteral reflux (VUR) in prepuberty children with urinary tract infection (UTI) varies among the different racial groups. The purpose of this study was to determine if the incidence of VUR is associated with age, gender and the clinical indications for the prepuberty children with UTI in Daegu city and the Gyeongbuk area, and we wanted to compare our findings to those reported findings for the other racial groups. MATERIALS AND METHODS: The medical records of all 2,474 prepuberty children who underwent a voiding cystourethrogram (VCUG) or radionuclide cystogram (RNC) between 1998 and 2003 were retrospectively reviewed. Age, gender and the clinical indications were recorded for the first VCUG or RNC. For the children with UTI, the highest grade of VUR and the number of UTIs were also examined. We analyzed the data by using chi square test and calculating the odds ratio with using SAS version 8.12. RESULTS: There were 2,037 prepuberty children with UTI (82.5%) among the 2,474 total subjects. Among the participants, 718 (35.2%) were female and 1,306 (64.1%) were male, and 13 were missing data. The overall rate of VUR was 21.2% (432/2,037) with a rate of 22.6% (162/718) for the females and 20.4% (267/1,306) for the males, respectively. With respect to the age distribution, none were younger than 1, 1 was younger than 2, the 2-6 year-olds were 17.3% (257/1,485), and the 7-12 year olds were 35.9% (103/287). Referring to the frequency of UTI, the patients experiencing their first, second. third, fourth, and over five episodes were 16.8%, 34.2%, 36.7%, 42.9% and 56.1%, respectively. As the patients got older, the first VCUG was done for recurrent UTI (p<0.05). CONCLUSIONS: We investigated the rate of VUR based on the clinical indications, age and gender among Korean preadolescents. The rate of reflux was 21.2% for the patients suffering with UTI. The female had VUD 1.1 times more frequent than did the males. The older patient had a higher reflux rate, which suggested that prepuberty children over 1 year of age with recurrent UTI should undergo their first VCUG or RNC.
Age Distribution ; Child ; Daegu* ; Female ; Gyeongsangbuk-do* ; Humans ; Incidence* ; Male ; Medical Records ; Odds Ratio ; Prevalence ; Radionuclide Imaging ; Retrospective Studies ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

Idiopathic cecal ulcer is a rare disease entity of unknown cause diagnosed by ruling out other known causes of cecal ulceration. The most common complication of an idiopathic cecal ulcer is bleeding; perforation, peritonitis, abscess, and stricture formation have been noted. The authors treated a 53-year-old woman who presented with fever and intermittent right upper quadrant abdominal pain. Multiple pyogenic liver abscess and a solitary cecal ulcer were diagnosed by radiologic, endoscopic, and pathologic examination, followed by laparoscopic cecectomy. After extensive study, we concluded that this patient's liver abscesses were a complication of the idiopathic cecal ulcer. Herein, we report a case of multiple pyogenic liver abscess caused by microperforation of idiopathic cecal ulcer.
Cecal Diseases/complications/*diagnosis/surgery ; Colonoscopy ; Female ; Humans ; Laparoscopy ; Liver/pathology ; Liver Abscess, Pyogenic/*diagnosis/etiology ; Middle Aged ; Tomography, X-Ray Computed ; Ulcer/complications/*diagnosis/surgery