The use of photocoagulation to treat proliferative diabetic retinopathy has gained widespread acceptance in ophthalmic practice since its introduction in 1959 by Meyer-Schwickerath. The purpose of photocoagulation is thought to reduce the stimulus for the vessel formation so characteristic of proliferative retinopathy. Photocoagulation may cause damage to Bruch's membrane, retinal pigment epithelium, and neurosensory retina and may result in either subretinal neovascularization or choroidal neovascularization. We found choroidal neovasaularization after performing photocogulation(one case is Argon laser the other Xenon-arch) in two diabetic retinopathy patients.
Argon ; Bruch Membrane ; Choroid* ; Choroidal Neovascularization ; Diabetic Retinopathy ; Humans ; Light Coagulation* ; Retina ; Retinal Pigment Epithelium

The search for a less traumatic method of cataract removal through a small incision, is on going. One of the advantages of phacoemulsification is that it permits the removal of a cataract through a small incision than otherwise possible. The small incision allows the refractive error to be stabilized sooner and reduces the amount of induced postoperative astigmatism. But it may be traumatic to the endothelium, especially in cases with hard nucleus. There is a method using the Nd:YAG laser to preoperatively soften the nucleus of the cataract intracapsularly and thereby simplyfing the technique of phacoemulsification. The aim of this study is to evaluate the safety of softening lens nucleus by Nd:YAG laser application for cataract operation, and we observed the change of corneal endothleium and IOP and corneal thickness according to varied intensity, and time of laser application. The authors attempted to soften the nucleus using the Q-switched Nd:YAG laser without opening the anterior capsule. The laser was focused into the center of the nucleus and 100, 150 and 200 laser shots were made with the power of 5 mJ, 7 mJ, 10 mJ and 15 mJ. The results were as follows: 1. The corneal thickness was increased to the peak 24 hours after Nd:YAG laser application in cases of 150 and 200 laser shots with 15 mJ (P<0.05). 2. Intraocular pressure was not changed in any group after Nd:YAG laser application. 3. In morphological study with scanning electron microscope, the cases of 200 laser shots with 10 mJ and 150 laser shots with 15 mJ showed moderatly decreased the number of microvilli and partial seperation of the intercellular junctions. The cases of 200 laser shots with 15 mJ showed markedly decreased the number of microvilli and partial seperation of the intercellular junctions.
Astigmatism ; Cataract ; Endothelial Cells* ; Endothelium ; Intercellular Junctions ; Intraocular Pressure* ; Microvilli ; Phacoemulsification ; Refractive Errors

The standard vision test using Snellen acuity is not always an accurate indicat or of functional vision loss. Acuity measures optical blur, but psudophakic eyes frequently do not affect optical blur. Therefore, acuity cannot provide relevant informations on the loss of vision experienced by the patients. Contrast sensitivity, not acuity, has been shown to be effective in determining functional vision loss due to psudophakic eyes. The MCT 8000(R), glare and contrast sensitivity system. was used for measurement of contrast sensitivity in 19 pseudophakic eyes at postoperative 1 month, 18 pseudophakic eyes at post-operative 3 months and 18 normal control eyes. The results were as follows: 1) Contrast sensitivity decreased in pseudophakic eyes compared to normal eyes in four different conditions; day vision, day vision with perpheral glare, night vision and night vision with central glare. 2) In pseudophakic eyes, contrast sensitivity was not different between 1 month and 3 months postoperatively.
Contrast Sensitivity* ; Glare ; Humans ; Night Vision ; Pseudophakia ; Vision Tests

In an attempt to assess the evidence of abnormal central vision before the development of either overt retinopathy or a reduction in visual acuity in patients with diabetes mellitus, hue discrimination and ccntrast sensitivity were tested in diabetic patients with background diabetic retinopathy(N=57) or no-retinopathy(N=28). The results were as follows: 1. There were statistically significant differences in the mean square root of total error score, blue-yellow and red-green partial error score between the normal controIs, the no-retinopathy group and the background diabetic retinopathy groups, respectively(P<0.001). 2. In the no-retinopathy group contrast sensitivity was decreased in high spatial frequency only in comparison with the normal controls. On the other hand, in the background diabetic retinopathy group contrast sensitivity was decreased in all spatial frequency in comparison with the normal controls and the no-retinopathy group(P<0.05). 3. The proportion of diabetic patients with statistically significant color vision and contrast sensitivity deficits in the no-retinopathy and the background diabetic retinopathy groups were 3.6% and 38.6% respectively.
Color Vision ; Contrast Sensitivity* ; Diabetes Mellitus ; Diabetic Retinopathy ; Discrimination (Psychology)* ; Hand ; Humans ; Visual Acuity

Full-thickness lamellar keratoplasty is a surgical method for corneal allografting, in which a full thickness corneal donor button without endothelium is transplanted deep into the lamellar bed of a recipient's cornea. Lamellar keratoplasty is indicated for tectonic, therapbeutic, or optical reasons. Usually the visual result with lamellar keratoplasty performed for optical purposes is less rewarding than penetrating keratoplasty. However the advantages of the lamellar graft are as follows: (1) the age limit of the donor material can be extended because the endothelium is not transplanted; (2) a lamellar graft is an extraocular procedure, and the complications in intraocular surgery can be avoided; and (3) there is no restriction as to size of the graft. We obtained good results from full-tickness deep lamellar keratoplasty on patients with granular corneal dystrophy, macular corneal dystrophy, keratoconus, and corneal scars(in cases of intact endothelium), in which penetrating keratoplasty used to be performed in the past.
Allografts ; Cornea ; Corneal Transplantation* ; Endothelium ; Humans ; Keratoconus ; Keratoplasty, Penetrating ; Macular Degeneration ; Reward ; Tissue Donors ; Transplantation, Homologous ; Transplants

A Clinical observation was made on the patients with bladder tumor admitted to the Department of Urology, Kyung Hee University Hospital during the period from January, 1973 to December,1979 Followings were the results: 1. During the period, 57 cases of bladder tumor among the 1716 total number of in-patients were hospitalized, giving a incidence rate of 3.3%. 2. Age distribution was between 4 and 85 years, the highest incidence rate was in the age group of 60-69 years. 3. Hematuria was the most common symptom occurred in 87.7%, frequency in 61.1%. dysuria in 52.6% and the others. 4. Among the 53 cases performed I.V.P., 79.3% of cases revealed normal upper tract, filling defect in the bladder was observed in 69.8% of them. 5. Associated diseases with bladder tumor were B. P. H. or B. N. C. each in 12.3% and U. T. I. in 31. 6%. 6. Pathologic examination was possible on 49 cases, transitional cell carcinoma occupied 44 cases, in 89.8% and Grade I was found most frequently. 7. 14 cases were studied by the non-invasive, simple method as computerized tomography: the effective staging procedure in invasion of bladder wall itself could be diagnosed very helpfully but distant metastasis not diagnosed very exactly, comparison with the operation stage. 8. 47 cases were treated, T. U. R. or T. U. C. were tried initially in 21 cases.
Age Distribution ; Carcinoma, Transitional Cell ; Dysuria ; Hematuria ; Humans ; Incidence ; Neoplasm Metastasis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

To assess the result of radiation therapy for fifteen years experience, a total of 81 cases of pathologically proven vocal cord cancer had been analysed according to patient survival retrospectively. All the patients had been treated with radiation therapy using Co-0 teleherapy unit in curative aim. The results are as follows ; 1. According to AJCC staging, five year survival rate was 75.0% in stage I, 73.1% in stage II, 36.0% in stage III, and 20.0% in stage IV. 2. According to T-taging, five year survival rate was 75.0% in T1, 73.1% in T2, 24.3% in T3, and 25.0% in T4. 3. According to nodal status, five year survival rate was 59.4% in negative node group and 14.2% in positive group. 4. According to the histologic grade, the better in differentiation, the more in number of cases and the better in prognosis. 5. In summary, five year actuarial survival rate was 55.5% and ten year survival rate was 49.8% and ten year survivors totalled 12 cases.
Humans ; Prognosis ; Retrospective Studies ; Survival Rate ; Survivors ; Vocal Cords*

BACKGROUND: Increased low density lipoprotein cholesterol (LDL-C) level and the presence of metabolic syndrome (MetS) are important risk factors for cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Recent studies demonstrated apolipoprotein B (apoB), a protein mainly located in LDL-C, was an independent predictor of the development of CVD especially in patients with T2DM. The aim of this study was to investigate the relationship between apoB and MetS in T2DM patients. METHODS: We analyzed 912 patients with T2DM. Fasting blood samples were taken for glycated hemoglobin, high-sensitivity C-reactive protein, total cholesterol, triglyceride (TG), high density lipoprotein cholesterol, LDL-C, and apoB. MetS was defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria. We performed a hierarchical regression analysis with apoB as the dependent variable. Age, sex, the number of components of MetS and LDL-C were entered at model 1, the use of lipid-lowering medications at model 2, and the individual components of MetS were added at model 3. RESULTS: Seventy percent of total subjects had MetS. ApoB level was higher in subjects with than those without MetS (104.5+/-53.3 mg/dL vs. 87.7+/-33.7 mg/dL, P<0.01) even after adjusting for LDL-C. ApoB and LDL-C were positively correlated to the number of MetS components. The hierarchical regression analysis showed that the increasing number of MetS components was associated with higher level of apoB at step 1 and step 2 (beta=0.120, P<0.001 and beta=0.110, P<0.001, respectively). At step 3, TG (beta=0.116, P<0.001) and systolic blood pressure (beta=0.099, P<0.05) were found to significantly contribute to apoB. CONCLUSION: In patients with T2DM, apoB is significantly related to MetS independently of LDL-C level. Of the components of MetS, TG, and systolic blood pressure appeared to be determinants of apoB.
Adult ; Apolipoproteins B ; Apolipoproteins* ; Blood Pressure ; C-Reactive Protein ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL* ; Diabetes Mellitus, Type 2 ; Education ; Fasting ; Hemoglobin A, Glycosylated ; Humans ; Risk Factors ; Triglycerides

PURPOSE: Insulinomas are a rare disease, which can be cured by surgical management if diagnosed early. However, diagnosis and localization are difficult, due to their small size and varied clinical manifestations. We analyzed the clinicopathological features, diagnosis and surgical management of insulinomas. METHODS: We retrospectively analyzed 12 insulinoma patients who had undergone pancreatic surgery, between 1988 and 2001, at the Department of Surgery, College of Medicine, The Catholic University of Korea. RESULTS: The male to female ratio of the insulinoma patients was 1: 1 with a mean age of 37.9 years, ranging from 20 to 65. The clinical manifestations were loss of consciousness, weakness, confusion and dizziness, and all the patients had findings compatible with Whipple's triad. The median duration of symptoms before surgery was 16.8 months, ranging from 1 to 48 months. Hyperinsulinemic hypoglycemia was confirmed, during prolonged fasting, when the concomitant fasting blood sugar level was 42.4mg/dl and insulin level was 25.2 microU/ml (8.1~61.8 microU/ml). The insulinoma can be localized in 11 patients (91.7%) preoperatively. For the preoperative localization, a transhepatic portal vein sample (THPVS), selective angiography and a CT scan were good diagnostic methods. Intraoperative ultrasonography was the most useful localization tool during the operation. For treating the insulinoma, an enucleation, a distal pancreatectomy, and a pylorus preserving pancreaticoduodenectomy were performed in 5, 6 and 1 patients, respectively. An enucleation case was diagnosed as nesidioblastosis after surgery, thus needing a near total pancreatectomy. One patient with a multiple endocrine neoplasia (MEN), subtype I, needed a thyroidectomy and an adrenalectomy. All cases were single, benign tumors within the pancreas. The symptoms of hypoglycemia and the laboratory values were normal in all patients after surgery. CONCLUSION: We experienced 12 insulinoma patients, where preoperative suspicions, proper utilization of diagnostic tools, and prudent intraoperative diagnostic procedures enhanced the diagnostic accuracy of the insulinoma, and led to better treatment strategies.
Insulinoma* ; Pancreas*

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is sometimes complicated with pneumonia, but little is known about the risk factors that promote the development of pneumonia in COPD. These risk factors were evaluated in the present study. METHODS: The data of 324 patients with COPD from a prospective multi-center observational cohort with obstructive lung disease were evaluated retrospectively. To identify risk factors for the development of pneumonia in COPD, the clinical and radiological data at enrollment and the time to the first episode of pneumonia were analyzed by Cox proportional hazard analysis. RESULTS: The median follow-up time was 1,099 days and 28 patients (8.6%) developed pneumonia. The Cox analysis showed that post-bronchodilator forced expiratory volume in one second (FEV1, % of predicted) and the computed tomography (CT) emphysema extent (inspiratory V950) were independent risk factors for the development of pneumonia (post-bronchodilator FEV1: hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.94-1.00; p=0.048 and inspiratory V950: HR, 1.04; 95% CI, 1.01-1.07; p=0.01). CONCLUSION: Emphysema severity measured by CT and post-bronchodilator FEV1 are important risk factors for the development of pneumonia in COPD.
Cohort Studies ; Emphysema* ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Diseases, Obstructive ; Lung* ; Pneumonia* ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive* ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed