PURPOSE: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(IPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. MATERIALS AND METHODS: We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40--85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. RESULTS: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower Iobe;10/19, left lower Iobe;5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). CONCLUSION: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the [ocatiaon where the most advanced fibrosis occur.
Carcinoma, Squamous Cell ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Retrospective Studies

PURPOSE: To assess the usefulness and reliability of the IOL power calculation computer program ('POWER!'). METHODS: Calculation times and projected postoperative refractive values of 100 patients with 'POWER!' program were compared with those of the program mounted on the Humphrey R A/B scan system (model 820) by SRK-II and SRK/T formula. RESULTS: There was no significant difference between the projected postoperative refractive values of 'POWER!' program and Humphrey R A/B scan system (paired-t test, p>0.05). Calculation time of 'POWER!' was shorter than that of the program mounted on the Humphrey R A/B scan system incalculating more than 3 sets of IOL (paired-t test, P<0.05) and there was no internal calculation error (ztest, p>0.05). CONCLUSIONS: 'POWER!' is a useful and reliable program for IOL power calculation using SRK-II and SRK/T formula.
Humans

PURPOSE: The effect of superior clear corneal incision and transverse astigmatic keratotomy on the with-the-rule astigmatism in sutureless, small incision cataract surgery was evaluated. METHODS: The postoperative keratometric changes were evaluated in 18 eyes with more than 1.4 diopter (D) of preoperative with-the-rule astigmatism, having sutureless, superior clear corneal incision phacoemulsification. Five eyes over 2.8 D with-the-rule astigmatism also had transverse corneal relaxing incision. Keratometric readings were done within 1 month preoperatively, 1 day and 2 months postoperatively and the changes were statistically analyzed. Simple subtraction method and Cravy method were used for the analysis of astigmatic changes. RESULTS: The mean astigmatism showed decreasing trend, 2.08, 2.25, 1.12 D, within preoperative 1 month, at postoperative 1 day and 2 months respectively and 3.70, 2.48, 2.06 D respectively when transverse keratotomy was added. The reduction of astigmatism was statistically significant at postoperative 2 months (P<0.05; Wilcoxon rank-sum test) and it was more significant with transverse astigmatic keratotomy (P<0.05, Mann-Whitney U test). CONCLUSIONS: The with-the-rule astigmatism over 1.40 D could be reduced in cataract surgery by sutureless, superior clear corneal incision and transverse corneal relaxing keratotomy.
Astigmatism* ; Cataract* ; Phacoemulsification ; Reading

Posterior lumbar apophyseal fracture characterized by osteochondral fragments from posterior rim of a lumbar vertebral body, has often been misdiagnosed as herniated disc or spinal stenosis due to its similarity of symptoms. But recent use of CT scan facilitated the diagnosis of the lesion as a separate entity. This study was performed to verify the clinical characteristics, to find out the mechanism of injury and to determine the most effective method of diagnosis and treatment. Authors reviewed 17 patients(14 male, 3 female) who were subjected to surgical treatment at Department of Orthopaedic Surgery, Seoul National University Hospital for posterior lumbar spophyseal fracture during the period of 1990-1992, and followed up for average of 1 year and 6 months(range 1 to 3 years). Thirteen patients (76%) were related to a history of trauma or strenuous physical activity prior to the onset of symptoms. The mechanism of injury was the rapid flexion with axial compression in 7, hyperextension in 4, and pure axial compression in 2 patients. The mean age at the time of injury was 20 years(range 10 to 31 years). All patients presented low-back pain radiating to lower extremities and 11 patients showed neurogenic intermittent claudication. The mean age at the time of surgical intervention was 23 years and 10 months(range 15 to 31 years), and the mean duration of symptoms was 3 years(range 2 months to 13 years). Simple X-ray revealed the lesion in only 3 cases but CT scan demonstrated the characteristic osteochondral fragment displaced posteriorly into the spinal canal and the corresponding defect with degenerative changes in all patients. The fracture occured through the superior apophyseal rim of L5 in 9 superior rim of L4 in 3, inferior rim of L4 in 2, inferior rim of L5 in, superior rim of L2 in 1, and superior rim of L1 in 2 patients. Two patients had concomitant fractures at two levels. All patients except one were treated with posterior decompression including the removal of the displaced fragment and posterolateral fusion with pedicular screws was carried out to prevent further degenerative change and instablilty. One patient with the lesion at the superior rim of L1 was treated by anterior decompression and fusion. All patients showed relief of pain and claudication with satisfactory results. One patient had partial tear of L4 root with slight weakness of greater toe dorsiflexion, but it recovered in 4 months. In conclusion, posterior lumbar spophyseal fracture predominantly affected young males and the most common causative mechanism was rapid flexion with axial compression. The CT scan facilitated identification of the lesion. The most frequently affected site was the superior rim of L5. Satisfactory results could be achieved bvy adequate posteriior decompression with the removal of the fragment and posterolateral fusion with pedicular screws.
Decompression ; Diagnosis ; Humans ; Intermittent Claudication ; Intervertebral Disc Displacement ; Lower Extremity ; Male ; Methods ; Motor Activity ; Seoul ; Spinal Canal ; Spinal Stenosis ; Tears ; Toes ; Tomography, X-Ray Computed

The utility of computerized tomogaphy in the study of the anatomy, and pathology of the musculoskeletal system has been the subject of considerable interest since the introduction of CT scanning. It provides an accurate and detailed cross-sectional image of normal anatomical structures and shows the relation of masses to these structures. In order to assess the utility of computed tomography, we analyzed the 92 clinical cases. We divided our experience into three major categories: spinal lesios, pelvic (including hip) lesions, and lesions of extremities. The advent of a new prototype scanning device has made it possible to exam a variety of abonormalities in the orthopedic diseases in a manner not previously possible.
Extremities ; Musculoskeletal System ; Orthopedics ; Pathology ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to evaluate the CT findings of renal parenchyma infiltrated by pelvocalyceal transitional cell carcinoma. MATERIALS AND METHODS: This study included 28 patients in whom transitional cell carcinoma was dignosed after nephrectomy. CT findings were analyzed for the presence or absence of renal parenchymal infiltration; diagnostic criteria for this included parenchymal inhomogeneous low attenuation, ill-defined margin between the mass and renal parenchyma, or focal calyceal dilatation. To detect renal parenchymal infiltration by transitional cell carcinoma, we evaluated the frequency, sensitivity and specificity of each CT finding. RESULTS: Pathologic reports showed that renal parenchymal infiltration had occurred in 17 of 28 patients, (60.7%) ; on CT scans, renal parenchymal infiltration was seen in 15 of these 28 (53.6%). It two patients who did not show CT findings of renal parenchymal infiltration, pathologic examination revealed parenchymal invasion. All 15 patients who showed renal infiltration on CT had parenchymal inhomogeneous low attenuation (sensitivity: 88.2%, specificity : 100%), 13 showed ill-defined margin of the mass (sensitivity : 76.5%, specificity : 100%), and six showed focal dilatation of the calyx (sensitivity : 35.3%, specificity : 100%). CONCLUSION: In patients with pelvocalyceal transitional cell carcinoma, CT findings of parenchymal inhomogeneous low attenuation, ill-defined margin of mass, and focal calyceal dilatation suggest renal parenchymal infiltration, and these findings may be helpful in preoperative prognosis.
Carcinoma, Transitional Cell* ; Dilatation ; Humans ; Nephrectomy ; Prognosis ; Sensitivity and Specificity ; Tomography, X-Ray Computed

BACKGROUND: Traditional visual reading of patch-test reactions is a rather subjective method, lacking the sensitivity and reproducibility needed in experimental studies. Recently the laser Doppler perfusion imaging (LDPI) has been used to measure objectively the increase in superficial blood flow which results in the appearance of erythema. OBJECTIVE: We designed this study to examine the relationship between the LDPI measurement and visual reading after patch test to several different irritants. METHODS: In this study, reading of erythema in experimentally-induced irritant contact dermatitis was performed visually and by laser Doppler perfusion imaging (LDPI). In addition, we investigated whether the LDPI measurement was appropriate in the routine patch test clinic. RESULTS: A close correlation was shown between the 2 methods (r=0.9046, p<0.001) and the LDPI producing mean adjusted perfusion values (APVs) was able to discriminate between the different visual grades. CONCLUSION: LDPI is a valuable instrument to objectively assess intensity of irritant patch-test reaction, and is indeed one of the few methods which overcomes the inter-individual variations in visual reading, but this instrument is not appropriate to use routinely in patch test clinic because of unacceptably long measurement time.
Dermatitis, Contact ; Erythema ; Irritants ; Methods ; Patch Tests ; Perfusion Imaging* ; Perfusion*

Patients with lumbar spinal stenosis may exhibit symptoms such as back pain, radiating pain, and neurogenic claudication. Although long-term outcome of treatments manifests similar results for both nonsurgical and surgical treatments, positive effects such as short-term improvement in symptoms and decreased fall risk may be expected with surgery. Surgical treatment is basically decompression, and a combination of treatments can be added depending on the degree of decompression and the accompanying instability. Recently, minimally invasive surgery has been found to result in excellent outcomes in the treatment of lumbar spinal stenosis. Therefore, better treatment effects can be anticipated with an approach aimed at understanding the overall pathophysiology and treatment methods of lumbar spinal stenosis.

Growth factor is a polypeptide regulating cell proliferation, maturation, activity, and apoptosis. Despite its small molecular weight, it exerts diverse and potent biologic effects on cellular function. With recent development of molecular biology and vector technology, it is now possible to administer recombinant growth factors in clinical dose and modify somatic cell with growth factor encoding gene. Research fields in spinal surgery can be divided into spinal fusion, disc regeneration and spinal cord regeneration. In this review, we discuss the action mechanism of growth factors and their possible clinical applications especially in the field of spinal fusion and disc regeneration.
Apoptosis ; Cell Proliferation ; Fibrinogen ; Intercellular Signaling Peptides and Proteins* ; Intervertebral Disc Degeneration ; Molecular Biology ; Molecular Weight ; Regeneration ; Spinal Cord Regeneration ; Spinal Fusion

PURPOSE: To determine the risk factors and incidence of cataract formation over a long-term mean follow-up of 7.5 years after type V4 implantable collamer lens (ICL) implantation. METHODS: We analyzed the preoperative, 3-month postoperative, 3-year postoperative, and last follow-up data of 228 eyes (118 patients) with mean preoperative spherical equivalent of -12.7 D and minimum postoperative follow-up of 3 years. Additionally, we determined the risk factors for cataract formation and calculated the 10.3 year cumulative cataract formation rate and 10.3 year cumulative cataract surgery rate using a survival curve. RESULTS: After type V4 ICL implantation with minimum follow-up of 3 years, the calculated 10.3 year cumulative cataract formation rate was 20% and actual cataracts developed in 34 eyes (14.9%). The 10.3 year cumulative cataract surgery rate was 12% based on a survival curve and actual cataract surgery was performed in 12 eyes (5.3%). The risk factors for cataract formation were age (odds ratio [OR] = 1.10, p = 0.00), preoperative spherical equivalent (OR = 0.90, p = 0.00), crystalline lens thickness (OR = 9.54, p = 0.00), axial length (OR = 1.33, p = 0.00), 3 months postoperative vault (OR = 0.50, p = 0.03), and existence of peripheral touch between ICL optic margin and crystalline lens at last follow-up (OR = 7.84, p = 0.00). CONCLUSIONS: We suggest one of the main risk factors for cataract formation after ICL implantation is decreased central vault and peripheral touch between ICL optic margin and crystalline lens.
Cataract* ; Follow-Up Studies* ; Incidence ; Lens, Crystalline ; Risk Factors*