The purpose of our study is to evaluate the visual, refractive and IOP results following combined small incision phacoemulsification, foldable lens implantation, and fornix based trabeculectomy with Mitomycin-C. Seventy-six eyes of 64 patients with cataract and glaucoma had undergone the combined procedure. Minimal follow-up period was 6 months(mean 12.8+/-4.8 months). All the eyes that were free of preexisting macular disease and endstage glaucomatous optic nerve damage demonstated significant improvement in visual acuity. Postoperative astigmatisn was negligible(-0.41diopters). The average IOP reduction was 7.7mmHg. Functioning filtrating bleb persisted in 76.3% of the eyes. Complications with this method were not significant compared with other studies reporting the combined procedure. The small incison phacotrabeculectomy with mitomycin-C technique that we describe appears to be effective in early restoration of visual acuity and reduction of IOP without significant complications.
Blister ; Cataract ; Follow-Up Studies ; Glaucoma ; Humans ; Mitomycin* ; Optic Nerve ; Phacoemulsification* ; Trabeculectomy* ; Visual Acuity

In order to study the clinical characteristics of primary acute angle closure glaucoma, we analyzed the data of 72 eyes from 63 patients with the disease from January 1, 1990 to December 31, 1993 to the Department of Ophthalmology of Chonnam University Hospital. The mean age of the patients was 63.3 years and female and male ratio was 5.9:1. And the mean IOP at first visit was 53.2 mmHg. There was no significant difference of rop between right and left eyes, and 11 patients had the disease in both eyes. 38% of the patients developed the disease in winter time. The development of the disease was closely associated with physical illness and emotional stress. 39 eyes(49.3%) of them was required filtering surgery because medication and laser treatment was insufficient to lower IOP.
Female ; Filtering Surgery ; Glaucoma, Angle-Closure* ; Humans ; Jeollanam-do ; Male ; Ophthalmology ; Stress, Psychological ; Trabeculectomy

No abstract available.
Autonomic Pathways* ; Rectal Neoplasms* ; Urodynamics*

No abstract available.
Congenital Abnormalities* ; Humerus* ; Osteotomy*

To assess the clinico-pathological characteristics of patients with multiple primary colorectal cancer, 458 patients who underwent curative surgery and being followed-up at our institution between Jan. 1987 and Dec. 1993 were evaluated in this study. The median follow-up period was 42 months. Synchronous cancer was defined as distinct lesions separated by a distance of greater than 4cm with the invasion of the tumor below the muscularis mucosa at the time of diagnosis or within 6 months after initial treatment, and metachronous cancer was defined as the development of colon cancers more than 6 months after the initial treatment without evidence of the recurrence or metastases from primary tumor. There were 29 cases of multiple primary colorectal cancer(6.3%). Eighteen cases(3.9%) of them were synchronous, 11 cases(2.4%) were metachronous cancers. Seven cases(1.5%) were related to 5 hereditary non-polyposis colorectal cancer(HNPCC) families. During the follow-up period, 11 patients(2.4%) developed cancers in other organs. Adenomatous polyps were identified 14 cases of 29 patients with multiple primary colorectal cancers(48.3%), compared to 43 cases(10%) in 429 patients with solitary colorectal cancer(p<0.01). After initial curative surgery, there were 8 recurrences in 29 patients with multiple primary colorectal cancers(23.6%), compared to 100 recurrences in 429 patients with solitary primary colorectal cancer(23.3%)(p>0.05). In aspect of family history, there was close-relationship with this regarding in the group of multiple primary colorectal cancers. However, authors were unable to make analysis this regarding in the group of solitary primaries because of lack of the information. Conclusively, authors guess the frequent association of the adenomatous polyps in multiple primary colorectal cancers as the evidence of the adenoma-carcinoma sequence. In addition, authors emphasized the importance of the total colonoscopic examinations in pre-and post-operation in order to make diagnosis of the multiple primary colorectal cancers and paying attention as to the family history of colorectal cancer patients because we have good therapeutic results after operation of early stage in synchronous cancers and co-existent adenomatous polyps.
Adenomatous Polyps ; Colonic Neoplasms ; Colorectal Neoplasms* ; Diagnosis ; Follow-Up Studies ; Humans ; Mucous Membrane ; Neoplasm Metastasis ; Recurrence

BACKGROUND: Thyroid nodules are among the most common endocrine diseases requiring surgical treatment. To determine the appropriate treatment methods for thyroid nodules, we conducted this study by analyzed the clinical characteristics of thyroid nodules, the surgical procedure, and postoperative complications. METHODS: We experienced 39 cases of thyroid nodules below 1 cm in size and treated them by surgical intervention at the Department of Surgery, Masan St. Mary's Hospital, from April 1994 to June 1996. We examined the age and the sex distributions, the clinical manifestations, the locations of the thyroid nodules, the pathologic findings, the ultrasonographic findings, the aspiration biopsy cytology findings, the surgical procedures, and the postoperative complications. RESULTS: 1) The mean age of the patients was 45 years, and the sex ratio of males to females was 1:18.5. 2) The nodules were located in the right lobe (24 cases), the left lobe (10 cases), both lobes (3 cases), isthmus (2 cases). 3) When 39 cases were examined by ultrasonography, the malignant nodules were found in 1 of 14 cases of anechoic nodules and 10 of 25 cases of isoechoic nodules. 4) Aspiration biopsy cytology was performed in 21 cases, and the false negativity was 25%, the false positivity was 25%, and the accuracy rate was 75%. 5) The histopathologic classification of the benign nodules were follicular adenomas, 13 cases; adenomatous goiters, 12 cases; Hashimoto's thyroiditis, 1 case; Hurthle cell adenoma, 1 case; and simple cyst, 1 case. The malignant diseases were papillary carcinoma, 10 cases; and follicular carcinoma, 1 case. 6) Most cases of benign nodules were treated with a lobectomy (72.4%). Malignant nodules were treated with an extended lobectomy and anterior compartment node dissection. 7) The major postoperative complication was transient hypocalcemia. CONCLUSIONS: When voice change or hoarseness is observed and a thyroid nodule is suspected on ultrasonography, aspiration biopsy cytology is considered to be required to exactly distinguish benign nodules from malignant nodules. Further, in case of malignant nodules, it can be concluded that a more active and careful operation may be required to minimize the complications, to decrease the recurrence rate, and to increase the survival rate.
Adenoma ; Biopsy, Needle ; Carcinoma, Papillary ; Classification ; Endocrine System Diseases ; Female ; Goiter ; Hoarseness ; Humans ; Hypocalcemia ; Male ; Postoperative Complications ; Recurrence ; Sex Distribution ; Sex Ratio ; Survival Rate ; Thyroid Gland* ; Thyroid Nodule* ; Thyroiditis ; Ultrasonography ; Voice

Brunner's gland hamartomas are rare, benign duodenal tumors. But, they are the commonest hamartomas in the small intestine and believed to represent hyperplasia of Brunner's glands, perhaps in response to excessive gastric acid secretion. Brunner's gland hamartomas are usually smaller than 1cm and asymptomatic, incidental finding during endoscopy or radiographic examination. We report a case of large Brunner's gland hamartoma which prolapsed into gastric antrum and caused gastric outlet obstruction, and was resected by endoscopic polypectomy.
Brunner Glands ; Endoscopy ; Gastric Acid ; Gastric Outlet Obstruction* ; Hamartoma* ; Hyperplasia ; Incidental Findings ; Intestine, Small ; Pyloric Antrum

No abstract available.

Hereditary nonpolyposis colorectal cancer(HNPCC) is an autosomal dominantly inherited disease associated with a marked increase in cancer susceptibility, especially cancer of the colorectum. The frequency of HNPCC in the general population is yet to be determined, but HNPCC may account for as much as 2% to 5% of colorectal cancer, Colorectal cancer in HNPCC differs from sporadic colorectal cancer by an early age of cancer onset, proximal predominance of colorectal cancer, an excess of synchronous and metachronous colorectal cancer, and excess extra-colonic cancers. We have found 5 HNPCC families since 1992 when we reported first HNPCC family (KHU-Hl) In order to register the patients of HNPCC and to review the clinicopathologic feature and appropriate management, we have analysed 5 HNPCC families. Five HNPCC families included 16 colorectal cancer patients(14 males and 2 females). The average age of first diagnosis was 39. Among 16 patients, 8 patient were operated at the KyungHee University hospital and their operative and pathologic records were available. Two synchronous and seven metachronous cancers were founded, so that eight patients had 15 colorectal cancer lesions. Ten cancers were located proximal to splenic flexure and five were distal. Partial resection of colon was performed in seven cases except one when the first diagnosis was made and recurrence was founded in 5 patients. Recurrence was treated by total colectomy in 3 cases and subtotal colectomy in two. In conclusion, we re-confirmed that HNPCC patient should be treated by no less than a subtotal colectomy because of high multiplicity and high recurrence rate of partial resection.
Colectomy ; Colon ; Colon, Transverse ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; Humans ; Male ; Recurrence

Inadvertent perforation of the globe, granuloma and hypersensitivity reaction have been recognized complications of the strabismus surgery. We performed experimental strabismus surgery with No.240 retinal band and histoacryl(group I), histocracyl only(group II), 6-0 vicryl(group III) in rabbit model to determine whether these techniques can replace the classic suture and decrease its complications. We measured maximum adhesion power by force gauge and observed histopathologic findings after sacrificing four rabbits at 1 day, 1 week, 4 week, and 8 weeks, respectively following experimental strabismus surgery. There were chronologically increasing tendency of adhesion power in all groups but no statistically significant differences among three groups. Pathologically inflammatory and foreign body reactions were decreased with time and there were no differences of inflammatory reactions among three groups. At four weeks after the experiment, there was encapsualation lined with loose fibrous tissue around the band in group I.In conclusion, We found that experimental strabismus surgery with tissue adhesives and No.240 retinal band showed good adhesion power and minimal tissue reaction. So, it is possible to do posterior fixation suture with tissue adhesive and No.240 retinal band in classic strabismus surgery.
Foreign Bodies ; Granuloma ; Hypersensitivity ; Rabbits ; Retinaldehyde ; Strabismus ; Sutures* ; Tissue Adhesives*