No abstract available.
Plasma Exchange* ; Plasma*

BACKGROUND: The fast EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used far transporting emergent patients. Authors, here upon, report the transporting experiences. METHODS: From Dec. 1, 1996 to Dec. 31,1997, Samsung Medical Centers EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. RESULT: A total of 65 patients were transported. Male to female ratio was 1.95 : 1. The mean transport time was 64.1min(10-160 min). Majority of the evacuated patients was surgical patients (General Surgery'16, Orthopedic surgery : 10, Neurosurgery : 6, Infernal medicine 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation amended The patients. No medical problems or deaths developed during the air evacuation period. CONCLUSION: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.
Aircraft* ; Critical Illness ; Emergencies* ; Female ; Humans ; Korea ; Male ; Neurosurgery ; Orthopedics ; Pediatrics ; Prospective Studies

No abstract available.

An isolated rupture of the posterior capsule that is caused by a blunt ocular trauma has been rarely reported and is usually detected incidentally during surgery for a complicated cataract. We found an isolated posterior capsule rupture on the third day after trauma in a 25-year-old man who was admitted for the treatment of traumatic hyphema and we performed a phacoemusification and anterior vitrectomy with PC-IOL, implantation because of the traumatic cataract which had progressed after the injury. The PC-IOL was implanted safely into the capsular bag without severe enlargement of the posterior capsular rupture. The break seems to function as a capsulotomy which provides a clear visual axis. We report this case with a review of the literatures.
Adult ; Case Report ; Cataract/*etiology ; Eye Injuries/*complications ; Human ; Lens Capsule, Crystalline/*injuries ; Male ; Rupture/etiology ; Wounds, Nonpenetrating/*complications

PURPOSE: To compare the induced astigmatism and clinical results after cataract surgery using different clear corneal incisions. METHODS: This prospective, nonrandomized study comprised 60 eyes (48 patients) scheduled for cataract surgery between October 2000 and March 2001; 20 eyes received 1-plane stab clear corneal incisions(Group 1), 20 eyes, 2-plane stab clear corneal incisions(Group 2) and 20 eyes, 2-plane hinge incisions(Group 3). Preoperative corneal astigmatism, surgically induced corneal astigmatism and changes of visual acuity were analyzed at 1 day, 1 and 2 weeks, 1 and 2 months postoperatively using ARK-700(NIDEK) and visual acuity chart projector. Data and group comparisons were evaluated by ANOVA, Chi-Square test, Repeated measures ANOVA, Kruskal-Wallis test, Analysis of CoVariance(ANCOVA). RESULTS: The surgically induced astigmatism in all groups showed no difference in WTR change and uncorrected visual acuity also showed no different results in all groups. Mean keratometric astigmatisms were 0.23+/-1.05 D (ATR) preoperatively, 0.03+/-1.31 D (WTR) at 1 day, 0.14+/-1.13 D at 1 week, 0.16+/-1.11 D at 2 weeks, 0.13+/-1.07 D at 1 month, 0.11+/-1.04 D (WTR) at 2 months. Mean surgically induced keratometric astigmatisms were 0.75+/-0.65 at 1 day, 0.65+/-0.43 D at 1 week, 0.54+/-0.48 D at 2 weeks, 0.53+/-0.45 D at 1 month and 0.45+/-0.46D (WTR) at 2 months after operation. CONCLUSIONS: There were no significant differences in postoperative visual acuity and surgically induced astigmatism at 2 months postoperatively among these three groups and all incisions offered satisfactory short-term astigmatic results and rapid visual rehabilitation. A longer study of a larger series should be done to confirm the findings.
Astigmatism* ; Cataract* ; Prospective Studies ; Rehabilitation ; Visual Acuity

Coronary artery ectasia (CAE) is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI). Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC). The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.
Angioplasty, Balloon ; Aspirin ; Coronary Vessels* ; Dilatation ; Dilatation, Pathologic ; Humans ; Liver Cirrhosis* ; Liver* ; Myocardial Infarction* ; Platelet Aggregation Inhibitors ; Prognosis ; Stents ; Thrombosis*

OBJECTIVE: To understand the pathogenesis of adenomyosis through the immunohistochemical staining with bcl-2 and matrix metalloproteinase-9 (MMP-9) antibody. METHODS: We selected 45 cases of adenomyosis among the uterine specimens that were extirpated surgically due to benign gynecologic problem. Immunohistochemical staining to the myometrial tissue was performed using anti-bcl-2 and anti-MMP-9 antibodies. Staining was qualitatively assessed in terms of extent and intensity. RESULTS: There were 32 cases of proliferative phase and 13 cases of secretory phase depending on the date of endometrium. Anti-bcl-2 stained 81.3% (26/32) compared with anti-MMP-9 stained 6.3% (2/32) in the glandular tissue of the proliferative phase (p<.001). In the secretory phase, anti-bcl-2 92.3% (12/13) and anti- MMP-9 7.7% (1/13) respectively (p<.001). In the stromal tissue of the proliferative phase, anti-bcl-2 stained 62.5% (20/32) compared with anti- MMP-9 stained 6.3% (2/32) (p<.001). In the secetory phase, anti-bcl-2 84.6% (11/13) and anti-MMP-9 15.4% (2/13) (p<.001). CONCLUSION: The adenomyosis may be developed from simple invagination and cellular proliferation of endometrial tissue, not caused by myometrial infiltration of endometrial tissue.
Adenomyosis* ; Antibodies ; Cell Proliferation ; Endometrium ; Female ; Matrix Metalloproteinase 9

OBJECTIVE: To compare the diagnostic accuracy of ultrasonographic endometrial thickness with that of hysteroscopy, it is to establish the most appropriate method for the diagnosis of endometrial cancer and other endometrial diseases in postmenopausal women with abnormal uterine bleeding (AUB). METHODS: This retrospective study was conducted in 105 consecutive postmenopausal patients with AUB, who underwent ultrasonographic evaluation of endometrial thickness, hysteroscopy and endometrial biopsy. Evaluation of sensitivity and specificity was performed. RESULTS: Histologic findings for <4 mm level revealed that atrophy was present in 30 (71.4%) and in 1 case (2.4%) endometrial cancer was found; for > or =4 mm values polyps and myomas were present in 31 (49.2%) and there were 3 (4.8%) in endometrial cancer. Sensitivity and specificity for trans-vaginal ultrasound, with a cut-off value > or =4 mm, was 75% and 40.6%. CONCLUSIONS: Generally speaking, obstetrics & gynecologists know that endometrial aspiration biopsy is the routine method in postmenopausal women with AUB. However transvaginal ultrasound remains the first line diagnostic procedure in postmenopausal women without AUB. In case of endometrial thickness less than 4 mm, it is likely to miss the early stage endometrial cancer but trans-vaginal ultrasound remains the first line diagnostic procedure in postmenopausal women, because it is not invasive and has high sensitivity for detecting endometrial cancer and other endometrial disease; According to our experience, hysteroscopy with biopsy is mandatory in all postmenopausal women with AUB.
Atrophy ; Biopsy ; Biopsy, Needle ; Diagnosis ; Endometrial Neoplasms ; Female ; Hemorrhage* ; Humans ; Hysteroscopy* ; Myoma ; Obstetrics ; Polyps ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Uterine Diseases ; Uterine Hemorrhage

About 5% of burn patients come with other injuries. When patients with multiple rib fractures are put under general anesthesia, there is a higher rate of a variety of complications, such as hemothorax, pneumothorax, lung contusion, and etc. Also, symptoms of the complications are likely to get worse. Therefore, it is important to decide when it is appropriate to perform surgery. Our hospital delayed operation time on two burn patients who had multiple rib fractures and then performed surgery under general anesthesia, treating patients without any particular complications.
Anesthesia, General ; Burns* ; Contusions ; Hemothorax ; Humans ; Lung ; Pneumothorax ; Rib Fractures* ; Thoracic Injuries

PURPOSE: To determine the prevalence of dry eye disease (DED) and risk factors among young people based on the Ocular Surface Disease Index (OSDI) questionnaire. METHODS: The authors of the present study distributed the OSDI questionnaire to 263 university students. DED was diagnosed when the OSDI score was greater than 13 points. According to the OSDI score, DED was classified as mild (13-22 points), moderate (23-32 points), or severe (33-100 points). Additionally, the associations between the OSDI score and possible risk factors such as gender, contact lens use and allergic conjunctivitis were studied. RESULTS: Of 263 students, diagnosed DED was present in 133 (50.6%) and severe cases of DED were observed in 49 (18.6%). A high OSDI score was associated with female sex (p < 0.01), a history of allergic conjunctivitis (p = 0.02), contact lens use (p < 0.01), self-awareness of the dry eye symptoms (p < 0.01) and a history of clinically diagnosed DED (p < 0.01). CONCLUSIONS: Prevalence of DED, which has been reported to be high in the elderly, was considered high at 50.6% among young people in the present study. Caution or education regarding DED is necessary for people who have a high OSDI score, particularly females, contact lens wearers and people with allergic conjunctivitis.
Aged ; Conjunctivitis, Allergic ; Eye ; Eye Diseases ; Female ; Humans ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Young Adult