PURPOSE: To study the results of intravitreal tissue plasminogen activator (tPA) and expansile gas injection for the treatment of submacular hemorrhage in age-related macular degeneration (AMD). METHODS: Eleven consecutive patients (11 eyes) with submacular hemorrhage in AMD were included in this study. All patients were treated with intravitreal injections of tPA and C3F8 gas. Postoperatively, patients' follow-up period were at least 3 months. Outcome measures included early and final visual acuity, age, disc areas of hemorrhage, duration of symptoms, displacement of blood from the fovea, and final macular status. RESULTS: The maximum diameter of the hematoma ranged from 2 to 10 disc diameters. The mean duration of submacular hemorrhage was 7.5 days. Submacular blood was completely displaced in 7 patients (64%) and partially in four (36%). Best postoperative visual acuity improved in 7 eyes; in 6 eyes (55%), the improvement was two or more lines. Final visual acuity improved in 7 eyes (64%), remained stable in 2 eyes (18%), and worsened in 2 eyes (18%). Choroidal neovascularization positioned at subfovea in 7 eyes (64%) and juxtafovea in 4 eyes (36%). No significant difference was found between postoperative visual recovery and these factors. CONCLUSIONS: Our findings suggest that intravitreal tPA and expansile gas injection are safe and of useful for displacing hemorrhages secondary to age-related macular degeneration. Final visual acuity was limited by the underlying choroidal neovascularization of AMD.
Choroidal Neovascularization ; Displacement (Psychology) ; Eye ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Intravitreal Injections ; Macular Degeneration ; Outcome Assessment (Health Care) ; Tissue Plasminogen Activator ; Visual Acuity

The abdominal tumors in children are different from those of adult. These tumors are the third most common one, preceded by leukemia and brain tumors, in children under 15 years. X-ray examination is the most important method among diagnostic approaches. The role of diagnostic imaging is to identify the precise anatomic location and extent of pathologic process with the minimal number of imaging procedures. 23 cases of abdominal tumors were reviewed in respect of age incidence, site of origin, radiologic findings. The results are briefly summarized as follows: 1. Neuroblastoma was the most common (6 cases) and wilm's tumor (5 cases), choledocal cyst (4 cases), ovarian mass (3 cases), hydronephrosis (2 cases), were descending order in frequency. 2. The most common site was retroperitoneum (60%) Kidney was the single most common site of origin. 3. Radiologic findings. The most common findings of plain radiography was ill defined soft tissue mass and this method was helpful in the presence of calcification especially in neuroblastoma. Ultrasonographic pattern was anechoic (cystic), echoic or mixed pattern, but this method provide less precise anatomical details, nevertheless Ultrasonography was particularly useful imaging modality for the pediatric abdominal tumors. IVP findings were renal displacement, caliceopelvic system distortion or nonvisualization of kidney, these information was helpful in determining the location of tumors. CT scan showed homogenous or inhomogeneous, cystic or solid, mass with their anatomic location. 4. Ultrasonography was the most widely used specific diagnostic method, but had limited value in detecting the anatomic location of tumors. CT scan was superior to ultrasound for determining the extent of tumors.
Adult ; Brain Neoplasms ; Child ; Diagnostic Imaging ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Leukemia ; Methods ; Neuroblastoma ; Radiography ; Tomography, X-Ray Computed ; Ultrasonography ; Wilms Tumor

PURPOSE: To determine the normal range of retinal nerve fiber layer (RNFL) thickness of normal children and adolescents by optical coherence tomography (OCT). METHODS: This study analyzed 144 eyes of 72 normal children and adolescents by OCTIII (Zeiss-Humphrey, San Leandro, CA., USA) and the results were compared with the RNFL thickness of Korean adults. RESULTS: The mean RNFL thickness of the 72 normal children and adolescents was 105.53+/-10.33 micrometer. The mean values for left and right eyes were 104.28+/-7.68 micrometer and 106.79+/-12.98 micrometer, respectively. There was no significant difference in mean RNFL thickness between the 4 quadrants of the left and right eyes (p=0.926). Additionally, the mean RNFL thickness showed a similar size pattern regardless of age (p=0.99). RNFL thickness was found to be greater in adults than in children or adolescents, although the difference was not statistically significant (p=0.295. Likewise, no significant difference was found with gender (p=0.822) or in the pattern of RNFL thickness of 12 sectors between children and adults (p=0.08). CONCLUSIONS: This study reports RNFL thickness, as determined by OCT, for normal children and adolescents. We found this measurement method to be suitable for the early diagnosis of glaucoma and to the examination of its progression in these subjects. The findings could be used as clinical parameters for adolescent glaucoma.
Tomography, Optical Coherence ; Retina/*anatomy & histology ; Reference Values ; Nerve Fibers/*ultrastructure ; Male ; Humans ; Female ; Child ; Adult ; Adolescent

PURPOSE: The number of laparoscopy-assisted distal gastrectomy procedures for the treatment of early gastric cancer patient to improve the quality of life has been gradually increasing. This study evaluated the technical feasibility, safety, and surgical results of LADG with lymphadenectomy by reviewing the initial experience. METHODS: From May 2003 to December 2005, 202 LADG with lymphadenectomy were performed on patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. RESULTS: There were 128 males and 74 females with a mean age of 58 years (range 24~78). The mean operation time was 212 minutes (range 105~450) and the operation time has decreased gradually with increasing number of cases. There were 16 operative morbidities (7.9%) including three operative mortalities. The restoration of the bowel sound was noted at 3.1 postoperative days, soft diet was started at 4.4 postoperative days and the duration of the hospital stay was 7.7 days. There were 105 mucosal, 64 submucosal, 22 proper muscle, 4 subserosal and 7 serosal lesions. A total 163 patients were treated with D2, 37 with D1+beta and 2 with D1+alpha LN dissection. The mean number of lymph nodes retrieved was 35 (range=10~81). Lymph node metastasis was noted in 30 patients. CONCLUSION: This study shows that laparoscopic procedure can be applied safely and effectively for the patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for the short- and long-term surgical outcomes is needed.
Diagnosis ; Diet ; Female ; Gastrectomy* ; Humans ; Laparoscopy* ; Length of Stay ; Lymph Node Excision* ; Lymph Nodes ; Male ; Mortality ; Neoplasm Metastasis ; Quality of Life ; Stomach Neoplasms

PURPOSE: Since its introduction in the mid-1990s, sentinel lymph node biopsy has been rapidly and widely adopted for the axillary staging of clinically node-negative breast cancer patients. However, there is some controversy in the clinical application because of its various identification rates and its false negative rates. The objective of this study was to assess the usefulness of endoscopic sentinel lymph node biopsy (ESNB) and to compare the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioisotope. METHODS: This study was carried out in 137 breast cancer patients (bilateral breast cancer, 3 cases) who underwent ESBN, at the Department of Surgery in Soonchunhyang University from May of 2007 to August of 2008. The technique involved the injection of 5 mL of 0.5% indigocarmine or Tc-99m tin colloid into subareolar plexus. The Visiport docked with a telescope was inserted through a low transverse axillary incison (1.0 cm in size) lateral to the pectoralis major. During the dissection, we identified sentinel nodes by following blue-stained lymphatic duct directly into blue-stained lymph nodes. We compared the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioactive tracer. RESULTS: The mean number of sentinel nodes was 1.27 (range, 1-4). The identification rate and false negative rate of the sentinel node were 94.3% (132/140) and 6.9% (3/43), respectively. We compared ESNB with using blue dye only (n=77) vs. a combination of blue dye and radioactive tracer (n=63). Sentinel lymph node identification rate were 90.9% (70/77) vs. 98.4% (62/63) (p=0.043). CONCLUSION: The endoscopic technique of sentinel node biopsy can keep better operative visual fields and is less invasive. The combination of blue dye and radioactive tracer was superior to blue dye only for identification rates.
Biopsy ; Breast ; Breast Neoplasms ; Colloids ; Humans ; Lymph Nodes ; Nitriles ; Pyrethrins ; Radioisotopes ; Sentinel Lymph Node Biopsy ; Telescopes ; Tin ; Visual Fields

PURPOSE: Since its introduction in the mid-1990s, sentinel lymph node biopsy has been rapidly and widely adopted for the axillary staging of clinically node-negative breast cancer patients. However, there is some controversy in the clinical application because of its various identification rates and its false negative rates. The objective of this study was to assess the usefulness of endoscopic sentinel lymph node biopsy (ESNB) and to compare the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioisotope. METHODS: This study was carried out in 137 breast cancer patients (bilateral breast cancer, 3 cases) who underwent ESBN, at the Department of Surgery in Soonchunhyang University from May of 2007 to August of 2008. The technique involved the injection of 5 mL of 0.5% indigocarmine or Tc-99m tin colloid into subareolar plexus. The Visiport docked with a telescope was inserted through a low transverse axillary incison (1.0 cm in size) lateral to the pectoralis major. During the dissection, we identified sentinel nodes by following blue-stained lymphatic duct directly into blue-stained lymph nodes. We compared the value of two methods for identification of ESNB using blue dye only or a combination of blue dye and radioactive tracer. RESULTS: The mean number of sentinel nodes was 1.27 (range, 1-4). The identification rate and false negative rate of the sentinel node were 94.3% (132/140) and 6.9% (3/43), respectively. We compared ESNB with using blue dye only (n=77) vs. a combination of blue dye and radioactive tracer (n=63). Sentinel lymph node identification rate were 90.9% (70/77) vs. 98.4% (62/63) (p=0.043). CONCLUSION: The endoscopic technique of sentinel node biopsy can keep better operative visual fields and is less invasive. The combination of blue dye and radioactive tracer was superior to blue dye only for identification rates.
Biopsy ; Breast ; Breast Neoplasms ; Colloids ; Humans ; Lymph Nodes ; Nitriles ; Pyrethrins ; Radioisotopes ; Sentinel Lymph Node Biopsy ; Telescopes ; Tin ; Visual Fields

PURPOSE: We wanted to compare the clinical and radiological results of surgical treatment of acetabular both column fracture according to the fixation method. MATERIALS AND METHODS: Between 1986 and 2008, 55 patients who underwent surgical treatment for acetabular both column fracture were clinically and radiologically evaluated after a minimum follow-up of one year. Of 55 patients, 29 cases were operated with a cerclage wire or cable (group I) and 26 cases were operated with a plate and screw (group II). The surgical approach, the intra- and post-operative complications and the reduction quality were compared between the two groups. The clinical and radiological results were analyzed according to the criteria reported by Matta. RESULTS: There were 14 (48.3%)/20 (76.9%) cases of anatomical reduction, 12 (41.4%)/6 (23.1%) cases of imperfect reduction, 1/0 case of poor reduction and 2/0 cases of surgical secondary incongruence, respectively. Thirty three patients of 34 anatomically reduced patients showed excellent clinical results and the anterior and posterior combined approach was frequent in group I. There were no differences between the two groups for the complications, although intraoperative complication was more frequent in group II and postoperative complication was more frequent in group I. CONCLUSION: The clinical and radiological results of surgical treatment in patients with both column fracture were satisfactory in both groups. However, the concerns related to the surgical approach and complications will require a randomized prospective study.
Acetabulum ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Postoperative Complications

During an investigation of microorganisms and pests in plant culture media from imported anthurium pots, a fungal isolate (DUCC4002) was detected. Based on its morphological characters including colony shape on potato dextrose agar, the microstructures of spores observed by light and scanning electron microscopy and the results of phylogenetic analysis using an internal transcribed spacer rDNA sequence, the fungal isolate was identified as Myrothecium roridum. Pathogenicity testing on anthurium leaves revealed that the fungus could colonize and produce sporodochia on the inoculated leaves. This is the first report of M. roridum detected in imported plant culture medium in Korea.
Agar ; Colon ; Culture Media ; DNA, Ribosomal ; Fungi ; Glucose ; Korea ; Microscopy, Electron, Scanning ; Plants* ; Solanum tuberosum ; Spores ; Virulence

Ascending aortic injury after blunt chest trauma is an emergency condition that requires urgent diagnosis and treatment. The authors report the case of a patient with traumatic ascending aortic injury who received ascending aorta replacement under cardiopulmonary bypass after failure of primary repair.

PURPOSE: Skin-sparing mastectomy (SSM) involves the resection of the nipple-areolar complex (NAC) along with the breast parenchyma, and this improves aesthetic outcome for breast cancer patients. Yet most patients desire preservation of the NAC. The purpose of this study was to determine the associated risk factors of NAC involvement and to identify the value of preoperative breast magnetic resonance imaging (MRI) for measuring the tumor-nipple distance (TND). METHODS: This prospective study was carried out in 92 breast cancer (3 patients with bilateral breast cancer) patients who underwent MRI and they had undergone modified radical mastectomy or SSM at the Department of Surgery in Soonchunhyang University Hospital from November of 2003 to March of 2006. The patients were divided into two groups: nipple-positive for malignancy (group 1; n=9) and nipple-negative for malignancy (group 2; n=86). We analyzed the risk factors of NAC involvement, including tumor size, nuclear grade, lymph node invasion, muticentricity, TND, the hormone recepor status, and lymphovascular invasion. The TND was measured by preoperative breast MRI (the imaging distance) in all patients and by the distance of specimens which were obtained postoperatively (the real distance) in 31 patients. RESULTS: The overall frequency of malignant nipple involvement was 9 of 95 (9.4%). There were no differences in tumor size, nuclear grade, lymph node invasion, muticentricity, the hormone recepor status and lymphovascular invasion between the two groups. The TND was identified as an independent predictor of malignant NAC involvement: the mean TND by breast MRI was 0.7 cm in group 1 and 2.7 cm in group 2 (p=0.01) the mean TND by pathologic measuring the specimen was 0.7 cm in group 1 and 3.2 cm in group 2 (p=0.02). In all the nipple involved cases, the tumor was within 2 cm of the nipple. In measuring the TND, there was no significant difference between the imaging distance of MRI and real distance of the sepcimen (p=0.166). CONCLUSION: The only predictive factor for malignant NAC invasion was TND in our study. NAC preservation would be appropriate for the patients with tumor located more than 2 cm away from the nipple. The TND as determined by preoperative MRI is considered to be helpful when deciding whether to preserve the NAC.
Breast Neoplasms* ; Breast* ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Mastectomy ; Mastectomy, Modified Radical ; Nipples* ; Prospective Studies ; Risk Factors