PURPOSE: To assess effectiveness, safety and stability of laser epithelial keratomileusis(LASEK), versus conventional photorefractive keratectomy(PRK) for low to moderate myopia. METHODS: 27 patients with a manifest refraction of -3.00 to -6.50 diopters were treated and followed-up for 3 months. In each case, one eye received PRK and the other LASEK. The surgical method and the sequence between the eyes were randomized. Postoperative pain, epithelial healing time, uncorrected visual acuity, manifest refraction, corneal haze and surgical preference were examined after the operation. RESULTS: During a 3-month-follow-up, we found no significant differences in epithelial healing time, uncorrected visual acuity and refractive error. However, LASEK treated eyes had lower postoperative pain scores(P=0.047), and corneal haze scores(1 month; P=0.02) than those of PRK. Seventeen patients(63%) preferred the LASEK procedure. CONCLUSION: LASEK and PRK has an equal effect in correction of myopia, but LASEK reduced incidence of postoperative pain and early postoperative corneal haze. This suggests LASEK can be an alternative procedure for correction of low to moderate myopia.
Humans ; Incidence ; Keratectomy, Subepithelial, Laser-Assisted ; Myopia* ; Pain, Postoperative ; Refractive Errors ; Visual Acuity

BACKGROUND: Drug resistant tuberculosis (TB) in patients who have not received previous TB treatment (initial drug resistance) is a serious problem for the control of TB. However, prevalence of initial drug resistance among pulmonary TB patients has not been well characterized in Korea, especially in the private sector. We assessed the prevalence of initial drug resistance and evaluated the risk factors for drug resistance in pulmonary TB patients, at a regional tertiary hospital in Cheonan. METHODS: We performed a drug susceptibility test for both first and second line anti-TB drugs in all culture-confirmed pulmonary TB patients who had not received a previous TB treatment at Dankook University Hospital from September 2005 to September 2007. In addition, we evaluated the initial drug resistance pattern and clinical characteristics of patients to evaluate the risk factors for initial drug resistance. We also assessed the influence of the drug susceptibility test results on the treatment regimen. RESULTS: Of the total 156 cases where the drug susceptibility test was performed, resistance to at least one anti-TB drug was found in 21 cases (15.6%) and multidrug resistance, where TB was resistant to at least isoniazid and rifampin, was found in one case (0.6%). Multivariate logistic regression showed no clinical characteristics were independently associated with initial drug resistance. Of the total 156 patients who underwent the drug susceptibility test, the treatment regimen was changed for 15 patients (9.6%) according to the results of the drug susceptibility test. CONCLUSION: Initial drug resistance is common and the drug susceptibility test is informative for pulmonary TB patients who have not received previous TB treatment.
Drug Resistance ; Drug Resistance, Multiple ; Humans ; Isoniazid ; Korea ; Logistic Models ; Prevalence ; Private Sector ; Rifampin ; Risk Factors ; Tertiary Care Centers ; Tuberculosis ; Tuberculosis, Pulmonary

Alopecia ; Bone Transplantation ; Burns ; Cicatrix ; Congenital Abnormalities ; Mandibular Reconstruction ; Tissue Expansion Devices ; Tissue Expansion ; Transplants

Gastrointestinal stromal tumor (GIST) is an uncommon mesenchymal tumor of the gastrointestinal tract and is generally located in the stomach and small intestine. They usually present with abdominal pain, gastrointestinal bleeding, and palpable mass. Some patients present with rare symptoms that are more common in malignant GIST. Malignant GIST combined with a liver abscess has not been reported yet in the literatures. We report a case of 67-year-old woman who suffered from liver abscess combined by malignant GIST with central necrosis and fistula in the ileum. She complained of fever, chills, and abdominal pain. Abdominal CT scan showed huge liver abscess and ileal mass with air pocket. Small bowel series showed contrast material filling into the ileal GIST mass. An operation was performed and the final diagnosis was malignant GIST of the ileum with invasion into the sigmoid colon and urinary bladder.
Aged ; Diagnosis, Differential ; Female ; Gastrointestinal Stromal Tumors/*diagnosis/pathology/surgery ; Humans ; Ileal Neoplasms/*diagnosis/pathology/surgery ; Liver Abscess/*etiology ; Neoplasm Invasiveness ; Proto-Oncogene Proteins c-kit/analysis ; Reagent Kits, Diagnostic

No abstract available.
Albendazole/therapeutic use ; Anthelmintics/therapeutic use ; Biopsy ; Combined Modality Therapy ; *Cysts/diagnostic imaging/parasitology/therapy ; *Echinococcosis, Hepatic/diagnostic imaging/parasitology/therapy ; Hepatectomy ; Humans ; *Liver/diagnostic imaging/drug effects/parasitology/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: X-ray film over responds to low-energy photons in relative photon beam dosimetry because its sensor is based on silver bromide crystals, which are high-Z molecules. This over-response becomes a significant problem in clinical photon beam dosimetry particularly in regions outside the penumbra. In intensity modulated radiation therapy (IMRT), the radiation field is characterized by multiple small fields and their outside-penumbra regions. Therefore, in order to use film dosimetry for IMRT, the nature the source of the over-response in its radiation field need to be known. This study is aimed to verify and possibly improve film dosimetry for IMRT. MATERIALS AND METHODS: Modulated beams were constructed by a combination of five or seven different static radiation fields using 6 MeV X-rays. In order to verify film dosimetry, we used X-ray film and an ion chamber were used to measure the dose profiles at various depths in a phantom. In addition, in order to reduce the over-response, 0.01 inch thick lead filters were placed on both sides of the film. RESULTS: The measured dose profiles showed a film over-response at the outside-penumbra and low dose regions. The error increased with depths and approached 15% at a maximum for the field size of 15X15 cm(2) at 10 cm depth. The use of filters reduced the error to 3%, but caused an under-response of the dose in a perpendicular set-up. CONCLUSIONS: This study demonstrated that film dosimetry for IMRT involves sources of error due to its over-response to low-energy photons. The use of filers can enhance the accuracy in film dosimetry for IMRT. In this regard, the use of optimal filter conditions is recommended.
Film Dosimetry* ; Photons ; Silver ; X-Ray Film

PURPOSE: Kikuchi-Fujimoto disease (KFD) is a benign disease, which is characterized by a cervical lymphadenopathy with fever, and it often mimics malignant lymphoma (ML). 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) is a powerful imaging modality for the diagnosis, staging and monitoring of ML, with the limitations including the nonspecific FDG uptake in infectious or inflammatory processes. This study compared clinical manifestations and PET/CT findings between KFD and ML patients. METHODS: We retrospectively reviewed the medical records of 23 patients with KFD and 33 patients with ML, diagnosed histopathologically, between January 2000 and May 2013 at the Department of Pediatrics, Yeungnam University Medical Center. Among them, we analyzed the clinical manifestations, laboratory findings and characteristics, and the amount of 18F-FDG uptake between 8 KFD and 9 ML patients who had 18F-FDG PET/CT. RESULTS: The 18F-FDG PET/CT maximum standardized uptake values (SUVmax) ranged from 8.3 to 22.5 (mean, 12.0) in KFDs, and from 5.8 to 34.3 (mean, 15.9) in MLs. There were no significant differences in SUVmax between KFDs and MLs. 18F-FDG PET/CT with ML patients showed hot uptakes in the extranodal organs, such as bone marrow, small bowel, thymus, kidney, orbit and pleura. However, none of the KFD cases showed extranodal uptake (P<0.001). 18F-FDG PET/CT findings of KFD with nodal involvement only were indistinguishable from those of ML. CONCLUSION: Patients who had extranodal involvement on PET/CT were more likely to have malignancy than KFD.
Academic Medical Centers ; Bone Marrow ; Child* ; Diagnosis ; Electrons ; Fever ; Fluorodeoxyglucose F18 ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Kidney ; Lymphatic Diseases ; Lymphoma* ; Medical Records ; Orbit ; Pediatrics ; Pleura ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography* ; Retrospective Studies ; Thymus Gland

BACKGROUND AND OBJECTIVES: It is important to figure out the location between the internal carotid artery (ICA) and the Eustachian tube (ET) for conducting safe ET surgery. Using computed tomography (CT), this study was aimed to evaluate the anatomical relationship between ET and ICA according to age and gender. SUBJECTS AND METHOD: Contrast enhanced CT scans of the paranasal sinus taken between January 2005 and December 2010 were reviewed retrospectively. A total of 216 patients (432 ears) were enrolled. In each patient, we measuresed the distance from the anterior cushion of torus tubarius to ICA (AC-ICA), the distance from the posterior cushion of torus tubarius to ICA (PC-ICA), the distance from the Rosenmuller fossa to ICA, the shortest distance from ET lumen to ICA (ET-ICA), and the angle between the imaginary lines from the orifice of ET to the posterior end point of nasal septum to point ICA (ET-NS-ICA). Patients were divided into 10 groups based on age difference of 15-years. RESULTS: For the female patients aged 65 to 80 years old, AC-ICA, PC-ICA were closest from the nasopharynx. For this group, at p<0.05, the distances of AC-ICA, PC-ICA and ET-ICA showed a negative correlation with increasing age, whereasET-NS-ICA (p<0.05) showed a positive correlation, indicating a tendency of medicalization with increased age. CONCLUSION: The distance between ET and ICA represents a variety of distribution according to gender and age. When performing a surgery for the nasopharyngeal portion of ET, the surgeon should be aware of the location of ICA in the preoperative CT findings.
Carotid Artery, Internal* ; Eustachian Tube* ; Female ; Humans ; Medicalization ; Nasal Septum ; Nasopharynx ; Retrospective Studies ; Tomography, X-Ray Computed

An one day old female baby was admitted to the Pediatric department of Korea University Anam Hospital for the evaluation of her facial anomaly. She was born by spontaneous vaginal delivery at term weighing 3.8 kg. On initial examination, she was noted to have congenital trismus and have cleft lip and palate. Bands of fibrous tissue were noted to extend from the superior alveolar part to inferior part at decidual molar tooth region and allowed oral opening of only 5 mm. She was transfered to the Plastic Surgery department under the diagnosis of cleft palate lateral synechia syndrome for resection of her synechial bands. In the operating room ECG, pulse oximeter and precordial stethoscope were applied to the patient and then, anesthesia was induced with , O2, N2O and enflurane. The 60 cm Olympus fiberscope with an external diameter of 2 mm was used and well lubricated 3.0 mm uncuffed endotracheal tube was threaded over the fiberscope through the oral cavity. The fiberscope was advanced into the midtrachea, then the endotracheal tube was passed over the fiberscope into the trachea After securing of the endotracheal tube, two lateral synechial bands were surgically divided. She tolerated oral feedings on postoperative 5 days without difficulty and discharged from the hospital on postoperative 6 days.
Anesthesia ; Cleft Lip ; Cleft Palate* ; Diagnosis ; Electrocardiography ; Enflurane ; Female ; Humans ; Infant, Newborn* ; Intubation* ; Intubation, Intratracheal ; Korea ; Molar ; Mouth ; Operating Rooms ; Palate ; Stethoscopes ; Surgery, Plastic ; Tooth ; Trachea ; Trismus

Nodular pulmonary amyloidosis is one of the rare manifestation of amyloid disease. It is known to be caused by anyloid L fibrils in the majority of case. We experienced an unusual case of a forty-one year-old woman who was presented with multiple nodular lesion on the chest X-ray. CT-guided core needle bilpsy, performed on the lesion, showed apple green birefringes, when stained Congo red and examined under polarized light. Ultrastructurally, there are randomly oriented, forming densed networks, and consists of fine, 7.5 to 10nm diameter, rigid, non-branching filaments of various lengths in electron-microscopic finding. We report a case of primary diffuse nodular pulmonary amyloidosis only localized in the lung, which was confirmed by CT guided core needle biopsy.
Amyloid ; Amyloidosis* ; Biopsy, Large-Core Needle ; Congo Red ; Female ; Humans ; Lung* ; Needles ; Thorax