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: 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

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

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

Small bowel obstruction can develop from adhesions, hernias, and less frequently from tumors. Superior mesenteric artery (SMA) syndrome is an uncommon cause of small bowel obstruction. We experienced a case of SMA syndrome caused by peritoneal seeding from colon cancer. A 57-year-old woman presented with nausea, post-prandial vomiting, and weight loss. She had been receiving palliative chemotherapy for 12 months to treat colon cancer with peritoneal seeding. Abdominal computed tomography and a small bowel series revealed typical findings of SMA syndrome. As conservative treatment including nutritional support and positional change was ineffective, she was treated surgically. An adhesive mass compressing the SMA and duodenum was found at the third portion of the duodenum. The pathologic diagnosis was metastatic adenocarcinoma of colorectal origin. Adhesiolysis and duodenojejunostomy relieved her symptoms. This case shows that SMA syndrome can develop via peritoneal seeding in cancer patients.
Adenocarcinoma ; Adhesives ; Colon ; Colonic Neoplasms ; Duodenum ; Female ; Hernia ; Humans ; Intestinal Obstruction ; Mesenteric Artery, Superior ; Middle Aged ; Nausea ; Nutritional Support ; Seeds ; Superior Mesenteric Artery Syndrome ; Vomiting ; Weight Loss

Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.
Bronchiectasis ; Carcinoma, Bronchogenic ; Humans ; Intestines ; Korea ; Lung ; Lung Abscess ; Lung Diseases ; Male ; Mouth ; Opportunistic Infections ; Polymers ; Trichomonas ; Trichomonas vaginalis