No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

The changes of corneal curvatures were measured in 63 cataract cases before and 2 months after cataract extraction with the aid of ophthalmometer and photo keratoscope. The change of the cornea in the vertical curvature was shown to be greater than that of horizontal curvature, in cases of conventional large corneal incision(120-170 degrees) of cataract surgery. Vertical curvature of the cornea was decreased and horizontal curvature was increased. The corneal astigmatism before and 2 months after surgery were respectively 0.67D. and 1.56D. showing the difference of 0.89D.
Astigmatism ; Cataract Extraction* ; Cataract* ; Cornea

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

Since the rectangular rod had been used by Eduardo R. Luque in 1979, many authors reported good results by this technique in low back arthrodesis. The advantages of this device are that the technique is relatively easy, the cost is cheaper than the other devices, and no special instruments are needed for application of this device. On the other hand, it has the disadvantage of possible neurologic damage while passing sublaminar wires. The rectangular rod functions fundamentally as a tension band that although it is strong in flexion, it is relatively weak in lateral bending or axial loading on the spine. From June, 1984 to June, 1988, the authors experienced 41 cases of rectangular rod instrumentation with sublaminar wiring in various low back conditions. And 30 cases of spondylolisthesis which could be followed for more than one year were analyzed. And the results obtained were as follows. l. Of 30 patients of spondylolisthesis, 7 cases(23.3%) were male and 23 cases(76.7%) were female. 2. 21 cases(70.0%) were isthmic type and 9 cases(30.0%) degenerative type. 3. 23 cases(76.7%) were in Grade I, 6 cases(20.0%) in Grade II and 1 cases(3.3%) in Grade III, according to Meyerding's classification. 4. At follow up examination, 18 cases(60.0%) were in excellent group, 8 cases(26.6%) in good, 2 cases(6.7%) in fair, according to Gill's criteria. Two cases(6.7%) of pseudoarthrosis were noted and these cases were classified in unsatisfactory group. 5. Rectangular rod with sublaminar wiring was not a good device for reduction of spondylolisthesis
Arthrodesis ; Classification ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Pseudarthrosis ; Spine ; Spondylolisthesis

Closed interlocking nailing has become a common method of treatment of femoral fractures in adults. Interlocking nailing had a tendency toward rotational deformity and shortening. Therefore, we determined anteversion of the femoral neck after closed IM nailing of the femoral fractures. Femoral rotational deformity in both leg was determined by the construction of a line through the femoral neck and another through the transcondylar plane of the distal portion of the femur, using the CT scanning. We performed a retrospective study of 15 patients treated with closed IM nailing for femoral shaft fractures from 1989 to 1994. 1. The average differences in anteversion angle was 12.9 degree. 2. 3 cases(50%) in 6 cases that have difference more than 15° are accompanied with ispilateral injury of the knee joint and the lower leg. 3. Angle difference of the rotational deformity of proximal or distal femoral fractures is 15.5° which is 3.5° larger than that of fractures of femoral midshaft, 12.0°.
Adult ; Congenital Abnormalities ; Femoral Fractures ; Femur ; Femur Neck ; Humans ; Knee Joint ; Leg ; Methods ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: Interhemispheric subdural hematoma (IHSDH) is uncommon, because of their unusual location. However, it is a distinct lesion with its unique characteristics. We investigated clinical features and outcomes of consecutive 42 patients with IHSDH, retrospectively. METHODS: From 2006 to 2015, we treated 105 patients with IHSDH. All patients were diagnosed by computed tomography (CT) or magnetic resonance imaging. We selected 42 patients with thick (3 mm or more) IHSDH. We retrospectively reviewed the clinical and radiological findings, management and outcomes. RESULTS: The male to female ratio was 2:1. Two thirds of the patients were over 60 years old. Slip or fall was the most common cause of trauma. The level of consciousness on admission was Glasgow Coma Scale (GCS) 13 to 15 in 25 patients. The most common symptom was headache. All IHSDH was hyperdense in CT at the time of diagnosis. IHSDH frequently accompanied convexity subdural hematoma. The outcome was favorable in 27 patients, however, six patients were expired. Twenty-two patients were managed conservatively. Surgery was performed in ten patients to remove the concurrent lesion. The outcome was poor in spontaneous one, patients with low GCS, and patients with conservative treatment. CONCLUSION: IHSDH is rare especially the isolated one. The outcome was dependent to the severity of injury. Surgery may be helpful to remove the concurrent mass lesion, however, conservative treatment is generally preferred.
Consciousness ; Craniocerebral Trauma ; Diagnosis ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Headache ; Hematoma, Subdural* ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Symptom Assessment

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.
Asia ; Asian Continental Ancestry Group* ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Financial Management ; Humans ; Internship and Residency ; Intubation ; Patient Care ; Patient Transfer ; Peer Review ; Triage ; Ultrasonography

BACKGROUND: Little data is available regarding hospitalized patients with nursing home-acquired pneumonia (NHAP). This is unfortunate because there is an increasing number of elderly persons who are living in nursing homes in Korea. The aim of this study was to compare clinical characteristics and treatment responses of NHAP with community-acquired pneumonia (CAP). METHODS: Patients with pneumonia who were admitted from eight nursing homes or from their own homes were enrolled between May 2007 and April 2009. Their clinical characteristics and treatment responses were reviewed retrospectively, and differences between the two groups were analyzed. RESULTS: Of 110 Patients with pneumonia, 66 (60%) were from nursing homes and their median age was 84. In the NHAP group, functional performance status was significantly poorer, classical symptoms of pneumonia were less severe, and multi-lobe involvement (on chest radiographs) was more frequent than in the CAP group. Patients with NHAP more frequently showed lymphocytopenia, anemia, hypoalbuminemia, hypoxemia, and elevated blood urea nitrogen on admission. The mean CURB-65 score was 2.2 in the NHAP group, higher than 1.7 in the CAP group (p=0.004), and multi-drug resistant pathogens were also highly identified in NHAP group (39% vs. 10%, p=0.036). The mean duration of antibiotic therapy was greater for the NHAP (12.6 days) than for the CAP group (6.6 days) (p<0.001). The mortality rate was 23% in NHAP group, which was significantly higher than 5% in the CAP group (p=0.014). CONCLUSION: NHAP should be more intensively investigated because of the higher frequency of multi-drug resistant pathogens and mortality than the CAP.
Aged ; Anemia ; Anoxia ; Blood Urea Nitrogen ; Humans ; Hypoalbuminemia ; Korea ; Lymphopenia ; Nursing Homes ; Pneumonia ; Pyrenes ; Retrospective Studies ; Thorax

We have surgically experienced a case with primary double cancer which metachronously occurred in the gall bladder and the distal portion of common bile duct. This 61-year-old male underwent cholecystectomy with en bloc wedge resection of liver due to the malignant tumor in the gall bladder about 30 months ago. The histopathological examination revealed that the lesion was adenocarcinoma, moderately to poorly differentiated, with partly neuroendocrine differentiation, in the neck portion of the gall bladder (Figure 1). The malignant potential invaded to the subserosal layer, and the resected margin of the cystic duct was free from the malignant invasion. During the post-operative period, he has periodically or sporadically visited the out-patient Department of Surgery and Internal Medicine at Taejeon St. Mary's Hospital for follow-up studies. He was admitted again because of the insiduous onset of painless jaundice along with generalized itching sensations. The studies, using the ultrasonogram and the CAT scan, showed that the intra- and extra-hepatic biliary trees were moderately dilated due to a mass effect at the distal portion of the common bile duct (Figure 2). The ERCP revealed the lesion was malignant(Figure 3), and histologically confirmed adenocarcinima, well differentiated. He underwent Whipple's pancreaticoduodenectomy with regional lymph node dissection(Figure 4). The histopathological examination revealed that the lesion was adenocarcinoma, moderately differentiated, with lymphatic and perineural invasion, in the distal portion of the common bile duct (Figure 5). The malignancy extended toward the submucosal layer of duodenum and the pancreatic parenchyme. The resected margin of common bile duct was free from malignant invasion. He recovered uneventfully from the second surgical intervention. He periodically visits the out-patient Department of Surgery nowadays.
Adenocarcinoma ; Animals ; Biliary Tract* ; Cats ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Common Bile Duct ; Cystic Duct ; Daejeon ; Duodenum ; Follow-Up Studies ; Humans ; Internal Medicine ; Jaundice ; Liver ; Lymph Nodes ; Male ; Middle Aged ; Neck ; Outpatients ; Pancreaticoduodenectomy ; Pruritus ; Sensation ; Ultrasonography ; Urinary Bladder