We have experienced six cases of postoperative capsular bag distension following continuous curvilinear capsulorhexis(CCC) and phacoemulisification with posterior chamber intraocular lens. Successful CCC, phacoemulsification and in the bag fixation of intraocular lens(IOL) were accomplished, and the optics of the IOL were made of silicone material in 6 cases. We have observed various degree of anterior chamber shallowing, anterior displacement of IOL, bulging of posterior capsule, and myopic shift of refractive error, and these findings improved by YAG laser anterior or posterior capsulotomy. Mean refractive change was +2.6D(diopter) at post-laser 1 day.
Anterior Chamber ; Cataract* ; Lasers, Solid-State ; Lenses, Intraocular ; Phacoemulsification ; Posterior Capsulotomy ; Refractive Errors ; Silicones

No abstract available.
Arteries* ; Intracranial Aneurysm*

No abstract available.
Low Back Pain* ; Sciatica*

The relationship between hiatal hernias and gastroesophageal reflux disease (GERD) has been greatly debated over the past decades, with the importance of hiatal hernias first being overemphasized and then later being nearly neglected. It is now understood that both the anatomical (hiatal hernia) and the physiological (lower esophageal sphincter) features of the gastroesophageal junction play important, but independent, roles in the pathogenesis of GERD, constituting the widely accepted "two-sphincter hypothesis." The gastroesophageal junction is an anatomically complex area with an inherent antireflux barrier function. However, the gastroesophageal junction becomes incompetent and esophageal acid clearance is compromised in patients with hiatal hernia, which facilitates the development of GERD. Of the different types of hiatal hernias (types I, II, III, and IV), type I (sliding) hiatal hernias are closely associated with GERD. Because GERD may lead to reflux esophagitis, Barrett's esophagus and esophageal adenocarcinoma, a better understanding of this association is warranted. Hiatal hernias can be diagnosed radiographically, endoscopically or manometrically, with each modality having its own limitations, especially in the diagnosis of hiatal hernias less than 2 cm in length. In the future, high resolution manometry should be a promising method for accurately assessing the association between hiatal hernias and GERD. The treatment of a hiatal hernia is similar to the management of GERD and should be reserved for those with symptoms attributable to this condition. Surgery should be considered for those patients with refractory symptoms and for those who develop complications, such as recurrent bleeding, ulcerations or strictures.
Adenocarcinoma ; Barrett Esophagus ; Constriction, Pathologic ; Esophageal Sphincter, Lower ; Esophagitis, Peptic ; Esophagogastric Junction ; Gastroesophageal Reflux ; Hemorrhage ; Hernia, Hiatal ; Humans ; Manometry ; Ulcer

Objective: This study aims to evaluate the effect of treatment for great saphenous vein incompetence with a fourth-generation 1940 nm laser with radial fiber and catheter directed foam sclerotherapy (CDFS) without a tumescent simultaneously. The procedure was termed laser assisted sclerotherapy (LAST). It is a kind of thermochemical ablation. Methods: From January 1 to June 30, 2023, 86 GSV cases from 50 patients who underwent LAST at Cheongmac hospital were enrolled in this retrospective study. Endogenous laser ablation (EVLA) was performed in the order of accessary vein, tributaries and truncal vein and then followed by CDFS which was performed with a 3% sodium tetradecyl sulfate (STS) mixed with CO 2 gas at a ratio of 1:4. The degree of pain was measured after procedure at 2 hours after the procedure. Follow-up was conducted at 1 week, 1 month, and 6 months. Results: Three of the 86 GSV observed for >6 months showed mild reflux. According to size and number of ablated vessels, various energy level was needed. Three percent STS was used 4.5±0.4 cc and operation time per GSV was about 8±2 minutes. The VAS score was 2.5±0.6 at 2 hours after surgery. The closure rate was 100% at 6 months. Symptoms improved after 6 months in all patients (6.2±1.2 to 0.9±0.2). Conclusion LAST showed a good closure rate in the early midterm follow up period. Ablation was possible with less energy compared with EVLA and the pain index was lower at the second hour after procedure.

Objective: This study aims to evaluate the effect of treatment for great saphenous vein incompetence with a fourth-generation 1940 nm laser with radial fiber and catheter directed foam sclerotherapy (CDFS) without a tumescent simultaneously. The procedure was termed laser assisted sclerotherapy (LAST). It is a kind of thermochemical ablation. Methods: From January 1 to June 30, 2023, 86 GSV cases from 50 patients who underwent LAST at Cheongmac hospital were enrolled in this retrospective study. Endogenous laser ablation (EVLA) was performed in the order of accessary vein, tributaries and truncal vein and then followed by CDFS which was performed with a 3% sodium tetradecyl sulfate (STS) mixed with CO 2 gas at a ratio of 1:4. The degree of pain was measured after procedure at 2 hours after the procedure. Follow-up was conducted at 1 week, 1 month, and 6 months. Results: Three of the 86 GSV observed for >6 months showed mild reflux. According to size and number of ablated vessels, various energy level was needed. Three percent STS was used 4.5±0.4 cc and operation time per GSV was about 8±2 minutes. The VAS score was 2.5±0.6 at 2 hours after surgery. The closure rate was 100% at 6 months. Symptoms improved after 6 months in all patients (6.2±1.2 to 0.9±0.2). Conclusion LAST showed a good closure rate in the early midterm follow up period. Ablation was possible with less energy compared with EVLA and the pain index was lower at the second hour after procedure.

Objective: This study aims to evaluate the effect of treatment for great saphenous vein incompetence with a fourth-generation 1940 nm laser with radial fiber and catheter directed foam sclerotherapy (CDFS) without a tumescent simultaneously. The procedure was termed laser assisted sclerotherapy (LAST). It is a kind of thermochemical ablation. Methods: From January 1 to June 30, 2023, 86 GSV cases from 50 patients who underwent LAST at Cheongmac hospital were enrolled in this retrospective study. Endogenous laser ablation (EVLA) was performed in the order of accessary vein, tributaries and truncal vein and then followed by CDFS which was performed with a 3% sodium tetradecyl sulfate (STS) mixed with CO 2 gas at a ratio of 1:4. The degree of pain was measured after procedure at 2 hours after the procedure. Follow-up was conducted at 1 week, 1 month, and 6 months. Results: Three of the 86 GSV observed for >6 months showed mild reflux. According to size and number of ablated vessels, various energy level was needed. Three percent STS was used 4.5±0.4 cc and operation time per GSV was about 8±2 minutes. The VAS score was 2.5±0.6 at 2 hours after surgery. The closure rate was 100% at 6 months. Symptoms improved after 6 months in all patients (6.2±1.2 to 0.9±0.2). Conclusion LAST showed a good closure rate in the early midterm follow up period. Ablation was possible with less energy compared with EVLA and the pain index was lower at the second hour after procedure.

Objective: This study aims to evaluate the effect of treatment for great saphenous vein incompetence with a fourth-generation 1940 nm laser with radial fiber and catheter directed foam sclerotherapy (CDFS) without a tumescent simultaneously. The procedure was termed laser assisted sclerotherapy (LAST). It is a kind of thermochemical ablation. Methods: From January 1 to June 30, 2023, 86 GSV cases from 50 patients who underwent LAST at Cheongmac hospital were enrolled in this retrospective study. Endogenous laser ablation (EVLA) was performed in the order of accessary vein, tributaries and truncal vein and then followed by CDFS which was performed with a 3% sodium tetradecyl sulfate (STS) mixed with CO 2 gas at a ratio of 1:4. The degree of pain was measured after procedure at 2 hours after the procedure. Follow-up was conducted at 1 week, 1 month, and 6 months. Results: Three of the 86 GSV observed for >6 months showed mild reflux. According to size and number of ablated vessels, various energy level was needed. Three percent STS was used 4.5±0.4 cc and operation time per GSV was about 8±2 minutes. The VAS score was 2.5±0.6 at 2 hours after surgery. The closure rate was 100% at 6 months. Symptoms improved after 6 months in all patients (6.2±1.2 to 0.9±0.2). Conclusion LAST showed a good closure rate in the early midterm follow up period. Ablation was possible with less energy compared with EVLA and the pain index was lower at the second hour after procedure.

BACKGROUND: Continuity is very important in primary care, and in most studies continuous care has been reported to have a good effect on the result of care. So we studied the factors influencing the continuity of patient care by physician in charge, especially in case of out-patient department in a university hospital. METHODS: We posed questionnaires to 55 persons who had visited continually to Paik Hospital in Pusan for at least 6 months. We classified them into three groups according to the degree of continuity using 'Modified Continuity Index', and compared the lower group (18 patients) with the higher group(18 patients). RESULTS: The incame of the higher continuity group was significantly less than that of the lower continuity group(P=0.042). But there were no significant differences between the two groups according to sex, age, the type of family, marital status, job and the level of education. The higher continuity group agreed more significantly than the lower continuity group with the question whether it is important to be treated continually from physician in charge(P=0.005). About the reasons for visiting to other doctors instead of the physician in charge, most of them in both group replied that they could not keep appointment. And there were no significant differences in the care pattern of disease between the groups. CONCLUSIONS: To improve the continuity of patient care by physician in charge, it is necessary to instruct the importance of continuous care to the patients and to motivate them through various methods.
Busan ; Continuity of Patient Care* ; Education ; Family Practice* ; Humans ; Marital Status ; Outpatients ; Primary Health Care ; Surveys and Questionnaires

PURPOSE: It was known that alpha-1 receptors are present in ureteral smooth muscle. We aimed to reveal the effect of an alpha-blocker (tamsulosin) and terpene mixture (Rowatinex(R)) on the expulsion of ureter stone (size less than 1cm), as well as its affect on the relief of pain. Material and Methods: The patients were classified into group A in which the size of the ureter stone less than 4mm (144 subjects) and group B in which the size of stone was between 4mm and 10mm (48 patients). Each study group was also further divided into 3 sub-groups: group 1 with analgesics only, group 2 with Rowatinex(R) as well as analgesics, and group 3 with 0.4mg of tamsulosin as well as analgesics. RESULTS: It was shown that the expulsion rates of ureter stone in sub-group 1 of group A, at the end of first week, was statistically lower (p<0.05) compared to that of sub-group 2 with Rowatinex(R). It was also shown that compared to sub-group 1, the expulsion rate of ureter stone at the end of first week in sub-group 3 was statistically significant (p<0.05). Compared to the consumed amount of analgesics in group A, it was revealed that sub-group 2 and sub-group 3 used statistically fewer ampules of than sub-group 1 (p<0.05). CONCLUSIONS: Our study clearly showed that both alpha-blocker and Rowatinex(R) are effective means of controlling colicky pain and they speed up excretion of ureter stones that are less than 4mm in size, at the end of first week. Therefore, we conclude that an alpha-blocker and Rowatinex(R) should be considered as an adjuvant regimen and this is beneficial for patients with ureter stone less than 4mm in size.
Analgesics ; Colic ; Humans ; Muscle, Smooth ; Terpenes ; Ureter* ; Ureteral Calculi