Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

PURPOSE: To evaluate the therapeutic efficacy of phacoemulsification in treating phacomorphic glaucoma. METHODS: We observed 25 eyes of 25 patients who had undergone phacoemulsification and intraocular lens implantation for the treatment of phacomorphic glaucoma. Intraocular pressure (IOP), best corrected visual acuity (BCVA), depth of anterior chamber, management and complications between preoperative and postoperative periods were analyzed retrospectively. RESULTS: The mean IOP was 49.0 +/- 10.6 mmHg (range: 31~70 mmHg) before the operation and 13.2 +/- 2.8 mmHg (range: 8~20 mmHg) at 36 months after surgery (Paired T-test, p<0.0001). We could not find any case with increased IOP in our series for more than 3 years. The postoperative IOP decreased significantly the day after surgery (Paired T-test, p<0.0001). Improvement of postoperative visual acuity was remarkable from the first week after operation (Paired T-test, p<0.0001). Postoperatively, the visual acuity was improved except for one eye with preoperative visual acuity of no light perception. Especially, BCVA in 15 cases (60%) was above 20/40. Preoperatively, the anterior chambers were extremely shallow (average: 1.5 +/- 0.3 mm) by the swollen lens, and the average postoperative anterior chamber depth increased significantly by 2.6 +/- 0.1 mm on A-scan. The ratio of lens thickness to axial length factor was 2.5 +/- 0.1, indicating the shallow anterior chamber. Continuous postoperative medical treatment for IOP control was needed in one case, where peripheral anterior synechiae were observed by gonioscopy immediately after surgery. CONCLUSIONS: Phacoemulsification is a very safe and effective procedure for the treatment of phacomorphic glaucoma.
Anterior Chamber ; Glaucoma* ; Gonioscopy ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification* ; Postoperative Period ; Retrospective Studies ; Visual Acuity

PURPOSE: To compare and analyze intraoperative and postoperative complications of corneal flap in the LASIK procedures using different types of manual microkeratomes (MLK, LSK, disposable Barron). METHODS: Eight hundred sixty-two eyes were retrospectively evaluated to study the effects of 3 different microkeratomes on the frequency of complications, managements, and postoperative best visual acuity. The eyes were grouped according to the microkeratomes used in making corenal flap: Group 1 (334 eyes) treated with MLK(SCMD, USA); Group 2 (256 eyes), LSK(Moria, France); Group 3 (272 eyes), disposable Barron(Katena, USA). RESULTS: Mean follow-up period was 6.3 months and mean age was 29.2 years (range 20 39). Complications of corneal flap were observed in 74(7.9%) of 862 eyes. Intraoperative flap complications occurred in 15 eyes (4.5%), 6 eyes (2.4%) and 3 eyes (1.2%) in each group, respectively. The postoperative flap complications were observed in 24 eyes (7.2%), 17 eyes (6.7%) and 9 eyes (3.3%) in each group. The postoperative best corrected visual acuity decreased by 2 lines or more in 2 eyes (0.6%), 1 eye (0.4%) and none (0%) of each group. CONCLUSIONS: The incidence of corneal flap-related complications by manual microkeratomes was relatively low. Disposable Barron microkeratome showed the lowest complication rate in our series. It also has an advantage of easy maneuverability, and reproducibility (equal size and thickness of corneal flap).
Follow-Up Studies ; Incidence ; Keratomileusis, Laser In Situ* ; Postoperative Complications ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluate the outcome of posterior continuous curvilinear capsulorhexis (PCCC) performed simultaneously with cataract surgery to inhibit after-cataract. METHODS: Among patients who underwent phacoemulsification and posterior chamber intraocular lens implantation from December 1999 through December 2001, we had followed on 94 eyes of 80 patients who underwent PCCC intraoperatively and 100 eyes in 92 patients without PCCC as control group. Both groups were divided into 4 categories: nonproliferative diabetic retinopathy(NPDR); uveitis; below 60 years without ocular and systemic disease; over 60 years without ocular and systemic disease. Preoperative and postoperative visual acuity and complications were analyzed from 6 months to 12 months. RESULTS: There was statistically no difference in the best corrected visual acuity at 6 months between PCCC and control group in all categories. Transient increase in the intraocular pressure was noted in 5 eyes (5%) of PCCC group and 3 eyes (3%) in control group. Vitreous prolapse into anterior chamber was found in 2 eyes (2%) of PCCC group. Cystoid macular edema was found in only 1 eye (1%) in NPDR patients of PCCC group. Progression of diabetic retinopathy was found in 1 eye (5.6%) and 3 eyes (12.5%) in each group respectively. There was no statistically significant difference in progression of diabetic retinopathy after surgery between the two groups. CONCLUSIONS: Primary PCCC is a safe procedure to perform in patient who has a predisposition to after-cataract.
Anterior Chamber ; Capsulorhexis* ; Cataract ; Diabetic Retinopathy ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular ; Macular Edema ; Phacoemulsification ; Prolapse ; Uveitis ; Visual Acuity

PUPOSE: This study was designed to investigate the validity of WHOQOL-BREF (Brief form of the World Health Organization Quality of Life Assessment Instrument) and to explore quality of life (QOL) by using WHOQOL-BREF in patients with stomach cancer after a curative resection. MATERIALS AND METHODS: Fifty (50) patients with stomach cancer after a curative resection were recruited with informed consents. Age- and gender matched hospital staffs served as controls. The 100-item WHOQOL instrument was employed for the all subjects. The scores of the WHOQOL-BREF, which is a short version (26 questions) of the WHOQOL, and includes four domains (physical, psychological, social, and environmental), were compared with those of WHOQOL. RESULTS: The scores of the WHOQOL-BREF were significantly correlated with those of the WHOQOL in all domains. Two domains, physical and social, were associated with worse quality of life in patients with stomach cancer after a curative resection. CONCLUSION: The WHOQOL-BREF is a valid instrument that is useful for evaluating the quality of life in patients with stomach cancer.
Humans ; Quality of Life* ; Stomach Neoplasms* ; Stomach* ; World Health Organization

PURPOSE: We conducted this study to evaluate the feasibility and the safety of a delta-shaped gastroduodenostomy after totally laparoscopic distal gastrectomy (TLDG) and to know about the factors having influence on surgeons' performance of anastomosis and technical details of this operation. METHODS: The clinical characteristics and the surgical results of 57 consecutive patients with delta-shaped gastroduodenostomy after TLDG at Incheon St. Mary's Hospital were reviewed. The patients were divided into 2 groups (before and after 20 cases) and their clinical characteristics and surgical results were compared. The factors which influenced the anastomotic time and the technical details of the operation were also investigated. RESULTS: There was no difference in age, gender, body mass index, surgical results except for operation time, anastomotic time, and starting day of oral feeding between the 2 groups. The experience of the surgeon was the only factor that influenced the anastomotic time. CONCLUSION: Delta-shaped gastroduodenostomy is a feasible and safe procedure even in the early years of a surgeon's career. It could feasibly be done in less than 20 minutes in relatively experienced hands.
Body Mass Index ; Gastrectomy ; Hand ; Humans

PURPOSE: A cross-calibration equation is needed to compare bone mineral density measured by different dual X-ray absoptiometry systems. We performed this study to establish appropriate cross-calibration equations between two different dual X-ray absorptiometry systems. MATERIALS AND METHODS: Bone mineral density of anterior-posterior lumbar spine (L2-4 level) and femoral neck were measured in 109 women (55+/-11yr) using two different dual X-ray absorptiometry systems (Lunar EXPERT-XL) and Hologic QDR 4500-A). Bone mineral density values measured by two systems, including area, bone mass content, bone mineral density and percentile of young normals were compared and cross-calibration equations between two systems derived. RESULTS: The bone mineral density values of 109 women measured by Lunar system were 0.958+/-0.17 g/cm2 at L2-4 and 0.768+/-0.131 g/cm2 at femur neck, which were significantly higher (13+/-6% at L2-4 and 19+/-7% at femur neck, p<0.001) than those (0.851+/-0.144 g/cm2 at L2-4 and 0.649+/-0.108 g/cm2 at femur neck) by Hologic system. Bone mineral content and percentile of young normals measured by Lunar system were also significantly higher than those by Hologic system (p<0.001), whereas there was no difference in area (p>0.05). There was a high correlation between bone mineral density values of L2-4 and femoral neck obtained with both dual X-ray absortiometry systems (r=0.96 and 0.95, respectively). Cross-calibration equations relating the bone mineral density were Lunar=1.1287xHologic-0.0027 for L2-4 and Lunar=l.1556xHologic+0.0l82 for femoral neck. CONCLUSION:: We obtained cross-calibration equations of bone mineral density between Lunar EXPERT-XL and Hologic QDR 4500-A. These equations can be useful in comparing bone mineral density obtained by different dual X-ray absorptiometry systems.
Absorptiometry, Photon* ; Bone Density* ; Female ; Femur ; Femur Neck ; Humans ; Osteoporosis ; Spine

This study proposed a mechanical model of the excimer laser photorefractive keratectomy(PRK) for myopia patients utilizing finite element method, which is a simulation technique widely used in engineering fields. The outcomes of the surgery depends on many factors, which are also dependent on each other. In this study, some mechanical factors are selected and the effects of the selected factors on the surgical results were analyzed. One of the important factors in the finite element analysis is the mechanical properties of the object. The representative characteristic of the human cornea is that it shows highly nonlinear property in the stress-strain relationship like most soft tissues in the human body. Therefore, the nonliear property was adopted in this study. Other important mechanical properties which affect the outcomes of the surgery are: a preoperative thickness, intraocular pressure, diameter of ablation zone and the depth of ablation. With various changes of the those mechanical factors, the outcomes of the surgery were predicted using the finite element method. The results show the qualitative agreement with clinical outcomes also promising agreement quantitatively. Therefore, this study shows a potential of the finite element method in clinical application of excimer laser PRK.
Cornea ; Finite Element Analysis ; Human Body ; Humans ; Intraocular Pressure ; Lasers, Excimer* ; Myopia ; Photorefractive Keratectomy*

PURPOSE: To determine the means, medians and reference intervals for TSH (thyroid-stimulating hormone) and fT4 (free thyroxine) for each month of gestation and for three trimesters in Korean pregnant women. METHODS: Serum samples were collected from 265 pregnant women with singleton gestation. Levels of TSH, fT4 were measured by immunoassay. After exclusion of subjects with positive antimicrosomal autoantibodies, the means, medians and reference intervals based on 2.5th and 97.5th percentiles for TSH, fT4 were determined. RESULTS: The study population consisted of 94 women in first trimester, 49 women in second trimester, and 122 women in third trimester. The trimester-specific reference intervals were: TSH (1st trimester: 0.03~2.72, 2nd: 0.27~2.29, and 3rd: 0.03~2.88 mIU/L), fT4 (1st trimester 4.50~19.75, 2nd: 4.70~12.98 and 3rd: 5.07~11.84 pg/mL). fT4 levels were significantly lower in the second and third trimesters. TSH levels were lower in the first trimester than second and third trimester, with gradual elevation in the second and third trimester. CONCLUSION: Levels of TSH, fT4 during pregnancy differ from those in non-pregnant women. Gestational age specific reference intervals will play a cental role in screening and diagnosis of thyroid disorders. Further studies for normal reference ranges during pregnancy are needed to create reference intervals in Korean pregnant women.
Autoantibodies ; Female ; Gestational Age ; Humans ; Immunoassay ; Mass Screening ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnant Women ; Reference Values ; Thyroid Function Tests ; Thyroid Gland ; Thyrotropin