The clinical results of 20 patients(20 eyes) who were operated due to perforated corneal laceration with traumatic cataract between March 5, 1991 and July 14, 1994 were analysed for the predictors of postoperative good visual outcome and compared simultaneous cataract surgery and implantation with secondary implantation. The most significant predictor of postoperative good visual outcome was the location of corneal laceration. Timing of lens implantation didn't influence significantly final visual acuity and postoperative inflammation. But postoperative complication were less frequent in patients where secondary IOL implantation was performed as opposed to those simultaneous IOL implantated.
Cataract* ; Humans ; Inflammation ; Lacerations* ; Postoperative Complications ; Visual Acuity

We report the results of field operation of TELEACE system between Kyung-Pook National University Hospital and Ul-Jin Goon Health Care Medical Center from December, 1990 to September, 1991, which had been operated as a kind of Integrated Services Digital Nework projects by KOREA TELECOMMUNICATION Inc. Ul-Jin Goon Health Care Medical Center transmitted 414 plain radiographs to our hospital in speed of 9600BPS. Each image was composed of 1024X1024 pixelsX8 bits/pixel. In our hospital, the image files were displayed on high resolution monitor (1280×1024 pixets). Text files of image interpretations were transmitted to the health care medical center. The two radiologists who had interpreted the transmitted images, went to the health care medical center and read radiographic film with blind test method. We obtained the following results: false negative rate of 6.3%, false postitve rate of 2.4%, mean sensitivity of 81.4%, mean specificity of 96.3%, and mean accuracy of 91.3%. In predictive value of 0.05, there was no significant difference between results of these two types of radiographs. In conclusion, TELEACE system was valuable to the clinicians isolated from services of radiologists.
Delivery of Health Care ; Korea ; Methods ; Sensitivity and Specificity ; Telecommunications ; X-Ray Film

Retinal dysplasia is an abnormal differentiation of the retina at embryonal retina stage with proliferation of its elements into rosettes, fold, and gliosis and it is very difficulat to distinguish between the various types of intraocular disease, especilaly retinoblastoma. We experienced a case of unilateral retinal dysplasia without systemic abnormalities occurring in a 5 months old boy. It was clinically suspected Retinoblastoma, which was proved to be Retinal Dysplasia by histopathologic examination.
Gliosis ; Humans ; Infant ; Male ; Retina ; Retinal Dysplasia* ; Retinaldehyde* ; Retinoblastoma

BACKGROUND: This study was designed to evaluate the role of KATP channel activation and change of monophasic action potential duration on cardioprotective effect of ischemic preconditioning in cat. METHODS: 34 cats were divided into 4 groups: control (n=10), ischemic preconditioning(n=8), glibenclamide pre-treated(n=8) and nicorandil pre-treated group(n=8). Ischemic preconditioning was done in ischemic preconditioning and glibenclamide pre-treated groups by 3 episodes of 5 min ischemia and 10 min reperfusion. All subjects underwent 40 min of ischemia and 40 min reperfusion. The KATP channel antagonist glibenclamide was given as intravenous bolus (0.5mg/kg) 10 min before ischemic precondtioning and infused (5 microgram/min) during ischemic preconditioning. Nicorandil, a KATP channel opener was injected as intravenous bolus (0.5mg/kg) before 40 min ischemic procedure. Monophasic action potential duration at 50% repolarization(MAP50) was measured in the ischemic and non-ischemic area respectively by epicardial probe throughout the experiment. The effects of ischemic preconditioning were determined by infarct size (% area at risk). RESULTS: Ischemic preconditioning or pretreatment with nicorandil prior to 40 min ischemia demonstrated a significant reduction in infarct size(26.6+/-7%, 33+/-8% infarction of the risk zone, respectively, p<0.01, p<0.05 vs. control) with respect to control(42+/-7% infarction of the risk zone). Pretreatment with glibenclamide abolished the effect of ischemic preconditioning(40+/-8% infarction of the risk zone, p=NS vs. control) Ischemic preconditioning group exhibited a significant reduction of ischemic area MAP50 duration in the ischemic area during preconditioning; at first preconditioning 123+/-9msec vs. 137+/-19msec control(p=NS), at second preconditioning 105+/-16msec vs. 140+/-19msec control(p<0.01), at third preconditioning 109+/-15msec vs. 138+/-19msec control(p<0.05). Pretreatment with glibenclamide prevented the reduction of MAP50 in the ischemic area during ischemic preconditioning. During 40 minutes ischemia, MAP50 shortening was more pronounced in the preconditioned group than in control group; at 10 min 85+/-22 msec vs. 131+/-31msec control(p<0.05), at 20 min 88+/-21msec vs. 130+/-32msec control(p<0.05), and at 30 min 103+/-24msec vs. 136+/-30msec control(p<0.05). This shortening effect was prevented by glibenclamide pretreatment. Nicorandil pretreatment pronounced the ischemic shortening of MAP50 in ischemic area and the nicorandil effect was most significant during early ischemic period; at 10 min 97+/-21msec(p<0.05 vs. control), at 20 min 104+/-32msec (p=NS vs. control), and at 30 min 134+/-28msec(p=NS vs. control). MAP50 measured in non-ischemic area was not significantly different between groups. CONCLUSION: We conclude that KATP channel activation and monophasic action potential duration shortening play a important role in myocardial protection during ischemic injury.
Action Potentials* ; Animals ; Cats* ; Glyburide ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Nicorandil ; Reperfusion

BACKGROUND: The value of coronary reperfusion resulting from Thrombolysis and/or coronary angioplasty in patients with evolving myocardial infarction has been rigorously evaluated and improved left venticular function and short-term survival rates have been demonstrated consistently in controlled studies. Benefits from delayed coronary angioplasty at 7-10 days after onset of acute myocardial infarction (AMI) without thrombolysis remains unclear. In order to assess the effect of delayed reperfusion in infarct-related artery(IRA), we analyzed the restenosis rate of IRA after successful coronary angioplasty and the change of left ventricular function at late follow-up angiogram. METHOD: Coronary angioplasty in 69 lesions of 55 patients(M/F:48/7, mean age 53 years) with acute myocardial infarction(AMI) were performed at 7-10 days after onset of AMI and follow-up coronary angiogram (25 lesions of 20 pts) with left ventriculogram were obtained at means 5.1 months(range 4-6 months) after angioplasty. Restenosis rate of dilated infaret-related arteries and the changes of left ventricular function after angioplasty were evaluated. RESULTS: The overall procedural success rate of delayed elective coronary angioplasty in patients with AMI was 86% with a higher success rate in subtotally occluded vessel(98%) than in the occluded IRA(64%). Complications included acute closure after large dissection in 1(1.6%) and on -hospital mortality due to cardiogenic shock in 1(1.8%). Angiographically restenosis rate of IRA was 65% at mean 5.1 months follow-up, which was relatively higher than that after non-IRA angioplasty in AMI(25%) and in patients with angina(24%). Left ventricular ejection fraction improved significantly from 47.2+/-12.7% to 58.8+/-8.6%(P<0.05) at follow-up. Patients who had a patent IRA at follow-up had a restenotic IRA at follow-up had no statistically significant improvement in EF(table 3). Patients with a left anterior descending artery(LAD) lesion had lower mean immediate EFs than patients with right coronary artery lesion, however the degree of improvement in EF at follow-up was more significant in patients with LAD lesion. CONCLUSIONS: Delayed elective angioplasty of IRA at 7-10 days after onset of AMI was relatively safe and had comparable procedural success rate. Higher restenosis rate(65%) of IRA at follow-up appeared to be related, at least on part, to the endothelial dysfunction after ischemic-reperfusion injury and clinically unstable status. Left ventricular function improved significantly after angioplasty at follow-up. Recovery of left ventricular function might be reated to whether or not the IRA had an angiographically restenosis at follow-up.
Angioplasty* ; Arteries ; Coronary Vessels ; Follow-Up Studies* ; Humans ; Mortality ; Myocardial Infarction* ; Myocardial Reperfusion ; Reperfusion ; Shock, Cardiogenic ; Stroke Volume ; Survival Rate ; Ventricular Function, Left

Hyperplastic gastric polyps (HPPs) are the most common type of gastric polyps. They are assumed to be caused by chronic inflammation and regenerative proliferation, although this has not been clearly investigated yet. Many studies suggested the development of fundic gland polyps and carcinoid during long-term proton pump inhibitor (PPI) therapy, but the relationship between PPIs and HPPs is still unclear. We encountered a patient who showed aggravation of HPPs after long-term use of PPIs. A 58-year-old male patient with liver cirrhosis visited our hospital because of hematemesis. We started PPI medication after confirming esophageal variceal bleeding and duodenal ulcer with blood clot in its base via emergency endoscopy. He took PPIs for three years because of an intractable duodenal ulcer. There was a marked increase in the size of the pre-existing polyps and in the development of new polyps. We presumed that the PPIs caused the aggravation of the HPPs, so we stopped their administration. After five months, the HPPs shrank and the polyps were partially degraded. More prospective studies are needed to investigate the relationship between HPPs and PPIs.
Carcinoid Tumor ; Duodenal Ulcer ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices ; Hematemesis ; Humans ; Inflammation ; Liver Cirrhosis ; Male ; Middle Aged ; Polyps* ; Proton Pump Inhibitors* ; Proton Pumps* ; Protons*

Primary adenocarcinoma of the duodenum is a rare disease, representing 0.35% of all gastrointestinal neoplasm and 0.042% of all malignant neoplasm. Since Ham-burger described the first duodenal caricinoma in 1746, the incidence has shown an increasing tendency. Compared with upper gastrointestinal contrast studies, the gastroduodenoscopy has gained an increasing popularity as an invesitigative tool in recent years. But the diagnosis is usually made at a very late stage because the symptoms are often non-specific, which contributes to delayed diagonsiss and poorer prognosis. We have experienced two cases of the primary carcinoma of the duodenal bulb and one case of carcinoma of the second portion, which were diagnosed by biopsy with gastrofiberoscopic endoscopy and operative finding. So we report three csses with a brief review of literature.
Adenocarcinoma* ; Biopsy ; Diagnosis ; Duodenum* ; Endoscopy ; Gastrointestinal Neoplasms ; Incidence ; Prognosis ; Rare Diseases

The interphalangeal joint (IPJ) of the hallux has received little attention compared with the first metatarsophalangeal joint. But, the hallucal IPJ has several disorders such intra-articular fractures, dorsal dislocation, alignment disorder, and inflammatory or degenerative arthritis. Among these disorders septic arthritis of the IPJ of the hallux is rare. We report a case of sepsis of the hallucal IPJ and adjacent underlying osteomyelitis without neuropathic problem and was performed through infected soft tissue and osseous debridement, temporary antibiotic-impregnated cement spacer, and delayed intercalary allogenic fibular bone graft with K-wire fixation.
Arthritis, Infectious ; Debridement ; Dislocations ; Hallux ; Intra-Articular Fractures ; Joints ; Metatarsophalangeal Joint ; Osteoarthritis ; Osteomyelitis ; Sepsis ; Transplants

This survey was performed to obtain the basic information for the prevention and management of occupational low back injury(LBI). The subjects of this survey were 952 workers(male, 892;female, 60) who had taken occupational LBI in some industries of Pusan area from January 1 to December 31, 1991. Observation period was 2.6 years from the beginning to the end of medical treatment. The obtained results were summarized as follows; 1. The proportion of LBI workers was 15.9% of the workers who had taken any occupational injuries and 0.32% of all workers in this surveyed area. 2. 8.0% of the workers had taken LBI on the 1st day of employment and 55.2% of the workers were within one year, 91.4% of the workers were within 10 years according to cumulative frequency distribution. 3. Handling of heavy objects was the most common cause of LBI(32.0%) and fall down(26.9%) and slip down(16.3%) were the next in order. 4. The most common causes of both lumbar sprain and HNP were handling of heavy objects and that of lumbar fracture was fall down. 5. The mean duration for medical treatment of LBI workers was 143 days. 6. The total direct compensation cost for LBI workers was 6,736 million Won and the proportion of medical, resting, disability compensation costs were 25.0%, 37.0%, 38.0% respectively. 7. The percentages of retreated workers and disabled workers were 11.9%(113 persons) and 22.9%(218 persons) of total LBI workers respectively.
Back Injuries* ; Busan* ; Compensation and Redress ; Employment ; Occupational Injuries ; Sprains and Strains

BACKGROUND: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigated the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. METHOD: 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. RESULT: Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure(PImax) was also significantly lower in the depleted group(p<0.05). CONCLUSION: We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.
Body Weight ; Electric Impedance ; Forced Expiratory Volume ; Humans ; Korea ; Mortality ; Nutritional Status* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Residual Volume ; Total Lung Capacity ; Vital Capacity ; Weight Loss