Recently, antimetabolotes such as 5-fluorouracil and mitomycin have been used successfully to reduce postoperative adhesions in animal models after strabismus surgery.Nine rabbits, 18 eyes, 36 areas were divided into 4 groups. The first group was a control one. The second group was treated with 5-fluorouracil intraoperatively. The third group was treated in the same manner as the second group, followed by subconjunctival injections of 5-fluorouracil from postoperative 7th day. The fourth group was treated with mitomycin C intraoperatively.The thied group(booster group) and the fourth group(mitomycin group) were superior to the others in preventing the postoperative adhesions. There was no statistically significant diference in scar length and adhesion grade between booster group and mitomycin group.This study reveals that the subconjunctival injections of 5-fluorouracil after intraoperative contact may reduce postoperative adhesions in secondary strabismus surgery and may prevent the possible serious complications of mitomycin C, giving the similar effect to potent mitomycin C.
Cicatrix ; Fluorouracil* ; Mitomycin ; Models, Animal ; Rabbits* ; Strabismus*

Ulcerative colitis is diffuse inflammatory condition at mucosal lining of the colon & rectum and rare in Korea but there are no pathognomonic features or specific diagnostic tests. However, recently the diagnostic methods for ulcerative colitis are much developed and the incidence of ulcerative colitis is increased in Korea. Therefor, an analysis of 31 cases of ulcerative colitis which was diagnosed and treated in the department of the YeungNam University Hospital from May l983 to April 1991 was reviewed. The results were as following: 1) The sex distribution assumed a ratio of 1 to 2.1 and the age distribution was vqriable but the most prevalent age group was 5th decade(29.0%). 2) The most common clinical manifestations were abdominal pain & bloody diarrhea. 3) As to the extent of disease determined by the barium enema & endoscopy, rectum or rectosigmoid colon was involved in majority of the cases 22.6%, 41.9 (respectively). 4) Significant laboratory findings were elevated ESR, anemia, leukocytosis, hypoalbuminemia. 5) The endoscopic examination was performed in all 31 cases and showed sinificant findings such as hyperemia, mucosai edema, superficial ulceration & mucosal friability. 6) 23 of 26 cases treated by sulfasalazine medication showed improved, and 3 cases were improved by steriod medication and the surgical operation was indicated in 1 case.
Abdominal Pain ; Age Distribution ; Anemia ; Barium ; Colitis, Ulcerative* ; Colon ; Diagnostic Tests, Routine ; Diarrhea ; Edema ; Endoscopy ; Enema ; Humans ; Hyperemia ; Hypoalbuminemia ; Incidence ; Korea ; Leukocytosis ; Rectum ; Sex Distribution ; Sulfasalazine ; Ulcer*

Thirty one cases of acromioclavicular injuries were treated in both Kangnam Sacred Heart Hospital and Hangang Sacred Heart Hospital during the period from May 1974 to April 1981. Three cases were classified to type 2 injuries and twenty eight were type 3. Among 31 cases one of the type 2 injuries was treated with closed reduction followed by thoracobrachial cast and remaining thirty received surgical treatment. Twenty one cases were operated on by technique of Weaver and Dunn, 8 cases by modified Phemister method and one case by Stewart technique. Preperative and postoperative stress film were evaluated and cap the coracoclavicular distance were measured. In twelve complete dislocation the authors modified the original Weaver and Dunn procedure by taking a bone chip along with the acromial end of the coracoacromial ligament. This seemed to provide a strong bony fulcrum for the suture of the ligament to clavicle as well as promoting bone to bone union. The results of this modified procedure were excellent.
Clavicle ; Dislocations ; Heart ; Ligaments ; Methods ; Sutures

Conjunctival bacterial cultures for 113 neonates who were delivered by cesarean section or vaginal delivery were performed within 30 minutes after birth. These neonates were in the condition of no eye drops applied. The 43 newborns were delivered by cesarean section(CS group) and the 70 newborns were delivered vaginally(VD group). The 10 newborns(P1) (14 eyes(P2)) in the CS group and the 29 newborns(41 eyes) in the VD group showed culture positivity. These differences between two groups were statistically significant(p1, p2<0.05). The CS group had significantly fewer species and colony forming units cultured per subject (0.395 +/- 0.821(p3), 5.116 +/- 27.095(p4) than the VD group(0.971 +/- 1.393, 25.843 +/- 62.285) (p3,p4<0.05). Coagulase negative staphylococci were predominantly isolated in the CS group and coagulase negative staphylococci, gram positive bacilli, E. coli, nonfermenting bacilli, and S. aureus in the VD group. Therefore it was found that the conjunctiva of the newborns delivered by cesarean section bore significantly fewer bacteria and need less prophylactic measures than that of newborns delivered vaginally.
Bacteria ; Cesarean Section* ; Coagulase ; Conjunctiva ; Female ; Humans ; Infant, Newborn ; Ophthalmic Solutions ; Parturition* ; Pregnancy ; Stem Cells

In oder to evaluate the efficacy of low vision aids in patients with optic atrophy, we analyzed sex, age distribution, preexisting conditions, visual acuities before and after low vision aids use. The sorts and magnifications of prescribed low vision aids were studied in patients with optic nerve atrophy whose visual acuities were not corrected with conventional glasses or contact lens. Our results indicate that distant and near visual acuities with low vision aids were significantly improved in patients with optic atrophy(p<0.01, paired ttest). We think that low vision aids are required to rehabilitate the visually impaired patients caused by optic atrophy because of high probability of visual rehabilitation.
Age Distribution ; Atrophy ; Eyeglasses ; Glass ; Humans ; Optic Atrophy* ; Optic Nerve ; Preexisting Condition Coverage ; Rehabilitation* ; Vision, Low* ; Visual Acuity

Purpose: This study aimed to report on a pancreas-preserving strategy consisting of the conversion to pancreaticogastrostomy (PG) for the salvage of disrupted pancreaticojejunostomy (PJ) following pancreaticoduodenectomy (PD). Methods: This single-center retrospective study included 188 patients who underwent PD between March 2000 and June 2021. Conversion to PG was performed by placing the pancreatic stump with an internal stent in the stomach through the posterior gastrostomy and suturing the wound in 2 layers through the anterior gastrostomy. Results: A total of 181 patients underwent PJ, while 7 underwent PG. Of all patients, 6 had International Study Group on Pancreatic Fistula grade C postoperative pancreatic fistulae (POPF; 3.3%) and 23 had grade B POPF (12.7%). Two of the 6 grade C patients underwent completion pancreatectomy and died of liver failure after common hepatic artery embolization due to pseudoaneurysm. Conversion to PG was performed in 4, all of whom survived and experienced no long-term pancreatic fistulae, remnant pancreatic atrophy, or newly developed diabetes after a median follow-up period of 11.5 months. Conclusion Conversion to PG for the salvage of disrupted PJ following PD is safe and effective in selected patients that can lower mortality rates while maintaining pancreatic function.

In vitro ethylene-diamine-tetra-acetic acid (EDTA) dependent satellitism and phagocytosis of platelets by neutrophils have been considered to be rare phenomena. It is associated with pseudothrombocytopenia, abnormal histogram of platelets and pseudoleukocytosis on complete blood cell count (CBC) by automated blood cell counter, but these findings are not found in heparinized or sodium citrated blood. It has no clinical significance such as bleeding tendency or abnormal platelet function. EDTA dependent platelet satellitosis and phagocytosis must be differentiated from true thrombocytopenia. We report a case of EDTA dependent platelet phagocytosis by neutrophils in a 68 year-old male patient who was diagnosed as mycosis fungoides. His EDTA blood smear showed frequent phagocytosis of platelets by neutrophils and occasional platelet satellitism. The bood cell counts were within normal limits without pseudothrombocytopenia. Phagocytized platelets were confirmed by immunohistochemistry using GpIIb/IIIa antibody and transmission electron micrographs.
Aged ; Blood Cell Count ; Blood Platelets* ; Cell Count ; Edetic Acid* ; Hemorrhage ; Heparin ; Humans ; Immunohistochemistry ; Male ; Mycosis Fungoides* ; Neutrophils* ; Phagocytosis* ; Sodium ; Thrombocytopenia

PURPOSE: We performed 3-channel single incision laparoscopic cholecystectomy (SILC) in earlier period of this study and modified our method to 4-channel SILC using a snake retractor for better operative field in later period. This study has been designed to evaluate the risk factors for prolonged operative time in SILC. METHODS: From April 2010 to August 2014, 323 cases of 3-channel SILC (Konyang standard method [KSM] group) and 399 cases of 4-channel SILC (modified KSM [mKSM] group) using a snake retractor were performed. RESULTS: The clinical characteristics were not significantly different between KSM and mKSM group except preoperative percutaneous transhepatic gallbladder drainage (PTGBD) treatment (9.6% vs. 16.5%, P < 0.007). The mean operation time was longer in mKSM group than KSM group (55.8 +/- 19.7 minutes vs. 51.7 +/- 20.1 minutes, P = 0.006). The estimated blood loss of KSM group was more than mKSM group (24.6 +/- 54.1 mL vs. 16.9 +/- 27.0 mL, P = 0.013). According to the histopathologic findings, acute cholecystitis or empyema were confirmed more in mKSM group as compared with KSM group (28% vs. 14.0%, P = 0.025). In multivariate analysis, the risk factors for prolonged operation time were drainage insertion, histopathologic findings (acute cholecystitis or empyema), surgeons' technical expertise, body mass index > 30 kg/m2 as well as the 4-channel SILC. CONCLUSION: Among patients with these risk factors, conventional laparoscopic cholecystectomy could be considered as well although SILC might be safe and feasible modality for benign gallbladder disease.
Body Mass Index ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute ; Drainage ; Empyema ; Gallbladder ; Gallbladder Diseases ; Humans ; Laparoscopy ; Multivariate Analysis ; Operative Time* ; Professional Competence ; Risk Factors* ; Snakes

BACKGROUND: The incidence of acute hepatitis A in adults has recently been increasing. This study was conducted to investigate the epidemiology and clinical characteristics of acute hepatitis A in Daegu province over the past 10 years. MATERIALS AND METHODS: We reviewed the medical records of 55 patients (male/female: 34/21), who were diagnosed with acute hepatitis A by confirmation of the IgM anti-HAV between January 1998 and June 2007. RESULTS: The mean age was 29.7+/-10.3 years (range; 17-65 years). The incidence was most common between March and June (56.1%), in the third and fourth decades of life (78.2%) and 90.9% (50/55) of the patients were diagnosed from 2003 to present. The common symptoms included anorexia, nausea or vomiting (69.1%), fever and chills (49.1%), myalgia (47.3%), weight loss (47.3%), fatigue (40.0%), abdominal pain (36.4%), diarrhea (9.1%) and pruritus (5.5%). The mean duration of hospital stay was 8.6+/-3.4 days (range; 3-20 days). The route of transmission was identified in only 11 patients (20.0%); 7 patients (12.7%) traveled (abroad or domestic), 2 patients (3.6%) ingested raw food and 2 patients (3.6%) had friends with acute hepatitis A. Fifty four patients recovered without complication; one patient developed fulminant hepatitis and recovered after a liver transplantation. CONCLUSION: The incidence of acute hepatitis A in adults is increasing. Because of the cost of treatment and potential for serious disease, persons, under 40 are recommened to have hepatitis A vaccination and confirmation of IgG anti-HAV.
Abdominal Pain ; Adult* ; Anorexia ; Chills ; Daegu ; Diarrhea ; Epidemiology ; Fatigue ; Fever ; Friends ; Hepatitis A Antibodies ; Hepatitis A virus ; Hepatitis A* ; Hepatitis* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Length of Stay ; Liver Transplantation ; Medical Records ; Myalgia ; Nausea ; Pruritus ; Vaccination ; Vomiting ; Weight Loss

PURPOSE: Hepatolithiasis causes many complications as well as an intrahepatic cholangiocarcinoma, which means that it should definitely be treated. However, it is difficult to make an accurate diagnosis for a concurrent cholangiocarcinoma prior to surgery. This study examined the surgical treatment for a hepatoithiasis with a hidden intrahepatic cholangiocarcinoma. METHODS: A retrospective analysis for patients who had undergone a hepatic resection for hepatolithiasis between September 1994 and July 2004 was made by comparing them in two groups. One group comprised of patients with hepatolithiasis only (group H) and the other group comprised of patients with hepatolithiasis and a hidden cholangiocarcinoma of which the preoperative diagnosis had failed (group HC). The prognostic factors, such as age, gender ratio (M: F), symptoms and the duration of their onset, tumor markers and total bilirubin, preoperative radiological findings, intraoperative findings, and operation type were analyzed. RESULTS: Group H consisted of 261 patients and the group HC consisted of 5. In group HC, 2 cases of tumor necrosis were misdiagnosed as a liver abscess, 1 case of hilar cholangiocarcinoma was misdiagnosed as severe cholangitis, and another case of intrahepatic cholangiocarcinoma was misdiagnosed as duct dilatation with periductal inflammatory proliferation. On the other hand, the presence of a history of a undergoing hepatobiliary surgery, the preoperative radiological findings of a liver abscess and lymphadenopathy, the type of surgery, and the site of the intrahepatic stones were statistically different in the two groups. CONCLUSION: A hidden cholangiocarcinoma should be suspected preoperatively in cases in whom there is a history of undergoing hepatobiliary surgery, the preoperative radiological findings of a liver abscess or lymphadenopathy. In addition, a meticulous exploration for a possible incidental tumor mass with an additional consultation of a frozen biopsy should be carried out intraoperatively to determine if the preoperative finding of a liver abscess is a tumor necrosis.
Bilirubin ; Biopsy ; Biomarkers, Tumor ; Cholangiocarcinoma* ; Cholangitis ; Diagnosis ; Dilatation ; Hand ; Humans ; Liver Abscess ; Lymphatic Diseases ; Necrosis ; Retrospective Studies