We evaluated the effectiveness of photoastigmatic refractive Keratectomy(PARK) by excimer laser on patients with compound myopic astigmatism. Spherocylindrical PARK was performed on 181 myopic eyes with astigmatism(mean spherical equivalent : -6.61 D, range : -1.88~-14.5 D) using the visx excimer laser. The eyes were divided into three groups according to the amount of desired astigmatic correction : Group 1(-0.5~-1.0 D), Group 2(-1.25~3.0 D), and Group 3(-3.25~-5.5 D). Patients were followed up for 6 months. Uncorrected visual acuity at postoperative 6 month, was 0.80+/-0.27 in Group 1, 0.79+/-0.19 and 0.71+/-0.21bin Group 2 and 3 respectively. The mean spherical equivalent refraction was -0.24 D 6 months after PARK. Mean astigmatism was reduced from preoperative -0.85+/-0.51 D to postoperative -0.34+/-0.38 D in Group 1, from -2.08+/-0.65 D to -0.43+/-0.64 D and from -4.42+/-0.63 D to -1.23+/-1.25 D in Group 2 and 3 respectively. We also analyzed the angle of error, magnitude of error, index of success, and coefficient of afjustment by vector analysis. No significant complications were observed during the follow-up period. These results show that PARK by excimer laser was effective in correction of astigmatism. The effect of astigmatic correction in Group 2 and 3 were better than that of Group 1. Group 1 showed overcorrected tendency and Group 2 and 3 showed undercorrected tendency.
Astigmatism ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Visual Acuity

We evaluated the effectiveness of photoastigmatic refractive Keratectomy(PARK) by excimer laser on patients with compound myopic astigmatism. Spherocylindrical PARK was performed on 181 myopic eyes with astigmatism(mean spherical equivalent : -6.61 D, range : -1.88~-14.5 D) using the visx excimer laser. The eyes were divided into three groups according to the amount of desired astigmatic correction : Group 1(-0.5~-1.0 D), Group 2(-1.25~3.0 D), and Group 3(-3.25~-5.5 D). Patients were followed up for 6 months. Uncorrected visual acuity at postoperative 6 month, was 0.80+/-0.27 in Group 1, 0.79+/-0.19 and 0.71+/-0.21bin Group 2 and 3 respectively. The mean spherical equivalent refraction was -0.24 D 6 months after PARK. Mean astigmatism was reduced from preoperative -0.85+/-0.51 D to postoperative -0.34+/-0.38 D in Group 1, from -2.08+/-0.65 D to -0.43+/-0.64 D and from -4.42+/-0.63 D to -1.23+/-1.25 D in Group 2 and 3 respectively. We also analyzed the angle of error, magnitude of error, index of success, and coefficient of afjustment by vector analysis. No significant complications were observed during the follow-up period. These results show that PARK by excimer laser was effective in correction of astigmatism. The effect of astigmatic correction in Group 2 and 3 were better than that of Group 1. Group 1 showed overcorrected tendency and Group 2 and 3 showed undercorrected tendency.
Astigmatism ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Visual Acuity

To evaluate the efficacy of optimizing of A-constant, the error in prediction was analyzed in three groups of eyes after posterior chamber lens implantation ; 102 eyes with bag placed, 66 eyes with simple sulcus places, and 25 eyes with sulcus placed with transscleral fixation suture. We compared the predictive accuracy of the SRK/T formula using optimized A-constant (bag-placed, sulcus-placed) derived from the 300 eyes with Holladay and SRK/T using original surgeon factor and A-constant. The SRK/T formula with optimized A-constant has a better mean relative, absolut, and standard error and has a better range of IOL prediction error, which was more accurate than other formulas without optimizing. In this study it is our recommendation that each surgeon use a different optimized A-constants for sulcus or bag placement to enhance the predictability of the postoperative refraction.
Sutures

Adenoid cystic carcinoma (ACC) of lacrimal gland is the most common epithelial neoplasms of the lacrimal gland. This highly invasive tumor disseminates hematogenously, but also infiltrates between tissue planes along nerves and blood vessels into the surrounding bone, represents low rate of the survival and difficult to cure. We experienced the case of a 41-year-old woman who had complained pain and downward displacement of the right eye. These symptoms had been occured 5 months ago. The MRI and the histopathologic findings revealed adenoid cystic carcinoma of the right lacrimal gland. We performed the lateral orbitotomy followed by macroscopical complete resection of tumors being different from radical therapy. The patient received 6.000 cGy of postoperative radiation for prevention of recurrence of tumor. While she has been treated from 9 months ago, there was no evidence of metastasis and recurrence, and we obtained good cosmetic results with our treatment modality. So we present our case with a brief review of the literature.
Adenoids* ; Adult ; Blood Vessels ; Carcinoma, Adenoid Cystic* ; Female ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Recurrence

PURPOSE: In spite of the development of asthma management guidelines, there are discrepancies between the guidelines and real management. We surveyed the insights and the real management of asthma to assess the current status of its management in Korea. METHODS: The objects of the survey were 266 parents with asthmatic children, who attended an educational lecture by the Korean World Asthma Day Project Office (KWADPO). Face to face interviews with questionnaires of 11 questions about understanding of asthma maintenance therapy, actual conditions of taking medicine and the impact of asthma on the family life were undertaken. RESULTS: The Median age of the patients was 5.2 years old and their parents' age ranged from those in their twenties to those in their forties. The number of the patients actually taking asthma maintenance medicine (40.6 percent) was a little bit lower than the level of awareness (53.0 percent). As a controller, patients are using short-acting beta2 inhalers (35.3 percent), steroid inhalers (including combination inhaler) (31.6 percent), leukotriene receptor antagonists (24.8 percent), antihistamines (25.6 percent), theophylline (2.3 percent), etc. Regular visits to hospital or clinic were done in 53.0 percent of the patients. As a controllers, oral medications (69.2 percent) was preferred to inhalers (18.0 percent) due to better compliance and easier dosage adjustment. CONCLUSION: According to the survey, asthma had negative effects on the life quality of patients and their families. Remarkable discrepancies were noticed between the guidelines and the real-world status of taking medicine in asthmatic children. It is necessary to have patients participate actively in making asthma management plans to raise their efficacy.
Asthma* ; Child* ; Compliance ; Histamine Antagonists ; Humans ; Korea ; Leukotriene Antagonists ; Nebulizers and Vaporizers ; Parents ; Quality of Life ; Surveys and Questionnaires ; Theophylline

A primary thyroid lymphoma is rare among all types of thyroid malignancy. Usually, a thyroid lymphoma is associated with underlying chronic autoimmune thyroiditis. Recently, we experienced a primary thyroid mucosa-associated lymphoid tissue(MALT) lymphoma, with an incidental micropapillary thyroid carcinoma, but lacking evidence of autoimmune thyroiditis. A female patient visited our hospital for further evaluation of a rapidly enlarging, painless thyroid mass which had been stable for 8 years. Lymphocytic thyroiditis or a lymphoma was suspected from fine needle aspiration performed at another hospital. The thyroid function test and other routine laboratory tests were normal. The histopathological findings after a total thyroidectomy revealed a MALT lymphoma with a micropapillary thyroid carcinoma. There was no evidence of chronic autoimmune thyroiditis. This is, to the best of our knowledge, the first case report of a MALT lymphoma arising from the thyroid gland without evidence of chronic autoimmune thyroiditis in Korea
Biopsy, Fine-Needle ; Female ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyroiditis, Autoimmune*

A primary thyroid lymphoma is rare among all types of thyroid malignancy. Usually, a thyroid lymphoma is associated with underlying chronic autoimmune thyroiditis. Recently, we experienced a primary thyroid mucosa-associated lymphoid tissue(MALT) lymphoma, with an incidental micropapillary thyroid carcinoma, but lacking evidence of autoimmune thyroiditis. A female patient visited our hospital for further evaluation of a rapidly enlarging, painless thyroid mass which had been stable for 8 years. Lymphocytic thyroiditis or a lymphoma was suspected from fine needle aspiration performed at another hospital. The thyroid function test and other routine laboratory tests were normal. The histopathological findings after a total thyroidectomy revealed a MALT lymphoma with a micropapillary thyroid carcinoma. There was no evidence of chronic autoimmune thyroiditis. This is, to the best of our knowledge, the first case report of a MALT lymphoma arising from the thyroid gland without evidence of chronic autoimmune thyroiditis in Korea
Biopsy, Fine-Needle ; Female ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyroiditis, Autoimmune*

PURPOSE: We evaluated the effects of epidermal growth factor(EGF) and transforming growth factor-alpha (TGF-alpha) on the growth of human transitional cell carcinoma cell lines. MATERIALS AND METHODS: T-24, KK47 and KU-1 cell lines established from human transitional cell carcinoma tissues were used. We cultured the cell lines in serum-free media for 48 hours and then administered EGF and TGF-alpha in the concentrations of 0.1ng/ml, 1ng/ml, 10ng/ml and 100ng/m1 respectively. We analysed the effects by MTT assay at 144 hours. RESULTS: There were statistically significant stimulatory effects on the growth of three cell lines in all cultures. Enhanced growth was also observed in the culture with administration of EGF and TGF-alpha simultaneously. None of stimulatory effects were dose-related. CONCLUSIONS: We should take into consideration of possible role of EGF which are excreted in urine in very high concentration in a biologically active form and TGF-alpha of which urinary level increases with various type of bladder injuries in occurrence, progression and recurrence of transitional cell carcinoma of urothelium.
Carcinoma, Transitional Cell* ; Cell Line* ; Culture Media, Serum-Free ; Epidermal Growth Factor* ; Humans* ; Recurrence ; Transforming Growth Factor alpha ; Transforming Growth Factors ; Urinary Bladder ; Urothelium

OBJECTIVE: This study aimed to achieve expert consensus for the development of strategies emergency medical services system (EMSS) after reunification of Korean using the Delphi method. METHODS: The Delphi study was performed through several rounds from January to February in 2017. Experts who have experiences of emergency medical support in North Korea and developing countries participated in the study. Respondents were asked to express their level of agreement following 7 categories: (1) emergency medical manpower, (2) communication system, (3) emergency facilities, (4) patient transfer system, (5) consumer participation and public education, (6) insurance system, (7) disaster planning. Score 1–3 was classified as disagreement, 4–6 as medium agreement, and 7–9 as agreement and consensus was considered being achieved when more than two thirds of respondents agreed in each question. RESULTS: Response rate were 80% in the first round and 75% in the second round. Consensus was achieved in emergency medical manpower, communication system, emergency facilities, patient transfer system, and disaster planning for the important factors immediately after reunification within 5 years. Consensus was achieved in emergency medical manpower, communication system, emergency facilities, patient transfer system, consumer participation and public education, and disaster planning for the prior factors when the reunification would happen rapidly without enough preparation. CONCLUSION: Consensus was achieved in emergency medical manpower, communication system, emergency facilities, patient transfer system, disaster planning for the essential EMSS elements. The consensus was expected to utilize as a basic data for the development of EMSS preparing for reunification.
Consensus* ; Consumer Participation ; Delphi Technique* ; Democratic People's Republic of Korea ; Developing Countries ; Disaster Planning ; Education ; Emergencies* ; Emergency Medical Services* ; Expert Testimony ; Insurance ; Korea* ; Methods ; Patient Transfer ; Public Health ; Surveys and Questionnaires

Gastric cancer (GC) is the fourth most common cause of cancer-related death globally. The classification of advanced GC (AGC) according to molecular features has recently led to effective personalized cancer therapy for some patients. Specifically, AGC patients whose tumor cells express high levels of human epidermal growth factor receptor 2 (HER2) can now benefit from trastuzumab, a humanized monoclonal Ab that targets HER2. However, patients with HER2negative AGC receive limited clinical benefit from this treatment. To identify potential immune therapeutic targets in HER2negative AGC, we obtained 40 fresh AGC specimens immediately after surgical resections and subjected the CD45 + immune cells in the tumor microenvironment to multi-channel/multi-panel flow cytometry analysis. Here, we report that HER2 negativity associated with reduced overall survival (OS) and greater tumor infiltration with neutrophils and non-classical monocytes. The potential pro-tumoral activities of these cell types were confirmed by the fact that high expression of neutrophil or non-classical monocyte signature genes in the gastrointestinal tumors in The Cancer Genome Atlas, Genotype-Tissue Expression and Gene Expression Omnibus databases associated with worse OS on Kaplan-Meir plots relative to tumors with low expression of these signature genes. Moreover, advanced stage disease in the AGCs of our patients associated with greater tumor frequencies of neutrophils and non-classical monocytes than early stage disease. Thus, our study suggests that these 2 myeloid populations may serve as novel therapeutic targets for HER2negative AGC.