PURPOSE: To evaluate near, intermediate, and distant vision, optical quality, and patient satisfaction with Acri.LISA aspheric diffractive multifocal IOL. METHODS: Forty eyes of 20 patients received phacoemulsification and implantation of Acri.LISA IOL. Visual acuity was measured postoperatively at 1 week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function via questionnaire were measured at postoperative 1 month. RESULTS: Uncorrected near, intermediate, and distanct visual acuity at 1 month were 0.09 +/- 0.14, 0.29 +/- 0.17 and 0.11 +/- 0.12, respectively. At 6 months, similar visual acuity results were measured. Total and higher-order wavefront aberration values were 0.66 +/- 0.29 and 0.24 +/- 0.08, respectively. Photopic contrast sensitivity at 1.5, 3, 6, 12, and 18 cycles/degree were 1.38 +/- 0.32, 1.73 +/- 0.24, 1.75 +/- 0.21, 1.33 +/- 0.18, and 0.77 +/- 23, respectively, and mesopic contrast sensitivity values were 1.37 +/- 0.27, 1.72 +/- 0.16, 1.63 +/- 0.14, 1.01 +/- 0.19, and 0.50 +/- 0.22. Total subjective visual function score was 3,127 +/- 354, near work was 244 +/- 36, distance work was 256 +/- 21, and night driving was 221 +/- 42. CONCLUSIONS: The Acri.LISA 366D multifocal IOL can be effective for improving patient satisfaction after cataract surgery as well as for presbyopia correction.
Cataract ; Contrast Sensitivity ; Eye ; Humans ; Lenses, Intraocular ; Patient Satisfaction ; Phacoemulsification ; Presbyopia ; Surveys and Questionnaires ; Vision, Ocular ; Visual Acuity

Factitious fever has been a rare cause of fever of unknown origin. We herein report a case of a young soldier, who presented with persistent fever of unusual pattern and bullae on both palms. After numerous investigations had excluded organic diseases, factitious fever was diagnosed with measurement of the freshly voided urine temperatures and body temperatures while directly observed. Biopsy of skin lesions revealed friction blister. Early recognition of this cause of fever is needed to avoid the unnecessary investigation and prolonged hospitalization.
Biopsy ; Blister ; Body Temperature ; Factitious Disorders ; Fever of Unknown Origin ; Fever* ; Friction ; Hospitalization ; Humans ; Military Personnel ; Skin

PURPOSE: Early traditional methods of surveillance to detect failing graft relied on recurrence of symptoms, change of pedal pulses, or a decrease in the Ankle-Brachial Index (ABI). More recently, graft surveillance with Duplex scan which has become an appropriate first-line alternative has been shown to be effective in identifying the patency of threatened femorodistal graft. The purpose of this study was to determine the relationship and significance among ABI change, run-off resistance score, and Duplex scan parameters in femorodistal graft bypass. METHOD: Among 52 patients who received femorodistal bypass, thirty-one femorodistal grafts (19: above knee, 12: below knee) which had followed up for more than 2 years were followed up by ABI at regular interval and Duplex scan at 2 year. Those were grouped according to the grade of ABI decrease as follows; Group I: <0.1 ABI decrease, Group II: 0.1or= 0.2 ABI decrease. Peak systolic flow velocity (PSFV) ratio, luminal diameter at near proximal and distal anastomosis, mean body graft velocity (cm/sec) were evaluated. Runoff resistance score was calculated by the finding of the pre-operative angiogram. RESULT: In proportion to the severity of ABI decrease, proximal and distal peak systolic flow velocity (PSFV) ratio and stenosis (%) increased, mean body graft velocity decreased. Significant statistical difference between groups were shown as follows; Group II and IV: distal PSFV ratio (2.17 vs 2.95, P=0.02), proximal stenosis (32.8% vs 47.4%, P=0.026), distal stenosis (21.7% vs 62.0%, P=0.007), mean body graft velocity (81 cm/sec vs 46 cm/sec, P=0.02) Group III and IV: distal PSFV ratio (2.29 vs 2.95, P=0.02), distal stenosis (40.5% vs 62.0%; P=0.003), body flow velocity (70 cm/sec vs 46 cm/sec, P=0.02). The higher runoff resistance score was, the more distal PSFV ratio, distal stenosis increased, but proximal stenosis, PSFV ratio, and mean body graft velocity did not change significantly. CONCLUSION: This study shows that higher decrease in ABI (>0.2) is well correlated with critical Duplex parameters. Longer graft patency and economic benefit may be obtained by active evaluation of failing graft using by Duplex scan when the ABI decrease is more than 0.2 in femorodistal graft bypass at regular examination.
Ankle Brachial Index ; Constriction, Pathologic ; Humans ; Knee ; Phenobarbital ; Recurrence ; Transplants*

No abstract available.
Small Cell Lung Carcinoma*

PURPOSE: Gonadotropin-releasing hormone agonist (GnRHa) is known for improving final adult height in patients with central precocious puberty (CPP). This study aimed to investigate the age of menarche and near adult height in girls with CPP who had been treated with GnRHa. METHODS: In this retrospective study, we reviewed the medical records of 71 Korean girls with CPP who had started menarche or reached over 13 years of bone age after long-term GnRHa treatment. We estimated near adult height using the Bayley-Pinneau method and identified the age of menarche in girls with CPP. RESULTS: Mean chronological and bone age at menarche were 11.9+/-0.7 and 12.8+/-0.4 years, respectively. The period between menarche and the end of treatment was 14.0+/-5.6 months. Posttreatment near adult height was 163.8+/-4.7 cm, which was significantly greater than pretreatment predicted adult height (158.7+/-4.1 cm). CONCLUSION: GnRHa treatment in girls with CPP could improve final adult height and made the age of menarche close to that of the general population.
Adult* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Medical Records ; Menarche* ; Puberty, Precocious* ; Retrospective Studies

No abstract available.
Glycopeptides*

PURPOSE: To investigate whether there was any difference in anterior capsular opening area between the use of silicone intraocular lens(IOL) and acrylic IOL after continuous curvilinear capsulorhexis(CCC). METHODS: In 42 eyes, acrylic IOL(Acrysof(R), Alcon, U.S.A.) were inserted into the capsular bag during phacoemulsification, and in 36 eyes silicone IOL(Chiroflex II(R) , Chiron, U.S.A.) were inserted. The reduction rate of anterior capsular opening area at first, second, third and sixth postoperative month were compared between the two groups. RESULTS: On the whole, the reduction in anterior capsular opening area was larger by 0.574 mm 2 when silicone IOL was used, but the different was not statistically significant(P= .061). The result was the same at 1 month(P= .149), 2 months(P= .144), 3 months(P= .223), 6 months(P= .163) after surgery. CONCLUSIONS: We concluded that there was little difference in the changes of anterior capsular opening area after CCC between the use of silicone IOL and acylic IOL, and other factors should be considered.
Phacoemulsification ; Silicones

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
Anti-Bacterial Agents ; Carbapenems ; Cross Infection* ; Delivery of Health Care ; Dichlorodiphenyldichloroethane ; Glycopeptides ; Infection Control ; Korea ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Seoul ; Staphylococcus aureus* ; Staphylococcus*

PURPOSE: The success rate for the replantation of an amputated digit in children is low. It demands precise anastomosis of vessels and nerves and expert technique. This paper reports upon cases of digital replantation in children. MATERIALS AND METHODS: From April 1994 to December 1999, 34 amputated digits of 30 patients were replanted. According to the age distribution, there were 18 children under 5 years of age, 5 between 6 and 10, and 7 between 11 and 15. Guillotine type of amputation was dominant and 19 cases were at zone I. End to end anastomosis of the digital artery and dorsal vein, vein graft, and the external bleeding method and epineurial suture were performed. RESULTS: The overall success rate was 88.2%, in zone I 16/19 cases, in zone II 10/11 cases and zone III 4/4 cases. CONCLUSION: The rate of survival of the amputated part in children was 88.2%. Although it is difficult to perform anastomosis of small vessels, postoperative physical therapy and the external bleeding method, digital replantation in children is recommended, when feasible, in order to prevent functional and growth disturbances for cosmetic reasons.
Age Distribution ; Amputation ; Arteries ; Child* ; Fingers* ; Hemorrhage ; Humans ; Replantation* ; Sutures ; Transplants ; Veins

No abstract available.
Antibodies ; Guillain-Barre Syndrome