We compared the rate of continuous curvilinear capsulorhexis[CCC]con traction and degree of postoperative capsular fibrosis between patients with non-proliferative diabetic retinopathy and age-matched non-diabetic patients after phacoemulsification with posterior chamber acryl foldable intraocular lens implantation.Sixty-two eyes of 42 patients of non-proliferative diabetic retinopathy and 78 eyes of 55 patients of control group who underwent cataract surgery with acryl foldable intraocular lens were enrolled in this retrospective study.During follow up examination the rate of CCC contractions were evaluated by NIDEK EAS-1000 System and we measured the area of anterior capsular opening.The diabetic patients average percentage of anterior capsular shirinkage rate was higher than non-diabetic patient's. But no statistically significant difference was found between the two groups. In conclusion, small incision cataract surgery with acryl foldable intraocular lens implantation showed good results in diabetic patients.Further studies will be needed for better clinical safety and efficacy.
Cataract ; Diabetic Retinopathy ; Fibrosis ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Retrospective Studies ; Traction

A ICL TM(STAAR Collamer Posterior chamber Implantable Contact Lens) lents ranging from -11D to -21.3D. And then we investigated the visualwas implanted in 12 eyes of 7 patients with preoperative spherical equivalents ranging from -11 D to -21.3 D. And then we investigated the visual acuity, mean endothelial cell loss, change of refractive error and postoperative complications.Average follow-up was 28.1 months. In the immediate postoperative days, all eyes had a significant increase in uncorrected visual acuity and the best corrected visual acuity was improved in 7 eyes(58.3%). Mean percent difference between preoperative and postoperative endothelial cell count was 3.22+/-0.05% . The mean preoperative spherical equivalent refraction was -15.65+/-2.78 D. At a mean follow-up of 1 month, mean spherical equivalent refraction was -1.67+/-0.72D, at a 6months, 12 months, 24 months, mean spherical equivalent refraction was each -1.56+/-0.72D, -1.63+/-0.68D, -1.73+/-0.76D. During follow-up days one eye developed an faint anterior subcapsular cataract but the patient remained symptom free. Other reported complication was transient increased intraocular pressure. Although the follow-up in our study was limited cases(12 eyes), from our experience, the posterior chamber implantable contact lens was efficacious and safe in the correction of high myopic refraction errors.
Cataract ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Refractive Errors ; Refractive Surgical Procedures ; Visual Acuity

No abstract available.
Cryptorchidism* ; Humans ; Infant* ; Male

Fibrous hamartoma of infancy in the middle ear is extremely rare. We report the case of a 26-month-old male patient who presented with a mass in the left middle ear. A temporal bone CT scan showed complete opacification of the left middle ear and mastoid air cells without ossicular erosion. On MRI, the mass revealed heterogeneous signal intensities indicative of fat and fibrous components. A definitive diagnosis was made postoperatively based on the histological results. Although rare, fibrous hamartoma of infancy should be considered as a differential diagnosis of a middle ear mass during childhood.

Although stroke is a great public health challenge in Korea, there have have been few epidemiologic studies of the risk factors stroke. A case-control study was performed to evaluate the risk factors for hemorrhagic stroke in Wonju, Korea. Ninety-five subarachnoid hemorrhage (SAH) and 102 intracerebral hemorrhage (ICH) patients aged 21-86 years, and 267 controls were recruited among the inpatients of Wonju Christian Hospital during 1994-1995. Information was gathered through interview and examinations. After adjustment for age and sex, family and past history of hypertension, drinking habits, age of menarche, height, weight, body mass index, waist and hip circumference, earlobe crease, prothrombin time, white blood cell count, hemoglobin, and total cholesterol were all found to be significantly associated with both SAH and ICH. The risk factor significantly associated only with ICH was smoking habits. In multiple logistics analyses, the independent risk factors for SAH and ICH were the same. Those included family and past history of hypertension, age of menarche, earlobe crease, prothrombin time, white blood cell count, hemoglobin and total cholesterol. In general, the risk factors for SAH and ICH were similar with each other, except smoking habits. Risk factors found in this study congruent with previous studies were family and past history of hypertension, drinking habits, body mass index, prothrombin time, white blood cell count, and hemoglobin. Those incongruent or rather newly found were age of menarche, a big physique, earlobe crease, and total cholesterol.
Adult ; Case-Control Studies ; Cerebral Hemorrhage/etiology* ; Cerebrovascular Disorders/etiology* ; Female ; Human ; Korea ; Male ; Middle Age ; Risk Factors ; Subarachnoid Hemorrhage/etiology*

Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group(RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of menarch, and prothrombin time. The factor whose level was higher in AMI than in RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAH than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAH and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age uric aci, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.
Adult ; Blood Glucose ; Body Mass Index ; Case-Control Studies* ; Cause of Death ; Cholesterol ; Coronary Disease* ; Discrimination (Psychology) ; Education ; Gangwon-do ; Hematocrit ; Humans ; Inpatients ; Korea ; Leukocyte Count ; Prothrombin Time ; Risk Factors* ; Stroke ; Triglycerides ; Uric Acid

PURPOSE: This study was designed to evaluate the benefits of the cross leg free flap for the hereconstruction of soft tissue defects in replanted or revascularized lower extremities. MATERIALS AND METHODS: From 1992 to 1999, six cross leg free flap procedures were performed using the latissimus dorsi muscle for the reconstruction of soft tissue defects in patients with a vascularly compromised lower limb after replantation or revascularization. Four male and two female patients were included in this study, and the average age of these patients was 34 years (from 22 to 56 years). This procedure was applied to four patients for soft tissue defects in the lower leg, and in two for foot reconstruction. RESULTS: All of the flaps survived after pedicle division. The average period of immobilization was 32 days (from 23 to 43 days). There were minor complications, such as joint stiffness, partial loss of skin graft and hematoma formation. CONCLUSION: The cross leg free flap provides the possibility for the reconstruction of complicated and unfavorable cases, otherwise considered, unreconstructable. The indication for this procedure is extensive soft tissue defect with lack of adequate recipient vessels, especially in patients after replantation or revascularization.
Female ; Foot ; Free Tissue Flaps* ; Hematoma ; Humans ; Immobilization ; Joints ; Leg* ; Lower Extremity* ; Male ; Replantation ; Skin ; Superficial Back Muscles ; Transplants

BACKGROUND: The autonomic nervous system plays a central role in the maintenance of hemodynamic stability. Cardiac autonomic dysfunction may result in serious complications, such as sudden cardiac death. Heart rate variability (HRV) is sigificantly reduced in patients undergoing chronic hemodialysis (HD). The aim of this study was to evaluate the effect of on-line hemodiafiltration (OL-HDF) on the autonomic nervous system in chronic HD patients. METHODS: Forty chronic HD patients were prospectively studied. The participants were divided into conventional HD and OL-HDF groups. They received regular high-flux HD or OL-HDF for 4-hour sessions, three times a week. Time-and frequency-domain measures of the 24-hour HRV were analyzed during the interdialytic period prior to postdilution OL-HDF and every 6 months for 24 months. The 7-year survival was also evaluated. RESULTS: Among the 40 participants, 15 patients in the HD group and 11 patients in the OL-HDF group completed the study. There was no difference in the baseline characteristics. After 24 months of treatment, beta2-microglobulin concentration decreased (from 33.4 +/- 15.2 mg/dL to 28.4 +/- 6.2 mg/dL, P = 0.02) in the OL-HDF group, while there was no change in the HD group In the HRV analysis, the frequency-domain HRV parameters increased significantly compared with baseline in the OL-HDF group [natural logarithmic high frequency (lnHF), 3.15 +/- 3.36 ms2 vs. 4.42 +/- 3.81 ms2; ln low frequency (LF), 3.56 +/- 3.17 ms2 vs. 4.78 +/- 3.99 ms2; ln very low frequency (VLF), 4.90 +/- 4.62 ms2 vs. 6.38 +/- 5.54 ms2; LF/HF ratio, 1.4 +/- 0.4 vs. 2.5 +/- 0.1]. The survival rate was similar between the groups. CONCLUSION: This study shows that OL-HDF improved autonomic nervous system dysfunction in chronic HD patients.
Autonomic Nervous System ; Death, Sudden, Cardiac ; Heart Rate* ; Heart* ; Hemodiafiltration* ; Hemodynamics ; Humans ; Kidney Failure, Chronic* ; Prospective Studies ; Renal Dialysis ; Survival Rate

BACKGROUND: Priming significantly shortened the onset of neuromuscular blockade(NMB), but also results in a high incidence of side effects. This study was designed to determine the effect of infusion priming method on the side effects, intubation condition, and onset of NMB compared with divided priming method. METHOD: The effects of different priming method of vecuronium on onset time and endotracheal intubation condition were investigated. 40 patients were studied in two parts. In control part, 20 patients were allocated into two groups(n=10 in each group) receving 10, 20 g/kg vecuronium as a priming dose, followed by a intubating dose(0.1 mg/kg-priming dose) 3 min later; the other part, 20 patients were allocated into two groups(n=10 in each group) receving 0.2 mg/kg/hr vecuronium continuous intravenous infusion, followed by a intubating dose(0.1 mg/kg-total infusion dose) 3, 5 min later. Onset time is calculated by single twitch stimulation test from injection of the intubating dose to maximum depression of the single twitch. Intubatin condition was appreciated based on vocal cord reflex, coughing, and jaw relaxation and scored. RESULTS: The times to fade out on the single twitch of the intravenous infusion priming group were shorter than control priming group. There was no difference between control priming group and infusion priming group to evaluate the intubation conditions. Side effects in the continuous infusion group were lesser than control priming group. CONCLUSION: This results suggest that the use of continuous infusion method is one of the promising methods to shorten the neuromuscular blockade and to provide more comfort to the patients.
Cough ; Depression ; Humans ; Incidence ; Infusions, Intravenous* ; Intubation ; Intubation, Intratracheal* ; Jaw ; Neuromuscular Blockade ; Reflex ; Relaxation ; Vecuronium Bromide* ; Vocal Cords

To evaluate the effect of capsular tension ring on prevention of capsular opening reduction induced by CCC in Phacoemulsification with silicone intraocular lens implantation, we prospectively studied 60 patients (60 eyes)who were operated from Sept, 1997 to Jun, 1998 at our hospital.All patients had standardized Phacoemulsification, continuous curvilinear capsulorhexis, and intraocular lens implantation performed by the same surgeon.Patients were randomized into two groups based on capsular tension ring insertion.We compared uncorrected visual acuity (UCVA), spherical equivalent (SE), astigmatism and the data obtained by the Anterior Eye Segment Analysis System (EAS-1000), anterior chamber depth, IOL tilting, decenteration, and anterior capsule opening area at 1 week and 1, 3, 6 months after surgery.Two groups showed a similar pattern of change of UCVA, SE and astigmatism. There are no statistical significances in comparison of anterior chamber depth and IOL decenteration in two groups, but IOL tilting of group II is greater than that of group I at 6 months after surgery.The mean anterior capsular opening area at 1, 3, 6 months postoperatively was smaller than that of 1 week in two groups, but no statistical significances were observed in group II (1, 3, 6 months, P = or > .05).The mean percentage reduction of group I was significantly smaller than that of group II at 3 and 6 months (P<.05)after surgery.Capsular tension ring might prevent a contraction of capsular opening and might enhance the stability of IOL.
Anterior Chamber ; Anterior Eye Segment ; Astigmatism ; Capsulorhexis ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Prospective Studies ; Silicones* ; Visual Acuity