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

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

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

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

Wilms' tumor is the most common renal malignancy in childhood. However Wilms' tumor originating in horseshoe kidney is rare. We present a case of Wilms' tumor arising from the isthmus of horseshoe kidney, and aim to highlight the problems faced in the diagnosis and management.
Diagnosis ; Kidney* ; Wilms Tumor*

BACKGROUND: The relatively recently developed I-gel (Intersurgical Ltd., Workingham, England) is a supraglottic airway device designed for single-use that, unlike conventional LMAs, does not require an inflatable cuff. In addition, the I-gel, much like the Proseal LMA (PLMA), has a gastric drainage tube associated with an upper tube for decompression of the stomach, thereby avoiding acid reflux and decreasing the risk of pulmonary absorption. The purpose of this study was to compare PLMA and I-gel devices in patients undergoing gynecological laparoscopy based on sealing pressure before and during pneumoperitoneum, insertion time, and gas exchange. METHODS: Following Institutional Review Board approval and written informed consent, 30 adult patients were randomly allocated to one of two groups (the PLMA or I-gel group). In each case, insertion time and number of attempts were recorded. After successful insertion, airway leak pressure was measured. RESULTS: Successful insertion and mechanical ventilation with both supraglottic airway devices was achieved on the first attempt in all 30 patients, and there were no significant differences with respect to insertion time. Likewise, leak pressure did not vary significantly either between or within groups after CO2 insufflation. In addition, differences between leak volume and leak fraction between groups were not significant. CONCLUSIONS: The results of our study indicate that the I-gel is a reasonable alternative to the PLMA for controlled ventilation during laparoscopic gynecologic surgery.
Absorption ; Adult ; Decompression ; Drainage ; Equipment Design ; Ethics Committees, Research ; Female ; Gynecologic Surgical Procedures ; Humans ; Informed Consent ; Insufflation ; Laparoscopy ; Pneumoperitoneum ; Respiration, Artificial ; Stomach ; Ventilation

Obstetrical procedures such as prolonged obstructed labour are responsible for the majority of vesicovaginal fistula(VVF) in developing countries, while gynecological procedures are more common causes in developed countries with hysterectomy accounting for 75% of fistulae. Other less common causes of VVF include uterine cancer, pelvic irradiation, gastrointestinal pelvic surgery, tuberculosis, intra-uterine device or Bechet's disease. Although radiation techniques are being advanced, several recent studies have shown the incidence of VVF after pelvic radiation therapy for cervical cancer to range from 0.6~2%. We report, a case of 47-year-old female with VVF after pelvic radiation therapy, which was treated by neurovascular pudendal-thigh flap.
Developed Countries ; Developing Countries ; Female ; Fistula ; Humans ; Hysterectomy ; Incidence ; Middle Aged ; Tuberculosis ; Uterine Cervical Neoplasms ; Uterine Neoplasms ; Vesicovaginal Fistula*