Recently, the number of cataract surgeries has rapidly increased. This study was devised to evaluate the post-operative daily life behavior and degree of satisfaction in the patients who underwent cataract surgery two or more years ago. Of 400 patients who underwent ECCE with IOL implantation, 125 patients[31%]replied to the mail questionnaire consisted of thirty questions. Hospital records were also reviewed. 84%of the patients were satisfied with outcomes of cataract surgery, which was significantly correlated with current visual acuity[p<0.01]. Degree of satisfaction was significantly higher in patients with bilateral surgery compared with those with unilateral surgery[p<0.05]. Age, sex, occupation, economic and general health status were not significantly associated with degree of satisfaction. As for life behavior, discomfort while driving an automobile was the most common complaint, especially in the patients who underwent unilateral surgery. Concerning ocular symptoms, many patients complained of foreign body sense, epiphora, glare, fatigue, and near vision discomfort. We reconfirmed that the decision to perform cataract surgery should be made with careful consideration of long term prognosis and above results.
Automobiles ; Cataract* ; Fatigue ; Foreign Bodies ; Glare ; Hospital Records ; Humans ; Lacrimal Apparatus Diseases ; Occupations ; Postal Service ; Prognosis ; Surveys and Questionnaires

Only a few cases of cyst related to cruciate ligament were reported in the literatrure. It is not only because of rarity but also difficulty of diagnosis by conventional method. Recentely, the precise intraarticular structure of the knee joint became to be seen by introduction of MRI and arthroscope and cycts would bave been found incidentally during the workup of the internal derangement of knee. We have experienced three cases of ganglion around the cruciate ligament in the patients whose symptom was mimic of intemal derangement of knee. We excised the ganglion with good clinical results.
Arthroscopes ; Diagnosis ; Ganglion Cysts ; Humans ; Knee Joint ; Knee ; Ligaments ; Magnetic Resonance Imaging ; Methods

Paraffinoma is a well known complication of previous paraffin injection into the subcutaneous layer that presents as various conditions including firm mass formation, edema, induration, ulceration, and skin necrosis. Paraffinoma can mimic neoplasm on physical examination and imaging studies and may complicate ultrasonographic diagnoses due to typical posterior shadowing and high echogenicity. When paraffinomas involve around the thyroid gland, the diagnosis of thyroid tumors is very difficult. We present a case of thyroid cancer, the evaluation of which was complicated by the presence of cervical paraffinoma.
Edema ; Hydrazines ; Necrosis ; Paraffin ; Physical Examination ; Shadowing (Histology) ; Skin ; Thyroid Gland ; Thyroid Neoplasms ; Ulcer

BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

PURPOSE: Amniotic membrane (AM) contains various proteinase inhibitors and when used as a graft, it could enhance healing process by blocking insult of inflammatory cells and inhibiting proteolytic damage. Thus we evaluated whether applying of amniotic membrane extract as eyedrops could get the same effect as amniotic membrane patching. METHODS: Alkali wounds were inflicted on the central corneas of rabbits by applying a round filter paper, 6.0 mm in diameter, soaked in 1N NaOH for 30 seconds. A total of 16 rabbits were divided into four groups: (1) applied with amniotic membrane extract; (2) applied with amniotic membrane extract and Healon(R); (3) applied with methylcellulose; and (4) control. Each material was applied for 1 week. During follow-ups, epithelial defects, corneal thickness and its opacity were measured. RESULTS: The epithelial healing was faster and the corneal thickness was thinner in amniotic membrane extract applied groups than in non-applied. Corneal opacity was much less in AM extract applied groups. CONCLUSIONS: AM extract as eyedrops promotes wound healing and it could be an effective method for treating various keratitis due to its convenience and good effect.
Alkalies* ; Amnion* ; Burns* ; Cornea ; Corneal Opacity ; Follow-Up Studies ; Keratitis* ; Methylcellulose ; Ophthalmic Solutions ; Rabbits ; Transplants ; Wound Healing ; Wounds and Injuries

Various bone grafting techniques have been reported for scaphoid nonunions. We describe surgical technique of osteosynthesis with bone graft using arthroscopic technique and percutaneous fixation as a minimal invasive procedure. Nine patients with scaphoid nonunion were treated with this technique, resulting in successful union at a mean of 10 weeks.
Arthroscopy ; Bone Transplantation ; Humans ; Transplants

BACKGROUND: The clinical use of intracoronary stents is impeded by the risk of subacute stent thrombosis and complications associated with the anticoagulant regimen. The use of high pressure balloon dilatations and confirmation of adequate stent expansion by intravascular ultrasound provide assurance that anticoagulation therapy can be safely omitted. Therefore, we evaluated the effect of anticoagulation of subacute thrombosis sfter stenting retrospectively on a consecutive series of patients who received palmaz-Schatz coronary stents with high pressure balloon dilatation. METHOD: From March 1995 to August 1995, 62 patients underwent Palmaz-Schatz coronary stent implantation. After deploying stents successfully, high pressure overdilatation of the stents was performed in all patients. According to post-stent anticoagulation, 32 patients received aspirin 200 mg/day, ticlopidine 500 mg/day and warfarin for two months, 30 patients received aspirin and ticlopidine. RESULTS: The clinical or angiographic variables were not significantly different between the two groups. There was no acute or subacute thrombosis in the two groups. The hospital stay after stenting was significantly shorter in the patients without antcoagulation than in patients with anticoagulation. CONCLUSION: The Palmaz-Schatz stent can be safely implanted without anticoagulation provided that stent expansion is daequate by the use high pressure balloon dilatation This technique significantly reduces hospital time and vascular complications and has a low stent thrombosis rate.
Aspirin ; Dilatation* ; Humans ; Length of Stay ; Retrospective Studies ; Stents* ; Thrombosis ; Ticlopidine ; Ultrasonography ; Warfarin

PURPOSE: The cervical lymph nodes are the most common sites of locoregional recurrence in patients with papillary thyroid carcinoma (PTC). Accurate tumor localization is important for the successful removal of impalpable recurrences in the cervical lymph nodes. We evaluated the benefits of ultrasound-guided localization (UGL) performed by a single surgeon on site. METHODS: Of 53 PTC patients who underwent reoperation for impalpable nodal recurrences, 32 (group 1) were assessed only using preoperative imaging, while 21 (group 2) were additionally evaluated by on-site UGL performed by the operating surgeon. Postoperative outcomes were compared between the two groups. RESULTS: Operation times were significantly shorter (P < 0.001) and the mean size of the resected lymph nodes were smaller (P = 0.013) for group 2 patients. More lymph nodes were identified and resected in group 1 (3.56 vs. 3.19), but the rate of positive lymph nodes was significantly higher in group 2 (P < 0.001). There were no differences between the two groups in terms of resection success rate, complication rate, and postoperative hospital stay. During a mean follow-up period of 27.6 months, 52 patients (98.1%) showed no evidence of recurrence on routine ultrasound, and serum thyroglobulin concentrations remained < 1 ng/mL in 49 patients (92.5%). CONCLUSION: On-site UGL performed by the operating surgeon is useful for accurate resection of impalpable nodal recurrences in PTC patients.
Carcinoma ; Factor IX ; Follow-Up Studies ; Humans ; Length of Stay ; Lymph Nodes ; Recurrence ; Reoperation ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: Perforated duodenal ulcer can be treated by variable methods ranging from non-operative management to immediate definitive acid-reduction surgery. With the current availability of potent H2 blocker, proton pump inhibitor, and effective Helicobacter pylori (H. pylori) eradication regimens, ulcer recurrence is usually low and the need for definitive surgery has been reduced. Furthermore, the introduction of laparoscopic closure makes the principles of conventional surgical approach weakened at present and surgeons are faced with the choice of definitive surgery or omental patch repair, open or laparoscopic surgery. The aims of this study were to evaluate the feasibility and efficacy of laparoscopic omental patch repair in comparison with conventional surgery and to investigate the status of H. pylori infection and the role of eradication of H. pylori. In addition, we tried to introduce our unique surgical experience using a 3-port technique. METHODS: We treated 31 patients of perforated duodenal ulcer laparoscopically and compared with 30 patients operated by conventional omental patch repair. The patients treated by laparoscopy were evaluated for H. pylori status postoperatively. H. pylori infected patients received 1 or 2 weeks course of Omeprazole plus Amoxicillin and Clarithromycin. RESULTS: Laparoscopic repair was successful in 26 cases and the conversion rate was 16.1%. There was no statistically significant difference in terms of operative time and mortality. Morbidity was comparable between both groups, but the wound infection was more common in the open group. The clinical course and hospital stay were significantly shorter in the laparoscopic group. H. pylori infection rate was 47% and there were 2 cases of ulcer recurrence and 2 cases of reperforation in H. pylori negative patients. CONCLUSIONS: Laparoscopic closure of perforated duodenal ulcer using a 3-port technique is a technically feasible and safe alternative to open repair, with early recovery and low morbidity. H. pylori is positive in about half of perforated duodenal ulcer patients and should be eradicated in positive patients. Other risk factors on ulcer perforation should be identified.
Amoxicillin ; Clarithromycin ; Duodenal Ulcer* ; Helicobacter pylori ; Humans ; Laparoscopy ; Length of Stay ; Mortality ; Omeprazole ; Operative Time ; Proton Pumps ; Recurrence ; Risk Factors ; Sutures* ; Ulcer ; Wound Infection

BACKGROUND: Although pulmonary artery catheters are useful to monitor hydration, these devices may be associated with severe morbidity and are not routinely used in kidney transplantation. A central venous pressure (CVP) catheter is preferred rather than a pulmonary artery catheter. Noninvasive continuous blood pressure monitors may substitute for intraarterial catheters, thereby preserving the radial artery in kidney transplantation patients should it be needed later to create an arteriovenous fistula. If there is a relationship between central venous and radial arterial blood for acid-base (pH, BE, HCO3(-)), we can use the blood sample from a CVP catheter instead of arterial blood from aradial artery catheter for testing acid-base and it can help patients. METHODS: A central venous catheter and radial artery catheter was inserted in 67 patients while undergoing kidney transplantation. To assess arteriovenous differences in acid-base status at operation start, before reperfusion of the transplanted kidney, after reperfusion, we measured the pH, BE and HCO3(-) simultaneously from the arterial and central venous circulation. RESULTS: Aacid-base using arterial and central venous samples at operation start, before reperfusion and after reperfusionb was evaluated. We found the relationship as follows: pH between arterial (pHa) and central venous blood (pHcv) in each: linear regression equation; pHcv = 0.668 + (0.906 X pHa), pHcv = 0.225 + (0.965 X pHa), pHcv = 0.646 + (0.908 X pHa), determination coefficient; 0.908, 0.926, 0.888, P values < 0.001 in each period. Base excess (BE) between BEa and BEcv in each period: linear regression equation; BEcv = 0.483 + (0.952 X BEa), BEcv = 0.032 + (0.939 X BEa), BEcv = 0.008 + (0.954 X BEa), determination coefficient; 0.844, 0.954, 0.962 P values < 0.001 in each period. HCO3(-) concentration between HCO3(-)a and HCO3(-)cv in each period: linear regression equation; HCO3(-)cv = 2.434 + (0.937 X HCO3(-)a), HCO3(-)cv = 2.093 + (0.942 X HCO3(-)a), HCO3(-)cv = 1.755 + (0.954 X HCO3 a), determination coefficient; 0.950, 0.925, 0.932 P values < 0.001 in each period. CONCLUSIONS: The acid base status of arterial blood is similar to that of central venous blood. Central venous blood gas values (pH, BE, HCO3(-)) may be an acceptable alternative to arterial blood gas values in kidney transplantation patients.
Arteries ; Arteriovenous Fistula ; Blood Pressure Monitors ; Catheters ; Central Venous Catheters ; Central Venous Pressure ; Humans ; Hydrogen-Ion Concentration ; Kidney ; Kidney Transplantation ; Linear Models ; Pulmonary Artery ; Radial Artery ; Reperfusion