Radical cystectomy and/or radiotherapy represent the standard treatment for invasive bladder carcinoma. However these approaches are less than ideal since a substantial number of patients have progressive disease and die of metastatic cancer. Then recent treatment modality is trending toward chemotherapy. Therefore, we performed the aggressive transurethral resection of the bladder tumor (TURBt) followed by the combined chemotherapy of methotrexate, vinblastine, doxorubicin and cisplatin(RI-VAC) for conservative treatment of muscle invasive transitional cell carcinoma of the bladder. From July 1990 to March 1995, 41 patients with stage T2 to T4 were entered into the study. Of that patients, 26 completed 4 to 8 cycles of M-VAC and were followed, while 15 were excluded from the study because of incomplete chemotherapy or inadequate follow-up. Median follow-up was 30 months(4-56 months). Median age of the patients was 66 years(range 48 to 85 years). All patients had Karnofsky performance status(KPS) score between 70 and l00. There were 3 patients with clinical stage T2, 8 with T3a, 7 with T3b, 8 with T4. G-CSF(Granulocyte-Colony Stimulating Factor) was used for 19 patients with M-VAC induced leukopenia, thereby allowing the chemotherapy to be complete on schedule. Responses to therapy were evaluated according to standard accepted phase II response criteria. Overall clinical response (complete and partia1) was noted in 15 patients(58%), and no response in 11(42%). Of the patients with T2 and T3a, 9(82%) showed complete and partial response, and of them with T3b and T4, 6(40%) showed complete and partial response. Of 26 patients 21(81%) are alive now. These data suggest that survival was no better than expected following radical cystectomy or radiotherapy in short term follow-up, so far, however systemic M-VAC chemotherapy in combination with radical TURBt is probably expected to provide a high response rate and a better survival with the particular advantage of preserving normal bladder function in patients with superficially invasive bladder tumor(T2/T3a).
Appointments and Schedules ; Carcinoma, Transitional Cell ; Cystectomy ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; Humans ; Leukopenia ; Methotrexate ; Radiotherapy ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Vinblastine

TURP is one of the common operations in the urologic field, and it has been well shown as a golden standard treatment modality for the patients with the BPH. Nevertheless, there was no available objective index to determine effective amount of the prostate resection. Therefore, we reviewed and evaluated the charts of 119 BPH patients more than 15 in modified Boyarsky symptom score evaluation, and who have undergone TURP from 1992 to June 1994. In addition, we excluded the cases associated with the other disease, such as neurogenic bladder, urethral stricture, or prostatic carcinoma. The volume of prostate was calculated by using of TRUS and ellipsoid formula. The maximal flow rate(MFR) was evaluated mostly on 5th post-operative volume of the day. We defined the resection rate(R.R) as the rate of the resected weight to the volume of the prostate. The results were as follows. 1. The mean resection rate of the prostate was 42.1%. 2. The average of the post-operative MFR was 20.52ml/sec. 3. The relevance between the RR and the post-operative MFR was not shown herein. 4. Distribution of the patients by the postoperative modified Boyarsky symptom score was different according to the resection rate. Statistically significant difference of the postoperative modified Boyarsky symptom score was shown between the greater than 30% resection group 1ess than 30% resection group(P=<0.05) 5. The post-operative modified Boyarsky symptom score could be predicted by the equation induced through the regression analysis. Symptom score = 5.28 - (0.04'RR) Our results suggest that resection rate of 30% is the marginal rate for the desirable voiding improvement, and, if it is practicable, the resection of more than 30% is favorable for all patients with BPH.
Humans ; Prostate ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder, Neurogenic

PURPOSE: To compare the surgical outcomes between modified bilateral lateral rectus muscle (BLR) recession and augmented unilateral recession-resection (R&R) for the convergence insufficiency intermittent exotropia (IXT). METHODS: 37 patients with convergence insufficiency IXT were divided into two groups: 13 patients (underwent BLR recession) and 24 patients (underwent unilateral R&R). Success was defined as within 10 prism diopters (PD) at distance and near, and within 10 PD of the difference between them at postoperative 12 months. RESULTS: After the patch test, the preoperative distance deviation angle in the BLR group was 29.9 ± 8.4 PD, and the near deviation angle was 42.3 ± 9.7 PD; the difference between them was 12.5 ± 3.2 PD. In the R&R group, the preoperative distance deviation angle was 26.7 ± 5.8 PD, and the near deviation angle was 41.5 ± 7.4 PD; the difference between them was 14.8 ± 4.3 PD (p = 0.235, p = 0.987, and p = 0.123). At the 12-month follow-up in the BLR group, the distance angle was 3.8 ± 5.1 PD, and the near deviation angle was 4.9 ± 6.1 PD; the difference between them was 2.9 ± 5.9 PD. In the R&R group, the postoperative distance deviation angle was 4.7 ± 6.1 PD, and the near deviation angle was 7.9 ± 6.6 PD; the difference between them was 3.65 ± 5.1 PD (p = 0.708, p = 0.162, and p = 0.632, respectively). The surgical success rate did not differ significantly between groups at 12 months postoperatively (76.9%: BLR group and 70.8%: R&R group; p = 0.690). CONCLUSIONS: Modified BLR recession showed a similar surgical success rate to augmented unilateral R&R, and was effective in reducing both distance and near exodeviation, and in decreasing the difference between distance and near deviation in convergence insufficiency IXT.
Exotropia ; Follow-Up Studies ; Humans ; Ocular Motility Disorders ; Patch Tests

BACKGROUND: The majority of patients undergoing stem cell transplantation (SCT) require a blood transfusion until the complete engraftment. Because blood transfusion rules for patients with ABO-incompatible SCT are complicated, we developed an ABO-incompatible transfusion management system (ABO-ITMS) for accurate blood transfusion and improved manageability. METHODS: A committee composed of medical doctors, technicians, and a programmer developed ABO-ITMS during the eight months from July 2013 to February 2014. The program has been linked with other databases, including clinical and laboratory databases and resulted in a new subsystem of the health information system. Server computer's operating system was Window Server 2008, and the database manager program was Oracle 11g. Programming language was ASP.Net (VBScript, C #), and the server and client computer were used to connect to the web server using a web browser. RESULTS: ABO-ITMS was designed to follow three main steps by hematologic oncology clinic, laboratory physician, and blood bank. In the first step, a hematologic-oncology clinic doctor inputs SCT recipients' data and appropriate ABO group for each phase of post-transplantation. Laboratory physician enters the isoagglutinin titer and ABO group at the second step. Finally, blood bank workers enter the results of type, screening, and antibody identification. The patient's SCT information and the previous immunohematologic test results are shown on the screen. CONCLUSION: ABO-ITMS can replace the existing complicated system and workflow. ABO-ITMS will contribute to reducing medical error and improving quality of SCT recipient care.
Blood Banks ; Blood Transfusion* ; Health Information Systems ; Humans ; Mass Screening ; Medical Errors ; Programming Languages ; Stem Cell Transplantation* ; Web Browser

The number of low vision patients and the demand for low vision rehabilitation are increasing as the life expectancy and visual impairment due to largely untreatable ocular conditions are.It is therefore, imperative to recognize the importance of low vision aids, which have recently been developed actively.To evaluate the efficacy of low vision aids for low vision rehabilitation, we reviewed the clinical records of 350 patients who had visited our low vision clinic more than twice and had been prescribed with low vision aids. According to the data analysed, optic nerve atrophy, macular degeneration and retinitis pigmentosa were the leading causes of visual impairment in those patients.The purposes to visit our low vision clinic were to read books, read letters on the black board, identify a person at a distance, etc.Hand-held magnifiers, aspheric doublet lens and telemicroscope with plus cap were commonly used for near vision, while Keplerian and Galilean telescope were popular aids for distant vision.Visual acuity after prescription was improved when it was compared with that before prescription.Majority of the patients benefited from attending low vision clinic.These results suggest that the optical low vision aids were required to rehabilitate the visually impaired patients.
Atrophy ; Humans ; Life Expectancy ; Macular Degeneration ; Optic Nerve ; Prescriptions ; Rehabilitation ; Retinitis Pigmentosa ; Telescopes ; Vision Disorders ; Vision, Low*

Immunoglobulin G4-related disease (IgG4-RD) can involve any organ. The majority of reported cases involve IgG4-RD of the biliary tract or pancreas, while only two cases of pericarditis have been reported. A 58-year-old man visited the outpatient clinic of our institution with a seven-day history of progressive dyspnea. Based on his transthoracic echocardiogram and transesophageal echocardiogram, he was diagnosed with constrictive pericarditis. The histopathology of his pericardiectomy revealed the cause of constrictive pericarditis to be IgG4-RD. Prednisolone (40 mg) was initiated after the pericardiectomy. As the patient's symptoms resolved, he was discharged and followed-up on an outpatient basis. This is the first case report of constrictive pericarditis caused by IgG4-RD in Korea.
Ambulatory Care Facilities ; Biliary Tract ; Dyspnea ; Humans ; Immunoglobulin G ; Immunoglobulins* ; Inflammation ; Korea ; Middle Aged ; Outpatients ; Pancreas ; Pericardiectomy ; Pericarditis ; Pericarditis, Constrictive* ; Prednisolone

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*

In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.
Cicatrix ; Congenital Abnormalities ; Epistaxis ; Fractures, Bone* ; Humans ; Nasal Cavity ; Nasopharynx ; Paresthesia ; Rhinoplasty ; Ribs ; Surgery, Plastic ; Transplants

Background: Korean society is afflicted with rapid aging. Aging is a risk factor for pain, and pain can reduce patients’ quality of life. Thus, adequate management and monitoring of changing trends accompanying the demographic shift are highly valuable. However, this study was conducted because no studies have investigated the recent changes in the prevalence of pain. Methods: The extent of the prevalence of pain was determined by questions related to quality of life based on the data derived from the Korea National Health and Nutrition Survey (KNHNS) from 2005 to 2016. The annual frequencies of the pain group and severe pain group were calculated using the survey questionnaire. Multiple logistic regression analysis was performed to determine possible differences in prevalence by year. Results: The prevalence of pain in all populations was 30.6% in 2005 and 18.9% in 2016. The average prevalence from 2005 to 2016 was 21.9%. A declining trend occurred over time with an odds ratio of 0.929 per year (95% CI: 0.921-0.938).The prevalence of severe pain was 2.35% in 2005 and 1.88% in 2016. Likewise, a decrease was observed over time, with an odds ratio of 0.920 per year at 95% CI 0.901-0.939. The decline in age-/sex-stratified analysis also showed a statistically significant trend in all groups. Conclusions The prevalence of pain in Korean society, based on the KNHNS, has declined since 2005. Such a trend was observed in all ages and sexs, and was most significant in the elderly.

0.05). Mean changes in central macular thickness showed significant differences at 1 and 4 months postoperatively (−1.44 ± 11.72 and 10.44 ± 22.48 µm in bromfenac group vs. 47.19 ± 70.24 and 31.69 ± 48.04 µm in control group, p < 0.001 and p = 0.016) and mean changes in macular volume showed a significant difference at 1 month postoperatively (−0.08 ± 0.47 mm³ in bromfenac group vs. 0.58 ± 1.28 mm³ in control group, p < 0.001). There were no significant differences thereafter (p > 0.05).CONCLUSIONS: Treatment with 0.1% bromfenac sodium hydrate ophthalmic solution showed good efficacy for preventing cystoid macular edema early after cataract surgery in patients with diabetes.]]>
Anti-Inflammatory Agents, Non-Steroidal ; Cataract ; Diabetes Mellitus ; Humans ; Macular Edema ; Retrospective Studies ; Sodium ; Visual Acuity