The effect of IDU and cryocautery in the treatment of Herpes Simplex Keratitis was presented. The cryoapplicator was a model of Krwawlcz probe (2 mm in diameter) which was refrigerated in a mixture of dry ice and methyl alcohol. The applicator was appJied on the lesions 7 seconds each and antibiotics and atropine solutions were instilled. A good result was experienced in the treatment of several cases of dendritic kenititis by freezing the corneal lesions by means of cryoappJicator, which had not been responded to IDU therapy speedy. The deep neovascularization of the cornea in a case of stromal keratitis was disappeared after cryocautery for the treatment of the superficial corneal ulcers.
Anti-Bacterial Agents ; Atropine ; Cornea ; Dry Ice ; Freezing ; Herpes Simplex* ; Keratitis ; Keratitis, Herpetic* ; Methanol ; Ulcer

Muscle transplanation surgery is presently widely accepted as a good precedure not only for cosmetic, but also for functional results, a concept to which Marina's observations on the absence of fixed and predetermined functions in the nuclei and associated tracts of the oculomotor system give great support; however, not everyone is in agreement with this concept. This paper report one case in which the total transplantation of the vertical rectus muscles midway between their insertions and the insertion of the lateral rectus muscle were carried out, in addition recession of the medial rectus muscle and resection of the paralyzed lateral rectus muscle. Our case have been followed up during 8 months to rule out late complications, aspecially ocular movement and diplopia. No late complications, however, have been found up to remaining underaction of the right superior and inferior oblique muscles and also medial rectus muscle. The eyes were straight with abduction of the right eye up to 40 prism diopters. Binocular vision was present and there was no diplopia. The cosmetic result was excellent.
Diplopia ; Muscles ; Paralysis* ; Vision, Binocular

Malignant melanoma of the urinary bladder is very rare, 7 cases were reported in the literature. The tumor shows early metastasis with poor prognosis. Treatment measures include surgical extirpation, radiotherapy and chemotherapy but the results were bad.Herein, we report a case of malignant melanoma of the urinary bladder in a 45-year-old man which was managed by transurethral resection and combination chemotherapy.
Drug Therapy ; Drug Therapy, Combination ; Humans ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Urinary Bladder

PURPOSE: Detecting and treating early colorectal cancers are most important for preventing advanced colorectal cancers which are difficult to manage. However, there is still a lack of data and guidelines in Korea about early colorectal cancers, especially when endoscopy is concerned. This study was undertaken in an effort to gather information in this area. METHODS: We experienced 107 early colorectal cancers from 1995 to 1998. We analyzed them with special reference to endoscopic characteristics and treatment. Ninty-six cases were followed for an average of 17 months. RESULTS: Ninty-four (87.9%) of the early colorectal cancers were detected during the last two years of the study. The male-to-female ratio was 2.1 to 1. The most common age group was the 7th decade. The rectum and the sigmoid colon were involved in 85% of the early cancers. Lesions smaller than 20 mm accounted for 54.2% of the early cancers and ones smaller than 10 mm 15%. There were no malignancies in flat-elevated lesions smaller than 10 mm; to the contrary, there was a 66.7% malignancy rate in depressed lesions. Malignancy developed in LSTs (Laterally spreading tumors) larger than 20 mm. Regarding configuration, protruded-type tumors accounted for 80.4% of the lesions, depressed-type tumors 5.6%, and LSTs 4.7%. The most common endoscopic characteristic of early colorectal cancer was redness. White spots, hardness, easy bleeding upon touch, and nodules were recognized in more than 20% of the tumors; depression and erosion were noticed in more than 10%. An expanded figure, convergence of mucosal folds, a whitish patch, and ulceration were useful in some cases. The submucosal cancer rate was 30.2% in protruded-type lesions and 66.7% in depressed-type ones. The overall adenoma-association rate was 93%. All lesions without an adenomatous component were submucosal cancers. The overall endoscopic resection rate was 87.9%. Among them, those who needed additional surgical resection accounted for 13.8% (13/94). Three recurrences were recognized. Those three were all early rectal cancers associated with villous tumors and were larger than 20 mm. All recurrences were treated endoscopically. There was one case of bleeding within 1 day after endoscopic resection. That was associated with a 20-mm, pedunculated lesion in the ascending colon and was treated using a detachable snare. CONCLUSIONS: It is important to recognize the endoscopic characteristics of early colorectal cancers, especially those of depressed lesions and LSTs. Those characteristics are also useful in selecting appropriate candidates for endoscopic resection.
Colon, Ascending ; Colon, Sigmoid ; Colorectal Neoplasms* ; Dental Caries ; Depression ; Diagnosis* ; Endoscopy ; Hardness ; Hemorrhage ; Humans ; Korea ; Rectal Neoplasms ; Rectum ; Recurrence ; SNARE Proteins ; Ulcer

Idiopathic central serous chorioretinopathy is localized detachment of the neurosensory retina in the macula which is commonly seen. However extensive sensory retinal detachment of the posterior role and multiple leaking points are rare characteristics of idiopathic central serous chorioretinopathy. Idiopathic central serous chorioretinopathy with bullous retinal detachment is frequently misdiagnosed and treated improperly. The authors experienced a case of atypical type of idiopathic central serous chorioretinopathy that has bullous retinal detachment and multiple Ieaking points in the both eyes.
Central Serous Chorioretinopathy* ; Retina ; Retinal Detachment* ; Retinaldehyde*

Severe fever with thrombocytopenia syndrome (SFTS) is firstly reported in China in 2011. Thereafter it is reported an infectious disease in Japan and Korea. It is caused by bunyavirus, called SFTS virus (SFTSV). The main vector of SFTS is Haemaphysalis longicornis tick. We investigated the distribution and detection of SFTSV in ticks collected from the environment using the dragging method and dry ice fogging method from May to November 2014 in Jeollanam-do, Korea. Sampling was taken from the province Suncheon, Gokseong, Boseong, Goheung where patients have occurred in 2013 and Gurye as control. Among the total 3,048 ticks collected, 3,030 ticks were H. longicornis (99.4%) and 18 were Amblyomma testudinarium. H. longicornis was collected 1,330 ticks in Gokseong, 1,188 ticks in Boseong, 240 ticks in Suncheon, 150 ticks in Goheung and 140 ticks in Gurye. Developmental stages by month of H. longicornis were revealed that nymph (92%) was collected from May to June, adult (30%) and nymph (70%) in July, and 93% of larvae from September to October. These results showed the different dominant stage of ticks according to seasons. However, no SFTSV-specific gene was detected in 3,030 ticks of H. longicornis.
Adult ; China ; Communicable Diseases ; Dry Ice ; Fever* ; Humans ; Japan ; Jeollanam-do* ; Korea* ; Larva ; Methods ; Nymph ; Orthobunyavirus ; Seasons ; Thrombocytopenia* ; Ticks* ; Weather

BACKGROUND/AIMS: Superficial esophageal squamous cell carcinoma (SESCC) is being increasingly detected during screening endoscopy. Endoscopic submucosal dissection (ESD) allows for en bloc and histologically complete resection of lesions. This study assessed the technical feasibility and long-term outcomes of ESD for SESCCs. METHODS: Between January 2005 and August 2012, 27 patients with 28 SESCCs underwent ESD at Pusan National University Hospital. The en bloc and pathologically complete resection rates, complication (perforation and bleeding) rate, incidence of esophageal stricture after ESD, and overall and disease-specific survival rates were evaluated. RESULTS: The en bloc and pathologically complete resection rates were 93% and 83%, respectively. No significant bleeding occurred, and perforation with mediastinal emphysema was observed in two patients (7%). Post-ESD stricture occurred in two patients (7%) who had mucosal defects involving more than three-fourths of the esophageal circumference. During a mean follow-up of 23 months, local tumor recurrence was seen in two of four lesions with pathologically incomplete resection; one was treated by re-ESD, and the other was treated by surgical esophagectomy. The 5-year overall and disease-specific survival rates were 84% and 100%, respectively. CONCLUSIONS: ESD seems to be a feasible, effective curative treatment for SESCCs. All patients should be closely followed after ESD.
Aged ; Carcinoma in Situ/pathology/*surgery ; Carcinoma, Squamous Cell/pathology/*surgery ; Cohort Studies ; Disease-Free Survival ; Dissection ; Esophageal Neoplasms/pathology/*surgery ; Esophageal Perforation ; Esophageal Stenosis ; Esophagoscopy ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Mucous Membrane/pathology/*surgery ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/*pathology ; Operative Time ; *Postoperative Complications ; Postoperative Hemorrhage ; Retrospective Studies ; Treatment Outcome ; Tumor Burden

PURPOSE: This study was aimed to develop secondary triage rule for decision of interfacility transfer to higher level of trauma center for patients with traumatic brain injury (TBI). METHODS: In a prospective observational study from August 2006 to December 2007 conducted in an urban tertiary emergency department, data were obtained from patients more than 15 years old and with TBI. Primary outcome was defined as meaningful positive CT findings. Secondary outcome was defined as meaningful intervention. Non-adjusted univariated logistic regression model was derived from result of chi-square test and adjusted model was derived using stepwise selection manner. Hosman-Lemeshow test for the goodness of fit was used. RESULTS: Total number of eligible patients with traumatic brain injury was 653. Primary outcome was positive in 103 patients and secondary outcome was positive in 42 patients. In univariate logistic regression, risk factors were age over 65(OR: 2.40), history of cerebrovascular disease(OR: 7.08), fall over two meter(OR: 6.28), pedestrian struck(OR: 18.5), headache(OR: 2.18), vomiting(OR: 3.03), disorientation(OR: 5.37), any evidence of open fracture(OR: 24.03), Glasgow coma sacle less than 13(OR: 4.97), Racoon's eye sign (OR: 2.50). These 10 risk factors were statistically significant in adjusted model which was derived using stepwise selected manner. Hosman-Lemeshow test for the goodness of fit was used and chi-square was 1.307(p=0.86). This decision rule had a sensitivity of 93.48%, a specificity of 41.13%, and a negative predictive value of 97.32%. CONCLUSION: A sensitive clinical decision rule with high negative predictive value for detection of abnormal CT lesions which need transfer to higher level of trauma center was developed.
Brain Injuries ; Coma ; Emergencies ; Eye ; Humans ; Logistic Models ; Prospective Studies ; Risk Factors ; Sensitivity and Specificity ; Trauma Centers ; Triage

Diffuse telangiectatic type of pulmonary arteriovenous malformation (AVM) is an uncommon disease entity in which numerous small arteriovenous connections occur throughout the lungs. It has rarely been confirmed by pulmonary angiography. We report a case of diffuse telangiectatic pulmonary AVM occurring in a patient with dyspnea and confirmed by CT using the slab maximum intensity projection (MIP) technique and conventional direct pulmonary angiography.
Angiography ; Arteriovenous Malformations* ; Dyspnea ; Humans ; Lung ; Tomography, X-Ray Computed*

PURPOSES: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, burns, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc. METHODS: We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients' data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test. RESULTS: There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005). CONCLUSION: Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it's impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable.
Accidents, Traffic ; Amputation ; Animals ; Asphyxia ; Burns ; Drowning ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Lacerations ; Mortality