PURPOSE: To evaluate clinical features and therapeutic modality of conjunctival nevi in Korean patients. METHODS: A retrospective analysis was performed on 197 patients (75 males and 122 females) with nevi who were diagnosed by slit lamp examination from 1997 to 2008. RESULTS: Nevi occurred most commonly on bulbar conjunctiva (88%), followed by caruncle and plica semilunaris (7%). The nevi involved temporal (71%), nasal (21%), inferior (2.8%) and superior (0.7%) quadrants of the conjunctiva. The mean horizontal length was 4.3+/-2.0 mm and the mean vertical 4.45+/-2.2 mm. Thirty-five patients (7.8%) received no treatment. Excisional biopsy was performed in 38 patients (19.3%). Argon laser photoablation of conjunctiva nevi was performed in 124 patients (62.9%). CONCLUSIONS: The pattern of conjunctival nevi in Korean patients was similar to Caucasian patients. The biopsy was performed according to appropriate guidelines however, nevus which does not require a biopsy, could be treated by argon laser photoablation.
Argon ; Biopsy ; Conjunctiva ; Humans ; Male ; Nevus ; Retrospective Studies

No abstract available.
Lipoma* ; Neck*

No Abstract Available.
Mass Screening*

PURPOSE: We report early experiences on endovascular abdominal aortic aneurysm repair (EVAR). METHOD: We reviewed the results of 15 patients underwent EVAR between 2003 and 2007 in the Kyung Hee University Medical Center, retrospectively. RESULT: Mean age of patients was 71.2 years (range, 51~85 years). 14 patients (93.3%) had comorbidities. All of AAAs were infrarenal types. The mean size of AAA was 58.5 mm (38~91 mm), and the mean length, diameter, and angle of neck was 26.4 mm, 19.9 mm, and 37.7degrees, respectively. Ten patients were accompanied with iliac aneurysm. 14 were bifurcated grafts and 1 was straight tubular graft. Mean procedure time was 100.6 minutes. Mean length of hospitalization was 6.5 days (2~10 days). There was no need of transfusion or use of an intensive care unit. Fever of unknown origin occurred in 7 cases but resolved spontaneously. Device deployment was successful in 100% (primary 9 cases, assisted-primary 6 cases). There were seven endoleaks during interventions. One patient with secondary type II endoleak and suprarenal enlargement of AAA sac died from aortoenteric fistula. In one patient with perigraft abscess after EVAR, surgical drainage was performed. Decrease of AAA diameter > or =5 mm in two patients, newly developed suprarenal aortic aneurysm in one patient were detected on CT scan during mean follow-up of 11.4 months (2-29 months) and remained unchanged in other twelve cases. CONCLUSION: These early results suggest that EVAR offers considerable benefits for appropriate patients, but is thought to need more experiences and long-term outcomes.
Abscess ; Academic Medical Centers ; Aneurysm* ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Comorbidity ; Drainage ; Endoleak ; Fever of Unknown Origin ; Fistula ; Follow-Up Studies ; Hospitalization ; Humans ; Iliac Aneurysm ; Intensive Care Units ; Neck ; Retrospective Studies ; Tomography, X-Ray Computed ; Transplants

The DNA flow cytometric analysis in colorectal cancer has been studied for more than 10 years as an independent prognostic factor or a factor correlated with other preexistent prognostic factors, such as the depth of invasion, lymph node status, histologic differentiation, etc. To clarify the influence of DNA contents (DNA ploidy, DNA index) and lymph node status on disease free survival in colorectal cancer, we investigated the relationship between them, retrospectively. METHODS: This study included 198 patients with curatively resected Dukes' stage A, B, and C colorectal cancer who had taken DNA flow cytometric analysis from June of 1996 to March of 1999 at Department of Surgery, Inha University Hospital. RESULTS: In over all twelve-month disease free survival, there were 92.5% in DNA diploid and 74.3% in DNA aneuploid tumors. And so forth, there were 78.0% in positive and 91.9% in negative lymph node tumors. In the event of a DNA index greater and lesser than 1.15, the twelve-month disease free survival was 72.9% and 92.7%, respectively. These results were statistically significant (p<0.05). Therefore, patients with a negative lymph node, diploid colorectal cancer or DNA index lesser than 1.15 had a longer disease free survival than those with a positive lymph node, aneuploid one or DNA index greater than 1.15. CONCLUSIONS: In conclusion, there seems to be a significant relationship between DNA contents and lymph node status on disease free survival. Thus, these factors are considered to be valuable in predicting the recurrence of colorectal cancer.
Aneuploidy ; Colorectal Neoplasms* ; Diploidy ; Disease-Free Survival* ; DNA* ; Humans ; Lymph Nodes* ; Ploidies* ; Recurrence ; Retrospective Studies

BACKGROUND: The brain is a common site of a metastasis in lung cancer patients. If left untreated, the patients succumb to progressive neurological deterioration with a lower survival rate than with other metastases sites. Contrast-enhanced MR imaging in the absence of symptoms or clinical signs is not recommended for identifying a cerebral metastasis in lung cancer patients because of management effectiveness. This pilot study was performed to estimate whether or not limited brain MR imaging, which has a lower cost, could be used to replace conventional brain MR imaging. METHOD: Between April 1999 and March 2001, 43 patients with a primary lung cancer and the others (breast cancer, stomach cancer, colon cancer, malignant melanoma etc), who had neurological symptoms and signs, were examined using conventional brain MR imaging to examine brain metastases. The control group involved four patients who had no evidence of brain metastases the sensitivity, specificity and correlation of limited brain MR imaging were compared with conventional brain MR imaging. RESULTS: All the 43 patients who were examined with conventional brain MR imaging showed evidence of brain metastases, whereas limited brain MR imaging indicated that 42 patients had brain metastases(sensitivity=97.67%). One patient in whom limited brain MR imaging showed no brain metastasis had a metastasis in the cerebellum, as shown by the contrast-enhanced T1 weighted axial view using conventional brain MR imaging. The conventional brain MR imaging and the limited brain MI imaging of the 4 control patients both indicated no brain metastases (specificity=100 %). The Pearson Correlation of the two groups was 0.884(Confidence Interval : 99%) observed. CONCLUSION: Limited brain MR imaging can detect a brain metastasis with the same accuracy. In addition, it is cost-effective (229,000 won, 180$) compared to conventional brain MR imaging(529,000 won, 480$) when patients had neurological symptoms and signs or staging.
Brain* ; Cerebellum ; Colonic Neoplasms ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging* ; Melanoma ; Neoplasm Metastasis* ; Pilot Projects ; Stomach Neoplasms ; Survival Rate

BACKGROUND: In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tubersulosis Hospital. METHOD: Retrospective cohort study was made 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Now. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group l : OFX+PTA+CS+PAS+Aminoglycoside, Group ll : PZA+PTA+CS+PAS+Aminoglycoside, Group lll : PZA+OFX+PTA+PAS+Aminoglycoside). RESULTS: The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was most frequent in the males(81patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regaimens were HERAZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients (39.4%) and others in 15 patients(14.4%). Result of drug sensivivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is in 12 patients(11.5%), INH s in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspenea on exertion(37.5%), weight loss(33.7%) blood tinged sputum (15.4%) and otheres. The extent of disease on the radiograph was far-advanced in 73 patients (70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.8%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgai in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group l, 80% in Group ll and 90.5% in Group lll). The average negative conversion time on sputum was 4 month(4.0 month in Group l, 4.6 month in Group ll and 3.0 month in Group III). CONCLUSION: In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substively substituting for CS.
Age Distribution ; Cohort Studies ; Drug Therapy ; Exanthema ; Humans ; Ofloxacin ; Retreatment* ; Retrospective Studies ; Sex Distribution ; Sputum ; Tolnaftate ; Tuberculosis, Pulmonary*

Obstructive jaundice caused by tuberculous lymphadenitis is a rare manifestation of tuberculosis (TB), with 15 cases having been reported in Korea. We experienced a case of obstructive jaundice caused by pericholedochal tuberculous lymphadenitis in a 30-year-old man. The patient's initial serum total bilirubin level was 21.1 mg/dL. Abdominal computed tomography revealed narrowing of the bile duct by a conglomerated soft-tissue mass involving the main portal vein. Abrupt obstruction of the common bile duct was observed on cholangiography. Pathologic analysis of a ultrasonography-guided biopsy sample revealed chronic granulomatous inflammation, and an endoscopic examination revealed esophageal varices and active duodenal ulceration, the pathology of which was chronic noncaseating granulomatous inflammation. Hepaticojejunostomy was performed and pathologic analysis of the conglomerated soft-tissue mass revealed chronic granulomatous inflammation with caseation of the lymph nodes. Tuberculous lymphadenitis should be considered in patients presenting with obstructive jaundice in an endemic area.
Adolescent ; Adult ; Bilirubin/blood ; Duodenal Ulcer/pathology ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices/pathology ; Female ; Humans ; Jaundice, Obstructive/*diagnosis ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node/*diagnosis ; Young Adult

Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.
Budgets ; Compensation and Redress ; Cost-Benefit Analysis* ; Health Care Costs ; Humans ; Low Back Pain* ; Occupational Injuries ; Pain Clinics ; Rehabilitation ; Return to Work

PURPOSE: Although the analgesic effects of corticosteroids have been well documented, little information is available on periarticular injection (PI) containing corticosteroids for early postoperative pain management after total knee arthroplasty (TKA). We performed a prospective double-blind randomized trial to evaluate the efficacy and safety of an intraoperative corticosteroid PI in patients undergoing TKA. MATERIALS AND METHODS: Seventy-six consecutive female patients undergoing bilateral staged TKA were randomized to receive steroid or non-steroid PI, with 3 months separating the procedures. The steroid group received PI with a mixture containing triamcinolone acetonide (40 mg). The non-steroid group received the same injection mixture without corticosteroid. During the postoperative period, nighttime pain, functional recovery [straight leg raising (SLR) ability and maximal flexion], patient satisfaction, and complications were recorded. Short-term postoperative clinical scores and patient satisfaction were evaluated at 6 months. RESULTS: The pain level was significantly lower in the PI steroid than the non-steroid group on the night of the operation (VAS, 1.2 vs. 2.3; p=0.021). Rebound pain was observed in both groups at POD1 (VAS, 3.2 vs. 3.8; p=0.248), but pain remained at a low level thereafter. No significant differences were seen in maximal flexion, frequency of acute rescuer, clinical scores, and patient satisfaction. The steroid group was able to perform SLR earlier than the non-steroid group (p=0.013). The incidence of complications was similar between the groups. CONCLUSION: PI containing a corticosteroid provided an additional pain-relieving effect on the night of the operation. In addition, corticosteroid PI did not increase the perioperative complications of TKA.
Adrenal Cortex Hormones ; Arthroplasty* ; Female ; Humans ; Incidence ; Knee* ; Leg ; Methods ; Pain Management* ; Pain, Postoperative ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Triamcinolone Acetonide