PURPOSE: To compare the accuracy of intraocular lens (IOL) power calculation formulas in eyes with primary angle closure glaucoma (ACG). METHODS: This retrospective study compared the refractive outcomes of 63 eyes with primary ACG with the results of 93 eyes with normal open angles undergoing uneventful cataract surgery. Anterior segment biometry including anterior chamber depth, axial length, and anterior chamber depth to axial length ratio were compared by the IOL Master. Third generation formulas (Hoffer Q and SRK/T) and a fourth generation formula (Haigis) were used to predict IOL powers in both groups. The predictive accuracy of the formulas was analyzed by comparison of the mean error and the mean absolute error (MAE). RESULTS: In ACG patients, anterior chamber depth and the anterior chamber depth to axial length ratio were smaller than normal controls (all p < 0.05). The MAEs from the ACG group were larger than that from the control group in the Haigis formula. The mean absolute error from the Haigis formula was the largest and the mean absolute error from the Hoffer Q formula was the smallest. CONCLUSIONS: IOL power prediction may be inaccurate in ACG patients. The Haigis formula produced more inaccurate results in ACG patients, and it is more appropriate to use the Hoffer Q formula to predict IOL powers in eyes with primary ACG.
Aged ; Biometry ; Cataract Extraction ; Glaucoma, Angle-Closure/*complications ; Glaucoma, Open-Angle/complications ; Humans ; *Lens Implantation, Intraocular ; *Lenses, Intraocular ; Middle Aged ; *Optics and Photonics ; Reproducibility of Results ; Retrospective Studies

PURPOSE: We sought to evaluate the clinical usefulness of CT colonography (CTC) after incomplete conventional colonoscopy (CC) for occlusive colorectal cancer (CRC) according to the tumor location. MATERIALS AND METHODS: Seventy-five patients with occlusive CRC underwent subsequent CTC immediately after incomplete CC. Fifty-nine patients had distal CRC and 16 had proximal colon cancer. Experienced radiologists prospectively analyzed the location, length, and TNM staging of the main tumor. The colorectal polyps in the remaining colorectum and additional extraluminal findings were also recorded. Sixty-seven patients underwent colorectal resection. We retrospectively analyzed the surgical outcome and correlated CTC and CC findings. RESULTS: The overall accuracies of tumor staging were: T staging, 86%; N staging (nodal positivity), 70% (80%); and intra-abdominal M staging, 94%. Additional colonic polyps were found in 23 patients. Six synchronous carcinomas were detected (9%); three in the proximal colon and three in the distal colon of occlusion. Clinically significant localization errors at CC were noted in 8 patients (12%, 5 proximal colon cancers and 3 distal CRCs) and were corrected by CTC. After CTC, the surgeons modified the initial surgical plan in 11 cases (16%). CONCLUSION: In occlusive CRC, CTC is not only useful in the evaluation of the proximal bowel, but can also provide surgeons with accurate information about staging and tumor localization. CTC is recommended when endoscopists encounter occlusive CRC, regardless of tumor location.
Adult ; Aged ; Aged, 80 and over ; Colonography, Computed Tomographic/*methods ; Colonoscopy/*methods ; Colorectal Neoplasms/pathology/radiography/*surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Reproducibility of Results

PURPOSE: This study was undertaken to investigate the therapeutic effects of topiramate on pediatric patients with migraine, especially migraine accompanied by aura. METHODS: From January. 2004 to December. 2006, we reviewed the medical records of 27 patients who were diagnosed as migraine and treated with topiramate. And we analysed to see whether there was any improvement of symptoms based on the migraine criteria by International Headache Society. RESULTS: There was a correlation between the migraine criteria and the improvement of symptoms after the treatment by topiramate. The symptoms of nausea, vomiting and hypersensitivity to light and sound were not associated with the improvement of symptoms after the treatment by topiramate. The symptom of aura was related with the improvement of symptoms, moreover, closely related with disappearance of symptoms after the treatment by topiramate. CONCLUSION: It is estimated that more accurate diagnosis coupled with the presence of aura is a condition to improve the treatment effects of topiramate.
Diagnosis ; Epilepsy* ; Headache ; Humans ; Hypersensitivity ; Medical Records ; Migraine Disorders* ; Nausea ; Vomiting

BACKGROUND: The blood processing works are composed of phlebotomy, donor testing, manufacturing, storage, transportation, and quality control. Among these, storage, transportation and quality control are done partially at the blood collection centers and finally accomplished at the hospital blood banks. We tried to analyze blood processing costs in hospital blood banks. METHODS: Blood processing costs are divided into physician works, practice expenses, and professional liability insurance according to RBRVS (Resource-Based Relative Value Scale). Physician works were analyzed according to the study of the 'Physician work RBRVS committee of the Korean society for laboratory medicine'. For the practice expenses, three university hospital blood banks data were analyzed. The costs for the blood supply of small clinics or hospitals without blood banks were investigated by questionnaire. RESULTS: Comprehensive works of physician were such as laboratory administration, quality control, preparation of procedure manual, education, quality improvement control. Specific works of physician were such as supervision over technologists, analysis of quality control data, management of blood inventory, storage and issue, blood utilization review, management of adverse transfusion reaction, blood return and disposal. As for one unit of blood, the standard labor time of technologists was 28.8 minutes (which is equivalent of 7,680 won) and the mean equipment cost was 592 won. The mean cost of small clinics or hospitals for blood supply was 12,150 won. CONCLUSION: The reimbursement of blood processing cost for the hospital blood bank would contribute to stable blood bank administration, stable blood supply and safe transfusion.
Blood Banks* ; Blood Group Incompatibility ; Education ; Humans ; Insurance ; Liability, Legal ; Organization and Administration ; Phlebotomy ; Quality Control ; Quality Improvement ; Tissue Donors ; Transportation ; Utilization Review ; Surveys and Questionnaires

PURPOSE: To compare T2-weighted MR cholangiography (T2-MRC) and contrast-enhanced T1-weighted MRC (enhanced T1-MRC) in the assessment of biliary anatomy in donor candidates for living related liver transplantation (LRLT). MATERIALS AND METHODS: Thirty-three potential donors underwent MR examination for preoperative evaluation. Using the single-shot half-Fourier RARE sequence, T2-weighted single-section and coronal images were obtained, and enhanced T1-MRC was performed, using 3D GRE sequences after the administration of mangafodifir trisodium. To assess the hilar ductal branching pattern and determine diagnostic confidence, two reviewers first evaluated the unpaired T2-MRC and enhanced T1-MRC images, and then paired T2-MRC and enhanced T1-MRC images together. In particular, in 12 cases in which direct cholangiographys were performed, the feasibility of single duct-to-duct anastomosis was assessed using the unpaired and the paired sets sequentially. RESULTS: The reviewers' confidence tended to be higher for enhanced T1-MRC than T2-MRC, but the difference was not statistically significant. For both reviewers, confidence was significantly higher for the paired set than for T2- or enhanced T1-MRC alone (p < .001). The types of biliary anatomy determined in the paired set matched the consensus reading in 33 (100%) and 30 cases(91%) assessed by reviewer 1 and 2, respectively. The separate interpretation of T2- and enhanced T1-MRC findings matched the consensus interpretation in 30 (91%) and 28 cases (85%), respectively, assessed by reviewer 1, and 26 (79%) and 28 cases (85%), respectively, assessed by reviewer 2. The possibility of single anastomosis was accurately predicted in 91.6% of cases in T2-MRC, and 100% at enhanced T1-MRC and the combined set. CONCLUSION: In the evaluation of the biliary anatomy of potential donors for LRLT, the combined use of T2-MRC and enhanced T1-MRC may improve diagnostic confidence and decrease the occurrence of a non diagnostic or equivocal interpretation at T2-MRC alone.
Adult* ; Cholangiography* ; Consensus ; Humans ; Liver Transplantation ; Liver* ; Tissue Donors*

BACKGROUND/AIMS: Vascular endothelial growth factor (VEGF) is a potent angiogenic factor. Hepatocellular carcinoma (HCC) is a typical hypervascular tumor and VEGF may play a important role in its carcinogensis and progression. Transcatheter arterial chemoembolization (TACE) which is one of the therapeutic modalities of HCC induces hypoxia to the tumor. VEGF is known to be up-regulated by hypoxia. In this study, we examined the level of VEGF in the course of TACE. METHODS: Twenty-two HCC patients were enrolled in this study. Serum VEGF level was investigated before and 1, 5 and 10 days after TACE. The correlation of clinical factors of patients and the level of serum VEGF before TACE was evaluated. Platelet count was also measured with VEGF. RESULTS: Mean serum VEGF level increased significantly 1 and 5 days after TACE. Platelet count decreased significantly 1 day after TACE. Serum VEGF level was positively correlated with platelet count before and 1 day after TACE. CONCLUSION: TACE may increase the serum level of VEGF induced by hypoxia.
Angiogenesis Inducing Agents ; Anoxia ; Carcinoma, Hepatocellular* ; Humans ; Platelet Count ; Vascular Endothelial Growth Factor A*

A giant esophageal liposarcoma showing rapid growth over 7 months is presented in 56-year-old man. It originated from the pharyngo-esophageal junction with a short stalk, and extended downward to the distal esophagus. A barium swallow study showed a large, sausage-like intraluminal mass in the dilated esophagus. CT and MR imaging showed a heterogeneous mass with a fatty component in the esophagus. A total laryngopharyngo-esophagectomy was performed and the histological diagnosis was of a well-differentiated liposarcoma.
Esophageal Neoplasms/*diagnosis/pathology ; Esophagus/radiography ; Human ; Liposarcoma/*diagnosis/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVE: The authors analyze the incidence, etiological and prognostic factors between contralateral and ipsilateral delayed epidural hematoma after evacuation of initial hematoma and to formulate recommendations for early detection of evolving hematoma and improvement of outcome. METHODS: Between July 1997 and December 1999, 417 patients underwent craniotomy at department of neurosurgery to evacuate an acute posttraumatic intracranial hematoma. Analysis of these clinical and neuroradiologic data showed that we underwent a second operation on 24 patient(5.8%) for removal of delayed epidural hematoma. In 10(2.4%) of these patients the second operation was undertaken to evacuate a new hematoma that had developed at a contralateral side from the initial hematoma. In 14 patients(3.4%), the second operation was to remove a epidural hematoma at the same site as the first craniotomy. RESULTS: 24 patients were divided into two groups. In Group A, 10 patients who developed contralateral delayed epidural hematoma were 31.5 years(11-61) of age and had skull fracture at the site of delayed epidual hematoma formation. Two of these patients revealed severe brain swelling during the evacuation of acute subdural hematoma. Eight of them were diagnosed within 24 hours after craniotomy through immediately postoperative computed tomography scan. In Group B, 14 patients who developed ipsilateral epidural hematoma were 56.1 years(27-75) of age. Six of them had hemorrhagic tendency related to past medical history. Eleven of these patients were associated with thrombocytopenia and consumptive coagulopathy when required second operation. Twelve patients were diagnosed within 48-72 hours after craniotomy due to clinical deterioration or failure to improve. There was no significant difference in outcome between two groups. CONCLUSION: The authors sought differential factors between contralateral and ipsilateral delayed epidural hematoma. Delayed epidural hematoma after craniotomy may need an urgent operation or lead to serious complication or disability. Postoperative computed tomography scan, intracranial pressure monitoring and repeat computed tomography scan within 72 hours of injury are strongly recommended in these cases, especially after decompression of cranial cavity.
Brain Edema ; Craniotomy ; Decompression ; Hematoma* ; Hematoma, Subdural, Acute ; Humans ; Incidence ; Intracranial Pressure ; Neurosurgery ; Skull Fractures ; Thrombocytopenia

PURPOSE: Of the cancers in childhood, leukemia is the most frequent one. For the desirable control of childhood leukemia, the basic data for the incidence has a great importance. The authors made a report about the incidence of leukemia in childhood, which analyzed the data from 126 cases in Kyongnam province, Korea, during 1991~1995. METHODS: The data were obtained from 126 new cases of childhood leukemia who had been living in the Kyongnam province and were diagnosed at the 26 university hospitals or general hospitals in the Kyongnam area and other cities from 1991 to 1995. RESULTS: The age-and-sex adjusted annual incidence rate per 100,000 population during 1991~1995 varied from 1.82 to 2.86, and cumulative annual incidence rate was 2.41 (male 2.26 and female 2.57 respectively). Male to female sex ratio was 1:1 in total cases. By the major types of childhood leukemia, the cases were composed of acute lymphocytic leukemia 70.6%, acute myelocytic leukemia 26.9% and chronic myelocytic leukemia 2.5%. The cumulative annual incidence rate per 100,000 population (crude rate) during 1991~1995 were 2.77 in Ulsan city, 2.62 in Chinju city and 2.34 in the whole area of Kyongnam province. CONCLUSION: It was concluded that the age-and-sex adjusted annual incidence rate per 100,000 of childhood in Kyongnam province was 2.41, which was lower than that in Pusan city in the same period. And, there was no significant difference of the cumulative annual incidence rate between Ulsan area and Chinju area in the same period.
Busan ; Female ; Gyeongsangnam-do* ; Hospitals, General ; Hospitals, University ; Humans ; Incidence* ; Korea* ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sex Ratio ; Ulsan

PURPOSE: Thawed stem cells should be infused as early as possible because delay of infusion leads to decrease of cell viability and formation of DNA clumping. The procedure of 10% Dimethyl sulfoxide(DMSO) removal and a long distance from the thawing location to the patient are the main causes of delay of infusion that results in the loss of cell viability and apoptosis. Therefore, we investigated the changes of cell viability and apoptosis after thawing with lapse of time. METHODS: Five samples of mobilized peripheral blood were evaluated. We measured cell viability, colony forming unit(CFU) and apoptosis at 0, 1, 2, 4, and 24 hours after thawing. The state of stem cells were divided into live, apoptotic and dead with double staining using annexin V and 7-aminoactinomycin D(7-AAD) in flow cytometry. RESULTS: Viability of the total cells after thawing was 77.3(53.3-97.7)%. The percentage which recovered to initial CFU at 1, 2, 4 and 24 hours after thawing decreased to 63.9%, 50.2%, 45.8% and 11.6%, respectively. The proportion of apoptotic cells among CD34+ cells after thawing were increased from 0.2% at 0 hour to 16.5% at 1 hour, 21.9% at 2 hours, and then decreased to 15.0% at 4 hours, 2.7% at 24 hours because they were replaced by dead cells. CONCLUSION: Thawed cells changed to apoptotic and had less colony forming capacity from 1 hour after thawing, and were then replaced by dead cells from 4 hours after thawing.
Annexin A5 ; Apoptosis* ; Cell Survival ; DNA ; Flow Cytometry ; Humans ; Stem Cells*