The cataract extraction in traumatic cataract with corneal laceration is likely to be different from the ordinary cataract extraction in several points. We tried to know the problems of the operation, the visual outcomes and the postoperative complications in these eyes. In 25 traumatic cataract with corneal laceration, we performed cataract extraction and corneal suture at the same time in 11 eyes and at different time in 14 eyes. The intraoperative problems were difficult anterior capsulotomy, corneal opacity, difficult lens delivery etc.The major postoperative complications were anterior chamber inflammation, corneal edema, posterior capsular opacity and exudative pupillary membrane. In 23 eyes[92%], the visual acuity was increased more than 2 lines. Cataract extraction in traumatic cataract with corneal laceration was very effective surgery, and cataract extraction after primary corneal suture has done had good results in severe corneal laceration with suspicious posterior capsular rupture and non-fitted preoperative preparation.
Anterior Chamber ; Cataract Extraction ; Cataract* ; Corneal Edema ; Corneal Opacity ; Inflammation ; Lacerations* ; Membranes ; Postoperative Complications ; Rupture ; Sutures ; Visual Acuity

PURPOSE: Subtotal thyroidectomy has been the standard operation for Graves' disease in achieving a favorable outcome in recovery of euthyroid state. However, the postoperative outcomes following subtotal thyroidectomy differ by surgeon and postoperative thyroid dysfunctions develop as time passes. Here, we have studied the validity of total thyroidectomy for Graves' disease patients, with a comparison to subtotal thyroidectomy. METHODS: A total of 299 patients with Graves' disease underwent thyroid operation consecutively in Asan Medical Center, Seoul, Korea from December 1995 to December 2005. Among them, 241 cases had subtotal thyroidectomy and 43 had total thyroidectomy. The subtotal thyroidectomy cases were divided into 3 groups according to estimated remnant thyroid; <4 g, 4< or =~<6 g and > or =6 g. Also, according to postoperative thyroid function, the patients were divided into euthyroid, hypothyroidism and hyperthyroidism groups. The postoperative changes of thyroid function, postoperative complications and hospital days were analyzed. RESULTS: In subtotal thyroidectomy, postoperative thyroid function showed euthyroid in 25 (10.4%), hypothyroidism 206 (85.5%) and hyperthyroidism 10 (4.1%). However, total thyroidectomy showed no persistent hyperthyroidism or recurrence. The postoperative thyroid function state changed in 24 patients out of 148 who had more than 2 years postoperative follow-up. Hyper-functional changes developed with higher rates (Hypo-6 vs. hyper-18). The postoperative complication rate was higher in subtotal thyroidectomy including bleeding, hoarseness and hypocalcemia. CONCLUSION: In our study, the patients showing normal thyroid function after subtotal thyroidectomy were very limited and thyroid dysfunction developed continuously with time lapse, especially towards hyperthyroid state. Therefore, we suggest that total thyroidectomy should be considered as a treatment option in Graves' disease.
Follow-Up Studies ; Graves Disease ; Hemorrhage ; Hoarseness ; Humans ; Hyperthyroidism ; Hypocalcemia ; Hypothyroidism ; Korea ; Postoperative Complications ; Recurrence ; Thyroid Gland ; Thyroidectomy

Intraocular hemorrhage is a major problem during the vitreous surgery, despite of improvements in instrumentation and operative methods. Infusion of thrombin has been reported as an efficacious method of control of intraocular hemorrhage in various vitreous surgery. In this study, 100 U/ml diluted thrombin was injected through the infusion system of Grieshaber manipulator into the vitrous cavity on the bleeding site instead of adding to the infusion solution in 10 cases of vitreous surgery including proliferative diabetic retinopathy, posttraumatic advanced proliferative vitreoretinopathy and giant retinal tear. As the result, all cases of intraocular hemorrhage were controlled within 2 min utes after the injection of thrombin, with the combined use of intraocular diathermy or elevation of intraoclar pressure. The amount of diluted thrombin which was injected in concentration of 100 U/ml, was less than 5ml. The 6 cases of postop erative complication were noted, including 2 cases of vitreous hemorrhage and 4 cases of hypopyon which were controlled within 5 days with topical steroid therapy.
Diabetic Retinopathy ; Diathermy ; Hemorrhage* ; Retinal Perforations ; Thrombin* ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage

Proliferative vitreoretinopathy is an abnormality in which the rhegmatogenous retinal detachment is complicated by proliferation of membrane on both surfaces of the detached retina and on the posterior surface of the detached vitreous gel. The contraction of these membranes, causing distortion and further elevation of the retina, is the most important cause of failure in retinal reattachment surgery. The author studied the ultrastructural features of preretinal and subretinal membranes which were removed during vitreous surgery in four patients with proliferative vitreoretinopathy. The results were as follows: 1. In the four preretinal membranes, five morphologically distinguishable cell types-retinal pigment epithelial cells, fibrous astrocytes, macrophages, fibrocytes and myofibroblasts-were observed, and the extracellular matrix was composed of collagen fibrils measuring 15-25nm in diameter. 2. In one subretinal membrane, retinal pigment epithelial cells, fibrous astrocytes and macrophages were observed and the major cell type was the retinal pigment epithelial cell. The diameter of the extracellular collagen fibrils was almost the same as that of the preretinal membranes. 3. In the preretinal and subretinal membranes, some of the fibrocytes and macrophages were believed to be derived from retinal pigment epithelial cells.
Astrocytes ; Collagen ; Epithelial Cells ; Extracellular Matrix ; Humans ; Macrophages ; Membranes* ; Retina ; Retinal Detachment ; Retinaldehyde ; Vitreoretinopathy, Proliferative

PURPOSE: We attempted to evaluate the outcomes of a newly inaugurated surgical technique of laparoscopic pyloromyotomy with microscope and stab incision (MS-LP) with right upper quadrant transverse open pyloromyotomy (RT-OP), which were performed in a single institution. METHODS: The outcome variables in terms of total anesthesia time, operative time, postoperative emesis, time to full-enteral feeding, postoperative hospital stay, cosmetic result score, medical cost, and postoperative wound complications were compared between the MS-LP and RT-OP groups. RESULTS: Fifty-one consecutive pyloromyotomy cases were enrolled; MS-LP (n=33) and RT-OP (n=18). There was no difference in age, pyloric thickness, and preoperative electrolyte levels between the two groups. The total anesthesia time and operative time of MS-LP were not significantly longer than that of RT-OP. Time to full-enteral feeding and postoperative hospital stay were shorter in MS-LP (20.0±18.3 vs. 35.3±14.8 hrs. and 2.4±1.3 vs. 3.4±1.2 days; p=0.047 and 0.050, respectively). The cosmetic result score and medical cost were significantly higher in MS-LP (9.1±1.0 vs. 7.3±1.2 in terms of scores and 3,501,950±1,093,147 vs. 2,522,474±68,605 in terms of KRW; p=0.001 and 0.021, respectively). No difference in postoperative wound complications was observed between the two groups. CONCLUSION: Laparoscopic pyloromyotomy with microscope and stab incision may suggest recovery benefits with a shorter time to full-enteral feeding and postoperative hospital stay, as well as better cosmetic results than RT-OP. However, MS-LP may induce higher costs.
Anesthesia ; Length of Stay ; Operative Time ; Postoperative Nausea and Vomiting ; Pyloric Stenosis, Hypertrophic* ; Wounds and Injuries

We recently encountered a patient with membranous obstruction of the inferior vena cava in whom the left superior intercostal and hemiazygos veins were dilated. At chest radiography, the dilation simulated the presence of a second aortic knob and descending thoracic aorta lateral to the originals, and an "aorta-in-aorta" appearance was thus created.
Aorta, Thoracic ; Humans ; Radiography ; Radiography, Thoracic* ; Thorax* ; Veins* ; Vena Cava, Inferior

The clinicopathological manifestations of gastric mucormycosis range from colonization of ulcer disease to infiltration of tissue with or without vascular involvement. The prognosis of this disease is extremely poor when blood vessel invasion is observed. Herein, we report on a rare case of ischemic gastric perforation that was associated with vascular invasive mucormycosis in a renal recipients 7 years after transplantation.
Blood Vessels ; Colon ; Kidney Transplantation ; Mucormycosis* ; Prognosis ; Transplantation* ; Ulcer

PURPOSE: The optimal timing of a surgery for well-differentiated thyroid carcinoma detected during pregnancy remains controversial. This study was performed to determine the optimal timing of surgery for a well-differentiated thyroid carcinoma detected during pregnancy. METHODS: Betwwen July 1991 and June 2004, 20 cases diagnosed with a well-differentiated thyroid carcinoma during pregnancy were retrospectively analyzed. All 20 patients had undergone surgery. The patients were divided into three groups according to the timing of their surgery. Group I (n=9) had a thyroidectomy after delivery, group II (n=6) had a thyroidectomy during the second trimester, and group III (n=5) had a thyroidectomy after an abortion. Group III was excluded from the study as our particularly interest was in determining the optimal timing of surgery during pregnancy. RESULTS: No significant differences were noted between groups I and II with regard to age, tumor size, TNM stage and the timing of diagnosis. There were no TNM stage changes in group I, although a slight increase in tumor size during pregnancy was noted. There were no significant differences in the surgical outcomes between groups I and II with regard to types of operation, operation times, perioperative complications, length of hospital stays and treatment outcomes. CONCLUSION: The treatment of a well-differentiated thyroid carcinoma detected during pregnancy can be delayed until after delivery in most patients.
Diagnosis ; Female ; Humans ; Length of Stay ; Pregnancy Trimester, Second ; Pregnancy* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Parathyroid carcinoma is a rare malignancy presenting hyperparathyroidism. At times, diagnosis and localization are difficult. The optimum treatment for parathyroid carcinoma is en bloc resection when malignancy is highly suspicious or diagnosed. However, even after the adequate surgical treatment, persistent or recurrent disease is well encountered. Here we report a case with recurred parathyroid carcinoma presenting discrepancy between image findings and operative findings.
Diagnosis ; Hyperparathyroidism ; Parathyroid Neoplasms* ; Recurrence* ; Ultrasonography

BACKGROUND: Pulmonary complications following bonemarrow transplantation(BMT) are common and associated with a high mortality rate, We investigated the yield, safety, and impact of fiberoptic bronchoscopy(FOB) for diagnosis of postBMT pneumoniae. METHODS: From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with repiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL(bronchoalveolar lavage), TBLB(transbronchial lung biopsy), PSB(protected specimen brush). RESULTS: The characteristics of the subjects were as follows:37 males, 15 females, mean age of 31.3 years(17-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following:12 cytomegalovirus(CMV) (21.4%), 7 pneumocystis carinii(PC) (12.5%), 11 CMV with PC (19.6%), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases(23.2%), 13 died of CMV pneumoniae(n=2), PCP(n=2), mixed infection with CMV and PC(n=3), underlying GVHD(n=1), underlying leukemia progression(n=1), or respiratory failure of unknown origin(n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleedig and 1 episode temporary hypoxemia. CONCLUSION: Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.
Anoxia ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchoscopy* ; Coinfection ; Diagnosis* ; Female ; Glass ; Humans ; Leukemia ; Lung ; Male ; Mortality ; Pneumocystis ; Pneumonia* ; Respiratory Insufficiency ; Siblings ; Streptococcus ; Tissue Donors ; Tuberculosis