No abstract available.
Varicose Veins

Purpose: The study investigated the results of direct surgical scleral depression using four ports and the chandelier lighting system in rhegmatogenous retinal detachment. Methods: Anatomical and functional success rates and complications were analyzed in 179 eyes diagnosed with rhegmatogenous retinal detachment that underwent primary vitrectomy using four ports at our hospital between March 2012 and February 2022. Results: A total of 168 (93.9%) eyes had anatomical success without reoperation while 11 (6.1%) developed recurrence. However, the final success rate was 100%. The best-corrected visual acuity improved significantly from logarithm of the minimum angle of resolution (logMAR) 1.03 ± 0.92 to logMAR 0.24 ± 0.39 after surgery (p < 0.001). Complications included a temporary increase in the intraocular pressure (n = 3, 1.7%), leakage through the scleral incision (n = 2, 1.1%), hyphema and vitreous hemorrhage (n = 10, 5.6%), and iatrogenic retinal break (n = 1, 0.6%), but these improved after treatment. Conclusions Four-port vitrectomy for rhegmatogenous retinal detachment in which scleral depression is directly performed using the chandelier lighting system is a useful surgical method. It allows effective visualization of the peripheral retina regardless of the assistant’s proficiency which results in a more meticulous surgery. The anatomical and functional results of this technique were similar to the conventional technique.

Nonunion is one of the important complication during treatment of forearm fracture. Nonunion of the forearm fracture inevitably prolongs the treatment course and markedly impairs the function of the forearm. We analyzed 34 cases of nonunion of forearm fracture in 21 persons from Jan. 1979 to Dec. 1985. The results are as follows. 1. The greater force of traffic accident of machine injury produced nonunion more frequently. 2. The predilection site of the nonunion was coincidental to the fracture site of the forearm. 3. Unstable fracture such as comminuted, segmental, spiral or oblique fracture was more closely related to the nonunion than the stable fracture. Hypervascular type nonunion was more prevalent than the avascular type. 4. The probable causes of nonunion were poor external fixation, severe soft tissue injury, displaced or comminuted fracture and inadequate or inappropriate surgery. 5. Obtained bone union in all cases, but the functional result was not improved compared to the preoperative state.
Accidents, Traffic ; Clinical Study ; Forearm ; Fractures, Comminuted ; Humans ; Soft Tissue Injuries

PURPOSE: In this study we compared the clinical outcomes of idiopathic epiretinal membrane (ERM) surgery according to the use of indocyanine green (ICG) and ICG exposure time. METHODS: The medical records of 76 patients with an idiopathic ERM that underwent vitrectomy and ERM and internal limiting membrane (ILM) removal were reviewed. We compared the results (best corrected visual acuity [BCVA, log MAR] and central macular thickness [CMT, µm]) of idiopathic ERM surgeries using ILM peeling with (group I, 39 eyes) and without ICG (group II, 37 eyes). Additionally, the correlation of ICG exposure time and clinical outcomes in group I was analyzed. RESULTS: Gender, age, lens state, preoperative BCVA, and preoperative CMT were not significantly different between the two groups. The postoperative BCVA was significantly improved in both groups but the difference was not statistically significant. The postoperative CMT was significantly improved in both groups and the change amount of group I was more larger than group II. Additionally, ICG exposure time was not significantly correlated with changes of BCVA and CMT. CONCLUSIONS: Intravitreal ICG-assisted ILM peeling did not significantly affect the recovery of BCVA, however that impaired the recovery of CMT. ICG exposure time did not affect the postoperative visual outcome.
Epiretinal Membrane* ; Humans ; Indocyanine Green ; Medical Records ; Membranes* ; Visual Acuity ; Vitrectomy

The incidence of transient bacteremia following esophageal variceal sclerotherapy (EVS) was evaluated in 29 patients. These 29 patients underwent a total of 83 sclerotherapy sessions.Prior to EVS, all instruments were sterilized. Blood cultures were drawn pre-EVS and post-EVS.All pre-EVS and post-EVS blood cultures were negative. In conclusion, it was found bacteremia following sclerotherapy is not easily developed, if a vigorous approach of using well cleaned equipment is used. Unless there is a cardiac prothesis or valvular heart disease, antibiotic prophylaxis is not warranted.
Antibiotic Prophylaxis ; Bacteremia* ; Esophageal and Gastric Varices* ; Heart Valve Diseases ; Humans ; Incidence ; Sclerotherapy*

No abstract available.
Male ; Penile Erection*

Minimally invasive surgery, which has been extensively used to treat gastric adenocarcinoma, is now regarded as one of the standard treatments for early gastric cancer, and its suitability for advanced gastric cancer is being investigated. The use of cutting-edge techniques for minimally invasive surgery enables surgeons to deliver various treatment options to minimize a patient's distress and to maintain oncologic safety. Ongoing multicenter prospective studies aim to validate the efficacy of these surgical techniques and to expand the indications of minimally invasive surgery for the treatment of gastric cancer. In this review, we summarize the current status and issues regarding minimally invasive surgery for the treatment of gastric cancer.
Gastrectomy/*methods/trends ; Humans ; Laparoscopy/*methods/trends ; Multicenter Studies as Topic ; Patient Selection ; Randomized Controlled Trials as Topic ; Republic of Korea ; Robotic Surgical Procedures/*methods/trends ; Sentinel Lymph Node Biopsy/methods/trends ; Stomach Neoplasms/*surgery

PURPOSE: We report a case of a scleral perforation during inferior rectus recession in congenital fibrosis of extraocular muscles and the management of this perforation with a scleral patch graft. CASE SUMMARY: A 20-month-old female with bilateral ptosis, absence of elevation and a chin-up position was diagnosed with congenital fibrosis of extraocular muscles. Because severe esotropia in the downward gaze was observed, we first performed esotropia surgery. After 1 year, she underwent a bilateral ptosis correction. We decided to perform bilateral inferior rectus recession due to an abnormal head posture and the absence of elevation. Because the inferior rectus muscles were extremely tight and adhered to the sclera, hooking and isolating these muscles during surgery was difficult. After muscle suture placement, a portion of the sclera that contacted the left inferior rectus was chipped off as this muscle was disinserted with blunt Westcott scissors. A scleral perforation was observed, thus, we placed a scleral patch graft using the donor sclera and finished the bilateral inferior rectus recession. No abnormal findings for the vitreous or retina were detected. At 8 months after surgery, the patient exhibited exotropia of 12 prism diopters in her primary gaze. Her abnormal head posture nearly disappeared. CONCLUSIONS: Careful isolation and disinsertion of the muscle from the globe is necessary in the treatment of patients who are expected to exhibit severe adhesions between the muscle and sclera, such as patients with congenital fibrosis of extraocular muscles.
Esotropia ; Exotropia ; Female ; Fibrosis* ; Head ; Humans ; Infant ; Muscles* ; Posture ; Retina ; Sclera ; Sutures ; Tissue Donors ; Transplants

PURPOSE: To investigate the preoperative factors affecting the visual outcome after a vitrectomy in a rhegmatogenous retinal detachment (RRD). METHODS: A retrospective study of 79 eyes was carried out. The 41 eyes were macula-off RRD (group I), the 38 eyes were macula-on RRD (group II). The preoperative factors examined in this study included the preoperative best corrected visual acuity (BCVA), age, the duration of macular detachment, the extent of the detached retina, the delay of operation. The correlation between these factors and the postoperative 6 months BCVA were investigated. RESULTS: In group I, preoperative BCVA (r = 0.313, p = 0.037) and preoperative retinal detachment (RD) extent (r = 0.483, p = 0.001) were significantly correlated with postoperative 6 months BCVA. In group II, preoperative BCVA and preoperative RD extent were not significantly correlated with postoperative 6 months BCVA. Regardless of including macula, the patient's age, duration of symptom and delay of operation after clinic visit were not affected to the visual outcome. Patients with symptom duration of 7 days or less achieved better final BCVA (0.36 ± 0.45 log MAR, n = 29) than patients with longer symptom duration (0.79 ± 0.55 log MAR, n = 16) (p = 0.008). CONCLUSIONS: After vitrectomy for macula-off RRD, the factors related to favorable visual outcome were the better preoperative BCVA, the less extent of the detached retina. And surgical repair within 7 days of the symptom onset yielded better visual outcomes. Otherwise, in macula-on RRD, preoperative BCVA, age, the duration of retinal detachment, the extent of the detached retina, the delay of operation did not impact on visual outcome.
Ambulatory Care ; Humans ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity ; Vitrectomy*

As a material of metal-ceramic prosthesis, nickel as a form of Ni-Cr alloy has been used for many dental prostheses in many cases. However, several problems in use of the alloy have been revealed (ex ; tissue stimulation, skin allergy, hypersensitivity, cytotoxicity and carcinogenecity). Little is known about nickel with respect to the relationship between Ni-prosthesis and gaining of Ni-resistance in oral microorganisms. The present study was undertaken to check wheather use of Ni-prosthesis leads to occurrence of Ni-resistant microorganisms. So this study may suggest the possible relationships between the oral microorganisms and nickel-resistance in oral enviroment. Bacteria were isolated from the gingival crevicular fluid on the patients wearing Ni-Cr prosthesis. The isolated bacteria were tested for their Ni-resistance in nickel containing media at different concentration from 3mM to 110mM. E. coli HB101 was used as control. The Ni-resistant bacteria were isolated and biochemically identified. The Ni-resistant bacteria were tested several biochemical, molecular-biological tests. Performed tests were ; measuring the growth curve, antibiotic test, growth ability test in liquid media, isolation of the chromosome and plasmid, digestion of DNA by restriction enzyme, electrophoresis of chromosome and plasmid DNA, identification of Ni-resistant genes by the DNA hybridization. The results were as follows: 1) The bacteria isolated from gingival crevicular fluid on the patients wearing Ni-Cr alloy prosthesis showed nickel-resistance. 2) The isolated microorganisms grew at nickel containing media of high concentrations (60mM-110mM). 3) Based on the biochemical tests, the isolated microorganisms were identified as Enterococcus faecalis(13 cases), Klebsiella pneumoniae(1 case) and Enterobacter gergoviae(1 case). 4) Enterococcus faecalis expressed not only nickel resistance but also the multi-drug resistanceto several antibiotics ; chloramphenicol, kanamicin, streptomycin, lincomycin, clindamycin. However all strain showed the sensitivity against the tetracycline. 5) DNA hybridization result suggest that there is no homology between the previousely known gene of nickel resistance in Klebsiella pneumoniae and chromosomal DNA Enterococcus faecalis.
Alloys* ; Anti-Bacterial Agents ; Bacteria* ; Chloramphenicol ; Clindamycin ; Dental Prosthesis ; Digestion ; DNA ; Electrophoresis ; Enterobacter ; Enterococcus ; Enterococcus faecalis ; Gingival Crevicular Fluid* ; Humans ; Hypersensitivity ; Klebsiella ; Klebsiella pneumoniae ; Lincomycin ; Nickel ; Plasmids ; Prostheses and Implants* ; Skin ; Streptomycin ; Tetracycline