PURPOSE: To evaluate the causes of low uncorrected visual acuity below 20/40 after LASIK (laser in situ keratomileusis). METHODS: 289 eyes (more -6.0 D myopia) that had LASIK between July 1997 and December 1999 by one surgeon were observed for at least 6 months. We evaluated their uncorrected visual acuity and ocular state. RESULTS: 51 eyes (17.64%) of 289 eyes have lower uncorrected visual acuity than 20/40 after LASIK. The causes were myopic regression (22/51), decentering (10/51), undercorrection of myopia (5/51), corneal ectasia (5/51), undercorrection of astigmatism (4/51), central island (2/51), free flap (1/51), postoperative flap displacement (1/51) and incomplete keratome pass (1/51). CONCLUSION: Although LASIK is a safe and effective procedure, many patients had lower uncorrected visual acuity less than 20/40 after LASIK. We must be able to manage correctable factors among the causes above.
Astigmatism ; Dilatation, Pathologic ; Free Tissue Flaps ; Humans ; Keratomileusis, Laser In Situ* ; Myopia ; Visual Acuity*

No abstract available.
Genitalia* ; Humans ; Male*

For precise diagnosis and therapeutic interventions for chronic lumbar pain, lumbar nerve block has been performed primarily by computed tomography or C-arm fluoroscopy. The use of such equipment has disadvantages in that both patient and surgeon are exposed to radiation, and it could be used in limited areas. The current role of ultrasound guidance for musculoskeletal intervention treatments has been reported. Recently, to compensate for such disadvantage and to be able to approach easily in the outpatient department, interest in ultrasound-guided lumbar nerve block is increasing, and several studies have reported relatively high success rates. However, ultrasound-guided intervention for lumbar nerve block has not been exactly described. Therefore, we conducted this review to evaluate the feasibility of ultrasound guided lumbar interventions.
Diagnosis ; Fluoroscopy ; Humans ; Nerve Block ; Outpatients ; Spine* ; Ultrasonography

PURPOSE: We used the sensitized rat model to study the effect of the inflammation evoked by immune response on the smooth muscles of the urinary bladder, trachea and intestine and changes of mast cell. MATERIALS AND METHODS: The rats were divided into 3 groups (group 1: control - not-sensitized. no antigen challenge, group 2: sensitized, no antigen challenge, group 3: sensitized, antigen challenge). Each group was divided into two subgroups of male and female. Rats were sensitized by intraperitoneal injection of ovalbumin (10mg/ml/kg) given on days 1, 3 and 5, 4 weeks after last injection, sensitized rats were treated with intravesical ovalbumin for 1 hour (antigen challenge) and controls runned simultaneously with the unsensitized rats by intravesical instillation of normal saline. After intravesical instillation contractility and number of mast cells of each organ were measured. RESULTS: Only female-sensitized group showed significantly increased contractility of bladder muscle (p<0.05) while no significant difference in trachea and intestine among groups. In male rats there were no significant differences between groups and organs. In male and female groups, there was increased contractility in female rats than male but showed no significant difference between sexes. In histologic study, sensitized, ovalbumin group showed more mast cells in detrusor muscle and submucosa than non-sensitized, saline group in both male and female rats. Also there were significant differences in female rats than male rats. Detrusor to submucosa mast cell ratio was significantly higher in sensitized, ovalbumin group. CONCLUSIONS: We concluded that there might be some other factors that made differences in response to antigen challenge between sexes and among the organs. We observed increased contractility in female rat bladder and this may explain higher incidence of interstitial cystitis in female than male.
Administration, Intravesical ; Animals ; Cystitis, Interstitial ; Female ; Humans ; Incidence ; Inflammation ; Injections, Intraperitoneal ; Intestines* ; Male ; Mast Cells* ; Models, Animal ; Muscle, Smooth* ; Ovalbumin ; Rats* ; Trachea* ; Urinary Bladder*

No abstract available.
Classification* ; Humans ; Spinal Cord* ; Urodynamics*

In cerebrovascular disease, the measurement of cerebral blood flow(CBF) is an important indicator of a patient's clinical status, treatment and prognosis. The main advantage of Stable Xenon CT is that it noninvasively provides three-dimensional, high resolution, quantitative local cerebral blood flow information coupled to anatomic exposition. Using this modality, we measured postoperative CBF in 50 patients with subarachnoid hemorrhage from a ruptured intracranial aneurysm. The results were as follows : 1) There was a negative relationship between age and CBF. 2) Among postoperative disability patients, global and regional CBF were markedly diminished. 3) CBF on the ipsilateral side of a craniotomy site was markedly lower than on the contralateral side. Xenon CT is a very useful method for the evaluation of postoperative CBF in intracranial aneurysm patients.
Craniotomy ; Humans ; Intracranial Aneurysm* ; Prognosis ; Subarachnoid Hemorrhage ; Xenon*

PURPOSE: The purpose of the present study was to evaluate and analyze the clinical outcomes of the percutaneous repair of acute achilles tendon ruptures. MATERIALS AND METHODS: We performed a retrospective study on 14 patients with acute closed rupture of the Achilles tendon and they were managed with percutaneous repair from Jan. 2006 to Jun. 2007. The clinical outcomes were analyzed according to the causes of the injury and the postoperative functional performances. RESULTS: All the cases showed good or excellent outcomes, according to the Arner-Lindholm scale for the evaluation of acute Achilles tendon rupture. The average AOFAS score was 95.6 (range: 91-100). Nine patients were very satisfied and five patients were satisfied. They were satisfied especially because of the minimal postoperative scar. Two cases of sural nerve injury were reported as complications, and these cases fully recovered at postoperative three months. No evidence of surgical wound infection, necrosis of the wound or rerupture of the tendon was seen. CONCLUSION: The percutaneous repair of acute Achilles tendon rupture achieved high functional outcomes, a successful return to previous work and high satisfaction, with a relatively low incidence of complications.
Achilles Tendon ; Cicatrix ; Humans ; Incidence ; Necrosis ; Organic Chemicals ; Retrospective Studies ; Rupture ; Sural Nerve ; Surgical Wound Infection ; Tendons

Labyrinthitis ossificans (LO) is a pathologic formation of fibrosis and new bone within the lumen of the otic capsule. The LO is a challenging issue in cochlear implantation since obliteration and obstruction of the cochlea make electrode insertion through scala tympani (classic route) difficult. Moreover, tympanomastoidectomy for resolution of chronic otitis media is also simultaneously considered for tympanogenic LO with severe to profound hearing loss because ossification could progress in case of staged or delayed implantation after initial tympanomastoidectomy. We report a patient with tympanogenic LO, who received subtotal petrosectomy with simultaneous cochlear implantation via scala vestibuli instead of the scala tympani for hearing rehabilitation.
Cochlea ; Cochlear Implantation* ; Cochlear Implants* ; Ear, Inner* ; Electrodes ; Fibrosis ; Hearing ; Hearing Loss ; Humans ; Labyrinthitis* ; Otitis Media ; Rehabilitation ; Scala Tympani ; Scala Vestibuli*

Background: The largest outbreak of enterohemorrhagic Escherichia coli (EHEC) O157:H7 occurred at a preschool in South Korea from June 12 to 29, 2020. This study aimed to analyze the epidemiological and clinical characteristics of EHEC infection in this outbreak. Methods: Epidemiological investigation was performed on all 184 children and 19 workers at the preschool using a standard questionnaire to assess symptoms, food intake, attendance, and special activity history. Pulsed-field gel electrophoresis analysis of confirmed cases was performed to determine genetic relevance. Results: During this outbreak, 103 children were affected, whereas only one infection was identified in adults. Of the 103 pediatric patients, 85 had symptoms (82.5%), including diarrhea, abdominal pain, bloody stool, fever, and vomiting. Thirty-two patients (31.1%) were hospitalized, 15 (14.6%) were diagnosed with hemolytic uremic syndrome, and 4 (3.9%) received dialysis treatment. Pulsed-field gel electrophoresis analysis identified 4 genotypes with high genetic relevance (92.3%). Epidemiological investigation revealed that this outbreak might have occurred from ingesting foods stored in a refrigerator with a constant temperature above 10°C, which was conducive to bacterial growth. Despite several measures after outbreak recognition, new infections continued to appear. Therefore, the preschool was forced to close on June 19 to prevent further person-to-person transmission. Conclusion Our findings from the response to the largest outbreak will help prepare countermeasures against future EHEC outbreak.

OBJECTIVE: The aim of this study is to evaluate of the significance of intraoperative electrophysiologic monitoring and follow up electrophysiologic study at seven days after microvascular decompression(MVD) for hemifacial spasm(HFS). METHODS: Thirty nine patients with hemifacial spasm were included in this study and were treated with MVD of the facial nerve from Jun 1990 to May 2001. The patients were divided into a monitoring group and a non-monitoring group. We compared the surgical outcomes, operation related complications between two groups. The abnormal muscle response(AMR) of preoperative electromyographic recording appeared on the mentalis muscle during stimulation of the zygomatic branch of the facial nerve was compared with those of changed during operation, immediately after operation and at postoperative 7th day(POD 7). The relationship between degree of AMR disappearance and surgical outcome was analyzed. RESULTS: There was no difference in surgical outcomes but significant difference in the incidence of operation-related complications between two groups. The results of electrophysiologic study at POD 7 were significantly correlated with surgical outcome in the monitoring group. CONCLUSION: The electrophysiologic study is helpful for identifying the offenders, determining the adequacy of vascular decompression and decrease of operation-related complications. The clinical and electrophysiologic status of HFS after MVD has continuously changed, and therefore the results of eletrophysiologic study at POD 7 are useful for predicting the surgical outcome.
Criminals ; Decompression ; Electromyography* ; Facial Nerve ; Follow-Up Studies* ; Hemifacial Spasm* ; Humans ; Incidence ; Microvascular Decompression Surgery*