In order to evaluate contamination of the topical eye drugs, 112(36 kinds) medications used over 1 month by the patients and 80(25 kinds) medications used at OPD(outpatient department) were studied by culturing the caps, the tips and the contents. Coagulase-negative staphylococcus was mainly isolated from the caps and the tips(p<0.05). But the other gram-positive bacteria, gram-negative bacteria and fungi were isolated from all medication sites. The most frequent site of contamination was the tips of the medications. Frequency of contamination based on detail of medications and preservatives of medications was not statistically significant(p>0.05). The medications used by the patients for a long time in comparison with the medications used at OPD were significantly more likely to be contaminated(p<0.0001). Therefore, we think that the topical eye durgs should be used with proper instillation and storage for a short period because of increase risk of contamination.
Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Staphylococcus

To evaluate croneal haze related to amount of correction, age and sex following excimer laser photorefractive keratectomy(PRK) in myopic eyes, 39months follow-up study on 358 eyes was performed prospectively. The preoperative spherical equivalent refraction ranged from -1.0D to 11.25D(mean -6.18D). The subjective corneal haze grading showed a maximum with mean grading of 0.92 at 2 months and a gradual decrease to 0.14 at 24 months after PRK. The degree of haze was statistically greater with higher amount of correction(p<0.05). No difference was found related to age and sex(p>0.05). Clinically significant corneal haze and scarring was frequent in higher myopia group(p<0.05). Individual variation in corneal haze after PRK was found. However, high myopia is a risk factor of the corneal haze following PRK, and further study to decrease the corneal haze after PRK is necessary.
Cicatrix ; Follow-Up Studies ; Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Risk Factors

PURPOSE: To report a case of laser photocoagulation treatment for the patient of Coats' disease accompanying a retinal macrocyst. CASE SUMMARY: A three-year-old boy visited the hospital whose chief complaint was visual acuity decrease of his left eye. Fundus examination showed macular scar, foveal hard exudates and inferior retinal cystic lesion in his left eye. Two months later, examination under anesthesia (EUA) and fluorescein angiography (FAG) was performed. The results revealed inferior retinal macrocyst, nasal avascular retina and telangiectasia around the retinal macrocyst. Laser photocoagulation was performed around the retinal macrocyst and at the nasal avascular retina. One year after the laser photocoagulation, retinal macrocyst did not further progress and the retina was stabilized. CONCLUSIONS: Laser photocoagulation was done around the retinal macrocyst and at the nasal avascular retina of the Coats' disease accompanying a retinal macrocyst and the lesions did not further progress and the retina was stabilized.
Anesthesia ; Cicatrix ; Exudates and Transudates ; Eye ; Fluorescein Angiography ; Humans ; Light Coagulation ; Retina ; Retinaldehyde ; Telangiectasis ; Visual Acuity

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

Obstructive jaundice by vascular compression is rare. The causative arteries were identified as the right hepatic artery, gastroduodenal artery, cystic artery, proper hepatic artery, and an unspecified branch of the common hepatic artery. Also the venous system, such as enlarging collateral veins in cases of portal hypertension was a causative vessel. Herein, we describe a case of a proximal choledocholithiasis due to compression of the common bile duct by right hepatic artery originated from gastroduodenal artery. Final diagnosis and treatment were achieved through an operation.
Cholangiography ; Common Bile Duct/blood supply/*pathology/surgery ; Diagnosis, Differential ; *Hepatic Artery ; Humans ; Jaundice, Obstructive/*diagnosis/etiology/radiography ; Male ; Middle Aged ; Tomography, X-Ray Computed

PURPOSE: We evaluated the validity of laparoscopy-assisted distal gastrectomy (LADG) with systemic lymphadenectomy for early gastric cancer in elderly patients compared with younger patients. METHODS: Seventeen elderly patients (aged 70 years or more) and 113 younger patients who underwent LADG for early gastric cancer between May 1998 and July 2004, at the department of Surgery, Dong-A University Medical Center, were studied. Postoperative outcomes were compared. RESULTS: In elderly patients, co-morbidity was more common than in younger ones (P=0.0220) and postoperative complication rate was more common, too (P=0.0480). Operation time (P=0.7301), time to first flatus (P=0.4766), postoperative hospital stay (P=0.4860), mortality (P=0.2453), were similar in these two groups. CONCLUSION: Because LADG with systemic lymphadenectomy in elderly patients has more co-morbidity and complications than younger ones, great cares should be given to treat co-morbidity preoperatively and prevent complications during operation and postoperative period in elderly patients.
Academic Medical Centers ; Aged* ; Flatulence ; Gastrectomy* ; Humans ; Length of Stay ; Lymph Node Excision* ; Mortality ; Postoperative Complications ; Postoperative Period ; Stomach Neoplasms*

PURPOSE: This study was to observe whether the apoptotic function of tumor-infiltrating lymphocytes (TIL) is induced in human gastric epithelial dysplasia and gastric adenocarcinoma according to the role of FasL expression. MATENRIALS AND METHODS: A total of 56 gastric epithelial dysplasia and gastric adenocarcinoma patients were enrolled in this study: 9 cases of gastric epithelial dysplasia, 18 cases of early gastric carcinomas (EGC) and 29 cases of advanced gastric carcinomas (AGC). Immunohistochemical staining was performed for FasL and CD45, and the terminal deoxynucleotidyl transferase mediated dUTP nick end labelling (TUNEL) method was used to detect cell death in tumor-infiltrating lymphocytes. RESULTS: 1) Positive reactions of FasL to neoplastic cells were 88.9% (8/9) in gastric epithelial dysplasia, 83.3% (15/18) in EGC, and 75.9% (22/29) in AGC. 2) Expression of TIL was decreased in the FasL positive region and was increased in the FasL negative region, and significant expression of TIL was observed in the AGC group (P=0.001). 3) Expression of apoptotic TIL was very similar to the FasL expression, and 100% expression was observed in gastric epithelial dysplasia group. 4) Expression of apoptotic TIL was increased in the FasL positive region and decreased in the FasL negative region, and significant apoptotic expression was observed in the gastric epithelial dysplasia and EGC groups (P=0.0420, P=0.0263, respectively). CONCLUSION: These results suggest that FasL is a prevalent mediator of immune privilege in epithelial dysplasia and cancer of the stomach.
Adenocarcinoma* ; Apoptosis* ; Cell Death ; DNA Nucleotidylexotransferase ; Humans ; Lymphocytes, Tumor-Infiltrating ; Stomach Neoplasms

PURPOSE: To investigate the surgical outcome of patients with partially accommodative esotropia with a large angle of deviation. METHODS: Twenty-one patients with partially accommodative esotropia that had angles of deviation of at least 40 prism diopters without correction, were retrospectively studied. They underwent standard surgery, for which the amount of recession was based on the average of the distance and near deviation with correction. The angle of deviation were evaluated at postoperative 3 months and at the last follow-up, and the Titmus test and Worth 4-dot test were performed after surgery. RESULTS: The mean angle of deviation without correction at the first examination was 57.0PD, and the mean age of correction with glasses was 2.6 years. The mean angle of deviation with correction was 31.4PD. The mean age at surgery was 4.4 years. The mean follow-up period was 5.4 years. At 3 months postoperatively, 66.7%, 28.6%, and 4.8% of patients showed acceptable correction, undercorrection, and overcorrection, respectively. At the last visit, undercorrection decreased while overcorrection increased (66.7%, 23.8%, 9.5%). Titmus stereotest showed in positive results with more than 800 seconds of arc in 9 of 16 patients. A Worth 4-dot test resulted in a fusion response at far or at near in 4 of 17 patients. CONCLUSIONS: In partially accommodative esotropia with a large angle of deviation (at least 40PD without correction), the results of conventional surgery were relatively fair, while the prognosis of sensory function was poor.
Esotropia* ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Prognosis ; Retrospective Studies ; Sensation

Tuberculosis of the pancreas is a rare disorder. The clinical presentation of pancreatic tuberculosis include nonspecific symptoms such as fever, fatigue and weight loss. The radiological features mimic pancreatic malignancy or pancreatitis. So, the diagnosis of pancreatic tuberculosis is very difficult. A 62-year-old man was referred for pancreatic mass. Findings on preoperative imaging modalities were consistent with pancreatic carcinoma, and fine needle aspiration test indicated microcystic adenoma or carcinoma. Pylorus-preserving pancreaticoduodenectomy was done. Final diagnosis was pancreatic tuberculosis combined with microcystic adenoma. We conclude in that patients who have a mass in the pancreas, pancreatic tuberculosis should be considered, particularly in the developing country and immunosuppressed individuals.
Adenoma* ; Biopsy, Fine-Needle ; Developing Countries ; Diagnosis ; Fatigue ; Fever ; Humans ; Middle Aged ; Pancreas ; Pancreaticoduodenectomy ; Pancreatitis ; Pancrelipase ; Tuberculosis* ; Weight Loss

PURPOSE: As preoperative diagnostic tools have advanced, the rate of multiple early gastric cancer diagnoses have increased. The author investigated the clinicopathological features of multiple early gastric cancers to elucidate the clinical feasibility of minimally invasive gastrectomy such as laparoscopy or robot assisted gastrectomy for their surgical treatment. METHODS: One thousand one hundred and eighty-five open gastrectomies and 607 laparoscopies or robot-assisted gastrectomies for gastric cancers from January 2003 through August 2009 were retrospectively reviewed. Among them, 844 were diagnosed as early gastric cancers, of which 47 cases had multiple early gastric cancers. Twenty-seven cases underwent open gastrectomy and 20 cases underwent laparoscopy or robot assisted gastrectomy. The author analyzed clinicopathological features in these multiple early gastric cancers. RESULTS: The incidences of multiple early gastric cancers among the early gastric cancers were 5.6%. There were no statistical differences in the clinicopathological parameters except the type of gastrectomy and anastomosis. The distances of both proximal and distal margin show no statistical difference in both groups. The hospital stay was shorter in laparoscopy or robot assisted gastrectomy group (P=0.022). The postoperative complications developed 7 cases in open group and 1 case in laparoscopy or robot assisted gastrectomy group (P=0.046). During the mean follow-up period of 43.8+/-26.4 and 36.2+/-19.8 months, no recurrence was found in both groups. CONCLUSION: Laparoscopy or robot assisted gastrectomy are as acceptable as open methods to obtain a safe surgical margin, and to perform the desirable type of gastrectomy and radical lymph node dissection.
Follow-Up Studies ; Gastrectomy ; Incidence ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms