The choice of operative procedures was determined by many factors, but the levator function is considered as the most important factor. Fox recommended that when the levator function was 2 to 9 mm, the patient should be treated by the levator resection and when the levator function was below 2 mm, the patient should be crated by frontalis suspension. But Collin recommended that when the levator function was below 4 mm, the brow suspension procedure got the better result. Beside that, many other authors recommended various opinions. Therefore, when levator function of the patients was between 2 and 4 mm, the choice of operative procedure was much confusing us. The aim of this study is to clarify which is better Procedures between levator resection and the frontalis transfer or orbicularis oculi muscle transfer among the patients with 2 to 4 mm of levator action. From Jan. of 1991 to Dec. of 1994, among 26 patients with 2 to 4 mm levator function, 13 cases of 10 patients were operated by levator resection, 21 cases of 16 patients were teated by frontalis transfer or orbicularis oculi muscle flap. The results were evaluated with the average 27 months of follow-up and we compared the result of the levator resection procedure with that of frontalis muscle transfer or orbicularis oculi muscle transfer. The preoperative average amount of ptosis is about 2.7 mm in cases with levator resection, about 4.0 mm in cases with frontalis muscle transfer or orbicularis oculi muscle flap transfer. The postoperative average amount of ptosis is about 1.7 mm in cases with levator resection about 2.14 mm in cases with frontail muscle transfer or orbicularis oculi muscle flap transfer and so the postoperative improvement of amount of ptosis is about 1.0 mm in cases with levator resection, about 1.86 mm in cases with frontails muscle transfer or orbicularis oculi muscle flap transfer. The major complication of levator resection method is undercorrection. However, the eyelid deformity due to excessive upward traction was more frequent in frontalis muscle flap technique.
Blepharoptosis* ; Congenital Abnormalities ; Eyelids ; Follow-Up Studies ; Humans ; Surgical Procedures, Operative ; Traction

No abstract available.
Colitis, Ulcerative* ; Sweet Syndrome* ; Ulcer*

During the period from March 1990, through September 1993, 11 patients with moyamoya disease underwent superficial temporal artery(STA)-to-middle cerebral artery(MCA) anastomosis and encephalomyosynangiosis(EMS) bilaterally. The mean follow-up period was 30.6 months(range 17 to 42 months). The most frequent computed tomographic findings were intraventricular hemorrhage in adult patients and cortical infarction in pediatric patients. In all of the patients, confirmatory diagnosis could be made by angiography, and all had typical angiographic finding of moyamoya disease. According to angiographic classification by Suzuki, the most frequent phase was stage three. A modified continuous suture technique was used during anastomosis. The advantages of this microvascular suture technique are saving time for the surgical procedure, lessening bleeding from the anastomotic site and the ease and safety with which anastomosis can be achieved in the deep cranial cavity. Postoperatively, follow-up angiography was taken between 1 year and 2 years after operation. The angiography revascularization rate was 100%, excellent in 6, and good in 5. The typical postoperative angiography findings are as follows : 1) reduction of moyamoya vessels, 2) normalization or improvement of abnormal posterior circulation, 3) visualization of MCA territory through MCA-STA bypass, and 4) dilatation of STA. There were no major complication in patients with surgery, and no poor outcomes. These results indicate that the STA-MCA anastomosis and EMS in moyamoya disease can normalize cerebral circulation and reduce repeat ischemic attack and repeated bleeding.
Adult ; Angiography ; Cerebral Arteries* ; Classification ; Diagnosis ; Dilatation ; Follow-Up Studies* ; Hemorrhage ; Humans ; Infarction ; Moyamoya Disease* ; Suture Techniques

Moyamoya disease is an unusual vascular disorder highlighted by progressive bilateral internal carotid artery occlusion and collateralization of intracranial blood flow. The purposes of the bypass procedures : 1) reduce or arrest of the chance of repeated ischemic attack by making the additional collateral blood flow, 2) decrease the chance of repeated bleeding by reducing the number of moyamoya vessels. During the period from June 1989 through February 1991, 8 moyamoya diseases associated with intraventricular hemorrhage were operated by STA-MCA anastomosis plus EMS. Results are as follows : 1) Slightly female dominancy in incidence(5 : 3), and all of the patients were middle aged(range 32 to 55 years). 2) All of the patients had sudden onset of headache, and most patients whad neck stiffness and vomiting. 3) In all of the patients, confirmatory diagnosis could be done by angiography, and all of the patients had gypical angiographic findings of moyamoya disease. 4) All of the patients had IVH in brain CT scan. 5) All of the patients were surgically treated : STA-MCA anastomosis plus EMS. 6) The postoperative revascularization rate was 89%(8 sides in 9 sides). 7) The postoperative results were excellent in 5, good in 1, and death in 2. The rarity of such lesions in KOrea and their surgical results are reviewed briefly.
Angiography ; Brain ; Carotid Artery, Internal ; Diagnosis ; Female ; Headache ; Hemorrhage* ; Humans ; Korea ; Moyamoya Disease* ; Neck ; Tomography, X-Ray Computed ; Vomiting

The surgical intervention for secondary developmental cervical spinal stenosis that results in myelopathy and radiculopathy has been modified by technical improvement to obtain more reliable enlargement of the cervical spinal canal. The authours have experienced good results with the modified open door expansive laminoplasty, so we report this article. The patients were treated by surgical intervention during the period from October 1989 to February 1991. The results obtained were as follows : 1) The average age was 54.7 years, and the sex distribution ratio of female to male was 2 : 8. 2) In clinical symptoms and symptoms of both myelopathy and radiculopathy. 3) In morphological analysis of lesions, all patients except one case had lesions over 3 levels, The lesions were spondylosis, spondylosis combined with soft disc herniation, spondylosis combined with OPLL, spondylosis combined with OPLL and soft disc herniation, OPLL and OYL in the order of frequency. 4) The operation method was as follows : after the patient was positioned in modified Concorde position, open door lamina was anchored to faced joint capsule and surrounding tissue with nylon sutures. And then the raw epidural space was covered with Lyodura by the modified Hirabayashi method. By this method, reclosure of widened spinal canal was prevented. 5) The outcomes were evaluated by JOA score difference between preoperation and post operation times. The outcome of recovery rate was 100% in five cases. Therewere no aggravated or unimproved cases. The results were excellent 8 cases, good 1 case, unchanged 0 case, poor 0 case and expired 1 case.
Epidural Space ; Female ; Humans ; Joint Capsule ; Male ; Nylons ; Radiculopathy ; Sex Distribution ; Spinal Canal ; Spinal Cord Diseases ; Spinal Stenosis* ; Spondylosis ; Sutures

PURPOSE: Renal cell carcinoma(RCC) in solitary kidney is an absolute indication for partial nephrectomy. We evaluated the renal function after partial nephrectomy for renal cell carcinoma in a solitary kidney. MATERIALS AND METHODS: Partial nephrectomy was performed in 14 patients with localized sporadic RCCs that developed in a solitary kidney between January 1993 and December 2005. In 8 patients(57%), the contralateral kidney had been surgically removed. In the remaining 6 patients, 4 had a contralateral nonfunctioning kidney(29%) and 2 had nephrolithiasis (14%). Three patients were treated with enucleation, and partial nephrectomy was done in 11 patients. The recorded variables we studied were the preoperative and postoperative serum creatinine levels, whether renal ischemia and hypothermia was used, the duration of renal ischemia and the percent of renal parenchyma that was resected. RESULTS: At mean follow-up of 55.6 months(range: 16.3-106.6), the mean serum creatinine had increased from 1.03mg/dl preoperatively to 1.26 mg/dl postoperatively(p>0.05). The mean serum creatinine had significantly increased at 3, 6 and 12 months after surgery(p<0.05). The postoperative serum creatinine after 16 months was still increased compared to the preoperative serum creatinine, but there was no statistical significance(p>0.05). None of the 14 patients required dialysis for end stage renal disease after surgery. The normal preoperative serum creatinine had increased above 1.5mg/dl in two patients, but not above 2.0mg/dl. One patient had multiple renal cell carcinoma masses and one had diabetes mellitus. The postoperative creatinine of the 9 patients who had renal warm ischemia was not significantly different from the 5 patients who had no ischemia(p>0.05). The renal ischemia time, cold ischemia and the resected percent volume of the renal parenchyma were found to have no statistically significant impact on postoperative renal function(p>0.05). CONCLUSIONS: Partial nephrectomy safely preserves renal function in patients with solitary kidney.
Carcinoma, Renal Cell* ; Cold Ischemia ; Creatinine ; Diabetes Mellitus ; Dialysis ; Follow-Up Studies ; Humans ; Hypothermia ; Ischemia ; Kidney Failure, Chronic ; Kidney* ; Nephrectomy* ; Nephrolithiasis ; Warm Ischemia

Recently we performed a modified sternum-splitting approach in surgery for anterior space-taking lesion in the upper thoracic region. In contrast to the original trans-sternal approach introduced by Cauchoix, we cut only the manubrium and split it using vertebral spreader. After reaching the anterior surface of the cervico-Thoracic vertebrae, the central portion of the vertebral body was removed with air-drill under an operating microscope. The longitudinal bone defect of the vertebral bodies was filled with a bone graft obtained from the iliac bone. Removal of the space-taking lesions in the cervico-thoracic junction and upper thoracic region can be performed safely by utilizing the modified sternum-splitting approach. This approach can be applied also to endarterectomies at the origins of the vertebral arteries and the subclavian artery.
Endarterectomy ; Manubrium ; Microsurgery ; Spine ; Subclavian Artery ; Transplants ; Vertebral Artery

Dermatophytes invades and destroys keratinized tissue of the skin, hairs and nails by keratinase. The prevalence and clinical characteristics of dermatomycosis are changed under the various influences such as geographic factor, social environment and development of therapy. Infections caused by some 10 species of dermatophytes isolated since 1924 in Korea. There was a general rise in the cases of Trichophyton (T.) rubrum infections and in recent years the prevalence of Microsporum (M.) canis infections has markedly increased but those of M. ferrugineum have decreased. The yeasts of genus Malassezia are dimorphic and lipophilic and are numbers of the normal flora in humans. Malassezia yeasts are implicated in various diseases, including pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis and systemic fungal infections.
Arthrodermataceae ; Dermatitis, Seborrheic ; Dermatomycoses* ; Folliculitis ; Geography ; Hair ; Humans ; Korea* ; Malassezia ; Microsporum ; Prevalence ; Skin ; Social Environment ; Tinea Versicolor ; Trichophyton ; Yeasts

The Rathke's cleft cyst is generally thought to be derived from Rathke's pouch remanants. Symptomatic Rathke's cleft cyst was first described by Goldzieher in 1913. Recently, several cases have been reported by the gradual development of diagnostic methods. We present our experience of a rare case of ectopic suprasellar Ratheke's cleft cysts. The cysts were located in the interpeduncular cistern. We performed a successful operation and made immunohistochemical examinations.

Diastasis of the ankle joint was associated with extensive ligamentous rupture and resulted from external rotation or abduction injuries at the ankle. It might occur without associated fracture but was more frequently seen in cases of bimalleolar fracture in which there was fracture of the medial malleolus or rupture of the deltoid ligament with fracture of the lower third of the fibula. Thirty patients of diastasis of the ankle joint were admitted and treated by internal fixation with screw and bolt from January 1978 to December 1981. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other causes were slipping down and sports injury in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type (20 cases, 67%). 3. Partial diastasis of the ankle joint or anterior type was 14 cases (47%) and complete diastasis or total type was 16 cases (53%). 4. In all cases, mixed oblique fibular fracture and medial instability were seen. 5. The good results were achieved in 24 patients (80%).
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Fibula ; Humans ; Ligaments ; Rupture