BACKGROUND AND OBJECTIVES: In patients with fungal sinusitis, purulent discharge from the maxillary sinus is frequently observed and it responds to antibiotic treatment. Even though fungal sinusitis is resolved after surgery, the purulent discharge continues in some cases. We aimed to identify the pathogens of the purulent discharge in fungal sinusitis and to obtain information for appropriate antibiotics through a sensitivity test. MATERIALS AND METHOD: Among 71 patients with fungal sinusitis of the maxillary sinus, purulent secretions were found in 44 patients (62%) during an endoscopic sinus surgery. Endoscope-guided collection of the maxillary sinus secretions were performed and specimens were sent to the laboratory for bacterial cultures and antibiotic sensitivity tests. RESULTS: Among 44 cases with fungal lesions and purulent secretion in the maxillary sinus, bacteria were isolated in 27 cases (61.4%). Gram (+) aerobes were recovered in 19 cases, and Gram (-) aerobes were recovered in 16 cases. Mixed infection by Gram (+) and Gram (-) bacteria were observed in 8 patients. Anaerobic bacteria were not isolated. Among the Gram (+) aerobes, S. aureus was the most common organism (8 cases), while Enterobacter aerogenes was the most common organism (7 cases) of the Gram (-) aerobes. In an antibiotic sensitivity test for Gram (+) bacteria, ciprofloxacin, vancomycin, and teicoplanin showed sensitivity over 85 %. For Gram (-) bacteria, ceftazidime, ciprofloxacin, ticarcillin, tobramycin, and imipenem showed sensitivity over 90%. CONCLUSION: In patients with fungal sinusitis, concomitant bacterial infections are identified in more than half of the cases. Thus, postoperative administration of appropriate antibiotics can be justified in the treatment of fungal sinusitis.
Anti-Bacterial Agents* ; Bacteria* ; Bacteria, Anaerobic ; Bacterial Infections ; Bacteriology ; Ceftazidime ; Ciprofloxacin ; Coinfection ; Enterobacter aerogenes ; Humans ; Imipenem ; Maxillary Sinus* ; Maxillary Sinusitis* ; Sinusitis ; Teicoplanin ; Ticarcillin ; Tobramycin ; Vancomycin

PURPOSE: To evaluate the efficacy, safety, predictability and subjective symptoms of the implantable contact lens to treat moderate to high myopia. METHODS: A Staar Collamer posterior chamber phakic IOL was implanted in 83 eyes of 44 patients with spherical equivalent -10.10D (-3.87~-19.37D). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, adverse events, subjective quality of vision and satisfaction were evaluated. Mean follow-up was 4.9 months (3~9 months). RESULTS: All patients had a UCVA of 0.7 or better, and 61.4% had UCVA of 1.0 or better. Gains of 2 or more lines of BCVA occurred in 15 eyes (18.1%). Mean spherical equivalent refraction at postoperative 3 months was -0.37D (+0.25~-1.75D) and remained stable. There was no change in cylinder diopters. 81.9% of eyes were within +/-0.5D, and 97.6% were within +/-1.0D of predicted refraction. Glare and halo was observed in 5 eyes (6%) after laser iridotomy, lens flipping in 1 eye (1.2%), corneal edema in 2eyes (2.4%), drug induced ocular hypertension in 4eyes (4.8%). There was no case of cataract, glaucoma, retinal detachment, and lens dislocation. There was significant decrease of pupil diameter at postoperative 1 month and decreased pupil diameter was maintained until the last examination. Generally patient satisfaction was very good. But, some patients reported poor in the category of glare and halo. CONCLUSIONS: ICL implantation had good visual, refractive results, and stability. Long term follow-up is required to confirm the significant complications that do not occur in most patients over time.
Cataract ; Corneal Edema ; Follow-Up Studies ; Glare ; Glaucoma ; Humans ; Lens Subluxation ; Lenses, Intraocular* ; Myopia* ; Ocular Hypertension ; Patient Satisfaction ; Pupil ; Retinal Detachment ; Visual Acuity

OBJECTIVE: To observe the change of sympathetic skin response (SSR) before and after sympathectomy in patients with idiopathic palmar hyperhidrosis and to find the usefulness of SSR for assessment of the effects of sympathectomy. METHOD: The SSR was measured in 20 patients with palmar hyperhidrosis and 20 normal control group. Ten days after thoracoscopic sympathectomy, SSR was also measured. A 50~150 V stimulus was applied over the median nerve and SSR was recorded on bilateral palms and soles with Viking IV (Nicolet Biomedical Ins., U.S.A.). Patient's satisfaction with operation was assessed by questionnaire. RESULTS: Absent or unstable SSR recordings rate was increased and amplitudes of SSR were significantly decreased in patients with palmar hyperhidrosis compared with control group. After sympathectomy, SSR was absent in all cases on bilateral palms and these results were correlated with clinical improvment. All patients who had undergone surgery showed significant clinical improvement for palmar hyperhidrosis and about 75% of the cases were found to have compensatory sweating from other site of the body. CONCLUSION: Abnormal sympathetic nerve system responses were observed in patients with palmar hyperhidrosis. SSR recordings and clinical manifestations were influenced by sysmpathectomy.
Humans ; Hyperhidrosis* ; Median Nerve ; Surveys and Questionnaires ; Skin* ; Sweat ; Sweating ; Sympathectomy

STUDY DESIGN: A retrospective study. PURPOSE: To comparatively investigated the rate of the adjacent segment degeneration and the clinical outcomes in patients with spondylolytic spondylolisthesis, spinal stenosis or degenerative spondylolisthesis. OVERVIEW OF LITERATURE: There have been few studies reported on the adjacent segment degeneration following posterior lumbar interbody fusion(PLIF). Many risk factors for the adjacent segment degeneration following PLIF have been proposed. The range of decompression has been presented as one of the risk factors, yet controversial. METHODS: This study enrolled sixty-three patients who had been treated with single-level PLIF and who were followed up for more than two years. The patients were divided into 3 groups based on the preoperative diagnosis. We analyzed the difference between the preoperative and postoperative intervertebral disc heights of the superior adjacent segments. The incidence rates of instability and the clinical outcomes were comparatively analyzed between each group. RESULTS: The average age of the patients was 55.8 years in the spondylolytic spondylolisthesis group, 65.9 years in the degenerative spondylolisthesis group and 60.4 years in the spinal stenosis group. The average follow-up period was 44 months, 43 months and 42 months, respectively. At the last follow-up, compared to the preoperative period, the intervertebral disc height decreased in all three groups. A statistically significant decrease (p < 0.01) was observed only in the spondylolytic spondylolisthesis group and no significant difference was observed between each group (p = 0.41). The incidence rate of instability and the clinical outcome were not significantly different between each group. CONCLUSIONS: Spondylolytic spondylolisthesis with total laminectomy and single-level PLIF showed no significant difference in the superior adjacent segment degeneration and instability, and the clinical outcome as compared to that of partial laminectomy with single-level PLIF for treating degenerative spondylolisthesis or spinal stenosis.
Decompression ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Laminectomy ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spondylolisthesis

Carpal tunnel syndrome, compression of the median nerve in the carpal tunnel at the wrist, is the most common entrapment syndrome of peripheral nerve. It is characterized by sensory and motor symptoms and signs in the distribution of the median nerve. Radiofrequency thermocoagulation is a neuroablative treatment for various chronic pain disorders, but is associated with neural injury, neuritis, and occasional neuroma. Unlike RF, pulsed radiofrequency, the use of the high current intensity and electrical fields, has been proposed for the modulation of the excited nervous system pathway of pain without neuro-destruction and other potential complications. We report a case of bilateral carpal tunnel syndrome that was relieved after PRF lesioning of both median nerves.
Carpal Tunnel Syndrome ; Chronic Pain ; Electrocoagulation ; Humans ; Median Nerve ; Nervous System ; Neuritis ; Neuroma ; Peripheral Nerves ; Wrist

Lumbosacral fixation or spinopelvic fixation is frequently required for the surgical treatment of neuromuscular scoliosis and degenerative lesions, trauma and tumor in the lumbosacral vertebrae. However, the establishment of stable fixation with these procedures is difficult due to the anatomic characteristics of the sacrum and this is even more problematic for the cases with long segmental fixation, severe instability and bone defects. Although the emergence of pedicle screws makes spinal fixation easier and more rigid, S1 pedicle screws alone do not provide enough stability for lumbosacral fixation. For the purposes of reinforcing lumbosacral fixation, procedures using rods or screws can be used: the procedures using rods include the Galveston method, the McCarthy S-rod and the Jackson intrasacral rod, and the procedures using screws include sacral alar screws, transdiscal screws and iliac screws. The purpose of this study was to ascertain the proper fixation methods, according to each indication, for spinopelvic fixation and we analyzed the advantages and drawbacks of each fixation method. In addition, the fixation method of iliac screws, which has recently become more popular, is presented in detail to enhance the availability and reduce the complication of this technique.
Sacrum ; Scoliosis ; Spine ; Succinates

An increase has been see in fall injuries at construction sites and in penetrating injuries by iron bars or pipes associated with the fall. In particular, a thoraco-abdominal penetrating injury had the worse prognosis, and multiple organ injury occurred because of blunt trauma associated with fall. Iron bars were the most common penetrating materials, and pipe penetrating injuries were uncommon. However, because the diameter of the pipes were large than those of the bars, penetrating injuries associated with pipes were more often fatal. A secondary thoraco-abdominal injury worsened the prognosis. We reported a case of a 33-year-old man with a thoraco-abdominal trauma secondary to a penetrating injury with a scaffolding pipe following a fall.
Adult ; Humans ; Iron ; Prognosis

An increase has been see in fall injuries at construction sites and in penetrating injuries by iron bars or pipes associated with the fall. In particular, a thoraco-abdominal penetrating injury had the worse prognosis, and multiple organ injury occurred because of blunt trauma associated with fall. Iron bars were the most common penetrating materials, and pipe penetrating injuries were uncommon. However, because the diameter of the pipes were large than those of the bars, penetrating injuries associated with pipes were more often fatal. A secondary thoraco-abdominal injury worsened the prognosis. We reported a case of a 33-year-old man with a thoraco-abdominal trauma secondary to a penetrating injury with a scaffolding pipe following a fall.
Adult ; Humans ; Iron ; Prognosis

Enlargement of the thyroid gland is the most frequently encountered disorder of the endocrine system. A clinical evaluation is helpful in diagnosis but has its limitation. Until recently, surgical excision has been the only means by which a precise diagnosis of thyroid nodule is made, based upon the histopathologic evaluation. Authors studied 117 cases of thyroid nodule operated at Department of Surgery, College of Medicine, Hallym University, from January 1985 to July 1994. The results were analyzed with X2-test and summarized as follows. 1. The thyroid nodules were most frequently seen in third and fourth decades (57.3%), and more in female (5.9:1). 2. The most common symptoms and duration were palpable mass (97.4%) and within 3 months (41.1%). 3. Most cases of thyroid nodules were treated with lobectomy (41.0%). 4. On the radioisotope scanning, the incidence of malignant nodule with cold nodules was 17.9% and the incidence of benign nodule with hot nodule was 91.7%. 5. The overall postoperative and specific complications were only related to the histopathologic finding (P=0.0026, P=0.0207), and not related to the type of operation and size of the thyroid nodules.
Diagnosis ; Endocrine System ; Female ; Humans ; Incidence ; Radionuclide Imaging ; Thyroid Gland* ; Thyroid Nodule*

Burkitt's lymphoma is a highly aggressive small B-cell lymphoma. The treatment of choice is complex chemotherapy. As a rare tumor in the head and neck area, Burkitt's lymphoma usually involves cervical lymph nodes, and only fewer than 25% of cases involves extranodal regions. Involvement of the paranasal sinuses has been reported in only 14 cases in the past century. We describe here two patients with rare, sporadic, American type Burkitt's lymphoma involving the nasal cavity and paranasal sinuses manifesting nasal obstruction. We also review clinical and histological features of Burkitt's lymphoma.
Burkitt Lymphoma ; Head ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Nasal Cavity ; Nasal Obstruction ; Neck ; Paranasal Sinuses