No abstract available.

The functioning filtering bleb constructed after trabeculectomy in glaucomatous patient might be fail after cataract operation probably due to transient collapse during cataract extraction and inflammatiry reaction of the filtering bleb which result in unsuccessful intraocular pressure control. To compare if the results were identical in cases with the use of encircling band to enlarge the aqueous absorbing scar tissue to trabeculectomy, intraocular pressure was followed for more than 6 months after cataract extraction and posterior chamber lens implantation in 7 eyes that previously underwent silicone tube insertion with the use of encircling band. There were no cases with increased intraocular pressure needed to control postoperatively. Therefore it could be possible to concluded that inflammatory reaction of the filtering bleb or transient collapse during cataract extraction has no negative influences on intraocular pressure in silicone tube implanted eye using encircling band.

The maintenance of balance between water and electrolyte is essential for keeping the lens transparent. The outflow of the Na+ ion from the membrane and inflow of the K+ ion both of which are sustained by the Na+ - K+ - ATPase, play an important role in maintaining this balance. In this study, by comparing the lens Na+ - K+ - ATPase activity in Spontaneous Hypertensive Rat(SHR) and Sprague-Dawley Rat (SDR), we determined the significance of increase in blood pressure and the change in the enzyme activity after control of blood pressure by administration of Inderal, an anti-hypertensive drug. The Na+ - K+ - ATPase activity was significantly lowered(P<0.01) in the lens of SHR compared to that of SDR. The longer the anti-hypertensive drug was administered and then controlled the blood pressure, the higher the recovery rate of the lowered Na+ - K+ - ATPase activity of SHR, rising up to about 50%. From the results of this study, it is suggested that the activity of lens Na+ - K+ - ATPase may be reversibly recovered after blood pressure control, and that the pathogenesis of high blood pressure-associated cataract may be partially prevented by controlling the blood pressure.
Adenosine Triphosphatases* ; Animals ; Blood Pressure* ; Cataract ; Membranes ; Propranolol ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: In an effort to improve the diagnostic accuracy of the exercise electrocardiography (ECG) to detect coronary artery disease, exercise-induced changes in Q, R and S wave amplitudes has been evaluated in conjunction with or without ST segment changes. We measured the exercise-induced changes in Q, R and S wave amplitudes, and calculated the Athens QRS score to assess its diagnostic value. MATERIALS AND METHOD: Fifty patients who underwent the exercise test and MIBI myocardial scan and were proved to have coronary artery diameter stenosis > or =50% in coronary angiography were included in the patient group. Data of forty-nine persons showing negative findings in the exercise test and MIBI scan were used as control. The exercise test was performed according to the modified Bruce protocol using Marquette case 16. Exercise ECG was positive in 58% (29/50) of the patient group. The Q, R and S wave amplitudes at peak exercise were subtracted from the values of standing position at rest to obtain Athens QRS score. RESULTS: The mean age of patients and control were 54.5+/-9.4 years and 49.8+/-11.4 years respectively (p=NS), and their exercise capacity was 8.5+/-3.1 mets and 9.8+/-1.9 mets respectively (p=NS). The values of delta(R-Q-S)V5 + delta(R-Q-S)aVF and delta(R-Q-S)aVF were significantly lower in patients than the control (0.85+/-6.60 mm vs 3.72+/-5.09 mm, p=0.017, -0.60+/-4.76 mm vs 1.00+/-2.72 mm, p=0.030), and the values of deltaQV5 and deltaSaVF were significantly higher in patients than the control (-0.045+/-0.65 mm vs -0.41+/-0.78 mm, p=0.012, -0.84+/-1.90 mm vs -1.62+/-1.60 mm, p=0.009). However, the values were too widely overlaped between the patients and the control to give diagnostic cutoff points. CONCLUSION: It seems that exercise QRS scores do not have additive diagnostic value for coronary artery disease.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Electrocardiography ; Exercise Test ; Humans

No abstract available.
Humans

Thirty one free vascularized fibula bone grafts were performed for treatment of osteonecrosis of the femoral head in 26 patients, 24 men and 2 women aged from 16 to 48(mean:32 years). Twenty one patients had unilateral disease. Five patients had bilateral disease underwent staged bilateral free vascularized fibula grafts three months apart. Associated etiological factors included alcohol(9 patients), steroid(7 patients), and trauma(one patient). The condition was considered idiopathic in the remaining 9 patients. Radiologic staging by Ficat included stage 1 in one hip, stage II in 15 hips, stage III in 14 hips, and stage IV in one hip. A skin island flap was used for monitoring purpose for the grafted fibula. One monitoring, flap was necrotized due to vascular occlusion but the fibula bone graft was left in place to use as a nonvascularized bone graft. Average follow-up period was 21 months in 31 hips. Pain was relieved in 28 hips(93.3 percent) and aggravated in 2 hips(6.7 per cent). On radiographic evaluation, 26 hips(86.7 per cent) demonstrated excellent preservation of the femoral head contour. Progressive collapse of the femoral head (greater than 1-2 mm) occurred in 2 hips, i mm depression in one hip with stage III and 2 mm collapse in one hip with stage IV. In conclusion, the free vascularized fibula bone graft is an excellent treatment modality for preserving the femoral head and relieving symptoms in cases of the osteonecrosis of the femoral head.
Depression ; Female ; Fibula* ; Follow-Up Studies ; Head* ; Hip ; Humans ; Male ; Osteonecrosis* ; Skin ; Transplants

The number of cancers in the head and neck areas has been increasing due to the increasing life span of the patients and a free flap is a common procedure to reconstruct defect in the head and neck area. From March 1990 to February 1998, 105 patients underwent 110 free flap operations after head and neck cancer ablation and they were reviewed retrospectively. Among 110 free flaps, 93 are forearm flaps, 6 jejunal flaps, 5 vascularized fibular osteocutaneous flaps, 2 lateral arm flaps, 2 rectus abdominis myocutaneous flaps and 1 latissimus dorsi muscle flap and 1 latissimus dorsi myocutaneous flap. Sixty-five radial forearm flaps and 4 ulnar forearm flaps were utilized in patched type and 24 radial forearm flaps in tubed type mainly for the reconstruction of intraoral and hypopharyngeal defects. Sis jejunal flaps were utilized for the esophageal reconstruction and 5 vascularized fibular osteocutaneous flaps for the mandibular reconstruction. The remaining flaps were for the reconstruction of other areas of head and neck.Overall survival rate of the flap was 95.5%. Immediate complications were fistula formation(3 cases), total flap loss (4 cases) or partial flap loss(3 cases) and donor site problems(10 cases). Superior thyrodial artery was the most commonly used recipient artery(89 cases) which was followed by facial artery, lingual artery and transverse cervical artery. Size discrepancy was not remarkable between the donor and recipient arteries. However, there was usually a marked size discrepancy between donor and recipient veins. More than two venous anastomoses were performed to increase the success rate of the flap surgery. An average follow-up period was 38 months ranging from 3 months to 6 years. There was no patient who died during or right after the operations, but 23 patients died due to recurrence of tumors or underlying heart disease during the follow-up period. Remaining patients lived well excluding 6 late postoperative complications such as 4 cases of esophageal stenosis and 2 cases of osteoradionecrosis. We conclude that free flap reconstruction after head and neck cancer ablation improves the quality of life and minimizes the loss of function.
Arm ; Arteries ; Esophageal Stenosis ; Fistula ; Follow-Up Studies ; Forearm ; Free Tissue Flaps* ; Head and Neck Neoplasms* ; Head* ; Heart Diseases ; Humans ; Mandibular Reconstruction ; Myocutaneous Flap ; Neck ; Osteoradionecrosis ; Postoperative Complications ; Quality of Life ; Rectus Abdominis ; Recurrence ; Retrospective Studies ; Superficial Back Muscles ; Survival Rate ; Tissue Donors ; Veins

The authors experienced of two cases of steroid-induced glaucoma, the one was developed both systemic administration of corticosteroids and topical application of it on the face for 15 years, and the other was developed by topical instillation of corticosteroids in the eye for 20 years respectively. The clinical and literary review were made upon its pathogenesis and treatment.
Adrenal Cortex Hormones ; Glaucoma*

The current author surveyed cleft treatment protocol for 15 surgeons in Korean Society of Plastic and Reconstructive Surgeon. Survey items were operative age, techniques in incomplete cleft lip and isolated cleft palate, types of preoperative orthopedics in complete cleft lip and palate, correction ages of cleft lip nasal deformity and alveolar cleft. In incomplete cleft lip only, operative age ranged 10 weeks to 6 months(most common in 3 months), and most common operative technique was modified Millard method. In isolated cleft palate, operative age ranged 8 months to 24 months(most common in 12 months), Furlow-Z plasty or push-back procedure or two-flap palatoplasty was used or combined. In unilateral complete cleft lip and palate, eleven of fifteen surgeons used preoperative orthopedics. Preoperative orthopedics started between within 1 week and 2 months. Types of preoperative orthopedics were active appliance or combined with lip adhesion, passive appliance combined with lip adhesion, and nasoalveolar molding with skin tape. The definitive cheiloplasty was done between 3 months and 7 months old. In bilateral complete cleft lip and palate, all surgeons used preoperative orthopedics, and one-stage lip repair. The operative techniques were Millard method in 6 surgeons, modified Mullikin method in 4 surgeons, modified Noordhoff method in 3 surgeons, and Veau III operation in 2 surgeons. The operative age was between 10 weeks and 6 months old. The correction of cleft lip nasal deformity was at primary cheiloplasty in 3 surgeons, age 4 to 6 in 2 surgeons, age 4 to 6 in 9 surgeons, age 4 to 6 and age 9-16 in 2 surgeons. The alveolar bone graft was done at age 9 to 11(mixed dentition period) in all surgeons.
Cleft Lip ; Cleft Palate ; Clinical Protocols* ; Congenital Abnormalities ; Dentition ; Fungi ; Humans ; Infant ; Korea* ; Lip ; Orthopedics ; Palate ; Plastics ; Surgical Tape ; Transplants

To manage a unilateral complete cleft lip and palate, lip adhesion along with the positioning of a passive alveolar molding appliance was performed in infants at 4 to 6 weeks of age. The lip adhesion creats a force acting on the cleft alveolus. Thereafter, the greater segment of the alveolus is guided by the appliance, while the lesser segment of the alveolus is prevented from collapsing. Definite cheiloplasty was then performed at 4 to 5 months of age and palatoplasty at 12 months of age. Twenty-five patients with a unilateral complete cleft lip and palate were treated using this protocol from 1994 to 2002. Fifteen were male and ten were female. The mean follow-up period was one to nine years. Dental cast measurements were performed at lip adhesion, definite cheiloplasty and palatoplasty in 18 patients, 3 to 9 years in 19 patients. The alveolar gap, length of maxillary alveolar cleft, width of maxillary alveolar cleft and palatal gap were 10.1 +/-4.2mm, 6.1+/-0.9mm, 10.2+/-4.8mm, 13.4+/-2.9mm at lip adhesion, 3.1+/-1.4mm, 2.6+/-0.8mm, 2.7+/-1.6mm, 9.6+/-1.5mm at definite cheiloplasty, and 0.2+/-0.1mm, 1.5+/-0.7mm, 0.2+/-0.1mm, 8.3+/-1.1mm at palatoplasty respectively. Measurements at palatoplasty were decreased with statistical significance(p<0.05). Twenty- three patients developed good symmetrically aligned alveolar segments plus a symmetric platform for the nose. However, two patients developed poor maxillary orthopedics because of the displacement of the appliance by the patient. On the following maxillary dental cast from 8 to 9 years, intercanine width and canine arch length were within the normal value. However, intermolar width and molar arch length was decreased slightly compared to the normal with a statistical significance (p<0.005). In conclusion, lip adhesion and passive alveolar molding appliance achieve a normal position and stabilizing the arch, a symmetrical platform. However, longer follow- up is necessary until 15 years old for permanent dental arch establishment.
Adolescent ; Cleft Lip* ; Dental Arch ; Female ; Follow-Up Studies ; Fungi* ; Humans ; Infant ; Lip* ; Male ; Molar ; Nose ; Orthopedics ; Palate* ; Reference Values