No abstract available.
Osteotomy* ; Prognathism* ; Recurrence*

Patients with convergence insufficiency were complaint from diplopia and asthenopia at near Most patients respond well to orthoptic therapy, glasses, prism. In the case of patient unresponsive to conventional non-surgical orthoptic treatment, surgery remained controversial due to recurrence of symptoms reported following conventional bilateral medial rectus resection. To overcome these problems, an angled tuck of the medial recti was performed. Strengthening of the lower margin of the medial recti, by tucking them more than these of the upper margin results in a same aligment of the eye for near and distance deviation and relief of symptoms.
Asthenopia ; Diplopia ; Eyeglasses ; Glass ; Humans ; Ocular Motility Disorders* ; Orthoptics ; Recurrence

In chicks, visual deprivation lead to myopia and enlargement of the vitreous chamber of the eye. In an attempt to elucidate the eyeball enlargement by iatrogenic cataract, two-day old white Leghorn chickens(n=28) were lightly anesthetized with ether and iatrogenic cataract was induced by YAG laser. The other eye was used as control group. Refractive error, corneal curvature, and axial length by ultrasonography were assessed before the study, and 3 weeks and 6 weeks after cataract formation. At 6 weeks, intraocular pressure, dimension changes and weight of enucleated eyeball were measured. The axial lengths in the iatrogenic cataract eye group were significantly larger than their control eyes in both the axial and the equatorial dimensions. Corneal sag and diameter, intraocular pressure, were not significantly different between two groups. We conclude that form vision deprivation with cataract induces the enlargement of the eyeball, especially the posterior segment of the eyeball.
Cataract* ; Chickens* ; Ether ; Intraocular Pressure ; Lasers, Solid-State ; Myopia ; Refractive Errors ; Ultrasonography

Jensen procedures with medial rectus recession were performed on 13 eyes of 10 patients with lateral rectus palsy caused by trauma. The cases were reviewed retrospectively to assess efficacy of the procedure and long-term stability. After the average 10.2 months of follow-up period, the 7 patients on whom unilateral Jensen procedures and medial rectus muscle recession were performed improved an average of 45.0 delta, and the 3 patients who underwent bilateral Jensen procedures and medial rectus muscle recession improved an average of 82.3 delta. Preoperatively, 12 eyses demonstrated abduction of -4, and 1 eye demonstrated abduction of -1. Postoperatively, abductions of eyes are as follows: 3 eyes -4, 5 eyes -3, 3 eyes -2, and 2 eyes -1. 10 eyes (76.9%) showed improved abduction of lateral rectus muscle, but 3 eyes(23.1%) were not changed. 4 patients(40.0%) acquired a functional area of diplopia free vision, but 6 patients(60.0%) did not, 1 patient developed diplopia postoperatively. No significant cases of vertical deviation were created. One showed anterior segment ischemia, but recovered without complications. Based on these results, the Jensen procedure combined with medial rectus recession is effective in correcting palsies of the lateral rectus muscle that is not recovered.
Abducens Nerve Diseases* ; Diplopia ; Follow-Up Studies ; Humans ; Ischemia ; Paralysis ; Retrospective Studies

Clincal studies were made on 166 cases of spontaneous subarachnoid hemorrhage (SAH), were admitted to the keimyung university Dongsan hospital from January 1981 to March 1984. The age and sex distribution, causes of SAH, clinical symptoms and signs, computed tomographic (CT) findings, aneurysmal site, number and size, comparison between the highest density on CT findings and site of aneurysm confirmed by angiography,relationship between CT class and clinical grade, complication, and relationship between hospital course and clinical grade on admission were analysed. The results summarized as follow. 1. The most prevalent age group was between 41-60 years of age, and above 61 years, 31-40 years and below 30 years of age in the order of frequency. Male to female ratio was 43.4 : 56.6. 2. The most common causes of 100 cases of SAH confirmed by cerebral angiography was cerebral aneurysm (75 cases), and the other causes were unknown cause (16 cases), arteriovenous malformation (6 cases), moyamoya disease (3 cases) in the order of frequency. 3. The clinical symptoms on admission in the order of frequency were headache, nausea and vomiting, brief loss of consciousness, dizziness, seizure, and urinary incontinence. The neurological findings showed stiffneck, hemiparesis, cranial nerve palsies, papilledema and/or hemorrhage on the fundus, and Babinski sign in that order. 4. CT findings (158 cases) revealed typical high densities consistent with SAH in 125 cases (79.1%), associated with the low density (13 cases), and visible cerebral aneurysm (5 cases), while negative findings were 33 cases (20.9%). 5. The most common site of aneurysm among the 75 cases of SAH confirmed by the cerebral angiography was the region of the anterior communicating artery (AcomeA) which accounted for 30 cases (35.3%), and posterior communicating artery (PcomeA) and middle cerebral artery (MCA) 23 cases (27%), respectively, the internal carotid artery 5 cases (5.9%), the anterior ecrebral artery (ACA) 2 cases (2.4%), the posterior inferior cerebellar artery and basilar artery 1 cases (1.2%), respectively in the order of frequency. Among the 75 cases of cerebral aneurysms, single aneurysms were 67 cases (89.3%) and multiple aneurysms were 8 cases (10.7%). The most common size of the aneurysms was 6-10 mm (47 cases), and below 5 mm (30 cases), and above 10 mm (8 cases) in the order of frequency. 6. Sixteen out of 27 cases of AcomA aneurysms present the highest density on CT scan in the anterior hemispheric fissure, 9 out of 22 cases of PcomA aneurysms in syulvian fissure and 6 cases in suprasellar cistern, and all cases of MCA aneurysm (21 cases) in the ipsilateral aneurysmal site. 7. Comparison between CT grade by Davis (1980) and clinical grade by Hunt-Hesse (1968) revealed that the 93 of 94 patients (pts) with CT class 1 or 2 belong to under clinical grade 3, the 17 of 64 pts with CT class 3 or 4 belong to clinical grade IV or V, and the 17 of 18 pts with clinical grade IV or V belong to CT class 3 or 4. 8. The most common complication was the hydrocephalus (30.1%), and cerebral arterial spasm (24.1%), SIADH (8.4%), and rebleeding confirmed by lumbar puncture and/or CT (4.2%), in the order of frequency. 9. One hundred and four pts (62.7%) out of total 166 patient with SAH were improved, whereas 39 pts (23.5%) were not improved or signed out without clinical improvement, and 23 pts (13.8%) were died. The 81 (77.9%) of 104 pts who were improved belong to clinical grade I or II on admission, the 18 (78.3%) of 23 pts who were expired belong to clinical grade III or IV, and the 19 (48.7%) of 39 pts who were signed out without improvement belong to clinical grade III to V.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Carotid Artery, Internal ; Cerebral Angiography ; Cranial Nerve Diseases ; Dizziness ; Female ; Headache ; Hemorrhage ; Humans ; Hydrocephalus ; Inappropriate ADH Syndrome ; Intracranial Aneurysm ; Male ; Middle Cerebral Artery ; Moyamoya Disease ; Nausea ; Papilledema ; Paresis ; Reflex, Babinski ; Seizures ; Sex Distribution ; Spasm ; Spinal Puncture ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed ; Unconsciousness ; Urinary Incontinence ; Vomiting

STUDY DESIGN: A case report. OBJECTIVES: Lumbar burst fracture was treated with operation, which delayed recollapse of L1 and led to conus medullaris syndrome. SUMMARY OF LITERATURE REVIEW: After operation, conus medullaris syndrome causing by delayed recollapse is not frequently reported. MATERIALS AND METHODS: A 56-year-old male was admitted with lower back pain caused by a fall. Radiologic findings showed L1 burst fracture with about 42% of height loss. There was no neurologic deficit. Posterior fusion was performed using instrumentation. Five weeks after the operation, the patient was admitted for urination and defecation difficulty. Radiologic findings showed that the L1 had recollapsed with about 38% of height loss. To resolve the problem, anterior surgery was performed. RESULTS: Two years after surgery, bladder and anal sphincter dysfunction wasn't recovered. CONCLUSIONS: Lumbar burst fracture should be follow up carefully until union of the fracture because burst fracture leads to delayed recollapse.
Anal Canal ; Defecation ; Humans ; Low Back Pain ; Male ; Middle Aged ; Neurologic Manifestations ; Spinal Cord Compression* ; Urinary Bladder ; Urination

Teratomas of the fallopian tubes are very rarely encountered in the western literature, and not a single case has been documented in Korea. The authors experienced two cases of tubal teratomas. Both patients developed a teratoma in an ampullary portion of the right fallopian tubes. One case occured as an incidental finding, and the other case was presented with a tubal mass. The gross and light microscopic features of these teratomas were described, and a brief review of the literature on the tubal teratomas is made.

Deep vein thrombosis and pulmonary embolism are serious and fatal complications in orthopedic surgery. Most cases of symptomatic pulmonary embolism in knee surgery have been reported after total knee arthroplasty, but rarely after patella fracture. We report on a case of symptomatic pulmonary embolism after surgical treatment of a patella fracture in a 42-year-old female patient.
Adult ; Arthroplasty ; Enclomiphene ; Female ; Humans ; Knee ; Patella* ; Pulmonary Embolism* ; Venous Thrombosis

The non-invasive assessment of bone turnover has received increasing attention over the past few years, because of the need of sensitive markers in clinical investigation of osteoporosis. The purpose of this study was to assess the availibility of the bone resorption marker and bone formation marker in menopause and to assess the correlation of bone markers and osteoporosis. This study was undergone from January 1995 to October 1995 retrospectively for total 88 postmenopause women who were not treated by hormone replacemetn therapy. The subjects comprised 28 healthy perimenioausal women; 55 healthy natural postmenopausal women; 5 women with surgical menopause. We measured serum osteocalcin as a bone formation marker and urinary deoxypyridinoline as a bone resorption marker. Bone mineral densities were also measured by Dual Energy X-ray Absortiometry(DEXA). The mean serum osteocalcin level in perimenopausal women was 6.40+/-3.12ng/ml, and mean levels in potmenopausal women with duration of menopause for 12 to 48 months, 49 to 84 months, 85 to 120 months, over 121 months were 9.26+/-5.89ng/ml, 9.01+/-2.75ng/ml, 8.36+/-4.99ng/ml, 9.88+/-3.82ng/ml, respectively. The level in surgical menopausal women was 8.76+/-5.24ng/ml. The mean serum osteocalcin levels were significantly higher in post- menopausal women with duration of menopause for 12 to 48 months(p < 0.05), for 49 to 84 months(p < 0.05), and over 121 months(p < 0.01). The urinary deoxypyridinoline level in perimenopausal women was 5.67+/-1.26 nMDpD/ mMCr, and the levels in postmenopausal women with duration of menopause for 12 to 48 months, 40 to 84 months, 85 to 120 months, over 121 months were 7.13+/-1.35 nMDpD/mMCr, 5.14+/-0.83 nMDpD/mMCr, 5.04+/-1.11 nMDpD/mMCr, 6.09+/-1.86 nMDpD/mMCr, respectively. The level in surgical menopausal women was 6.26+/-1.35 nMDpD/mMCr. The urinary deox- pyridinoline level was significantly higher in postmenopausal women with duration of menopause for 12 to 48 months(p < 0.01). There was a tendency that osteocalcin levels were increasing according to decrease in bone mineral density but osteocalcin levels were not statistically significant among 3 groups such as normal, osteopenic, and osteoporotic groups and there was also no significance in deoxypyridinoline levels among 3 groups. As a conclusion, there were no significant correlation between bone formation and resorption markers, indicated that there was imbalance in bone formation and resorption in menopause period. Also bone loss of menopause was peak in 2 to 4 years after menopause.
Bone Density ; Bone Resorption ; Female ; Humans ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Postmenopause ; Retrospective Studies

Laparoscopy is a procedure that uses a narrow telescope to view the interior of abdominal cavity. Medical endoscopy was introduced a long time ago, but rapid progress and technological advances in laparoscopy have been witnessed during past two decades. Operative laparoscopy was developed during the 1970s, and laparoscopy was first used during the early 1980s. And now, hynecologic surgery may be performed laparoscopically in 30% to 80% of patients currently undergoing laparotomy. More recently, with an improvement in our ability to maintain intraabdominal hemostasis, complex surgical precedures are able to be performed laparoscopically. We used laparoscopic hysterectomy from 1991. At that time, we experienced many complications byt now performed successful laparoscopic hysterectomy due to sdillful surgical technique and improvement in surgical devices. So, we report surgical experiences from April 1991 to October 1996 and divided the patients into 3 groups. The 1st, 2nd and 3rd group underwent laparoscopic hysterectomy were 1991-1992, 1993-1994, 1995-1996, respectively. The number of patient underwent laparoscopic hysterectomy was 300,300,300, respectively. The results were as follows.1) The mean age of each group patient was 41.4 +/- 7.3, 43.6 +/- 6.9, 44.4 +/- 7.1, respectively. 2) The mean parity of all group was 2.2 +/- 1.3, 2.5 +/- 1.2, 2.3 +/- 1.1, respectively. 3) The most common operative indication was myoma uteri in all group. The 2nd most common indication was chronic pelvic pain in 1st, 2nd group and intractable menorrhagia in 3rd group. Other indications were carcinoma in situ, uterine prolapse, adenomyosis, endometriosis, chronic or severe infection, adnexal mass,. etc. 4) The mean hemoglobin change of all group from preoperative day to postoperative 1 day was 2.1 +/- 1.5 g/dl, 1.9 +/-1.2 g/dl, 1.5 +- 1.1 g/dl, respectively. %5) The mean operative time of all group was 158.4 +/- 43.2 minutes, 116.9 +/- 36.5 minutes, 69.8 +/- 23.2 minutes, respectively. 6) The mean uterine weight of all group was 178.3 +/- 79 gm, 186.2 +/- 89 gm, 188.5 +/- 92.5 gm, respectively. 7) The most common complication was subcutaneous emphysema in all group. Other complications were ureteral injury, vesico-/uretero-vaginal fistula, intestinal injury, bladder dysfunction and injury, hemorrhage due to vessel injury, incisional hernia, peroneal nerve palsy. etc.
Abdominal Cavity ; Adenomyosis ; Carcinoma in Situ ; Endometriosis ; Endoscopy ; Female ; Hemorrhage ; Hemostasis ; Hernia ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Intestinal Fistula ; Laparoscopy ; Laparotomy ; Menorrhagia ; Myoma ; Operative Time ; Paralysis ; Parity ; Pelvic Pain ; Peroneal Nerve ; Subcutaneous Emphysema ; Telescopes ; Ureter ; Urinary Bladder ; Uterine Prolapse ; Uterus