PURPOSE: To evaluate the correlation between nuclear density measured using the Pentacam(R) (Oculus Optikgerate GmbH, Wetzlar, Germany) Scheimpflug imaging system and phacoemulsification parameters. METHODS: The nuclear density was measured using maximal nuclear density with ImageJ, Pentacam(R) nucleus staging (PNS), average value and maximal value in lens densitometry. Intraoperatively, effective phaco time (EPT) and balanced salt solution (BSS) used were noted and compared with the nuclear density calculation methods. As an index of corneal endothelial cells, the changes in cell density (CD) were compared with the nuclear density. RESULTS: Regarding EPT, maximal nuclear density with ImageJ (r = 0.379, p < 0.01) and PNS (r = 0.367, p < 0.01) were correlated positively, but the other methods were not correlated. Concerning BSS used, maximal nuclear density with ImageJ (r = 0.279, p = 0.03) and PNS (r = 0.286, p = 0.04) were positively correlated, but the other methods were not correlated. The specular microscopy showed that as the nuclear density increased, the postoperative CD tended to decrease, but without statistical significance. CONCLUSIONS: Preoperative nuclear density measurements using maximal nuclear density with ImageJ or PNS were correlated with phacoemulsification parameters.
Cell Count ; Densitometry ; Endothelial Cells ; Microscopy ; Phacoemulsification*

In spite of numerous dinical and patho-anatomical studies made in the past, there are still different opinions concerning the mechanism of low back pain. The sciatic symptoms in degenerative lumbar disc disease may arise from the direct mechanical effect of pressure exerted by protruding disc material on nerve roots, and that such symptoms may therefore be relieved by surgical decompression of the nerve roots, has been widely accepted for nearly 40 years. There is, however, a good deal of evidence, both from operative and histological findings as well as from indirect sources, which suggests that inflammatory changes present in and around affected nerve roots may also be of importance in the production of sciatic symptoms in lumbar disc disease. The possibility that, at least in some cases, these inflammatory changes could contribute significantly or even predominantly to the production and persistence of sciatic symptoms, has stimulated many attempts to treat sciatica by means of local antiinflammatory measures in particular, corticosteroid injections. We have studied the effect of the injection of mixture triamcinolone and local anesthetic (1% xylocaine or 0.5% marcaine) comparing with the effect of usual conservative treatment of low back pain and sciatica. Of the 92 patients suffered from lumbago & sciatica, who were treated from 1979. 7 to 1981. 7 in Korea and Jae Il general hospital, 44 patients were treated with intermittent epidural block, 12 patients with continuous epidural block and 36 patients were treated only with usual conservative treatment. The results of clinical observation were as follows: 1. The causative disease were herniated nucleus pulposus in 60 patients (64%), lumbar sprain in 12 (13%), degenerative joint disease of spine in 11 (12%),… 2. The epidural block cases were divided into acute group (symptoms less than 3 months) and chronic group (symptoms longer than 3 months). The over all improvement of the acute group was 22 of 27(81%) and of the chronic group was 22 of 29(76%). The duration of symptoms didnt influenced significantly the effect of epidural block. 3. Therapeutic effect of epidural block was as follows; complete relief 22 of 56(39%), marked relief 13 of 56(23%), slight relief 9 of 56(16%), no improvement 12 of 56(22%). The over all improvement was resulted in 44 of 56(78%): intermittent epidural block 34 of 44(77%), continuous epidural block 10 of 12(83%). 4. Therapeutic effect of conservative treatment was as follows; complete relief 10 of 36(28%), marked relief 7 of 36(19%), slight relief 4 of 36(11%), no improvement 15 of 36(42%). The over all improvement of symptoms was resulted in 21 of 36(58%). 5. Follow up period of epidural block patients were 3 months in average, and persistent relief of symptom were obtained in 12 out of 20 patients(60%), and recurrence of symptom were in 6 of 20 patients(30%). It is considered that epidural block will shorten the time of recovery from severe pain, avoid hospitalization or long periods of bed rest and allow earlier physiotherapy. In addition it may avoid the need for surgical intervention to produce rapid relief of acute pain and give to patient economic, psychologic benefit.
Acute Pain ; Bed Rest ; Decompression, Surgical ; Follow-Up Studies ; Hospitalization ; Hospitals, General ; Humans ; Joint Diseases ; Korea ; Lidocaine ; Low Back Pain ; Recurrence ; Sciatica ; Spine ; Sprains and Strains ; Triamcinolone

Tuberous sclerosis is reported rarely and is associated with systemic lesions including central nervous system, skin, heart, eye and kidney. Approximately 5-15% of individuals with tuberous sclerosis will develop brain neoplasia, almost invariably subependymal giant-cell astrocytoma (SGCA). We experienced a case of SGCA with tuberous sclerosis operated by the transcallosal approach and report with literature review.
Astrocytoma* ; Brain ; Central Nervous System ; Heart ; Kidney ; Skin ; Tuberous Sclerosis*

The authors have been performed stereotactic endoscopy to diagnose and treat 6 cases of ventricular and juxtaventricular lesions using Brown-Wells system under the local anesthesua. We thought that stereotactic endoscopy was easier and safer than conventional surgery for these lesions.
Endoscopy*

The diagnosis of neurocysticercosis is relatively easy with brain computed tomo-grarhy(CT) and/or magnetic resonance imaging(MRI) and ELISA test of serum and cerebrospinal fluid(CSF). The clinical manifestation of the disease are varied and correlated with the infection sites. The use of praziquantel and/or surgical excision are effective in treatment of the disease. The effect of treatment has been evaluated with imaging studies and changes of clinical manifestation. The authors reviewed 97 neurocysticercosis patients to evaluate the prognostic predictability of serum and CSF ELISA titers after treatment . We classified the patients into two groups. Rebound group was patients which showed higher ELISA titers after praziquantel medication than pretreatment. The responses to treatment were evaluated with the changes on brain CT or MRI. The Initial ELISA titers were lower in rebound group than those of nonrebound group, but three month after treatment, rebound group showed higher titers. The changes of ELISA titers in rebound group were greater in CSF than those in serum. The reduction of cyst on brain CT or MRI was more remarkable in rebound group than in nonrebound group and the prognosis of rebound group was better. Changes of ELISA titers was valuable in predicting the effect of treatment and prognosis.
Brain ; Diagnosis ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Magnetic Resonance Imaging ; Neurocysticercosis* ; Praziquantel ; Prognosis*

Recurrent lumbar disc herniation after standard lumbar discectomy was the mostcommon complication among the failed back surgery syndrome. Clinical manifestations and radiologic findings were analyzed in 56 paients who were proved to have recurrent lumbar disc herniation. Comparative analysis with Lumbar Disc Surgery Predictive Score(LDSPS) between 160 patients of failed back surgery syndrome and 56 patients of recurrent disc herniation was performed. LDSPS of the recurrent disc herniation was 81.3. The interval of the reoperation after onset of symptom was considered to be one ofthe major factors in the prognosis of the recurrent disc herniation. The patient must be educated how to prevent lumbar disc herniation. When recurrency was suspected one must diagnose precisely with the help of MRI andreoperate as soon as possible.
Diskectomy ; Failed Back Surgery Syndrome ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Reoperation

PURPOSE: Owing to the trend of a nuclear family the concern and protection are still more increasing than before. The patients admitted to hospital for intussusception, as well as their parents, seem to be under great stress when non- operative treatments fail. In order to identify those patients likely to fail an attempted non-operative treatment, and to administer prompt treatment, the patients that came to our hospital for pediatric intussusception were analyzed. METHODS: 285 cases, between 2000 and 2003 were reviewed. They were divided into two groups from their medical records, and retrospectively compared. Group I included 243 pneumoreduction cases and group II 42 operation cases. To find the probability of non-operative treatment failure, an attempt was made to analyze and score the risk factors that increase the possibility of operative treatment. RESULTS: The factors contributing to an increased possibility of operative treatment were fever, leukocyte count, plain abdominal X-ray findings and duration of symptoms. CONCLUSION: This study revealed that fever, leukocyte count, plain abdominal X-ray findings and duration of symptoms contributed to an increased possibility of operative treatment. An increase in the sum of the scores of each factor increased the possibility of operative treatment. This simple scoring system could eliminate excessive and repeated pneumoreduction, thus indicating its potential value as a useful aid in surgical decision making for high failure rate cases of pneumoreduction in intussusception.
Decision Making ; Fever ; Humans ; Intussusception* ; Leukocyte Count ; Medical Records ; Nuclear Family ; Parents ; Retrospective Studies ; Risk Factors ; Treatment Failure

Brain Computerized Tomography(CT) and cerebral angiography were reviewed in thirty-six patients with multiple intracranial aneurysms(22.5%) among the 160 consecutive surgical cases of intracranial aneurysms. The prevalent sites of multiple aneurysms were the middle cerebral artery(37.0%), posterior communicating artery(22.2%), and internal carotid artery(14.8%) in sequence. However, the vertebrobasilar system(83.3%), anterior communicating artery(63.6%), and posterior communicating artery(50.0%) had higher probability of rupture than internal carotid artery(8.3%) or middle cerebral artery(33.3%). Based on CT and angiographic information, the site of rupture can be predicted with a high degree of reliability. These factors were the presence of localized hemorrhage on CT, focal vasospasm, size and irregularity of aneurysms, and relative hyperplasia of parent artery.
Aneurysm ; Arteries ; Brain ; Cerebral Angiography ; Hemorrhage ; Humans ; Hyperplasia ; Intracranial Aneurysm ; Parents ; Rupture

A 33-year-old woman who was diagnosed as medullary carcinoma by fine needle aspiration of thyroid mass is presented. The smear revealed dispersed pattern and small clusters of cells without follicular or papillary structures. The nuclei were round, oval or spindle shaped and eccentrically located. The cytoplasm was abundant and showed red-stained cytoplasmic granulation and tail-like projection with indistinct border. Clumps of amorphous, light-green material were intermingled with tumor cells.
Adult ; Biopsy, Fine-Needle ; Carcinoma, Medullary ; Child* ; Cytoplasm ; Female ; Granular Cell Tumor ; Humans ; Hypercalciuria* ; Mass Screening* ; Thigh ; Thyroid Gland

BACKGROUND: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. METHODS: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels − the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. RESULTS: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). CONCLUSIONS: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Body Mass Index ; Bone-Patellar Tendon-Bone Grafts ; Female ; Humans ; Knee ; Linear Models ; Male ; Outcome Assessment (Health Care) ; Patellar Ligament ; Retrospective Studies ; Tears ; Transplants*