In order to evaluate the long-term effect of single lateral rectus muscle recession for the moderate angle exotropia(20-3-PD), we retrospectively studied 30 cases which were recessed by 8-9mm. The average follow-up period was 35.8 month. At 6 month postoperatively, the success rate was 75% in 8mm recession group and 84% in 8.5mm group, 88% in 9mm group. At the last follow-up, the success rate was 62%, 38%, 22% respectively. The recession of single lareral rectus muscle for the moderate angle exotropia was successful during the early postoperative period. But, its success rate was gradually decreased in the long-term follow-up especially for exotropia over 25PD. So, we should consider to recess lateral rectus muscle more than 8-9mm or choose the classic surgical method such as both lateral rectus recession or recession-resection for exotropia over 25PD.
Exotropia* ; Follow-Up Studies ; Postoperative Period ; Retrospective Studies

Primary tumors of the heart are rare, three quarter of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, however, only 3 to 4 percent of myxoma are detected in the left ventricle. We report on a 32 years old woman with left ventricular myxoma who presented with shortness of breath, chest tightness, and general weakness. Acute pulmonary embolism and left ventricular myxoma were found on a perfusion lung scan and echocadiogram. A mass located on septal wall of left ventricle was excised en bloc. The patient recovered uneventfully and careful follow up has be performed periodically.
Adult ; Dyspnea ; Female ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Lung ; Myxoma* ; Perfusion ; Pulmonary Embolism* ; Thorax

One of the complication during or after subclavian vein cannulation is intravascular catheter or wire embolization. Although some studies have reported safety of retaining foreign body embolization, and even death. The intravascular foreign body can be removed surgically or non-surgically. With improvement in instrument technology and technique, percutaneous retrieval of intravascular foreign bodies has become a relatively common procedure. Commonly used methods to remove intravascular foreign bodies are loop snare and basket technique. Sometimes biopy forcep can be used. We have experienced 2 cases of non-surgical removal of intravascular foreign bodies. One of the foreign bodies was 7cm wire fragment in right atrium(RA), the other was a 50cm guide wire. We used the standard loop snare technique for removal of 7cm wire fragment in RA and stone removal basket and 3.0mm ACS PTCA balloon to remove the 50cm short guide wire.
Catheterization ; Catheters ; Foreign Bodies* ; SNARE Proteins ; Subclavian Vein ; Surgical Instruments

BACKGROUND: Primary stenting as a direct reperfusion procedure after acute myocardial infarction might reduce recurrent myocardial infarction and target vessel revascularization. However, result of long or multiple stenting in the long or tandem lesions were not known. METHOD: From Jan. 1996 to Dec. 1998, patients with acute myocardial infarction including cardiogenic shock were undergone primary stenting using long or multiple stent. The clinical end points were death, recurrent infarction, subsequent bypass surgery, or repeat angioplasty of the infarct-related vessel. The results were compared with age, sex, lesion, and risk matched standard stenting group. RESULT: Baseline characteristics were similar for the 20 patients who underwent standard length stenting and the 13 patients who underwent long or multiple stenting. Stent diameter was similar in two group (3.4+/-0.3 mm vs. 3.5+/-0.4 mm, p=0.65), but total stent length was longer in long or multiple stenting group (15.5+/-1.8 mm vs. 40.18.4 mm, p=0.01). Average numbers of stent using in multiple stenting were 1.5+/-0.7. Stenting in the infarct-related artery was successful in all patients randomized to stent treatment. At 6 months, the incidence of the primary end point was 25% (5/20) in the standard stent group and 31%(4/13) in the long or multiple stent group (p=0.5). CONCLUSION: Outcomes of long or multiple stenting including mortality, recurrent myocardial infarction and target vessel revascularization was similar to standard stenting. Long or multiple stenting after acute myocardial infarction may possible procedure in some selective cases having long or tandem lesion.
Angioplasty* ; Arteries ; Humans ; Incidence ; Infarction ; Mortality ; Myocardial Infarction ; Reperfusion ; Shock, Cardiogenic ; Stents*

Aortopulmonary fistula is an exceedingly rare vascular malformation. It is commonly derived after chest injuly or from complication of chest operation and aortic dissection and congenital aortopulmonary fistula is only several cases combined with Tetralogy of Fallot or aortic stenosis. But a congenital aortopulmonary fistula without any hemodynamic abnormalities was not reported. A 56-year old man with exertional dyspnea was admitted. In an examination on admission, there were no abnomalities. Aortography showed an aortopulmonary fistula that branches from the ascending aorta adjacent to the right coronary artery, running to the main pulmonary artery. Transcatheter coil embolization was performed and he was discharged 7 day after embolization without complication. Exertional dyspnea disappeared and careful follow up has be performed periodically.
Aorta ; Aortic Valve Stenosis ; Aortography ; Coronary Vessels ; Dyspnea* ; Embolization, Therapeutic ; Fistula* ; Follow-Up Studies ; Hemodynamics ; Humans ; Middle Aged ; Pulmonary Artery ; Running ; Tetralogy of Fallot ; Thorax ; Vascular Malformations

BACKGROUND: Although the superior reperfusion and improved clinical outcome following angioplasty for acute myocardial infarction (AMI) have been well known, 10 to 15% of reinfarction and recurrent ischemia in hospital are main limitation of primary percutaneous transluminal coronary angioplasty (PTCA). This study was undertaken to examine the safety and feasibility of stent-supported primary angioplasty in acute myocardial infarction. METHODS: Between July 1995 and Jun. 1997, 32 patients underwent direct or rescue PTCA, including patients with cardiogenic shock. After PTCA, stenting was attempted in patient with dissection or having more than 30% of residual stenosis. Result: In patient with direct PTCA, angiographic success rate was obtained in 91% (30/32). Stenting was attempted in 15 of 30 patients. These patients had suboptimal results (8 patients), non-occlusive dissection (3 patients) and acute occlusion (2 patient). Thrombolysis in myocardial infarction (TIMI) grade 3 flow was restored in 28 patients (93%). In one patient no-reflow phenomena was observed following stent insertion. Despite intra-aortic balloon pumping, there was one death during the hopitalization due to cardiogenic shock following PTCA. Subacute stent thrombosis developed in two patients. 27 patients (90%) were event-free and clinically improved through out the follow up period (11.5+/-5.2 month). Quantitative angiography showed excellent angiographic result after stenting compared with balloon PTCA (2.4+/-0.6 mm vs. 3.4+/-0.3 mm p<0.01). CONCLUSION: After failure of initial angioplasty, coronary stenting can be a supportive therapeutic strategy. Coronary stenting results in a high degree of angiographic success, a low incidence of subacute thrombosis.
Angiography ; Angioplasty* ; Angioplasty, Balloon* ; Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Intra-Aortic Balloon Pumping ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Shock, Cardiogenic ; Stents ; Thrombosis

No abstract available.
Acrodermatitis*

Although intracranial cartilaginous tumor are distinctly uncommon, they have several distinct features. They are slow growing tumors with predirection for the base of skull and plain skull roentgenegram often demonstrates destruction and calcification at the site of the tumors. The authors report a case of cartilaginous tumor arisen from the sphenoid sinus with characteristic features. Biopsy yielded the pathologic diagnosis of chondroma.
Biopsy ; Chondroma* ; Diagnosis ; Skull ; Skull Base ; Sphenoid Sinus*

Intraaortic balloon counterpulsation (IAB) has been shown to prolong survival in the critically ill cardiac patients. Originally developed for use in the patients with cardiogenic shock, the indications have been expanded. But despite technical advances, the complication rate associated with IAB remains high. The most commonly reported complications include damage to the femoral artery and distal embolization. Other reported major complications are balloon rupture, limb loss, bleeding, systemic infection and bowel infarction. We report a patient complicated by ischemic colitis causing stenosis and intestinal obstruction after IAB insertion.
Colitis, Ischemic* ; Constriction, Pathologic* ; Counterpulsation* ; Critical Illness ; Extremities ; Femoral Artery ; Hemorrhage ; Humans ; Infarction ; Intestinal Obstruction ; Rupture ; Shock, Cardiogenic

PURPOSE: To compare the effect of an intravitreal injection of triamcinolone acetonide with bevacizumab in the treatment of diabetic macular edema (DME). METHODS: For this study, the medical records of patients with diabetic macular edema, who received intravitreal triamcinolone injection (IVTA) or intravitreal bevacizumab injection (IVB), were reviewed. Best corrected visual acuity (BCVA), central macular thickness (CMT) and total macular volume (TMV) were evaluated before injection and at 1 week, 1 month, 2 months, 3 months, and 6 months after injection. The adverse events, such as increased intraocular pressure, and progression of cataract, were also reviewed. RESULTS: A total of 72 eyes from 72 patients, (IVTA: 40 eyes, IVB: 32 eyes) were included in this study. In the IVTA group, BCVA improved significantly at 1 week after injection and was maintained until 3 months after injection. In the IVB group, BCVA improved significantly at 1 week after injection and was maintained until 2 months after injection. In the IVTA group, CMT and TMV decreased significantly at 1 week after injection and were maintained until 3 months after injection, while in the IVB group CMT and TMV were maintained until 2 months after injection. The IVTA group showed significantly better results in visual improvement, CMT and TMV reduction compared to the results of the IVB group, from 1 month to 3 months after injection. In the IVTA group, intraocular pressure increased to more than 25 mmHg in 12.5% of patients during the follow-up period. CONCLUSIONS: While the functional and anatomical improvements are achieved by both IVTA and IVB for diabetic macular edema, the effect of IVTA is more prominent with longer duration than IVB.
Antibodies, Monoclonal, Humanized ; Cataract ; Eye ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema ; Medical Records ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab