Today, the exact causal relationship between prolapsed intervertebral disk and sciatica remains unclear. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that causal irritant is likely to be a chemical product of disk degeneration. The administration of steroids into the epidural space reduces the inflammatory process of the neural structure is well known. We have studied the effect of injection of methylprednisolone acetate (Depomedrol) comparing with the effect of operative treatment. One hundred and eleven cases suffuring from diskogenic low back pain had been treated at Wallace Memorial Baptist Hospital during 2.5 years period from May 1979 to Nov. 1981. The results were as follows: 1. Sixteen patients (14%) stated that they had no relief from the injection, 24(22%) were moderately improved, 52(47%) were markedly improved and 19(17%) were completely relieved of symptoms. 2. The candidates for laminectomy which were confirmed by myelogram had complete improvement in 12%, marked improvement in 39%, moderate improvement in 21%, no relief in 28%.
Back Pain ; Epidural Space ; Humans ; Inflammation ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Laminectomy ; Low Back Pain ; Methylprednisolone ; Protestantism ; Sciatica ; Steroids

No abstract available.
Fractures, Spontaneous*

The effect of IDU and cryocautery in the treatment of Herpes Simplex Keratitis was presented. The cryoapplicator was a model of Krwawlcz probe (2 mm in diameter) which was refrigerated in a mixture of dry ice and methyl alcohol. The applicator was appJied on the lesions 7 seconds each and antibiotics and atropine solutions were instilled. A good result was experienced in the treatment of several cases of dendritic kenititis by freezing the corneal lesions by means of cryoappJicator, which had not been responded to IDU therapy speedy. The deep neovascularization of the cornea in a case of stromal keratitis was disappeared after cryocautery for the treatment of the superficial corneal ulcers.
Anti-Bacterial Agents ; Atropine ; Cornea ; Dry Ice ; Freezing ; Herpes Simplex* ; Keratitis ; Keratitis, Herpetic* ; Methanol ; Ulcer

The epidural injection of corticosteroid reduces the inflammatory process of the neural structure and its neighbor structures. Morphine, also injected epidurally, has been reported to alleviate severe pain with the short-acting property. In attempt to prolong the effectiveness of pain relief, we have studied the effect of the epidural injection of the morphine and steroid frorg May 1987 to Oct. 1987, and compared with the effect of the epidural injection of the steroid and local anesthetics from Jan. 1986 to Oct. 1987. In this study, we obtained following results; 1. The major causative diseases were herniated necleus pulposus in 34 cases(48.5%), spinal stenosis in 16 cases(22.9%) and spondylolisthesis in 9 cases(12.9%). 2. In morphine-injected group, 100% of acute group and 92.3% of chronic group was improved. In non-morphine injected group, there was no significant difference between the acute and chroinc groups. 3. The effect of epidural morphine and steroid was as follows; Complete relief 14 cases (63.6%), marked improvement 5 cases(22.7%), moderate improvement 2 cases(9.2%) and no relief 1 case(4.6%). The overall improvement was resulted in 21 cases(95.4%). 4. The effect of epidural steroid and local anesthetics was as follows; Complete relief 10 cases(20.8%), marked improvement 14 cases(29.2%), moderate improvement 12 cases(25%~ and no relief 12 cases(25%). The overall improvement was resulted in 36 cases(75%). 5. The average duration of pain relief was 2.5 months in morphine injected group and 1.3 months in non-morphine injected group. 6. The side effects associated with opiate, such as generalized pruritus, nausea, vomiting and urinary retention were reported in 16 cases(72.7%), but responded readily to Naloxone injection and subsided within 24 hours. It is considered that epidural injection of morphine and steroid prolong the effect and duration of pain relief for low back pain and sciatica when compared with the epidural injection of steroid and local anesthetics.
Anesthetics, Local ; Injections, Epidural ; Low Back Pain ; Morphine ; Naloxone ; Nausea ; Pruritus ; Sciatica ; Spinal Stenosis ; Spondylolisthesis ; Urinary Retention ; Vomiting

No abstract available in English.
Femur

Adenoid cystic carcinoma (ACC) of lacrimal gland is the most common epithelial neoplasms of the lacrimal gland. This highly invasive tumor disseminates hematogenously, but also infiltrates between tissue planes along nerves and blood vessels into the surrounding bone, represents low rate of the survival and difficult to cure. We experienced the case of a 41-year-old woman who had complained pain and downward displacement of the right eye. These symptoms had been occured 5 months ago. The MRI and the histopathologic findings revealed adenoid cystic carcinoma of the right lacrimal gland. We performed the lateral orbitotomy followed by macroscopical complete resection of tumors being different from radical therapy. The patient received 6.000 cGy of postoperative radiation for prevention of recurrence of tumor. While she has been treated from 9 months ago, there was no evidence of metastasis and recurrence, and we obtained good cosmetic results with our treatment modality. So we present our case with a brief review of the literature.
Adenoids* ; Adult ; Blood Vessels ; Carcinoma, Adenoid Cystic* ; Female ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Recurrence

We examined uncorrected visual acuity, surgically induced astigmatism and complications of 122 eyes underwent cataract surgery with implantation of the AMO Phacoflex SI-30NB. More than 80% of all cases showed uncorrected visual acuity better than 20/40. Temporal incision revealed less surgically induced astigmatism and faster rehabilitation than superior incision. Posterior capsular opacity was found in 14.8%, however Nd-YAG laser capsulotomy was performed in 2.5%. The incidences of contraction of capsular opening and displacement of intraocular lens were 4.9% and 4.1%, respectively. The range of displacement was within 1mm. Conclusively, cataract surgery with implantation of the AMO Phacoflex SI-30NB through clear corneal incision of 3.2mm revealed a low incidence of complication and provided patients rapid visual rehabilitation.
Astigmatism ; Cataract ; Humans ; Incidence ; Lasers, Solid-State ; Lenses, Intraocular ; Rehabilitation ; Silicones* ; Visual Acuity

From September 1987 to June 1994, the authors had performed posterolateral fusion in one patient, anterior spinal fusion alone in four patients, anterior spinal fusion after posterior augmentation with Rectangle Luque and posterolateral fusion in four patients of tuberculosis of the lumbosacral junction. The purpose of this study was evaluated the reliability of the posterior augmentation with Rectangle Luque and posterolateral fusion. We divided into two groups: the study group was anterior spinal fusion after posterior augmentation with Rectangle Luque in four patients, the control group was anterior spinal fusion alone in four patients. The average follow up was obtained at 16 months(12 to 20 months) in study group, at 42.7 months in control group. Results were as follows: 1. Clinical results according to Moskowitz criteria were 2 patients with grade I. 2 patients with grade II in the study group; one patient with grade I, one patient with grade II, one patient with grade III, one patient with grade IV in the control group. Hypolordosis(less than 10 degree) at the lumbosacral junction was associated with a higher incidence of back pain. 2. Radiographically well consolidated anterior fusion was noted in all patients within average 6 months (5-7 months) in the study group and 7.2 months (5-10 months) in the control group. 3. Radiologically the lumbosacral saggital angle was corrected after operation and the mean angle was 16.5 degrees(12 to 20 degrees) in the study group, 7.2 degrees(3 to 20 degrees) in the control group. The mean loss of angular correction was 5 degrees(1 to 8 degrees) in the study group, 6.2 degrees(1 to 13 degrees) in the control group at postoperative one year follow up. In conclusion, this results suggest that the anterior spinal fusion concomitant with the posterior augmentation with Rectangle Luque is the recommendable methods for tuberculosis of the lumbosacral junction in adults.
Adult ; Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Spinal Fusion ; Tuberculosis

The Graf system has supposed advantages with its flexible nature, as compared with rigid fixation. But there have been no reports about effects in the adjacent motion segment after soft stabilization. The purpose of this study was to evaluate the radiologic changes occuring in the adjacent segments of the Graf system and to assess its ability stabilizing the lumbar spine. A retrospective review of radiographs and medical records was undertaken in 32 cases who had been treated with the Graf system in degenerative lumbar spinal disorders. The average age at operation was 52.5 years and the average follow up period was 49.6 months. The results of this study were as follows: clinical assesments based on the Kirkaldy-Willis criteria revealed excellent in 13 cases (40.6%), good in 16 cases (50%), fair in 2 cases (6.3%) and poor in 1 case (3.1%). Radiologically we analysed the adjacent segments in 25 cases except the cases which did not have the correspondence between the clinical findings and the radiological findings, and the fixated segments in 32 cases. The acceleration of degenerative changes were found in the above adjacent segments in 11 cases (44%) and in the below adjacent segments in 5 cases (27.7%). Also, those changes were found in the fixated segments with discectomy in 19 cases (50%) and in the fixated segments without discectomy in 9 cases (37.5%). In conclusion, we think that the Graf system in a lumbar region may biomechanically influence the adjacent segments. The mechanical effects of the device could be changed by the polyester bands which were followed for a longer period of time in the fixated segments. Therefore, randomized prospective studies comparing the Graf system to other treatement methods could provide clear indications for lumbar spinal disorders.
Acceleration ; Diskectomy ; Equidae ; Follow-Up Studies ; Lumbosacral Region ; Medical Records ; Polyesters ; Retrospective Studies ; Spine

Although there are various methods of operative treatment for hony mallet finger, the operative technique is not so easy and complications such as joint stiffness, sott tissue prohlems, infection, change of nail shape and arthrosis are common. The authors performed operations for 26 cases of hony mallet fingers, fixing the hony frapment by Kirschner wire, pull-out wire suture and miniscrew respectively, from Jan. l988 to Jun. l996. The results were as follows. l. According to Niechajev's classification. there were 3 cases of type B, 7 cases of type C, l4 cases of type D, and 2 cases of type E. And 11 cases were accompanied hy crushing injury. 2. Involved fingers were third finger in 11cases, fit'th finger in 7 cases, fourth finger in 5 cases, second finger in 2 cases. and thumb in I case. 3. The hony mallet finger was caused hy occupational injury in l6 cases, direct blow in 7 cases and sports injury in 3 cases. 4. The fractured fragment was fixed hy Kirschner wire in 9 cases, by pull-out suture in 9 cases and by miniscrew in 8 cases. 5. The results were evaluated hy Kanies scale. Sixteen cases had satisfactory results. Seven cases (87.5%) were satisfactory in miniscrew fixations. 5 cascs (55.6%) in pull-out wire suture methocls and 2 cases (22.2%) in Kirschner wire tixations. 6. The complications were joint incongruity in 4 cases, dorsal prominece in 6 cases, painful limitation of motion in 2 cases which were treated by arthrodesis, pin site infection in 2 cases and hreakage of wire suture in 1 case. 7. The miniscrew fixation offered relatively firm fixation, low complication rate, and good results. so it can be considered as one of the good methods of treatment for hony mallet finger.
Arthrodesis ; Athletic Injuries ; Classification ; Fingers* ; Joints ; Occupational Injuries ; Sutures ; Thumb