No abstract available.
Fractures, Spontaneous*

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

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 evaluated the effectiveness of photoastigmatic refractive Keratectomy(PARK) by excimer laser on patients with compound myopic astigmatism. Spherocylindrical PARK was performed on 181 myopic eyes with astigmatism(mean spherical equivalent : -6.61 D, range : -1.88~-14.5 D) using the visx excimer laser. The eyes were divided into three groups according to the amount of desired astigmatic correction : Group 1(-0.5~-1.0 D), Group 2(-1.25~3.0 D), and Group 3(-3.25~-5.5 D). Patients were followed up for 6 months. Uncorrected visual acuity at postoperative 6 month, was 0.80+/-0.27 in Group 1, 0.79+/-0.19 and 0.71+/-0.21bin Group 2 and 3 respectively. The mean spherical equivalent refraction was -0.24 D 6 months after PARK. Mean astigmatism was reduced from preoperative -0.85+/-0.51 D to postoperative -0.34+/-0.38 D in Group 1, from -2.08+/-0.65 D to -0.43+/-0.64 D and from -4.42+/-0.63 D to -1.23+/-1.25 D in Group 2 and 3 respectively. We also analyzed the angle of error, magnitude of error, index of success, and coefficient of afjustment by vector analysis. No significant complications were observed during the follow-up period. These results show that PARK by excimer laser was effective in correction of astigmatism. The effect of astigmatic correction in Group 2 and 3 were better than that of Group 1. Group 1 showed overcorrected tendency and Group 2 and 3 showed undercorrected tendency.
Astigmatism ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Visual Acuity

We evaluated the effectiveness of photoastigmatic refractive Keratectomy(PARK) by excimer laser on patients with compound myopic astigmatism. Spherocylindrical PARK was performed on 181 myopic eyes with astigmatism(mean spherical equivalent : -6.61 D, range : -1.88~-14.5 D) using the visx excimer laser. The eyes were divided into three groups according to the amount of desired astigmatic correction : Group 1(-0.5~-1.0 D), Group 2(-1.25~3.0 D), and Group 3(-3.25~-5.5 D). Patients were followed up for 6 months. Uncorrected visual acuity at postoperative 6 month, was 0.80+/-0.27 in Group 1, 0.79+/-0.19 and 0.71+/-0.21bin Group 2 and 3 respectively. The mean spherical equivalent refraction was -0.24 D 6 months after PARK. Mean astigmatism was reduced from preoperative -0.85+/-0.51 D to postoperative -0.34+/-0.38 D in Group 1, from -2.08+/-0.65 D to -0.43+/-0.64 D and from -4.42+/-0.63 D to -1.23+/-1.25 D in Group 2 and 3 respectively. We also analyzed the angle of error, magnitude of error, index of success, and coefficient of afjustment by vector analysis. No significant complications were observed during the follow-up period. These results show that PARK by excimer laser was effective in correction of astigmatism. The effect of astigmatic correction in Group 2 and 3 were better than that of Group 1. Group 1 showed overcorrected tendency and Group 2 and 3 showed undercorrected tendency.
Astigmatism ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Visual Acuity

To evaluate the efficacy of optimizing of A-constant, the error in prediction was analyzed in three groups of eyes after posterior chamber lens implantation ; 102 eyes with bag placed, 66 eyes with simple sulcus places, and 25 eyes with sulcus placed with transscleral fixation suture. We compared the predictive accuracy of the SRK/T formula using optimized A-constant (bag-placed, sulcus-placed) derived from the 300 eyes with Holladay and SRK/T using original surgeon factor and A-constant. The SRK/T formula with optimized A-constant has a better mean relative, absolut, and standard error and has a better range of IOL prediction error, which was more accurate than other formulas without optimizing. In this study it is our recommendation that each surgeon use a different optimized A-constants for sulcus or bag placement to enhance the predictability of the postoperative refraction.
Sutures

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

Rhabdomyosarcoma is a highly aggressive and the most common soft tissue sarcoma in children. Sites of involvement include the orbit, the nose, the paranasal sinuses, the oropharynx, soft tissue, the nasopharynx, and the external ear or mastoid; however, the nasal vestibule, in particular, is an uncommon site. Rhabdomyosarcoma in the nasal vestibule has been reported in only one case in the literature so far and has never been reported in Korea. We experienced a case of embryonal rhabdomyosarcoma of the nasal vestibule which was managed with total excision of tumor mass and chemotherapy. We report the case and discuss the therapy and management of this unusual problem.
Child ; Drug Therapy ; Ear, External ; Humans ; Korea ; Mastoid ; Nasopharynx ; Nose ; Orbit ; Oropharynx ; Paranasal Sinuses ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal ; Sarcoma

A 45-Year-old para 1-0-1-1 had submucosal myoma diagnosed by ultrasonogram and hysteroscopic examination. During 60 minutes hysteroscopic myomectomy, 8,000 ml of sorbitol-mannitol distention medium was used and 6,500 ml collected, resulting in a deficit of 1,500 ml. The patient received Ringer`s lactate 1,000 ml intravenously. Her urine output was 400 ml. Blood loss was 40 ml. After operation, hyponatremia(115 mEq/L) was developed and pulmonary edema was also diagnosed clinically at that time and later confirmed by chest radiograph. The judicious administration of diuretics and normal saline fluid replacement to prevent overcorrection to hypernatremia resulted in return of serum electrolytes to normal level and resolution of the pulmonary edema by postoperative day 1. We have experienced a case of pulmonary edema during hysteroscopic myomectomy with sorbitol-mannitol distention medium, which is presented with a brief review of literatures.
Diuretics ; Electrolytes ; Humans ; Hypernatremia ; Hyponatremia ; Lactic Acid ; Middle Aged ; Myoma ; Pulmonary Edema* ; Radiography, Thoracic ; Ultrasonography

Basaloid squamous cell carcinoma (BSCC), an uncommon tumor with predilection for the upper aerodigestive tract, is a distinct variant of squamous cell carcinoma, because of its unique histological features and ominous clinical behavior. Basaloid squamous cell carcinoma is a high-grade variant of squamous cell carcinoma. Reports subsequent to its initial description in 1986 by Wain et al. have confirmed that the head and neck region is the most frequently involved region, with majority of the cases arising in the supraglottic larynx, hypopharynx, tonsil and base of tongue. Other head and neck sites include the palate, buccal cavity, floor of mouth, nasopharynx, trachea, and sinonasal tract. BSCC is not limited to the head and neck region but has also been described in the esophagus, lung, thymus, anus and cervix among other sites. We experienced and treated a case of BSCC extended to the temporal bone with characteristic histopathologic and immunologic features. Therefore, we report here the rare case of BSCC invading the temporal bone with literature.
Anal Canal ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Esophagus ; Female ; Head ; Hypopharynx ; Larynx ; Lung ; Mouth Floor ; Nasopharynx ; Neck ; Palate ; Palatine Tonsil ; Temporal Bone* ; Thymus Gland ; Tongue ; Trachea