PURPOSE: To evaluate the effectiveness of amniotic membrane transplantation and adjunctive mitomycin C in the treatment of symblepharon. METHODS: Amniotic membrane transplantation was performed and adjunctive mitomycin C was applied in 7 patients with symblepharon, resulting from various causes. Mitomycin C soaking (0.02%, 5 minutes) was used intraoperatively followed by meticulous dissection of adherent tissue. Next, amniotic membrane transplantation was done with 2 layers of removed conjunctival tissue and a silicone band bolster was applied to the reconstructed fornix. Evaluating factors were the depth of reconstructed fornix, limitation of eyeball movement, recurrence and presence of complication. These factors were checked at the last visit. RESULTS: Mean follow-up period was 9.0 x +/-A 4.54 months and all patients showed reconstructed fornix. Six patients showed successful outcome (depth of fornix >or=8 mm) and one patient showed 6 mm of forniceal depth and mild limitation of gaze. CONCLUSIONS: Treatment of symblepharon by amniotic membrane transplantation and adjunctive mitomycin C administration can reduce the recurrence rate of symblepharon without complication.

Most of intradural epidermoid cyst arise as slowly growing extraaxial lesions but purely intracerebral epidermoid cysts are rare. A 39-year-old female presented with a headache during several months. Brain computed tomography (CT) scan showed a mass lesion in the both frontal lobe with heterogenous density approximately 5x5cm in size. Magnetic resonance imaging (MRI) revealed a mass of heterogenous signal intensity on T1, T2-weighted image and faint enhancement with gadolinium (Gd). Through the both interhemispheric approach, mass was removed subtotally except the calcified portion tightly attached to the corpus callosum. The patient discharged without neurological deficit. The authors report a case of epidermoid cyst in the corpus callosum and discuss the pathogenesis of the intraparenchymal epidermoid cyst.
Adult ; Brain ; Corpus Callosum* ; Epidermal Cyst* ; Female ; Frontal Lobe ; Gadolinium ; Headache ; Humans ; Magnetic Resonance Imaging

OBJECTIVE: The postoperative subsidence of anterior cervical interbody fusion for cervical degenerative diseases gives rise to segmental kyphotic collapse, screw loosening, and chronic neck pain. So, intraoperative custom-made polymethylmethacrylate (PMMA) C-cage has been developed to prevent subsidence following anterior cervical fusion. METHODS: A total of patients who underwent anterior cervical interbody fusion with a intraoperative custom - made cervical cage filled with local bone and demineralized bone matrix (group A) were analyzed prospectively from June 2004 to June 2005. These were compared with 40 patients who were treated with iliac bone graft (group B). We evaluated subsidence ratio, change of segmental angle, distraction length and segmental angle. Statistical analysis was performed using independent sample t-test and Pearson correlation coefficient. RESULTS: Group A had a statistically significant decrease in subsidence ratio (0.64+/-0.43%, p=0.00), distraction length (2.42+/-1.25 mm, p=0.02), and follow angle change (1.78+/-1.69degrees, p=0.01) as compared with Group B. However, there was no statistically significant difference in postoperative segmental angle change (p=0.66). On the analysis of the correlation coefficient, the parameters showed no interrelationships in the group A. On the other hand, subsidence ratio was affected by distraction length in the group B (Pearson correlation=0.448). CONCLUSION: This operative technique would be contributed for the reduction of a postoperative subsidence after the anterior cervical interbody fusion procedure for cervical disc disease with moderate to severe osteoporotic condition and segmental loss of lordosis.
Animals ; Bone Matrix ; Hand ; Humans ; Lordosis ; Neck Pain ; Polymethyl Methacrylate ; Prospective Studies ; Transplants

No abstract available.
Amyloidosis* ; Heart* ; Stem Cell Transplantation* ; Stem Cells*

PURPOSE: To evaluate the clinical effect of endonasal dacryocystorhinostomy as a primary treatment of acute dacryocystitis with lacrimal sac abscess formation. METHODS: The study comprised 14 patients with acute dacryocystitis and lacrimal sac abscess formation who underwent endonasal dacryocystorhinostomy as a primary treatment. Postoperative evaluations included symptoms of acute dacryocystitis, physical examination, and lacrimal irrigation. Success was defined as the absence of epiphora and good lacrimal irrigation at the last follow-up. RESULTS Of the patients, two were male and twelve were female. The mean age was 54.7 years and mean follow-up period was 8.3 months. Resolution of symptoms and signs of acute dacryocystitis occurred in all patients. In one patient, recurrence of acute dacryocystitis occurred 6 months after surgery. At last follow-up, epiphora and failure of lacrimal irrigation had developed in two patients. CONCLUSIONS: Endonasal dacryocystorhinostomy is considered a safe and effective primary treatment of acute dacryocystitis with lacrimal sac abscess formation.
Abscess ; Dacryocystitis* ; Dacryocystorhinostomy* ; Female ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases ; Male ; Physical Examination ; Recurrence

PURPOSE: To predict the surgical outcome of esotropia by considering the axial length of the functional equator in addition to the preoperative deviation angle. METHODS: Forty patients with partially accommodative esotropia or infantile esotropia who had received bilateral medial rectus muscle recession were studied for axial length of the functional equator in addition to the preoperative near deviation angle. Patients were followed for more than 12 months. All patients were checked for near and far deviation angles at postoperative 1 week, 1 month, 6 months and 12 months. RESULTS Seventeen of the 40 patients had partially accommodative esotropia and 23 had infantile esotropia. The overall mean age was 4.1 years and the mean follow-up period was 14.1 months (12-18 months). Preoperative near and far deviation angles were respectively 30.6+/-8.1PD and 25.6+/-12.2PD in partially accommodative esotropia patients and 44.9+/-11.7PD and 43.1+/-13.5PD in infantile esotropia patients. The amount of mean medial rectus muscle recession was 5.15+/-0.87 mm in the former group and 6.26+/-1.12 mm in the latter. At the postoperative 12-month follow-up, 20 (86.9%) partially accommodative esotropia patients showed successful outcomes and 3 (13.1%) had under correction; the outcome was successful in 15 (88.2%) infantile esotropia patients while 2 (11.8%) showed under correction. CONCLUSIONS: A successful outcome was achieved in patients with partially accommodative esotropia and infantile esotropia with consideration of the functional equator.
Esotropia* ; Follow-Up Studies ; Humans

PURPOSE: To predict the surgical outcome of esotropia by considering the axial length of the functional equator in addition to the preoperative deviation angle. METHODS: Forty patients with partially accommodative esotropia or infantile esotropia who had received bilateral medial rectus muscle recession were studied for axial length of the functional equator in addition to the preoperative near deviation angle. Patients were followed for more than 12 months. All patients were checked for near and far deviation angles at postoperative 1 week, 1 month, 6 months and 12 months. RESULTS Seventeen of the 40 patients had partially accommodative esotropia and 23 had infantile esotropia. The overall mean age was 4.1 years and the mean follow-up period was 14.1 months (12-18 months). Preoperative near and far deviation angles were respectively 30.6+/-8.1PD and 25.6+/-12.2PD in partially accommodative esotropia patients and 44.9+/-11.7PD and 43.1+/-13.5PD in infantile esotropia patients. The amount of mean medial rectus muscle recession was 5.15+/-0.87 mm in the former group and 6.26+/-1.12 mm in the latter. At the postoperative 12-month follow-up, 20 (86.9%) partially accommodative esotropia patients showed successful outcomes and 3 (13.1%) had under correction; the outcome was successful in 15 (88.2%) infantile esotropia patients while 2 (11.8%) showed under correction. CONCLUSIONS: A successful outcome was achieved in patients with partially accommodative esotropia and infantile esotropia with consideration of the functional equator.
Esotropia* ; Follow-Up Studies ; Humans

PURPOSE: To report a case of candida infection after Medpor(R) orbital implantation. METHODS: A 51-year-old man was admitted complaining of painful swelling and discharge about 3 years after orbital Medpor(R) implantation. External examination revealed signs of infection and exposure of the implant. Medpor(R) was surgically removed. In laboratory studies, white colony was detected in blood agar, potato dextrose agar, and CHROMagar. Automatic identification with yeast standard test revealed Candida parapsilosis. RESULTS: Six months after surgery, the wound had healed well. In addition, cosmesis was acceptable with the artificial eye, except mild superior sulcus deformity. CONCLUSIONS: Although rare, fungal infection of the implant should be suspected when there are the long standing signs of infection and exposure after orbital Medpor(R) implantation.
Agar ; Candida* ; Congenital Abnormalities ; Eye, Artificial ; Glucose ; Humans ; Middle Aged ; Orbit* ; Orbital Implants* ; Polyethylene* ; Solanum tuberosum ; Wounds and Injuries ; Yeasts

OBJECTIVE: To compare the second and third cesarean section by clinical and statistical analysis. METHODS: From June 1993 to February 1997, we experienced 296 cases of the third cesarean section and 541 cases of the second cesarean section. We analyzed their incidence, age distribution, gestational week at operation, weight distribution of baby at birth, hemoglobin change, estimated blood loss during operation, obstetrical complication, combined operation, and degree of pelvic adhesion, presence of wound dehisence of uterus, post operative complication. RESULTS: Of the total deliveries, overall incidence of cesarean section was 51.4%, while the incidence of the second cesarean section was 16.0%, and that of the third cesarean section was 1.1%. In the third cesarean section the age group of 31-35 was most common(49.7%), and the most common gestational week at operation was 39th week(43.9%). In the third cesarean section, the hemoglobin change of 1.0g% less was most common(95.2%), and the most common amount of estimated blood loss was 400-600ml(61.0%). There was statistically significant difference of the blood transfusion rate between the third cesarean section(41 cases, 13.8%, p=0.04) and second cesarean section(27 cases, 5.0%). The most common combined operation in the third cesarean section was tubal ligation(51.7%), and the others were bladder wall repair(2.0%), cesarean hysterectomy(1.7%). In the third cesarean section, the incidence of mild intraabdominal adhesion was 16. 9% and that of severe adhesion was 11.8%. It was statistically significant compared to the second cesarean section. Among the complications of the third cesarean section, there were 9 cases of placenta accreta(3.0%), 4 cases of placenta previa totalis(1.4%), and 1 case of uterine rupture, uterine atony, uterine arterial rupture(0.3% each other), and did not proved statistical significance. CONCLUSION: In this study, we found that the rate of blood transfusion, cesarean hysterectomy, bladder wall repair, and the degree of intraabdominal adhesion were more common in the third cesarean section than second section. But, if pre- & postoperative management is adequate, maternal mobidity and neonatal mobidity is not affected.
Age Distribution ; Blood Transfusion ; Cesarean Section* ; Female ; Humans ; Hysterectomy ; Incidence ; Parturition ; Placenta ; Placenta Previa ; Pregnancy ; Urinary Bladder ; Uterine Inertia ; Uterine Rupture ; Uterus ; Wounds and Injuries

BACKGROUND: The rectum is a relatively uncommon site for lymphoma compared with other gastrointestinal sites; no consensus regarding management of primary rectal lymphoma (PRL) has been formed due to its limited frequency. We aimed to investigate clinical characteristics and treatment outcomes in patients with PRL in a single center patient cohort. METHODS: We retrospectively analyzed the results of 16 consecutive patients with PRL, identified and treated at the Asan Medical Center, Seoul, Korea between January 1993 and December 2014. RESULTS: These 16 patients with PRL constituted 0.8% of all non-Hodgkin's lymphoma patients (N=1,984). B-cell lymphomas (N=14) made up the majority of the series, and half of these were extranodal marginal zone lymphomas (ENMZL, N=7). Ten patients received systemic chemotherapy with (N=3) or without rituximab (N=7), and 4 of these received additional local therapy. The others received radiotherapy (N=3) or endoscopic mucosal resection (N=3). Twelve patients (75%) achieved complete response (CR) after first-line treatment. Event-free survival (EFS) and overall survival (OS) in stages IE and IIE were significantly longer compared with stages IVE (P=0.001 and P=0.001, respectively). All patients with ENMZL (N=7) achieved CR during or after initial treatment. CONCLUSION: PRL is very rare and seems to present mostly as B-cell type. Stage is the most important prognostic factor, with significantly better survival associated with localized diseases. ENMZL may be one of the most common types of PRL with favorable treatment outcomes.
B-Lymphocytes ; Chungcheongnam-do ; Cohort Studies ; Consensus ; Disease-Free Survival ; Drug Therapy ; Humans ; Korea ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Prognosis ; Radiotherapy ; Rectum ; Retrospective Studies ; Rituximab ; Seoul