No abstract available.
Bronchi* ; Carcinoma, Mucoepidermoid*

PURPOSE: The purpose of this study was to evaluate the visual outcomes and complications of unilateral scleral fixation of posterior chamber intraocular lenses (SF-PCIOLs) in pediatric complicated traumatic cataracts without capsular support. METHODS: This study involved five eyes of five children who underwent unilateral SF-PCIOL. All patients had a unilateral complicated traumatic cataract associated with anterior or posterior segment injury. Visual acuity (VA), IOL position, and postoperative complications were assessed during follow-up. RESULTS: The mean age of patients at the time of SF-PCIOL was 90 months (range, 66-115). The mean duration of follow-up time after surgery was 22 months (range, 5-55). In all patients, the best-corrected VA was either improved or was stable at last follow-up following SF-PCIOL implantation. There were no serious complications. CONCLUSIONS: Unilateral scleral fixation of PCIOL can be a safe and effective procedure for pediatric, unilateral, complicated traumatic cataracts without capsular support in selected cases.
Anterior Eye Segment/injuries ; Aphakia, Postcataract/*surgery ; Cataract/*etiology/physiopathology ; Child ; Child, Preschool ; Endophthalmitis/etiology ; Eye Injuries/*complications ; Female ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular/*methods ; Male ; Postoperative Period ; Retrospective Studies ; Sclera/*surgery ; *Suture Techniques ; Visual Acuity

A biliary web is a rare lesion, which may produce an extrahepatic biliary obstruction. Even though congenital in nature, they usually present later in life, due to their initial patency, which allows bile drainage from the liver. Herein, a case of an operation on an isolated mucosal web of the common hepatic duct, in a 45 years old male, is presented.
Bile ; Bile Ducts, Extrahepatic ; Drainage ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive ; Liver ; Male ; Middle Aged

The authors experienced a case of cystic cerebellar astrocytoma which showed sudden respiratory arrest after an uneventful operation. Preoperative cerebrospinal fluid diversion was not performed despite moderate hydrocephalus because we thought that complete removal of tumor enables the cerebrospinal fluid pathway to be reconstitute. After full awakening from anesthesia postoperatively, the patient's mentality deteriorated again rapidly with sudden respiratory arrest. Brain CT scan taken immediately after revealed no specific finding except moderate hydrocephalus which was the same degree as the preoperative one. This hydrocephalus was alleviated and the patient recovered slowly. We postulate several pathogenic mechanisms for this unusual event. First, chronic compression of fourth ventricle resulted in marked subependymal gliosis and obliteration of outlets of fourth ventricle. Therefore, postoperative reaccumlation of cerebrospinal fluid in ventricles caused serious pressure effect on the lower brain stem with resultant sudden respiratory arrest. Second, sudden decompression of brain stem might induce marked hemodynamic change in the brain stem. Third, there was some traction injury to brain stem by gravity in the sitting position. We suggest that preoperative cerebrospinal fluid diversion and its adeqaute postoperative maintenance is important in posterior fossa tumor surgery in cases with obliteration of perimesencephalic cistern and fourth ventricle, and with brain stem compression or angulation in preoperative magnetic resonance images.
Anesthesia ; Astrocytoma* ; Brain ; Brain Stem ; Cerebrospinal Fluid ; Decompression ; Fourth Ventricle ; Glioma, Subependymal ; Gravitation ; Hemodynamics ; Humans ; Hydrocephalus ; Infratentorial Neoplasms ; Tomography, X-Ray Computed ; Traction

The authors have operated on fifteen cases of intracranial arachnoid cyst during the last 4 years. Among them, eleven cases of middle cranial fossa arachnoid cyst have undergone uniformly cystoperitoneal shunt. The craniotomy and fenestration(open surgery) was performed in three cases which located in quadrigeminal cistern(1 case) and harvored other combined problems(2 cases, intracystic hemorrhage and exophthalmos due to defect of lateral orbital wall respectively). A case of intraventricular arachnoid cyst was managed by ventriculocystostomy. All of above procedures showed good clinical and radiological results with acceptable morbidity and no mortality. With these observation, we thought as follows : 1) In middle cranial fossa cysts, cystoperitoneal shunt is sufficient as the first choice of operative intervention because it revealed good results with low morbidity and negligible complications. 2) Open surgery seems to be indicated only in deep seated cyst around brainsterm where the introduction of shunt catheter is difficult and dangerous and in cyst combinind other problems necessitating surgical intervation also.
Arachnoid ; Arachnoid Cysts* ; Catheters ; Cranial Fossa, Middle ; Craniotomy ; Exophthalmos ; Hemorrhage ; Mortality ; Orbit

BACKGROUND AND PURPOSE: At least 100 Ryanodine receptor type 1 (RYR1) mutations associated with malignant hyperthermia (MH) and central core disease (CCD) have been identified, but 2 RYR1 mutations accompanying multiminicore myopathy in an MH and/or CCD family have been reported only rarely. METHODS: Fifty-three members of a large MH family were investigated with clinical, histopathologic, RYR1 mutation, and haplotyping studies. Blood creatine kinase (CK) and myoglobin levels were also measured where possible. RESULTS: Sequencing of the entire RYR1 coding region identified a double RYR1 mutation (R2435H and A4295V) in MH/CCD regions 2 and 3. Haplotyping analysis revealed that the two missense heterozygous mutations (c.7304G>A and c.12891C>T) were always present on a common haplotype allele, and were closely cosegregated with histological multiminicores and elevated serum CK. All the subjects with the double mutation showed elevated serum CK and myoglobin, and the obtained muscle biopsy samples showed multiminicore lesions, but only two family members presented a late-onset, slowly progressive myopathy. CONCLUSIONS: We found multiminicore myopathy with clinical and histological variability in a large MH family with an unusual double RYR1 mutation, including a typical CCD-causing known mutant. These results suggest that multiminicore lesions are associated with the presence of more than two mutations in the RYR1 gene.
Alleles ; Biopsy ; Clinical Coding ; Creatine Kinase ; Haplotypes ; Humans ; Malignant Hyperthermia ; Muscles ; Muscular Diseases ; Myoglobin ; Myopathies, Structural, Congenital ; Myopathy, Central Core ; Ophthalmoplegia ; Ryanodine ; Ryanodine Receptor Calcium Release Channel

PURPOSE: To assess the methods for the clinical evaluation of the longitudinal bone changes after implantation of tooth ash-plaster mixture into the defect area of human jaws. MATERIALS AND METHODS: Tooth ash-plaster mixtures were implanted into the defects of 8 human jaws. 48 intraoral radiograms taken with copper step wedge as reference at soon, 1st, 2nd, 4th, and 6th week after implantation of mixture were used. X-ray taking was standardized by using Rinn XCP device customized directly to the individual dentition with resin bite block. The images inputted by Quick scanner were digitized and analyzed by NIH image program. Cu-equivalent values were measured at the implanted sites from the periodic digital images. Analysis was performed by the bidirectional subtraction with color enhancement and the surface plot of resliced contiguous image. The obtained results by the two methods were compared with Cu-equivalent value changes. RESULTS: The average determination coefficient of Cu-equivalent equations was 0.9988 and the coefficient of variation of measured Cu values ranged from 0.08 ~ 0.10. The coefficient of variation of Cu-equivalent values measured at the areas of the mixture and the bone by the conversion equation ranged from 0.06 ~0.09. The analyzed results by the bidirectional subtraction with color enhancement were coincident with the changes of Cu-equivalent values. The surface plot of the resliced contiguous image showed the three dimensional view of the longitudinal bone changes on one image and also coincident with Cu-equivalent value changes after implantation. CONCLUSION: The bidirectional subtraction with color enhancement and the surface plot of the resliced contiguous image was very effective and reasonable to analyze clinically and qualitatively the longitudinal bone change. These methods are expected to be applicable to the non-destructive test in other fields.
Copper ; Dentition ; Humans ; Jaw ; Radiography* ; Tooth*

A case of chronic epidural hematoma in the left frontal region is presented. The patient presented with a unique neurologic sign, exophthalmos, which was not a result of the injury but of in-growth of granulation tissue of the hematoma capsule into the orbit through the orbital roof defect. The time interval between head injury and the operation was about 25 years. Our case represent the second most longest time interval among the reviewed literatures.
Craniocerebral Trauma ; Exophthalmos* ; Granulation Tissue ; Hematoma* ; Humans ; Neurologic Manifestations ; Orbit

Sometimes physicians and clinical pathologists find very high levels of alkaline phosphatase (ALP) activity in their patients. This condition is associated with transient, marked increase in serum ALP in healthy infants and children. It has also been described in adults. Clinical and biochemical features of transient hyperphosphatasemia in infancy and early childhood are reviewed in six patients that we have studied. The diagnosis is suggested by findings of increased activity of alkaline phosphatase in plasma, typically more than fivefold the upper reference value for adult, in a child under five years of age, without evidence of liver or bone disease. The condition is confirmed by the presence of a characteristic pattern of alkaline phosphatase isoenzymes and by the normalization of enzyme activity in plasma within approximately six months after the original observation. The etiology of the condition and possible mechanism of the elevated ALP is discussed.
Adult ; Alkaline Phosphatase ; Bone Diseases ; Child ; Diagnosis ; Humans ; Infant ; Isoenzymes ; Liver ; Plasma ; Reference Values

The traffic accident was one of most common cause for the facial bone fracture. When it involved the midfacial structures, the nasal bone fracture was usually shown. If the reduction was not done in time, it would result in facial deformity. Simple case could be corrected by simple rhinoplasty. However, severe cases would require more invasive technique. We used triangular osteotomy included the nasal bones, the vomer, and the medial wall of maxilla for the correction of post-traumatic nasal deformity and reported the result with the review of literatures.
Accidents, Traffic ; Congenital Abnormalities* ; Facial Bones ; Maxilla ; Nasal Bone ; Osteotomy* ; Rhinoplasty ; Vomer