A case of Osteogenic sarcoma arised from orbit 4 years after the radiation therapy for retinoblastoma in a 9 years old girl is presented. 4 Years ago, under the diagnosis of retinoblastoma, the left orbital exenteration was performed and was treated with x-ray radiation giving 4.500 gamma tumor dose in 4, weeks. On admission, the left orbital cavity was filled with hard mass and orbital bone revealed extensive destruction with osteoplastic changes on x-ray, and diffuse sarcomatous growth of anaplastic cells with abundant osteogenesis and osteoclastic activity microscopically. It is of authors' opinion that osteogenic sarcoma of orbital bone in this presented case might developed by irradition on retinoblastoma.
Child ; Diagnosis ; Female ; Humans ; Orbit ; Osteoclasts ; Osteogenesis ; Osteosarcoma* ; Retinoblastoma*

BACKGROUNDING/AIMS: It has been nearly established that liver resection for colorectal metastases is a relatively safe procedure with survival benefit to patients. This study was performed to evaluate if the liver resection for colorectal metastases is effective method and to determine the appropriate therapeutic modality. METHODS: Between January 1995 and January 1999, sixteen patients who had liver resectin for metastatic colorectal carcinoma at our hospital were analyzed retrospectively. RESULTS: Wedge resection was performed in 7 patients, segmentectomy in 3 patients, and lobectomy in 6 patients. The median survival time was 26 months and cumulative 1 and 4-year survival rate were 83.1% and 34.6%, respectively. Extent of hepatic resection had marginally influenced the survival(p=0.0514). No prognostic factor was related significantly to survival. Recurrence in remaining liver following the anatomical liver resection was significantly low compared with wedge resection( 12.5% vs. 71.5%, p=0.035). CONCLUSION: Liver resection is an effective and safe treatment for colorectal liver metastases. The anatomical liver resection decreased recurrence rate in the remnant liver. The curative resection with an adequate surgical margin will improve outcome.
Colorectal Neoplasms ; Humans ; Liver* ; Mastectomy, Segmental ; Neoplasm Metastasis* ; Recurrence ; Retrospective Studies ; Survival Rate

No abstract available.

BACKGROUND: To reduce surgical stress, fentanyl is frequently used for neurosurgical procedure where focal and/or global ischemia may occur. However, the effect of fentanyl on the cytokine level during ischemia/reperfusion is still uncertain. The goal of this study was to evaluate the effect of fentanyl infusion on the proinflammatory cytokine, TNF-alpha and IL-1beta, levels during global cerebral ischemia/reperfusion (I/R) in rats using the intracerebral microdialysis technique. METHODS: Forty male S-D rats weighing 280 320 g were randomly assigned to four groups. Group 1: no fentanyl infusion and only I/R, Group 2: 1.5 ng/ml of fentanyl infusion during I/R, Group 3: 3.0 ng/ml of fentanyl infusion during I/R (n = 10 in each group). Rats were anesthetized with a intraperitoneal injection of pentobarbital (50 mg/kg), intubated and ventilated with room air using an animal ventilator. Two femoral arteries and one femoral vein were cannulated with PE-50 tubing for hemorrhagic hypotension, drug infusion and hydration. Both carotid arteries were dissected and a sling was placed for brain ischemia. The head was fixed on a stereotaxic device and a small burrhole was made for probe insertion. A CMA-12 probe was inserted into the left hippocampal CA-1 region according to the guidelines. Artificial CSF was run from the inserted microdialysis probe and infused with or without fentanyl at 3 microliter/min using a microinjection syringe pump during I/R. Ischemia was induced by clamping the carotid arteries while hemorrhagic hypotension for 17 min via the femoral artery and reperfusion were accomplished by the unclamping of the sling and reinfusing the blood via the femoral artery. Nasopharyngeal and rectal temperatures were maintained within the normal range during the whole procedure. After 2 hours of stabilization, the microdialysate was collected every 17 min just before (control) and during I/R and stored at 80oC until analysis using HPLC. RESULTS: During global I/R, TNF-alpha and IL-1 beta significantly increased at reperfusion (R5) compared to the control value (P < 0.05). However, in both cases of fentanyl infusion, TNF-alpha and IL-1 beta did not increase compared to the control value. CONCLUSIONS: Fentanyl inhibited the increase of proinflammatory cytokine TNF-alpha and IL-1 beta levels during global cerebral ischemia/reperfusion in rats.
Animals ; Brain Ischemia ; Carotid Arteries ; Chromatography, High Pressure Liquid ; Constriction ; Femoral Artery ; Femoral Vein ; Fentanyl* ; Head ; Humans ; Hypotension ; Injections, Intraperitoneal ; Interleukin-1beta ; Ischemia ; Male ; Microdialysis ; Microinjections ; Neurosurgical Procedures ; Pentobarbital ; Rats* ; Reference Values ; Reperfusion ; Syringes ; Tumor Necrosis Factor-alpha* ; Ventilators, Mechanical

PURPOSE: To make an optic nerve crush injury model and to investigate the neuroprotective effect of intravitreally injected ciliary neurotrophic factor (CNTF) on rat retinal ganglion cells (RGCs) in the model. METHODS: The optic nerves of 12 Sprague-Dawley rats were crushed at 3 mm posterior to the eyeball for 1 minute using aneurysm clip (110 g). Two micrograms of CNTF in 2 micro liter of vehicle was injected intravitreally in one group (n=6) and 2 micro liter of PBS was injected in the control group (n=6) at 4, 7, and 10 days after the optic nerve injury. After 2 weeks, the retrograde labeling of the RGCs was done by the dextran tetramethylrhodamine. Twenty-four hours after the labeling, the retina was wholly mounted and the labeled RGCs were counted under the fluorescence microscope. RESULTS: The death of RGCs in this model began at 1 week and continued for 3 weeks. The number of labeled RGCs in CNTF-injected group (510+/-139/mm2) were significantly higher than that in control group (345+/-87/mm2)(p<0.05). CONCLUSIONS: The optic nerve crush injury model was established by use of aneurysm clip. In this model, the intravitreally injected CNTF had a neuroprotective effect on the rat RGCs.
Aneurysm ; Animals ; Ciliary Neurotrophic Factor* ; Dextrans ; Fluorescence ; Neuroprotective Agents* ; Optic Nerve Injuries ; Optic Nerve* ; Rats* ; Rats, Sprague-Dawley ; Retina ; Retinal Ganglion Cells* ; Retinaldehyde*

BACKGROUND: To evaluate the prognostic factors of seizure recurrence in newly diagnosed epilepsy at 1 year follow up. METHODS: From the IUED (Inje University Epilepsy Database) we retrieved the epilepsy patients who had never before taken any antiepileptics (AED) and were followed up for 1 year. We retrospectively reviewed the medical records with special attention to : a) age of onset, b) history of antecedents, c) seizure frequency before starting AED, d) abnormal neurological examination, e) MRI findings, f) EEG findings, g) epileptic syndrome classification. We defined seizure recurrence as any seizure occurring during the 1 year evaluation follow up except during the AED titra-tion period, having only an aura and being in poor compliance. We analyzed the prognostic factors that could reliably predict the seizure recurrence at 1 year follow up. RESULTS: We found 104 patients (64 male, 40 female) who met the inclusion criteria. The mean age of onset was 23.7 years. Of 104 patients 19 had generalized epilepsy, 82 had partial epilepsy and 3 had unclassified epilepsy. Thirteen percent (13/104) developed seizure recurrence at the 1 year follow up. Significant univariate associations were noted between seizure recurrence and these factors: presence of antecedents [odds ratio (OR) 4.8; 95% confidence interval (CI) 1.2-18.5 ], post-encephalitic epilepsy (OR 7.7; 95% CI 2.1 ~ 28), and abnormal neurological examination(OR 14.6; 95% CI 3.9-55). With multivariate logistic regression, the independent predictor of seizure recurrence was the abnormal neurological examination (OR 9.7; 95% CI 2.4 ~ 39.4). CONCLUSIONS: The chance of developing a seizure recurrence at the 1 year follow up was 13 percent and the prognostic factors were the presence of antecedents, post-encephalitic epilepsy and an abnormal neurological examination.
Age of Onset ; Anticonvulsants ; Classification ; Compliance ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Generalized ; Follow-Up Studies ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Medical Records ; Neurologic Examination ; Recurrence* ; Retrospective Studies ; Seizures*

PROPOSE: There have been many debates about the ideal surgical technique for acute Achilles tendon rupture. The purpose of this study is to review and analyze the clinical outcome of the acute Achilles tendon ruptures that had been repaired by indirect suture technique with minimal incision that utilized an instrument called Achillon (Newdeal, France). MATERIALS AND METHODS: This study is based on the 14 cases (14 patients) of acute Achilles tendon total ruptures that have been repaired by minimal incision technique utilizing Achillon instrument from June 2003 to December 2004. Two cases were reruptured before 8 weeks and repaired again using Krackow suture which left 12 feet for postoperative functional evaluation with at least 6 months of follow-up. Ten cases were men and average age at time of injury was 34.4 (26-49) years. The time from injury to surgery was an average of 4.5 (1-9) days and the postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. The ability to return to original work and sports activities as well as patient satisfaction were also evaluated. RESULTS: The follow-up period was averaged for 13.2 (6-24) months. Seventy-one percent of cases were ruptured during sports activities. The ruptured level was the average of 5.1 cm (3.2-8 cm) above calcaneal attachment and the skin incision was averaged for 2.7 cm (2.5-3.0 cm) long. At final follow-up, standing on tip-toe was possible in all cases while the heel-floor height on ruptured side was shorter by 0.7 cm (0-2 cm). By Arner-Lindholm evaluation scale, 9 cases were excellent, and 3 cases were good. Overall AOFAS score was an average of 96.1 (94-100), and all patients were satisfied with the result. Patients returned to work at an average of 1.3 months after the surgery and pre-injury sports activities were all possible from at 6 months after operation. CONCLUSION: Since we have treated acute Achilles tendon ruptures with minimal incision technique utilizing the Achillon and gained encouraging functional results with all patients returning to previous work with high patient satisfaction, this technique could be recommended as one of the ideal surgical options for the Achilles tendon ruptures.
Achilles Tendon* ; Follow-Up Studies ; Foot ; Humans ; Male ; Patient Satisfaction ; Rupture* ; Skin ; Sports ; Suture Techniques ; Sutures

PROPOSE: There have been many debates about the ideal surgical technique for acute Achilles tendon rupture. The purpose of this study is to review and analyze the clinical outcome of the acute Achilles tendon ruptures that had been repaired by indirect suture technique with minimal incision that utilized an instrument called Achillon (Newdeal, France). MATERIALS AND METHODS: This study is based on the 14 cases (14 patients) of acute Achilles tendon total ruptures that have been repaired by minimal incision technique utilizing Achillon instrument from June 2003 to December 2004. Two cases were reruptured before 8 weeks and repaired again using Krackow suture which left 12 feet for postoperative functional evaluation with at least 6 months of follow-up. Ten cases were men and average age at time of injury was 34.4 (26-49) years. The time from injury to surgery was an average of 4.5 (1-9) days and the postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. The ability to return to original work and sports activities as well as patient satisfaction were also evaluated. RESULTS: The follow-up period was averaged for 13.2 (6-24) months. Seventy-one percent of cases were ruptured during sports activities. The ruptured level was the average of 5.1 cm (3.2-8 cm) above calcaneal attachment and the skin incision was averaged for 2.7 cm (2.5-3.0 cm) long. At final follow-up, standing on tip-toe was possible in all cases while the heel-floor height on ruptured side was shorter by 0.7 cm (0-2 cm). By Arner-Lindholm evaluation scale, 9 cases were excellent, and 3 cases were good. Overall AOFAS score was an average of 96.1 (94-100), and all patients were satisfied with the result. Patients returned to work at an average of 1.3 months after the surgery and pre-injury sports activities were all possible from at 6 months after operation. CONCLUSION: Since we have treated acute Achilles tendon ruptures with minimal incision technique utilizing the Achillon and gained encouraging functional results with all patients returning to previous work with high patient satisfaction, this technique could be recommended as one of the ideal surgical options for the Achilles tendon ruptures.
Achilles Tendon* ; Follow-Up Studies ; Foot ; Humans ; Male ; Patient Satisfaction ; Rupture* ; Skin ; Sports ; Suture Techniques ; Sutures

PURPOSE: To report the experience of treating chronic granulomatous canaliculitis induced by permanent silicone punctal plugs used for dry eye syndrome treatment. METHODS: The transformation of puncta below both eyes and secretions in the lacrimal duct were observed for a 56-year-old female patient who had attended hospital for 4 months due to epiphora and secretions. Under the diagnosis of lacrimal duct inflammation for the lower lacrimal duct of both eyes, three-snip punctoplasty, curettage in the lacrimal duct, and pathological examination on the part of the lacrimal duct obtained from the three-snip punctoplasty were carried out. RESULTS: The lacrimal silicone plugs were removed from the lacrimal duct at the time of the lacrimal duct curettage, and a diagnosis was made based on tissue biopsy of chronic granulomatous canaliculitis induced by permanent silicone punctal plugs. After the above surgical operations, the epiphora and the anterior eye segment symptom both disappeared. CONCLUSIONS: The permanent silicone punctal plug used to permanently close the lacrimal punctum scarcely causes disorder in the lacrimal drainage system with epiphora and inflammation by acting as a foreign substance. It therefore should only be used when essential.
Anterior Eye Segment ; Biopsy ; Curettage ; Diagnosis ; Drainage ; Dry Eye Syndromes ; Female ; Humans ; Inflammation ; Lacrimal Apparatus Diseases ; Middle Aged ; Silicones* ; Canaliculitis

We have performed photorefractive keratectomy(PRK) and Laser In situ keratomileusis(LASIK) to compare the clinical results of PRK with that of LASIK in moderate myopes retrospectively. Of 70 eyes who were between -4.0 diopter and -8.0 diopter, there were 40 eyes, 33 patients treated by PRK and 30 eyes, 23 patients treated by LASIK. Follow-up evaluations were done at 1, 2, 3, 6, 9 months and uncorrected visual acuity, best corrected visual acuity, spherical equivalent, corneal haze, complications were analized. The postoperative uncorrected visual acuity was 0.72, 0.86, 0.86, 0.91, 0.85 in PRK and 0.86, 0.86, 0.83, 0.85, 0.82 in LASIK and the best corrected visual acuity was 0.94, 0.97, 0.97, 0.99 0.97 in PRK and 0.96, 0.97, 0.97, 0.97, 0.96 in LASIK respectively. Although the postoperative refractions within +/-1 diopter of emmetropia were 32.5% in PRK and 76.7% in LASIK and statistically significantly different between the two groups at 1 months(P<0.05), the difference was not significant(P>0.05) from 2 months. The average corneal haze was not significant(P>0.05) from 2 months. The average corneal haze was decreased from Grade 1.66 to Grade 0.48 in PRK at 1, 6 months but in LASIK, the corneal haze was low grade of Grade 0.35 from 1 month. The complications of PRK were irregular astigmatisms in 2 eyes and that of LASIK, the corneal haze was low irregular astigmatisms in 2 eyes and that of LASIK were interface particles in 3 eyes, irregular astigmatisms in 3 eyes. The clinical results of PRK and LASIK were satisfactory and the two technical methods were effective for correction of moderate myopes.
Emmetropia ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Myopia* ; Photorefractive Keratectomy* ; Retrospective Studies ; Visual Acuity