In the case presented a Botulinum toxin was injected into the extraocular muscles to treat limitation of eyeball movement due to retention of a metallic foreign body in the orbit. A 32-year-old man had had a major complaint of exohypotropia with diplopia for 15 years and a routine X-ray examination and C-T scan of the orbit revealed an approximately 5 cm long metallic foreign body bridging the right retrobulbar space, the right ethmoid sinus and the sphenoid sinus. During the course of extracting the foreign body, a lesion on the muscle, fatty tissue and fibrotic adhesion, resulting in disuse atrophy or mechanical damage of the right medial rectus and right superior rectus appeared likely. The injection of 5 units of Botulinum toxin into both the right lateral rectus and the right inferier rectus appeared clinically successful after 6 months, resulting in orthophoria and diminishing diplopia.
Adipose Tissue ; Adult ; Botulinum Toxins* ; Diplopia ; Ethmoid Sinus ; Foreign Bodies ; Humans ; Muscles ; Muscular Disorders, Atrophic ; Orbit* ; Sphenoid Sinus

Twenty cases of blepharospasm and thirty five cases of hemifacial spasm were treated by injection with Botulinum Toxin A during a fifteen-month period. A total of 74 treatment sessions were given for 7 months follow-up period and the mean dose of 17.81 units per lid and brow was administered according to Scott's method. The mean ages of blepharospasm and hemifacial spasm patients were 59 years and 49 years, respectively. The mean response time of toxin against blepharospasm and hemifacial spasm were 159.9 days and 167.1 days respectively. The maximum effect of toxin appeared in the first 1 month period following injection. The mean preinjection spasm grade was +3.17 in blepharospasm, and +2.41 in hemifacial spasm, and mean postinjection spasm grade was +0.88 in blepharospasm and +0.52 in hemifacial spasm. The mean preinjection muscle strength was +3.15 in blepharospasm, and +3.07 in hemifacial spasm, and mean postinjection muscle strength was +1.12 in blepharospasm, and +1.24 in hemifacial spasm. The complications attributed to toxin injection were lagophthalmos, and epiphora. These ocular complications were localized, mild and transient, and no systemic side effects were noted.
Blepharospasm* ; Botulinum Toxins* ; Follow-Up Studies ; Hemifacial Spasm ; Humans ; Lacrimal Apparatus Diseases ; Muscle Strength ; Reaction Time ; Spasm

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.
Chemotherapy, Adjuvant ; Child ; Colon, Transverse ; Fibrosarcoma ; Hemangioma ; Humans ; Infant, Newborn ; Lymphangioma ; Magnetic Resonance Spectroscopy ; Parturition ; Picibanil ; Recurrence ; Thigh

PURPOSE: To report the result of Fresnel prism application and adaptation for visual field relocation and functional vision improvement in homonymous hemianopsia patients. METHODS: Fifteen homonymous hemianopsia patients were prescribed Fresnel prism. To expand the visual field, Fresnel prism was placed base-out toward the defective field and patients were given an adaptation period of 1 month. The effects of the prism on field expansion was evaluated using Goldmann perimetry. In addition, the NEI-VFQ25 questionnaire was utilized asking patients regarding their subjective functional vision and satisfaction in daily life before and after using the Fresnel prism. RESULTS: After 1 month of Fresnel prism prescription, 53% of patients showed objective visual field expansion to the defective field of 12.5 degrees on average. Monocular or macular splitting hemianopsia patients showed more visual field expansion than binocular macular sparing hemianopsia patients. The NEI-VFQ25 score increased significantly and abnormal head position decreased or disappeared after 1 month of using the prism. However, 47% of patients failed to adapt to the prism. CONCLUSIONS: Using Fresnel prism in homonymous hemianopsia patients effectively expands the visual field, corrects abnormal head position, and improves functional vision. However, to improve the success rate, for certain patients the proper choice of prism application method, prism diopters, and constant management are necessary.
Head ; Hemianopsia* ; Humans ; Prescriptions ; Telescopes ; Visual Field Tests ; Visual Fields*

Secondary eyeball injury can be caused by head injury as well as direct injury of the eyeball or the orbit. Authors of this report have researched on 117 patients who were applied for ophthalmic examination which in care of the neurosurgical department and have researched frequency of secondary eyeball injury, association between the eyeball injury and the head injury, and favourable frequency of the eyeball injury which were developed without direct injury of the eyeball. There were 21 eyes(9.0%) with external ocular abnormality in 18 patients which included lagophthalmos, ptosis, paralytic strabismus, and there were 14 eyes(6.0 %) with posterior segment abnormality which were vitreoretinal hemorrhage, option. injury and papilledema in 11 patients. In association between the head injury and the eyeball injury, there were many external paralytic injury in basal skull injury and many posterior segment injury in cerebral parenchymal injury. After their injury, follow-up was executed in 3 month interval for 12 month. 15 eyes with external ocular abnormality and 8 eyes with posterior segment abnormality showed favourable progression. Posterior segment abnormality improved statistically significant at 3 month after injury(p<0.05). Secondary ophthalmic injury can be caused by various head injuries. Based on periodic observation, external ocular abnormality improved frequently at more than 9 months after injury. In cases of posterior segment abnormality, there was statistically significant improvement at 3 month after injury(p<0.05). Thus careful observation and treatment should be made in its early stage.
Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hemorrhage ; Humans ; Orbit ; Papilledema ; Skull ; Strabismus

PURPOSE: This study was attempted to grasp the factors affecting the decision-making conflicts of preoperative cancer patients. METHODS: The subjects of this study were 110 cancer patients scheduled to undergo surgeries at K university hospital. Data were collected utilizing scales for decision-making conflicts and anxiety state, and measurement tools for attitude toward treatment and, shared decision-making. RESULTS: The level of decision-making conflicts over cancer treatment of preoperative cancer patients turned out to be slightly lower than the median. There were significant correlations between shared decision-making between physicians and patients, and quality of life which was a subdomain of attitude toward treatment. In multiple regression analysis, the most powerful predictor was the shared decision-making of physicians and patients. Overall, the explanatory power of the measured variables for decisionmaking conflicts about cancer therapy was 20%. CONCLUSION: The study highlights the importance of shared decision-making and quality of life which involves attitude toward treatment. Thereby, it is deemed to be necessary to develop intervention strategies regarding decision-making conflicts about cancer treatment in consideration of these variables.
Anxiety ; Decision Making* ; Drug Therapy* ; Hand Strength ; Humans ; Quality of Life ; Weights and Measures

No abstract available.
Cervix Uteri* ; Female

Phthisis bulbi, resulting from repeated ocular inflammation and infection or ocular trauma, causes various degeneration of ocular tissue as well as changes in ocular external shape. It shows the impression of scleral thickening with calcification of ocular tissue and an unusual ossification as well. Having observed 31-year-old patients of phthisis bulbi and band keratopathy caused by repeated operation after ocular trauma years ago, we extracted the tan brown colored shell-like firm tissue in posterior segment and report sclerotic impression of some of ocular tissue and histopathologic finding of the typical ossificationof ocular tissue during the course evisceration.
Adult ; Humans ; Inflammation ; Triacetoneamine-N-Oxyl

No abstract available.
Femur* ; Osteosarcoma*

We have analyzed 27 cases(38.8%) of scapho-lunate(SL) dissociation which were the most com- mon type of total 72 cases of post-traumatic wrist instabilities since 1985. As a result, SL dissociations associated with wrist fracture were 23 cases, more common than simple dynamic SL dissociation(4 cases). Early diagnosis and treatment influenced on their prognosis, and both wrist PA roentgenograms were useful for the confirmative diagnosis of SL dissociation. In 16 cases with early diagnosis, closed reduction, 2 or 3 K-wires fixation under C-arm image and short arm cast for 8 weeks were effective. But in 11 cases with neglected diagnosis and with wrist fractures showed poor results. Excessive wrist ligamentous reconstruction in chronic cases should be avoided because of osteoporosis and wrist stiffness. Conclusively, clinical wrist symptoms are more important than radiological changes in wrist insta- bilites. So if the symptoms are not so severe, we must consider the patient's age, occupation and their social activities etc. to decide the proper way of treatment.
Arm ; Diagnosis ; Early Diagnosis ; Ligaments ; Occupations ; Osteoporosis ; Prognosis ; Wrist