PURPOSE: To compare results of laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) for the treatment of high myopia. METHODS: In this study, 129 patients with a manifest refraction over -6.00 diopters were assigned two groups for 144 eyes of 72 patient treated with LASIK and 114 eyes of 57 patients treated with LASEK. Uncorrected visual acuity, manifest refraction, corneal haze and other complications were reviewed in LASIK- and LASEK-treated eyes at 6 months after the operation. RESULTS: At the 6-month follow-up, there were significant between-eye differences in uncorrected visual acuity and mean spherical equivalent. And LASEK-treated eyes had more corneal opacity and it makes decreased uncorrected visual acuity. CONCLUSIONS: Both laser refractive surgeries were safe and effective methods to treat eyes with high myopia. But LASIK procedure may prove superior to decrease corneal opacity and visual predictability.
Corneal Opacity ; Follow-Up Studies ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ* ; Myopia* ; Refractive Surgical Procedures ; Visual Acuity

PURPOSE: To evaluate clinical and radiological results of AO type C distal radius fractures treated with a volar locking plating system. MATERIALS AND METHODS: We retrospectively reviewed 31 patients with AO type C distal radius fracture treated with a volar locking plating system. We evaluated the clinical results according to the Mayo wrist performance scoring system and disabilities of the arm, shoulder and hand (DASH) score and evaluated the radiographic results. RESULTS: All cases had bony union. The mean Mayo wrist performance score was 81.9. The mean DASH score was 11.2. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 8.8 mm to 13mm, radial inclination from 14.7degrees to 22.5degrees, volar tilt from -11.3degrees to 9.4degrees and intra-articular step-off from 2.2 mm to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured under 1 mm, radial inclination under 1degrees, volar tilt under 1degrees and intra-articular step-off under 1 mm (p>0.05). Internal fixation using volar locking compression plate could allow early postoperative exercise and could result in low incidence of postoperative complication. All cases showed bone union showing no evidence of malunion, nounion, nor metal failure. CONCLUSION: Treatment of AO type C fractures using a volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.
Arm ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Postoperative Complications ; Radius ; Radius Fractures ; Retrospective Studies ; Shoulder ; Wrist

PURPOSE: To evaluate clinical and radiological results of AO type C distal radius fractures treated with a volar locking plating system. MATERIALS AND METHODS: We retrospectively reviewed 31 patients with AO type C distal radius fracture treated with a volar locking plating system. We evaluated the clinical results according to the Mayo wrist performance scoring system and disabilities of the arm, shoulder and hand (DASH) score and evaluated the radiographic results. RESULTS: All cases had bony union. The mean Mayo wrist performance score was 81.9. The mean DASH score was 11.2. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 8.8 mm to 13mm, radial inclination from 14.7degrees to 22.5degrees, volar tilt from -11.3degrees to 9.4degrees and intra-articular step-off from 2.2 mm to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured under 1 mm, radial inclination under 1degrees, volar tilt under 1degrees and intra-articular step-off under 1 mm (p>0.05). Internal fixation using volar locking compression plate could allow early postoperative exercise and could result in low incidence of postoperative complication. All cases showed bone union showing no evidence of malunion, nounion, nor metal failure. CONCLUSION: Treatment of AO type C fractures using a volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.
Arm ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Postoperative Complications ; Radius ; Radius Fractures ; Retrospective Studies ; Shoulder ; Wrist

While it is generally considered that tuberculous meningitis (TBM) causes various vascular complications, there have been few reports of moyamoya syndrome following TBM. A 23-year-old female was diagnosed as TBM. Preliminary brain MRA yielded normal findings. Follow-up MRA and cerebral angiography conducted 1.5 years later yielded findings that were consistent with moyamoya disease. They showed no interval change after 2 years, and the patient had no neurological deficits. This patient with TBM subsequently developed moyamoya syndrome during the course of antituberculosis medication.
Brain ; Cerebral Angiography ; Female ; Follow-Up Studies ; Humans ; Moyamoya Disease ; Tuberculosis, Meningeal ; Young Adult

BACKGROUND: To evaluate the clinical results and operation technique of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP) lesions, all of which had an anterior-inferior Bankart lesion that continued superiorly to include separation of the biceps anchor in the patients presenting recurrent shoulder dislocations. METHODS: From May 2003 to January 2006, we reviewed 15 cases with combined Bankart and SLAP lesions among 62 patients with recurrent shoulder dislocations who underwent arthroscopic repair. The average age at surgery was 24.2 years (range, 16 to 38 years), with an average follow-up period of 15 months (range, 13 to 28 months). During the operation, we repaired the unstable SLAP lesion first with absorbable suture anchors and then also repaired Bankart lesion from the inferior to superior fashion. We analyzed the preoperative and postoperative results by visual analogue scale (VAS) for pain, the range of motion, American Shoulder and Elbow Surgeon (ASES) and Rowe shoulder scoring systems. We compared the results with the isolated Bankart lesion. RESULTS: VAS for pain was decreased from preoperative 4.9 to postoperative 1.9. Mean ASES and Rowe shoulder scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1, respectively. There were no specific complication and no significant limitation of motion more than 10 degree at final follow-up. We found the range of motions after the arthroscopic repair in combined lesions were gained more slowly than in patients with isolated Bankart lesions. CONCLUSIONS: In recurrent dislocation of the shoulder with combined Bankart and SLAP lesion, arthroscopic repair using absorbable suture anchors produced favorable clinical results. Although it has technical difficulty, the concomitant unstable SLAP lesion should be repaired in a manner that stabilizes the glenohumeral joint, as the Bankart lesion can be repaired if the unstable SLAP lesion is repaired first.
Adolescent ; Adult ; Arthroscopy/*methods ; Humans ; Magnetic Resonance Imaging ; Male ; Orthopedic Procedures/*methods ; Pain Measurement ; Postoperative Care ; Range of Motion, Articular ; Shoulder Dislocation/diagnosis/etiology/physiopathology/*surgery ; Tendon Injuries/complications/diagnosis/physiopathology/*surgery ; Treatment Outcome ; Young Adult

PURPOSE: We evaluated the outcome of femoral stem revision for Vancouver B2 and B3 periprosthetic femoral fractures. MATERIALS AND METHODS: We conducted a retrospective assessment of 15 patients who had received treatment for a periprosthetic unstable femoral fracture after primary hip arthroplasty between May 1997 and September 2009. According to Vancouver classification, 11 patients were type B2 and four were B3. Open reduction and long stem revision were performed in all 15 cases. In Vancouver type B3 fractures, we treated patients with open reduction and long stem revision with an allogenic cancellous bone graft, which is the same as in that used in Vancouver type B2 fractures. An allogenic onlay cortical bone graft was used when additional stability was required. The mean age of patients was 67.1 years at the time of surgery and the mean duration of follow-up was 31.5 months. We described the clinical and radiographic results. RESULTS: Using Beals and Tower's criteria, fair to good clinical and radiologic results were observed at the latest follow up, with an average Harris hip score of 94.4 points. Fractures were united in all 15 patients. One patient had non-union of the greater trochanter of the femur, one patient had superficial infection, and one patient had non-union of onlay bone graft, however, there were no further complications, such as dislocations, periprosthetic infections, or nerve injuries. There was no loosening of the femoral stems. CONCLUSION: In Vancouver type B2 and B3 fractures, when there is loosening of the femoral stems, open reduction and long stem revision with allogenic cancellous bone graft provided a satisfactory result. However, long-term follow up is needed.
Arthroplasty ; Dislocations ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip ; Humans ; Inlays ; Periprosthetic Fractures ; Reoperation ; Retrospective Studies ; Transplants

Lung cancer begins insidiously, metastasizes early, and is frequently nonresectable at the time of diagnosis. Gastrointestinal metastases are considered the most unusual. A 60 year-old man was admitted for the evaluation of dizziness. For two weeks prior to admission, he had mild blood-tinged sputum and melena. He had right cervical lymphadenopathy, measured by 2 2 cm. Laboratory studies demonstrated hemoglobin of 3.7 g/dL. Posteroanterior and lateral chest radiographs revealed mass-like lesion of right upper lobe. An umblicated mass was found in the sigmoid colon by colonoscopic examination and biopsy was done. He developed abdominal pain, tenderness and rebound tenderness at admission 10 days. Abdominal CT showed that focal thickened wall and suspicious perforated lesion at the ileum. Operation was done. In recent time, we experienced a case in which perforation of gastrointestinal metastases developed with malignant tumors of the lung.
Abdominal Pain ; Biopsy ; Colon, Sigmoid* ; Diagnosis ; Dizziness ; Humans ; Ileum ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Melena ; Middle Aged ; Neoplasm Metastasis* ; Radiography, Thoracic ; Sputum ; Tomography, X-Ray Computed

PURPOSE: To compare short-term clinical results of LASEK and epi-LASIK. METHODS: Fifteen subjects (30 eyes) underwent uncomplicated LASEK on one eye and uncomplicated epi-LASIK on the other eye by a single surgeon, and uncorrected visual acuity, refractive change, postoperative pain, and postoperative satisfaction were compared at postoperative week one, at one month, and at three months. RESULTS: Postoperative uncorrected visual acuities were 0.68+/-0.20, 0.96+/-0.22, and 1.05+/-0.17 for LASEK and 0.75+/-0.21, 0.92+/-0.14, and 1.01+/-0.21 for epi-LASIK at one week, one month, and three months, respectively. Epi-LASIK showed faster improvement in visual acuity at one week, while LASEK showed faster improvement afterward. However, no statistical significance was found. Spherical equivalet of LASEK was -0.66+/-1.28D and that of epi-LASIK was -0.61+/-0.92D at postoperative week one, implying faster refractive recovery for epi-LASIK, but after one month, LASEK was faster in refractive recovery and all these changes were not statistically significant. Durations of postoperative pain were 3.13+/-1.25 days for LASEK and 3.02+/-1.32 days for epi-LASIK. Pain scores (0~10 point scale), however, were also lower for LASEK by 0.33 point, 0.57 point, and 0.45 point for postoperative day 1, 2, and 3, respectively. No statistical significance was noted in either pain duration or pain score. When asked for overall satisfaction, six subjects preferred LASIK, four subjects preferred epi-LASIK, and five subjects showed no preference. CONCLUSIONS: Both LASEK and epi-LASIK are effective for surgical correction of myopia, and no significant difference in visual recovery, refractive change or degree of postoperative pain was noted in this study.
Eye ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Myopia ; Pain, Postoperative ; Visual Acuity

BACKGROUND: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. METHODS: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, 90° flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. RESULTS: Ulno-humeral joint moved to the varus on the coronal plane during flexion, 25.45° in the non-united cubitus valgus group and −2.03° in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane −26.75° in the non-united cubitus valgus group and −3.09° in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. CONCLUSIONS: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.
Biomechanical Phenomena ; Congenital Abnormalities ; Elbow ; Elbow Joint ; Imaging, Three-Dimensional ; Joints ; Osteotomy ; Tomography, X-Ray Computed