Exotropic shift is a significant problem in the exotropia.There has been much presumption about factors that affect the surgical outcome of intermittent exotropia such as amblyopia, stereopsis, age at operation, frequency of manifestation, deviation of angle and associated strabismus.The authors compared preoperative and postoperative factors between 36 patients who had second operation because of recurrent exotropia and 30 patients who had satisfactory surgical results.A 'satisfactory surgical result'was defined as a final alignment of orthotropia, esotropia less than 5 prism diopter or exotropia less than 10 prism diopter at postoperative 6 months.Sex, age at operation, angle of deviation, presence of amblyopia, associated hypertropia and type of intermittent exotropia were not different between two groups. Inferior oblique overaction and poor stereopsis were more common in reoperation group (p<0.05).Initial postoperative undercorrection in satisfactory surgical result was also more frequent in reoperation group (p<0.05).
Amblyopia ; Depth Perception ; Esotropia ; Exotropia* ; Humans ; Recurrence* ; Reoperation ; Risk Factors* ; Strabismus

PURPOSE: We described a patient with decreased vision due to circumscribed choroidal hemangioma and the patient was treated with transpupillary thermotherapy. METHODS: A 40-year-old male with circumscribed choroidal hemangioma combined with serous retinal detachment involving macula was managed by 2 sessions of transpupillary thermotherapy with 810 mm infrared diode laser. RESULTS: Improvement of central visual acuity, atrophy of circumscribed choroidal hemangioma and reabsorption of serous retinal detachment were observed without any complication during 6 months follow up period after 2 sessions of transpupillary thermotherapy. CONCLUSIONS: Transpupillary thermotherapy is a safer and alternatively effective treatment in circumscribed choroidal hemangioma with serous retinal detachment rather than ordinary photocoagulation or radiotherapy.
Adult ; Atrophy ; Choroid* ; Follow-Up Studies ; Hemangioma* ; Humans ; Hyperthermia, Induced* ; Lasers, Semiconductor ; Light Coagulation ; Male ; Radiotherapy ; Retinal Detachment ; Visual Acuity

PURPOSE: Predicting the change in breast size for a specific patient's need is a challenging problem in breast augmentation. We intended to investigate the post-augmentation degree of breast size according to the size of cohesive silicone gel implant. METHODS: To predict post-augmentation breast size, we measured 100 patients' pre-and postoperative 3 month's bust circumference. All patients were performed by total subfascial breast augmentation with moderate profile cohesive silicone gel implant through areolar omega (transareolar-perinipple) incision. RESULTS: According to this study, each additional one pair of 100mL in implant size yielded an approximate 1.5cm increase in bust circumference(p=0.006). CONCLUSION: From this result, we conclude that each additional one pair of 100mL in implant volume yielded about 1.5cm increase in bust circumference. Although this result may not be applied to every patient, we believe that it yields a practical chart that can help to predict the amount of increase in breast size with the use of cohesive silicone gel implant of a specific size preoperatively.
Breast ; Humans ; Silicone Gels

STUDY DESIGN: Retrospective study. PURPOSE: To investigate the relation between the progression of kyphotic deformity and magnetic resonance imaging (MRI) findings in conservatively treated stable thoracolumbar fractures. OVERVIEW OF LITERATURE: When treated conservatively, excessive progression of kyphotic deformity and vertebral compression can emerge during follow-up. We sought to identify predictors of vertebral body deformation using MR images. METHODS: The presence in MR images of anterior longitudinal ligament (AL) or posterior longitudinal ligament (PL) injury, superior or inferior endplate disruption, superior or inferior disc injury in fractured vertebral bodies, the existence of low signal intensity on T2 weighted images, and bone edema of intravertebral bodies were assessed. RESULTS: The presence of superior endplate disruption and a higher level of bone edema were found to cause the progressions of kyphotic angle (KA), wedge angle (WA), and anterior vertebral compression (AVC) rate. When AL or superior disc injury was observed, only KA increased meaningfully. When low signal intensity was present on T2 weighted images WA and AVC increased significantly, but PL injury, inferior endplate disruption, and inferior disc injury showed no notable correlation with kyphotic deformity progression. The risk factors found to be associated with an increase of KA to >5degrees were AL injury, superior endplate disruption, superior disc injury, and a bone edema level of over 1/3, and their associated risks versus no injury cases were 14.1, 3.7, 6.8, and 10.4-fold, respectively. CONCLUSIONS: AL injury, superior endplate and disc injury, or a high level of bone edema, were critical factors that determine kyphotic deformity progression.
Congenital Abnormalities ; Edema ; Follow-Up Studies ; Kyphosis* ; Longitudinal Ligaments ; Magnetic Resonance Imaging* ; Orthotic Devices ; Retrospective Studies ; Risk Factors ; Spinal Fractures

This study is a retrospective analysis of 1244 cases of the inguinal hernia in children under the age of fifteen years who were operated at the department of pediatric surgery, Inje University Busan Paik Hospital from March, 1997 to February, 2007. The ratio of male to female was 3.6:1. The type of hernia was indirect in all of the cases. The hernia was on the right side in 656 cases (53.9 %), left side in 467 cases (37.5 %), and bilateral in 121 cases (9.7 %). The hernia presented most frequently in infants under age 12 months; 364 cases (29.2 %). Fifty-nine cases (21.7 %) were in female and 305 cases (31.3 %) in male. There were 428 cases (33.6 %) in 1-3 years age group, 295 cases (23.7 %) in 4-6 years, 112 cases (9.0 %) in 7-9 years, 39 cases (3.1 %) in 10-12 years and 16 (1.2 %) in 13-15 years. The content of hernia sac was small bowel (59 %), omentum (31 %) in males and the ovary and tube (54 %) and small bowel (26 %) in female. The incidence of combined operation at the time was 3.2 %, and consisting of orchiopexy (67.5 %), frenulotomy (12.5 %), appendectomy (10 %), circumcision (5 %), and fistulotomy (5%). The incidence of combined disease was 2.8 % and consisting of undescended testis, Hirschsprung's disease, idiopathic hypertrophic pyloric stenosis, imperforate anus, and congenital heart disease. After unilateral inguinal hernia repairs, contralateral hernias developed in 34 patients. The laterality of the primary site of hernias were left in 19 cases (55.8 %), and right 15 cases (44.1 %). The 936 cases (75.2 %) were operated under general anesthesia; Mask bagging 663 cases (53.2 %), endotracheal intubation 257 cases (20.6 %), and laryngeal mask 16 cases (1.2 %). The remainder 308 cases (24.7 %) were operated under regional caudal anesthesia.
Anesthesia, Caudal ; Anus, Imperforate ; Appendectomy ; Child ; Circumcision, Male ; Cryptorchidism ; Female ; Heart Diseases ; Hernia ; Hernia, Inguinal ; Hirschsprung Disease ; Humans ; Incidence ; Infant ; Intubation, Intratracheal ; Laryngeal Masks ; Male ; Masks ; Omentum ; Orchiopexy ; Ovary ; Pyloric Stenosis, Hypertrophic ; Retrospective Studies

PURPOSE: We attempt to evaluate the significance of calcaneal posterior tuberosity fragment reduction when treated with surgical open reduction in displaced intra-articular calcaneal fractures. MATERIALS AND METHODS: A total of 90 patients with displaced intra-articular calcaneal fracture, between January 2010 and December 2015, treated with open reduction and internal fixation were enrolled in this study. At postoperative 3 months, we evaluated the reduction state of calcaneal posterior tuberosity fragment by measuring the degree of lateral displacement of the posterior tuberosity fragment on the calcaneal axial view. Moreover, we also evaluated the difference in the calcaneal length and height with the uninjured side on the lateral view of both sides. In addition, we estimated the reduction state of the posterior facet by measuring the degree of gap and step-off on the semi-coronal view of postoperative computed tomography and estimated the restoration of calcaneal angle by measuring the difference in Böhler's and Gissane angle with the uninjured side on the lateral view of both sides. RESULTS: The correlation coefficient with 3 components for evaluating the reduction state of posterior tuberosity fragment and gap and step-off of posterior facet was r=0.538, 0.467, r=0.505, 0.456, r=0.518, and 0.493, respectively, and restoration of Böhler's and Gissane angle was r=0.647, 0.579, r=0.684, 0.630, r=0.670, and 0.628, respectively. The relationship of each component shows a significant correlation as all p-values were <0.01. CONCLUSION: The precise reduction of calcaneal posterior tuberosity fragment developed by the primary fracture line was considered as an important process of anatomical reduction of calcaneal body, including the posterior facet and calcaneal angle restoration.
Calcaneus ; Humans ; Intra-Articular Fractures

Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). The authors investigated the incidence and risk factors of rib fracture in 284 patients with OVCF using bone scans and evaluated the feasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptake lesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography. However, no statistical significances were found. In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rate of less than 15% could not be identified definitely by initial plain radiography, but were confirmed by bone scans. It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. Non-adjacent multiple fractures in both thoracic and lumbar spines and fractures not identified definitely by plain radiography were detected on bone scans, which provided a means for determining management strategies and predicting prognosis.
Aged ; Aged, 80 and over ; Bone Density ; Female ; Fractures, Compression/diagnosis/*epidemiology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoporosis/pathology/*radiography ; Osteoporotic Fractures/diagnosis/*epidemiology/radiography ; Rib Fractures/*epidemiology ; Spine/pathology ; Tomography, X-Ray Computed

Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). The authors investigated the incidence and risk factors of rib fracture in 284 patients with OVCF using bone scans and evaluated the feasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptake lesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography. However, no statistical significances were found. In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rate of less than 15% could not be identified definitely by initial plain radiography, but were confirmed by bone scans. It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. Non-adjacent multiple fractures in both thoracic and lumbar spines and fractures not identified definitely by plain radiography were detected on bone scans, which provided a means for determining management strategies and predicting prognosis.
Aged ; Aged, 80 and over ; Bone Density ; Female ; Fractures, Compression/diagnosis/*epidemiology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoporosis/pathology/*radiography ; Osteoporotic Fractures/diagnosis/*epidemiology/radiography ; Rib Fractures/*epidemiology ; Spine/pathology ; Tomography, X-Ray Computed

Acute interstitial nephritis may result from a variety of causes and may present a variety of clinical and laboratory findings. If there was or going deterioration of renal function in patients with glomerular disease but without any evidence of other causes for that especially after administration of drug, acute interstitial nephritis should be considered as one possible causes for that Acute interstitial nephritis may be progressing more rapidly than expected but since acute interstitial nephritis is reversible with withdrawal of the drug, its early detection is very important. Acute interstitial nephritis induced by furosemide is rarely reported. But furosemide is a well know drug commonly used in the management of edema due to various causes. Therefore considering furosemide as one possible cause of acute interstitial nephritis is clmicaly important. We experienced a case of acute interstitial nephritis in a 29 year old man with nephrotic syndrome after treatment of furosemide. On admission, physical examination lower extremities revealed severe pitting edema. Serum creatinine level was 1.2 mg/dL. For edema control, we started furosemide therapy. After furosemide therapy, his serum creatinine level was elevated to 3.5mg/dL. He had mild but transient fever. Peripheral eosinophilia, eosinophiluria, skin rash were not observed and threr was no evidence of any infection. Definite diagnoisis was established by renal biopsy and renal biopsy revealed a diffuse interstitial nephritis with dense infiltration by lymphocytes and plasma cells. In addition, moderate tubular atrophy and diffuse interstitial edema was present. The patient recovered promptly after withdrawal of furosemide and with steroid therapy.
Adult ; Atrophy ; Biopsy ; Creatinine ; Edema ; Eosinophilia ; Exanthema ; Fever ; Furosemide* ; Humans ; Lower Extremity ; Lymphocytes ; Nephritis ; Nephritis, Interstitial* ; Nephrotic Syndrome* ; Physical Examination ; Plasma Cells