PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

Intertrochanteric fractures frequently occur in elderly patients. Early mobilization after rigid internal fixation of unstable intertrochanteric fractures has recently reduced the mortality and morbidity. Between March, 1976 and February, 1980, eighteen patients over 60 years old with unstable intertrochanteric fractures were treated by Jewett nailing after Dimon & Hughstons reduction at the department of Orthopaedic Surgery, Chung Nam University. Among the eighteen patients, twelve patients could be followed, ranging from 6 months to 2.1 years, with an average follow-up of 11 months. The results were obtained as follows: 1. The main causes of fractures were falling down and slip down. 2. In treatment of unstable intertrochanteric fractures by medial displacement and valgus nailing with Jewett nail, early ambulation and early weight bearing were possible with satisfactory results. 3. The average time for fracture union in twelve cases who were followed up were 17.1 weeks, but two cases with severe comminution of posterior and medial fragment of the trochanter revealed delayed union. 4. The medial displacement of distal fragment and valgus nailing in unstable intertrochanteric fracture shortened the operation time and reduced complications by early ambulation, but had disadvantages such as some limitation of motion of affected hip joints, shortening of affected extremities and delayed union.
Accidental Falls ; Aged ; Early Ambulation ; Extremities ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip Joint ; Humans ; Mortality ; Weight-Bearing

The authors have presented 44 cases of chronic subdural hematoma which were diagnosed by brain computerized tomographic (CT) scan at the Department of Neurosugery, Keimyung University, School of Medicine from May 1980 to July 1982. There were 42 men and 2 women. The common incidence of age was between fourth and fifth decade. Most of the cases(80%) had a history of head injury and nearly all cases complained headache(93%). The most common sign was papilledema(71%) in relatively young age patients and mental change(62%) in old age patients. All cases performed brain CT scan, which showed hypodense(41%), isodense(21%), hyperdense(21%) and mixed dense(18%) lesion. The thickness of hematoma which was measured by brain CT scan revealed 10 mm-30mm in most cases and showed the tendency of increase in old age patients. Of 44 cases, 23 cases were treated with craniotomy and membranectomy, 18 cases with burr hole and drainage, and 3 cases which were bilateral lesion with both methods. There was not any different result in both methods and most of all cases showed good postoperative course except 3 cases of poor preoperative state.
Brain ; Craniocerebral Trauma ; Craniotomy* ; Drainage* ; Female ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Male ; Tomography, X-Ray Computed

PURPOSE: We evaluated the predictability and efficacy of LASIK using 1 mm spot scanning laser (LaserScan LSX(R)). METHODS: LASIK was performed on 135 eyes of 73 patients from December, 1999 to February, 2001. The range of refractive error was from .11.5 D to .2.0 D (mean+/-SD : .5.88 D+/-1.79 D) and age was from 20 to 42 years (mean age: 27.8 years). They were divided into two groups according to their manifest refractive error(spherical equivalent): Group I (< -6.0 D, 73 eyes) and Group II (> of = -6.0 D, 62 eyes). And according to their astigmatism: Group A (< or = 0.75 D, 51 eyes), Group B (> or = 1.0 D, 48 eyes). RESULTS: Mean uncorrected visual acuity of 1 year after LASIK improved from 0.06 before operation to 1.0 in Group I and from 0.04 to 0.9 in Group II. Uncorrected visual acuity of 0.8 or better was achieved in 90% of eyes in Group I and 74% in Group II. Mean preoperative spherical equivalent was -4.6 D in Group I and -7.4 D in Group II. Mean spherical equivalent of 1 year after LASIK was -0.1 D in Group I and -0.37 D in Group II. The postoperative refractions within +/-0.5 D of emmetropia were 97% in Group I and 85% in Group II. Mean preoperative astigmatism was 0.56 D in Group A and 1.68 D in Group B. Mean postoperative astigmatism was 0.15 D in Group A and 0.17 D in Group B. Postoperative refraction showed slight regression of 0.16 D in Group I and 0.45 D in Group II throughout the follow-up period. CONCLUSIONS: We conclude that LASIK using spot scanning laser (LaserScan LSX(R)) appears to be a safe and relatively accurate procedure to correct moderate to high myopia and astigmatism.
Astigmatism ; Emmetropia ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Myopia* ; Refractive Errors ; Visual Acuity

PURPOSE: To report MALT (mucosa associated lymphoid tissue) type lymphoma in ocular adnexa. METHODS: This retrospective study included 11 patients (13 cases) of MALT type lymphoma between August 1995 and July 2000. We identified 11 lymphoma cases with MALT characteristics by conventional examination and immunohistochemical staining. Twelve cases were treated with partial excision and radiotherapy, one case with partial excision and chemotherapy. RESULTS: The patients consisted of 4 females and 7 males with an age range of 29~88 (average 48) years old. Mean follow up period was 24.8 (6~60) months following treatment. Eleven patients had ocular adnexal involvement at presentation; 7 eyes in conjunctiva, 5 eyes in orbit and one in eyelid. All cases represented extranodal marginal zone B-cell lymphoma by REAL classification. Control of lymphomas was achieved in all but 4 cases which developed recurrence after irradiation and chemotherapy, and were salvaged with further radiotherapy. Complications such as cataract, radiation retinopathy, ptosis and alopecia developed later in 4 eyes. CONCLUSIONS: Surgical excision and radiotherapy seemed to be effective for the treatment of primary ocular adnexal MALT lymphoma. Long-term follow up should be warranted.
Alopecia ; Cataract ; Classification ; Conjunctiva ; Drug Therapy ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Male ; Orbit ; Radiotherapy ; Recurrence ; Retrospective Studies

PURPOSE: This study was aimed to evaluate the efficacy of an eye-tracking system, in terms of the amount of decentration. Comparison was made between two LASIK groups operated with and without the use of eye-tracking system. METHODS: An eye-tracking system was used in 41 eyes(Group 1) and patient fixation alone without an eye-tracking system in 41 eyes(Group 2). Corneal topography(Humphrey ATLAS(TM) Corneal Topography System; Zeiss Humphrey Systems, Dublin, California, U.S.A.) was performed before surgery and 3 months postoperatively. The amount of ablation decentration was measured on the difference map obtained from the axial map. RESULTS: The mean +/-SD of decentration was 0.38 +/-0.23 mm in group 1, and 0.49 +/-0.24 mm in group 2(p=0.047). The amount of decentration was graded as follows: grade I(<0.5 mm); Grade II(0.5~1.0 mm); Grade III(>1.0 mm). Grade I, there was a significantly less decentration in group 1(p=0.037). For grade II, however, there was no significant difference between the two groups(p=0.766). CONCLUSIONS: Using eye-tracking system alone may not be effective in decreasing moderate decentration. Good fixation of the patients seemed to be as effective as an eye tracking system in achieving good ablation centration.
California ; Corneal Topography ; Humans ; Keratomileusis, Laser In Situ*

Malignant schwannoma is a relatively rare malignant neoplasm arising from schwann cell of neuroectodermal origin that infiltrate locally and widely, and metastases. Inreaosseous bone involvement or retroperitoneal location of this tumor is extremely rare. A rare case of solitary malignant schwannoma which originated in the sacrum and extended to the retroperitoneal space in a 34 year-old male without neurofibromatosis reported. Simple X-ray showed not sclerotic, smooth marginated lytic defect in the right sacral bone. Computed tomography(CT) of sacrum revealed homogenous soft mass with intraosseous and dumbel shaped retroperitoneal extension without enhancement after were appeared in serial iliac artery angiogram. We could remove the tumor mass without specific technical difficulty with the help of CT and angiographic findings.
Adult ; Humans ; Iliac Artery ; Male ; Neoplasm Metastasis ; Neural Plate ; Neurilemmoma* ; Neurofibromatoses ; Retroperitoneal Space ; Sacrum*

PURPOSE: To evaluated the effect of cataract surgery on intraocular pressure (IOP) in primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG), and to find predictors for a favorable postoperative IOP after cataract surgery in patients with coexisting cataract and glaucoma. METHODS: Various clinical factors were evaluated in 68 patients (76 eyes) with well controlled primary glaucoma who had undergone cataract surgery. The differences in parameters between groups divided by postoperative IOP course were analyzed. RESULTS: For this study, successful IOP control was defined as an IOP between 6 mmHg and 21 mmHg without anti-glaucoma medication at last visit after cataract surgery. Eyes with the highest preoperative IOPs less than 28 mmHg in POAG and 42 mmHg in PACG had a significantly higher probability of success. In PACG, the probability of success was significantly higher, if fewer than three anti-glaucoma medications were given before surgery and if the areas of PAS before surgery were less than 4 hours. CONCLUSIONS: Primary small incision cataract surgery using phacoemulsification and foldable intraocular lens implantation could be considered the procedure of choice for a selective group of patients with coexisting glaucoma and visually significant cataract, with respect to IOP, the number of anti-glaucoma medications, and the area of peripheral anterior synechiae.
Cataract* ; Glaucoma ; Glaucoma, Angle-Closure* ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure* ; Lens Implantation, Intraocular ; Phacoemulsification

PURPOSE: We evaluated the efficacy of classic Harada-Ito procedure with intraoperative adjustment for excyclotorsion. METHODS: This study represents a retrospective review of 22 patients surgically treated for the diagnosis of excyclotorsion with abnormal head posture between January 1995 and August 2001. Head tilt, facial asymmetry, diplopia and excyclotorsion were measured preoperatively and postoperatively. Intraoperative adjustment was made by observing the torsional position of the fundus with indirect ophthalmoscopy. Cyclotropia was measured with the Maddox double-rod test or fundus photography with the eyes in primary and down gaze. RESULTS: Causes of excyclotorsion were congenital (7 patients, 32%), trauma (11 patients, 50%)and idiopathic (4 patients, 18%). Of the 22 patients, 19 patients had a head tilt toward the nonparetic side and the others paretic side. Head tilt was uniformly eliminated in 19 of 22 patients (86%). Six of 22 patients had facial asymmertry. After surgical correction, facial asymmetry gradually disappeared in 2 congenital patients. Preoperatively fourteen of 22 patients had diplopia. Postoperatively, eighth of patients had no diplopia and the others had improved of the symptom except one case. The median measured value change of excyclotorsion before and after the surgery in the primary position was reduced from 7.2+/-5.2degrees to 1.7+/-2.8degrees (76%) and 5.3+/-2.2degrees to 0.4+/-1.1degrees in congenital patients, from 8.9+/- 6.6degrees to 1.5+/-2.6degrees in trauma and from 6.0+/-3.4degrees to 4.3+/-4.2degrees in idiopathic. In downgaze, the median measured value change from 10.9+/-5.3degrees to 2.9+/-3.3degrees (73%) and 7.0+/-3.9degrees to 1.1+/-3.0degrees in congenital patients, from 13.2+/-5.7degrees to 3.2+/-3.0degrees in trauma and from 11.5+/-1.0degrees to 5.0+/-4.1degrees in idiopathic. CONCLUSIONS: Intraoperative adjustable classic Harada-Ito procedure was an effective treatment in correcting head tilt, facial asymmetry and diplopia.
Diagnosis ; Diplopia ; Facial Asymmetry ; Head ; Humans ; Ophthalmoscopy ; Photography ; Posture ; Retrospective Studies