It is the purpose of this study to compare the postoperative results of 168 patients with exotropia of basic and simulated divergence excess type over 40 prism diopters; 86 patients had bilateral rectus muscle recessions and 82 patients underwent lateral rectus muscle recession and medial rectus muscle resection. The patients in the former group had averaged 13.7 years of age and 8.2 months of postoperative follow-up period. Those in the latter group averaged 22.9 years and had been followed up for 7.1 months. The postoperative success rates are as follows: 66.7%(57/86) in the bilateral rectus muscle recession group and 68.1%(58/82) in the lateral rectus muscle recession and medial rectus muscle resection group(P>0.05). And the success rates of those older than 16 years without amblyopia are 60.0%(18/30) in the former group and 75.0%(24/32) in the latter group(P>0.05). The lateral rectus muscle recession and medial rectus muscle resection group showed somewhat higher rates of success even though it proved statistically insignificant.
Amblyopia ; Exotropia* ; Follow-Up Studies ; Humans

Dermal melanocytosis is characterized by the presence of ectopic melanocytes in the dermis and shows several morphological forms, including the mongolian spot, the blue nevus, the nevus of Ota, the nevus of Ito, and dermal melanocyte hamartoma. A 30-month-old boy had a gray blue patch on the left deltoid region, upper back, sacral area, the entire length of the right arm, and right hand. There was a bluish speckled patch on the right palm. The lesions were present at birth, and no appreciable change in appearance had occurred. He also had blue to brownish pigmentation on the right side of his face with dark bluish pigmentation of the right sclera. His Mental and physical development had been normal. The histopathological examination revealed dendritic dermal melanocytes, mainly in the upper and mid dermis. Clinically and pathologically, the patient was diagnosed as having Ota nevus, Ito nevus, mongolian spot, and dermal melanocyte hamartoma. To our knowledge, dermal melanocytosis with 4 different morphological forms in a patient has not previously been reported. We report this unique case of dermal melanocytosis with various morphological forms.
Arm ; Child, Preschool ; Dermis ; Hamartoma ; Hand ; Humans ; Male ; Melanocytes ; Mongolian Spot ; Nevus ; Nevus of Ota ; Nevus, Blue ; Parturition ; Pigmentation ; Sclera

Endoscopic intraluminal implantation of a self-expandable permanent urethral stent ( Wallstent) has found increased use in patient with recurrent urethral strictures because of its simple implantation technique. But there has been a few reports of explantation due to complete luminal obstruction. Herein we report one with literature.
Humans ; Phenobarbital ; Stents ; Urethral Stricture

The computed tomography (CT) number is closely related to hematocrit level according to many of the previous reports. We measured the CT number in various organs, such as the frontal white matter, basal ganglia, occipital white matter, cerebrospinal fluid, liver, abdominal aorta, spleen, kidney, and psoas muscle. We correlated the CT numbers of the organs with hematocrit levels which were graded into 10% increments (20.0-29.9%, 30.0-39.9%, 40.0-49.9%). Thus the change of CT numbers in various organs according to the hematocrit level was analyzed. The increased CT numbers according to the 10% increment of hematocrit in the frontal white matter, basal ganglia, occipital white matter, liver, abdominal aorta, spleen, and psoas muscle were 1.3, 1.5, 1.6, 3.3, 5.3, 3.8, 2.4 respectively. Even though the CT numbers of the cerebrospinal fluid and kidney were not influenced by hematocrit level the CT numbers in most of the there organs postitively correlated with hematocrit level. Therefore, it was concluded that in the differential diagnosis using CT numbers, the hematocrit level of patient must be taken into consideration.
Aorta, Abdominal ; Basal Ganglia ; Cerebrospinal Fluid ; Diagnosis, Differential ; Hematocrit* ; Humans ; Kidney ; Liver ; Psoas Muscles ; Spleen ; White Matter

Vascular lesions involving the upper extremities have been treated by different route of upper thoracic sympathectomy with varying success. More recently, the anatomic and physiologic interest for autonomic nervous system has been progressively mounted but the surgical attack has plateau. It may be worthy for academic interest and clinical practice to estimate and to compare with the different surgical method. This paper concerns the treatment of a case suffering from atherosclerotic occlusion whom were treated by upper thoracic sympathetic ganglionectomy through the transaxillary transpleural route. This operation seems to be simpler than other surgical methods with lower morbidity, fewer complication and satisfying results.
Autonomic Nervous System ; Ganglionectomy ; Sympathectomy* ; Upper Extremity

PURPOSE: This study was designed to analyze the short-term clinical and functional outcomes of perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse. METHODS: The data were prospectively collected and consisted of the clinical data, the functional status before and after surgery, the operation record, and the postoperative course. The functional status was evaluated by using Wexner's constipation score (0-30), Wexner's incontinence score (0-20), anorectal manometry, and pudendal nerve terminal motor latency. Follow-up was performed at 3-6 months after the operation by using both a standardized questionnaire completed in the outpatient clinic or telephone interview (n=23) and an anorectal physiology test (n=7). RESULTS: During a one-year period, 23 patients (male=10) underwent perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse. The median duration of the operations was 88 minutes. The median length of postoperative hospital stay was 6 days. There was one urinary tract infection and no mortalities. The constipation score was significantly decreased after the operation (9.8 vs 3.8; P<0.001), and constipation was improved in 90 percent (19/21) of the cases. The incontinence score was significantly decreased after surgery (mean preop.=11.6, postop.=3.7; P<0.001) and incontinence was improved in 17 of 21 patients with impaired continence (81 percent). Anal sphincter function was not improved but rectal reservoir capacity was significantly decreased after surgery (rectal urgent volume (45.7 cc vs 37.1 cc; P=0.045), maximal tolerable volume (120 cc vs 85.7; P=0.011). Most patients (83 percent) felt that the operation had improved their symptoms. The major reasons for dissatisfaction after surgery were frequent defecation, fecal soiling, persistent or aggravated fecal incontinence, and recurrence. One patient had a complete recurrence (4.3 percent), and another patient had a mucosal prolapse which was treated. CONCLUSIONS: Perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse is a safe technique with acceptable short-term functional results; however, it is not recommended for rectal prolapse patients with diarrhea-predominant irritable bowel syndrome.
Ambulatory Care Facilities ; Anal Canal ; Constipation ; Defecation ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Interviews as Topic ; Irritable Bowel Syndrome ; Length of Stay ; Manometry ; Mortality ; Physiology ; Prolapse ; Prospective Studies ; Pudendal Nerve ; Surveys and Questionnaires ; Rectal Prolapse* ; Recurrence ; Soil ; Urinary Tract Infections

OBJECTIVE: The purpose of this study was to determine differential findings between Type I degenerative endplate changes and diskitis on MR images. MATERIALS AND METHODS: MR images(T1, T2 weighted or Gradient echo) of L-spine in twelve patients with a Type I degenerative endplate change and nine patients with diskitis were reviewed for the morphologic and signal intensity changes of intervertebral disc, vertebral endplate and vertebral body. RESULTS: involvement of the marrow of one side of intervertebral disk was noted in 33%(4/12) of Type I endplate changes, and 11%(1/9) of diskitis. Decreased signal intensity of intervertebral disc was seen in 92% (11/12) of Type I endplate changes, and 11%(1/9) of diskitis on T2 weighted or Gradient echo image. Loss of intranuclear cleft signal was noted in 17%(2/12) of Type I endplate changes, and 78%(7/9) of diskitis. Even disc space narrowing was seen in all cases of Type I endplate changes, but uneven narrowing was seen in 44%(4/9) of diskitis. Only partial cortical disruption was noted in 42%(5/12) of Type I endplate changes, while partial or total cortical disruption was noted in 89%(8/9) of diskitis. The extent of marrow involvement more than 2/3 was noted in 8%(1/12) of Type I endplate changes, but 56%(5/9) of diskitis. The margin of signal intensity change was well defined in 33%(4/12) of Type I endplate changes, but that of diskitis was ill defined in all cases(9/9). Gadolinium enhancement was homogeneous in all cases(5/5) of Type I endplate changes, and 63%(5/8) of diskiris. CONCLUSION: We conclude that involvement of one side of endplate, decreased signal intensity of intervertebral disc on T2 weighted or gradient echo image, even narrowing of disc space, lesser extent of marrow involvement, well defined margin and homogeneous enhancement pattern are the findings of Type I degenerative endplate changes on MR images.
Bone Marrow ; Diagnosis, Differential* ; Discitis* ; Gadolinium ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging*

Due to recently advanced endourologic development. most patients with complications in horsehoe kidney can be managed with endourologic treatment and ESWL. From June 1986 to June 1990, 26 kidney units in 23 patients with horseshoe kidney were evaluated. They were treated in 6 kidney units with open surgery, 6 kidney units with endoscopic surgery, 6 kidney units with ESWL, 2 kidney units with combination of percutaneous nephrolithotomy and ESWL and 1 kidney units with combination of nephrolithotomy and ESWL, respectively. Of 14 kidney units with endourologic management and ESWL, the complications in 13 kidney units were managed successfully. The percutaneous nephrolithotomy, endopyelotomy and ureterorenoscopic management in horseshoe kidneys do not carry a greater risk than that reported for normal kidneys. In ESWL, focal pointing of the calculi may be difficult due to increased distance between the flank and renal calculi. But without major technical modification, stones in a horseshoe kidney may be treated by ESWL. In conclusion, most patients with calculi or obstruction in horseshoe kidneys can be managed primarily with endoscopic surgery or ESWL.
Calculi ; Humans ; Kidney Calculi ; Kidney* ; Lithotripsy* ; Nephrostomy, Percutaneous ; Shock*

Due to recently advanced endourologic development. most patients with complications in horsehoe kidney can be managed with endourologic treatment and ESWL. From June 1986 to June 1990, 26 kidney units in 23 patients with horseshoe kidney were evaluated. They were treated in 6 kidney units with open surgery, 6 kidney units with endoscopic surgery, 6 kidney units with ESWL, 2 kidney units with combination of percutaneous nephrolithotomy and ESWL and 1 kidney units with combination of nephrolithotomy and ESWL, respectively. Of 14 kidney units with endourologic management and ESWL, the complications in 13 kidney units were managed successfully. The percutaneous nephrolithotomy, endopyelotomy and ureterorenoscopic management in horseshoe kidneys do not carry a greater risk than that reported for normal kidneys. In ESWL, focal pointing of the calculi may be difficult due to increased distance between the flank and renal calculi. But without major technical modification, stones in a horseshoe kidney may be treated by ESWL. In conclusion, most patients with calculi or obstruction in horseshoe kidneys can be managed primarily with endoscopic surgery or ESWL.
Calculi ; Humans ; Kidney Calculi ; Kidney* ; Lithotripsy* ; Nephrostomy, Percutaneous ; Shock*

No abstract available.
Cisplatin* ; Drug Therapy* ; Humans ; Ifosfamide* ; Paclitaxel*