We retrospectively reviewed clinical and radiologic findings of 19 patients who had been diagnosed as epithelial tumors of the lacrimal gland histopathologically after biopsy and surgery at Shinchon Severance Hospital from April, 1991 to July, 1998 and evaluated their correlation to the pathologic diagnosis, treatment and prognosis. There were 7 men and 12 women with the mean age of 41.0+/-13.3 years. Histopathologically, there were 7 cases of adenoid cystic carcinoma, 1 case of adenocarcinoma, 1 case of malignant mixed tumor, 9 cases of pleomorphic adenoma, and 1 case of benign oncocytoma. In comparison with benign epithelial tumor of the lacrimal gland, the characteristic clinical findings of malignant epithelial tumor of the lacrimal gland were pain, limitation of motion, and diplopia[44.4%]. The mean duration of the symptoms of malignant epithelial tumor was shorter[10.3+/-6.6 months] than that of benign epithelial tumor[19.5+/-14.4 months]. In radiologic CT and MRI findings, there were characteristic bony destructions in malignant epithelial tumors of the lacrimal gland[55.6%] compared with benign tumors and poorly marginated outline of the tumor was noted in malignant tumors[44.4%] but not in benign tumors. Therefore, clinical and radiologic findings of epithelial tumors of the lacrimal gland were well correlated with the pathologic diagnosis and would attribute to early diagnosis of malignant tumors.
Adenocarcinoma ; Adenoma, Oxyphilic ; Adenoma, Pleomorphic ; Biopsy ; Carcinoma ; Carcinoma, Adenoid Cystic ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Male ; Mixed Tumor, Malignant ; Prognosis ; Retrospective Studies

Botulinum toxin chemodenervation is widely used for the treatment of acute paralytic strabismus. We reviewed the effect of botulinum toxin chemodenervation for the treatment of chronic paralytic strabismus. Between 1996 and 1998, 13 patients with chronic paralytic strabismus were treated with botulinum toxin chemodenervation. The palsy of extraocular muscle persisted for at least 6 months. Each patient received an injection of 1.25 to 5 units of botulinum toxin[Botox]to the antagonist muscle of the paralytic muscle and two patients received injections two times. The follow-up was more than 6 months [mean 7.62 months].2 patients were treated with surgery of horizontal muscles and 3 patients were treated with muscle transposition surgery before injection. The mean preinjection deviation was 36.7PD and the mean strabismus angle after injection was 19.2PD and improving rate of the strabisbismus angle was 47.6%. The final deviations of 6 patients were within 10PD[46.2%]and 4 of 7 patients with final deviation above 10PD were treated with surgery later. Ptosis occurred in 4 patients[30.8%]and hypertropia occurred in 4 patients[30.8%]. In addition to the prevention of muscle contracture with botulinum toxin injection, it is likely that the therapeutic effect of botulinum toxin is produced by permanent alteration in the muscle and influence on the peripheral and central nervous system. Therefore botulinum toxin chemodenervation can be considered as a primary therapy or a subsequent therapy of surgery for chronic paralytic strabismus and further study is needed.
Botulinum Toxins* ; Central Nervous System ; Contracture ; Follow-Up Studies ; Humans ; Muscles ; Nerve Block* ; Paralysis ; Strabismus*

To maintain the function of central vision from the sensory retina at the macular area, we performed macular trasnlocation for the treatment of subfoveal lesion. Laser photocoagulation hardly avoid central scotoma and surgical removal of neovascular membrane tends to result in poor visual outcome because of the unhealthy underlying retinal pigment epithelium. We performed macular translocation in four patients with subfoveal lesion using modified macular translocation technique. Surgical steps include trans pars plana vitrectomy, creation of a retinal detachment, scleral shortening, air-fluid exchange and gas injection. The results were the increased visual acuity in two patients and the improved symptom in two patients. Our result suggested that the macular translocation procedure may be considered as a therapeutic modality for the treatment of patients with subfoveal lesion.
Humans ; Light Coagulation ; Membranes ; Retina ; Retinal Detachment ; Retinal Pigment Epithelium ; Scotoma ; Visual Acuity ; Vitrectomy

BACKGROUND: Glucocorticoids have anti-inflammatory effects and have been used to treat many types of nerve injury- associated chronic pain conditions. A randomized double-blind study was performed to determine if methylprednisolone could prevent the development of neuropathic pain after a peripheral nerve injury in rats. METHODS: Two groups of rats, one group (n = 50) injected intraperitoneally with methylprednisolone (100 mg/kg/day, for 7 days starting from 3 days prior to the nerve injury) and the other (n = 58) treated with saline with same manner, were compared in terms of the incidence and intensity of allodynia after a superior caudal trunk transection at the level between the 3rd and 4th sacral spinal nerves. The tail-flick responses to normally innocuous mechanical and thermal stimuli applied to the tail were observed as the behavioral signs of neuropathic pain. RESULTS: The proportions of rats exhibiting tail-flick responses to the mechanical (but not thermal) stimuli 7, 14 and 21 days after the nerve injury were significantly smaller in the methylprednisolone-treated group (2, 3 and 4 of 50 rats, respectively) than in the saline-treated, control group (11, 14 and 15 of 58 rats, respectively) (P = 0.009). However, the pain intensity was similar in mechanical allodynia developed rats of the two groups (P > 0.05), which was estimated based on the frequency and latency of the tail-flick responses after applying mechanical and thermal stimuli, respectively. CONCLUSIONS: These results suggest that a pre-emptive treatment with high methylprednisolone doses may be used to prevent the development of mechanical allodynia following peripheral nerve injuries.
Animals ; Axotomy ; Chronic Pain ; Double-Blind Method ; Glucocorticoids ; Hyperalgesia* ; Incidence ; Methylprednisolone* ; Neuralgia ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Spinal Nerves

PURPOSE: To evaluate the results of fracture fixation between using Proximal Femoral Nail and using Proximal Femoral Nail A and to analyze the effectiveness of proximal femoral nail A. MATERIALS AND METHODS: We reviewed 32 patients who suffered from intertrochanteric fracture in our hospital, which were 19 cases of PFN and 13 cases of PFNA. Retrospectively we evaluated mean operation time, amount of bleeding, beginning of ambulation, average union period, changes of neck shaft angle and complication on set of telephone interview and OPD. We also evaluated postoperative capability of function and mobility using 'Social function score' and 'Mobility score'. RESULTS: PFNA showed shorter mean operation time, less bleeding, shorter average union period, earlier ambulation and less change of neck shaft angle than PFN. Although they didn't show statistical difference, postoperative capability of function and mobility showed statistical and mathematical difference on each group. CONCLUSION: PFNA showed better results of postoperative function and mobility and less complications than PFN. So treatment using PFNA is better method than that of PFN.
Fracture Fixation ; Hemorrhage ; Humans ; Interviews as Topic ; Nails ; Neck ; Retrospective Studies ; Walking

Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above 90degrees. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.
Female ; Follow-Up Studies ; Humans ; Male ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Ultrasonography

We evaluated the relative tear flow in the upper and lower canaliculus using dacryoscintigraphy. 22 eyes were studied in 11 persons and the upper or lower punctums of both eyes were occluded with 0.3 or 0.4 mm diameter 1.75 mm long collagen plug and 13 of Technetium-99m sulphur colloid were placed in both eyes. Dacryoscintigraphy was performed in the upright position for 12 minutes. Using Pegasys. program, time-activity curve and T1/2 of radioisotope in the palpebral aperture were measured twice and the mean T1/2 was calculated. T1/2 values with the upper and lower canaliculus occluded were compared and analyzed. Of 22 eyes studied, 12 had more rapid tear transport in the upper canaliculus and 10 through the lower. The mean T1/2 of transport in the upper canaliculus was 703.2+/-789.2 seconds and 692.3+/-450.3 seconds in the lower. Tear drainage in the lower canaliculus was more rapid but this value was not found to be statistically significant (P=0.626 ). Therefore there was no significant difference between the upper and lower canalicular tear flow but individual variabilities. Considering these results, when punctum occlusion for the treatment of dry eye and reconstruction of canalicular laceration are performed we should equally weigh on both the upper and lower canaliculus.
Collagen ; Colloids ; Drainage ; Humans ; Lacerations ; Tears*