OBJECTIVE: For the treatment of carotid cavernous fistula(CCF), transarterial detachable balloon occlusion(DBO) is the method of choice. When it has failed to occlude the fistula, various embolization methods are used to treat the fistula. Transvenous embolization through the superior ophthalmic vein(SOV) is another method of treatment. The venous approach through the SOV after surgical dissection and exposure of this vein has been recommended by some delete, but(here) delete delete(an) alternative treatment method by percutaneous puncture of the SOV without surgical dissection(is described). METHODS: A 19-year-old woman admitted to our hospital two months after accident, presented with proptosis, chemosis, occulomotor and abducens nerve palsies, and bruit of the right eye. The authors tried DBO via transarterial route in initial treatment and the fistula was occluded with subsequent disapearance of bruit. However, 2 weeks later, she complained of recurence of bruit. Transarterial approach was attempted again, but the fistula hole was too small for this approach. The venous approach via SOV by percutaneous puncture was then tried. Puncture was made at the medial one third of the superior orbital rim and the fistula was embolized with Guglielmi detachable coils (GDCs). RESULTS: The fistula was completely occluded and no early and late complications noted. The patient's clinical symptoms were improved within a few days. CONCLUSION: Treatment of CCF by percutaneous puncture of the SOV is an alternative and effective method when other approaches are not feasible.
Abducens Nerve Diseases ; Exophthalmos ; Female ; Fistula* ; Humans ; Orbit ; Punctures* ; Veins* ; Young Adult

For undercorrected esotropia after bilateral medial rectus(MR) recession, we performed unilateral or bilateral MR rerecession, unilateral rerecession or marginal myotomy of the recessed medial rectus muscle combined with lateral rectus(LR) resection, or unilateral LR resection. The correction of deviation was 15 delta in unilateral 2.0mm MR rerecession. Bilateral 2.0mm MR rerecession corrected 20 to 25 delta of esodeviation, but undercorrection was noted in one case. With unilateral 2.0mm rerecession or marginal myotomy of the recessed medial rectus muscle combined with 5.5mm or 8.0mm LR resection, the correction of deviation was 26 to 29 delta, and there was no under- or overcorrection. The corrective effect of this procedure was therefore greater and more stable than that of bilateral 2.0mm MR rerecession. Unilateral 8.0mm LR resection performed 3 months after bilateral MR recession showed correction of 15 delta, whereas the same procedure performed 3 weeks after bilateral MR rerecession showed correction of 24 delta. Unilateral LR resection procedure seems to be more efficacious for residual esotropia if performed as soos as possible within 3 months after sufficient bilateral MR recession or rerecession.
Esotropia* ; Methods ; Reoperation

We studied the ultrastructural features of four consecutive subfoveal neovascularmembranes (SFNM) associated with age-related macular degeneration. Cellular components of the membranes included retinal pigment epithelial (RPE) cells, endothelium-lined vascular channels, macrophages, myofibroblasts, fibrocytes, glial cells, erythrocytes, and lymphocytes. Extracellular interstitial constituents included collagen fibrils, basal laminar deposits, fibrin and young elastic fibrils. These findings show that SFNMs consist of various cells originating from surrounding tissues and vessels. Among these RPE cells and macrophages are the main cellular components and in conjunction with various extracellular matrix, especially collagen, may play an important role in the formation and maintenance of the membranes.
Basement Membrane/surgery/ultrastructure ; Humans ; Macular Degeneration/complications ; Microscopy, Electron ; Retina/*ultrastructure ; Retinal Neovascularization/etiology/*pathology/surgery

Endoscopic dacryocystorhinostomy appears to have a lower success rate than of conventional external dacryocystorhinostomy. However, recently this procedure has been widely performed due to its several advantages. The most frequent cause of failure in endoscopic dacryocystorhinostomy is the obstruction of mucosal or bony openings; thus various techniques were introduced to minimize this obstruction of the opening site. Between November 1995 and February 1997, we performed 60 endoscopic dacryocystorhinostomy procedures on 46 patients diagnosed with mitomycin-C, an antimetabolic agent, was performed on the osteotomy site, intraoperatively. The postoperative follow-up interval ranged from 4 to 20 months(mean, 10.3 months). The success rate of the primary operation ws 66.7%(40 of 60 eyes), and with revision of failed cased the final success rate reached 90.0%(54 do 60 eyes). No complication associated with use of mitomycin-C was observed. Thus it suggests that the endoscopic dacryocystorhinostomy with the application of mitomycin-C is a useful technique in the management of obstruction of the nasolacrimal duct.
Dacryocystorhinostomy* ; Follow-Up Studies ; Humans ; Mitomycin* ; Nasolacrimal Duct ; Osteotomy

Metastasis of signet ring cell gastric carcinoma to the breast is extremely rare. The common clinical findings are redness, edematous skin and pain, and these findings are similar to those of inflammatory breast cancer. We describe here a case of metastatic signet ring cell gastric carcinoma to the bilateral breasts, and this presented as bilateral palpable breast lumps after the patient had undergone radical total gastrectomy two years previously.
Breast ; Carcinoma, Signet Ring Cell ; Gastrectomy ; Humans ; Inflammatory Breast Neoplasms ; Neoplasm Metastasis ; Skin ; Stomach

Pulmonary lymphangioleiomyomatosis is a disease involving the proliferation of atypical smooth muscle cells trom the perilymphatics, peribronchial and perivascular region of the lung and the retroperitneum. The disease usually affects women of child-bearing age. We recently experienced a case of pulmonary lymphangioleiomyomatosis in a 31-year-old women who had suffered from a chylous pleural effusion. Histologic confirmation of lymphangioleiomyomatosis was made upon a video-associated thoracoscopic lung biopsy. Here we report this case with a brief review of the literature.
Adult ; Biopsy ; Female ; Humans ; Lung ; Lymphangioleiomyomatosis* ; Myocytes, Smooth Muscle ; Pleural Effusion*

We are report a case of surgically treated a huge neurilemmoma in the lower thoracic and lumbosacral areas. A 57-year-old women presented with low back pain, motor weakness of the both lower extremities and urination difficulty. Magnetic resonance imaging revealed a huge enhancing lesion at the L3-S1 levels and isolated two small enhancing lesions at the T12 and L1 level respectively. This case was treated with extensive laminectomy from T12 through S1 level and total resection. The pathological findings were consistent with neurilemmoma. The patient's preoperative neurologic deficit has been recovered and no postoperative complications developed.
Cauda Equina* ; Female ; Humans ; Laminectomy ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma* ; Neurologic Manifestations ; Postoperative Complications ; Urination

No abstract available.
Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Toes*

For the treatment of carotid-cavernous fistula, detachable balloon occlusion(DBO) is the method of choice. When it fails, or when the fistula is incompletely occluded, alternative treatment methods include direct surgery and internal carotid artery occlusion at the proximal and distal portion of the fistula. Before ligation or occlusion of the internal carotid artery, however, coil embolization should be considered, as this preserves patent internal carotid artery. The authors used DBO in a 22-year-old male patient with carotid-cavernous fistula which developed after head injury. During the procedures the fistula was partially obstructed by one detachable balloon. In spite of several attempted occlusions with a second balloon, this could not be introduced into the small remnant fistula hole. The second stage of intervention involved embolization with a Guglielmi detachable coil(GDC) ; this was successfully introduced into the partially obstructed fistula, which was thus completely occluded, and the patient's clinical symptoms improved. In this case, GDC emboization was an effective tool for the treatment of carotid-cavernous fistula incompletely occluded by a detachable balloon.
Carotid Artery, Internal ; Craniocerebral Trauma ; Embolization, Therapeutic ; Fistula* ; Humans ; Ligation ; Male ; Young Adult

For the treatment of carotid-cavernous fistula, detachable balloon occlusion(DBO) is the method of choice. When it fails, or when the fistula is incompletely occluded, alternative treatment methods include direct surgery and internal carotid artery occlusion at the proximal and distal portion of the fistula. Before ligation or occlusion of the internal carotid artery, however, coil embolization should be considered, as this preserves patent internal carotid artery. The authors used DBO in a 22-year-old male patient with carotid-cavernous fistula which developed after head injury. During the procedures the fistula was partially obstructed by one detachable balloon. In spite of several attempted occlusions with a second balloon, this could not be introduced into the small remnant fistula hole. The second stage of intervention involved embolization with a Guglielmi detachable coil(GDC) ; this was successfully introduced into the partially obstructed fistula, which was thus completely occluded, and the patient's clinical symptoms improved. In this case, GDC emboization was an effective tool for the treatment of carotid-cavernous fistula incompletely occluded by a detachable balloon.
Carotid Artery, Internal ; Craniocerebral Trauma ; Embolization, Therapeutic ; Fistula* ; Humans ; Ligation ; Male ; Young Adult