The anatomic and physiologic changes of the anopthalmic orbit affect cosmetic appearance of the patient and function of the socket and the prosthesis. During the past three years, the authors studied 13 cases of dermis-fat graft and 27 cases of posterior Tenon's capsule suturing with a plastic implant, and compared the post'operative effects of the two procedures. Dermis-fat graft produced good fornix formation with no remarkable fat atrophy after both primary and secondary proceddure. Posterior Tenon's capsule suture technique showes good effect to keep implant from migration or extrusion. Size of the plastic implant and fixation of the extraocular muscles were important factors also for good cosmesis and implant motility. There revealed no significant difference between the two procedures in EOM motility, enophthalmos, deep superior sulcus deformity, implant migration or prolapse etc.

This study was carried out to compare the clinical effect of the endonasal lacrimal surgery done in 75 eyes of the 62 patients with that of the conventional lacrimal surgery done by the same operator in 72 eyes of the 57 patients. The diameter of intranasal ostium was 1.9 +/- 0.4 mm in endonasal approach and 2.6 +/- 1.4 mm in skin approach (p<0.05), respectively. Postoperative hospitalization were 1.7 - 2.5 days shorter in endonasal lacrimal surgery than those of conventional lacrimal surgery (p<0.001). Satisfactory tear drainge was observed in 29 eyes (90.6%) after endonasal dacryocystorhinostomy and in 28 eyes (90.3%) after conventional dacryocystorhinostomy, and 41 eyes (95.3%) revealed astisfactory tear drainge after endonasal conjunctivodacrystorhinostomy and 39 eyes (95.1%) showed good results after conventional conjunctivodacr yocystorhinostomy. In summary, endonasal lacrimal surgery showed no cutaneous scar, less edema and hematoma with short recovery time and similar success rate to the conventional lacrimal surgery. Thus, endonasal lacrimal surgery might be better than conventional lacrimal surgery.
Cicatrix ; Dacryocystorhinostomy ; Edema ; Hematoma ; Hospitalization ; Humans ; Skin ; Tears

Symptomatic epiphora has been rarely observed in patients jwith only one canaliculus obstruction. The authors experienced 7 cases of only lower canahculus obstruction without epiphora. Tear drainge of these eyes was assessed using dacryoscintigraphy and compared with the comtrol eyes. The measurement of T1/2 valuse, the duration of which a given amount of 99m-Tc-phytate drops to half in the conjunctival fornix was performed. The T1/2 valuse was 368.1 seconds in average in the eye with the lower canaliculus obstruction and 263.3 seconds in the control eyes(p Drainage* ; Humans ; Lacrimal Apparatus Diseases ; Tears*

The prognosis of severe head injured patients (Glasgow coma scale 3 to 8) was assessed through clinical prognostic factors in 209 cases, retrospectively. Severe head injured patients were 9.1% of all head trauma and 55% of cases were diffuse brain injury. Mechanism of injury were motorvehicle accident, falls, bicycle, and others. The patients with normal pupillary reaction had a significantly higher percentage of good outcome (77%) than the patient with bilateral 3rd nerve palsy (14.2%)(p<0.0001), 79% of good motor responsive patients had a good outcome compared to none of patients with poor motor response(p<0.0001). The patients with short duration of unawareness(within 30days) significantly higher percentage of good outcome(98%) than the patients with long duration of unawaereness(24%)(p<0.0001). The patients with initial high GCS score(6-8 score) had a significantly higher good outcome(58%) than the patients with low GCS score(3-5 score)(p<0.0001), 87% of pediatric patients had a good outcome compared to 38% of adults(p<0.0001). The diffuse head injured patients without basal cistern compression had a significantly hgher percentage of good outcome(83%) than the patients with basal cistern compression(41%)(p<0.0001), 62% of patients with skull fracture had a good outcome compared to 39% of patients without skull fracture(39%)(p<0.0017). Individual prognostic factors affect to patient's outcome and utilize to be powerful tool for assessing the relative efficacy of alternative treatments as well as patient's prognosis.
Brain Injuries ; Coma ; Craniocerebral Trauma ; Head* ; Humans ; Paralysis ; Prognosis ; Retrospective Studies ; Skull ; Skull Fractures

No abstract available.
DNA* ; Kinetics* ; Nervous System Neoplasms* ; Nervous System*

The case of an 33-year-old man with an intradural and extramedullary enterogenous cyst in the thoracic spinal canal is presented. Enterogenous cysts are rare cystic tumors located in the spinal canal and causing spinal compression, and about half of the cases of enterogenous cysts are associated with congenital anomalies. This patient, however, had no vertebral anomaly or other evidence of congenital melformation. We reviewed literatures and recorded the distinguished features of intraspinal enterogenous cysts and discuss the clinical, radiological and histological findings.
Adult ; Humans ; Spinal Canal*

Crohn's disease is an inflammatory bowel disease like ulcerative colitis. Distinct from ulcerative colitis, Crohn's disease may involve any portion of the alimentary tract from the mouth to the anus. Recently, the incidence of Crohn's disease has been increasing in Korea. The proportion of the colon type is smaller than that of the ileocecal type or the small-bowel type. In the colon, Crohn's disease affects mainly the right side. Relatively, the sigmoid colon is rarely involved. Small-bowel obstruction is the most common complication requiring surgery in Crohn's disease. On the contrary, an obstruction limited to the colon requiring surgery is less common in Crohn's disease. We experienced a case of a severe acute sigmoid colon obstruction with peritonitis. At first, we suspected colon cancer, but after an emergency laparotomy, we diagnosed it as Crohn's disease. Such a situation is rare in Korea, so we hope this case report may provide a good opportunity to reconsider Crohn's disease.
Anal Canal ; Colitis, Ulcerative ; Colon ; Colon, Sigmoid* ; Colonic Neoplasms ; Crohn Disease* ; Emergencies ; Hope ; Incidence ; Inflammatory Bowel Diseases ; Korea ; Laparotomy ; Mouth ; Peritonitis

PURPOSE: We investigated the value of the free to total PSA ratio of intermediate serum PSA levels(4-20ng/m1) in the detection of prostate cancer. MATERIALS AND METHODS: Free PSA, total PSA levels and free to total PSA ratio(F/T ratio) were measured on sera samples of 103 men with symptomatic BPH and 20 men with prostate cancer, who were proved by biopsy, by using ELSA-PSA2 and FPSA-RIACT. And we used transrectal ultrasound determined prostate volume to calculated PSA density(PSAD). RESULTS: In all patients, mean PSAD was significantly greater for patients with cancer(2.07+/- 1.65) versus BPH(0.120.12). The F/T ratio was significantly lower for cancer(0.12+/-0.04) compared with BPH(0.32+/-0.20). At a time, when serum PSA between 4 and 20ng/m1 was considered in 8 patients with cancer and 38 patients with BPH, mean total serum PSA was significantly greater for patients with cancer(12.02+/- 3.54ng/m1) versus BPH(7.21 +/-3.68ng/m1). Mean PSAD was significantly greater for patients with cancer(0.36+/- 0.12) versus BPH(0.20+/-0.12) and the F/T ratio was significantly lower for cancer(0.14+/-0.03) compared with BPH(0.25+/-0.12). Use of the Ff ratio of 0.15 resulted in the highest sensitivity(75%) and specificity(89.5%) and the F/T ratio was superior to total PSA when compared with receiver operating characteristic curve . CONCLUSIONS: The F/T ratio give a significant improvement over total PSA value in the diagnosis of prostate cancer in patients with intermediate PSA levels. But, to assess accurately usefullness of F/T ratio in early prostate cancer detection, further studies are needed and consensual threshold value is necessary.
Biopsy ; Diagnosis* ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; ROC Curve ; Ultrasonography

The association of exposure to bleomycin with the development of scleroderma-like cutaneous abnormalities has been reported. We experienced a case of scleroderma involving the hands, feet, and forearms after bleomycin chemotherapy. The present report supports the possible causal relation of bleomycin with scleroderma. Regarding the widespread use of bleomycin, this complication is thought to be under appreciated.
Bleomycin/*pharmacology ; Case Report ; Foot Dermatoses/*chemically induced/pathology/therapy ; Hand Dermatoses/*chemically induced/pathology/therapy ; Human ; Male ; Middle Age ; Scleroderma, Circumscribed/*chemically induced/pathology/therapy

PURPOSE: Thyroid cancer is rare in childhood. Although thyroid cancer is biologically more aggressive in children because of the high incidence of lymph node metastasis and distant metastasis when compared with that of adults, the prognosis is better. This study investigated the prognosis of pediatric differentiated thyroid cancer with 15 years or greater follow-up and we consider the proper treatment of pediatric differentiated thyroid cancer. METHODS: From January, 1979 to December, 1994 during 16 years, 17 patients younger than 17 years old and who underwent thyroid surgery for well differentiated thyroid cancer at the Department of Surgery at Presbyterian Medical Center were retrospectively reviewed by the medical records and they were interviewed by telephone. RESULTS: Total thyroidectomy was performed in 4 patients (23.5%), subtotal thyroidectomy was performed in 10 patients (58.8%) and lobectomy was performed in 3 patients (17.7%). The mean follow-up period was 23.5 years (range: 15~28.2 years) and recurrence was found in 7 cases (41.3%). Five cases (29.5%) showed locoregional recurrence and 2 cases (11.8%) showed distant metastasis. Postoperative radioiodine (¹³¹I) therapy was done in 6 cases (35%) and 6 cases (35%) underwent radioiodine therapy as a therapeutic modality for metastasis. CONCLUSION: The pediatric well differentiated thyroid cancer in this study showed high rates of lymph node metastasis at the time of diagnosis and a high recurrence rate, but the prognosis was good (100% overall survival rate during the follow-up period). Therefore, total thyroidectomy, radical lymph node dissection and postoperative radioiodine therapy are considered the initial patient management. This aggressive therapeutic management can decrease of the recurrence rate and increase the therapeutic effect. A radioiodine scan and thyroglobulin can used for follow-up.
Adult ; Child ; Diagnosis ; Follow-Up Studies* ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Protestantism ; Recurrence ; Retrospective Studies ; Survival Rate ; Telephone ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy