The long term results in 22 eyes of 21 patients of intractable glaucoma who are managed by silicone tube shunt to encircling band in a modified method by author are presented. Ten eyes had neovascular glaucoma and twelve eye had refractory nonneovasular glaucoma in whom previous several surgery was unsuccessful. All cases have been followed up for at least six months. Using the author's criteria, the success rate was 86%. Visual acuity was maintained or improved in 82%. The author's personal method of making a pressure valve like slit incision for prevention of postoperative shallow anterior chamber is described.
Anterior Chamber ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Silicones* ; Visual Acuity

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

LASIK procedure was introduced recently for the correction of high myopia because of many complications in high-myopic PRK. The characteristic procedures such as hinged flap formation and stromal ablation may increase decentration. We evaluated the amount of decentration relative to the pupil center in 80 eyes of LASIK and 52 eyes of PRK using corneal topography(Corneal Analysis System: EyeSys Laboratories). All treatments were performed using excimer laser, Aesculap-Meditec, MEL 60-94 and corneal light reflex was used for centering. The vacuum ring was used for globe fixation. Mean amount of decentration in LASIK(0.65+/-0.42mm) was statisticallysignificantly increased compared with 0.49+/-0.29mm in PRK(p=0.01). Under -12D of attempted correction, mean amount of decentration in LASIK was 0.54+/-0.38mm which was not significantly different from 0.49+/-0.29mm in PRK(p=0.07). No correlation was observed between the magnitude of decentration and the frequency of loss of best cerrected visual acuity and night glare(p>0.05). The decentration more than 1mm was associated with increased amount of attempted correction (p=0.003) and low preoperative best corrected visual acuity(p=0.01). We considered that the differencee of the magnitude of decentration was attributed to some difference in procedures between LASIK and PRK. When vaccum ring is not used in other reports with other device, the decentration of LASIK was approximately twice as much as in PRK. The use of vacuum ring for the maintenance of globe may be effective in LASIK in which patients self fixation during ablation is more difficult than in PRK because the ablation time is longer and the ablation is performed on the stroma after flap formation.
Humans ; Keratomileusis, Laser In Situ ; Lasers, Excimer ; Myopia ; Pupil ; Reflex ; Vacuum ; Visual Acuity

There has been many ophthalmologists warning sudden loss of central vision and small residual visual fields in far advanced glaucomatous damaged eyes after filtration surgery. Although this warning against glaucoma surgery in patients with limited visual fields has been a concern for over a century, little data exist to convincingly support this belief. The purpose of this paper is to share our experience in facing this dilemma. Authors performed filtration surgery on 31 eyes with advanced glaucomatous field defects and evaluated postoperative visual field and visual acuity at 8 weeks postoperatively in order to ensure if there was any change. The eyes were classified into three categories according to the severity of the visual field loss evaluated with Humphrey computerized visual field analyser. No patients suffered a sudden loss of central visual acuity or a rapidly progressive loss of small residual visual fields after filtration surgery during 8 weeks follow-up period. In the light of our clinical experiences, authers concluded that there was nothing to worry about in performing filtration surgery on far advanced glaucomatous damaged eyes just only because they have small residual visual fields.
Filtering Surgery* ; Filtration* ; Follow-Up Studies ; Glaucoma ; Humans ; Visual Acuity* ; Visual Fields*

Argon laser iridotomy is at present the procedure of choice in Korea for the treatment of pupillarx block and angle closure glaucoma. However, despite modified argon laser techniques, difficulties in penetration of irides and closure of hole have been widely reported. Recently reported Q-switched Nd-YAG laser iridotomy have a many complications such as bleeding, lenticular opacity and small hole. And so argon laser and Nd-YAG laser combined iridotomy was performed on 80 eyes, 57 patients with angle closure glaucoma. The follow up period ranged from 1 to 14 months. 71(88.7%) of 80 eyes treated required a single lasing session for patency, and six eyes required two sessions and three eyes required three sessions. Closure of the iridotomy site occurred in 6.2% of eyes, an incidence remarkably lower than that of argon laser iridotomy alone. Localized lenticular opacity and bleeding were not observed, but immediate postoperative iritis and elevation of intraocular pressure were observed.
Argon* ; Follow-Up Studies ; Glaucoma, Angle-Closure ; Hemorrhage ; Humans ; Incidence ; Intraocular Pressure ; Iritis ; Korea ; Lasers, Solid-State*

Argon laser iridotomy is at present the procedure of choice in Korea for the treatment of pupillarx block and angle closure glaucoma. However, despite modified argon laser techniques, difficulties in penetration of irides and closure of hole have been widely reported. Recently reported Q-switched Nd-YAG laser iridotomy have a many complications such as bleeding, lenticular opacity and small hole. And so argon laser and Nd-YAG laser combined iridotomy was performed on 80 eyes, 57 patients with angle closure glaucoma. The follow up period ranged from 1 to 14 months. 71(88.7%) of 80 eyes treated required a single lasing session for patency, and six eyes required two sessions and three eyes required three sessions. Closure of the iridotomy site occurred in 6.2% of eyes, an incidence remarkably lower than that of argon laser iridotomy alone. Localized lenticular opacity and bleeding were not observed, but immediate postoperative iritis and elevation of intraocular pressure were observed.
Argon* ; Follow-Up Studies ; Glaucoma, Angle-Closure ; Hemorrhage ; Humans ; Incidence ; Intraocular Pressure ; Iritis ; Korea ; Lasers, Solid-State*

PURPOSE: To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Materials andMethods : Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion.Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We usedan 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens wereobtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and theirrate were evaluated. RESULTS: For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, andthe findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 offibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. Theprocedure time was about 15 minutes and no significant complications were noted. CONCLUSION: In breast corebiopsy, the coaxial technique is simple and time-saving, and compared with stan-dard breast core biopsy, may alsobe less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells.
Biopsy* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Fibroadenoma ; Inflammation ; Needles ; Surgical Instruments

PURPOSE: To evaluate injury patterns of facet joints and associated soft tissue injuries in patients withacute traumatic cervical facet joint injuries. MATERIALS AND METHODS: From among patients with cervical spinetrauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzedwith regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, andother associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury,intervertebral disc herniation, and spinal cord injury. RESULTS: The most common location of facet joint injurywas C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) hadbilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fractureof inferior facet was more frequent than superi-or. Patterns of fracture were vertical, transverse, or comminuted,but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facetfractures. Fractures other than facet includ-ed pillar(n=11), lamina(n=6), transverse process(n=14), body(n=13),and spinous process(n=3). On MR im-ages, anterior longitudinal ligament injury was found in 8 patients(30%),posterior longitudinal ligament injury in 4(15%), and interspinous ligament injury in 20(74%). Twelvepatients(44%) had spinal cord injuries includ-ing edema(n=8) and hemorrhage(n=4). Among patients with discabnormalities, 11(41%) had intervertebral disc injuries, and traumatic disc herniations were found in nine. CONCLUSION: Traumatic cervical facet joint injuries were manifested as various patterns and frequentlyassoci-ated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patternshelped formulate a therapeutic plan and determine of prognosis.
Dislocations ; Humans ; Intervertebral Disc ; Ligaments ; Longitudinal Ligaments ; Magnetic Resonance Imaging* ; Prognosis ; Soft Tissue Injuries ; Spinal Cord Injuries ; Spine* ; Tomography, X-Ray Computed ; Zygapophyseal Joint*

Patients with chronic myeloid leukemia (CML) in lymphoid blast phase can present clinical characteristics resembling Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). It is crucial to distinguish between two diseases since their treatments differ. We present two cases of children who presented with CML lymphoid blast crisis, who were initially difficult to distinguish from Ph+ ALL.

The incidence of anomalous aortic origin of the coronary arteries in the general papulation is unknown. In recent reports from various laboratories, the incidence was between 0.6-12% in patients referred for coronary arteriogtaphy. Anomalous origin of the right coronary artery from the left sinus of Valsalva is reported to constitute from 6% to 27% of all coronary anomalies, For many years pathologists classified it as a minor anomaly of no clinical importance. Recently, manifstations of myocardial ischemia have been described in patients with this anomaly in the absence of additional atherosclerotic or other disease processes. These manifestations have included acute myocardial infarction, angina pectoris, syncope, nonfatal ventricular fibrillation, and sudden death. We report a case of 56-year-old male with the anomalous origin of the right coronary artery from the left sinus of Valsalva, who had been admitted due to severe substernal chest pain and acute inferior wall myocardial infarction. The coronary angiography revealed that the right coronary artery originated from the left coronary sinus without significant atheroscleotic narrowing. The anomalous right coronary artery passed anteriorly between pulmonary artery and aortic root without significant coronary obstruction.
Angina Pectoris ; Chest Pain ; Coronary Angiography ; Coronary Sinus ; Coronary Vessels ; Death, Sudden ; Humans ; Incidence ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia ; Pulmonary Artery ; Sinus of Valsalva ; Syncope ; Ventricular Fibrillation