Nine patient with paralyzed strabismus of large deviation(Seven patients with lateral rectus or medial rectus muscle palsy and two patients with double elevator palsy) had full tendon transposition procedure. If remained strabismus was large postoperatively, recession of anatagonist of paralyzed muscle and botulinum toxin infection was performed respectively. Five patients achieved single binocular vision within central 10 degree of visual field. And six patients achieved less than 10 prism diopter of deviation in primary position. Our method compares favorably with previously descrived transposition procedure for muscle palsy in terms of the amount of correction and the extent of the window of single binocular vision with low risk of anterior ischemia syndrome.
Botulinum Toxins ; Elevators and Escalators ; Humans ; Ischemia ; Paralysis ; Strabismus* ; Tendons* ; Vision, Binocular ; Visual Fields

No Abstract Available.
Mass Screening*

BACKGROUND: The purpose of this study was to evaluate the angle between the long head of the biceps tendon (LHBT) and the glenoid during arthroscopic surgery and its correlation with biceps subluxation on magnetic resonance imaging (MRI). Furthermore, we evaluated the relationship of this angle with subscapularis tears and biceps pathologies. METHODS: MRI and arthroscopic images of 270 consecutive patients who had undergone arthroscopic surgery were retrospectively evaluated. On MRI, 60 shoulders with biceps subluxation and 210 shoulders without subluxation were identified. On the arthroscopic view from the posterior portal, the angle between the LHBT and the glenoid (biceps-glenoid angle) was measured. The biceps-glenoid angle, tears of the LHBT, degenerative superior labrum anterior to posterior (SLAP) lesions, and presence of a subscapularis tear were compared according to the presence of biceps subluxation on MRI. RESULTS: In the subluxation group, 51 (85%) had a subscapularis tendon tear and all shoulders showed biceps tendon pathologies. In the non-subluxation group, 116 (55.2%) had a subscapularis tendon tear, 125 (60%) had tears in the biceps tendon, and 191 (91%) had degenerative SLAP lesions. The incidences of subscapularis tears (p < 0.001) and biceps pathologies (p < 0.001) showed significant differences. The mean biceps-glenoid angle was 87.0° (standard deviation [SD], 11.4°) in the subluxation group and 90.0° (SD, 9.6°) in the non-subluxation group, showing a statistically significant difference (p = 0.037). CONCLUSIONS: Shoulders with subluxation of the biceps tendon on the preoperative MRI revealed more pathologies in the subscapularis tendon and biceps tendon during arthroscopy. However, the arthroscopically measured biceps-glenoid angle did not have clinical relevance to the determination of subluxation of the LHBT from the bicipital groove.
Arthroscopy ; Head* ; Humans ; Incidence ; Magnetic Resonance Imaging ; Pathology ; Retrospective Studies ; Shoulder ; Tears* ; Tendons*

Although spinal arachnoid cysts are relatively common findings observed incidentally in adults, they are much rarely reported in children. They are usually asymptomatic and are mainly located in the middle and lower thoracic regions. However, in rare circumstances, these cysts can cause mass effects that lead to neurologic symptoms. We report the rare case of a spinal extradural arachnoid cyst in a 12-year-old boy who showed signs and symptoms of cauda equina syndrome. Magnetic resonance imaging of the lumbar spine revealed a huge extradural arachnoid cyst extending from L2 to L5. Emergent laminectomy and repair of dural defect was performed after total resection of the extradural arachnoid cyst. There were no postoperative complications. Total recovery was achieved 6 months after surgery. Here, we report this rare case with a review of the literature.

The traumatic optic neuropathy occurs in 0.5 to 5% of closed head trauma cases. Because it may cause permanent blindness, the early diagnosis and proper treatment are very important. We have treated 6 traumatic optic neuropathy patients among 433 head trauma cases from Sep, 1997 to Aug, 1998. Four patients showed visual recovery with steroid therapy. The diagnosis can be made clinically when the patient suffers from acutely decreased vision, Marcus-Gunn pupil, with its relatively normal fundoscopic finding, is considered as the most sensitive indicator and the first herald of visual tract injury, even though visual acuity is normal at the initial stage. The megadose steroid therapy must be diagnosed for the recovery of incompletely injured axons rather than regeneration. The optic canal decompression surgery must be spared for the delayed onset optic neuropathy patients who do not respond to the steroid therapy. In a case of indirect optic neuropathy, the associated orbital fracture reduction should not be undertaken until the optic neuropathy has stabilized. But severely displaced blow-in fracture of the orbit that decreases orbital volume should repaired early for orbital decompression.
Axons ; Blindness ; Craniocerebral Trauma ; Decompression ; Diagnosis ; Early Diagnosis ; Head Injuries, Closed ; Humans ; Optic Nerve Diseases ; Optic Nerve Injuries* ; Optic Nerve* ; Orbit ; Orbital Fractures ; Pupil Disorders ; Regeneration ; Visual Acuity

Paraffinoma on nose from injection of paraffin by the quack doctor for the purpose of augmentation rhinoplasty has so many problem, especially when invaded overlying nasal skin. 6 cases of skin involved severe paraffinoma were treated by one step reconstruction with pericraniosubgaleal flap and follow up periods was 2 to 17 months. All patients were successfully treated without any complications and had satisfactory results. In cases of three telangiectasis among six patients, the severity of telangiectasis was improved, but not completely. We believe that the advantages of this method are one step reconstruction and good vascularity, which prevent infection and enable easy to make variable shape. When the overlying skin loss was developed, the flap became tolerable graft bed. The authors conclude that the pericraniosubgaleal flap is one of the reliable surgical options for treatment of the skin involved severe nasal paraffinoma.
Follow-Up Studies ; Humans ; Nose ; Paraffin ; Rhinoplasty ; Skin* ; Telangiectasis ; Transplants

The dose response of the number of micronuclei in cytokinesis-blocked (CB) lymphocytes after in vitro irradiation with -rays and neutrons in the 5 dose ranges was studied for a heterogeneous population of 4 donors. One thousand binucleated cells were systematically scored for micronuclei. Measurements performed after irradiation showed a dose-dependent increase in micronuclei(MN) frequency in each of the doctors studied. The dose-response curves were analyzed by a linear-quadratic model, frequencies per 1000 CB cells were (0.31+/-0.049) D+(0.0022+/-0.0002) D2+(13.19+/-1.854) (r2=1.000, X2=0.7074, p=0.95) following irradiation, and (0.99+/-0.528) D+(0.0093+/-0.0047) D2+(13.31+/-7.309) (r2=0.996, X2=7.6834, p=0.11) following neutrons irradiation (D is irradiation dose in cGy). The relative biological effectiveness (RBE) of neutrons compared with -rays was estimated by best fitting linear-quadratic model. In the micronuclei frequency between 0.05 and 0.8 per cell, the RBE of neutrons was 2.37+/-0.17. Since the MN assay is simple and rapid, it may be a good tool for evaluating the y-ray and neutron response.
Humans ; Lymphocytes* ; Neutrons ; Relative Biological Effectiveness ; Tissue Donors

Twenty seven lesions of 25 patients with locally advanced malignant tumors were treated with combined hyperthermia introduced by microwave and ultrasound and radiotherpy. Most of all patients were failed with previous conventional therapeutic trial. Hyperthermia had been done immediately after radiotherapy, twice a week, 43degree C for one hour and radiotherapy had been done 5 fractions per week with fraction size of 2 gy up to 30 to 60 gy. Conclusions are as follows. Total response rate (PR+PR) to thermoradiotherapy with microwave and ultrasound was 81%. Tumor depth, minimum temperature of tumor center, number of heat fraction and radiation dose were statistically significant factors affecting response. Hyperthermia with microwave and ultrasound can be used efficiently to control locally advanced malignant disease whether previously received near tolerance dose of radiotherapy or not.
Fever* ; Hot Temperature ; Humans ; Microwaves* ; Radiotherapy ; Ultrasonography*

Retrospective analysis of survival rates was undertaken in the patients of 58 cases treated with conventional radiation therapy for malignant salivary gland tumors between January 1975 and December 1984 in Korea Cancer Center Hospital (KCCH). They were patients whose long-term follow-up was possible and who had refused surgery or had had recurrences postoperatively. Out of 58 patients, 25 patients (43.1%) had mucoepidermoid carcinomas and 24 patients (41.3%) adenoid cystic carcinoma. Total actuarial survival rates at 5 years and 10 years were 68.2% and 31.8% respectively, but disease-free survival rates, 43.2% and 13.0%, respectively. According to TNM stage, the survival rates at 5 years were 86.5% in T1, 40.0% in T2 + T3, and 0% in T4. In terms of histologic types, 5 years disease-free survival rate of adenoid cystic carcinomas (40.1%) was lower than that of mucoepidermoid carcinomas (49.8%) but overall survival rate (77.3%) was much higher than that of mucoepidermoid carcinomas (51.5%). Therefore, we concluded that the patients, who had had disease after failure of treatment, could survive during a certain period of time and their alive times were 2 years on the average. There was a difference in survival rates in the mucoepidermoid carcinomas in terms of histological grade of differentiation and it was a arbiter in prognosis: 5 YSR of low-grade was 78.8% and higher 2 times than that of high-grade. There was no difference in survival rates according to location and sex. The number of patients having minor salivary gland tumors was 6 cases and their actuarial 5 YSR was 32.3%. Consequently, prognostic factors which influence the survival rates of patients with malignant salivary gland tumors are thought to be 1) histological ubtypes 2) T and N staging (AJCC) 3) histological grade, especially in mucoepidermoids.
Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Korea* ; Prognosis ; Recurrence ; Retrospective Studies ; Salivary Glands* ; Salivary Glands, Minor ; Survival Rate

BACKGROUND: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. METHODS: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. RESULTS: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34–74). Mean follow-up duration was 24 months (range, 12–40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up (p≤0.001 for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. CONCLUSIONS: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.
Adhesives ; Arthroscopy ; Bursitis ; Female ; Follow-Up Studies ; Humans ; Joint Capsule Release ; Male ; Pathology ; Retrospective Studies ; Rotator Cuff ; Shoulder Joint ; Shoulder ; Synovitis ; Tears