No abstract available.
Chylothorax* ; Lymphangiectasis*

The blow-out fracture can be reconstructed by various autogeneous and alloplastic material. Particulate, nonresorbable hydroxyapatite is currently one of the choice of implant material available for reconstruction of blow-out fracture. Hydroxyapatite is radiopaque ceramic, physically and chemically similar to enamel and cortical bone. It is a biomaterial derived from natural corals to use as a bone graft substitute. And we looked into the clinical usefulness of 2 type of hydroxyapatite with their advantages and disadvantages in reconstruction of blow-out fracture. 183 patients with blow-out fracture who underwent surgical reconstruction with two types of hydroxyapatite from March 1933 to July 1977 have been analyzed the results of surgical reconstructions, and have been followed up for more than a year. And the condition of formerly inserted hydroxyapatite was observed in the patients who needed 2nd surgical reconstruction due to the enophthalmos. The disadvantages of hydroxyapatite are fragility, size and contour limitations. In spite of these demerits, hydroxyapatite can be one of the prospective materials to reconstruct orbital floor. Through the clinical experiences for 5 years, we have not found any of complications of exposure, infection, and foreign body reaction. Low rates of diplopia, limitation of ocular movement, and enophtalmos was observed. Hydroxyapatite was well adherent to adjacent orbital bone in most patients who needed secondary reconstruction for enopthalmos. In conclusion, our study shows that the availability of hydroxyapattite in reconstruction of blow-out fracture is recommendable, with low complication rates. Hydroxyapatite important appears to be well tolerated, and provides useful alloplastic prosthesis with few problems in reconstruction of blow-out fracture.
Anthozoa ; Ceramics ; Dental Enamel ; Diplopia ; Durapatite* ; Enophthalmos ; Foreign-Body Reaction ; Humans ; Orbit* ; Orbital Fractures* ; Prostheses and Implants ; Transplants

No abstract available.
Enophthalmos* ; Orbit*

BACKGROUND AND OBJECTIVES: Ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia (AVNRT) can be performed by using a specific intracardiac electrogram findings predicting a successful radiofrequency catheter ablation. The purpose of the present study is to recognize a specific intracardiac electrogram findings predicting a successful sites of radiofrequency catheter ablation in patients with AVNRT. MATERIALS AND METHODS: The study population consisted of the 18 patients (7 males, mean age:46 yr) to undergo successful catheter ablation using radiofrequency current in order to eliminate AVNRT from January 1993 to september 1994. We have analyzed local intracardiac electrogram at successful and unsuccessful sites of radiofrequency catheter ablation before the radiofrequency application: Atrial electrogram amplitude, duration, number of peaks in atrial electrogram, atrial/ventricular (A/V) electrogram amplitude ratio, and presence of His potential and/or slow potential. RESULTS: Of 18 patients, 16 patients underwent a slow pathway ablation, the other 2 patients a fast pathway ablation. The mean A/V electrogram amplitude ratio at successful and unsuccessful sites was 0.69+/-0.91 and 1.86+/-2.03, respectively. The mean atrial electrogram duration and number of peaks at successful and unsuccessful sites was 57+/-16 msec vs 69+/-16 msec and 1.7+/-0.5 vs 2.2+/-0.7, respectively. His bundle electrogram was seen in one slow pathway ablated and one fast pathway ablated patient. No slow potential could be identified in any of these 18 patients. CONCLUSION: We think that A/V electrocardiogram amplitude ratio below 0.5 at posterior interatrial septum along tricuspid annulus is important marker indicating a successful ablation sites.
Catheter Ablation* ; Electrocardiography ; Electrophysiologic Techniques, Cardiac* ; Humans ; Male ; Tachycardia, Atrioventricular Nodal Reentry*

Adenocarcinoma of the meibomian gland is relatively uncommon. In recent years, the authors have experienced a case of histologically proven meibomian gland adenocarcinoma. This was a 80-year-old female who had a regrowing large mass in the right upper eyelid. She was treated with surgical excision but rejected radiation therapy. A biopsy was performed and the histopathological examination revealed adenocarcinoma of the meibomian gland.
Adenocarcinoma ; Aged, 80 and over ; Anesthesia, Local ; Biopsy ; Conjunctivitis ; Eyelids* ; Female ; Humans ; Meibomian Glands* ; Molluscum Contagiosum* ; Skin

From June 1982 to Feb. 1987, 250 cases of planned ECCE with posterior chamber lens implantation were performed in Koryo General Hospital. Among them, 200 cases had been followed up for more than 2 months. The results were as follows: 1. Among 200 cases, the most prevalent age groups were age 40s to 50s for men(103 cases, 64.4% of 160 male cases) and age 60s to 70s for women(32 cases, 80% of 40 female cases). The mean age was 49.67 years for men and 65.84 years for women. 2. Before the operation, diabetes mellitus and hypertention were shown to be the most common systemic diseases, which were found in 8 cases and 6 cases, respectively. Exotropia and macular degeneration were some what more common ophthalmic problems, which were found in 2 cases, respectively. 3. Early postoperative complications were striate keratitis, corneal edema (180 cases, 90%), and uveitis (160 cases, 80%). These figures show that almost all cases have the above complications developed after planned ECCE and posterior chamber lens implantation. 4. Late complications were after cataract(6 cases, 3%) and secondary glaucoma (5 cases, 2.5%). 5. The best corrected visual acuity after operation of 0.5 or better was 84%. 6. The spherical equivalent between -2.00D and emmetropia of postoperative corrective spectacle lens power was composed of 132 cases(66%). 7. Postoperative astigmatism occurred in 103 cases. Among them, the lens power of 0.01 to 1.50D was found in 58 cases(56.3%). The most common axis of astigmatism was 180degree, which appeared in 28 cases.
Astigmatism ; Axis, Cervical Vertebra ; Corneal Edema ; Diabetes Mellitus ; Emmetropia ; Exotropia ; Female ; Glaucoma ; Hospitals, General ; Humans ; Keratitis ; Macular Degeneration ; Male ; Postoperative Complications ; Uveitis ; Visual Acuity

In analyzing the postoperative results or evaluating the velopharyngeal incompetence after palatoplasty, speech evaluation is the inevitable factor. However, a standardized method for evaluating the speech problem in Korean cleft palate patients has not been available until now. So, the authors tried to establish a method of speech evaluation which is simple, economic and applicable to young patients, and to make a scoring method of the speech results in cleft palate patients based on the 'hypernasality diagnosing tool for cleft palate patient (OK Ran Jung)' which is commonly used by domestic speech therapists. The authors adopted the 'hypernasality diagnosing tool for cleft palate patients (OK Ran Jung)' male and female of children and adults, each consisting of 10 patients and make them speak according to the items about hypernasality and misarticulation evaluation, and record the results. We also calcuted the degree of the formants of the vowels (/a/, /o/, /u/)using sound spectrography. We examined the interjudge and intrajudge reliance of speech evaluation among the 10 inverstigators, revised the evaluation tool, devised the scoring method according to the above results, and compared the scoring results with those of sound spectrography to prove the reliance of our speech evaluation tool. With the scoring method, the authors could estimate the degree of hypemasality and misarticulation in cleft palate patients with evidence of reliability based on point-to-point agreement in two items. In comparing the results of our scoring method with the formant of vowels using sound spectrography, staistical significance existed except /u/F2 and that meant that our scoring method was reliable. We suggest that this simple, economic and reliable method of speech evaluation in cleft palate patients can create the basis for speech evaluation in patients of cleft palate and velopharyngeal incompetence under circumstances in which the results of various speech treatments are evaluated in comparison to various methods of speech evaluation.
Adult ; Articulation Disorders ; Child ; Cleft Palate* ; Female ; Humans ; Male ; Research Design ; Sound Spectrography ; Velopharyngeal Insufficiency

Many methods of correcting secondary cleft lip nose deformity have been introduced, but a single best method that can be uniformly adjusted for all cases does not exist. Since it is difficult to make the nostril of the cleft side symmetric with that of normal side, the authors tried to formulate the basis for correction of unilateral secondary cleft lip nose deformity according to the varying amounts of deformed nostril. We then adopted 4 different methods of correcting the soft tissue and nostril deformity in 63 patients from 1996 to 1998 and surveyed the results. Our principles were as follows: 1) Alar rim incision was done in cases of different-shaped cleft-side nostrils with nearly the same measured area in comparison to the normal side. 2) When deformity of the alar-columellar web was severe, we performed modified Z-plasty. 3) When the nostril of the cleft-side nostril was smaller than the normal side with slight asymmetry, reverse W-plasty was done. 4) We adopted a reverse-U incision when there was a discrepancy in height with moderate asymmetry compared with the normal nostril. After dissection, repositioning of alar cartilage was done by same method in each case. A nasal stent was kept in position for at least 6 months postoperatively in almost all cases. After follow-up of 6 to 24 months, we concluded that our choice was correct in selecting the optimal operative method, considering the characteristics of deformity of the cleft side nostril in an effort to make it symmetric with that of the normal side.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Nose* ; Stents

Mucormycosis is an opportunistic fungal infection caused by the mucorales, which consist of the Rhizophus, Absidia, Mortierella, and Mucor. The diverse clinical forms of mucormycosis can be categorized as rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous and miscellaneous. Although it can cause disease in healthy people, it most commonly affects patients who are diabetic or immunosup-pressed. Rarely, mucormycosis develops confined to the subcutaneous tissue. We experienced a case of cutaneous mucormycosis developed in a well-controlled diabetic patient who had previously injected foreign material on her face for an aesthetic purpose at the behest of an unlicensed physician. The patient had tissue necrosis and purulent discharge on her left cheek. Following histologic examination, we diagnosed the condition as cutaneous mucormycosis and treated it by wide excision combined with amphotericin B therapy. The disease was cured without any significant sequelae within 6 months of follow up. Cutaneous mucormycosis is rarely reported but it can cause facial deformity due to tissue necrosis, so that early diagnosis and appropriate treatment are important. Currently, foreign material injection for aesthetic purposes is still performed by unlicensed physicians. We present a case report concluding that one should consider the possibility of fungal infection in skin lesion in diabetic or other immunosup-pressed patients. We also emphasize the seriousness of illegal injection of foreign material.
Absidia ; Amphotericin B ; Cheek ; Congenital Abnormalities ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortierella ; Mucor ; Mucorales ; Mucormycosis* ; Necrosis ; Paraffin* ; Skin ; Subcutaneous Tissue

Authors have experienced a case of retinal occlusion in patient with mitral valve prolapse. The patient was 10-year-old male who had visited our hospital due to the sudden onset of painless diminished vision and visual field defect of right eye since 2 days ago. The funduscopic finding of right eye showed typical appearance of retinal arterial occlusion with ischemic retinal whitening which app3ared as opacification. And, we also found mitral valve prolapse in this patient. One of the recently reported complications of mitral valve prolapse is thromboemboli resulting in cerebral ischemic events and visual complications. Such emboli can explain some cases of branch and central retinal arterial occlusion.
Child ; Humans ; Male ; Mitral Valve Prolapse* ; Mitral Valve* ; Retinal Artery* ; Retinaldehyde* ; Vision, Low ; Visual Fields