No abstract available.
Anti-Bacterial Agents* ; Prevalence* ; Shigella*

PURPOSE: When recurrent dissociated vertical deviation (DVD) is cosmetically objectionable after superior rectus recession is used to surgically treat DVD, inferior rectus resection or superior rectus re-recession should be considered. The effect of re-recession of the superior rectus was, therefore, evaluated as a treatment of recurrent DVD. METHODS: We retrospectively reviewed the medical records of 9 eyes from 7 patients who had undergone superior rectus re-recession as a second surgery due to recurrence after superior rectus recession for DVD. RESULTS: The mean follow-up period after re-recession of the superior rectus was 32.1 (22~66) months. The preoperative mean deviation was 16.0 prism diopters (PD), and the postoperative mean deviation was 4.9PD. According to the classification of recurrent DVD by Scott, the surgical results of five eyes were excellent (0~4PD), those of 2 eyes were good (10~14PD), and those of 2 eyes were fair. The mean corrected DVD was 4.1PD per 1 mm recession. CONCLUSIONS: Postoperatively, 7 of 9 eyes (77.7%) were aligned within 9PD. In cases of recurrent DVD, superior rectus re-recession yielded satisfactory results with minimum surgery on the superior rectus. The results of this study will be helpful in deciding surgical amount of superior rectus re-recession to be performed.
Eye ; Follow-Up Studies ; Humans ; Medical Records ; Recurrence ; Retrospective Studies

PURPOSE: To study the efficacy of unilateral rectus resection in the surgical treatment of undercorrected or recurrent strabismus. METHODS: A retrospective chart review of patients who had undergone a unilateral rectus resection with at least 6 months (mean 35.6 months) of postoperative follow-up was performed. RESULTS: A resection of a single rectus muscle was undergone by 92 patients: 70 underwent a unilateral resection of the medial rectus and 22 underwent a unilateral resection of the lateral rectus. The mean preoperative deviations of patients were 23.6+/-5.9 prism diopters (PD). The amount of unilateral medial rectus resection ranged from 3 to 7 mm and unilateral lateral rectus resection ranged from 5 to 10 mm. The satisfactory surgical result was considered to be any deviation within 8 PD. The success rates were 81.4% in the unilateral medial rectus resection group and 72.7% in the unilateral lateral rectus resection group. The satisfactory surgical result of the group of preoperative deviation less than or equal to 20 PD was 93.2%, the group of greater than 20 PD and less than or equal to 25 PD was 65.6% and the group of greater than 25 PD was 68.8%. This difference in results between three groups was statistically significant (p=0.006). CONCLUSIONS: The unilateral rectus resection is an effective procedure for the treatment of undercorrected or recurrent strabismus with small to moderate preoperative deviations.
Follow-Up Studies ; Humans ; Reoperation* ; Retrospective Studies ; Strabismus*

A 69-year old man presented with severe epigastric pain for 1 day. He had early gastric cancer at the antrum and underwent a distal subtotal gastrectomy and Billorth II gastrojejunostomy one month later without any post-operative complications. Radiologic examination revealed a large amount of retroperitoneal free air formation. Because of unremitting pain and unstable vital sign, exploratory laparotomy was followed. During the operation, a perforated duodenal diverticulum at the posterior wall of the 2nd portion of the duodenum was identified. He underwent diverticulectomy and primary closure. He was discharged on the 18th post operative day and has been followed up without any evidence of comlpication for several months.
Aged ; Diverticulum* ; Duodenum ; Gastrectomy* ; Gastric Bypass* ; Humans ; Laparotomy ; Stomach Neoplasms ; Vital Signs

No abstract available.
Child* ; Fibroma* ; Frontal Bone* ; Humans

No abstract available.
Hyperaldosteronism*

BACKGROUND: In athlete's heart, functional and structural alteration are main features. We studied electrocardiograms(ECG's) and echocardiograms(UCG's) in soccer players before and after intensive training. METHODS: Fifteen soccer players with the mean age and career of 19.3 and 8.5 years,respectively,underwent intensive training for 5-5.5 months, which included running of 2 km daily during the last 2-2.5 months. Comparisons of ECG's and UCG's recorded before and after the training were made. RESULTS: The major abnormal finding in pre-training ECG's was high voltage being seen in 40% of the cases, and in UCG's left ventricular(LV) dilatation and/or hypertrophy or asymmetrical septal hypertrophy(ASH) were noted in approximately 80% of the cases. The incidences of these finding after the intensive training were essentially unchanged, and the mean of pre-and post-training fractional shortening(FS) and LV and left atrial dimensions were similar. The high voltage in ECG's showed no close correlation with LV dilatation or hypertrophy on UCG's. After the training, however, the mean values of the thickness of LV posterior wall and ventricular septum along with LV mass were significantly increased, and the right ventricular dimension was significantly decreased. CONCLUSIONS: The most frequent finding in ECG's and UCG's in soccer players, before and after intensive training,were high voltage, LV dilatation and /or hyperophy with or without ASH. The intensive training of 5-5.5 months duration caused no change in F8,but caused significant increase in the thickness of LV posterior wall and ventricular septum, and LV mass.
Dilatation ; Electrocardiography* ; Heart ; Hypertrophy ; Incidence ; Running ; Soccer* ; Ventricular Septum

PURPOSE: Laparoscopic totally extraperitoneal herniorrhaphy (TEP) was developed as an alternative treatment of inguinal hernias to open hernia repair. This study evaluated 92 cases of laparoscopic surgery to determine the effectiveness and safety of laparoscopic TEP. METHODS: Laparoscopic TEP was performed on 92 patients with inguinal hernias from January 2008 to December 2010. Through a retrospective study of these patients, information om TEP repair was collected including the patients' characteristics, operation time, hospital stay, analgesic use and related complications. RESULTS: Laparoscopic herniorrhaphy were performed on a total of 92 patients (85 men and 7 women, age ranging from 16 to 83 years, with a mean of 56 years). The mean operation time for a unilateral inguinal hernia and bilateral inguinal hernia was 58.7 and 84.2 min, respectively. The mean postoperative hospital stay was 4.0 days (range, 2~9 days). Thirty nine patients were discharged without an analgesic injection, whereas 36 patients were injected with analgesic on the day of surgery. Of these 92 procedures, 10 complications were recorded; one granuloma complication, two patients with operation site discomfort, five with urinary retention issues, one patient with a scrotal seroma, and one patient with scrotal edema. CONCLUSION: TEP repairs have minimal morbidity and are more effective with less pain than the open procedure. TEP repair can be considered a favorable procedure for patients who request minimally invasive procedures for inguinal hernia repairs.
Female ; Granuloma ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Laparoscopy ; Length of Stay ; Male ; Pyrazines ; Retrospective Studies ; Seroma ; Urinary Retention

BACKGROUND: Authors have undertaken this study to see if the choice of anesthesia can directly or indirectly provide immunomodulation for cytokines, to determine the relationship of cytokines and hypothalamo-pituitary-adrenal axis in stomach cancer surgery patients, and also to see whether the amount of morphine administration and choice of analgesia can influence cytokine release, and possibly immunity. METHODS: Total 19 gastric cancer surgery patients were randomly assigned in double-blind fashion into two groups. Group-G (n=9) was provided with general anesthesia plus morphine intravenous patient controlled analgesia (IV-PCA), whereas group-GE (n=10) with preemptive epidural and general anesthesia plus continuous epidural analgesia for control of postoperative pain. At predetermined time interval, proinflammatory cytokines and stress hormones were evaluated with visual analog pain scale. Simultaneous assessments of operating and anesthesia time, total morphine doses, the time to recovery of gastrointestinal function and incidences of complications were also made. RESULTS: Demographic data, the durations of operation and anesthesia and recovery of gastrointestinal function were similar in both groups. Total morphine doses were approximately four times greater in group-G. Secretions of interleukin-1 beta , TNF and epinephrine were blocked by preemptive epidural anesthesia, meanwhile, interleukin-6 as well as ACTH and cortisol were not. After 24 hours after skin incision, the differences of cytokines, ACTH and cortisol between two groups were dissipated. In spite of these hormonal findings, visual analog pain scale could not disclose any differences. Incidences of complications were statistically insignificant except that of itching in group-GE. CONCLUSION: Preemptive epidural anesthesia and analgesia can partially block only some of cytokines and stress hormones, and these effects do not have clinically relevant long term influences. The amounts and means of morphine administered by continuous epidural analgesia block or IV-PCA demonstrated no evidence of immunosuppression at clinical dose range.
Adrenocorticotropic Hormone ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Anesthesia and Analgesia* ; Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Axis, Cervical Vertebra ; Cytokines ; Epinephrine ; Humans ; Hydrocortisone ; Immunomodulation* ; Immunosuppression ; Incidence ; Interleukin-1beta ; Interleukin-6 ; Morphine ; Pain Measurement ; Pain, Postoperative ; Pruritus ; Skin ; Stomach Neoplasms* ; Stomach*

PURPOSE: The purpose of this study is to describe the usefulness of intraoperative mobile CT scans in the reduction of zygomatic arch fracture. Method: Two patients with zygomatic arch fractures were selected who were indications of closed reduction by Gilles' approach. After the reduction was done in the operating room with zygomatic arch elevator, intraoperative CT scan was done to check the extent of reduction. Additional reduction was performed according to the obtained images from the intraoperative mobile CT scan. Examination of the preoperative CT, intraoperative CT after the reduction, and postoperative plain X-ray films were done for documentation and analysis. RESULTS: Reduction was carried out successfully to the patients without any complications. Both patients were satisfied with the postoperative cosmetic and functional outcome. Revisional surgery was not necessary during the 6 months follow up. CONCLUSION: The advantage of this method is that it is easier to obtain three dimensional relationships of the fracture site. Furthermore, the operator is less exposed to radiation hazards compared to other methods that obtain intraoperative images such as the C-arm. In conclusion, intraoperative mobile CT scan can be a useful surgical aid in the reduction of zygomatic arch fractures.
Cosmetics ; Elevators and Escalators ; Humans ; Imidazoles ; Nitro Compounds ; Operating Rooms ; X-Ray Film ; Zygoma