No abstract available.
Multiple Organ Failure* ; Sepsis*

No abstract available.
Multiple Organ Failure* ; Sepsis*

We reviewed the records of 23 patients who underwent repeat operation after initial vitreoretinal surgery in Chungnam National University Hospital between January 1993 and December 1993. Of 193 eyes who underwent vitreoretinal surgery in that period, 23(12%) had undergone reoperation. The most common cause of initial anatomic failure and reoperation was either new or recurrent proliferative vitreoretinopathy(10 eyes). Other causes included iatrogenic retinal tears(5 eyes), hidden retinal breaks(4 eyes), vitreous traction(1 eye), inappropriate chorioretinal adhesion(1 eye), and new break(1 eye). We performed vitreous base dissection on all 9 eyes with anterior proliferative vitreoretinopathy. With additional surgery and after a mean follow-up period of 10.4 months, 21(91%) of 23 retinas were reattached. The final cause of anatomic failure was anterior proliferative vitreoretinopathy. Of the 23 reoperated eyes, 20(87%) had postoperative visual acuity of 0.05 or better.
Chungcheongnam-do ; Follow-Up Studies ; Humans ; Reoperation ; Retina ; Retinaldehyde ; Visual Acuity ; Vitreoretinal Surgery* ; Vitreoretinopathy, Proliferative

Four patients with intraocular foreign bodies and traumatic cataracts underwent combined pars plana lensectomy, vitrectomy, and intraocular foreign body removal. During pars plana lensectomy, anterior lens capsule and zonules were left intact. At the end of surgery, a posterior chamber intraocular lens was placed in the sulcus in front of the anterior capsule through a 7-mm limbal incision. This procedure was performed in selected cases of combined anterior and posterior segment trauma. Combining pars plana lensectomy and posterior chamber intraocular lens implantation with posteior segment procedures allows rapid visual rehabilitation and functional unaided vision. We therefore suggest that this technique is effective in treating selected patients with both cataract and vitreoretinal diseases.
Cataract ; Foreign Bodies* ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Rehabilitation ; Vitrectomy

A cilioretinal artery occlusion associated with a central retinal vein occlusion is a rare condition and has been reported to have a good visual prognosis. We report a young patient with this condition who also demonstrated prolonged filling of the branch retinal arteries with fluorescein angiography. Her initial visual acuity was 0.03 in the affected eye. Two months later, normal central retinal artery inflow resumed. Her visual acuity has improved to 0.5 over the three years' follow-up.
Arteries* ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Prognosis ; Retinal Artery ; Retinal Vein* ; Visual Acuity

Spontaneous dissection of the vertebrobasilar arterial system is less common than that of the carotid system. These dissections are usually found extracranially or in a combination of intracranial and extracranial location. Pure intracrainl involvement is uncommon. Particularly in oriental country. This vascular anomaly is one of the important causes of posterior circulation stroke in young and middle-aged adults. Lf manifested as brainstem, ischernia, the usual symptoms and signs are typically neck or occipital pain followed later by particular features of the lateral medullary syndrome. Etiology remains obscure in most cases of spontaneous dissection and management is still controversial. We present three cases of dissecting aneurysm of the intracranial portion of unilateral vertebral artery. The two patients manifested as lateral medullary syndrome with sudden neck pain and digital substracted angiogram revealed proximal narrowed segments and distal fusiform dilatation of the unilateral vertebral arter.,v. The other patient manifested as subarachnoid hemmorrhage and angiographically dilatation at the junction of vertebral artery and posterior inferior cerebellar artery was noted. In operative field, two cases were confirmed as dissecting aneurysm.
Adult ; Aneurysm, Dissecting* ; Arteries ; Brain Stem ; Dilatation ; Humans ; Lateral Medullary Syndrome ; Neck ; Neck Pain ; Stroke ; Vertebral Artery*

PURPOSE: The purpose of this study was to assess the usefulness of CT angiography(CTA) with spiral CT in evaluation of intracranial vascular lesions. MATERIALS AND METHODS: CTA and conventional angiography(CA) were performed in 22 patients with suspected intracranial vascular lesion. Nine patients had 10 aneurysms and 2 patients had arteriovenous malformation(AVM)s, while the remaining 11 patients had no vascular lesion. Twenty seconds after beginning injection of contrast media(100 mL with use of a power injector at the rate of 3 mL/sec), CT scanning(30-second continuous exposure and 60-mm length) was performed with a table speed of 2mm/sec and a section thickness of 2mm. The starting point was selected at the floor of the sella turcica. The resulting data were reformatted by MIP and SSD after reconstruction of 1 mm interval. For aneurysm, its size, shape, direction, neck and the relationship to adjacent vessels were compared to CA. RESULTS: The aneurysm diameter was ranged between 3mm and 20mm and all aneurysms were clearly visualized with CTA. CTA findings of the size, shape, direction, and neck of aneurysms and the relationship between aneurysm and adjacent vessels were well correlated with CA. In one case of aneurysm, calcification of the aneurysm wall was demonstrated on CTA. In one case of AVM, the nidus and its arterial supply and venous drainage were well visualized. In the other case of AVM, however, the feeding artery of AVM was not demonstrated on CTA(it was also unclear on CA). CONCLUSION: CTA with spiral CT may be useful in the evaluation of intracranial vascular lesion and valuable as a screening test for intracranial aneurysm.
Aneurysm ; Angiography* ; Arteries ; Drainage ; Humans ; Intracranial Aneurysm ; Mass Screening ; Neck ; Sella Turcica ; Silver Sulfadiazine ; Tomography, Spiral Computed*

Haemophilus aphrophilus, a fastidious, gram-negative oropharyngeal species grouped as a HACEK organism, is a rare cause of infective endocarditis. Three cases of endocarditis with Haemophilus aphrophilus were reported in Korea, and all of them required valve replacement surgery. We describe a case of native valve infective endocarditis with cerebral embolism and infarction caused by Haemophilus aphrophilus in a 61-year-old woman who was successfully treated with antibiotic therapy for 6 weeks without valve replacement surgery.
Embolism ; Endocarditis ; Female ; Haemophilus ; Humans ; Infarction ; Intracranial Embolism ; Korea ; Middle Aged

Patients with secondary hyperparathyroidism usually present with a history of underlying disease such as chronic renal failure. Tertiary hyperparathyroidism usually exists in situations of secondary hyperparathyroidism. It occurs when parathyroid hyperplasia becomes so severe that removal of the underlying cause does not eliminate the stimulus for PTH secretion and hypertrophic chief cells become autonomous. Surgical parathyroidectomy sould be considered in patients with uncontrolled hyperparathyroidism. Hungry bone syndrome is known to be developed due to extensive remineralization of skeleton after parathyroidectomy. It is characterized by prolonged symptomatic hypocalcemia, as a complication of the parathyroidectomy for hyperthyroidism. We have experienced a female patient with hypercalcemia, who had been on maintenance hemodialysis for 15 years. She had elevated intact PTH and alkaline phosphatase. We decided parathyroidectomy because of uncontrolled hyperthyroidism despite of medical treatment. A few weeks after the operation she developed a muscle pain and arthralgia, which were found to be due to severe hypocalcaemia. Calcium suppletion led to normalization of the serum calcium level. she was discharged from the hospital in good condition after calcium supplement. We report a case of hungry bone syndrome developed after parathyroidectomy in this patient.
Alkaline Phosphatase ; Arthralgia ; Calcium ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperplasia ; Hyperthyroidism ; Hypocalcemia ; Kidney Failure, Chronic ; Myalgia ; Parathyroidectomy* ; Renal Dialysis ; Skeleton

BACKGROUND: In the management of mallet deformities, oblique retinacular ligament (ORL) reconstruction provides a mechanism for automatic distal interphalangeal (DIP) joint extension upon active proximal interphalangeal joint extension. The two variants of ORL reconstruction utilize either the lateral band or a free tendon graft. This study aims to compare these two surgical techniques and to assess any differences in functional outcome. As a secondary measure, the Mitek bone anchor and pull-in suture methods are compared. METHODS: A single-institutional retrospective review of ORL reconstruction was performed. The standard patient demographics, injury mechanism, type of ORL reconstruction, and pre/postoperative degree of extension lag were collected for the 27 cases identified. The cases were divided into lateral band (group A, n=15) and free tendon graft groups (group B, n=12). Group B was subdivided into the pull-in suture technique (B-I) and the Mitek bone anchor method (B-II). RESULTS: Overall, ORL reconstructions had improved the mean DIP extension lag by 10degrees (P=0.027). Neither the reconstructive technique choice nor bone fixation method identified any statistically meaningful difference in functional outcome (P=0.51 and P=0.83, respectively). Soft-tissue injury was associated with 30.8degrees of improvement in the extension lag. The most common complications were tendon adhesion and rupture. CONCLUSIONS: The choice of the ORL reconstructive technique or the bone anchor method did not influence the primary functional outcome of extension lag in this study. Both lateral band and free tendon graft ORL reconstructions are valid treatment methods in the management of chronic mallet deformity.
Congenital Abnormalities ; Demography ; Finger Injuries ; Humans ; Joints ; Ligaments* ; Reconstructive Surgical Procedures ; Retrospective Studies ; Suture Anchors ; Suture Techniques ; Sutures ; Tendons* ; Transplants* ; Wounds and Injuries