No abstract available.
Acoustics* ; Ear, Inner ; Hearing* ; Neuroma, Acoustic* ; Semicircular Canals*

OBJECTIVE: To investigate the effectiveness and safety of the laparoscopic L5-S1 fusion, its perioperative parameters and long-term outcome are compared with those of open anterior surgical approach. METHODS: Data of 54 consecutive patients who underwent anterior approach for L5-S1 fusion either by laparoscopic or open mini-anterior lumbar interbody fusion(ALIF) from 1997 to 1999 were analyzed. Among them, 47 cases were available with more than 2-years follow-up data. In all cases, carbon cage and autologous bone graft were used. RESULTS: Twenty five patients underwent a laparoscopic procedure and twenty two a open mini-ALIF. Three laparoscopic procedures were converted to open ones. For perioperative parameter, only the operative time was statistically different(p=0.001) while length of postoperative hospital stay and blood loss were not. The incidence of operative complication was three in laparoscopic group and two in open mini-ALIF group. After the follow-up of at least two years, the two groups showed no statistical difference in visual analog scale for pain, Oswestry disability index, and patient satisfaction index. The fusion rate was 91% in each group. CONCLUSION: The findings of this study suggest that laparoscopic ALIF has similar effectiveness and safety with open mini-ALIF. However, the advantage of laparoscopic approach as a minimally invasive surgery should be reconsidered because no objective additional benefit was found.
Carbon ; Follow-Up Studies ; Humans ; Incidence ; Length of Stay ; Operative Time ; Patient Satisfaction ; Surgical Procedures, Minimally Invasive ; Transplants ; Visual Analog Scale

INTRODUCTION: Anterior lumbar interbody fusion with video-assistance has become an increasing popular technique to stabilize the anterior vertebral column disease. A minimally invasive technique with reduced soft tissue dissection allows low morbidity and has cosmetic and functional advantages. METHOD: Fifty patients with chronic degenerative lumbar instability [degenerative disc disease(14), degenerative spondylolisthesis(14), Grade I lytic spondylolisthesis(9) and failed back syndrome(13)] who did not respond to conservative treatment for 6 months underwent minimal invasive retroperitoneal ALIF with video-assistance from Oct. 1996 to Sep. 1997. Access to lumbar disc was achieved through retroperitoneal space with a small vertical 4 to 5 cm incision on the midline after retroperitoneal endoscopic ballooning. After performing complete discectomy under guidance of endoscopic viewing and restoring the narrowed disc height, we stabilized the spine with carbon interbody fusion cages filled with allograft bone. RESULTS: Postoperatively the patients were usually allowed to ambulate on the following day and were discharged within 4 days. There were three major complications; one ureter injury, one retroperitoneal hematoma and one osteomyelitis. With an average 10 months follow up, 42 out of 50 patients(84%) have shown relief of symptomatic back pain. And 27 out of 28 patients with degenerative disc disease and degenerative spondylolisthesis(96%) had successful results. CONCLUSIONS: Minimal invasive retroperitoneal ALIF with video-assistance offers an attractive method to significant decreased postoperative pain and hospital stay compared with conventional anterior approaches. The patients with degenerative disc disease or degenerative spondylolisthesis were more likely to have a successful outcome than those with Grade I lytic spondylolisthesis or failed back syndrome(p=0.02).
Allografts ; Back Pain ; Carbon ; Diskectomy ; Follow-Up Studies ; Hematoma ; Humans ; Length of Stay ; Osteomyelitis ; Pain, Postoperative ; Retroperitoneal Space ; Spine ; Spondylolisthesis ; Ureter

A single intraoperative application of mitomycin C(MMC) has been used to improve the surgical outcome of glaucomatous eyes. But this soaking method has a few disadvantages, including difficulty in controlling amount. The purpose of this study is to evaluate the effectiveness of intraoperative subconjunctival injection of MMC to overcome this problem. In a retrospective analysis, 29 eyes of 24 consecutive patients, who were phakic primary glaucoma, who underwent primary trabeculectomy with subconjunctival injection of MMC (0.04 mg/ml, 0.05ml) were reviewed. All patients were followed for a periods of 3 months to 1 year. Preoperative mean intraocular pressure(IOP) was 33.9 +/- 9.3mmHg. The mean IOPs after 1, 3, and 6 months were 16.4 +/- 7.0, 16.1 +/- 7.5 and 16.9 +/- 5.8 mmHg, respectively. Twenty two eyes(76%) achieved an IOP of less than 21mmHg without antiglaucoma medication. Postoperative complications were transient hyphema in 3 eyes(20%), shallow anterior chamber in 2 eyes(7%), conjunctival wound leakage in 1 eye(3%), and hypotony maculopathy in 1 eye(3%). There were 4 cases (14%) of avascular cystic bleb and 8 cases (28%) of nonfunctional fibrotic bleb. We suggested that intraoperative subconjunctival injection of MMC could control concentration and amount of MMC.
Anterior Chamber ; Blister ; Glaucoma ; Humans ; Hyphema ; Mitomycin* ; Postoperative Complications ; Retrospective Studies ; Trabeculectomy* ; Wounds and Injuries

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Colon* ; Dilatation* ; Humans ; Infant, Newborn*

Optic disc can be analyzed with computerized optic nerve head analyzer or confocal scanning laser ophthalmoscope because optic disc has 3-dimensional structure. But the great cost of these instruments makes their utility for the average ophthalmologist unlikely. We measured optic discs with personal computer and stereophotograph and report as follows. Seventy-six optic discs of 76 normal subjects[61 men, 15 women; mean age: 25.5 years] were evaluated by stereoscopic optic disc photography. The area and length were measured by a computer graphic program and converted to absolute unit with Littmann's formula. The mean vertical disc diameter[1.94+/-0.24 mm], the mean horizontal disc diameter[1.67+/-0.23 mm], the mean vertical cup diameter[1.03+/-0.20 mm], the mean horizontal cup diameter[0.96+/-0.19 mm], the mean disc area[2.64+/-0.62 mm2], the mean disc circumference length[5.84+/-0.67 mm], the mean cup area[0.82+/-0.30 mm2], the mean cup base area[0.22+/-0.17 mm2], the mean cup slope area[0.60+/-0.21 mm2] and the mean rim area[1.82+/-0.41 mm2] were evaluated. The new technique to measure optic disc with stereophotograph and personal computer is thought to be a useful method to understand threedimensional structure of optic disc with relatively simple instruments.
Computer Graphics ; Female ; Humans ; Male ; Microcomputers ; Ophthalmoscopes ; Optic Disk ; Photography

We conducted a prospective study to compare MMC subconjunctival injection with MMC soaking for surgical outcome and postoperative complications as an adjunct to trabeculectomy in eyes with glaucoma. Eleven patients with bilateral glaucoma had undergone primary trabeculectomy with adjunctive subconjunctival mitomycin-C injection in one eye[Group I] and primary trabeculectomy with subconjunctival mitomycin-C soaking in the other eye[Group II]. Minimal follow-up period was 6 months and mean follow-up period was 12.8 months. Preoperative mean IOP was 35+/-10.9 mmHg in the group Iand 33+/-14.4 mmHg in the group II, and there was no statistical significance. Postoperative mean IOP at 1, 3, 6 months were 13+/-2.3, 13+/-3.1, 13.6+/-2.9 mmHg in the group I, and 11.3+/-3.3, 12.2+/-3.4, 12.9+/-2.7 mmHg in the group IIand no statistical significance. Each of ten eyes[91%] in both groups achieved intraocular pressure of less than 21 mmHg and good bleb formation without any medication. Postoperative complications were transient hyphema[18% in the group I, 9% in the group II], cystic bleb[9% in the group I, 27% in the group II] and shallow anterior chamber[9% in the group II]. Postoperative corneal endothelial cell density per square millimeter averaged 2, 221+/-306/mm2[mean+/-standard deviation] in the group I and 2, 195+/-272/mm2in the group II and there was no statistical significance. The rates of surgical success and postoperative complications were similiar in the two groups. Subconjunctival injection has similar effect to soaking method. This method enables us to have accurate control of concentration and amount of MMC, and thereby reduces complications and improves surgical outcomes in trabeculectomy.
Blister ; Endothelial Cells ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Prospective Studies ; Trabeculectomy*

A corticocancellous core was removed from both femurs and tibias in 5 skeletally immature pigs. The cavity was treated with 5%, 25% phenol cautery, cryosurgery, and normal saline irrigation (control). The animals were sacrified after 7days. The extent of the bone necrosis was assessed by gross examination, simple radiography, MRI evaluation and histological examination with tissue mapping. After cryosurgery, the extent of necrosis was most profound in the depth of 2.0-9.0mm beyond the cavity wall. The effect of 25%-phenol was next to cryosurgery, with a depth of 1.0-3.0mm of necrosis. 5%-phenol made necrosis with the depth of 1.0-2.5mm. Very mild degree of necrosis with the width of 0.5-1.0mm was found along the cavity wall even in control group. On MRI, signal change was well visualized on T2 weighted coronal section and it was quite coincided with the extent of bone necrosis proved by histological tissue mapping to all cases. When the epiphyseal plate was open or very close to the cavity, curettage itself, 5%- and 25%-phenol cautery and cryosurgery all produced mild ischemic necrosis along the provisional calcification zone of physeal plate. These findings suggest that cryosurgery made more profound necrosis beyond cavity than phenol cautery and MRI is very sensitive and specific to find osteonecrosis along the cavity wall after phenol cautery or cryosurgery. When epiphyseal plate is open or very close to the cavity, phenol cautery, or cryosurgery, or even curettage itself could produce an ischemic necrosis to the physeal plate itself.
Animals ; Cautery* ; Cryosurgery* ; Curettage ; Femur* ; Growth Plate ; Magnetic Resonance Imaging ; Necrosis* ; Osteonecrosis ; Phenol* ; Radiography ; Swine ; Tibia*