To determine clinical features and outcomes of retinal detachments[RDs] following trans-scleral fixation of posterior chamber intraocular lens[PC-IOL], we reviewed the medical records of 249 eyes[239 patients] which had undergone trans-scleral fixation of PC-IOL and had been followed 6 months or longer. Retinal detachment occurred in 8 out of 249 eyes[3.2%]. The incidences of RDs were as follows:in 2/19 eyes[10.5%] with PC-IOL exchange for PC-IOL tilt, in 1/16 eyes[6.3%] with posterior capsule rupture during ECCE, in 1/26 eyes[3.8%] with ICCE, in 2/78 eyes[2.6%] with posterior capsule rupture during phacoemusification, in 2/106 eyes[1.9%] with aphakia, and in 0/4 eyes[0%] with anterior IOL exchange with PC-IOL. The sites of retinal break corresponded with the directions of needle during fixation in 5/8 eyes[62.5%] and all retinal breaks were located anterior to the equator. The timing of RD was between 2 weeks and 4.8 years after fixation although it occured within 2 months in most cases. Pars plana vitrectomy and scleral buckling were performed in 7 eyes and scleral buckling only in one eye. Retinal reattachment was achieved in seven eyes including three eyes which required two surgical interventions. The vitrectomy should be performed with meticulous care to reduce vitreous traction as much as possible during trans-scleral fixation of PC-IOL and a close follow-up examination for RD is required during the first two months.
Aphakia ; Follow-Up Studies ; Incidence ; Lenses, Intraocular* ; Medical Records ; Needles ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Rupture ; Scleral Buckling ; Traction ; Vitrectomy

Utile recently, osteotomy & reposition surgery of prominent zygoma have been performed by means of a coronal incision or intraoral preauricular incision. But penalties are paid, such as scar, the possibility of facial nerve injury and long operative time. Reflecting on our past experiences of facial bone surgery, we developed an alternative approach. In our method, the protrusion in the cheekbone is corrected by performing an osteotomy and reposition method through intraoral incision only. During the past 3 years we have operated on 23 patients of malar prominences. The amount of the bone to be removed is determined on preoperative interview, physical examination and x-rays. Intraoral incision provide access to the zygomatic body and lateral orbital rim. After L-shaped osteotomy, two paralle vertical and one transverse osteotomies, at medical part of the zygomatic body, the midsegment is removed. Posterior portion of zygomatic arch was approached through medical aspect and was outfractured using curved osteotome. After completion of triple osteotomy, the movable zygomatic complex was reduced medially and fixed with miniplates and screws on the zygomaticomaxillary buttress. The patients were followed for 9.5 months with acceptable result and little complication. The author concludes that this technique is effective and safe method in reduction malarpalsty.
Cicatrix ; Facial Bones ; Facial Nerve Injuries ; Humans ; Operative Time ; Orbit ; Osteotomy ; Physical Examination ; Zygoma

No abstract available.
Carbon* ; Knee*

Since last August, 29 cases of synovial punch biopsy have been carried out with Franklin-Silverman needle which was used in liver biopsy, instead of the specialized needle for the synovium. Authors report the applicable utility of Franklin-Silverman needle for the synovial biopsy, diagnostic value of this procedure and histopathologic findings of the results. The rate of the technical success to abtain synovial tissue was about 76%. Complications after procedure have been very rarely encountered, consisting of mild transient hemarthrosis. In 17 cases, the histopathologic changes was compatible with their clinical findings. In the remainders, we experienced the failures to get synovial tiasue at all in 7 cases and to give the significant synovial changes in 5 successful specimens. Fortunately, the important diagnostic aid was achieved in 3 cases which were conformed early diagnosis of tuberculous arthritis. This needle biopsy was also thought to contribute to rule out the gouty arthritis from other hyperuricemic conditions. But the histologic changes were non specific inflammatory findings in the synovial mambrane of rheumatoid arthritis, osteoarthritis, traumatic and infectious arthritis.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Early Diagnosis ; Hemarthrosis ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane

Multiple involvement of arterial fibromuscular dysplasia is unusal and such a case is quite limited in the literature. We present a case of multiple arterial fibromuscular dysplasia with aneurysm formation in a 38-year-old non-hypertensive man. Angiographic study showed multiple aneurysmal dilatations of the right renal, superior mesenteric, celiac axis, and left colic arteries. The resected right kidney demonstrated an aneurysm of the main renal artery and extensive infarction in the midportion of the renal parenchyma. The segmentally resected superior mesenteric artery disclosed a similar nature of aneurysm occluded by recent thrombi. Microscopically, all the resected arterial walls showed both intimal and medial fibroplasia together with periadventitial fibrosis resulting in marked narrowing of the lumen and subsequent thrombus formation.

Anisakiasis is a parasitic infectious disease caused by eating raw, infected fish. It causes severe abdominal pain-like acute abdomen, but not fatal. Anisakiasis was firstly reported by van Thiel et al. in 1960 in Netherlands and it has subsequently been reported in the Netherlands, Japan, the United states, Korea as well as other nations. Because Koreans like eating raw fish, the anisakiasis of the stomach was occasionally reported, but the case of severe gastric bleeding was very rare. So we report one case of gastric ulcer bleeding due to gastric anisakis larva proven by endoscopy and gastric resection.
Abdomen, Acute ; Anisakiasis* ; Anisakis ; Communicable Diseases ; Eating ; Endoscopy ; Hemorrhage* ; Japan ; Korea ; Larva ; Netherlands ; Stomach ; Stomach Ulcer* ; United States

Primary leiomyosarcoma is a rare tumor of the ovary. We experienced a case of primary ovarian leiomyosarcoma in a 68 year old woman. Microscopically, the tumor was characterized by interlacing bundles of plump spindle cells that showed immunoreactivity for alpha-smooth muscle actin, pleomorphic multinucleated giant cells and an increased mitotic rate. Ultrastructural features included abundant smooth muscle type filaments and irregular bodies. Consequently, this case has led us to propose ultrastructural and immunohistochemical criteria for primary ovarian leiomyosarcoma.
Female ; Humans

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

No abstract available.
Rectal Neoplasms*

We reviewed a total of 36 cases of gastrointestinal carcinoid tumors during a period of ten and a half years at Seoul National University Hospital, looking at their histologic and ultrastructural features, as well as immunohistochemical results, then we correlated these with location. The primary sites of carcinoid tumors were rectum(39%), stomach(25%), appendix(22%), small intestine(8%) and colon(6%), in order of frequency. The predominant histologic types by organ were mixed and solid(A) types in all location, the solid type(type A) in the stomach, and tubular type(type C) in the rectum. Six out of 8 cases of appendiceal carcinoid were type A and the other two cases were mucinous carcinoid. Tubular adenoma or adenocarcinoma was associated with 36% of the rectal carcinoids, with one case of carcinoid in the small intestine, and one(11%) of the gastric carcinoids was found near an adenocarcinoma. Metastasis was found in one case of ileal carcinoid(100%), one case of cecal carcinoid, 3 of gastric carcinoid(33%) and 2 of rectal carcinoid(14%). Primary tumor size ranged from 1 to 7 cm. Tumor necrosis and endolymphatic tumor emboli were found in 57% and 43% of the metastatic carcinoids, respectively. PCNA index showed a borderline significant difference between metastatic and nonmetastatic groups(P value=0.063). The low prevalence of appendiceal carcinoid and the relatively high prevalence of gastric-rectal carcinoid may reflect a low chance of incidental appendectomy and frequent detection of gastrointestinal endoscopy.
Adenocarcinoma ; Adenoma ; Neoplasm Metastasis