PURPOSE: Various methods of scleral fixation for the cases of posterior chamber intraocular lens (PCL) dislocation or subluxation into the vitreous cavity had been developed, and in the recent year a modification of internal scleral fixation using a hollow-bore needle has been introduced. The authors endeavored to evaluate clinical usefulness of the method. METHODS: The study was conducted for four cases of PCL dislocation or subluxation. A 10-0 polypropylene suture was threaded up the internal shaft of a 30 G straight needle and retrieved. The needle containing this suture was then inserted through the bed of the partial-thickness scleral flap 1.5 mm posterior to the limbus. The loop of suture was hooked with haphic of PCL. After the needle was retracted, the haptic was captured and the suture was tied to the sclera. The same maneuver was performed for the haptic in the opposite side. RESULTS: Except for pars plana vitrectomy, time taken for the above procedure was 10~15 minutes. Postoperatively induced astigmatism of all 4 cases were less than 3 diopters on the second postoperative day. No specific complication associated with this procedure was noted. IOL remained stable without tilting or rotation 18 months after procedure. CONCLUSIONS: This modified internal scleral fixation technique must be a convenient and effective procedure for repositioning posteriorly dislocated PCL.
Astigmatism ; Dislocations* ; Lenses, Intraocular* ; Needles* ; Polypropylenes ; Sclera ; Sutures ; Vitrectomy

No abstract available.
Colon* ; Rats, Sprague-Dawley* ; Rectum*

The duplicated origin of vertebral artery (VA) is a very rare condition. It could be easily misdiagnosed as an arterial dissection on selective catheter angiography, especially in a patient with acute cerebellar infarction of unknown etiology. We report a patient with an acute cerebellar infarction and duplicated origin of the left VA, which was found during the selective catheter angiography.
Angiography ; Catheters ; Humans ; Infarction ; Vertebral Artery*

SAPHO syndrome is an acronym for an increasingly recognized syndrome of synovitis, acne, pustulosis, hyperostosis, and osteitis. Most of the previously reported case are from Japan and Europe. The authors report a case of SAPHO syndrome in Korean female who presented with extrasternal neurologic symptoms. A 60-year-old female with thoracic and right chest wall pain presented with the sternocostoclavicular hyperostosis, and recurrent aseptic osteitis. Previously, she had hystrectomy and thyroidectomy due to uterine malignancy 25 years ago. Also, she started to take medications for palm and sole pustulosis 7 days prior to admission. Through evaluation of clinical, radiological, serological studies, studies was done along with bone needle biopsy for the biological reassessment. The hyperostosis was found in the pedicles of thoracic 8, 9, 10 vertebrae and sternoclavicular joint. Radio-isotope bone scan showed an accumulation of tracer in thoracic vertebra. The bone biopsy from these site showed increased osseous turnover, thickening of trabeculae accompanied by mild acculuation of granulation tissue and round cell infiltration, compatible with mild chronic inflammation with marrow fibrosis. The patient showed good response to conservative management. The authors report a case of SAPHO syndrome with thoracic radiculopathy. It is considered that SAPHO syndrome is related to spondyloarthropathy, and appears to have benign disease process with good prognosis.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Biopsy ; Biopsy, Needle ; Bone Marrow ; Europe ; Female ; Fibrosis ; Granulation Tissue ; Humans ; Hyperostosis ; Hyperostosis, Sternocostoclavicular ; Inflammation ; Japan ; Middle Aged ; Neurologic Manifestations ; Osteitis ; Prognosis ; Radiculopathy* ; Spine ; Spondylarthropathies ; Sternoclavicular Joint ; Synovitis ; Thoracic Wall ; Thyroidectomy

OBJECTIVE: Whereas fusion with pedicle screw fixation has shown satisfactory clinical results, solid fusion has been reported to accelerate degenerative changes in adjacent unfused levels. The purpose of this study was to evaluate the effect of bone/ligament/bone integrity after subtotal or total laminectomies on the development of adjacent segment instability (ASI). The hypothesis that total laminectomy would increase ASI more than would subtotal laminectomy was analyzed. Material and METHODS: This is a retrospective study of 316 patients who were treated with posterior fusion and pedicle screw fixation between 1996 and 2001. After attempts to review all 316 patients and radiologic files, 36 patients who were diagnosed with ASI were carefully reviewed, including follow-up periods of 2-8 years. The medical records were carefully reviewed for recurrence of low back pain or neurologic symptoms after a period of postoperative relief, and the radiologic files were evaluated to determine instability. All patients had undergone single-level or multilevel instrumented posterior lumbar interbody fusion for intractable pain related to degenerative conditions of the spine. RESULTS: Patients over the age of 60 were at a higher risk of developing clinical ASI however,fusion length, level and gender were not associated with ASI. The ASI was noted to occur most commonly in the cranial segment prior to fusion. CONCLUSIONS: This study revealed more frequent ASI after total laminectomy than after subtotal laminectomy, especially in elderly patients. The ideal procedure will be one combining maximal canal and foraminal decompressions with minimal resection of bony structures and supporting ligaments.
Aged ; Follow-Up Studies ; Humans ; Laminectomy ; Ligaments ; Low Back Pain ; Medical Records ; Neurologic Manifestations ; Pain, Intractable ; Recurrence ; Retrospective Studies ; Spine

No abstract available.
Lymphoma, Non-Hodgkin* ; Spinal Cord Compression* ; Spinal Cord*

OBJECTIVE: Radiation therapy is an effective adjunctive therapy in the management of brain and spinal cord tumors. The damage to normal tissue, however, has been often the dose-limiting factor in radiation therapy. The purpose of this study is to see whether nimodipine, the one of calcium channel blockers, is effective for the prevention of irradiation-induced apoptosis in the rat spinal cord. METHODS: Sprague-Dawley rats were used: Control(n=12), Nimodipine-treated(0.5mg/kg, n=12). After nimodipine was administered intraperitoneally, the spinal cord of cervicothoracic junction was exposed to a single 10Gy dose of gamma rays using Ir-192. All spinal cords underwent histological examination at 4, 8, and 12 hours after irradiation, and apoptotic cells were detected by TUNEL assay and were determined by direct visual counting at magnification of x200. RESULTS: On the standard H-E stain, little evidence of histopathological change was noted within the 12 hours after irradiation. Both groups showed gradual increase of apoptotic cell counts with the lapse of time. But, in nimodipine-treated group, apoptotic cell counts were reduced significantly, compared to those of control group after irradiation, especially at 8 and 12 hours. CONCLUSION: The results suggest that nimodipine may have effects on the prevention of radiation-induced apoptosis in the spinal cord.
Animals ; Apoptosis* ; Brain ; Calcium Channel Blockers ; Cell Count ; Gamma Rays ; In Situ Nick-End Labeling ; Nimodipine* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord Neoplasms ; Spinal Cord*

The National Health Screening program has been implemented in Korea since 1980. First, we had searched recent scientific evidences and verified the accuracy of the data on target oral diseases. In order to determine the validity, we searched scientific bibliographic data and concluded that dental caries and periodontal disease were major oral problems. Second, we developed new improved forms for National Oral Health Screening. To improve these forms, we reviewed previous forms and gathered expert opinions. The new forms were consistent with the examination forms given to all age groups, and information on oral health conditions, dental education needs, and post-treatment care was included in the modified forms. We then designed manuals for dentists, which contained information on the screening criteria as well as consultation and patient education guidelines. The manuals were divided into three parts, including explanation of the screening criteria, standard of the decision, and education and consultation guidelines. By using these new and modified National Oral Health Screening forms, we expect an improvement in the National Oral Health Screening Program and enhancement in the oral health condition of patients.
Adult ; Counseling ; Dental Caries ; Dentists ; Education ; Education, Dental ; Expert Testimony ; Humans ; Infant ; Korea ; Mass Screening* ; Oral Health* ; Patient Education as Topic ; Periodontal Diseases ; Tooth Diseases

Gastrointestinal (GI) fistulas are frequently very serious complications that are associated with high morbidity and mortality. GI fistulas can cause a wide array of pathophysiological effects by allowing abnormal diversion of the GI contents, including digestive fluid, water, electrolytes, and nutrients, from either one intestine to another or from the intestine to the skin. As an alternative to surgery, recent technical advances in interventional radiology and percutaneous techniques have been shown as advantageous to lower the morbidity and mortality rate, and allow for superior accessibility to the fistulous tracts via the use of fistulography. In addition, new interventional management techniques continue to emerge. We describe the clinical and imaging features of GI fistulas and outline the interventional management of GI fistulas.
Drainage ; Gastric Fistula/diagnosis/radiography/*therapy ; Humans ; Intestinal Fistula/diagnosis/radiography/*therapy ; Punctures ; *Radiography, Interventional

OBJECTIVE: Radiation injury includes radiation necrosis and apoptosis. The purpose of this study is whether steroids and calcium channel blockers are effective for the prevention of single high dose irradiation-induced apoptosis in the rat brain. METHODS: Eighty Sprague-Dawley rats were divided into four experimental groups: Control(nontreated, n=20), Dexamethasone-treated(0.1mg/kg, n=20), Prednisolone-treated(2mg/kg, n=20), Nimodipine-treated (0.5mg/kg, n=20). After drug was administered, the right hemisphere of rat's brain was exposed to a single 10Gy dose of gamma rays using Ir-192. All brains underwent histological examination at 1 week, 2 weeks, 4 weeks, and 8 weeks after irradiation to evaluate cortical thickness and number of apoptotic cells. Apoptotic cells were detected by TUNEL assay. RESULTS: In nimodipine-treated group, apoptotic cell count was reduced significantly, compared to that of control(non treated) group at 4 and 8 weeks after irradiation(p<0.05). The decrease of cortical thickness was reduced significantly in nimodipine-treated group, compared to that of control group(p<0.05). There was no significant changes in the number of apoptotic cells and cortical thickness in prednisolone and dexamethasone-treated groups compared with those of control. CONCLUSION: These results suggest that nimodipine treatment may have effects on the prevention of radiation-induced apoptosis. If it could be established that calcium channel blockers inhibit radiation injury, they might be useful in radiation therapy. Further investigation of calcium channel blockers including dosage effectiveness, intracellular calcium ion concentration and effects on tumor tissue are necessary to clarify the usefulness of nimodipine.
Animals ; Apoptosis* ; Brain* ; Calcium Channel Blockers ; Calcium Channels* ; Calcium* ; Cell Count ; Dexamethasone ; Gamma Rays ; In Situ Nick-End Labeling ; Necrosis ; Nimodipine ; Prednisolone ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley ; Steroids