One case of osteoid osteoma in the lamina of the fifth lumbar spine with hamstring muscle tightness was experienced and successfully treated by surgery at the department of orthopedic surgery in Seoul National University Hospital. Literature on the subject was reviewed in detail.
Muscle Tonus ; Orthopedics ; Osteoma, Osteoid ; Seoul ; Spine

Marfan Syndrome is a rare congenital disease characterized by the abnormalities of Sheletal system, eye and cardio-vascular system which was initially desiribed by Marfan in 1896. One case of marfan syndrome was treated at the department of Orthopedic Surgery, College of Medicine, Seoul National University for multiple skeletal deformities. Moderate degree of scoliosis was treated with Milwaukee brace and finger deformities with Z-plasty and full thickness skin graft.
Braces ; Congenital Abnormalities ; Fingers ; Marfan Syndrome ; Orthopedics ; Scoliosis ; Seoul ; Skin ; Transplants

Two hundreds cases of spine tuberculosis were treated surgically for the period of 7 years between 1970 and 1976 at Seoul National University Hospital and following results were obtained. 1. Many patients failed to be treated with conservative method. Spontaneous fusion was found in 10% of 200 cases with long duration of disease. Anterior fusion was performed in 166 cases and posterior fusion was carried out in 34 cases. In those 34 cases, anterior currettage was combined in 7 cases, anterior fusion combined in 19 cases in which 7 cases were performed anterior and posterior fusion at one stage. Posterior fusion alone was carried out only in 8 cases. 2. Anterior fusion is indicated for: a. decompression in cord involvement b. confirmation of diagnosis c. involvement of one joint space in children d. mild to moderate kyphosis in adult 3. Anterior and posterior fusion is indicated in: a. severe kyphosis for solid funsion b. involvement of more than two joint spaces in children to prevent increasing kyphosis c. one stage operation was technically possible and has many advantages 4. Posterior fusion is indicated in: a. poor general condition b. technically difficult cases.
Adult ; Child ; Decompression ; Diagnosis ; Humans ; Joints ; Kyphosis ; Methods ; Seoul ; Spine ; Tuberculosis

We assessed the accuracy of Goldmann or Schi-(phi)tz tonometric readings in the gas filled vitrectomized eyes. We performed pars plana vitrectomy with or without lensectomy in 8 rabbit eyes, and in 6 enucleated porcine eyes. Fluid-air exchange was done at the end of the procedure. Intraocular pressure was measured using Goldmann tonometer and Schi-(phi)tz tonometer and was compared with true pressure which was monitored by manometer with indwelling catheter in the intravitreal cavity. Goldmann and Schi-(phi)tz tonometry always showed lower presure value than manometeric one(P<0.05) and the discrepancy was greater at higher range of intraocular pressure. Between these two methods Goldmann tonometry was more accurate in the rabbit eye (P>0.05).
Catheters, Indwelling ; Intraocular Pressure* ; Manometry ; Reading ; Vitrectomy

PURPOSE: There have been several reports of optic neuropathy preceding acute retinal necrosis(ARN) in patients with acquired immunodeficiency syndrome. We report one case of bilateral ARN that followed unilateral optic neuropathy in otherwise healthy person. METHODS: We report on a previous healthy 54-year old man who developed unilateral optic neuropathy 8 weeks after varicella-zoster dermatitis. Central retinal vascular obstruction developed subsequently in his ipsilateral eye. Later on, classic presentation of ARN appeared in his contralateral eye. RESULTS: The patient was diagnosed with bilateral ARN that followed unilateral optic neuropathy. Intravenous acyclovir stopped the progression of retinitis and resulted in healing of retinal lesions. CONCLUSIONS: ARN is a visually devastating clinical syndrome of which prompt diagnosis and early treatment are important in improvement the overall prognosis. This case suggests that optic neuropathy, especially with preceding shingles, should be suspected as prodrome of ARN which necessitates prompt initiation of antiviral therapy.
Acquired Immunodeficiency Syndrome ; Acyclovir ; Dermatitis ; Diagnosis ; Herpes Zoster ; Humans ; Middle Aged ; Optic Nerve Diseases* ; Prognosis ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde ; Retinitis

The purpose of this study was to evaluate the anatomical outcomes of vitrectomy with internal limiting membrane removal in highly myopic eyes with retinal detachment caused by a macular hole. Nineteen, consecutive, highly myopic eyes with full thickness macular hole with retinal detachment were treated by vitrectomy with internal limiting membrane removal, endolaser photocoagulation on the center of the hole and fluid gas exchange. In five eyes with other peripheral breaks, scleral buckling (3 cases), encircling (1 case) and barrier laser (1 case) were combined. In 15 eyes (79.0%) the macular hole was closed after the initial surgery. In 4 eyes (21%) the macular hole was reopened, but these were successfully treated with fluid gas exchange (1 case) or macular buckling (3 cases). The visual acuity was improved in 15 eyes (79.0%). In conclusion, these results suggest that the removal of the perifoveal internal limiting membrane may be an important adjuvant in the treatment of the myopic macular hole with retinal detachment.
Adult ; Aged ; Aged, 80 and over ; Basement Membrane/surgery ; Comparative Study ; Female ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Myopia, Degenerative/*complications ; Retinal Detachment/etiology/*surgery ; Retinal Perforations/*complications ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*methods

Massive subretinal hemorrhage may develop secondary to choroidal neovascularization. The poor visual prognosis associated with submacular hemorrhage can be explained by preexisting abnormality of photoreceptorretinal pigment epithelium-Bruch's membrane complex and fibrin-mediated injury to the outer segment of photoreceptor. An animal experiment showed that subretinal fibrin induced irreversible damage to the retina within 24 hours. We use recombinant tissue plasminogen activator(rt-PA), at doses(3 microgram substantially lower than previously reported, to aid in the surgical evacuation of massive subretinal hemorrhage within 2 days of its development. The subretinal hemorrhage in both patients developed in association with age-related macular degeneration. Postoperative corrected visual acuity improved from counting fingers to 0.3 in one patient and from hand motion to 0.04 in the other. There has been no complication except ocular hypertension which is medically controllable. Subfoveal neovascularization explains poor postoperative vision in one case. It seems that visual recovery is facilitated by early evacuation of massive subretinal hemorrhage and by using low-dose rt-PA. Low-dose rt-PA may minimize the risks of intraocular hemorrhage and retinal toxicity.
Animal Experimentation ; Choroidal Neovascularization ; Fibrin ; Fingers ; Hand ; Hemorrhage* ; Humans ; Macular Degeneration ; Membranes ; Ocular Hypertension ; Plasminogen ; Prognosis ; Retina ; Retinaldehyde ; Tissue Plasminogen Activator* ; Visual Acuity

Multifocal choroiditis and panuveitis(MCP) is a clinical syndrome characterized by vitritis, and punched-out fundus lesions mimicking presumed ocular histoplasmosis. We diagnosed MCP in a twenty-eight years old woman with the complaint of decreased vision and floater symptom. Retinochoroidal anastomosis via one of retinochoroidal scars was noted in this case. The patient was treated with oral and periocular steroid and ws observed for 11 months during which choroidal neovascularization and macular edema ws not developed. We present this case because, as far as our knowledge goes, There has been no reported case of MCP with retinochoroidal anastomosis.
Choroid* ; Choroidal Neovascularization ; Choroiditis* ; Cicatrix ; Female ; Histoplasmosis ; Humans ; Macular Edema ; Panuveitis*

The retrospective study of 231 eyes which were underwent the vitrectomy for the proliferative diabetic retinopathy was done. The purpose of this study was to identify the factors associated with visual prognosis and to understand the clinical features of traction-rhegmatogenous retinal detachment in diabetic retinopathies. The functional outcome of vitrectomy in these group revealed 44.6% of visual improvement, 40.3% of visual constancy and 15.1% of visual deterioration. Anatomically, 55.8% of eyes in these study showed retinal attachment and clarity of ocular media, postoperatively. The preoperative factors associated with visual outcome were vitreous hemorrhage land retinal detachment. The postoperative factors were hyphema, iatrogenic break formation and rubeosis iridis. Preoperatively and intraoperatively, retinal breaks were found in 43 eyes among 142 eyes of retinal detachment. In 43 eyes, 39 eyes showed only one break. The site of retinal breaks was majorly at posterior pole and the shape of breaks showed no difference between them in frequency. Our clinical data proved that the extent of traction rhegmatogerious retinal detachment was larger than pure traction retinal detachment which has a tendency to be localized at posterior pole. The leading complication after operation was lens opacity(19.3%).
Diabetic Retinopathy* ; Hyphema ; Prognosis ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Traction ; Vitrectomy* ; Vitreous Hemorrhage

Delayed absorption of subretinal fluid[SRF]occurs not so infrequently after scleral buckling for rhegmatogenous retinal detachment and needs to be differenciated from the condition caused by incomplete closure of retinal break or by proliferative vitreoretinopathy.The purpose of this study was to identify perioperative factors associated with delayed absorption of SRF after scleral buckling.Eighty-four consecutive cases of rhegmatogenous retinal detachment had undergone scleral buckling and been followed for more than 3 months.The duration was shorter than 7 days in early reattachment group[group A, n=65]and the duration was the same as 7 days or longer in delayed absorption group[group B, n=19].Perioperative demographic and ocular factors were analysed.Old age, inferior retinal detachment, operculated tear and proliferative vitreoretinopathy were more prevalent in group B than in group A[p<0.05]. Subretinal gliotic band, demarcation line and subretinal precipitate were detected in group B.Our results suggest that the hypofunction of retinal pigment epithelium and the vitreous traction may play a role in delayed absorption of SRF.
Absorption* ; Retinal Detachment* ; Retinal Perforations ; Retinal Pigment Epithelium ; Retinaldehyde* ; Scleral Buckling* ; Subretinal Fluid* ; Traction ; Vitreoretinopathy, Proliferative