Pneumatic retinopexy was introduced by Hilton in 1986, and this methed is a recently described procedure used for the treatment of primary rhegmatogenous retinal detachment. A gas bubble is injected into the vitreous cavity so that the bubble closes the retinal break, permitting resorption of subretinal fluid. A chorioretinal adhesion formed around the break by cryotherapy or laser photocoagulation secures the retina in place. Indication of pneumatic retinopexy in A Two-step Outpatient Operation Without Conjuntival Incision described by Hilton in 1986 is retinal detachments secondary to one break or group of breaks no larger than 1 o'clock hour located within the superior 8 o'clock hours of the fundus. The ocular conditions of the 26 cases included in this study were proliferative vitreoretinopathy C1, C2, aphakia, multiple breaks in multiple quadrants, extensive retinal detachment more than 3 quadrants in size, pseudophakia. The overall success rate for primary pneumatic retinopexy was 73.1%(19 eyes). The greatest number of failure were due to delayed absorption of subretinal fluid (5 eyes). With subsequent procedure, 7 eyes that failed with primary pneumatic retinopexy were reattached.
Absorption ; Aphakia ; Cryotherapy ; Humans ; Light Coagulation ; Outpatients ; Pseudophakia ; Retina ; Retinal Detachment ; Retinal Perforations ; Subretinal Fluid ; Vitreoretinopathy, Proliferative

No abstract available.
Child* ; Humans ; Natural History* ; Ureter* ; Ureterocele*

We experienced one case of treatment of clozapine for neuroleptic-induced tardive dyskinesia which was developed during low-dose risperidone treatment. The patient was a 22-year-old man with a 2-year history of schizophrenia. While he was taking 4-6 mg/d of Risperidone, he was capable of carrying a normal daily routine. But, after 11 months of taking risperidone(3 mg/d), dyskinetic movements had developed on his neck, trunk, and mainly on the right upper extremity. Simultaneously, his symptoms such as anxiety, persecutory delusion, and auditory hallucination were aggravated. Despite of adding the clonazepam(1 mg/d), no improvement of dyskinetic movements were observed. Then, we decreased the dose of risperidone and decided to switch the drug treatment from risperidone to clozapine. On admission, the total AIMS was 26 points (severe degree) and the total BPRS was 50 points. On the 9th day of the clozapine(100 mg/d) treatment, there were significant improvements in psychotic symptoms and dyskinetic movements(moderate degree). Then, we increased the dose of clozapine up to 350 mg/d on the 4th week. By then, the AIMS and the BPRS were 10 and 13 points respectively.
Anxiety ; Clozapine* ; Delusions ; Hallucinations ; Humans ; Movement Disorders* ; Neck ; Risperidone ; Schizophrenia ; Upper Extremity ; Young Adult

A spinal cord injury without radiographic abnormality(SCIWORA) was defined by Pang and Wilberger in 1982 as the "objective signs of myelopathy as a result of trauma" in which no evidence of fracture, subluxation, or instability on plain radiographs, or computed tomography is demonstrable. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric bony cervical and thoracic spine exceedingly vulnerable to deforming forces. We report here on a case of SCIWORA in a 3-year-old girl who presented with lower extremity paralysis, paresthesia, and voiding difficulty. The mechanism of neural damage in this case was purely longitudinal distraction. Such stress on the spine resulted from severe pulling up the lower extremity by her father, which was not thought to be damaging at that time.
Child ; Child, Preschool ; Elasticity ; Fathers ; Female ; Humans ; Infant ; Lower Extremity ; Paralysis ; Paresthesia ; Spinal Cord Diseases ; Spinal Cord Injuries* ; Spinal Cord* ; Spine

Twin pregnancies have a higher rate of premature delivery than singleton pregnancies and a substantially higher perinatal mortality. Twin gestation complicted by a single anomalous fetus diffculties in obstetric management. Options available to patients include continuing the entire pregnancy, selective termination of the anomalous fetus, or termination of the entire pregnancy. The incidence of one anomalous fetus in twin pregnancy is rare. Gastroschisis is intestinal herniation through a defect in the anterior abdominal wall usually to the right of umblicus. There is no sac and the intestines are covered with a thickened inflammatory exudate. Most case of gastroschisis occur sporadically and chromosomal anomaly are less common. A case of one gastroschisis in twin pregnancies diagnosed by ultrasonography is reported with a brief review of the literature.
Abdominal Wall ; Exudates and Transudates ; Fetus ; Gastroschisis ; Humans ; Incidence ; Intestines ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin* ; Twins* ; Ultrasonography

No abstract available.
Silicones*

PURPOSE: The aim of this study was to establish a measurement standard for the weight-bearing axial alignment of the lower extremities when performing a lower extremity reconstruction. MATERIALS AND METHODS: Among 274 patients (147 males and 127 females) in their 20s to 30s without any physical disabilities, and who had undergone weight-bearing full leg standing radiographs, 188 patients (100 males and 88 females) were examined this study. The data was analyzed further according to their age and gender using the radiographic value on the coronal and sagittal alignment of the lower extremities. RESULTS: The weight bearing ratio was 38.47+/-10.52% on the coronal plane and 36.11+/-7.88% on the sagittal plane. Both the mechanical axis and the the weight bearing axis were not identical due to their 0.68+/-0.89degrees difference on average. The most adjacent point of the femoral condyles to the tibial plateau on the sagittal plane was assigned to the center of the knee joint. The difference between the mechanical axis and weight bearing axis was 0.04degrees, which was not significant. CONCLUSION: There is a difference between the mechanical axis, which consists of both a line from the center of the femoral head to the center of knee joint and a line from the center of the knee joint to the center of ankle joint, and the weight bearing axis, which is linked directly from the center of the femoral head to the center of the ankle joint. Furthermore, the weight bearing axis passes through the anteromedial part in the knee joint. The center of the knee joint is defined as the most adjacent point of both femoral condyle to the tibial plateau on the sagittal plane.
Adult ; Ankle Joint ; Axis, Cervical Vertebra ; Head ; Humans ; Knee Joint ; Leg ; Lower Extremity ; Male ; Weight-Bearing

Interests in the microanatomy of the proximal segment of the internal carotid artery(ICA) have been increased due to the anatomical complexity of this region and the potential sites of the aneurysmal formation. In this study, microanatomical dissections were performed in 70 specimens obtained from 35 formalin-fixed human cadaveric heads to examine the superior hypophyseal arteries(SHAs), ophthalmic artery, and the carotid cave. In our study, 54(77%) carotid caves were presented in 70 specimens. Twenty-five(71%, 50 caves) cadavers harbored the carotid caves on both sides, 4(11%, 4 caves) cadavers only on the one side and the remaining 6(17%) didn't have the caval structure. Total of 162 SHAs which have showen to arise from the medial or posterior aspect of the ophthalmic(C6) segment of the ICA in all cases were identified: 108(67%) arose from the proximal half of the C6 segment and 54(33%) from the distal half. Interestingly, in 54 specimens which had the carotid caves, one to four SHAs arose from the part of the C6 segment within the cave in the 43(80%) specimens. Total number of the SHAs originated within the carotid cave were 51. Sixty-four(91%) of ophthalmic arteries have shown to arise just distal to the distal dural ring on C6 segment, whereas 4(6%) from the clinoid(C5) segment and in 2(3%) cases, the ophthalmic artery arose just at the insertion of the distal dural ring level. The authors describe the microanatomical relationships between the SHA and the carotid cave, and the origin of the SHA and the ophthalmic artery. We hope to get better knowledge of the vascular relationship and the possible mechanism of the SHA aneurysm.
Aneurysm ; Arteries* ; Cadaver ; Caves ; Head ; Hope ; Humans ; Ophthalmic Artery

The intracranial hematoma following cerebral aneurysmal rupture makes patient's clinical status and outcome worse by pressure effect on the brain structure. It's incidence has varied with authors between 5-30% of patients with ruptured cerebral aneurysms. Several authors emphasized the importance of early operation to obtain better results by early removal of hematoma and reducing intracranial pressure. The authors retrospectively evaluated seventy-six patients with intracranial hematomas in 370 patients with ruptured aneurysms from Jan. 1987 to Dec. 1992. The incidence of hematoma resulting from ruptured aneurysm was 20.5%. The most frequent site of aneurysm which was accompanied by intracranial hematoma was the middle cerebral artery, and the next was the anterior cerebral artery. The amount of hematoma and/or evidence of midline shift were the important factors in predicting the clinical outcome. The most favorable outcome was found in cases with intracerebral hematoma only, and the worst was in cases with intracerebral hematoma associated with intraventricular hemorrhage. Fifty out of 76 patients with intracranial hematomas were operated on. Their outcomes were more favorable than in the patients who were not operated on. Aggressive surgical intervention was especially effective in patients with poor Hunt & Hess grades(IV or V) .
Aneurysm ; Aneurysm, Ruptured* ; Anterior Cerebral Artery ; Brain ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Intracranial Pressure ; Middle Cerebral Artery ; Retrospective Studies ; Rupture

Flexible fiberoptic colonoscopy is extensively used for the diagnosis and management of colorectal disease. Many possible complications can occur. The most common and most serious complications are hemorrhage, perforation and respiratory problems. Colonic perforation usually results in a fatal and emergent condition. However, management of iatrogenic colonic perforation has been controversial. The choice between the medical versus the surgical approach has been dependent on the mechanism of the perforation, bowel preparation, location, size of the defect and severity of symptoms. We report here a case where colonic perforation emerged during endoscopic submucosal resection of a rectal tumor. The rectal perforation was accompanied with pneumoperitoneum, subcutaneous emphysema, pneumoretroperitoneum and pneumomediastinum. As the bowel preparation was excellent, intravenous antibiotics and total parenteral nutirition were administered. The patient was treated successfully without any complications.
Anti-Bacterial Agents ; Colon ; Colonoscopy ; Diagnosis ; Hemorrhage ; Humans ; Mediastinal Emphysema* ; Pneumoperitoneum* ; Rectal Neoplasms ; Retropneumoperitoneum* ; Subcutaneous Emphysema*