No abstract available.
Arthrogryposis*

Brown's syndrome is characterized by inability to elevate the adducted eye and positive forced duction test. It is known as congenital disease but may occur as acquired disease Acquired Brown's syndrome may occur after superior oblique muscle tucking, frontal sinusitis, surgery of frontal sinus or orbit, scleral buckling, and inflammation in trochlear area. Brown's syndrome caused by inflammation of trochlear area is frequently combined with rheumatoid arthritis. The ocular motiliy is improved after systemic corticosteroid treatment or local injection of corticosteroid in trochlear area. An llyear old korean girl was found to have bilateral aquired Brown's syndrome caused by tenosynovitis. There were severe limitation of elevation in adduction and resistance in forced duction test in both eyes. The ocular motility was improved after local injection of dexamethasone in trochlear area.
Arthritis, Rheumatoid ; Dexamethasone ; Female ; Frontal Sinus ; Frontal Sinusitis ; Humans ; Inflammation ; Orbit ; Scleral Buckling ; Tenosynovitis*

Although the reports of the use of crotherapy in the control of the proliferative phase of retinopathy of prematurity varied in their conclusions regarding the merits and limitations of this therapy, cryotherapy has been consedered to be an effective treatment for retinopathy stage 3. The accepted method of therapy includes ablation of the whole avascular retina from the ridge to the ora serrata. This is achieved by 2 to 3 rows of cryoapplications with use of cryotherapy probe for ROP. Nissenkorn et al presented their new method of cryotherapy in which only one row of cryoapplications was applied in the avascular retina anterior to the fibrovascular ridge. So, we performed cryotherapy using Nessenkorn's new method on 7 babies and the anatomical results are reviewed. Complete regression of active retinopathy was achieved in all of the eyes treated.
Cryosurgery* ; Cryotherapy ; Retina ; Retinopathy of Prematurity

Many opthalmologists prefer to treat the eyes operated on with drops containing corticosteroids and antibiotics for a few days of a few weeks after strabismus surgery. But no controlled studies are available to support the rationale for such therapy. Therefore, we conducted a prespective double-blind masked trial to evaluate the clinical effectiveness of the drops containing antibiotics and steroid on 40 patients. There are no singnificant difference between the drug and the placebo groups.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Humans ; Masks ; Strabismus*

Many opthalmologists prefer to treat the eyes operated on with drops containing corticosteroids and antibiotics for a few days of a few weeks after strabismus surgery. But no controlled studies are available to support the rationale for such therapy. Therefore, we conducted a prespective double-blind masked trial to evaluate the clinical effectiveness of the drops containing antibiotics and steroid on 40 patients. There are no singnificant difference between the drug and the placebo groups.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Humans ; Masks ; Strabismus*

We performed trans scleral fixation techniques for implantation of posterior chamber lens in 25 eyes, in case of incomplete zonular or capsular support. This was done by securing both haptics of the posterior chamber lens to the sclera at the ciliary sulcus with 10-Onylon suture. Postoperative follow-up time ranged from 12 to 23 months, with all patients having at least one year of follow up. At the last follow up visit, 16 eyes (72%) had a vision of 20/50 or better, and 13 eyes (52%) had a vision of 20/30 or better. The transscleral fixation related complications included retinal detatchment, glaucoma and cystoid macular edema. During the relatively longterm follow up period, we did not find any serious complications due to the intraocular lens and there was no significant postoperative changes in the visual acuities.
Follow-Up Studies ; Glaucoma ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Macular Edema ; Retinaldehyde ; Sclera ; Sutures ; Visual Acuity

BACKGROUND: High dose fentanyl anesthesia has been recommended for circulatory stability during coronary artery bypass grafting (CABG), but hypertension and tachycardia in response to noxious stimulation have been noted. The purpose of this study was to evaluate the hemodynamic effects of extensive thoracic epidural analgesia (TEA) combined with general anesthesia (GA). METHODS: The hemodynamic effects in CABG were evaluated in 30 patients. They were randomized into two groups ; the GA group receiving high dose fentanyl (50-70 mcg/kg), the TEA group receiving 10 ml bupivacaine 5 mg ml 1 followed by 5 ml every two hours epidurally GA (N2O-O2). The hemodynamic parameters were evaluated before induction of anesthesia, 20 minutes after induction of anesthesia, after sternotomy, and 30 minutes after end of cardiopulmonary bypass. RESULTS: Heart rate and mean arterial pressure were significantly lower after sternotomy in the TEA group compared to the GA group. Significant increase in cardiac index and decrease in central venous pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure were found after induction of anesthesia and sternotomy in the TEA group compared to the GA group. Especially, the pulmonary vascular resistance was significantly lower during all the period in the TEA group compared to the GA group. No differences were observed in stroke volume index, systemic vascular resistance, left ventricular stroke work index between two groups. CONCLUSIONS: The present study suggests a more effective blockade of the stress response during CABG with TEA than with GA. So, we consider that TEA could be used as an adjunctive anesthetic method during CABG.
Analgesia, Epidural* ; Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Bupivacaine ; Cardiopulmonary Bypass ; Central Venous Pressure ; Coronary Artery Bypass* ; Coronary Vessels* ; Fentanyl ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Pulmonary Wedge Pressure ; Sternotomy ; Stroke ; Stroke Volume ; Tachycardia ; Tea ; Vascular Resistance

BACKGROUND: Diclofenac is a nonsteroidal anti-inflammatory drug widely used as adjuvant for postoperative pain management using intravenous Patient Controlled Analgesia (PCA). The analgesic and hemostatic effects of diclofenac were measured in 80 paturients after Cesarean section. METHODS: Eighty parturients were randomly allocated to four groups and each group had 20 women. The parturients were given loading dose of meperidine in D group and morphine in M group and then postoperative pain was controlled with PCA device for up to 48 hours after Cesarean section when the parturients awoke and complained pain. The parturients received intramuscular diclofenac 75 mg followed by loading dose of meperidine in DV group and morphine in MV group. Diclofenac was repeated every 12 hours. We evaluated the effects of diclofenac on postoperative opioid requirement, numerical rating score of pain and hemostasis at 48 hours after operation. RESULT: Diclofenac decreased almost 50% of opioid requirement and pain score lowered significantly at 12, 24 hours in DV group and at 12 hours in MV group. But there was no difference in laboratory data including hemoglobin, hematocrit, platelet count and bleeding time among the groups. CONCLUSION: We concluded that diclofenac is effective and safe adjuvant for postoperative pain management without hemostatic abnormality. But it is necessary to try further evaluation of hemostatic effect of diclofenac.
Analgesia, Patient-Controlled ; Bleeding Time ; Cesarean Section* ; Diclofenac* ; Female ; Hematocrit ; Hemostasis ; Humans ; Meperidine ; Morphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis* ; Platelet Count ; Pregnancy

Reconstruction in the head and neck region uses a wide range of surgical flaps for defect closure. The methods range from local, mostly myocutaneous flaps, and skin grafts to free microsurgical flaps. Reconstructive surgery must conserve the appearance and mimic the original function. Moreover, the donor-site defect needs to be reduced, with no resulting functional or aesthetic impairment. To achieve these goals, a thin reliable flap that is close to the face and neck region with a good match of the skin texture and a smooth, hairless skin surface is needed. So we used a flap from the shoulder region which provides an optimum skin texture to match the neck and face. This supraclavicular flap is a fasciocutaneous island flap, which has a vascular pedicle extending from the transverse cervical artery with two accompanying veins. Moreover, the tunneling method improves the donor site by reducing scarring. We hereby introduce the anatomic characteristics and effectiveness of this method.
Arteries ; Cicatrix ; Head* ; Humans ; Myocutaneous Flap ; Neck* ; Shoulder ; Skin ; Surgical Flaps ; Tissue Donors ; Transplants ; Veins

Background: Hematopyometra, an accumulation of bloody, purulent material in the ute-rine cavity, is a relatively uncommon event. The incidence is almost 0.01~0.5% in gynec-ologic patients. The most common cause of this condition is interference with the normal drainage of the uterus;endocervical obstruction by malignant disease. Other obstructive causes are the benign tumors in uterus, senile endocervicitis, long-term use of intrauterine device, cervical occlusion after surgery or radiation, intrauterinel infection, and congenital cervical anomaly. Methods: This report was performed to evaluate the hematopyometra patients, who were diagnosed and treated at Catholic University Medical College Hospitals from 1991 to 1995. Forty cases of hematopyometra were retrospectively reviewed by charts, radiologic and pathologic findings concerning with the clinical features. Results: 1) The most frequent age of hematopyometra patients was 50 to 59 years(45 %) and mean age was 63 years old. 2) Four patients(10 %) were at premenopausal period, and remaining 36 patients(90 %) were at the period of menopause(p<0.01). 3) The clinical manifestations of the patients were variable;profuse vaginal discharge(75 %), vaginal ble- eding or spotting(40 %), and lower abdominal pain(30 %). 4) The associating medical cond- itions or possible risk factors of hematopyometra are senile atrophic change(52.5 %), IUD inserted condition(25 %), genital malignant diseases(17.5 %), and uterine myoma(5 %). 5) The bacterial infection are frequently associated with hematopyometra and the causative ag ents are streptococci(50 %), E. coli(42 %), and mixed type(17 %). 6) Eight cases of them showed generalized peritonitis in the preoperative clinical course and three patients had been serious condition by septicemia. 7) The genital malignant diseases are associated with he- matopyomerta in 7 cases(17.5 %) of them(cervical cancer;4 cases, endometrial cancer;2 cases, and ovarian cancer;1 case). 8) All the cancer patients could be followed-up at le-ast for 2 years. Two patients, who were diagnosed for cervical cancer in the stage IIb and III, died of the persistent or recurrent disease in the period of following-up after the pri-mary treatment.
Bacterial Infections ; Drainage ; Female ; Humans ; Incidence ; Intrauterine Devices ; Menopause ; Middle Aged ; Peritonitis ; Premenopause ; Retrospective Studies ; Risk Factors ; Sepsis ; Uterine Cervical Neoplasms ; Uterus*