Vitreous opacity is one of the common indication for pars plana vitrectomy to restore clarity of the optical pathway of the eye. We reviewed the hospital records of 82 patients who underwent pars plana vitrectomy for vitreous opacity at Yeungnam University Hospital from July 1, 1983 to February 28, 1987 and analyzed the functional results. Causes of vitreous opacity were traumatic vitreous hemorrhage in 23.5%, that with retinal branch vein occlusion in 22.3%, endoph-thalmitis in 21.2% and vitreous hemorrhage with proliferative diabetic retinopathy in 10.5%. Visual improvement was noted in 64.7% and no change in 21.2% while 14.1% worsened following the operation. Vitrectomy was found to be more beneficial to vitreous hemorrhage in Terson's syndrome and that with retinal branch vein occlusion.
Diabetic Retinopathy ; Hospital Records ; Humans ; Retinaldehyde ; Veins ; Vitrectomy* ; Vitreous Hemorrhage

In order to simulate the hemorrhagic detachment stage of disciform macular degeneration, fresh blood was injected into the subretinal space of albino rabbits. In control group, the natural course of subretinal hemorrhage was studied with the ophthalmoscope and by electron microscopy. In experimental group, to study the effect of surgical intervention of the subretinal hemorrhage, a retinotomy was performed at the edge of the detached retina and the subretinal blood was removed by aspiration. And then the histopathologic change of the retina was exam ined by electron microscopy in both groups preceded by the ophthalmoscopic examination. In control group, between 12 hours and 4 days, there was partial damage of the photoreceptor cells characterized by destruction of the outer segment and swelling of mitochondria of the inner segment. In seven days after injection, irreversible retinal destruction was observed. In experimental group, two days after removal of subretinal hemorrhage in two hours following subretinal injection of blood, the outer segment was lost and destructed. Two days after removal of subretinal hemorrhage in five days following subretinal injection of blood, hydropic swelling and vacuolization of visual cells were characteristic. However there was no significant difference in the histopathologic change of retina between two groups.
Hemorrhage* ; Macular Degeneration ; Microscopy, Electron ; Mitochondria ; Ophthalmoscopes ; Photoreceptor Cells ; Rabbits ; Retina ; Retinaldehyde

BACKGROUND: Methemoglobinemia(MetHb) induced by dapsone overdose is not uncommon in Korea, especially in rural area. For treatment of dapsone-induced methemoglobinemia, methylene blue(MB) and activated charcoal(AC) should be used. To date, no reports have compared the amount of MB used between MB alone with MB & AC combined group(MB+AC). And also between moderate (MetHb<35%) and severe (MetHb>35%) intoxicated group defined by initial MetHb level. Authors hypothesized that less amount of MB can be used if MB and AC was used together and larger amount of MB is necessary to reduce MetHb level to asymptomatic level in severely intoxicated group. METHODS: From Jan 1990 to Dec 1996, a total of 54 patients who received treatment for dapsone intoxication were subject of study, The study was done retrospective chart analysis for initial MetHb level, total amount of MB and AC. Wilcoxon rank sum test and Chi-sqiare test was used to compare the total dosage of MB used for each group. Linear regression analysis was used between initial MetHb and the total amount of MB. Results were considered statistically significant when p<0.05. RESULTS: For MB alone and MB+AC group, the differences in total amount of MB used were statistically significant with mean dosage of 7.14+/-1.1mg/kg and 4.28+/-0.7mg/kg, respectively. And total amount of MB used between moderate and severe intoxicated group, the differences were statistically significant with mean dosage of 5.16+/-1.1mg/kg vs. 10.98+/-1.9mg/kg, respectively. There was significant correlation between initial MetHb level (X) and the amount of methylene blue (Y), Y=0.3X-2.42 (r2=0.41, p=0.0001) in MB alone, Y=0.186X-1.95(r2=0.21, p=0.034) in MB+AC respectively. CONCLUSION: For methemoglobinemia induced by dapsone, total amount of MB can be reduced especially in severe Intoxicated group if AC use was combined in treatment modality. There was significant correlationship between initial MetHb level and total amount of MB used.
Charcoal* ; Dapsone* ; Humans ; Korea ; Linear Models ; Methemoglobinemia ; Methylene Blue* ; Retrospective Studies

PURPOSE: To compare the results of posterior cruciate ligament reconstruction by open and arthroscopic method. MATERIALS AND METHODS: From 1995 to 1997, 18 reconstructions of posterior cruciate ligament were performed. Group 1 (open method) was composed of 9 cases and group 2 (arthroscopic method) was consisted of 9 cases. After 21-month follow-up, The two groups were compared by clinical and radiologic methods. RESULTS: Clinically, Lysholm knee score was 80 points in group 1 and 83 points in group 2 after operation. Post operative results by Hughston's criteria were good in 5, fair in 2 and poor in 2 cases (group 1) and good in 6, fair in 2 and poor in 1 cases (group 2). Radiologically, post operative average of posterior drawer stress view was 5.2 mm (group 1) and 5.0 mm (group 2). Almost double the operation time was taken to reconstruct posterior cruciate ligament by arthroscopic method than open method. There were technical errors in 2 cases performed by arthroscopic method. CONCLUSIONS: The results of both methods had no significant difference. We think that the reconstruction of PCL using patellar tendon by open method is a recommendable treatment method together with arthroscopic method, if the merits or demerits of both methods are considered carefully. But more long-term follow-up is necessary to compare the results of PCL reconstruction by open and arthroscopic methods.
Follow-Up Studies ; Knee ; Patellar Ligament ; Posterior Cruciate Ligament

PURPOSE: The aim of this study was to evaluate the utility of contrast-enhanced MRI with first-pass and delayed images in prediction of myocardial viability after acute myocardial infarction. MATERIALS AND METHODS: Ten patients (M:F=:4, mean age =6 5 years) with acute myocardial infarction underwent first-pass image after bolus injection of gadolinium (one image/sec for 120sec)and delayed image (7 2 minutes later). According to 60 segments on midventricular level, the assessment of MRI were concerned about location of lesion, depth of lesion, enhancement on first-pass image and enhancement pattern on delayed image. MRI findings were compared with wall motion on resting echocardiography and stress or follow-up echocardiography. RESULTS: 1) MRI findings were classified into 4 types: normal enhancement on first-pass and delayed images (type 1), normal enhancement on first-pass image and nontransmural hyperenhancement on delayed image (type 2), non-transmural enhancing defect on first-pass image and transmural enhancement with endocardial non-enhancing defect on delayed image (type 3), and transmural enhancing defect on first-pass image and transmural hyperenhancement on delayed image (type 4).2) Type 2 suggested viable myocardium and type 3 had high porbability of viability. Type was compatible with non-viable myocardium. CONCLUSION: Enhancing defect on first-pass image and involving thickness on both the first-pass image and delayed image in contrast enhanced MRI may predict myocardial viability.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Myocardium

STUDY DESIGN: A prospective study OBJECTIVES: To analyze the serial results of selective nerve root blocks in herniated lumbar disc patients. LITERATURE REVIEW SUMMARY: To our knowledge there has been no study demonstrating the serial efficacy of root blocks for patients with a herniated lumbar disc only. MATERIALS AND METHODS: Selective nerve root blocks were performed in 36 patients who had a lumbar disc herniation only, with radiculopathy, between November 2002 and April 2003. The diagnoses were made by CT or MRI, which agreed with the symptoms and physical examinations. There were 31 men and 5 women, with a mean age of 28.2 years. The mean interval between the onset and procedure was 7.6 weeks, ranging from 1 to 26 weeks. Mono- and double-segment injections were used in 18 cases, respectwely. The straight leg raising angle, visual analogue pain scale, and motor and sensory functions were investigated before, immediately, 2 days, and 1 and 3 months after the procedure. RESULTS: The mean straight leg raising angle improved significantly, from 28+/-9 degrees to 53+/-18 degrees, immediately, and was maintained until 3 months after the procedure (P<0.001). The visual analogue pain scale was also improved, from 4.6+/-0.9 to 2.0+/-1.5, immediately, and was maintained until 3 months after the procedure (P<0.001). Two of ten patients with motor weakness, and six of eighteen with sensory deficit were improved. There was no procedure related complication; however, surgical treatment was performed in two patients who showed no improvement until 3 months. CONCLUSIONS: Selective nerve root block is a safe and effective treatment method to obtain a rapid and remarkable improvement of radiculopathy in herniated lumbar disc patients.
Diagnosis ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Pain Measurement ; Physical Examination ; Prospective Studies ; Radiculopathy ; Sensation

STUDY DESIGN: A prospective study OBJECTIVES: To analyze the serial results of selective nerve root blocks in herniated lumbar disc patients. LITERATURE REVIEW SUMMARY: To our knowledge there has been no study demonstrating the serial efficacy of root blocks for patients with a herniated lumbar disc only. MATERIALS AND METHODS: Selective nerve root blocks were performed in 36 patients who had a lumbar disc herniation only, with radiculopathy, between November 2002 and April 2003. The diagnoses were made by CT or MRI, which agreed with the symptoms and physical examinations. There were 31 men and 5 women, with a mean age of 28.2 years. The mean interval between the onset and procedure was 7.6 weeks, ranging from 1 to 26 weeks. Mono- and double-segment injections were used in 18 cases, respectwely. The straight leg raising angle, visual analogue pain scale, and motor and sensory functions were investigated before, immediately, 2 days, and 1 and 3 months after the procedure. RESULTS: The mean straight leg raising angle improved significantly, from 28+/-9 degrees to 53+/-18 degrees, immediately, and was maintained until 3 months after the procedure (P<0.001). The visual analogue pain scale was also improved, from 4.6+/-0.9 to 2.0+/-1.5, immediately, and was maintained until 3 months after the procedure (P<0.001). Two of ten patients with motor weakness, and six of eighteen with sensory deficit were improved. There was no procedure related complication; however, surgical treatment was performed in two patients who showed no improvement until 3 months. CONCLUSIONS: Selective nerve root block is a safe and effective treatment method to obtain a rapid and remarkable improvement of radiculopathy in herniated lumbar disc patients.
Diagnosis ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Pain Measurement ; Physical Examination ; Prospective Studies ; Radiculopathy ; Sensation

BACKGROUND: The success rate of smoking cessation by patients with coronary artery disease is lower than expected and reportedly this rate increases once doctors intervene. The purpose of this study is to help doctors mediate their patients to quit smoking by investigating of smoking behavior following the diagnosis of coronary artery disease and promoting methods of smoking cessation with knowledge of factors influencing smoking cessation. METHODS: A total of 245 male coronary artery disease patients confirmed by coronary angiography in two university hospitals located in Seoul participated in the survey. RESULTS: The smoking cessation rate among the subjects for more than one year was 39.6%. More than 90% of the subjects were aware of the doctors warning about smoking, but no more than 6% of them heard how to actually stop smoking from their doctors. In the smoking cessation group the stress score was lower and the exercise performance rate was higher than the smoking group. Logistic regression analysis revealed the abstinence group succeeded in smoking cessation at higher rate than the drinking group (odds ratio 0.30; 95% confidence interval 0.14 to 0.65). CONCLUSION: In recommending that a patient quit smoking, doctors should inform patients that drinking could be a detrimental factor and should promote a smoking cessation program including exercise and stress control. Doctors should educate patients that smoking cessation program will be more effective than sheer will power.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Drinking ; Hospitals, University ; Humans ; Logistic Models ; Male ; Secondary Prevention ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking*

Avulsion of the pectoralis major muscle is a rare injury, with only about 20 cases reported in literature. Most cases occur in a younger, more athletic population. The object of this paper is to report our experience of a complete avulsion of the pectoralis major muscle from the insertion site of the proximal humerus and we obtained excellent result with immediate surgical repair and rehabilitation.
Humerus ; Rehabilitation ; Sports ; Tendons*

PURPOSE: To evaluate the clinical results between conservative and operative treatments and to give guidelines in the treatment of angulated fifth metacarpal neck fracture. MATERIALS AND METHODS: The 43 cases of fifth metacarpal neck fracture (25 operative cases, 18 conservative case) were reviewed. The functional and radiologic results between two groups were evaluated. RESULTS: Both the operative group (preop.: 41.9 degree) and the conservative group (preop.: 39.7degree)showed satisfactory results (operative group: 15.3 degree, conservative group: 24.1degree) immediately after the correction. The maintenance of angulation correction was superior in operative group (15.7degree) than in conservative group (34.2degree), and patients' subjective satisfactions were superior in operative group too. Depressed knuckle on dorsum of hand was more frequently observed in conservative group (38.9%) than operative group (4%). Functional result in both groups was good. CONCLUSION: Because the correction of angulation was not maintained well in conservative group and a large portion of complications often occurred in cases of angulation more than 40 degree, operative treatment is needed in cases of angulation of fractured site more than 40 degree in the fifth metacarpal neck fracture.
Hand ; Neck*