No abstract available.

Patients undergoing monocular excimer laser photorefractive keratectomy (PRK) for myopic correction can develop strabismus secondary to decompensated heterophorias. We experienced a case of ocular esodeviation and diplopia that developed 8 nionths after monocular excimer laser phtorefractive keratectomy. So, we report this case with 8 review of the literature.
Diplopia ; Esotropia ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy* ; Strabismus

Acute acquired comitant esotropia has been used to describe a dramatic onset of a relatively large angle of esotropia with diplopia and minimal refractive errors. The authors experienced two cases of acute acquired comitant esotropia in patients with the age of 28 and 40 years. Sudden diplopia and esodeviation developed in both patients. All ophthalmologic and neurologic examinations including brain MRI showed negative results. Amount of deviation remained constant. We performed recession of both medial rectus muscles. Four weeks after surgery, both patients showed orthotropia without any complaints of diplopia.
Brain ; Diplopia ; Esotropia* ; Humans ; Magnetic Resonance Imaging ; Muscles ; Neurologic Examination ; Refractive Errors

Neurogenic bladder is a common cause of acute pyelonephritis (APN) in cauda equina syndrome (CES). Perirenal hemorrhage, a rare complication of APN, can be a life-threatening condition. To our knowledge, there is no previous report of perirenal hemorrhage as a complication of APN in CES. A 57-year-old male, diagnosed with CES, due to a L3 burst fracture 3 months earlier, was presented with fever and chills. His diagnosis was APN due to neurogenic bladder. After treatment for APN, he was transferred to the department of rehabilitation medicine for management of his CES. Because of large post-voiding residual urine volumes, he performed self-catheterization after voiding. However, he presented again with fever and chills, and recurrent APN was diagnosed. On the third day of antibiotic treatment, he had acute abdominal pains and hypovolemic shock. Abdominal computed tomography and angiography showed left APN and a perirenal hematoma with left renal capsular artery bleeding. After embolization of the left renal capsular artery, no further active bleeding occurred. Because APN due to neurogenic bladder can lead to critical complications, such as perirenal hemorrhage, the physician should pay attention to the early diagnosis and treatment of urinary tract infection and the management of neurogenic bladder after CES.
Abdominal Pain ; Angiography ; Arteries ; Cauda Equina ; Chills ; Early Diagnosis ; Fever ; Hematoma ; Hemorrhage ; Humans ; Male ; Polyradiculopathy ; Pyelonephritis ; Shock ; Urinary Bladder, Neurogenic ; Urinary Tract Infections

Neurogenic bladder is a common cause of acute pyelonephritis (APN) in cauda equina syndrome (CES). Perirenal hemorrhage, a rare complication of APN, can be a life-threatening condition. To our knowledge, there is no previous report of perirenal hemorrhage as a complication of APN in CES. A 57-year-old male, diagnosed with CES, due to a L3 burst fracture 3 months earlier, was presented with fever and chills. His diagnosis was APN due to neurogenic bladder. After treatment for APN, he was transferred to the department of rehabilitation medicine for management of his CES. Because of large post-voiding residual urine volumes, he performed self-catheterization after voiding. However, he presented again with fever and chills, and recurrent APN was diagnosed. On the third day of antibiotic treatment, he had acute abdominal pains and hypovolemic shock. Abdominal computed tomography and angiography showed left APN and a perirenal hematoma with left renal capsular artery bleeding. After embolization of the left renal capsular artery, no further active bleeding occurred. Because APN due to neurogenic bladder can lead to critical complications, such as perirenal hemorrhage, the physician should pay attention to the early diagnosis and treatment of urinary tract infection and the management of neurogenic bladder after CES.
Abdominal Pain ; Angiography ; Arteries ; Cauda Equina ; Chills ; Early Diagnosis ; Fever ; Hematoma ; Hemorrhage ; Humans ; Male ; Polyradiculopathy ; Pyelonephritis ; Shock ; Urinary Bladder, Neurogenic ; Urinary Tract Infections

More than half of the cryptococcal infections occur in acquired immune deficiency (AIDS) patients, and more than half of the non-AIDS patients with cryptococcosis are immunocompromised. Most immunocompromised patients have meningoencephalitis at the time of diagnosis. Without the appropriate therapy, this from of the infection is invariably fatal. Death can occur any time from 2 weeks to several years after the onset of symptoms. Pulmonary crytococcosis in immunocompromised patients is usually asymptomatic, but coughing, chest pain, fever, or hemoptysis may occur in immunocompetent patients. Pulmonary cryptococcosis symptoms in immunocompetent patients tend to improve without treatment. Here, we describe the various pulmonary manifestations of cryptococcal pneumoniae in three immunocmpetent patients.
Chest Pain ; Cough ; Cryptococcosis ; Diagnosis ; Fever ; Hemoptysis ; Humans ; Immunocompromised Host ; Meningoencephalitis ; Pneumonia*

One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIgO including physical examination, pelvic examination, cystoscopy, ectosigmoidoscopy, chest X-ray, IVP, Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; In case of radiation therapy only, whole pelvic irradiation was given with C0-69 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cgy per day, 5 days per week and intracavitary insertion was performed. In stages la, lb, and lla with small primary lesion, external irradiation was initially given to pelvis up to 2000~3000 cgy/2x(1/2)-3x(1/2) weeks and then intracavitary insert in was performed using Fletcher-Mini-Declos Applicator with cesium-137 courses and followed by external irradiation of 1000~2000 cgy 1x(1/2)-2x(1/2) weeks via AP and PA parallel opposing fields with midline shield to spare of bladder and rectum. However, if the primary lesion is large, external irradiation was given without midline shield. More than stage llb, the patients were treated by external beam irradiation up to 5400 cgy/30f for 6 weeks via 4-oblique portals and at the dose of 5040 cgy/28f the field was cut 5 cm from the top margin for spare of small bowel, and followed by intracavitary irradiation. If there was residual tumor, an additional dose of 900~1200 cgy/5~7f was given to parametrium and/or residual tumor area. Total dose of radiation of A and B-point were as follows; A-point : B-point In early stages, la, lb, llb ; 8000~9000 5000~6000 cgy In advanced stages llb, llla, lllb; 9000~10000 6000~7000 cgy The results were obtained and as follows; The patients distribution according to FIgO staging system were stage la 6, lb 27, lla 28, llb 54, llla 12, lllb 18, and stage lVa 9. Value of CT scan were demonstration of cervix tumor mass, parametrial and pelvic side wall tumor spread, pelvic and inguinal lymph nodes metastases, and hydronephrosis. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. Local control rate of tumor according to the size was 91.3% for less than 5 cm in size and 44.6% in tumor over 5 cm (p<0.0068). Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the papa-aortic lymph nodes were the most common site for distant metastases. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. The 5-year survival rates showed; stage la and lb 95%, stage lla 81% stage llb 67%, stage llla 37.7%, stage lllb 23%, and 3-year survival rate of stage lVa showed 11.6%, retrospectively.
Cautery ; Cervix Uteri ; Cystoscopy ; Enema ; Female ; Gynecological Examination ; Hemorrhage ; Humans ; Hydronephrosis ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Pelvis ; Physical Examination ; Radiation Oncology ; Radiotherapy* ; Rectum ; Retrospective Studies ; Survival Rate ; Thorax ; Tomography, X-Ray Computed ; Tumor Burden ; Urinary Bladder ; Uterine Cervical Neoplasms*

PURPOSE: To determine the problems of anterior external fixators in unstable pelvic ring injuries. MATERIALS AND METHODS: We reviewed 25 patients with an unstable pelvic ring injuries who had been treated with only anterior external fixator over one year follow-up. By Tile's classification, type B 14, type C 11 and the radiological results were evaluated preoperation, postoperation and bone union state. The clinical evaluation was done in termas of the residual pain, discrepency in limb length, rotational deformities, gait disturbance, neurologic deficiency. RESULTS: In 25 patients with an unstable pelvic ring injuries, 18 (72%) patients were reducted and 3 (17%) patients of 25 were reduction failure at last follow up, they were all Tile type C. The residual pain was graded normal 3, mild 11, moderate 10, severe 1 respectively. The cases with discrepency in limb length and gait disturbance were 6 (all type C), 10 (type B 3, type C 7) respectively. The complication were 4 pin site infection, 3 pressure sore and 1 pyogenic hip arthritis. CONCLUSION: Our results indicate that anterior external fixator should be limited to vitally unstable patients in acute resuscitative phase and cases without vertical displacement.
Arthritis ; Classification ; Congenital Abnormalities ; External Fixators ; Extremities ; Follow-Up Studies ; Gait ; Hip ; Humans ; Pressure Ulcer

Ushers syndrome is an autosomal recessively inherited entity which is characterized by a retinitis pigmentosa and congenital sensorineural hearing loss. This syndrome represents different clinical features according to its subtypes. We experienced one case of type 1 Ushers syndrome, who had congenital hearing loss, visual field loss, visual loss of early childhood onset. We performed bilateral cataract extraction. Fundus examination after operation showed characteristic findings of retinitis pigmentosa. ERG was non-recordable ERG. Her audiogram confirmed the bilateral sensorineural hearing loss.
Cataract Extraction ; Cataract* ; Hearing Loss ; Hearing Loss, Sensorineural ; Retinitis Pigmentosa ; Usher Syndromes* ; Visual Fields

PURPOSE: The purpose of this study was to evaluate the outcomes of total hip arthroplasty (THA) with an ABG I hip prosthesis after a minimum ten-year follow up. MATERIALS AND METHODS: From January 1996 to March 2001, 121 hips in 104 patients, whi were followed up for a minimum of ten-years, were enrolled in this study. The clinical and radiographic outcomes were evaluated and Kaplan-Meier survival analysis was performed. RESULTS: The mean Harris hip score at the last follow-up was 84 points. A radiolucent line around the cup, osteolysis, and cup loosening were observed in 5 hips(4.1%), 53 hips(43.8%), and 5 hips(4.1%), respectively. In the femoral side, osteolysis and stem loosening were observed in 11 hips(9.1%) and 2 hips(1.7%), respectively. The mean linear wear rate of the polyethylene liner was 0.23 mm/yr. Forty four revisions(36.3%) were performed. The outcomes were similar regardless of the cause of primary THA. The survival rate with the end point of revision due to cup loosening was 56.3%, and revision due to stem loosening was 98.1% after a 16 year follow-up. CONCLUSION: High polyethylene wear and the disappointing survival rate of the ABGI cup were observed after a minimum ten year follow-up. Therefore, close observation of patients who have received an ABG I prosthesis is necessary.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies* ; Hip Prosthesis ; Hip ; Humans ; Osteolysis ; Polyethylene ; Prostheses and Implants ; Survival Rate