STUDY DESIGN: A retrospective study. OBJECTIVES: To assess the relationship between surgical outcomes and preoperative MRI findings, a retrospective review was conducted on the surgical outcomes depending on the preoperative MRI findings including type of herniation and Modic changes. SUMMARY OF LITERATURE REVIEW: In most reports, the patients that have large disc herniation were expected to have improved surgical outcomes. However, there have been controversies regarding the outcomes and Modic changes. MATERIALS AND METHODS: The retrospective review was conducted in 82 patients who underwent a discectomy for single level lumbar disc herniation. The average follow-up period was 34.2 months. Among their preoperative baseline MRI measurements, the stage of disc herniation, degree of nerve root compression, degree of dural sac compression, and Modic change of vertebral endplate were evaluated for the subsequent comparison between the preoperative and postoperative changes and ODI score. RESULTS: Patients with extrusion or sequestration type showed significant improvements compared to the patients with protrusion type disc herniation. By degree of nerve root compression, patients with root compression showed significant improvements compared to the patients who had contact type. The degree of dural sac compression revealed no correlation with changes in the ODI score. 23 of the 82 patients, the preoperative MRI showed a Modic change. Compared to the group who did not show such a Modic change, they turned out to be unrelated to the preoperative and postoperative changes in the ODI score. CONCLUSIONS: Patients who had extrusion or sequestration type disc herniation showed a better clinical improvement than protrusion type. Patients with compression type root lesion showed better clinical improvement than contact type root lesion. No correlation was noted regarding the outcomes of the surgical treatment and degree of dural sac compression or Modic changes.
Diskectomy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

A case of Wegener's granulomatosis is described, with special attention focused on the typical histologic findings and involvement of both middle ear and lung. The patient is a 37-year-old man presented with four-month history of cough and sputum. He had a past history of surgery of both ears because of otitis media followed by left facial palsy. Chest radiographs showed variable sized ill defined nodules in both lower lobes with internal airspace consolidation. Histologic preparations of the open lung biopsy specimens demonstrated a diffusely scattered palisading micro and macrogranulomas with central focus of neutrophils and necrotic collagen surrounded by histiocytes, histiocytic giant cells. Fibrinoid necrosis involved blood vessels and lung parenchyma. Chronic inflammation, diffuse granulation tissue formation and irregular fibrosis are also found in the lung parenchyma. The histologic findings of middle ear which was previously biopsied showed scattered palisading ill defined microgranulomas mixed with fibrotic tissue.
Adult ; Biopsy ; Blood Vessels ; Collagen ; Cough ; Ear ; Ear, Middle* ; Facial Paralysis ; Fibrosis ; Giant Cells ; Granulation Tissue ; Granuloma ; Histiocytes ; Humans ; Inflammation ; Lung* ; Necrosis ; Neutrophils ; Otitis Media ; Radiography, Thoracic ; Sputum ; Vasculitis ; Wegener Granulomatosis*

PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Dislocation of the hemate bone is very rare. There is no reported case in Korea. The mechanism of injury may be attributed to direct trauma. We have experiened a case of dislocation of the hamate bone, treated it by open reduction and internal fixation using two Kirschner wires. The result was satisfactory. A case of dislocation of the hamte bone is reported with brief review of literature.
Bone Wires ; Dislocations ; Hamate Bone ; Korea

One hundred and seventy-two cases of tuberculosis of the bones and joints were treated at the department of orthopedic surgery, Inchon Christian Hospital during the 3 years and 10 months from March, 1979, to December, 1982. The results obtained were as followings: 1. The incidence was decreased progressively 1.92% in 1980 to 1.18 in 1982. 2. Tuberculous lesions involved spine(50.58%), knee(16.28%), hip(13.37%), ankle(2.33%) and greater trochanter(2.33%) in order. 3. Age and sex distribution were not remarkable. 4. The main associated tuberculous lesions were pulmonary tuberculosis and tuberculous pleurisy (20.65%). Therefore, pulmonary problems should be always carefully investigated in every case of skeletal tuberculosis. 5. Average duration of disease was one year and 3.5 months, average hospital days was one month. 6. Initial miss diagnosis of lesions ultimately proved to be tuberculosis. Rheumatoid arthritis:13 cases, Osteoarthritis : 3 cases, Herniated lumbar disc: 3 cases, Cellulitis :2 cases, Neoplasm :2 cases. Early diagnosis is essential since proper therapy is available and far advanced destruction, long suffering and disability can be avoided. 7. Post operative complication was mainly due to failure of bone graft in tuberculous spondylitis and was draining sinus formation and wound disruption in other skeletal tuberculosis. 8. The result of treatment of skeletal tuberculosis from conservative methods were relatively poor. The corroboratory care of skeletal tuberculosis can be obtained by extensive surgery.
Cellulitis ; Diagnosis ; Early Diagnosis ; Incheon ; Incidence ; Joints ; Orthopedics ; Osteoarthritis ; Sex Distribution ; Spondylitis ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary ; Wounds and Injuries

Early MRI and arthroscopic findings were compared to evaluate the efficacy of the former for patients, who upon physical examination, were diagnosed with possihle acute ACL tears. MRI, taken between 1-21 days after injury, had to reveal complete ACL tears and arthroscopic surgery should have taken place 3-12 weeks after the injury for patients of this prospective study. Fifty such cases were initially catagorized according to five MRI patterns. Types I to V were separated by the following ACL tear characteristics: Enlarged and diffusely increased in signal, horizontally oriented, non-visualized, discontinuous and vertically oriented. The cases were then divided into two groups of arthroscopic findings; Group A included cases of complete ACL tearing and group B included those with intact or minimally torn ACLs. Of MRI types I through V, there were 31, 9, 5, 4, and I cases of each respectively. 37 cases resulted in complete ACL tears (21 type I, 6 type II, 5 type III, 4 type IV and 1 type V) and 13 cases were catagorized into group B, 10 of which had pattern type I and 3 of which had pattern type II. As result, types III, IV and V had a 100% Positive Predictive Value (PPV) whereas types I and II together had a 67% PPV vaiue. Division of the cases into the five pattern types in early MRI proved valuble for possible cases of acute ACL tears. MRI pattern types III, IV and V were correlated with definite complete ACL tears. However, caution must be taken for types I and II, the majority of the cases, for which there exists a significant possibility for misdiagnosis and consequently unnecessary arthroscopic surgery.
Arthroscopy ; Diagnostic Errors ; Humans ; Knee ; Magnetic Resonance Imaging* ; Physical Examination ; Prospective Studies

Purpose: To compare and investigate the short-term clinical outcomes between 10-0 polypropylene sutured intraocular lens (IOL) scleral fixation and modified Yamane sutureless IOL scleral fixation in patients with IOL or crystalline les dislocation and aphakic state. Methods: From August 2012 to May 2022, medical records were retrospectively analyzed for 43 patients with sutured scleral fixation and 40 patients with sutureless scleral fixation. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), total astigmatism, IOL astigmatism, refractive error, corneal endothelial cell density, surgical time and complications were compared before surgery, 1 week, 1 month, and 3 months after surgery. Results: In the two groups, after 3 months of surgery, UCVA and BCVA improved compared to before surgery, but there was no significant difference between two groups. The absolute refractive error and total astigmatism for one week after surgery and IOL astigmatism for one week and one month after surgery were significantly lower in sutureless fixation group. There was no significant difference in postoperative corneal endothelial cell density changes between two groups, and total surgical time and IOL fixation time were measured significantly lower in sutureless fixation group. Conclusions Although modified Yamane sutureless IOL scleral fixation did not show significant improvement in visual acuity compared with conventional sutured IOL scleral fixation, sutureless fixation provided better stability of IOL in the early stages after surgery and short in the surgical time. So it can be an effective alternative to conventional sutured scleral fixation in patients with IOL or crystalline lens dislocation and aphakic state.

No abstract available.
Angiofibroma ; Carbon ; Carbon Dioxide ; Lasers, Gas

PURPOSE: To determine the efficacy and safety of the in situ anterior vaginal wall sling procedure for the treatment of anatomical incontinence (AI) and intrinsic sphincter dysfunction (ISD). MATERIALS AND METHODS: A total of 53 women (31 with AI and 22 with ISD), having undergone in situ anterior vaginal wall sling procedures, were reviewed. The preoperative evaluation included a detailed history taking, physical examination and urodynamic study, including Valsalva leak point pressure (VLPP) and incontinence staging, with Stamey grade. The efficacy and clinical outcome of this procedure were accessed by telephone interviews. RESULTS: With a mean follow up of 30.8 months (24-52), 49 (92.5%) of the 53 patients were completely continent or improved. The success rate of AI and ISD patients were 93.5 and 90.9% respectively. One patient (1.9%) required a prolonged Foley catheter drainage of up to 2 weeks. Sixteen (84.2%) out of the 19 patients with preoperative urge incontinence improved postoperatively, and de novo urge incontinence developed in 1 patient (1.9%). Postoperative wound infections developed in 3 patients (5.7%). CONCLUSIONS: The in situ anterior vaginal wall sling procedure can be an effective and safe surgical treatment option in both AI and ISD patients.
Catheters ; Drainage ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Physical Examination ; Surgical Wound Infection ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urodynamics

Pericardial cysts have been recognized as infrequent benign intrathoracic lesions, and are mainly found by accident. Recently, we experienced 3 cases of pericardial cysts. We report these case with the brief review of literature.
Mediastinal Cyst*