The first myelography with air was carried out by Walter Dandy in 1919, and the myelography with positive contrast medium was done by Sicard and Forestier in 1922. Since Pantopaque was adopted as a contrast material by University of Rochester group in 1944, it has been rapidly popularized. Although higher diagnostic accuracy has been made with a development of the diagnostic aids such as electromyography, discography, epidural venography and computerized tomography, myelography has been popularized in our country with electromyography. The authars have seen and studied 107 cases of herniated lumbar disc with respect to the diagnostic accuracy of myelographic examination from January, 1976 to December, 1981 at the department of Orthopedic Surgery, Yonsei University College of Medicine. The results were as follows: l. Of the 107 cases, 59 were found in the age of 20 to 40 years and the ratio of male and female was 2:l. 2. Fifty eight cases (54.2%) had no history of back injury, but 40 cases (37.4%) had sprain of the back and 9 cases had direct trauma history. 3. In all cases, plain X-ray and myelogram were taken. Among them 55 cases showed narrowing of intervertebral space in plain film, and 100 cases showed positive myelographic findings such as lateral indentation of dural sac (41 cases), hour-glass defect (30 cases), root sleeve defect (12 cases), block defect (10 cases) and combined defects (7 cases). 4. Sixty one cases which confirmed by operation, the most frequent level of disc herniation was in L4-5 space. Clinical diagnosis was correct in 57.4%, and myelographic accuracy was coincided with operative finding in 80.3%. 5. Twelve (19.7%) of the 61 cases showed discrepancy between myelographic and operative findings, and these 12 cases consisted of 5 cases of level discrepancy, 3 cases of false positive and 4 cases of false negative.
Back Injuries ; Clinical Study ; Diagnosis ; Electromyography ; Female ; Humans ; Iophendylate ; Male ; Myelography ; Orthopedics ; Phlebography ; Sprains and Strains

PURPOSE: When the patients with both recurrent and primary pterygia, We performed conjunctival autograft transplantation for recurrent pterygium and bare sclera technique for primary pteygium. We then compared the recurrence of each case in order to find out the usefulness of each surgery and effective mothod of surgery. METHODS: We performed follow-up on 26 eyes of 13 patients for 14 months (mean); 8 patients (16 eyes) were female, and 5 patients (10 eyes) male. The mean age of the patients was 49.5 years ranging from 37 to 63. In the operation, all patients received with 0.02% Mitomycin C for 1 minute. RESULTS: Pterygium recurred in 3 of 13 eyes which underwent bare sclera technigue, and did not recur in 13 eyes undergoing conjunctival autograft transplantation, but there was no significant difference because of a small number of study cases (P=0.07). We found postoperative complications such as corneal fila-ment and conjunctival granuloma in the case of bare sclera technique; but none in conjunctival autograft transplantation. CONCLUSIONS: We recommend a conjunctival autograft transplantation with application of low concen-tration of Mitomycin C as a safe and effective method for recurrent pterygium or pterygium with high recurrence rate.
Autografts* ; Female ; Follow-Up Studies ; Granuloma ; Humans ; Male ; Mitomycin ; Postoperative Complications ; Pterygium* ; Recurrence* ; Sclera

In 1960 Jacobson and Suarez introduced the operating microscope to vascular surgery and demonstrated the superiority of small vessel repair using magnification. The first clinical replantation of an arm in the western world was performed by Malt in 1962, and Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. To perform a digit or hand replantation, microsurgical anastomosis of blood vessels is absolutely essential to revascularize the severed part. Without accurate repair of bone, nerves and tendons in addition to vascular anastomosis, however, it is impossible to gain functional success when replanting a digit or hand. This is a difficult task because all structures must be reconstructed at the same level and time. Even if the repair of some structures has been postponed, the secondary reconstruction may also be troublesome due to circular scarring at the replantation level. Since replantation surgery has been popularized throughout the world in recent years, the replantation sucess rate has increased and the surgeons interest in functional reconstruction of replanted digits or hands has been stimulated. The authors have seen and studied 6 cases of upper Jimb and 20 cases of finger replantation from May, 1980 through January, 1982 at the department of orthopedic surgery, Yonsei University College of Medicine. The results were as follows: I. The average age was 20 years and the male to female sex ratio was 4.5:1. 2, The causes of injury are detailed as follows: electric saw(6); cutting machine(5); roller(4}; presser(2); stone(2); others(3). 3. The level of amputation in 26 replantations was as follows: thumb, 3 cases; index finger, 4 cases; middle finger, 9 cases; ring finger, 4 cases; palm, I case, wrist, 3 cases; forearm, 1 case; upper arm, 1 case. 4. The maximum ischemic times for successtul results were 16 hours in limb replantation and 22 hours in finger replantation. 5. Six limbs, with four complete and two incomplete amputations, have been replanted and all six limbs survived: Twenty digits, with nine complete and eleven incomplete amputations, have also been replanted and 6.5 cases of nine complete amputations and 10 cases ot eleven incomplete amputations survived. A total of 22.5 cases(86.5%) of replanted limbs and digits survived. 6. The results of joint motion, two point discrimination, sensory recovery and status of sweating due to recovery ot sympathetic nervous function following replantation were satisfactory. 7. In the early stage of our series, postoperative systemic heparinization was used in some cases, but recently we have achieved good recults without it. 8. Main causes of reattachment failure were tissue crushing and secondary thrombosis of the anstomosed vessels.
Amputation ; Arm ; Blood Vessels ; Cicatrix ; Clinical Study ; Discrimination (Psychology) ; Extremities ; Female ; Fingers ; Forearm ; Hand ; Heparin ; Humans ; Joints ; Male ; Orthopedics ; Replantation ; Sex Ratio ; Surgeons ; Sweat ; Sweating ; Tendons ; Thrombosis ; Thumb ; Western World ; Wrist

The term “non-ossifying fibroma of bone” was introduced by Jaffe and Lichenstein in 1942 to describe a distinctive benign lesion occuring near the ends of the long bones in young people, and the lesion was subsequently described by Hatcher as a developmental defect rather than a true tumor. This lesion was presented as a clear-cut entity on the basis of pathological, clinical and roentgenographic manifestations. The diagnosis of non-ossifying fibroma was made by the histopathological findings of the curetted tissues. The authors have seen and studied 5 cases of non-ossifying fibroma from February 1976 to September 1981. The average duration of follow up was 2.2 years, with a range from 0.8 to 5 years, and the results of treatment were as follows: l. Of the five cases, two were associated with pathologic fractures. 2. The sites of the lesions in all cases were the long bones in the lower extremity. 3 In all cases, the complaints were of only a few days or weeks duration before admission to the hospital, and no cases were discovered incidentally by roentgenographic examination. 4. Good results were obtained by treatment with curettage and bone graft.
Curettage ; Diagnosis ; Fibroma ; Follow-Up Studies ; Fractures, Spontaneous ; Lower Extremity ; Transplants

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

PURPOSE: To investigate postoperative visual acuities of patients who underwent vitrectomy for their dense nondiabetic vitreous hemorrhage, and in addition to assess postoperative visual results of the group who underwent early vitrectomy. METHODS: Included in the study were 52 patients (52 eyes) who had undergone vitrectomy and been followed up for longer than 4 months after surgeries. Authors investigated the underlying diseases of vitreous hemorrhage, surgical outcomes, and the rate of complications. In addition, we evaluated the results of the group who had undergone vitrectomy between 4 weeks and 6 weeks after development of hemorrhage. RESULTS: The most common cause of vitreous hemorrhage was branch retinal vein occlusion followed by macular hole, ocular trauma, central retinal vein occlusion, age related macular degeneration, Terson`s syndrome, and unknown cases. Visual acuity before operation is less than light perception to 0.3 and improved in 44 eyes (84.6%) after operation. The rate of more than 5 lines' improvement is 63.4% (33 eyes) and 51.9% (27 eyes) obtained their visual acuity of 0.5 or better. In the group which had been operated 4 to 6 weeks after the development, visual acuity improved in 100% (16 eyes). Thirteen eyes (81.2%) showed more than 5 lines' improvement of their visual acuity and 12 eyes had 0.5 or better (75.5%). The most common complication after surgeries is cataract in 5 eyes (10.8%), others were macular hole in 3 eyes (5.7%), retinal detachment in 2 eyes (3.8%), macular hole in 1 eye (6.2%). CONCLUSIONS: Pars plana vitrectomy is a good procedure to improve visual acuity for the patients who have suffered persistent visual disturbances due to non-diabetic vitreous hemorrhage. Also, early vitrectomy should be considered for early visual rehabilitation.
Cataract ; Hemorrhage ; Humans ; Macular Degeneration ; Rehabilitation ; Retinal Detachment ; Retinal Perforations ; Retinal Vein ; Retinal Vein Occlusion ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage*

PURPOSE: This study was to investigate the effect on early visual outcome of corneal cap attachment with brushing after LASIK. METHOD: We studied 40 eyes of 20 patients who received LASIK from April, 1998 to March, 1999. Early visual acuity was measured in the first, second and third day after LASIK between the group that received brushing procedure and the group that didn't. RESULT: The consecutive group that received brushing procedure showed considerable increase in recovery rate of visual acuity compared to the control group that did not receive brushing procedure on the first day (P<0.001), second day (P<0.004) and third day (P<0.005) after LASIK. However, there was no difference of visual acuity between the two groups in one month, three months and six months (P>0.05) after LASIK. CONCLUSION: We think that corneal cap attatchment with brushing helps early visual recovery and further investigation in this study is needed.
Humans ; Keratomileusis, Laser In Situ* ; Visual Acuity

Recently, the incidence of fungal infection increases because of immunosuppressive therapy and chemotherapy. In immunosuppressed transplant recipients, Aspergillus can be a dangerous pathogen, capable of inducing fulminant clinical disease. Invasive fungal infections are life-threatening complications in solid-organ transplantation. Although the rate of fungal infections in transplant recipients is lower than that of other infections, the mortality rate is higher. A 34 year-old male was admitted to our hospital with fever and gross hematuria. He had received renal transplantation 2 years ago and had been transferred the other hospital 1 month ago. Initial laboratory data evaluation showed a pancytopenia and azotemia. We thought that pancytopenia was caused by immunosuppressive agents and infection. The patient was treated with antibiotics but fever was not subsided. After 4 days, he complained of transplant site pain and tenderness to percussion. A percutaneous renal biopsy was performed. Microscopic examination showed invasive aspergillosis in transplanted kidney and perirenal area. We removed the transplanted kidney and perirenal tissue, and prescribed antifungal agents for 3 months.
Anti-Bacterial Agents ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Azotemia ; Biopsy ; Fever ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Pancytopenia ; Percussion ; Transplants

OBJECTIVES: The purpose of this study was to evaluate the clinical usefulness of the protein/creatinine ratio of a spot urine specimen for early detection of proteinuria in the pregnancy induced hypertension and to suggest optimum cut-off value of that. STUDY DESIGN: A spot urine specimen and 24 hour urine collection for the proteinuria were ordered for 36 women admitted to obstetric unit for pregnancy induced hypertension and ROC curve analysis was performed to evaluate the usefulness of the protein/creatinine ratio of a spot urine specimen and to suggest optimum cut-off value. RESULT: The protein/creatinine ratio of spot urine positively correlated well with 24 hour urine proteinuria. (r=0.4322, p=0.0085) and the optimum cut-off value of the protein/creatinine ratio of a spot urine specimen to maximize the diagnostic accuracy was 5.0(Youden's index=0.66). CONCLUSION: We conclude that the protein / creatinine raio of a spot urine specimen may be a simple and inexpensive method for evaluation of proteinuria in the pregnancy induced hypertension when frequent determinations are necessary. This should improve clinical care, especially when managing hypertensive pregnant women as outpatients.
Creatinine* ; Female ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy* ; Pregnant Women ; Proteinuria ; ROC Curve ; Urine Specimen Collection