PURPOSE: To analyze the clinical features of patients with exodeviation of more than 15 prism diopters (PDs) within one month and with orthophoria over three years after surgical correction of intermittent exotropia. METHODS: The early recurrence group consisted of patients with a final distance and near exodeviation more than 15PDs within one month after surgical correction of intermittent exotropia. The surgical success group was defined as patients with orthophoria over three years after surgical correction of intermittent exotropia. Sex, age at onset and surgery, office control status, refraction status, A-V pattern, preoperative and postoperative angles of ocular deviation, binocular sensory status, and the presence of diplopia on postoperative one day were retrospectively investigated and compared between these two groups. RESULTS: Out of a total of 68 patients, early recurrence occurred in 33 patients, and success was achieved in 35 patients. Factors including sex, age at onset and surgery, office control status, and diplopia on postoperative one day did not differ between the two groups. Preoperative near-angles of ocular deviation, A-V pattern of strabismus, preoperative stereopsis, and the range of postoperative overcorrection contributed to early recurrence. CONCLUSIONS: Factors related to early recurrence were larger preoperative near-angles of ocular deviation, presence of A-V pattern, poor preoperative stereopsis, and a smaller amount of overcorrection on postoperative day 1.
Ambulatory Surgical Procedures ; Depth Perception ; Diplopia ; Exotropia ; Humans ; Recurrence ; Retrospective Studies ; Strabismus ; Telescopes

Dieulafoy lesion is very small and easily overlooked as a course of massive, often recurrent hemorrhage that results from the crosion of a submucosal artery, typically in the gastric cardia or fundus. The clinical picture of Dieulafoy lesion is quite uniform: patients commonly present with massive hemorrhage and melena without any relevant history. The diagnostic procedure of choice in patients with severe gastrointestinal bleeding is emergency endoscopy. The lesion is rare but potentially life threatening source of upper gastrointestinal bleeding. Before the endoscopic era, the prognosis for patients with these lesions was quite poor. However, recent reports have described the success of endoscopic therapy in the management of Dieulafoy lesion. We performed emergency endoscopy in 3 patients who had massive or recurrent episode of upper gastrointestinal bleeding, identified to the Dieulafoy lesion. We tried to Endoscopic "0" band ligation, successfully in hemostasis and prevention of recurrence.
Arteries ; Cardia ; Emergencies ; Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hemostasis ; Humans ; Ligation* ; Melena ; Prognosis ; Recurrence

A 30-year-old woman who was diagnosed as peripheral neuroblastoma by fine needle aspiration of a soft mass of the right upper arm is described. She presented a slowly growing, soft mass of the right upper arm for 1 month. The right humerus revealed no abnormal finding on X-ray. Ultrasonogram of the right upper arm revealed a well demarcated, smooth marginated solid mass without invasion of adjacent structures. Fine needle aspiration was done under the impression of soft tissue tumor with undetermined biologic behavior. The aspirates were highly cellular and the tumor cells were dispersed both singly and in clusters of varying size. The clusters occasionally showed a central capillary core and rosette-like structures. The tumor cells were small in size and had a small to medium amount of cytoplasm. Some of them revealed slender cytoplasmic processes. The nuclei showed distinct nuclear membranes, finely clumped chromatin and small conspicuous nucleoli. Cellular pleomorphism or mitotic figure was not definite. These cytologic findings were interpreted as a malignant, non-lymphomatous, small round cell tumor, most likely representing peripheral neuroblastoma or Ewing's sarcoma. Final diagnosis was confirmed by simple excision as peripheral neuroblastoma.
Adult ; Arm ; Biopsy, Fine-Needle ; Capillaries ; Child* ; Chromatin ; Cyclosporine* ; Cytoplasm ; Diagnosis ; Female ; Humans ; Humerus ; Nephrotic Syndrome* ; Neuroblastoma ; Nuclear Envelope ; Pilomatrixoma ; Sarcoma, Ewing ; Ultrasonography

The internal morphology of the right and left atria of rabbit, cat, pig, and human, particularly on the luminal structures of the auricle, were observed by stereomicroscope improving corrosion casting method using latex. Structures of the right auricular casts markedly differ from those of the left side, consisting of defined surface sturctures with distinct folds and branching patterns. The main atrial region consists of smooth surfaced single mass of the latex, and the auricular region is characterized by well developed branching patte and delicate small folds. The results of this study indicate that auricula have well organized duct-like luminal structures and many small pouches (out-pocketings) expanding the internal wall of the duct-like structures and small pouches. The endocardial nuclear imprints on the surface of the folds in the auricular region appeared larger and deeper than those on the atrium proper region of the atrial cast. These morphological observation will be aid in understanding structures of auricular lumen, regional differences of the endocardium and their function to the secretory process of atrial natriuretic peptide (ANP) release.
Animals* ; Cats ; Corrosion Casting* ; Corrosion* ; Endocardium ; Humans ; Latex ; Methods* ; Phenobarbital* ; Secretory Pathway

BACKGROUND: Laryngeal mask airway (LMA) partly can be replaced for a role of endotracheal tube intraoperatively. Even with selecting one from various insertion techniques of LMA, one cannot achieve its perfect hypopharyngeal position. Furthermore, which is chosen by most anesthesiologists in this country, use of muscle relaxant for LMA insertion appears to have a harmful effect on its position. We tried to confirm whether we can improve the hypopharyngeal position of LMA with additional elevation of epiglottis using direct laryngoscope during LMA insertion. METHODS: Forty healthy patients scheduled for surgical procedure under general anesthesia were randomly divided to two groups; Laryngoscope group (n=20) and Jaw thrust group (n=20). No premedicant was administered. Anesthesia was induced with thiopental, vecuronium plus 2~3 vol% enflurane in oxygen. Full muscular relaxation was judged by no adductor response of thumb to train-of-four stimuation. In Jaw thrust group, using Brain's standard technique with additional jaw thrust, LMA was inserted, while in Laryngoscope group, LMA was introduced into oral cavity and advanced farther with additional elevation of epiglottis with direct laryngoscope. Bronchoscopic grading of hypopharyngeal position of LMA was performed. Blood pressure and heart rate were recorded at arrival (control), preintubation and until postintubation 5 minutes at 1 minute interval. Each measured values were compared between groups. RESULTS: Bronchoscopic grade of Laryngoscope group was significantly better than that of Jaw thrust group (p<0.001). Mean arterial pressure and heart rate changes were not different between groups. Conclusion: In the case of LMA insertion using muscle relaxant, we can markedly improve the hypopharyngeal placement of LMA with help of direct laryngoscope.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Enflurane ; Epiglottis ; Heart Rate ; Humans ; Jaw ; Laryngeal Masks* ; Laryngoscopes* ; Mouth ; Oxygen ; Relaxation ; Thiopental ; Thumb ; Vecuronium Bromide

PURPOSE: To define and measure macular thickness and volume using Fourier domain OCT (FD OCT) and compare the values with Stratus OCT in normal eyes and eyes with macular disease. METHODS: On the same day, macular thicknesses of the ETDRS 9 subfield and total macular volumes were measured in 35 eyes of 23 normal subjects and 19 diseased eyes of 24 patients with FD OCT and Stratus OCT. The macular cube scan protocol for FD OCT and the fast macular thickness map protocol for Stratus OCT were used to measure macular thicknesses. RESULTS: Foveal thickness of the central subfield in FD OCT (251.49+/-79.45 micrometer) was thicker than the value of Stratus OCT (210.26+/-60.57 micrometer) (p<0.001) in all eyes. Total macular volume was 7.72+/-1.06 mm3 and 7.04+/-0.96 mm3 for FD OCT and Stratus OCT, respectively (p<0.001). Retina thickness of the ETDRS 9 subfields in FD OCT was thicker than the value obtained using Stratus OCT. In addition, foveal thickness differences were statistically significant in both the normal and diseased eye groups. CONCLUSIONS: Macular thickness and total macular volume as measured by the FD OCT were larger than the values obtained using the Stratus OCT in both the normal and the diseased eye groups. The measuring algorithm of FD OCT defines the top of RPE as the outer retinal boundary, but Stratus OCT defines the outer retinal boundary as the IS/OS junction of the photoreceptor. Therefore, macular thicknesses of FD OCT are thicker than those of Stratus OCT. This difference should be considered when comparing the results of FD OCT with those of Stratus OCT.
Antineoplastic Combined Chemotherapy Protocols ; Cisplatin ; Doxorubicin ; Eye ; Humans ; Mitomycin ; Retina ; Retinaldehyde ; Tomography, Optical Coherence

Idiopathic restrictive cardiomyopathy is characterized by clinical and hemodynamic findings of restrictive cardiomyopathy in the absence of morphologic cause. The differential diagnosis between idiopathic restrictive cardiomyopathy and noncalcified constrictive pericarditis is difficult but the distinction is crucial because of the therapeutic implication. The diagnosis of idiopathic restrictive cardiomyopathy is aided by echocardiography and cardiac catheterization, cardiac magnetic resonance imaging. The patients should be approached systemically to differentiate from noncalcified constritive pericarditis.
Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Restrictive* ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Hemodynamics ; Humans ; Magnetic Resonance Imaging ; Pericarditis ; Pericarditis, Constrictive

No abstract available.
Cystitis* ; Ultrasonography*

No abstract available.
Hypercalciuria*

PURPOSE: To evaluate the effectiveness of tramadol for the reduction of pain in panretinal photocoagulation (PRP). METHODS: A double-masked randomized controlled study was performed. Fifty-eight eyes in 29 patients with proliferative diabetic retinopathy were enrolled. The eyes of the patients were randomized into two groups. Group A received an empty capsule. Group B received an oral intake of 100 mg tramadol. The capsule used in Group A had the same appearance as that used in Group B. Pain during PRP was assessed using a visual analog scale. Vital signs, including blood pressure and heart rate, were measured. RESULTS: The mean pain scores for groups A and B were 4.80+/-2.10 and 3.83+/-1.82 (p=0.09). There were no significant differences in the mean pain scores between the two groups. More patients in group A complained of greater pain than moderate intensity (visual analogue scale=4). Systemic blood pressure increased significantly in group A after laser treatment. However, there were no significant differences in the diastolic blood pressure changes between the two groups. We found no statistical correlation in the heart rate changes. CONCLUSIONS: We failed to prove that tramadol is effective for pain relief because of the small sample size. However, tramadol was effective for the relief of more severe pain. It was also found to stabilize vital sign changes, such as systolic blood pressure during PRP.
Administration, Oral ; Adult ; Aged ; Analgesia/*methods ; Analgesics, Opioid/*administration & dosage ; Case-Control Studies ; Diabetic Retinopathy/*surgery ; Dose-Response Relationship, Drug ; Double-Blind Method ; Follow-Up Studies ; Humans ; Laser Coagulation/*methods ; Middle Aged ; Pain/*drug therapy/physiopathology ; Pain Measurement ; Prospective Studies ; Tramadol/*administration & dosage ; Treatment Outcome ; Vitreoretinopathy, Proliferative/*surgery