Ocular infection caused by Neisseria gonorrhea produces purulent conjunctivitis, which may lead to ulcerative keratitis and perforation if not promptly treated Most cases occur in neonates and rarely occur in adults. The author experienced a case of gonococcal keratoconjunctivitis which was confirmed by conjunctival exudate smear, culture and biochemical study.
Adult ; Male ; Female ; Infant, Newborn ; Humans

No abstract available.
Congenital Hypothyroidism*

The laparoscopic cholecystectomy, performed for the first time in France in 1987, has been accepted as in many countries the method of choice when performing a cholecystectomy. The trend toward minimally invasive surgery has prompted general surgeons to try it instead of open cholecystectomy. We performed 1000 laparoscopic cholecystectomies at the Department of General Surgery of Eulji Medical College Hospital from January 1992 to April 1997. The outcome data have been analyzed retrospectively. Moreover, we have compared the case histories of 13 patients who received cholecystostomy with those of 43 patient who did not. We also present preliminary results for an interval laparoscopic cholecystectomy which was a preceded by percutaneous cholecystostomy. The results are as follows: 1) The mean age was 54.3 years ranging from 17 to 86; there were 402 males and 598 females. 2) Of the 1000 patients, 123 patients (12.3%) had a history of abdominal surgery. 3) More than half of the patients(560 patients, 56.0%) underwent operations within 6 months of the onset of symptoms. 4) A preoperative endoscopic retrograde cholecystoscopy was performed on 220 patients (22.0%), and of these, 93 patients received endoscopic sphincterotomies because of bile duct stones. 5) The majority of patients(744 patients, 74.4%) had laparoscopic cholecystectomies which lasted 40 minutes or less. 6) More than half (54%) of the removed gallbladders showed grade II inflammation. 7) Drains were used in 142 patients (14.2%). 8) Postoperative complications were encountered in 48 patients (4.8%). 9) Postoperative oral intake was resumed within 24 hours in most patients. 10) Most patients(854 patients, 85.4%) were discharged within 3 days of the operation. 11) The pathologic diagnosis was chronic nonspecific inflammation in most cases (823 cases, 82.3%). 12) The most common microorganism in the bile was E. coli. 13) Patients who received a cholecystostomy had many benefits: a shorter operation time, a low rate of open cholecystectomy, early oral intake. 14) For the 1160 patients who underwent a cholecystectomy during the same period, the rate of open cholecystectomy was 13.8%.
Bile ; Bile Ducts ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystostomy* ; Diagnosis ; Female ; France ; Gallbladder ; Humans ; Inflammation ; Male ; Postoperative Complications ; Retrospective Studies ; Sphincterotomy, Endoscopic ; Surgical Procedures, Minimally Invasive

PURPOSE: To compare the peripapillary retinal nerve fiber layer (RNFL) thickness of normal patients and those with various glaucoma diseases by time domain (Stratus) and spectral domain (Spectralis) optical coherence tomography (OCT). METHODS: The RNFL thickness as measured by the Stratus and Spectral OCT was compared (paired t-test). The relationship and agreement of RNFL thickness between the two OCT modalities were evaluated by Pearson correlation, Bland-Altman plot, and area under the receiver operating characteristic curve. RESULTS: Two-hundred seventeen eyes of 217 patients, including twenty-four normal eyes, ninety-one glaucoma suspects, seventy-six normal tension glaucoma cases, and twenty-six primary open angle glaucoma cases (POAG) were analyzed. The peripapillary RNFL thicknesses as measured by Stratus OCT were significantly greater than those measured by Spectralis OCT. However, in quadrant comparisons, the temporal RNFL thickness obtained using Stratus OCT were significantly less than those obtained using Spectralis OCT. Correlations between RNFL parameters were strong (Pearson correlation coefficient for mean RNFL thickness = 0.88); a high degree of correlation was found in the POAG group. Bland-Altman plotting demonstrated that agreement in the temporal quadrant was greater than any other quadrant. CONCLUSIONS: Both OCT systems were highly correlated and demonstrated strong agreement. However, absolute measurements of peripapillary RNFL thickness differed between Stratus OCT and Spectralis OCT. Thus, measurements with these instruments should not be considered interchangeable. The temporal quadrant was the only sector where RNFL thickness as measured by Spectralis OCT was greater than by Stratus OCT; this demonstrated greater agreement than other sectors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Female ; Glaucoma, Open-Angle/*pathology ; Humans ; Low Tension Glaucoma/*pathology ; Male ; Middle Aged ; Nerve Fibers/*pathology ; ROC Curve ; Retina/*pathology ; Tomography, Optical Coherence/*methods ; Young Adult

Endophthalmitis after cataract surgery causes a profound visual loss. In this study, we performed bacterial cultures from conjuncitival swab atthe beginning of operation and of aqueous humor at the end of operation in 213 uncomplicated cataract surgery to examine the kinds of microorganisms being able to induce an endophthalmitis. Among five positive cultures from conjunctival swabs, Staphylococcus aureus was positive in four cases and Pseudomonas aeruginosa was positive in one case. In bacterial culture of aqueous humor, two microorganisms were observed, in which one case was Staphylococcus epidermidis and the other was Proteus vulgaris. However, ther was no case showing bacterial positive concurrently of conjunctiva and aqueous humor. In addition, there was no case of endophthalmitis. With these results, we could find that various microorganisms existed in conjunctival surface and in aqueous humor. However, itseems to be under the control of self-defense mechanis suppressing an endophthalmitis postoperatively in case of intact posterior capsule. Nevertheless, cataract surgeons should be careful to avoid an endophthalmitis with meticulous aseptic technique forundesirable events.
Anterior Chamber ; Aqueous Humor* ; Cataract ; Conjunctiva ; Endophthalmitis ; Proteus vulgaris ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Staphylococcus epidermidis

To manifest visual acuity of 20/20 or better, the requirements are good optical imagery, foveal fixation, intact receptor structure and function, and full integrity of the involved neural pathways. Person with hyperopia of 1-10 diopter or astigmatism of 1 diopter may be able to read the line marked 20/20 of Snellen's chart. Non-cycloplegic and cycloplegic subjective manifest refractions were done on 380 normal eyes with visual acuity of 20/20 or more to observe the prevalence, type and degree of the refractive errors. The results were as follows; 1. In non-cycloplegic subjective manifest refraction, 147 eyes(38.7%) had refractive error such as simple hyperopic astigmatism(50.3%), hyperopia(37.4%), simple myopic astigmatism(6.8%) and compound hyperopic astigmatism(5.4%). In cycloplegic subjective manifest refraction, 183 eyes(48.2%) were ametropia such as simple hyperopic astigmatism (49.7%), hyperopia(38.3%), compound hyperopic astigmatism(8.7%) and simple myopic astigmatism(3.2%). 2. As to the type of astigmatisms, "with the rule" astigmatism was 2.5 times more than "against the rule". 3. Average degree of refractive errors were 0.12 diopter in non-cycloplegic refraction and 0.22 diopter in cycloplegic refraction. 4. The degree of hyperopia was less than 1.00 diopter in all cases of noncycloplegic refractions and in most cases(93%) of cycloplegic refractions. 5. Degree of astigmatism were less than 1.00 diopter in the majority(98%).
Astigmatism ; Humans ; Hyperopia ; Neural Pathways ; Prevalence ; Refractive Errors ; Visual Acuity*

PURPOSE: The author compared the effect of the cup-to-disc ratio using the Volk Superfield lens and optical coherence tomography (OCT) to evaluate its usefulness in glaucoma diagnosis and follow-up. METHODS: One hundred ninety-seven eyes of 100 patients were enrolled: 34 normal, 75 glaucoma suspected, 43 normal tension glaucoma (NTG), 45 primary open angle glaucoma (POAG). Routine ophthalmic examinations, fundus examinations, and cup-to-disc ratio measurement using the Superfield lens after pupil dilatation, visual field test, OCT optic nerve head analysis, and OCT retinal nerve fiber layer analysis were performed. The author compared cup-to-disc ratio using the Superfield lens and OCT in normal, glaucoma suspected, normal tension glaucoma, and primary open angle glaucoma. RESULTS: Using the Superfield lens, the mean cup-to-disc ratio was 0.36+/-0.07 in normal eyes, 0.61+/-0.12 in suspected glaucoma, 0.75+/-0.11 in NTG, 0.70+/-0.17 in POAG. Using OCT, the mean cup-to-disc ratio was 0.58+/-0.13 in normal eyes, 0.69+/-0.12 in suspected glaucoma, 0.80+/-0.10 in NTG, and 0.76+/-0.15 in POAG. In all groups, cup-to-disc ratio using OCT were greater than using the Superfield lens and were statistically significant. CONCLUSIONS: Considering these differences in the clinical assessment of glaucoma, the combined use of the Superfield lens and OCT would be helpful in its diagnosis and follow-up.
Dilatation ; Eye ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma ; Nerve Fibers ; Optic Disk ; Pupil ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Field Tests

A 57 year old male, complaining of exophthalmos, disturbance of ocular motility and visual acuity in the right eye, was admitted under the disgnosis of orbital tumor. The tumor was removed by Kronlein procedure and verified as glioma microscopically. The following seven months period of postoperative observations revealed degenerative changes in the retina, atrophy of the optic nerve and enophthalmos in the affected side but no signs of recurrence.
Atrophy ; Enophthalmos ; Exophthalmos ; Glioma* ; Humans ; Male ; Middle Aged ; Optic Nerve ; Orbit* ; Recurrence ; Retina ; Visual Acuity

The increase of preoperative intraocular pressure by anesthetic is a troublesome problem in pin point anesthesia. In order to evaluate the efficacy of 4% lidocaine with less volume in pin point anesthesia 60 cataract surgeries were performed with different anesthetic dosage divided into 3 groups and compared preanesthetic with postanesthetic intraocular pressure and pain score(1; mild, 2; moderate, 3; severe). In the group 1(20 eyes), using 0.3ml of lidocaine, intraocular pressure change from preanesthesia to postanesthesia was 11.83+/-3.44mmHg to 12.19+/-3.27mmHg and there was no statistical significance(p=0.1025). In the group 2(20 eyes), using 0.4ml of lidocaine, intraocular pressure change was 11.53+/-3.22mmHg to 12.33+/-2.91mmHg and was statistically significant(p=0.0028). In the group 3(20 eyes), using 0.5ml of lidocaine, intraocular pressure change was 12.07+/-2.34mmHg to 13.41+/-2.51mmHg and was statistically significant(p=0.0000). Pain score in 3 groups were 1.60+/-0.17, 1.55+/-0.14, 1.35+/-0.11 and there was no statistical difference in 3 groups(p=0.5192). With these results, pin point anesthesia using 0.3ml of 4% lidocaine might be another useful local ocular anesthesia for the routine cataract operation.
Anesthesia* ; Cataract* ; Intraocular Pressure ; Lidocaine*

Endophthalmitis is one of the most catastrophic complications in intraocular surgery and penetrating injuries of the eye and intraocular injection of gentamicin is frequently used for its treatment. But the use of gentamicn resulted in sight-limiting complication such as cataract and the increased calcium level in the lens is an important factor of cataractogenesls. In this experiment, Ca++ - achivated ATPase activity, active Ca++ efflux and calcium concentration in the lens were measured at day 1, day 3 and 7 days after injection of gentamicin into the anterior chamber or vitreous to compare the effect on calcium transport in the rabbit lenses according to the route of administration. Ca++ -activated ATPase activity was progressively inhibited, active efflux of Ca++ was significantly decreased and calcium concentration progressively increased. So, it may be speculated that the decreased active efflux of Ca++ from the lens is related to inhibiting Ca++ -activated ATPase activity and this makes the accumulation of calcium in the lens. These effects were more severe in the intravitreal injection than in the intracameral injection group.
Adenosine Triphosphatases ; Anterior Chamber ; Calcium* ; Cataract ; Endophthalmitis ; Gentamicins* ; Injections, Intraocular ; Intravitreal Injections