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

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*

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

PURPOSE: To investigate the relationship of refraction, geometry of the posterior corneal surface and the residual corneal thickness after excimer laser photorefractive keratectomy. METHODS: Thirty eyes of 15 patients were treated with Star S2 Smooth Scan (VISX, U.S.A.) and followed up for 3 months. The refractive, anteroposterior changes in the posterior corneal surface and residual corneal thickness were measured using slit-scanning topography, Orbscan IIR (Orbtek, Bausch & Lomb) at 1 week preoperatively, and 1 and 3 months postoperatively. RESULTS: Mean forward shift of the posterior cornea surface was 8.83+/-1.34 micrometer, 11.53+/-4.23 micrometer and 14.70+/-3.50 micrometer at 1 week, 1 month, and 3 months respectively. Mean spherical equivalence of posterior cornea was = -7.01+/-0.31 D preoperatively; it changed to -7.17+/-0.47 D, -7.22+/-0.21 D and -7.17+/-0.6 D at 1 week, 1 month and 3 months. The degree of forward shift of posterior corneal surface is correlated with the posterior corneal refractive changes (r=-0.808, P< 0.01). The forward shift of the posterior corneal surface is correlated with the residual corneal thickness (r=-0.483, P< 0.01). CONCLUSIONS: Photorefractive keratectomy significantly influenced the forward shift of the cornea, which is correlated with the residual corneal thickness.
Cornea ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy*

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

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

It is generally accepted that a vascular accident in utero during the fetal period plays an important role in the occurrence of intestinal atresia. An experimental study, making use of chick embryos was made to induce intestinal atresia by vascular occlusion or ligation of a loop of intestine. A study using the chick embryos made it relatively easy to obtain the experimental group. Its advantages are a short incubation period(21 days) and many operations can be performed with only a limited supply of surgical instruments. Physiologic umbilical hernia of the chick embryo is present from the 9th to the 18th day of development. We used chick embryos between 9th to 15th day of development to perform experiments. In group I, as a control group, round shaped opening was made in the eggshell, shell membrane and chorioallantoic membrane with diameter of 1 cm, and then closed with transparent tape. In group II, the mesenteric artery was ligated with prolene 7-0. In the group III, a loop of intestine was ligated with prolene 7-0. The survival rate of group I was 35.7%(50/140), group II, 5.1%(36/700) and group III was 7.6%(53/700)(p<0.001). The intestinal atresia in hatched embryos showed no case in group I, 14cases out of 36cases in Group II(type II 5cases, type III 9cases), and all cases in Group III(type I 3cases, type II 29cases, type III 21cases). There was no significant relation between experimental group and type of intestinal atresia(p=0.09). In this experiments, the survival rate and incidence of intestinal atresia of group III were higher than group II. We concluded that vascular accident of intestine during fetal period was a factor in development of intestinal atresia, but, mechanical obstruction of intestinal loop was more important.
Animals ; Chick Embryo* ; Chorioallantoic Membrane ; Embryonic Structures ; Hernia, Umbilical ; Incidence ; Intestinal Atresia* ; Intestines ; Ligation ; Membranes ; Mesenteric Arteries ; Polypropylenes ; Surgical Instruments ; Survival Rate

PURPOSE: To assess the the accuracy and variability in pachymetry measurements obtained by Orbscan and ultrasonic pachymeter in laser in situ keratomileusis (LASIK). METHODS: Thirty two eyes of 16 patients before LASIK were measured by ultrasonic pachymeter and Orbscan. Thirty eyes of 16 patients that had LASIK were measured by ultrasonic pachymeter and Orbscan postoperatively. The theoretical residual corneal thickness was compared to measurements by both instruments in eyes that had LASIK procedures. RESULTS: The ultrasound pachymeter measurements (543.8+/-24.2 micrometer) were thicker than the Orbscan pachymetry measurements, (541.2+/-24.9 micrometer) by mean of 2.7+/-7.4 micrometer (SD), preoperatively. But this is not statistically significant (p>0.05). Postoperatively, the ultrsound measurements were consistent with theoretical residual corneal thickness, 461.8+/-37.4 micrometer versus 467.9+/-30.71 micrometer (p=0.064), while Orbscan measurements were statistically less than the theoretical residual corneal thickness, 433.2+/-48.75 micrometer versus 464.32+/-33.4 micrometer (p<0.001). CONCLUSIONS: In LASIK eyes, the ultrasonic pachymetry was a more accurate measurement of corneal pachymetry than Orbscan topography system.
Corneal Pachymetry ; Humans ; Keratomileusis, Laser In Situ* ; Ultrasonics* ; Ultrasonography