Retinoscopy was performed on 90 esotropic children (180 eyes) younger than 6 years with cyclopentolate-homatropine and atropine. This procedure involves the instillation of a combination of cyclopentolate 1% and homatropine 5% on the initial visit, (ollowed by the instillation of atropine 1% two to four weeks later. In group 1, the parents administered atropine to both eyes of the patient three times a day for 3 days prior to the refraction, and for group 2, atropine was administered twice a day alternately to both eyes for 5 days. Atropine revealed +0.74 diopters more hyperopia than cyclopentolate-homatropine in group 1, and +0.68 diopters more in group 2, No statistically significant difference in cycloplegic effect of atropine was found between the two groups. After use of the atropine, side effect of facial flushing occurred in 15 patients (30%) in group 1, and in 5 patients (12%) in group 2. This difference is statistically significant (p<0.05). The results imply that in clinical practice 5 days of alternate twice-daily instillation can be substituted for conventional "full" atropinization for 3 days.
Atropine ; Child* ; Cyclopentolate ; Esotropia ; Flushing ; Humans ; Hyperopia ; Parents ; Retinoscopy

BACKGROUND: There is a substantial evidence that anatomical connections and functional interactions exist between vestibular and autonomic systems. The nature of these interactions, however, is complex and has not been fully defined. Heart rate variability (HRV) was used to investigate the physiological role of the vestibular system on control of heart rate. METHODS: HRV including mean, standard deviation, coefficient of variation (CV), power spectrum was analyzed from R-R intervals of ECG during vestibular stimulation in rabbits. RESULTS: Urethane anesthesia increased heart rate and maintained regular R-R intervals, however, low frequency region/high frequency region (LF/HF) was not changed. In anesthetized rabbits, electrical stimulation of the vagus nerve decreased heart rate and decreased LF/HF by increasing HF. On the contrary, electrical stimulation of the cervical sympathetic nerve increased heart rate and increased LF/HF by increasing LF. Atropine, cholinergic blocker, increased heart rate and increased LF/HF by reducing HF, and propranolol, beta-adrenergic blocker, decreased heart rate and decreased LF/HF by reducing LF. In unanesthetized rabbits, stimulation of the vestibular system induced by rotation or caloric increased heart rate and increased LF/HF by increasing LF. Also electrical stimulation of the vestibular nerve produced the same effects as rotation or caloric in anesthetized rabbits. CONCLUSION: These results suggest that stimulation of the vestibular system increased heart rate not by inhibiting the parasympathetic nerve but by activating the sympathetic nerve.
Anesthesia ; Atropine ; Autonomic Nervous System ; Electric Stimulation ; Electrocardiography ; Heart Rate* ; Heart* ; Propranolol ; Rabbits* ; Urethane ; Vagus Nerve ; Vestibular Nerve

BACKGROUND: The orthostatic hypotension in response to the assumption of an upright posture is regulated by activation of sympathetic nerves. Role of the vestibular system and neural pathway on orthostatic hypotension were investigated. METHODS: Changes of arterial blood pressure produced by head-up tilting, rotatory stimulation of the vestibular system, or electrical stimulation to the vestibular nerve, vestibular nuclei, and rostral ventrolateral medulla (RVLM) were measured in Sprague-Dawley rats. Also, field potentials were recorded in the vestibular nuclei and RVLM and c-Fos expression was evaluated in the brain stem in order to investigate the vestibulosympathetic pathways. RESULTS: The three phasic blood pressure responses were elicited by head-up tilting: initial fall, early recovery, and late sustained pressure at near control levels, the magnitude of the pressure fall was parallel with the degree of head-up tilting in normal rats. Return position from head-up tilting recovered control level of blood pressure after a brief rapid elevation. However, bilateral labyrinthectomy resulted in exaggerated initial falling and devoid of early recovery phase during postural change. Sinusoidal rotation about off-vertical axis of the vestibular system elicited more elevation of blood pressure than rotation about earth vertical axis. Electrical stimulation of the vestibular nerve, vestibular nucleus, and RVLM produced elevation of blood pressure, which was the most prominent by stimulation of RVLM. Field potentials composed of P, N1, N2 waves in the vestibular nuclei were recorded by stimulation of the vestibular nerve, while weak potentials in RVLM were recorded by stimulation of the vestibular nuclei. An electrical stimulation of the vestibular nuclei expressed c-Fos immunoreactive cells in RVLM. CONCLUSION: These results suggest that the otolith organ of the vestibular system plays a major role in control of orthostatic hypotension, and the pathway of vestibulosympathetic reflex in control of blood pressure involves the vestibular nuclei, RVLM, intermed-iolateral nuclei of the thoracic spinal cord.
Animals ; Arterial Pressure ; Axis, Cervical Vertebra ; Blood Pressure ; Brain Stem ; Electric Stimulation ; Hypotension, Orthostatic* ; Neural Pathways ; Otolithic Membrane ; Posture ; Rats* ; Rats, Sprague-Dawley ; Reflex* ; Spinal Cord ; Vestibular Nerve ; Vestibular Nuclei

PURPOSE: Many recent studies have been performed to improve adult height in short normal girls with early puberty by arresting rapid pubertal progression. We evaluated the effect of combined therapy with growth hormone (GH) and gonadotropin releasing hormone agonist (GnRHa) on predicted adult height in girls with early puberty, comparing them with a group treated with GnRHa alone. METHODS: Twenty eight girls with early puberty were classified into two groups and treated for an average 18 months. Group I of 18 girls was treated with GnRHa alone (leuprolide acetate; dosage: 30-90 mcg/kg, s.c. every 28 days) and group II of 10 girls was treated in combination with GH (dosage: 0.1 IU/kg, s.c. 5-7 days/week). Two groups were compared in terms of bone age, height, sexual maturity, and predicted adult height at the start and after the treatment. RESULTS: Two groups were not significantly different from each other in chronologic age, bone age, weight, target height, and sexual maturity before and after treatment. After treatment, group I showed predicted adult height (157.1+/-6.2 cm) which was comparable to target height (157.1+/-3.7 cm) and was not significantly higher than predicted adult height before treatment (156.0+/-6.5). On the contrary, group II showed predicted adult height (158.5+/-4.6 cm) which was comparable to target height (156.2+/-3.6 cm), but significantly higher than predicted adult height before treatment (154.2+/-7.4 cm) (P<0.05). CONCLUSIONS: GH and GnRHa combination treatment is more effective than GnRHa treatment alone to improve predicted adult height in girls with early puberty.
Adolescent ; Adult* ; Female* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Growth Hormone* ; Humans ; Puberty*

BACKGROUND AND OBJECTIVES: The caveolin is known as a mediator of cell death or survival of injured cell and inhibitor of various signaling pathways. We examined expression of caveolin-1 involved by protein kinase A(PKA) signaling pathway in the differentiated mouse vestibular cell line(UB/UE-1) after gentamicin toxicity. MATERIALS AND METHOD: We observed caveolae in the vestibular hair cell of healthy guinea pig through electron microscope. UB/UE-1 cells were cultured at 95% CO2, 5% O2, 33DegreeC for 2days and at 95% CO2, 5% O2, 39DegreeC for 24 hours for differentiation. Cells were treated with 1 mM of gentamicin, 0.02 mM H89 (PKA inhibitor), and then incubated for 24 hours. Caveolin-1 expression was examined by western blot and PKA activity by PepTag? assay. RESULTS: Caveolae were observed in the vestibular hair cell of healthy guinea pig by electron microscope. Caveolin-1 was expressed spontaneously in differentiated UB/UE-1 cells and increased after gentamicin treatment. PKA is overactivated by gentamicin treatment. The gentamicin induced caveolin-1 expression and PKA overactivation was inhibited by H89. CONCLUSION: Our results indicate that gentamicin induced caveolin-1 expression is mediated by PKA signaling pathway. We conclude that the caveolae/caveolin through a PKA signaling pathway is the important mechanism of gentamicin induced ototoxicity.
Animals ; Blotting, Western ; Caveolae ; Caveolin 1* ; Cell Death ; Cell Line* ; Gentamicins* ; Guinea Pigs ; Hair Cells, Vestibular ; Mice ; Protein Kinases

Recurrent bacterial meningitis in adults is a rare disease mostly due to traumatic cerebrospinal fluid (CSF) fistula and usually occurs within 2 weeks after head trauma. Recurrent bacterial meningitis shows high mortality and requires prompt diagnosis and proper treatment. However, diagnostic problems often arise when there may be no recent history of head injury, no direct radiologic evidence, and no CSF rhinorrhea or otorrhea. A 43-year-old man who had head trauma 2 years ago was admitted two times during 3 months due to acute bacterial meningitis. Culture of CSF grew Streptococcus pneumoniae during the second admission. The temporal bone CT scan revealed the transverse fracture on the right temporal bone. CSF leakage through the fracture was corrected by the open cavity mastoidectomy with middle ear obliteration. After the operation further recurrence of bacterial meningitis has not occurred.
Adult ; Cerebrospinal Fluid* ; Craniocerebral Trauma ; Diagnosis ; Ear, Middle ; Fistula* ; Humans ; Meningitis, Bacterial* ; Mortality ; Rare Diseases ; Recurrence ; Streptococcus pneumoniae ; Temporal Bone ; Tomography, X-Ray Computed

A case of primary non-Hodgkin's malignant lymphoma of the vulva which occurred in a 68-year-old woman is presented. Non-Hodgkin's malignant lymphoma is infrequently involved in the female genital tract. Moreover, primary vulvar involvement of this tumor is very rare. To date only 6 cases have been reported in the literature. To our knowledge this is the first reported case of a non-Hodgkin's malignant lymphoma of the vulva in Korea.
Aged ; Female ; Humans ; Lymphoma, Non-Hodgkin/*pathology/therapy ; Vulvar Neoplasms/*pathology/therapy

OBJECTIVE: We report a case with a long-standing history of the ankylosing spondylitis(AS) who showed multiple cerebellar infarctions with bulbar symptom owing to vertebral artery obstruction, due to anterior and vertical subluxation of atlanto-axial and atlanto-occipital joint. CLINICAL PRESENTARION: An 51-year-old male patient with swallowing difficulty, tongue deviation to the left side and severe nuchal pain and rigidity is presented. INTERVENTION: After removal of posterior portion of foramen magnum, posterior portion of left transverse foramen of axis was decompressed. CONCLUSIONS: Spontaneous anterior atlanto-axial subluxation occurs in patients with AS about 2% of presents with or without signs of spinal cord compression. Vertical subluxation occurs in 3-8% of patient with rheumatoid arthritis but it is an exceedingly rare complication of AS. Close observation and follow-up are needed in patients with AS and if subluxation occurs, good prognosis is anticipated using an early operative treatment.
Arthritis, Rheumatoid ; Atlanto-Occipital Joint* ; Axis, Cervical Vertebra ; Deglutition ; Follow-Up Studies ; Foramen Magnum ; Humans ; Infarction ; Male ; Middle Aged ; Prognosis ; Spinal Cord Compression ; Spondylitis, Ankylosing* ; Tongue ; Vertebral Artery*

BACKGROUND AND OBJECTIVES: The vestibuloautonomic reflex controls respiration and blood pressure during locomotion. The purpose of this study was to investigate the role of the peripheral vestibular receptor in the control of blood pressure in sinoaortic denervated (SAD) rats. MATERIALS AND METHODS: The baroreceptor reflex was removed by SAD in labyrinthectomized rats. The expression of c-Fos protein in the vestibular nuclear complex, and other nuclei related to control of blood pressure, was measured following the induction of acute hypotension using sodium nitroprusside (SNP). RESULTS: The SNP induced acute hypotension, in intact labyrinthine rats, increased the expression of c-Fos protein in the supraoptic nucleus, paraventricular nucleus, rostral ventrolateral medulla, solitary nucleus, and vestibular nuclear complex. The expression of c-Fos protein, following the SNP induced acute hypotension in the SAD rats, increased the expression of c-Fos protein in the paraventricular nucleus, rostral ventrolateral medulla, and medial and inferior vestibular nuclei. The acute hypotension induced by SNP in a unilateral labyrinthectomy, with SAD, increased the expression of c-Fos protein in the contralesional vestibular nuclear complex, but decreased its expression in the ipsilesional vestibular nuclear complex. The acute hypotension induced by SNP in a bilateral labyrinthectomy, with SAD, showed only slight expression of c-Fos protein in the bilateral vestibular nuclear complex. CONCLUSION: These results suggest that the acute hypotension induced by SNP activates the vestibular nuclear neurons by decreasing the blood flow in the peripheral vestibular receptors, and that these in turn modulate blood pressure through activation of the catecholaminergic nervous system and neuroendocrine reflex.
Animals ; Baroreflex ; Blood Pressure* ; Hypotension ; Locomotion ; Nervous System ; Neurons ; Nitroprusside ; Paraventricular Hypothalamic Nucleus ; Pressoreceptors ; Rats* ; Reflex ; Respiration ; Solitary Nucleus ; Supraoptic Nucleus ; Vestibular Nuclei

In order to prepare the fundamental data for preventing the hazardous effects at toluene exposure in many kinds of industry, the authors determined the level of urinary hippuric acid on 592 toluene exposed women(exposed group) and 102 unexposed women(control group) in Pusan area, from April 1 to October 31, 1986. Hippuric acid was measured by high performance liquid chromatography. The results were summarized as follows; 1. The mean value of urinary hippuric acid concentration of the control group was 0.44+/-0.21g/l(0.11-0.89g/l). The distribution of urinary hippuric acid concentration of the control group was not fit to the normal distribution. 2. The mean value of urinary hippuric acid concentration of the exposed group was 1.56+/-0.95g/l(0.44-4.57g/l). The distribution of urinary hippuric acid concentration of control group was not fit to the normal distribution. 3. The urinary hippuric acid concentration by age group was not statistically significant in the control group, but in the exposed the urinary hippuric acid concentration was highest in women between 20-29 years old(1.71+/-0.95g/l) and was statistically significant(p<0.01). 4. The urinary hippuric acid concentration by duration of working hours was not statistically significant(p>0.1).
Busan ; Chromatography, Liquid ; Female ; Humans ; Toluene*