Dissociated vertical deviation(DVD) is a clinical entity consisting of an up ward and extorsional drift of a nonfixating eye. This can occur spontaneously or during occlusion of that eye. The cosmetic importance of surgical management of manifest DVD has been agreed upon, but a number of different operative approaches have been cited in the literature. The surgical treatments for DVD are large recession of the superior rectus(10-16mm), resection of the inferior rect-us as much as 8mm, posterior fixation suture of the superior rectus and posterior fixation suture combined with the superior rectus recession. However, in comparing the long-term effect of recession of the superior rectus muscle, reces-sion of the superior rectus muscle combined with posterior fixation, with that of posterior fixation of the superior rectus muscle without recession, Duncan and von Noorden concluded that the best results are obtained by conventional recession of the superior rectus muscle(4 to 5mm) combined with posterior fixation of 12-15mm behind the muscle insertion. 8 eyes of 7 patients received 4mm recession of the superior rectus muscle combined with 12-15mm posterior fixation suture for the treatment of DVD. All patients were followed for postoperative period of 4 weeks to 20 months. The results were as follows: 1. The amount of preoperative DVD has ranged from 20 delta to 38 delta. 2. The amount of postoperative DVD has ranged from 0 delta to 10 delta, and the effect of that surgery has ranged from 10 delta to 33 delta, average 23 delta. 3. After operation 7 of 8 eyes were aligned, within the good to excellent categories (0-10 delta).
Humans ; Postoperative Period ; Sutures*

In 1941 Wiberg discribed morphologic classification of patella in axial plane and the correlationship between its shape and dysfunction. Here the authors reviewed 120 cases and divided them into four groups. Group I is the one with no knee joint pain or patella dysfunction, group II is the patients with meniscus injury, gruop III is the patients with chondromalacia of patella and group IV is the patients with osteoarthritis of knee joint. We analysed them according to the ratio between the length of the patella and the articular surface in lateral X-ray films of patella. The results were as follows:1. The ratio between the length of the patella and the articular surface is 1.45±0.13(mean±SD) in group I, 1.47±0.18 in group II, 1.56±0.12 in group lll and 1.57±0.15 in group IV. 2. Statistically(P<0.05), no significant difference between group I and group II, but group III and group IV is significantly different from the group I. 3. The ratio between the length of the patella and the articular surface is thought to be helpful for diagnosing the patient with vague knee joint pain.
Cartilage Diseases ; Classification ; Humans ; Joints ; Knee Joint ; Osteoarthritis, Knee ; Patella ; X-Ray Film

The Tear Film Break-Up Time(BUT) in the diagnosis of the dry eye syndrome was widely used, but its results were variable according to the methods of measuring BUTs. Especially, the method of Fluorescein administration and concentration had a great influence on BUT. The purpose of this study was to standardize the method used in measurement of BUT, particularly fluorescein solution concentration. We measured BUT in seven groups of different fluorescein solution concentration and total subjects were 464 persons. The results were as follows; 1. The mean BUT was 14.24 +/- 2.04 seconds in 0.12% Fluorescein solution, 11.73 +/- 2.11 seconds in 0.25% solution, 11.34 +/- 3.00 seconds in 0.5% solution, 10.3 +/- 3.50 seconds in 1% solution, 9.59 +/- 2.74 seconds in 2% solution, 7.56 +/- 1.84 seconds in 5% solution and 5.55 +/- 1.20 seconds in 8% solution. 2. The more Fluorescein concentration was, the shorter BUT became and there were statistically significant decrease in 0.25%, 0.5% and 2% Fluorescein solution.
Diagnosis ; Dry Eye Syndromes ; Fluorescein* ; Humans ; Tears*

PURPOSE: To prospectively evaluate the clinical results of iris-fixed phakic intraocular lens (IOL) implantation (Artisan(R) implantation) in patients with high myopia. METHODS: Eighteen eyes of 10 patients underwent Artisan(R) implantation between December 2001 and February 2003 and were followed up for more than 6 months. The study prospectively analyzed the efficacy, safety and predictability of Artisan(R) implantation based on visual acuity and refractive errors. RESULTS: The preoperative mean uncorrected visual acuity (UCVA) was 0.02, and mean spherical equivalent refraction was -9.98D. Postoperative uncorrected vision was more than 0.5 in 83.3% of the eyes at 1 month and in 100% after 3 months. Also it was more than 0.9 in 22.2% of the eyes at 1 month, in 50.0% at 3 months and in 88.9% at 6 months. The spherical equivalent refraction after surgery was within 0.5D of emmetropia in 77.8% of eyes at 1 month, in 94.4% at 3 months and in 100% at 6 months. Also it was within 1.0D of emmetropia in 94.4% at 1 month and in 100% after 3 months. Complications included temporary glare or halo in 3 eyes, transient elevation of intraocular pressure in 1 eye, and decentration of IOL due to incomplete iris-fixation in 1 eye. CONCLUSIONS: Because of its good visual results and rare complications, the Artisan(R) implantation may be an effective surgical procedure for patients who cannot undergo laser in situ keratomileusis (LASIK).
Emmetropia ; Glare ; Humans ; Intraocular Pressure ; Keratomileusis, Laser In Situ ; Myopia ; Phakic Intraocular Lenses ; Prospective Studies ; Refractive Errors ; Visual Acuity

Acute peripheral vestibulopathy, of which the chief complaint is positional vertigo, comprises benign paroxysmal positional vertigo (BPPV), labyrinthitis, labyrinthine fistula, and cerebellopontine angle tumors. Since the typical presentation of labyrinthine fistulas may be sensorineural hearing loss, positional vertigo, or disequilibrium, it is often difficult to distinguish from BPPV or Meniere's disease. Herein we report a 61-year-old female patient with typical symptoms and signs attributable to geotropic type variant of the lateral semicircular canal BPPV on the left side, who eventually was confirmed as having a labyrinthine fistula from chronic otitis media with cholesteatoma on the left side. This is another case where, even in the presence of isolated vertigo showing typical findings of acute peripheral vestibulopathy, other otologic symptoms and signs must not be overlooked.
Cholesteatoma* ; Ear, Inner ; Female ; Fistula* ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis ; Meniere Disease ; Middle Aged ; Neuroma, Acoustic ; Otitis Media ; Semicircular Canals ; Vertigo* ; Vestibular Neuronitis

Metastatic tumors to the eye are probably the most common type of intraocular malignancies. The choroid is the most common site of involvement. Though the iris is a less common site of uveal involvement, metastases to the iris may occur and may produce a variety of clinical findings. The most common metastatic tumor to the eye is breast tumor and lung tumor is second, whereas the prompt most common metastatic tumor to the iris is lung tumor and breast tumor is second. The iris lesion may be the first presentation of the cancer and should make a search for the primary tumor. The diagnosis of metastatic tumor to the iris can be established by cytologic examination of aqueous. Local irradiation can spare the patient an enucleation and can preserve the eye for the generally few months of life that remain. Although the prognosis for vision is usually good, the prognosis for life is poor. The authors describe a 37 year old male patient having a metastasis from oat cell carcinoma of the lung to iris, which begins to respond to chemotherapy.
Adult ; Breast Neoplasms ; Carcinoma, Bronchogenic* ; Carcinoma, Small Cell ; Choroid ; Diagnosis ; Drug Therapy* ; Humans ; Iris* ; Lung ; Male ; Neoplasm Metastasis ; Prognosis

Pseudo-vestibular neuritis is a central pathology of acute vestibular syndrome, characterized by unidirectional nystagmus mimicking acute peripheral vestibulophaty. We report a 39-year-old female patient who developed cerebellar infarction with isolated vertigo, spontaneous nystagmus, a positive head thrust test, and unilateral canal paresis in the contralesional side. The patient had no vascular risk factors. A diffusion-weighted image of the brain showed infarction of medial branch of posterior inferior and superior cerebellar artery on the left side. A magnetic resonance angiography of neck disclosed a wide range of diffused severe stenosis and narrowing of right and left vertebral arteries, respectively. This case suggests the possibility of vestibular ischemia masking the central pathology in isolated vertigo.
Adult ; Arteries ; Brain ; Constriction, Pathologic ; Embolism ; Female ; Head Impulse Test ; Humans ; Infarction ; Ischemia ; Magnetic Resonance Angiography ; Masks ; Neck ; Neuritis* ; Nystagmus, Pathologic ; Paresis* ; Pathology ; Risk Factors ; Vertebral Artery ; Vertebral Artery Dissection* ; Vertigo ; Vestibular Neuronitis

BACKGROUND AND OBJECTIVES: We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. SUBJECTS AND METHODS: A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. RESULTS: The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. CONCLUSION: Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.
Adult ; Arm ; Blood Pressure* ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Cohort Studies ; Cross-Sectional Studies ; Humans ; Inflammation ; Logistic Models ; Metabolic Diseases ; Obesity ; Posture

OBJECTIVE: Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. METHODS: Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. RESULTS: In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p =0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p < 0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p < 0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. CONCLUSION: Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.
Aneurysm ; Anticonvulsants ; Craniotomy ; Follow-Up Studies ; Glasgow Outcome Scale ; Humans ; Hypertension ; Incidence ; Intracranial Aneurysm* ; Neurologic Manifestations ; Risk Factors ; Rupture ; Seizures* ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

Granulocytic sarcoma is characterized by the formation of clinically apparent invasive and destructive neoplasm composed of immature cells of the granulocytic (myeloid) series. It may arise either during the course of myelogenous leukemia or may precede the leukemic process for weeks to months. Because of its classical greenish appearance productd by a pigmented enzyme called myeloperoxidase, this tumor has long been called chloroma. But the currently preferred terms "granulocytic sarcoma" and "myeloid sarcoma" are more appropriate, as they reflect the cytologic composition of this tumor. Granulocytic sarcoma develops preferentially in bones or periosteum, especially those of the skull, and proptosis attributable to orbital involvement has long been recognized as a classical clinical feature. Children are affected more often than adults, and boys more frequently than girls. In the absence of systemic signs of leukemia, the histopathologic diagnosis may be quite difficult and may be confused with that of lymphoma, rhabdomyosarcoma, metastatic neuroblastoma and histiocytic or inflammatory tumors. Vigorous therapy directed toward the orbital lesion of granulocytic sarcoma may prevent or retard the development of systemic leukemia, a disease that frequently has a rapidly fatal outcome. The authors experienced a case of granulocytic sarcoma of bilateral orbits with exophthalmos and ptosis(O.S.) in a 7-year-old girl, which precede the acute myelogenous leukemia by 3 weeks.
Adult ; Child ; Diagnosis ; Exophthalmos ; Fatal Outcome ; Female ; Humans ; Leukemia ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Lymphoma ; Neuroblastoma ; Orbit* ; Periosteum ; Peroxidase ; Rhabdomyosarcoma ; Sarcoma, Myeloid* ; Skull