Iliff procedure was performed upon the nine ptotic eyes. The rate of success in our series was appeared to be the highest among the rex ports appeared in the literatures. Average amont of ptosis before the operation was 5.1 mm, when 10 mm of palpebral fissure is taken to be normal, and average amount of correction by the procedure was 4.4 mm, leaving average residual ptosis of 0.7 mm. In our series, there was no overcorrection and the other complications; such as entropion, lagophthalmos, granuloma of the lids, prolapse of the orbital fat and scarring of the lids. The high rate of success in our series could, the authers feel, be attributed to the simpleness of the procedure.
Cicatrix ; Entropion ; Granuloma ; Orbit ; Prolapse

12 cases of retinal detachment treated with scleral buckling Procedure of 4392 visitors the department of ophthalmology. Yonsei University medical school from Feb. 28th 1958 to April 30th 1959. 30 cases of retinal detachment were found 12 cases out of 30 received the scleral buckling procedure, and exhibited the following results. 1) a. Successful, b. Fair 3(25%), c. Failure 2(16.6%). 2) The shorter the duration of retinal detachment existed the better the resutls of the operation was. However in 2 cases of old retinal detachment lasted more than 7 months the results of the operation were also successful. 3) Results of the surgery were more favourable in the cases of having no definite hole. 4) In one case, retinal detachment was recurred a year after the first procedure and a secondary procedure was performed with fair results.
Ophthalmology ; Retinal Detachment ; Retinaldehyde* ; Schools, Medical ; Scleral Buckling*

OBJECTIVE: The object of this study was to assess the accuracy of dipyridamole stress intravenous (IV) myocardial contrast echocardiography (MCE) using pulse inversion harmonic imaging and PESDA in the detection of perfusion defect in the patients with coronary artery disease in comparison with dipyridamole stress Tc-99m sestamibi SPECT. METHODS: Total 46 patients (29 males, mean age 64 years old) were consecutively enrolled. Patients with prior myocardial infarction were excluded. MCE and Tc-99m sestamibi SPECT were performed at the same day during rest and after 0.56 or 0.84mg/Kg dipyridamole infusion. Continuous IV infusion of PESDA (2-5 mL/min) was administered while obtaining triggered (1:1) end-systolic apical 2, 4 chamber and long axis views. Tc-99m sestamibi was injected 3 minutes after dipyridamole. Tc-99m sestamibi SPECT images were obtained one hour later. Coronary angiography was followed within two days in all patients. Tc-99m sestamibi SPECT images were matched to the sixteen segments of left ventricle according to American Society of Echocardiography for segmental comparison. Both images were analyzed visually. Results Using coronary angiography as the standard, MCE showed overall sensitivity of 70.7%, specificity of 95.8%, positive predictive value (PPV) of 87.8% and negative predictive value (NPV) of 88.5% in the detection of coronary atherosclerosis (70% stenosis). Tc-99m sestamibi SPECT showed sensitivity of 75.6%, specificity of 98.9%, PPV of 96.8% and NPV of 90.6%. The overall concordance rate between MCE and Tc-99m sestamibi SPECT for the detection of perfusion defects was 86.9% (Cohen's kappa value 0.63) according to the coronary territory and 86.8% (Cohen's kappa value 0.55) according to segmental analysis. CONCLUSION: Dipyridamole stress IV MCE using pulse inversion harmonic imaging and PESDA is feasible and comparable to Tc-99m sestamibi SPECT in identifying significant coronary stenosis and inducible myocardial perfusion defects in the patients with coronary artery disease. MCE using pulse inversion harmonic imaging seems to be a promising modality for assessing myocardial perfusion in the patients with suspected coronary artery disease.
Axis, Cervical Vertebra ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Dipyridamole ; Echocardiography* ; Heart Ventricles ; Humans* ; Male ; Myocardial Infarction ; Perfusion* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To determine the significance of nerve root contrast enhancement in patients with residual or recurrent symptomatic postoperative lumbar spine. MATERIALS AND METHODS: Eighty-eight patients with 116 postoperative lumbar disc lesions causing radiating back pain underwent enhanced MR imaging. Intradural nerve root enhancement was quantified by pixel measurement, and affected nerve roots were compared before and after contrast administration. Extradural nerve root enhancement was assessed visually, and nerve root enhancement and clinical symptoms were correlated. Associated lesions such as recurrent disc herniation, scar tissue, nerve root thickening and nerve root displacement were also evaluated. RESULTS: Of 26 cases(22.4%) involving intradural nerve root enhancement, 22 (84.6%) showed significant clinical symptoms (p=0.002). and of 59 (50.9%) demonstrating extradural enhancement, clinical symptoms showed significant correlation in 47 (79.7%) (p=0.001). Nerve root enhancement, including eleven cases where this was both intra-and extradural, showed highly significant association with clinical symptoms in 74 of the 116 cases (63.8%) (p=0.000). Among 33 cases (28.4%) of recurrent disc herniation, nerve root enhancement was observed in 28 (84.8%) and in 24 of these 28 (85.7%), significant correlation with clinical symptoms was observed (p=0.000). Where epidural fibrosis was present, correlation between nerve root enhancement and clinical symptoms was not significant (p>0.05). Nerve root thickening and displaced nerve root were, however, significantly associated with symptoms(87.2% and 88.6%, respectively). CONCLUSION: In patients with postoperative lumbar spine, the association between nerve root enhancement revealed by MRI and clinical symptoms was highly significant.
Back Pain ; Cicatrix ; Fibrosis ; Humans ; Magnetic Resonance Imaging* ; Nerve Tissue ; Spine*

PURPOSE: To evaluate the diagnostic ability of optic disc topographic parameters and the retinal nerve fiber layer (RNFL) thickness parameter measured by optical coherence tomography (OCT) and to determine the association of these structural parameters with visual field indices. METHODS: Fifty-six glaucomatous eyes and 65 healthy control eyes were enrolled in this retrospective cross-sectional study. Each subject had a 24-2 full threshold test on a Humphrey visual field analyzer and an optical coherence tomographic evaluation. The parameters from the fast RNFL thickness algorithm and the fast optic disc algorithm were analyzed by an ROC curve, and we sought to determine the association of these parameters with visual field indices by linear and logarithmic regression. RESULTS: The area under the receiver operating characteristic curve (AUROC) value of the fast optic disc algorithm parameters ranged from 0.78 to 0.79 and that of the fast RNFL thickness algorithm parameters ranged from 0.74 to 0.81. The associations between the parameters from the fast optic disc algorithm and from the fast RNFL thickness algorithm with visual field indices were statistically significant (P<0.001). CONCLUSIONS: The fast optic disc algorithm and the fast RNFL algorithm revealed comparable diagnostic ability in discriminating glaucoma and significant associations with visual field indices.
Cross-Sectional Studies ; Eye ; Glaucoma ; Nerve Fibers ; Retinaldehyde ; Retrospective Studies ; ROC Curve ; Tomography, Optical Coherence ; Visual Fields

PURPOSE: To evaluate the structure-function relationships between retinal sensitivity measured by Humphrey visual field analyzer (HVFA) and the retinal nerve fiber layer (RNFL) thickness measured by scanning laser polarimetry (SLP) with variable corneal compensation (VCC) and enhanced corneal compensation (ECC) in glaucomatous and healthy eyes. METHODS: Fifty-three eyes with an atypical birefringence pattern (ABP) based on SLP-VCC (28 glaucomatous eyes and 25 normal healthy eyes) were enrolled in this cross-sectional study. RNFL thickness was measured by both VCC and ECC techniques, and the visual field was examined by HVFA with 24-2 full-threshold program. The relationships between RNFL measurements in superior and inferior sectors and corresponding retinal mean sensitivity were sought globally and regionally with linear regression analysis in each group. Coefficients of the determination were calculated and compared between VCC and ECC techniques. RESULTS: In eyes with ABP, R2 values for the association between SLP parameters and retinal sensitivity were 0.06-0.16 with VCC, whereas they were 0.21-0.48 with ECC. The association of RNFL thickness with retinal sensitivity was significantly better with ECC than with VCC in 5 out of 8 regression models between SLP parameters and HVF parameters (P<0.05). CONCLUSIONS: The strength of the structure-function association was higher with ECC than with VCC in eyes with ABP, which suggests that the ECC algorithm is a better approach for evaluating the structure-function relationship in eyes with ABP.
Algorithms ; Birefringence ; Cornea/physiology ; Cross-Sectional Studies ; *Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma/*diagnosis ; Humans ; Intraocular Pressure ; Lasers/diagnostic use ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Optic Nerve Diseases/*diagnosis ; Prospective Studies ; Retinal Ganglion Cells/*pathology ; Vision Disorders/*diagnosis ; *Visual Fields

PURPOSE: To investigate the visual field (VF) and retinal nerve fiber layer (RNFL) status of the fellow eyes in patients with unilateral retinal vein occlusion (RVO). METHODS: Fifty patients with unilateral RVO and 35 normal control subjects wereconsecutively recruited. Humphrey VF parameters and RNFL status using scanning laser polarimetry with variable corneal compensation (GDx-VCC) were compared between the fellow eyes of the patients with unilateral RVO and control eyes. We also assessed the risk factors for the development of glaucomatous damage in the fellow eyes of unilateral RVO patients. RESULTS: Twelve fellow eyes out of 50 patients with unilateral RVO showed glaucomatous VF and RNFL changes assessed by GDx-VCC. VF indices and RNFL thickness parameters in the study group were significantly lower than those in the control group (p<0.05). Increased age and vertical cup-to-disc ratio were significantly associated with severity of VF and RNFL damage in the fellow eye of unilateral RVO patients (p<0.05). CONCLUSIONS: The fellow eyes in patients with unilateral RVO showed significantly worse VF indices and lower RNFL thickness than normal control eyes. The glaucomatous change should be carefully monitored in the fellow eyes of unilateral RVO patients.
Compensation and Redress ; Eye ; Glaucoma ; Humans ; Nerve Fibers ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Risk Factors ; Scanning Laser Polarimetry ; Visual Fields

PURPOSE: To investigate the relationship between the SLP-VCC parameters and the SLP-ECC parameters in the eyes with typical retardation pattern (TRP) and atypical retardation pattern (ARP), and the sensitivities and specificities of the SLP-VCC parameters and the SLP-ECC parameters in the eye with TRP and ARP. METHODS: In this prospective study, 72 eyes with TRP images (30 glaucomatous and 42 normal eyes) and 53 eyes with ARP images (28 glaucomatous and 25 normal eyes) were recruited. For each group, we analyzed relationship between each parameters of GDx-VCC and GDx-ECC and the diagnostic ability of GDx-ECC by using the ROC curve. RESULTS: In the eyes with TRP, TSNIT average was significantly lower by GDx-ECC than GDx-VCC in the control group. Inferior average was significantly higher by GDx-ECC than GDx-VCC in both glaucomatous and normal group. TSNIT standard deviation was significantly higher by GDx-ECC than GDx-VCC in both groups. NFI was significantly lower by GDx-ECC than GDx-VCC in both groups. TSS (typical scan score) was significantly higher by GDx-ECC than GDx-VCC in both groups. In the eyes with ARP, TSNIT average was significantly lower by GDx-ECC than GDx-VCC in both groups. Superior and Inferior average was not different between GDx-ECC and GDx-VCC. TSNIT standard deviation was significantly higher by GDx-ECC than GDx-VCC in both groups. NFI was not different between groups. TSS was significantly higher by GDx-ECC than GDx-VCC in both groups. Comparison of ROC curve for the SLP parameters revealed no difference between VCC and ECC. TSNIT standard deviation, however, showed relatively high value in GDx-ECC compared with GDx-VCC. CONCLUSIONS: GDx-ECC has comparable diagnostic ability in discriminating glaucomatous and normal eyes with GDx-VCC and TSNIT standard deviation by the GDx-ECC algorithm could be a useful parameter in discriminating glaucomatous and normal eyes.
Compensation and Redress* ; Prospective Studies ; ROC Curve ; Scanning Laser Polarimetry*

This study demonstrates that the nonnarcotic analgesic Zomepirac sodium administered in repeated doses is well tolerated and effective in 42 patients with mild to severe chronic pain. When the relative incidence of side effects such as gastrointestinal up set and central nervous system disturbances are taken into account, Zomepirac is clearly the preferable therapeutic agent. We therefore, suggest that Zomepirac is an acceptable nonnarcotic agent for the management of chronic pain and that its efficacy and safety profile are consistent with current postsurgical managements including early ambulation.
Central Nervous System ; Chronic Pain* ; Early Ambulation ; Humans ; Incidence ; Sodium

Because the risk of adverse reactions is lower with nonionic radiocontrast media than with conventional ionic agent, it is recommended that high-risk patients receive lower osmolality, a nonionic radiocontrast for their examination. However, the occurrence of a severe, life-threatening anaphylactoid reaction to even a small dose of nonionic radiocontrast has been reported. We report the first case in Korea of near-fatal anaphylactoid reaction to a nonionic contrast media. A 21-year-old lady with an abdominal mass due to benign mucinous cystadenoma received an injection of iopromide (Ultravist ) for abdominal computerized tomogram. Two minutes after the injection, perioral swelling and erythema, vomiting, seizure, and cardiopulmonary arrests developed. Immediate cardiopulmonary resuscitation and administrations of antihistamine, steroid, and sympathomimetics were performed with successful recovery. She had a history of allergic rhinitis and showed mild airway hyperresponsiveness on histamine bronchoprovocation test. Since a pretreatment with corticosteroid & antihistamine regimen in addition to use of nonionic agent helped to reduce the further occurrence of anaphylactoid reactions in previous contrast reactors, this near-fatal anaphylactoid reaction in an atopic individual suggests that a use of pretreatment plus nonionic agent is desirable in all patients with atopy or asthma.
Asthma ; Cardiopulmonary Resuscitation ; Contrast Media* ; Cystadenoma, Mucinous ; Erythema ; Heart Arrest ; Histamine ; Humans ; Korea ; Osmolar Concentration ; Rhinitis ; Seizures ; Sympathomimetics ; Vomiting ; Young Adult