PURPOSE: We investigated the recommended minimum postoperative follow-up period for the determination of secondary corrective surgery for the consecutive esotropia (ET) and recurrent exotropia (XT) after the first intermittent XT surgery. METHODS: The medical records of 728 patients who underwent surgical treatment for intermittent XT between 2004 and 2009 with a minimum postoperative follow-up of 1 year were retrospectively reviewed. Each patient underwent a detailed sensory and motor examination, including measurements of near and distance stereoacuity, alternating-cover test, and extraocular muscle function testing. Consecutive ET was defined as esodeviation over 15 prism diopter (PD) at distance persisting for more than 6 months after surgery despite medical treatment. Recurrent XT was defined as exodeviation over 15 PD at distance after surgery despite medical treatment. RESULTS: The mean age of the 728 patients at first surgery was 7.5 years (range, 22 months - 30 years). When only the motor outcome was considered, 663 patients (91.1%) had an orthrotropia at the final follow-up and 44 patients (6.0%) among consecutive ET patients and 21 patients (2.9%) who had a recurrent XT underwent secondary surgical correction. Binocularity decreased postoperatively in patients with consecutive ET (p < 0.001), whereas the other patients demonstrated improved stereopsis postoperatively (p = 0.041, 0.021). Patients with consecutive ET showed esodeviation over 10 PD when compared with orthotropia after 2 months postoperatively (p = 0.005). At 6 months postoperatively, 17 (81.0%) of 21 patients with recurrent XT showed orthotropia with an exodeviation over 11 PD after 18 months postoperatively. CONCLUSIONS: The success rate of surgical correction for intermittent XT showed a favorable outcome. However, careful concern for consecutive ET and recurrent XT are required in postoperative follow-up periods. Over-corrected or consecutive ETs need early surgical correction because no further improvement of ocular alignment will occur after 2 months postoperatively and delayed correction can result in poor sensory binocularity. Under-corrected or recurrent XT should be observed for an extended period because of the exotropic drift after surgery, thus requiring periodic long term follow-up for secondary surgery at least for 18 months postoperatively.
Depth Perception ; Esotropia ; Exotropia* ; Follow-Up Studies* ; Humans ; Medical Records ; Retrospective Studies ; Telescopes

PURPOSE: We investigated the recommended minimum postoperative follow-up period for the determination of secondary corrective surgery for the consecutive esotropia (ET) and recurrent exotropia (XT) after the first intermittent XT surgery. METHODS: The medical records of 728 patients who underwent surgical treatment for intermittent XT between 2004 and 2009 with a minimum postoperative follow-up of 1 year were retrospectively reviewed. Each patient underwent a detailed sensory and motor examination, including measurements of near and distance stereoacuity, alternating-cover test, and extraocular muscle function testing. Consecutive ET was defined as esodeviation over 15 prism diopter (PD) at distance persisting for more than 6 months after surgery despite medical treatment. Recurrent XT was defined as exodeviation over 15 PD at distance after surgery despite medical treatment. RESULTS: The mean age of the 728 patients at first surgery was 7.5 years (range, 22 months - 30 years). When only the motor outcome was considered, 663 patients (91.1%) had an orthrotropia at the final follow-up and 44 patients (6.0%) among consecutive ET patients and 21 patients (2.9%) who had a recurrent XT underwent secondary surgical correction. Binocularity decreased postoperatively in patients with consecutive ET (p < 0.001), whereas the other patients demonstrated improved stereopsis postoperatively (p = 0.041, 0.021). Patients with consecutive ET showed esodeviation over 10 PD when compared with orthotropia after 2 months postoperatively (p = 0.005). At 6 months postoperatively, 17 (81.0%) of 21 patients with recurrent XT showed orthotropia with an exodeviation over 11 PD after 18 months postoperatively. CONCLUSIONS: The success rate of surgical correction for intermittent XT showed a favorable outcome. However, careful concern for consecutive ET and recurrent XT are required in postoperative follow-up periods. Over-corrected or consecutive ETs need early surgical correction because no further improvement of ocular alignment will occur after 2 months postoperatively and delayed correction can result in poor sensory binocularity. Under-corrected or recurrent XT should be observed for an extended period because of the exotropic drift after surgery, thus requiring periodic long term follow-up for secondary surgery at least for 18 months postoperatively.
Depth Perception ; Esotropia ; Exotropia* ; Follow-Up Studies* ; Humans ; Medical Records ; Retrospective Studies ; Telescopes

PURPOSE: To report a case of isolated squamous cell carcinoma of the orbit. CASE SUMMARY: A 75-year-old man with over a 50 pack-year history of smoking presented discomfort and visual disturbance of the left eye for several months. His best-corrected visual acuity was 0.3, intraocular pressure was 9 mm Hg, and extraocular movements were normal. Slit-lamp examinations revealed no specific findings in the anterior segment in the left eye. However, retinal exams showed an oval-shaped, juxtapapillary mass-like lesion associated with retinal folding in the left eye. A huge, distorted echoic mass with an initial prominent spike and low-to-medium internal reflectivity with diminishing amplitude was observed on ocular ultrasonography. Enhanced CT revealed a highly-intense, irregular-circumscribed heterogeneous mass (2.0 x 2.0 x 1.5) in the superomedial quadrant of the left eye. Metastatic workups, including bone scan and CT of the head, neck, chest, and abdomen, were unremarkable. One week after the initial visit, the patient experienced pain and reduced visual acuity (light perception) in the left eye. Following the diagnosis, enucleation with tumor resection and hydroxyapatite implantation was performed. Histopathologic examination revealed a moderated-differentiated squamous cell carcinoma invading the sclera. The patient subsequently underwent radiation treatment and no evidence of recurrence was reported 6 months after surgery.
Abdomen ; Aged ; Carcinoma, Squamous Cell ; Durapatite ; Eye ; Head ; Humans ; Intraocular Pressure ; Neck ; Orbit ; Recurrence ; Retinaldehyde ; Sclera ; Smoke ; Smoking ; Thorax ; Visual Acuity

STATEMENT OF PROBLEM: Regardless of any restoration, most of case, we used in screw connection between abutment and implant. For this reason, implant screw loosening has been remained problem in restorative practices. PURPOSE: The purpose of this study was to compare surface of coated/plated screw with titanium and gold alloy screw and to evaluate physical property of coated/plated material after scratch test in FESEM investigation. MATERIAL AND METHODS: GoldTite, titanium screw provided by 3i (Implant Innovation, USA) and TorqTite, titanium screw by Steri-Oss (Nobel Biocare, USA) and gold screw, titanium screw by AVANA (Osstem Implant, korea) - were selected for this study. Each abutment screw surface was observed at 100 times, and then screw crest, root, and slope were done more detailed numerical value, at 1000 times with FESEM. A micro-diamond needle was also prepared for the scratch test. Each abutment screw was fixed, micro-diamond scratch the surface of head region was made at constant load and then was observed central region and periphery of fine trace through 1000 times with FESEM. RESULTS: The surface of GoldTite was smoother than that of other kinds of screw and had abundant ductility and malleability compared with titanium and gold screw. The scratch test also showed that teflon particles were exfoliated easily in screw coated with teflon. Titanium screw had a rough surface and low ductility. CONCLUSION: It was recommended that the clinical use of gold-plated screw would prevent a screw from loosening.
Alloys ; Head ; Needles ; Polytetrafluoroethylene ; Titanium

No abstract available.
Intervertebral Disc* ; Retrospective Studies*

No abstract available.
Muscular Dystrophy, Oculopharyngeal*

Intracranial hypoglossal neurinomas are rare and only about fifty cases have been reported worldwidely. They usually present with hypoglossal nerve palsy preoperatively. The authors experienced, however, two cases of intracranial hypoglossal neurinomas without preoperative hypoglossal nerve palsy. One patient was operated using transcondylar retrosigmoid approach with C1 laminectomy and the other using midline suboccipital craniectomy with C1 laminectomy. Postoperatively hypoglossal nerve palsy was developed in both cases. Absence of preoperative hypoglossal palsy seemed to be related to somewhat different growth pattern in these two cases. When the tumor shows typical radiological findings of hypoglossal neurinoma, it must be included in differential diagnosis despite absence of preoperative hypoglossal nerve palsy.
Diagnosis, Differential ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Laminectomy ; Neurilemmoma* ; Paralysis

The authors report a case of malignant meningioma presented with spontaneous intracerebral hemorrhage(ICH). The 65-year-old woman presented with sudden severe headache and vomiting. She suffered from diabetes mellitus and hypertension for 3 years. Neurologic examination showed left hemiparesis and homonymous hemianopsia. Computed tomography and magnetic resonance images revealed hematoma in variable stages with surrounding edema in right parieto-occipital area. Cerebral angiogrpahy showed no vascular lesion. Under the impression of hypertensive ICH, total removal of mass was done. Histologic diagnosis was malignant meningioma with hemorrhage. Malignant meningioma presented with ICH is lacking in previous report. Prtinent literature review of meningioma presenting with hemorrhage is also performed.
Aged ; Brain Neoplasms ; Cerebral Hemorrhage* ; Diabetes Mellitus ; Diagnosis ; Edema ; Female ; Headache ; Hematoma ; Hemianopsia ; Hemorrhage ; Humans ; Hypertension ; Meningioma* ; Neurologic Examination ; Paresis ; Vomiting

PURPOSE: The aims of this study were to examine the distribution of refractive errors and clinical characteristics of strabismus in Korean patients with Down's syndrome. METHODS: A total of 41 Korean patients with Down's syndrome were screened for strabismus and refractive errors in 2009. RESULTS: A total of 41 patients with an average age of 11.9 years (range, 2 to 36 years) were screened. Eighteen patients (43.9%) had strabismus. Ten (23.4%) of 18 patients exhibited esotropia and the others had intermittent exotropia. The most frequently detected type of esotropia was acquired non-accommodative esotropia, and that of exotropia was the basic type. Fifteen patients (36.6%) had hypermetropia and 20 (48.8%) had myopia. The patients with esotropia had refractive errors of +4.89 diopters (D, +/-3.73) and the patients with exotropia had refractive errors of -0.31 D (+/-1.78). Six of ten patients with esotropia had an accommodation weakness. Twenty one patients (63.4%) had astigmatism. Eleven (28.6%) of 21 patients had anisometropia and six (14.6%) of those had clinically significant anisometropia. CONCLUSIONS: In Korean patients with Down's syndrome, esotropia was more common than exotropia and hypermetropia more common than myopia. Especially, Down's syndrome patients with esotropia generally exhibit clinically significant hyperopic errors (>+3.00 D) and evidence of under-accommodation. Thus, hypermetropia and accommodation weakness could be possible factors in esotropia when it occurs in Down's syndrome patients. Based on the results of this study, eye examinations of Down's syndrome patients should routinely include a measure of accommodation at near distances, and bifocals should be considered for those with evidence of under-accommodation.
Adolescent ; Adult ; Child ; Child, Preschool ; Down Syndrome/*complications/epidemiology ; Female ; Humans ; Incidence ; Male ; Prevalence ; Refractive Errors/complications/*epidemiology ; Republic of Korea/epidemiology ; Retrospective Studies ; Strabismus/complications/*epidemiology ; *Vision Screening ; Young Adult

Anal gland/duct cyst (AGC) is rare and observed in only 0.05% of patients undergoing anal surgery. AGC is thought to be a retention cyst in the anal gland and arises when an obstruction of the anal duct causes fluid collection in the anal gland. We report a case of AGC in a 66-year-old woman without anal symptoms. Found by colonoscopy, the AGC was excised transanally. The histopathology of the specimen confirmed AGC. Colonoscopists should include AGC in the differential diagnosis of anal canal mass and rule out of malignancy. Excision is recommended for definitive diagnosis and treatment.