This study was designed to validate the usefulness of the near point of convergence(NPC)test in determination of dominant & non-domnant eyes in intermittent exotropia patients. We performed NPC test in 36 intermittent exotrpic patients, and then, determined the non-dominant eye which deviated outward beyond the NPC. The dominant eyes determined by the NPC were compared to those that were determined by amblyopia, sensory fusion and photophobia. Best corrected visual acuity was used to divide patients into two groups : 26 patients without amblyopia, and 10 with amblyopia. Among the amblyopia group, if the eyes with better visual acuity were taken as dominant eyes, then eight(80%)cases were identical with the NPC test and two(20%)cases were different. Ten patients had sensory anomaly, and among then, nine(90%)cases were identical with the NPC test and one(10%)case was different. Twenty six(64%)patients had photophobia in one eye and all(100%)cases were identical with the NPC test. In intermittent exotropia, determination of dominant eye by the NPC test showed high coincidence with other tests. Therefore, we suggest that the NPC test is an easy and accurate method in determining either the dominant or non-dominant eye for surgery.
Amblyopia ; Dominance, Ocular* ; Exotropia* ; Humans ; Photophobia ; Visual Acuity

No abstract available.
Fingers* ; Nasal Bone*

Head tilt test is useful in diagnosing cyclovertical muscle palsy, especially superior oblique palsy, In this study, we observed efficacy and pattern of head tilt test in 12 patients of unilateral superior oblique palsy(7 congenital, 4 traumatic and 1 vascular) who had abnormal head tilt to nonparetic side. The results of head tilt test were compared to preoperative status in 8 patient, 3 month after surgery. All patients in this study showed positive response of head tilt test. Among them, 9 patients showed definite elevation of paretic eye. However, 2 patients mainly showed definite depression of nonparetic eyes that were amblyopic. The last patient did not show definite vertical deviation in either eye but complained of increasing diplopia. After surgery, abnormal head tilt and positive head tilt response disappeared in 7 patients. In conclusion, preoperative head tilt test is one of the valuable methods in diagnosisng unilateral superior oblique palsy especially in young patients and in those who developed spread of comitance. In addition, the positive head tilt test does no always mean the elevation of paretic eye.
Depression ; Diplopia ; Head* ; Humans ; Paralysis*

Tetanus is a rare disease in the developed countries, including Korea, as a result of nearly universal active immunization. Because many physicians have little experience with its diagnosis and management, misdiagnosis and therapeutic delay may result in catastrophic consequences. We report one case of generalized tetanus. A previously healthy 35-year-old man was admitted to the emergency department because of stiffness on jaw and neck. board-like abdomen, extended and rigid both legs, chest tightness, and dyspnea. Seven days before admission, he was injured on the right thing at work. In the emergency department, he was given 5,000 units of human tetanus immunoglobulin intramuscularly, as well as diazepam 2 mg/hr intravenously. On the second hospital day, tracheostomy was performed. Ten days later, his condition was improved. Twenty eight days after admission, he was discharged without any complication.
Abdomen ; Adult ; Developed Countries ; Diagnosis ; Diagnostic Errors ; Diazepam ; Dyspnea ; Emergency Service, Hospital ; Humans ; Immunoglobulins ; Jaw ; Korea ; Leg ; Neck ; Rare Diseases ; Tetanus* ; Thorax ; Tracheostomy ; Vaccination

We perfomed this study to evaluate the incidence of the oculocardiac reflex(OCR) and its difference relative to each extraocular muscles. In addition, preventive methods for oculocardiac reflex were also evaluated. From Febrary 1997 to January 1998, we examined the occurrence of the OCR of 65 patients who underwent strabismus surgery in 123 extraocular muscles under the general anesthesia. Those who showed severe OCR were prepared with retrobulbar injection of 1% lidocaine 2cc or 1% intravenous atropine and observed wheather OCR was prevented. The overall incidence of the OCR was 66.2% and there was no significant difference between the incidence in both eyes(p>0.999). The incidence in each of the extraocular muscles did not show statistically significance when the patients were prepared with preoperative intramuscular atropine(p=0.018). The incidence after intraoperative retrobulbar injection or intravenous atropine was decreased to 27.3% but was not statistically significant(p=0.34).
Anesthesia, General ; Atropine ; Humans ; Incidence ; Lidocaine ; Muscles ; Reflex, Oculocardiac* ; Strabismus*

Authors decided to test whether differences occurred in automated and subjective refraction in untreated, PRK, and LASIK-treated eyes. Ninety six eyes of 50 patients(96 eyes) who underwent PRK(57 eyes) or LASIK(39 eyes) for myopia and myopic astigmatism were routinely autorefracted with the CANON RK-3 before subjective refraction was done, using several parameters. This two procedures were done preoperation and 3 months after operation. In comparing the postoperative(PRK, LASIK) results, automated refraction showed more myopia and higher cylinder power, without significant difference in refractive axis, than those of subjective measurement. The difference of cylinder power were found in the cases of large ablation depth(above 100micrometer), high degree of eccentric ablation(above 0.25 mm), LASIK operation. The significant differences of cylinder power and axis were found in the cases of high degree of eccentric ablation(above 0.25 mm). So we recommend the method of subjective refraction before PRK and LASIK operation instead of using automated refraction. Postoperatvely, we also should evaluate the postoperative status of the patient by subjective refraction. And we should decide the amount of ablation in case of retreatment by subjective refraction, instead of autorefraction. We have to be cautious of evaluating the automated refraction results after operation, especially in cases of large ablation depth, high degree of eccentric ablation, and LASIK.
Astigmatism ; Axis, Cervical Vertebra ; Humans ; Keratomileusis, Laser In Situ ; Myopia ; Retreatment

Inclusion bodies containing glycogen granules are characteristic feature of infected cells with Chlamydia trachomatis(C. trachomatis). In this study, we investigated the serial changes of the glycogen granules in a rabbit conjunctival epithelial cells co-cultivated with C. trachomatis.The epithelial cells isolated grom conjunctiva of rabbit were initially cultured for 3 weeks. After the cells had attained confluency, they were infected with C. trachomatis serotype D. After co-cultivation for 24, 48 and 96 hours, electronmicroscopic study was performed.After co-cultivation for 24 hours, a few glycogen granules were observed within the premature inclusion body containing some elementary bodies and reticulate bodies. After 48 hours of co-cultivation, typical inclusion bodies were observed and numerous electron-dense glycogen granules predominated around reticulate bodies. After 96 hours of co-cultivation, scattered glycogen granules were observed in granular pattern within the expanding inclusion occupying the bulk of the host cell cytoplasm.These results suggest that glycogen granules are closely related to the developmental cycle of the C. trachomatis and they may be an energy source for active multiplication of the reticulate bodies.
Chlamydia trachomatis* ; Chlamydia* ; Conjunctiva ; Epithelial Cells* ; Glycogen* ; Inclusion Bodies

In adults, it is known that tetastatic tumor to the eye and its adnexa is rare compared with other sites. Orbital tumors can be classified as primary, secondary, and metastatic. Secondary orbital tumors are those that extend to the orbit from a contiguous structure. Metastatic tumors are those that spread to the orbit from more distant site in the body. and their prognosis for life is poor because of widespread systemic malignancy. We experienced a case of metastatic uterine cervical carcinoma of the orbit in a 33-year-old female patient who came to us with a history of sudden proptosis and decreased vision. Eighteen months earlier, the patient had been diagnosed with squamous cell carcinoma of the uterine cervix, and she had undergone chemotherapy, irradiation and surgical intervention. Lung and parametrium metastases were also found six months previously. We report a case of metastatic uterine cervical cancer of the orbit with a review of the literature.
Adult ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Exophthalmos ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Orbit* ; Prognosis ; Uterine Cervical Neoplasms

The antimicrobial agents reduced infectious diseases significantly. However, antibiotic resistance has followed for almost every antimicrobial agent. Especially, Staphylococcus aureus was one of the most notorious for the multidrug resistance. Streptomyces sp. 681 has been selected for antibiotic-producing strain against methicillin-resistant Staphylococcus aureus (MRSA) from 1,000 strains of Actinomycetales which had been isolated from soil. In antimicrobial susceptibility test, all of the test strains were susceptible to vancomycin. However, most strains of Staphylococcus aureus were found to be resistant to methicillin. Ninety eight (75%) strains out of 129 strains showed multiple resistance pattern to more than 5 antimicrobial agents. The MIC values of the purified antibiotic (K-681) were 1-32 ug/ml against Gram-positive bacteria compared to >128 ug/ml against Grarn-negative bacteria or fungi. The MIC was 8 ug/ml for 90% of the 129 clinical isolates of S. aureus. The antibiotic showed no cytotoxicity against P 388, HeLa, and S180 at the concentration of 500 ug/ml.
Actinomycetales ; Anti-Infective Agents ; Bacteria ; Communicable Diseases ; Drug Resistance, Microbial ; Drug Resistance, Multiple ; Fungi ; Gram-Positive Bacteria ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Soil ; Staphylococcus aureus* ; Staphylococcus* ; Streptomyces* ; Vancomycin

The fibrillar coat of Candida albicans is of interest as its significance in antigenicity, antiphagocytosis, and adherence to host tissues. The partial biochemical properties and ultrastructure of fibrillar coat induced by rabbit sera were examined. The induced fibrillar layer was destroyed by treatments of lyticase, proteinase K and dithiothreitol. The total protein concentration of fibrillar cell wall lysate was higher than that of non-fibrillar cell wall lysate, but the total sugar concentration was similar. On SDS-PAGE analysis, the protein profiles between in fibrillar cells and in non-fibrillar cells were shown to be different. In fibrillar cells, the major bands of cell wall lysate were 83, 66, 54, 47, 33, and 26 kDa in dithiothreitol-treated lysate. The proteins of 26 and 19 kDa were predominant in lyticase-treated lysate. Although the fibrillar thickness and protein amount of cell wall lysate were increased in according to the incubation time, the protein profiles did not changed. These results suggest that the proteins of 83, 66, 54, 47, 33, 26, and 19 kDa may be major constituents of fibrillar coat in C. albicans.
Candida albicans* ; Candida* ; Cell Wall ; Dithiothreitol ; Electrophoresis, Polyacrylamide Gel ; Endopeptidase K