The introduction of beta-adrenergic blocking agents for the treatment of glaucoma was a major advance in the continued search for medications that effectively control the intraocular pressure with minimal side effect. Beta-adrenergic blocking agents block the aqueous pump of the ciliary epithelium resulting in decreased aqueous formation and drop in intraocular pressure. The fact that beta-adrenergic blocking agents had an affinity to intraocular tissues containing melanin granules has been reported. The purpose of this study is to know that mechanism of decrease of intraocular pressure and an affinity to melanin granules of the beta-adrenergic blocking agents. Two drops of 1% befunolol were instilled in the albino and pigmented rabbits, and the eyes were enucleated on 1, 2, 6 and 24 hours after instillation. These eyes were studied with electron microscopic examination. The results were as follows: 1. In the non-pigment epithelium of the ciliary body, mitochondria became swollen. 2. These changes appeared earlier and were more remarkable in albino rabbits than in pigmented ones. 3. In pigmented rabbits, these changes appeared slowly, but continued for longer duration and it seems to be due to affinity of beta-adrenergic blocking agents to the melanin pigment. 4. Swelling of mitochondria at the non-pigmented epithelium of the ciliary body after instillation of beta-adrenergic blocking agents seems to be the pharmacological mechanism of the drugs against aqueous formation in the ciliary body.
Adrenergic beta-Antagonists ; Ciliary Body ; Epithelium* ; Glaucoma ; Intraocular Pressure ; Melanins ; Mitochondria ; Rabbits

Iridocorneal endothelial syndrome is a disease characterized by corneal endothelial degeneration, corneal edema, peripheral anterior synechia, iris stromal change, and secondary glaucoma. This syndrome is considered to have three major variations: Chandler's syndrome, progressive (essential) iris atrophy, and Cogan-Reese syndrome. We experienced three cases of iridocorneal endothelial syndrome with transient intraocular pressure elevation.

OBJECTIVE: The purpose of this study was to compare the displacement patterns shown by finite element analysis when the maxillary anterior segment was retracted from different orthodontic miniscrew positions and different lengths of lever arms in lingual continuous and segmented arch techniques. METHODS: A three dimensional model was produced, the translation of teeth in both models was measured and individual displacement was calculated. RESULTS: When traction was carried out from miniscrews in the palatal slope, lingual tipping of crowns and extrusion of the maxillary anterior segment were found in both continuous and segmented arches as the lever arms were made shorter. With miniscrews in the midpalatal suture area, the displacement patterns were similar to the palatal slope, but bodily movement of the upper incisors was observed in both continuous and segmented arches with the lever arm at 20 mm. When lever arms were longer, there was less extrusion of the incisors and more buccal displacement of the canines. Such displacement was shown less in the continuous arch than the segmented arch. The second premolar showed crown mesial tipping and intrusion, and the molars showed distal tipping in the continuous arch. The posterior segment was displaced three dimensionally in the segmented arch, but the amount of displacement was less than the continuous arch. CONCLUSIONS: It is recommended that lever arms of 20 mm in length be used for bodily movement of the anterior segment. Use of continuous or segmented arches affect the displacement patterns and induce differences in the amount of displacement.
Arm ; Bicuspid ; Crowns ; Displacement (Psychology) ; Finite Element Analysis ; Incisor ; Molar ; Sutures ; Tooth ; Traction

We recently obsesved an unusual case of visual loss after the facial injection of autologous fat. A 42-year-old woman underwent autologous fat injection into the temple area to reduce facial wrinkles. The procedure was performed by a surgeon at local clinic. The patient immediately complained of severe right hemicranial pain and lid swelling. She vistied to the ophthalmic department of our hospital 1 week later because of total loss of vision on the right eye. We believe that the cause of blindness was multiple microembolization in the central retinal artery and posterior ciliary branches of the ophthalmic artery via lateral palpebral artery.
Adult ; Arteries ; Blindness ; Choroid* ; Female ; Humans ; Ophthalmic Artery ; Retinal Artery ; Retinaldehyde*

Canalicular occlusion with silicone plug was carried out in 11 patient, 21 eyes with dry eye syndrome and the effect and safety of the procedure were evaulated. Artificial tears were discontinued or frequency of instillation was reduced in 66.6% of eyes after occlusion of canaliculi. There were no stastiscally significant differences in the mean value of B.U.T. and Schirmer test pre-and post-canalicular occlusion. There were no cases of postoperative epophora, allergic reaction and infection.
Dry Eye Syndromes ; Humans ; Hypersensitivity ; Ophthalmic Solutions ; Silicones

Generally accepted mechanisms of involutional entropion are as follows: 1. dysfunction of the inferior eyelid retractors, 2. migration of the preseptal orbicularis fibers upward, 3. reduced support of the lower lid against glove due to enophthalmos, 4. reduced horizontal support because of involutional changes in the lateral and medical canthal tendons. Sanford D. Hecht reported that the above four problems could be corrected simply and successfully by a full thickness excision of Bowlegs shape(Pentagon-shape). Five eyelids of involutional entropion were treated by the Boelegs procedure. The results were successful.
Enophthalmos ; Entropion* ; Eyelids ; Tendons

Generally accepted mechanisms of involutional entropion are as follows: 1. dysfunction of the inferior eyelid retractors, 2. migration of the preseptal orbicularis fibers upward, 3. reduced support of the lower lid against glove due to enophthalmos, 4. reduced horizontal support because of involutional changes in the lateral and medical canthal tendons. Sanford D. Hecht reported that the above four problems could be corrected simply and successfully by a full thickness excision of Bowlegs shape(Pentagon-shape). Five eyelids of involutional entropion were treated by the Boelegs procedure. The results were successful.
Enophthalmos ; Entropion* ; Eyelids ; Tendons

PURPOSE: To evaluate the enhancement patterns of nodular and massive hepatocellular carcinoma (HCC), with or without portal vein thrombosis, on three-phase spiral CT. MATERIALS AND METHODS: Contrast enhancement patterns in 61 patients with HCC were retrospectively analysed. Three-phase spiral CT images of the hepatic arterial dominant phase, portal dominant phase, and delayed phase were obtained 30, 60-70, and 360 seconds after the injection of contrast material was initiated. Tumors were divided into grossly nodular and massive type and enhancement patterns of HCC, with and without portal vein thrombosis, were compared. These patterns were divided into three groups, as follows: High/High/Low; High/Low/Low; Low/Low/Low. HCC with portal vein thrombosis was found in 21 of 61 cases ; this carcinoma without portal vein thrombosis was found in 40 cases. The nodular type accounted for 39 cases, and the massive type for 22. RESULTS: In 21 cases of HCC with portal vein thrombosis, the most common enhancement pattern was L/L/L, and was seen in 13 cases (62%); H/L/L was seen in eight (38%), but H/H/L was not seen. In 40 cases of HCC without portal vein thrombosis, the most common enhancement pattern was H/L/L, seen in 25 cases (63%) ; this was followed by L/L/L (11 cases ; 27%), and H/H/L (4 cases ; 10%). In the arterial dominant phase, among cases of HCC with portal vein thrombosis, low attenuation was more common (13/21) than high (8/21);among cases of HCC without portal vein thrombosis, high attenuation was more common (29/40) than low (11/40). Among 39 nodular-type cases, HCC with portal vein thrombosis was found in six (H/H/L and L/L/L: three each), and HCCwithout portal vein thrombosis was seen in 33 (H/L/L: 22; L/L/L: 7; H/H/L; 4). Among 22 cases of the massive type, HCC with portal vein thrombosis accounted for 15 (L/L/L: 10, H/L/L: 5), and seven cases without portal vein thrombosis were seen (L/L/L: 4 ; H/L/L : 3). CONCLUSION: On Three-phase spiral CT, HCC showed different enhancing patterns according tumor type and the presence of portal vein thrombosis.
Carcinoma, Hepatocellular* ; Humans ; Retrospective Studies ; Tomography, Spiral Computed* ; Venous Thrombosis

PURPOSE: To evaluate anatomical locations and distributions of supraorbital notch and foramen using facial 3D computed tomography in the Korean adult population. METHODS: The study sample was composed of 87 adult patients with no history of trauma or ocular disease. The horizontal position of the supraorbital foramen or notch was recorded in relation to a vertical line defined by a reproducible hypothetical point, such as the nasion and mid-maxilla and the midpoint of the horizontal supraorbital plane. The distance and angle for each supraorbital foramen and notch were calculated from the defined vertical line. Furthermore, vertical distance from supraorbital plane, which was established using the highest points of both supraorbital rims, was obtained from the supraorbital foramen. RESULTS: The mean age of the 87 patients was 45.44 +/- 8.34 years (range, 30-59 years). There were 66 eyes in the supraorbital notch and 108 eyes in the supraorbital foramen. There were no distributional differences between the 2 sides. The mean horizontal distance of both types was 23.95 +/- 3.93 mm (range, 16.41-38.94 mm). The horizontal distance of male patients was longer than the female patients (25.18 +/- 4.16 mm vs. 22.63 +/- 3.19 mm, p < 0.001, based on independent t-test) and the horizontal distance of supraorbital notch was shorter than the supraorbital foramen (22.59 +/- 3.18 mm vs. 26.18 +/- 4.04 mm, respectively, p < 0.001, based on independent t-test). The mean vertical distance and mean angles of the supraorbital foramen were 3.02 +/- 1.119 mm and 6.81 +/- 2.31 degrees (degrees), respectively. CONCLUSIONS: The present study described the anatomical location of each supraorbital opening type in Korean adults. According to horizontal distance, a surgeon can avoid iatrogenic injury of the supraorbital neurovascular complex, especially during brow surgery. In addition, the anatomy can aid in targeting supraorbital neurovascular complex in cases of nerve block.
Adult ; Female ; Humans ; Male ; Nerve Block

OBJECTIVE: This study compared three prominent midsagittal planes (MSPs) to identify the MSP that best approximates the true symmetrical MSP. METHODS: Forty-three patients (mean age, 23.0 ± 8.20 years) were grouped as follows: group 1 consisted of 10 patients with skeletal Class I and a menton (Me) deviation of < 2 mm; group 2, 11 patients with skeletal Class III and a Me deviation < 2 mm; group 3, nine patients with skeletal Class III and a Me deviation of 2 to less than 4 mm; and group 4, 13 patients with skeletal Class III and an Me deviation ≥ 4 mm. The candidate MSPs were established by three-dimensional (3D) cone beam computed tomography (CBCT) reorientation methods (RMs): (1) the MSP perpendicular to the Frankfort horizontal (FH) plane while passing through the crista galli and basion; (2) the MSP including the nasion, incisive foramen, and basion; (3) the MSP including the nasion, anterior nasal spine, and posterior nasal spine. The mean absolute distances (MADs) to the MSPs were calculated from the coordinates of 1,548 points on 129 CBCT images. The differences in the values of the 3D coordinates among RMs were compared. RESULTS: The MADs of the three RMs showed significant differences (p < 0.05). Most of the differences in values of the coordinates were not significant among RMs. CONCLUSIONS Although the differences in distance among the three MSPs were minor, the MSP perpendicular to the FH plane while passing through the crista galli and basion best approximated the true symmetrical MSP.