PURPOSE: To evaluate the clinical features and natural course of sixth cranial nerve palsy. METHODS: We reviewed the medical records of 50 patients who were diagnosed with sixth nerve palsy from January 2000 to December 2006 to analyze the age of onset, etiology, recovery, and natural course of this disease. RESULTS: The mean age at onset was 43.2 years old. Vascular disease (n=17, 34.0%) was the most common cause of sixth cranial nerve palsy, followed by undetermined causes (n=14, 28.0%), trauma (n=10, 20.0%), and neoplasm (n=3, 6.0%). According to age group, vascular disease (n=7, 46.7%) was the most common cause in patients in their fifties and sixties, and trauma and undetermined causes (n=10, 76.9%) were the most common causes of this disease in patients in their twenties and thirties. Of the 40 patients who were followed up for more than 6 months, 28 (70.0%) showed improvement of paresis and 26 (65.0%) achieved complete recovery. The mean period to recovery was 3.7 months. No significant differences were observed in sex, age, laterality, and etiology between non-recovered and completely-recovered patients, but completely-recovered patients showed a significantly smaller initial angle of deviation than non-recovered patients. CONCLUSIONS: Vascular disease was the most common etiology of sixth nerve palsy. Sixty-five percent of patients showed spontaneous complete recovery, and completely-recovered patients showed a significantly smaller initial angle of deviation compared to that of non-recovered patients.
Abducens Nerve ; Abducens Nerve Diseases ; Age of Onset ; Humans ; Medical Records ; Paresis ; Vascular Diseases

No abstract available.
Humans ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio cholerae* ; Vibrio*

PURPOSE: To evaluate changes in refractive errors and quantify optometric values in 4th graders at an urban elementary school in Korea. METHODS: A total of 188 school children (376 eyes) were assessed in a population-based, cross-sectional and longitudinal follow-up study between March and December 2003. Uncorrected visual acuity, best corrected visual acuity, corneal refractive power measured with auto keratometer (KR-8100, Topcon(R) Inc., Japan), axial length measured with A-scan ultrasound biometry (A/B-scan system 835, Humphrey(R) Inc., Dublin, CA), and cycloplegic refraction were evaluated on March and December, respectively. RESULTS: Mean visual acuity decreased from -0.15+/-0.29 LogMAR to -0.20+/-0.35 LogMAR and mean spherical equivalent (SE) showed myopic progression from -0.65+/-1.57 diopter (D) to -0.88+/-1.75D. The prevalence rate of myopia (< or =-0.50D SE) was increased from 44.1% to 50.3%, while that of hyperopia (> or =+1.00D SE) was decreased from 8.0% to 5.8%. Mean corneal refractive power changed from 43.21+/-1.29D to 43.35+/-1.31D, and mean axial length changed from 23.38+/-0.88 mm to 23.60+/-0.92 mm, respectively. CONCLUSIONS: We assessed the changes of refractive errors and quantified the optometric values in a population-based, longitudinal follow-up study. The results showed that the prevalence of myopia and the mean axial length increased during our study in urban elementary 4th graders in Korea.
Biometry ; Child ; Follow-Up Studies ; Humans ; Hyperopia ; Korea* ; Myopia ; Prevalence ; Refractive Errors* ; Ultrasonography ; Visual Acuity

PURPOSE: We investigated the therapeutic effects of monoclonal anti-TNF antibody (infliximab) on experimental uveitis. METHODS: Twenty New Zealand White rabbits were immunized with Mycobacterium tuberculosis H37Ra antigen and then challenged with intravitreal injection of tuberculin antigen to introduce a uveitis. Then infliximab was injected into rabbit eyes at an intravenous concentration of 5 mg/kg and intravitreal concentrations of 1 mg/0.1mL and 100 microg/0.1mL. As a control, the vehicle was injected intravenously or intravitreally. To evaluate the therapeutic effects, inflammation was assessed by slit lamp biomicroscopy and scored according to the severity of inflammation. The animals were also evaluated by electroretinography and histopathology. RESULTS: Regardless of the administration route, inflammatory activities of anterior chamber and engorgement of vascular structures were reduced in the infliximab treated group compared to control. Different administration routes and different concentrations of infliximab did not affect the therapeutic outcome of the clinical scoring. Intravenous (5 mg/kg) and intravitreal diluted (100 microg/0.1mL) infliximab injection groups showed significant improvement in electroretinographic findings and significant reduction of inflammatory cells with preservation of retinal tissue architecture on histopathologic examination. However, focal loss of the photoreceptor outer segment is observed in intravitreal undiluted (1 mg/0.1 mL) infliximab injected eyes. CONCLUSIONS: Infliximab may be a useful treatment modality to suppress ocular inflammation in experimental uveitis models in rabbits.
Animals ; Anterior Chamber ; Electroretinography ; Inflammation ; Intravitreal Injections ; Mycobacterium tuberculosis ; Necrosis* ; Rabbits ; Retinaldehyde ; Tuberculin ; Tumor Necrosis Factor-alpha ; Uveitis* ; Infliximab

We report a case of a retained graphite anterior chamber foreign body that was masquerading as stromal keratitis. A 28-year-old male visited with complaints of visual disturbance and hyperemia in his right eye for four weeks. On initial examination, he presented with a stromal edema involving the inferior half of the cornea, epithelial microcysts, and moderate chamber inflammation. Suspecting herpetic stromal keratitis, he was treated with anti-viral and anti-inflammatory agents. One month after the initial visit, anterior chamber inflammation was improved and his visual acuity recovered to 20/20, but subtle corneal edema still remained. On tapering the medication, after three months, a foreign body was incidentally identified in the inferior chamber angle and was surgically removed resulting in complete resolution of corneal edema. The removed foreign body was a fragment of graphite and he subsequently disclosed a trauma with mechanical pencil 12 years earlier. This case showed that the presence of an anterior chamber foreign body should always be considered in the differential diagnosis of idiopathic localized corneal edema.
Adult ; Anterior Chamber/*injuries/pathology ; Corneal Stroma/*pathology ; Diagnosis, Differential ; Eye Foreign Bodies/*diagnosis/physiopathology/surgery ; Eye Injuries, Penetrating/*diagnosis/physiopathology/surgery ; *Graphite ; Humans ; Keratitis/*diagnosis ; Male ; Ophthalmologic Surgical Procedures ; Visual Acuity

PURPOSE: To investigate the clinical manifestation and the structural optic disc changes according to the development of reproducible visual field defects in a group of preperimetric patients converting to early glaucoma. METHODS: Standard automated perimetry (Humphrey Field Analyzer) was performed every six months in 294 preperimetric patients. Each subject was classified as either converter or non-converter according to glaucomatous visual field changes, and the clinical manifestations were analyzed retrospectively. Sequential optic disc images were obtained using the TopSS scanning laser ophthalmoscope (TopSS(TM)) and optic disc parameters were measured to determine if any change had occurred. RESULTS: A total of 44 eyes from 44 subjects (14.9%) in 294 patients subsequently developed early glaucomatous field loss (converters). The progression rate of visual field defect is 0.43dB/year. In respect to age, sex, refractive error, and diabetes mellitus, no significant differences were observed. Elevated IOP, hypertension, and family history of glaucoma were detected more frequently in the converter group than in the non-converter group. Among TopSS parameters, cup-to-disc ratio, effective area, volume above, maximum slope, and neuroretinal rim area showed statistically significant change. Changes of the neuroretinal rim were prominent in superior and inferior sectors. CONCLUSIONS: Among TopSS parameters, cup-to-disc ratio, effective area, volume above, and neuroretinal rim are useful in detecting the progression of glaucoma. Furthermore, neuroretinal rim changes in each sector may provide clinically relevant information in detecting and monitoring the progression of glaucoma.
Diabetes Mellitus ; Glaucoma* ; Humans ; Hypertension ; Ophthalmoscopes ; Optic Disk* ; Optic Nerve* ; Refractive Errors ; Retrospective Studies ; Visual Field Tests ; Visual Fields

PURPOSE: To investigate the clinical manifestation and the structural optic disc changes according to the development of reproducible visual field defects in a group of preperimetric patients converting to early glaucoma. METHODS: Standard automated perimetry (Humphrey Field Analyzer) was performed every six months in 294 preperimetric patients. Each subject was classified as either converter or non-converter according to glaucomatous visual field changes, and the clinical manifestations were analyzed retrospectively. Sequential optic disc images were obtained using the TopSS scanning laser ophthalmoscope (TopSS(TM)) and optic disc parameters were measured to determine if any change had occurred. RESULTS: A total of 44 eyes from 44 subjects (14.9%) in 294 patients subsequently developed early glaucomatous field loss (converters). The progression rate of visual field defect is 0.43dB/year. In respect to age, sex, refractive error, and diabetes mellitus, no significant differences were observed. Elevated IOP, hypertension, and family history of glaucoma were detected more frequently in the converter group than in the non-converter group. Among TopSS parameters, cup-to-disc ratio, effective area, volume above, maximum slope, and neuroretinal rim area showed statistically significant change. Changes of the neuroretinal rim were prominent in superior and inferior sectors. CONCLUSIONS: Among TopSS parameters, cup-to-disc ratio, effective area, volume above, and neuroretinal rim are useful in detecting the progression of glaucoma. Furthermore, neuroretinal rim changes in each sector may provide clinically relevant information in detecting and monitoring the progression of glaucoma.
Diabetes Mellitus ; Glaucoma* ; Humans ; Hypertension ; Ophthalmoscopes ; Optic Disk* ; Optic Nerve* ; Refractive Errors ; Retrospective Studies ; Visual Field Tests ; Visual Fields

Embryonic stem cells (ESCs) are metabolically distinct from their differentiated counterparts. ESC mitochondria are less complex and fewer in number than their differentiated progeny. However, few studies have examined the proteins responsible for differences in mitochondrial structure and function between ESCs and somatic cells. Therefore, in this study, we aimed to investigate the differences between mitochondrial proteins in these two cell types. We demonstrate that HSP60 is more abundant in mouse ESC mitochondria than in mouse embryonic fibroblasts. Depletion of HSP60 inhibited mouse ESC proliferation and self-renewal, characterized by decreased OCT4 expression. HSP60 depletion also enhanced apoptosis during mouse ESC differentiation into embryoid bodies. Our results suggest that HSP60 expression has an essential role in ESC self-renewal and survival of differentiated cells from ESCs.

Standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) have been considered prognostic factors for survival in many cancers. However, their prognostic value for radiotherapy-treated squamous esophageal cancer has not been evaluated. In this study, SUV, MTV, and TLG were measured to predict their prognostic role in overall survival (OS) in 38 esophageal cancer patients who had undergone 18F-FDG PET/CT before radiotherapy. TLG demonstrated higher sensitivity and specificity for predicting OS than MTV and SUV; and a better OS was observed in patients with low TLG compared to those with high TLG in locally advanced disease (OS, 46.9 months; 95% confidence interval [CI], 33.50-60.26 vs. 25.3 months; 95% CI, 8.37-42.28; P=0.003). Multivariate analyses in these patients determined that TLG and the use of combination chemotherapy were the independent prognostic factors for OS (hazard ratio [HR], 7.12; 95% CI, 2.038-24.857; P=0.002 and HR, 6.76; 95% CI, 2.149-21.248; P=0.001, respectively). These results suggest that TLG is an independent prognostic factor for OS and a better predictor of survival than MTV and SUV in patients with locally advanced esophageal cancer treated with radiotherapy.
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Esophageal Neoplasms/mortality/pathology/*radiography ; Female ; Fluorodeoxyglucose F18/chemistry ; Glycolysis/*physiology ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; *Positron-Emission Tomography ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Radiopharmaceuticals/*chemistry ; Retrospective Studies ; Survival Rate ; *Tomography, X-Ray Computed

Purpose: To compare the prognosis of patients with axillary adenocarcinoma from an unknown primary (ACUPax) origin with negative MRI results and those with MRI-detected primary breast cancers. Materials and Methods: The breast MRI images of 32 patients with ACUPax without signs of primary breast cancer on mammography and ultrasound (US) were analyzed. Spot compression-magnification mammography and second-look US were performed for the area of MRI abnormality in patients with positive results; any positive findings corresponding to the MRI abnormality were confirmed by biopsy. If suspicious MRI lesions could not be localized on mammography or US, MR-guided biopsy or excision biopsy after MR-guided localization was performed. We compared the prognosis of patients with negative breast MRI with that for patients with MRI-detected primary breast cancers. Results: Primary breast cancers were confirmed in 8 (25%) patients after breast MRI. Primary breast cancers were not detected on MRI in 24 (75%) patients, including five cases of false-positive MRI results. Twenty-three patients underwent axillary lymph node dissection (ALND) followed by whole breast radiation therapy (WBRT) and chemotherapy (n=17) or subsequent chemotherapy only (n=2). Recurrence or distant metastasis did not occur during follow up in 7/8 patients with MRI-detected primary breast cancers and 22/24 patients with negative MRI results. Regional recurrence or distant metastasis did not occur in any MR-negative patient who received adjuvant chemotherapy after ALND and WBRT. Conclusion The prognoses of MR-negative patients with ACUPax who received ALND and WBRT followed by chemotherapy were as good as those of patients with MRI-detected primary breast cancers.