The use of succinylcholine chloride(Anectin(R)) prior to intubation, can cause increased contracture of ocular muscles. Therefore the authors studied the change of the squint angle under general anesthesia using pancronium bromide (Myoblock(R)) in 81 horizontal strabismus patients who had no neurologic disease and mechanical restrictions of eye movement. We used the alternative cover test and Krimsky method to measure the eye position under general anesthesia.
Anesthesia ; Anesthesia, General* ; Contracture ; Eye Movements ; Humans ; Intubation ; Muscles ; Strabismus* ; Succinylcholine

Choristoma is a congenital abnormal growth of tissue with components which are not characteristic of the location. Most choristomas often affect tissues of one germinal layer, mainly ectodermal layer, but complex choristoma contains two or more choristomatous tissues(ectodermal, mesodermal and rarely entodermal tissue) except lacking pilosebaceous apparatus. We experienced a case of large bilateral saccular complex choristomas including scleral and episcleral cartilage in the upper part of cornea, limbus and sclera, which was confirmed histopathologically.
Cartilage* ; Choristoma* ; Cornea ; Ectoderm ; Mesoderm ; Sclera

OBJECTIVE: To evaluate whether co-culture of oocytes on vero cell monolayers from Day 0 (Day 0 group) after egg retrieval results in an increase in developmental capacity such as fertilization rate, embryo quality, blastulation and clinical pregnancy rate compared with co-culture of oocytes from Day 1 (Day 1 group). METHODS: Sperms were treated with Hams F-10 supplemented with 10% human follicular fluid (hFF). Vero cells for co-culture were prepared in TCM-199 with 10% FBS. Oocytes were co-cultured from Day 0 and fertilized oocytes were co-cultured from Day 1 on vero cell monolayers in DMEM with 10% and 20% hFF, respectively after egg retrieval. On day 1, 2 and 5, fertilization rate and grade of embryos and blastocysts were evaluated. Results (fertilization rate, cleavage rate, grade of embryos and blastocysts and pregnancy rate) were considered statistically significant when p value was less than 0.05 using t-test and ci2. RESULTS: In sibling oocytes of same cycles, no differences were found in fertilization rate (94.6 vs. 91.4%), cleavage rates (94.6 vs. 91.4%), embryo grade (on day 2 and 3) and blastulation (65.6 vs. 57.0%) and their grade. In different oocytes of different cycles (patients), no differences were found in fertilization (79.8 vs. 78.3%), cleavage rates (77.7 vs. 76.4%) and blastulation (56.0 vs. 45.3%), but pregnancy rate was higher in the Day 0 group than in the Day 1 group (60.0 vs. 42.9%). CONCLUSIONS: This study revealed that the embryonic development capacities were not affected by the different co-culture time in the sibling oocytes of same cycles. Although no statistical significance, because of small size of study, there was a trend for higher pregnancy rates in Day 0 group compared to Day 1 group in different oocytes of different cycles.
Blastocyst ; Coculture Techniques* ; Embryonic Development* ; Embryonic Structures ; Female ; Fertilization ; Follicular Fluid ; Humans ; Oocytes* ; Ovum ; Pregnancy ; Pregnancy Rate ; Siblings ; Spermatozoa ; Vero Cells

Intermittent exotropia at times is completely controlled by the convergence mechanisms and at other times escapes this control and becomes a manifest exotropia. The treatment of choice is surgical and the treatment is directed at normalization of binocular functions, and recurrence and overcorrection are frequently seen after surgery. Therefore it is important to decide the time and the type of surgery. The author experienced 66 cases of intermittent exotropia in which surgery was done. Surgery was indicated in the cases with deviation of 20 PD or more, deviation of less than 20 PD with asthenopia, exotropia occurred during more than 40% of waking hours, and deterioration of stereoacuity even at early age. Bilateral recession was initial procedure regardless type of intermittent exotropia. In the case with amblyopia, however, R and R was done on the amblyopic eye and in convergence insufficiency type bimedial resection. Lateral Incomitancy was present in 37.9%. The basic type which was shown in 68.2% was the most frequent one. The amount of esodeviation was 15 to 10 PD in 43.9% and 11 to 15 PD in 21.2% on the first postoperative day. The phoria within 10 PD was shown in 95.4% 6 weeks after surgery, in 98.5% 3 months after surgery, and in 93.9% 6 months after surgery. Six months after surgery, 4 cases revealed exodeviation above 16 PD and no case esodeviation. Stereopsis was tested in 54 cases who understood the test before operation and 43 cases(79.6%) showed stereopsis. Nine out of 11 cases who had no stereopsis showed stereopsis after operation. In this study, success rate of first surgery was as high as 93.9% in 6 months follow-up and stereopsis was restored in considerable number of cases in intermittent exotropia compared to other types of strabismus and binocular function could also be restored and improved after surgery.
Amblyopia ; Asthenopia ; Depth Perception ; Esotropia ; Exotropia* ; Follow-Up Studies ; Ocular Motility Disorders ; Recurrence ; Strabismus ; Telescopes ; United Nations

Anisometropia is caused by axial ametropia and refractive ametropia. Almost all anisometropia in children are known to be caused by axial ametropia. Axial ametropic anisometropia is corrected by the spectacles by Knapp's rule. We experienced 41 patients with anisometropia, in whom the relationship between the difference in axial length in each eye(x) and the difference in refractive error in each eye(y) was linear, y = -0.00758+2.18554x. According to this approximate regression formula, 27 patients(66%) showed axial ametropic anisometropia and 14 patients(34%) showed refractive ametropic anisometropia. Twenty three(85%) out of 27 patients had had amalyopia. Ten patients(83%) at the age of 9 or less improved their visual acuity after amblyopia treatment, but only 4 patients(36%) older than 9 showed mild improvement. In authors' experience, axial ametropic anisometropia can be corrected by spectacles with full amount of refractive error and by proper amblyopia treatment. It is important to diagnose and treat the axial ametropic anisometropia in early childhood, however even in the patients older than 9 years old the visual prognosis is not so hopeless if treated with fully corrected spectacles and proper amblyopia treatment.
Amblyopia ; Anisometropia ; Child ; Eyeglasses ; Humans ; Prognosis ; Refractive Errors ; Visual Acuity

Soft contact lenses have become a popular modality for the cosmetic correction of refractive errors. Recent reports of bacterial corneal ulcer in cosmetic soft contact lens wearers prompted the evaluation of the possible sources of bacterial contamination which are wetting saline solution, soft contact lens case, concurrent conjunctivitis, lens surface abnormalities, inadequate temperature and duration of disinfection, poor hygiene in contact lens handling and aging of the lens. Of these factors, the authors considered that the wetting solution and cases of contact lens were most important sources. The extensive bacteriologic study and sensitivity test to antibiotics were done with 200 soft contact lens cases containing; wetting saline solution in 100 patients. The study showed that 149 cases containing wetting saline solution(74.5%) were contaminated with bacteria which serve as a possible source of corneal ulcers. Form 149 contaminated cases of soft contact lens, a total of 231 isolates were cultured. Of these 231 isolates, 32 isolates(13.9%) showed gram positive bacteria; 199 isolates(86.1%) gram negative bacteria. Major organisms were Enterobacter species(21.2%), Serratia marcescens(19.9%), pseudomonas species(17.7%), Adnetobacter calco var. antitrat(10.4%) and Bacillus subtilis(10.0%). Therofore, it should be emphasized that adequate and meticulous home disinfection of contact lens cases and wetting solution is done for prevention of bacterial contamination of soft contact lens.
Aging ; Anti-Bacterial Agents ; Bacillus ; Bacteria ; Conjunctivitis ; Contact Lenses, Hydrophilic* ; Corneal Ulcer ; Disinfection ; Enterobacter ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Hygiene ; Pseudomonas ; Refractive Errors ; Serratia ; Sodium Chloride ; Ulcer

Eyes as an exposed organ of human body are easily contaminated from environment including air and water and by bacteria on skin of hands and eyelids. Recently the contamination of environment is increasing and new generations of antibiotics are introduced and moreover their abuse is also serious, especially in Korea. All those factors seem to make the normal flora of conjunctiva change. It is true that psychosocial activity and environment change according to age. Therefore the authors investigated bacterial flora of the eye on 408 eyes of 408 Koreans without any inflammations. They were subdivided into eight groups by difference of psychosocial behaviour. In this study overall positive culture rate was 37.5% and total 168 isolates and 19 species were cultured. Major organisms were Staphylococcus epidermidis(42.8%), Staphylococcus aureus(19.0%) and Diphtheroid(14.8%). The rate of positive culture was 26.5% in the neonatal period, 53.3% in the infany, 42.7% in the preschool period, 48.5% in the late childhood, 32.7% in the adolescence, 27.1% in the adulthood, 43.6% in the middle age, and 41.9% in the old age. The highest rate of positive culture was 53.3% of the infancy and the lowest rate 26.5% of the neonatal period. It is interest that this study revealed the difference between male and female. The mean of positive culture rate was similar: 35.5% in male and 39.5% in fernale. The positive culture rate in female was much higher in the preschool period, the late childhood and the old age than in other periods; much lower in the adolescence and the adulthood. There was no significant difference in positive culture rate of each period in male, except the lowest rate in neonatal period and the highest rate in the infancy. The big difference of positive culture between male and female was shown in the late childhood and the adulthood. In the late childhood, female has much higher rate than male and much lower rate in the adulthood. As the result of this study, the authors concluded that normal flora of bacteria in conjunctiva was affected by psychosocial activity and environment according to age.
Adolescent ; Anti-Bacterial Agents ; Bacteria ; Conjunctiva* ; Eyelids ; Family Characteristics ; Female ; Hand ; Human Body ; Humans ; Inflammation ; Korea ; Male ; Middle Aged ; Skin ; Staphylococcus

Following both tenotomy and tenectomy of the homolateral superior oblique muscle as surgical tnatment for isolated paresis of inferior oblique muscle, iatrogenic progressing paralysis of the superior oblique muscle can occur. But tenotomy of the superior oblique muscle resulted in a far lower rate of superior oblique palsy than that of the tenectomy. The authors experienced a case of left superior oblique muscle(LSO) palsy and moderate limitation of left eye in left down gaze after superior oblique tenotomy in left inferior oblique(LIO) paresis and we performed adhesiolysis at tenotomy site and modified Harada-Ito procedure on reconnected superior oblique muscle which had been tenotomized. After surgery, right head tilting disappeared and diplopia remained in left down gaze with minimal limitation of left eye in that direction.
Diplopia ; Head ; Paralysis* ; Paresis* ; Tenotomy*

Background: Maladaptation to vascular, metabolic, and physiological changes during pregnancy can lead to fetal growth disorders. Moreover, adverse outcomes during pregnancy can further increase the risk of cardiovascular and metabolic diseases in mothers. Delivering a large-for-gestational-age (LGA) baby may indicate a pre-existing metabolic dysfunction, whereas delivering a small-for-gestational-age (SGA) baby may indicate a pre-existing vascular dysfunction. This study aims to assess the risk of hypertension (HTN) and diabetes mellitus (DM) in women with normal body mass index (BMI) scores who did not experience gestational DM or hypertensive disorders during pregnancy based on the offspring’s birthweight. Methods: This retrospective nationwide study included women with normal BMI scores who delivered a singleton baby after 37 weeks. Women with a history of DM or HTN before pregnancy and those with gestational DM or hypertensive disorders, were excluded from the study. We compared the risk of future maternal outcomes (HTN and DM) according to the offspring’s birthweight. Multivariate analyses were performed to estimate the hazard ratio (HR) for the future risk of HTN or DM. Results: A total of 64,037 women were included in the analysis. Of these, women who delivered very LGA babies (birthweight > 97th percentile) were at a higher risk of developing DM than those who delivered appropriate-for-gestational-age (AGA) babies (adjusted HR = 1.358 [1.068–1.727]), and women who delivered very SGA babies (birthweight < 3rd percentile) were at a higher risk of developing HTN than those who delivered AGA babies (adjusted HR = 1.431 [1.181–1.734]), even after adjusting for age, parity, gestational age at delivery, fetal sex, maternal BMI score, and a history of smoking. Conclusion These findings provide a novel support for the use of the offspring’s birthweight as a predictor of future maternal diseases such as HTN and DM.

BACKGROUND: Anaphylaxis is a systematic allergic reaction, which may be fatal. However, despite its seriousness, its low level of incidence has prevented in depth studies. Thus, we analyzed the causes of anaphylactic shock in patients admitted in a tertiary hospital, observed its clinical symptoms, and formed a basis for adequate emergency treatment, as well preventive methods. METHODS: The patients who visited Ajou university hospitals from June 1994 to May 2000(7 years) and who met the 1974 JAMA definition were selected for this retrospective study. The analysis of causative agents was made on the basis of clinical symptoms and the patients' chief complaints at the time of admission. Patients diagnosed with anaphylactic shock included those showing at least two types of IgEmediated symptoms; and those with a simple rash or breathing difficulties were excluded from the study. RESULTS: Of 36 patients, 22 were male and 14 female, Those below the age of 20 comprised 16.7% of the patients(6 patients), between 20 and 29 comprised 16.7%(6 patients), 30 and 39 comprised 25%(9 patients), 40 and 49 comprised 27.8%(10 patients), over 50 comprised 14%(5 patients). The overall percentage show 70% of the patients in active adult age group. Rash was the most common clinical symptoms(89%, 32 patients) and hypotension the second(75%, 27 patients), followed by respiratory distress, fainting, and arrhythmia. Causative agents were insect bites, including bee stings(15 patients), medication(12 patients), food(8 patients), and unknown(1 patients). Nine(9) of the 36 case, were diagnosed as having an atopic origin. CONCLUSION: Bee sting was the single most common cause in the insect criteria while penicillin and NSAIDs accounted for most of medication-induced cases. Food showed a varied distribution. An atopic origin was not a basis for anaphylactic shock, but did show a two-fold increase of prevalence. This study is the first of its kind in addressing anaphylactic shock, a potentially severe illness, over a period of 7 years.
Adult ; Anaphylaxis* ; Anti-Inflammatory Agents, Non-Steroidal ; Arrhythmias, Cardiac ; Bees ; Bites and Stings ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Exanthema ; Female ; Hospitals, University ; Humans ; Hypersensitivity ; Hypotension ; Incidence ; Insect Bites and Stings ; Insects ; Male ; Penicillins ; Prevalence ; Respiration ; Retrospective Studies ; Syncope ; Tertiary Care Centers*