We measured the near point of accommodation in 59 patients (59 eyes), who were implanted with 3M diffractive multifocal intraocular lens, in order to evaluote the pseudoaccommodation Average amount of pseudoaccommodation were 3.65 diopter (standard deviation was 1.75) and it was greater than that of monofocal intraocular lens Far vision and age did not affect the pseudoaccommodation. Near visual acuity alone appeared to have a positive correlation with pseudoaccommodation.
Humans ; Lenses, Intraocular* ; Visual Acuity

A 52-year-old male was visited our clinic complaining of severe right ocular pain, redness. He had highly elevated intraocular pressure, corneal edema, ciliary injection, cells and flare in the anterior chamber, and vitreous opacities. Then We performed anterior chamber paracentesis and aspiration cytology and this showed typical RBC ghosts with Heinz body so we confirmed the diagnosis of ghost cell glaucoma and treated him with standard medical treatment for glaucoma and anterior chamber irrigation. Since there has been no previous reports of cases like this, we present this case for the first time in Korea.
Anterior Chamber ; Corneal Edema ; Diagnosis ; Glaucoma* ; Humans ; Intraocular Pressure ; Korea ; Male ; Middle Aged ; Paracentesis ; Vitreous Hemorrhage

Neurocutaneous melanosis is a rare non-familial congenital neurocutaneous syndrome characterized by the presence of large or multiple congenital melanocytic nevi in association with benign or malignant proliferation of melanocytes in the leptomeninges. It is believed to be an embryonic neuroectodermal dysplasia. The Dandy Walker complex is an uncommon disorder of the CNS, also. refers to a condition with a broad posterior fossa and high tentorium insertion, hypoplasia or aplasia of the cerebellar vermis and cystic dilation of the fourth ventricle communication with the posterior fossa. We report a patient with NCM associated with the DWC that was diagnosed by MRI. The patient had multiple, small to medium-sized melanocytic nevi on the scalp and back, presenting at birth. At 6 months of age, frequent daily attacks of partial seizures were noted. T1 weighted MR images showed multiple high signal lesions in the amygdala, cerebellar folia, deep nuclei, and basis pontis, compatible with intraparenchymal melanin deposits. In addition, hypoplasia of the inferior vermis and a broad posterior fossa were identified. The patient failed to respond to oxcarbazepine. The seizure frequency did not decrease for the first three months. Vomiting and mild elevation of the liver enzymes were observed after adding valproic acid. However, after topiramate was started the frequency of the seizures decreased, and the oxcarbazepine and valproic acid were discontinued. With 5 mg/kg of topiramate treatment, the patient became seizure free for 20 months; however, infrequent seizures recurred thereafter. The dosage of topiramate was increased to 13 mg/kg, and for the following 15 months, there have been no seizures. Seizures were well controlled by topiramate for four years.
Amygdala ; Carbamazepine ; Dandy-Walker Syndrome ; Fourth Ventricle ; Fructose ; Humans ; Liver ; Melanins ; Melanocytes ; Melanosis ; Neural Plate ; Neurocutaneous Syndromes ; Nevus, Pigmented ; Parturition ; Scalp ; Seizures ; Valproic Acid ; Vomiting

In order to evaluate the microbial contamination of contact lens cases in patients with contact lens-induced keratitis, 27 contact lens storage cases were collected and their solutions were cultured. Of 27 contact lens cases, 25%(93%) showed microbial contamination, Four contact lens cases(15%) were contaminated by single species., 14 contact lens cases(52%) by two species. and 9 contact lens cases(33%) by more than three species. Of total 36 identified microorganisms, the most commonly cultured microorganism was Pseudomonas sp.. Other G(-) bacteria such as Serratia, Enterobacter and Acanthamoeba were also cultured. Based on data from this study, most contact lens cases of patients with contact lens=induced keraititis were contaminated with multiple microorganisms. When considering the high contamination rate of contact lens cases and its causative factor in development of keratitis, proper disinfection of contact lens cases can not be overemphasized. Therefore, ophthalmologists should continue patient education for proper care of contact lens, especially disinfection of contact lens cases.
Acanthamoeba ; Bacteria ; Disinfection ; Enterobacter ; Humans ; Keratitis* ; Patient Education as Topic ; Pseudomonas ; Serratia

We evaluated one of the new non-contact tonometers, the Pulsair non-contact tonometer, to assess its accuracy and reliability. Measurements on 101 eyes were used to assess its accuracy against Goldmann tonometry measurements, and another 24 eyes were used to assess its reliability (reproducibility). The results showed the instrument to be highly accurate and reliable in measurement.
Evaluation Studies as Topic ; Female ; Humans ; Intraocular Pressure ; Male ; Ocular Hypertension/diagnosis ; Predictive Value of Tests ; Regression Analysis ; Reproducibility of Results ; Tonometry, Ocular/*instrumentation ; Vision Screening/*methods

PURPOSE: There have been a few data about esophageal length in children and previous data are improper for application to various procedures. Because of the variability in height and weight of each the individuals especially in children, measurable external parameters are needed. METHODS: We measured distance from upper incisor to esophago-gastric junction using a flexible endoscope and compared these data with age, height and weight in 262 children who underwent upper gastrointestinal endoscopy. RESULTS: The mean age was 9.0+/-3.6 year (from 2 days to 16 year of age), mean height was 132.89+/-23.49 cm and mean length from upper incisor to esophago-gastric junction was 33.34+/-5.42 cm. Correlation between distance from upper incisor to esophago-gastric junction and height was the mostly predictable indicator of the esophageal length (Pearson correlation=0.944). We propose a formula [Esophageal length=4.419+(0.218 x height)] as a indicator of the esophageal length (p=0.000, R2=0.891). CONCLUSION: The esophageal length in children and for application to various procedures can be reliably predicted by using the height.
Child* ; Endoscopes ; Endoscopy* ; Endoscopy, Gastrointestinal ; Humans ; Incisor

PURPOSE: The foreing bodies in the upper GI tract are chiefly caused by accidental swallowing and rarely provoke symptoms. It is recommended to remove the foreign bodies if they produce symptoms or remain in GI tract for long duration or complications are expected to bring about. Nowadays the development of pediatric therapeutic endoscopy enables the removal of the foreign bodies in upper GI tract easily. METHODS: A clinical study of 30 cases of pediatric patients with the foreign bodies in the upper gastrointesinal tract diagnosed by the endoscopy at Seoul Red Cross hospital from January 1991 to December 1995 was perforemed. RESULTS: 1) The ages ranged from 1 year to 9 years and the male to female ratio was 2.3:1. 2) The types of ingested foreign bodies were coins (63.3%), audiokeys (10.0%), plastic toy (3.3%), earphone cap (3.3%), metal (3.3%), screw (3.3%), and battery (3.3%). Eighteen cases (60.0%) were located in the 1st narrowing part of the esophagus and 10 cases (33.3%) were in the stomach 3) Presenting symptoms were asymptomatic in 46.7%, dysphagia in 20.0%, vomiting in 16.7%, sore throat in 10.0%, and poor oral intake in 10.0%. The most common symptom in the cases of gastric foreign bodies was asymptomatic (90%), and common symptoms in the cases of 1st esophageal foreign bodies were dysphagia (33.3%), vomiting (27.8%) and asymptomatic (27.8%). 4) Abnormal endoscopic findings were erosive gastritis (16.7%), erosive esophagitis (6.7%), esophageal ulcer (3.3%), esophagitis (3.3%), and pharyngeal necrosis (3.3%) in order. CONCLUSIONS: The upper GI endoscope is a safe and essential method to diagnose and treat foreign bodies in the upper GI tract in pediatric patients.
Child* ; Deglutition ; Deglutition Disorders ; Endoscopes ; Endoscopy ; Esophagitis ; Esophagus ; Female ; Foreign Bodies* ; Gastritis ; Gastrointestinal Tract ; Humans ; Male ; Necrosis ; Numismatics ; Pharyngitis ; Plastics ; Play and Playthings ; Red Cross ; Seoul ; Stomach ; Ulcer ; Upper Gastrointestinal Tract* ; Vomiting

No abstract available.
Caroli Disease*

Acute gastric volvulus is uncommon but surgically emergent. Normally, the stomach is held in position by four ligaments: gastrophrenic, gastrohepatic, gastrosplenic, and gastrocolic. In addition, relative fixation of the pylorus and esophagus provides further anchorage. A normal diaphragm also helps to prevent abnormal displacement of abdominal viscera and development of gastric volvulus. Volvulus may be organoaxial, mesenteroaxial, or a combination of both. Organoaxial volvulus is the rotation of the stomach around an axis extending from the hiatus of the diaphragm to the pylorus. Mesenteroaxial volvulus is the rotation of the stomach around an axis transecting the lesser and greater curvatures of the stomach. The symptoms of gastric volvulus depend on its type, the extent and degree of rotation and obstruction, and associated defects. Classic clinical features of acute gastric volvulus, as by Borchardt in 1904, include unproductive retching, acute, localized epigastric distention, and the inability to pass a NG tube. The Presence and severity of these features depend on the degree of gastric obstruction of both the gastroesophageal junction and pyloric outlet. It may be suspected on plain abdominal radiographs and usually confirmed by upper gastrointestinal series. Acute volvulus requires immediate surgical repair, fixation to avoid recurrence, and correction of any underlying anatomic abnormality. Any associate defect should be repaired and the stomach must be fixed. The authors report a case of an 3-year-old girl who had a mesenterioaxial gastric volvulus.
Axis, Cervical Vertebra ; Child ; Child, Preschool* ; Diaphragm ; Esophagogastric Junction ; Esophagus ; Female* ; Humans ; Intestinal Volvulus ; Ligaments ; Pylorus ; Recurrence ; Stomach ; Stomach Volvulus* ; Viscera

PURPOSE: Positive ratio of routine EEG in adult epilepsy was widely known, but small number was reported in child epilepsy. Thus, we studied the difference of positive ratios between ages. METHODS: We reviewed the clinical records of 756 patients, who visited the pediatric neurology clinic with more than 2 afebrile seizures except neonatal seizures, from March 1997 to December 2004. Excluded were children with previous history of antiepileptic medication or failure of EEG. Clinical aspects and EEG findings of left 609 patients were evaluated retrospectively. RESULTS: Median age of EEG examination was 7.0 years (range, 3 months to 19.8 years) and male was 339. Number of child under 2 years was 112, 2-4 was 96, 5-9 was 233, 10-14 was 160 and over 15 was 8. All 279 positive past history was known in 222 persons, 98 of them had previous febrile seizures, 37 had CP or MR, 11 had neonatal seizures, 11 had birth asphyxia, 28 was prematurity. Waking EEG was checked in 398, sleep EEG in 547. Abnormal findings were found in 443 (72.7%). Definite epileptiform discharges were found in 388 patients (63.7%), suspicious spike discharges in 37 (6.2%). Patients under 2 years had 50.0% positive ratio of epileptiform discharges, 2-4 had 62.5%, 5-9 had 85.8%, 10-14 had 66.3% and over 15 had 37.5%. CONCLUSIONS: High positive ratio of routine EEG was found in child epilepsy, thus routine EEG seems to be very useful for the first diagnostic examination in child epilepsy.
Adult ; Asphyxia ; Child* ; Electroencephalography* ; Epilepsy* ; Humans ; Male ; Neurology ; Parturition ; Retrospective Studies ; Seizures ; Seizures, Febrile