Macular hemorrhage which result from breaks of Bruch's membrane or from choroidal neovascularization can develop in high degenerative myopia, but its occurrence after photorefractive surgery has rarely been reported. We experienced a case of macular hemorrhage after laser in situ keratomileusis[LASIK]:A 28-year-old female patient with high myopia of -16.5 diopters, who had received successful LASIK operation on her left eye.complained of a sudden drop in vision 20 days postoperatively.On fundus examination, macular hemorrhages were detected on her left eye.Eventually the hemorrhages resolved, but more than 2 lines of her best corrected visual acuity were lost.During follow-up, a new hemorrhagic lesion was incidently found on the other eye. This case demonstrates that macular hemorrhages may develop after LASIK in eyes with high degenerative myopia, and lead to a permanent reduction in visual acuity.We should be alert to any potential retinal pathology in patients having refractive surgery.
Adult ; Bruch Membrane ; Choroidal Neovascularization ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Keratomileusis, Laser In Situ* ; Myopia ; Myopia, Degenerative ; Pathology ; Refractive Surgical Procedures ; Retinaldehyde ; Visual Acuity

We identified facial asymmetry in 81 patients with a history of long standing head tilt due to congenital or early childhood onset superior oblique palsy(SOP). To determine facial asymmetry, full frontal photographs of face were taken for each patient in a straight ahead position. They were also evaluated for skull molding, sleeping habit and degree of head tilt. Facial asymmetry was noted in 62 of 81(76.5%) patients with early onset superior oblique palsy. Eighteen of 36(50%) patients with facial asymmetry had skull molding and sleeping habit to lay down on the one side of head. Incidence of facial asymmetry was high in patients with head tilt. In addition, one of 3(33.3%) patient less than 24 months of age showed constant head tilt and facial asymmetry. After surgical correction of superior oblique palsy, head tilt was eliminated and facial asymmetry gradually disappeared. Facial asymmetry was found in 5 of 9(55.6%) patients between 2 and 3 years of age, and in 25 of 28(89.3%) patients more than 3 years of age. Fortunately it gradually improved at the long term follow-up. This study shows that the facial asymmetry cold be produced by chronic head tilt from even less than 2 years of age. Skull molding may develop in infants who prefer to sleep on one side of head. To prevent the development of facial asymmetry, early surgery less than 2 years of age may be needed. Monitoring of head position during sleep may be important to prevent skull molding. If head tilt persist even after surgical correction of SOP, secondary scoliosis, contracture of the neck muscle or habit should be considered and physical therapy may be needed.
Contracture ; Facial Asymmetry* ; Follow-Up Studies ; Fungi ; Head* ; Humans ; Incidence ; Infant ; Neck Muscles ; Paralysis* ; Scoliosis ; Skull

PURPOSE: After Langendorff made aortic perfusion system with the extracted animal heart for the experimental study regarding cardiac mechanical action and rhythm, this system has been modified by various methods for the hemodynamic studies. The authors developed cardiac perfusion system using personal computer for mechanical cardiac contraction and electrophysiologic studies without the effects of autonomic nervous system and hemodynamic influences from various causes. METHODS: This system consisted of perfusion system, electrical pulse generator, and data acquisition system. the perfusion system has reservoir containing physiologic solution, heat exchange system, and organ chamber. The pulse generator composed of personal computer and digital/analog converter can produce electrical pulses with adjustable amplitude and cycle length. The mode of stimulations were as follows; maintenance, programmed, and burst mode. The data acquisition system was composed of amplifier, analog/digital converter, and AcqKnowledge program that are provided by Biopac system. The data were sampled at 1kHz as a digitized form, and the noises wee reduced by filtering at band width 30-500Hz. Krebs' solution was used as perfusate through the aorta of isolated heart with mean pressure of 40mmHg. RESULTS: With this system, AH and HV interval, refractory period of AV node and His-Purkinje system, and Wenckebach cycle length were measured. CONCLUSION: Studies for cardiac mechanical contraction as well as electrophysiologic properties in vitro with or without specific cardiac drugs would be possible with this system in isolated experimental heart without autonomic nervous effects.
Animals ; Aorta ; Atrioventricular Node ; Autonomic Nervous System ; Electrophysiology ; Heart ; Hemodynamics ; Hot Temperature ; Humans ; Microcomputers* ; Noise ; Perfusion*

No abstract available.
Hyperostosis, Cortical, Congenital*

PURPOSE: This study was conducted to investigate the relationship between axial length(AL) and proliferative diabetic retinopathy(PDR). METHODS: We reviewed the medical charts of the nondiabetic patients who had undergone cataract surgery and diabetic patients who had undergone vitrectomy or cataract surgery at Korea University Kuro Hospital between January, 1998 and July, 2000. Eyes with previous ocular surgery or other severe ocular disease were excluded from the analysis. Eyes with axial length greater than 24 mm were also excluded. The eyes were divided into 4 groups: Non-DM group, nondiabetic; Non-DR group, diabetic without retinopathy; NPDR group, with nonproliferative diabetic retinopathy; and PDR group, with proliferative diabetic retinopathy. Each group contained 42 eyes which were matched for age and sex. RESULTS: The AL values of each group were compared. The mean AL of the PDR group(22.2+/-0.8 mm) was significantly shorter than each of the other groups: Non-DM group(23.1+/-0.7 mm, p<0.05); Non-DR group(22.9+/-0.9 mm, p<0.05); NPDR group(22.8+/-0.8 mm, p<0.05). Within the PDR group, the eyes that had received preoperative panretinal photocoagulation(27 eyes, mean: 22.0+/-1.1 mm) showed a shorter AL than those that had not(15 eyes, mean: 22.7+/-0.8 mm), which was not statistically significant(P=0.08, t-test). CONCLUSION: The results suggest that a shorter axial length may be associated with severe proliferative diabetic retinopathy.
Cataract ; Diabetic Retinopathy* ; Humans ; Korea ; Vitrectomy

Laser assisted in situ keratomileusis(LASIK) is a widely used technique for correcting high myopia. Its technical methods and excellent clinical results are well known, but its potential risk on the corneal endothelium are poorly known. We used specular microscope to underwent LASIK for the correction of myopia. The mean preoperative refraction was ?4.5 diopters (range, -10.00 to -23.50 diopters.). The average endothelial cell densities were 2,817+/-205 cells/mm2 (mean +/-SD) preoperatively and 2,789+/-211 cells/mm2 3 months postoperatvely, corresponding to fall of 28 cells/mm2. This fall in endothelial cell density was not statistically significant (P>0.05). But significant correlation between the change in cell density and the residual corneal thickness was found(P>0.05). These results suggest that LASIK is a predictable and safe method for correcting high myopia, but care is recommended when doing deep corneal ablation. Long term follow-up may be needed to confirm its safety.
Cell Count ; Endothelial Cells ; Endothelium, Corneal ; Follow-Up Studies ; Keratomileusis, Laser In Situ ; Myopia

The present study has been undertaken to pursue the cytotoxic effects of cis-Platin on the osteoid formation in metaphysis of rat tibia. By using the immunohistological staining method for type I collagen in rat tibial osteoid, the author detected the deposition of type I collagen, which is the collagenous constituent of endochondral osteoid, after administration of cis-Platin in experimental animals. For the immunological reactions of type I collagen, we used the rabbit anti-rat collagen type I polyclonal antibody as primary antibody and biotinylated goat anti-rabbit IgG as secondary antibody. The distributions of immunohistological reactions in the each of metaphyseal osteoids were analyzed with an image analyzer, and we studied the variances of type I collagens by statistical probabilities. In 12 hours after cis-Platin injection, immunoreactive area in the osteoid of metaphysis was distinctly decreased. Immunoreactive area of type I collagen in osteoids of 1 day and 3 days group metaphysis was increased more than that of 12 hours group and the type I collagen in the metaphysis showed weak immunoreactions of type I collagens with an image analyzer. In the osteoids of 7 days group after cis-Platin injection, the immunoreactive area was similar to that of control group. It is consequently suggested that cis-Platin would induce the decrease of type I collagen in the osteoid. But the type I collagen in tibial osteoid shows the increase from a few days after cis-Platin injection.
Animals ; Collagen ; Collagen Type I* ; Goats ; Immunoglobulin G ; Rats* ; Tibia*

No abstract available.
Muscular Dystrophy, Oculopharyngeal*

BACKGROUND AND OBJECTIVES: The mucosal immune response depends on the surveillance network established by dendritic cells (DC) localized within the respiratory epithelium. Fungi have been increasingly recognized as important pathogens in respiratory diseases. We hypothesized that DCs play a central role in the immune response against airborne fungi. MATERIALS AND METHODS: Monocyte-derived DCs were developed by incubating monocytes with interleukin-4 (IL-4) and granulocyte-macrophage colony-stimulating factor. DCs were stimulated with Alternaria alternata and Aspergillus nigra for 24 hours and then co-cultured with CD4-positive lymphocytes for 6 days. Levels of IL-6 and tumor necrosis factor-alpha (TNF-alpha) were measured to determine activation of the DCs, and levels of TNF-alpha, IL-5, and interferon-gamma (INF-gamma) were measured to determine Th polarization. DC migration was induced with conditioned media from nasal polyp epithelial cells stimulated with fungi. RESULTS: Alternaria and Aspergillus activated DCs with enhanced production of cytokines. When activated DCs were co-cultured with CD4-positive lymphocytes, Th2 cytokine and IL-5 production was significantly increased by Alternaria. DC migration was significantly increased by conditioned media from cells that were activated with Alternaria. CONCLUSION: Airborne fungi induced different immune responses depending on the fungi. Alternaria strongly induced DC migration and a Th2 immune response.
Alternaria ; Aspergillus ; CD4-Positive T-Lymphocytes ; Culture Media, Conditioned ; Cytokines ; Dendritic Cells ; Epithelial Cells ; Fungi ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immunity, Mucosal ; Interferon-gamma ; Interleukin-4 ; Interleukin-5 ; Interleukin-6 ; Monocytes ; Nasal Polyps ; Respiratory Mucosa ; Tumor Necrosis Factor-alpha

PURPOSE: To investigate whether performance of point-of-care ultrasound (POCUS) can reduce emergency department length of stay (EDLOS) for children with nonspecific manifestations of intussusception (NMI), defined as 2 or less manifestations of the classic triad of intussusception, and/or vomiting. METHODS: We reviewed medical records of 141 consecutive children with intussusception aged 6 years or younger who visited the emergency department of Asan Medical Center in Seoul, Korea from May 2014 through April 2016 and underwent diagnostic radiology ultrasound and pneumatic reduction. The children were grouped according to whether they underwent POCUS or not (POCUS and no POCUS groups, respectively). POCUS was performed to children with NMI by an attending emergency physician who had completed a POCUS training course endorsed by the Korean Society of Pediatric Emergency Medicine. We measured EDLOS, which consisted of door-to-reduction and observation times. These time intervals were compared between the 2 groups. RESULTS: Of 112 eligible children, 65 (58%) underwent POCUS. The median EDLOS was shorter in the POCUS group than in the no POCUS group (566 minutes, interquartile range [IQR] 497 to 765 vs. 745 minutes, IQR 551 to 981; P = 0.003). The median door-to-reduction and observation times were also shorter in the POCUS group (105 vs. 138 minutes, P < 0.001 and 440 vs. 628 minutes, P = 0.008, respectively). These differences were possibly due to the performance of POCUS and the trend toward early discharge after pneumatic reduction. We found 1 child with false negative result on POCUS, but there may have been more. CONCLUSION: Performance of POCUS may reduce EDLOS in children with NMI.
Child* ; Chungcheongnam-do ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intussusception* ; Korea ; Length of Stay* ; Medical Records ; Point-of-Care Systems* ; Seoul ; Ultrasonography* ; Vomiting