No abstract available.
Asthma*

The trabeculectcmies were performed on 12 eyes with uncontrolled glaucoma which had not been treated by the maximum use of tolerated antiglaucoma medication. We assumed that all of these eyes would be at increased risk by episcleral cicatricial closure in the patient with one of the following cases; congenital glaucoma, age of 40 year or less, previously failed glaucoma filtration surgery, aphakia and uveitis. A standard operation was performed except tbat triamcinolone acetonide(4mg) was injected subconjunctivally at the intended trabeculectcmy site one week before surgery in 10 eyes, and cn the day of surgery in 2 eyes. During the followup period of 5 months or more, 11 of 12 eyes had an intraocular pressre(IOP) of 19mmHg or less. The average IOP for these 11 eyes was 14.5 +/- 3.4mmHg(mean +/- SD), and only 2 of the 11 eyes required antiglaucoma medication. One eye was a surgical failure. All eyes with controlled IOP showed micro cystic filtration blebs on slit lamp examination. The postoperative visual acuity was within one line of the preoperative level in all eyes, except for the one surgical failure. The use of triamcinolone acetonide does not seem to have added any additional risks to the postoperative period.
Aphakia ; Blister ; Filtering Surgery ; Filtration* ; Follow-Up Studies ; Glaucoma* ; Humans ; Postoperative Period ; Triamcinolone Acetonide ; Triamcinolone* ; Uveitis ; Visual Acuity

We reviewed 9 eyes which underwent combined phacoemulsification and trabeculectomy at separate site. Phacoemulsification was performed using corneal incision and trabeculectomy was performed at one superior quadrant using a limbus-based conjunctival flap with mitomycin C(0.2mg/ml, 3-5 minutes). Six eyes received 3-piece folable silicone lenses and 3 eyes received 1-picec PMMA(diameter 5.5mm) lenses. Mean preoperatie intraocular pressure (IOP) was 23.4+/-8.7mmHg. Mean follow-up period was 12.7(range 6-21)months. The mean postoperative IOP at 1, 6, 12 months were 14.6+/-4.8mmHg, 13.8+/-4.4mmHg, 16.6+/-6.8mmHg, respectively. Seven eyes achieved a final fisual acuity of 0.7 or better. One patient developed vision-impairing complications; flat anterior chambe and anterior dislocation of silicone lens. Other complications include posteror synechiae(4 eyes), capsular opacities (3 eyes), lens decentration with capsular contracture(1 eye). These rusults suggest that combined corneal incision phacoemulsification and trabeculectomy at separate site offers an effective technique to control postoperative intraocular pressure in patients with coexsisting cataract and glaucoma, though this procedure is not devoid of complications.
Cataract ; Dislocations ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Mitomycin ; Phacoemulsification* ; Silicones ; Trabeculectomy*

Retinal arteriovenous crossing sites are important because they are generally the points at which. in branch retinal obstruction, a blockage of venous blood flow occurs. We evaluated retrospectively the cases of 54 patiens wIth a recent temporal branch retinal vein occlusion to determine the relative anatomic position of the obstructed vein in relation to its crossing artery. In 54 (100%) of 54 eyes, the artery lay antenor to the vein, toward the vitreous cavity. In the control corssing site, the artery lay anterior to the vein 41.3% (J9/46) of the time (p<0.01) The second control group, which was obtained by examining all of the first-and second-order, without BRVO, consisted of 103 crossing sites. In this second control group's artenovenous crossmgs, the arteries were situated anteriorly in 83 (80.6%) of 103 crossing sites (p<0.005). Our observation that the artery lies anterior to the vein at the all of BRVO crossing sites contributes further evidence that mechanical factors play a prominent role in the causing BRVO.
Arteries ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Veins

PURPOSE: This study was conducted to identify the caring experience of the mothers of childhood burn patients. METHODS: Data were collected from 28 mothers of childhood burn patients, through semi-structured in-depth interviews. Data were categorized and coded by using content analysis. RESULTS: 27 categories and 102 statements were drawn from 4 domains. The analyzed domains were psychological sufferings, confronted harsh reality, coping method, and future concerns. Psychological sufferings were categorized heartache, sense of guilt, confusion, regret, depression, sorriness, getting hurt, frustration and upset feeling. Confronted harsh nature were categorized economic difficulty, physical burn-out, lack of caring other children and family troubles. Coping method were categorized positive thinking, having hope, ventilating feelings, accepting the situations, demanding help from family members, changing patterns of the burned child rearing, collecting information for burn treatment, refusing accept the condition of burned child, avoiding personal and social relationship, and reliance on religion. Concerns were categorized concerns of growth and adaptation of the burned child, anxiety for scar, concerns of adapting school life and vague future concerns. CONCLUSION: The nursing interventions for early assessing psychological problems and providing social supports for caring both burn patients and other siblings should be provided to the mothers of childhood burn patients.
Adaptation, Psychological ; Anxiety ; Burns ; Child ; Child Rearing ; Cicatrix ; Depression ; Frustration ; Guilt ; Humans ; Mothers ; Siblings ; Thinking

Complicated microphthalmos can be diagnosed when a reduction in global dimension is combined with other structural anomalies. These include corneal opacity or staphyloma, cataract, aniridia, corectopia, persistence of pupillary membrane or the tunica vasculosa lentis and hyaloid vessel, thickening or ossification of the choroid and various retinal anomalies. Complicated microphthalmos is frequently hereditary and the transmission may be either as an autosomal dominant or recessive or as a sex linked recessive trait. Four cases of bilateral complicated microphthalmos with cataract were found in a family.
Aniridia ; Cataract ; Choroid ; Corneal Opacity ; Humans ; Membranes ; Microphthalmos* ; Retinaldehyde

PURPOSE: Suprapubic vibrating stimulus may improve the urinary symptom in patients with neurogenic bladder. We attempted to evaluate the suprapubic vibration effect on urodynamic study in patient with voiding dysfunction. MATERIALS AND METHODS: From October 1997 to July 1998, We have performed urodynamic studies(UDS) on 30 patients(13 males, 17 females). They had intact suprapubic sensation without lower urinary tract obstruction, who visited under the chief complaints of voiding dysfunction(frequency, voiding difficulty etc.). All patients were checked UDS before and after using a vibrating device(frequency 120Hz, mechanical output 0.081mm), which was placed on the 2?3cm above the pubic symphysis. Results of detrusor pressure were compared pre- and post-vibration at 150ml bladder filling and at strong desire to void and maximum bladder capacity. The most common underlying disease was peripheral lesions(11 cases). Results of UDS were grouped into three. Group I consisted of 11 patients with hyperactive bladder. Group II consisted of 6 patients with normal bladder, and group III consisted of 13 patients with hypoactive bladder. RESULTS: Changes of detrusor pressure at the 150ml bladder filling in group I couldn`t be measured due to early urine leakage. In group II&III, the average detrusor pressure changes of pre- and post-vibration were from 4.2+/-.6cmH2O to 3.8+/-.2cmH2O(p>0.05) and from 5.7+/-.8cmH2O to 6.7+/-.2cmH2O(p>0.05) respectively. Detrusor pressure at strong desire to void was changed from 39.0+/-8.6cmH2O to 40.0+/-0.0cmH2O in group I(p>0.05), 25.3+/-2.8cmH2O to 19.0+/-2.2cmH2O in group II(p>0.05), and from 15.0+/-.9cmH2O to 19.5+/-2.3cmH2O in group III(p<0.05). Changes of maximum bladder capacity were from 222.7+/-8.4ml to 187.5+/-1.7ml in group I(p>0.05), from the 402.0+/-2.8ml to 399.3+/-4.5ml in group II(p>0.05), and from 547.5+/-9.5ml to 520.1+/-9.6ml in group III(p<0.05). In group III, ten of the 13 patients(77%) showed the increase of detrusor pressure at strong desire to void(mean: 6.6cmH2O) and nine of the 13 patients(69%) showed the decrease in maximum bladder capacity(mean: 46.4ml)(p<0.05). CONCLUSIONS: These results suggest that the use of suprapubic vibrator may be an ancillary therapeutic tool in selected patients of voiding dysfunction with hypoactive bladder.
Humans ; Male ; Pubic Symphysis ; Sensation ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Tract ; Urodynamics* ; Vibration*

PURPOSE:Decreased bone mineral density(BMD) has been reported in girls with Turner syndrome. Estrogen therapy is recommanded to improve sexual infantilism and decreased BMD. Short stature is also characteristic finding in patients with Turner syndrome. Treatment modality for short stature has included estrogen, anabolic steroids and growth hormone(GH). Recently GH therapy in GH deficient children could increase BMD in addition to improve short stature. We observed the treatment effects on bone mineral density in patients with Turner syndrome. METHODS: Bone Mineral Density in second to fourth lumbar spine area were measured by dual energy X-ray absorptiometry in 56 girls with Turner syndrome, before and after growth hormone and/or estrogen. All Turner girl was confirmed by clinical and chromosomal examination. RESULTS: 1) There was no significant difference in BMD according to karyotype. 2) The mean BMD of untreated Turner syndrome was 0.752+/-0.122g/cm2. 3) The mean BMD before and after GH treatment were 0.620+/-0.028g/cm2, 0.793+/-0.093g/cm2 respectively. The mean BMD before and after estrogen treatment were 0.761+/-0.125g/cm2, 0.918+/-0.141g/cm2 respectively. In combined group, the BMD were 0.752+/-0.087g/cm2 and 0.939+/-0.134g/cm2. Growth hormone was also effective to improve BMD as well as estrogen. But the changes of BMD were more significant in estrogen and combined group(p<0.05). 4) A significant positive correlation was found between age and BMD(p<0.05). CONCLUSIONS:Estrogen therapy can accelerate epiphysial maturation and compromise final height. Growth hormone therapy in Turner girls was effective for improvement bone mineral density as well as growth improvement. But growth hormone and estrogen combined therapy or Estrogen therapy is more effective to improve bone mineral density in Turner syndrome. Estrogen replacement can be delayed for a while on growth hormone treatment and the appropriated time of estrogen therapy should be elucidated.
Absorptiometry, Photon ; Bone Density* ; Child ; Estrogen Replacement Therapy ; Estrogens ; Female ; Growth Hormone ; Humans ; Karyotype ; Sexual Infantilism ; Spine ; Steroids ; Turner Syndrome*

A Macular hole may change in size of the hole; may increase in size with time and an epiretinal membrane may form. Rarely, a rhegmatogenous retinal detachment may occur with time and long term visual acuity usually remains stable or progressively worse. But to our knowledge spontaneous disappearance of a macular hole caused by development of an epiretinal membrane with improvement in vision rarely occurs. The traumatic, full-thickness macular hole in a 15-year-old man during 3 month follow-up period, changed its biomicroscopic appearance and fluorescein angiographic finding. Furthermore, visual acuity showed some improvement. The authors believe this spontaneous disappearance of macular hole is probably occured as a result of epiretinal membrane formation.
Adolescent ; Epiretinal Membrane ; Fluorescein ; Follow-Up Studies ; Humans ; Retinal Detachment ; Retinal Perforations* ; Visual Acuity

Spondylolisthesis, named by Kilian in 1854, is a major cause of low back pain and numerous methods were designed for its treatment. The 80 cases out of 132 spondylolysis and spondylolisthesis were analysed and evaluated the result cf their treatment. The results are summerized as follows. 1. The most common type of spondylolisthesis was isthmic type (58 cases, 72.5%). 2. The most common site of incidence was L5 and L4, L3 were next to it. 3. All of the dysplastic type were in L5, isthmic type were in L3, L4 and the degenerative type were most common in L4, and followed L5,L3 consecutively. 4. The 67 cases out of 80 were treated conservatively and rest of cases had operative care with six cases of anterior fusion and seven cases of posterior fusion. 5. The results of tretment was evaluated and graded more than good in all cases of operative care and 51 cases (76.2%) in conservative management.
Incidence ; Low Back Pain ; Spondylolisthesis ; Spondylolysis