We performed this study to investigate the distribution of axes of astigmatism, the occurrence and amount of astigma- tism among pediatric population aged from 1 to 15 years who have visited our clinic from January to December 1997. After routine ophthalmologic examination to rule out any organic abnormality, the cycloplegic refraction was performed with 0.5-1.0% atropine on 529 eyes. Out of 529 eyes, astigmatism was found in 356 eyes (67.3%) with the highest incidence in 15-year-old group being 87.0%. Among 356 eyes with astigma- tism, with-the-rule astigmatism was found in 322 eyes (90.4%); against-the-rule, 30 eyes (8.5%); oblique, 4 eyes (1.1%). With-the-rule astigmatism occurred far more frequently found than against-the-rule in all age groups. As to the type of astigmatism classified by the state of refractive errors,hyperopic astigmatism was found in 144 eyes (40.4%); myopic,136 eyes (38.3%); mixed, 76 eyes (21.3%). Of the total of 356 eyes with astigmatism, astigmatism of 1.0 diopter or less was found in 181 eyes (50.8%).
Adolescent ; Astigmatism* ; Atropine ; Axis, Cervical Vertebra* ; Child* ; Humans ; Incidence

In determining the effects of strabismus surgery, it is very important to know where the reattachment site of an extraocular muscle following recession procedure is located. Undercorrections or overcorrections after muscle surgery have been thought to be due to a postoperative positional changes of reattachment site along the surface of the globe. The author performed this experimental study to evaluate the amounts of changes of reattachment site after recession procedure in rabbit with 4 different methods of scleral fixation;direct suture with 6-0 vicryl, hang-back suture, application with Tisseel and Histoacryl. Superior rectus recession was performed in all 40 rabbit eyes, 10 eyes in each group. The distance from limbus to proximal end of recessed superior rectus muscle was measured on day 1, 2, 3, 5 and 7 postoperatively. Further measurements were followed at 2, 3, 4 and 8 weeks after recession procedure. The muscles were found an average of 0.4mm posterior to the intended position in direct suture group and 0.5 mmin hang-back suture group at one week postoperatively. But in the other two groups in which tissue adhesive agents, Tisseel and Histoacryl were used, the amount of displacement of the reattachment site were minimal of within 0.1 mm. From this experimental study, it is suggested that the positional changes of the reattachment site after recession procedure may influence the surgical corrective effects for strabismus.
Enbucrilate ; Fibrin Tissue Adhesive ; Muscles ; Polyglactin 910 ; Strabismus ; Sutures ; Tissue Adhesives

Esotropia that is related to accommodative effort may be divided into two major categories: (1) refractive accommodative esotropia with a normal AC/A ratio and (2) nonrefractive accommodative esotropia with a high AC/A ratio. To evaluatedthe clinical characteristics and the results of therapy, we performed a clinical analysis of 54 cases of accommodative esotropia. Female were 28 cases and male 26. The age of onset were 0 to 6 years with most of the cases were 0 to 2 years. The refractive errors were ranged from less than +2.00D to over +6.00D. The amount of deviation before correction with glasses were 20-29delta in 16 cases, 30-39delta in 25, 40-49delta in 12 and one cases was over 50 delta. The refractive type was 46 cases and 8 cases were nonrefractive type. It is recommended that the patients with accommodative esotropia should be followed up for a long time even with their glasses, because of variable clinical course.
Age of Onset ; Esotropia* ; Eyeglasses ; Female ; Glass ; Humans ; Male ; Refractive Errors

Relapsing polychondritis is a rare autoimmune disease of unknown etiology characterized by recurrent inflammation of cartilaginous structures of the ears, nose, respiratory tract and joints. Relapsing polychondritis may affect proteoglycan-rich tissues, such as the eyes, aorta, heart, and skin. Several cardiovascular complications have been reported in patients with relapsing polychondritis. The most common findings of cardiovascular manifestations are aortic or mitral regurgitation and aortic aneurysm. Aortitis is a very rare complication of relapsing polychondritis. We report a case of 48-year-old man who had relapsing polychondritis with aortitis mimicking Takayasu's arteritis.
Aorta ; Aortic Aneurysm ; Aortitis ; Autoimmune Diseases ; Ear ; Heart ; Humans ; Inflammation ; Joints ; Middle Aged ; Mitral Valve Insufficiency ; Nose ; Polychondritis, Relapsing* ; Respiratory System ; Skin ; Takayasu Arteritis* ; Vasculitis*

Protein-losing enteropathy is a rare complication of autoimmune diseases. We report a case of primary Sjogren's syndrome with protein-losing enteropathy in 50-year-old female who complained of generalized edema. Protein-losing enteropathy of the small intestine was demonstrated by Tc-99m labeled albumin abdominal scintigraphy. Duodenal biopsies showed chronic inflammatory cell infiltration without lymphangiectasis or vasculitis. The patient received oral prednisolone (60 mg/day) for 4 weeks with subsequent clinical improvement. Primary Sjogren's syndrome or other autoimmune diseases should be considered in cases of protein-losing enteropathy.
Autoimmune Diseases ; Biopsy ; Edema ; Female ; Humans ; Intestine, Small ; Lymphangiectasis ; Middle Aged ; Prednisolone ; Protein-Losing Enteropathies* ; Radionuclide Imaging ; Sjogren's Syndrome* ; Vasculitis

Sjogren's syndrome is one of chronic inflammatory autoimmune diseases involving exocrine gland. Involvement of central nerve system was rarely reported. We report a case of primary Sjogren's syndrome presenting as transverse myelitis in 37-year-old female who complained of tingling sense in both legs and voiding difficulty. Magnetic resonance imaging shows high signal intensity with cord swelling from C6 to T7 in T2 weighted image. The patient received intravenous methylprednisolone (1,000 mg/day) for 10 days followed by prednisolone and intravenous monthly cyclophosphamide with subsequent clinical improvement.
Adult ; Autoimmune Diseases ; Cyclophosphamide ; Exocrine Glands ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Methylprednisolone ; Myelitis, Transverse* ; Prednisolone ; Sjogren's Syndrome*

Epithelioid hemangioendothelioma is a rare vascular tumor, which occurs in the lung, liver, bone, and soft tissue. Hypertrophic osteoarthropathy is a syndrome characterized by subperiosteal new bone formation, joint effusion and clubbing, and may be associated with cyanotic heart disease, chronic pulmonary disease, liver disease, and other miscellaneous diseases. The activation of endothelium and platelets has been suggested to be involved in the development of hypertrophic osteoarthropathy. We report a rare case of hypertrophic osteoarthropathy, which developed in association with hepatic epithelioid hemangioendothelioma with pulmonary metastasis. We also discuss the role of vascular endothelial growth factor in its pathogenesis.
Adult ; Biopsy ; Blood Platelets/metabolism ; Endothelium/metabolism ; Femur/radiography ; Hemangioendothelioma, Epithelioid/*complications/*pathology ; Human ; Lung/pathology ; Lung Neoplasms/*complications/pathology ; Male ; Osteoarthropathy, Secondary Hypertrophic/*complications/*pathology ; Vascular Endothelial Growth Factor A/metabolism ; Vascular Neoplasms/*diagnosis/pathology