Bacterial endophthalmitis is an ocular emergency that requires rapid diagnosis and therapeutic decision making. Before the use of intravitreal antibiotics, endophthalmitis almost always resulted in the loss of vision in the affected eye. The introduction of intravitreal injection of antibiotics had been a major advancement because it has resulted in a marked improvement in visual outcome. Current therapy is to administer broad-spectrum antibiotic agents covering both gram-positive and gram-negative organisms. Typically, vancomycin hydrochloride and aminoglycoside, such as amikacin sulfate, are administered as separate intrvitreal injections on an empiric basis. We experienced a case of culture-proven Pseudomonas aeruginosa endophthalmitis treated with intravitreal ceftazidime injection. We present it with a review of literature.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime* ; Decision Making ; Diagnosis ; Emergencies ; Endophthalmitis* ; Intravitreal Injections ; Pseudomonas aeruginosa* ; Pseudomonas* ; Vancomycin

Recently, acute pseudomonas keratitis is reported to occur more frequently. If treatment is not adequate after the invasion of Pseudomonas into the cornea, corneal perforation ensues within 48 hours. Hence the rapid diagnosis and treatment is required, and the treatment mostly depends on the antibiotics. Pseudomonas keratitis induced in the rabbit cornea by inoculating Pseudomonas aeruginosa (lID 1210). Then the keratitis was treated with topical antibiotics available in Korea Chloramphenicol(R), Polyspectran(R), Tobra(R), Gentamicin(R), Tarivid(R). The effect of the antibiotics on Pseudomonas keratitis was evaluated clinically as well as bacteriologically and irritation of the antibiotics against the eye was also obsesved. 1. Polyspectran(R), tobra(R), gentamicin(R), tarivid(R) treated experimental Pseudomonas keratitis in the rabbit eyes but chloramphenicol(R) and saline did not inhibit the bacterial growth of the rabbit corneas. 2. Against the rabbit eyes, chloramphenicol(R) and polyspectran(R) were the most irritable aptibiotics, where as Gentamicin(R) and tarivid(R) were the moderate, and tobra(R) and saline were the least in the extent of irritation.
Anti-Bacterial Agents* ; Cornea ; Corneal Perforation ; Diagnosis ; Keratitis* ; Korea ; Pseudomonas aeruginosa ; Pseudomonas*

BACKGROUND: This study evaluated postoperative changes in the supraspinatus from time-zero to 6 months, using magnetic resonance imaging (MRI). We hypothesized that restoration of the musculotendinous unit of the rotator cuff by tendon repair immediately improves the rotator cuff muscle status, and maintains it months after surgery. METHODS: Totally, 76 patients (29 men, 47 women) with rotator cuff tears involving the supraspinatus tendon who underwent arthroscopic rotator cuff repairs were examined. MRI evaluation showed complete repair with intact integrity of the torn tendon at both time-zero and at 6 months follow-up. All patients underwent standardized MRI at our institution preoperatively, at 1 or 2 days postoperative, and at 6 months after surgery. Supraspinatus muscular (SSP) atrophy (Thomazeau grade) and fatty infiltrations (Goutallier stage) were evaluated by MRI. The cross-sectional area of SSP in the fossa was also measured. RESULTS: As determined by MRI, the cross-sectional area of SSP significantly decreased 11.41% from time-zero (immediate repair) to 6 months post-surgery, whereas the Goutallier stage and Thomazeau grade showed no significant changes (p<0.01). Furthermore, compared to the preoperative MRI, the postoperative MRI at 6 months showed a no statistically significant increase of 8.03% in the cross-sectional area. In addition, morphological improvements were observed in patients with high grade Goutallier and Thomazeau at time-zero, whereas morphology of patients with low grade factors were almost similar to before surgery. CONCLUSIONS: Our results indicate that cross-sectional area of the initial repair appears to decrease after a few months postoperatively, possibly due to medial retraction or strained muscle.
Atrophy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Muscular Atrophy ; Rotator Cuff ; Tears ; Tendons

STUDY DESIGN: Case report. OBJECTIVES: We report 3 cases of loss of disc height after spontaneous regression of a herniated lumbar disc. SUMMARY OF LITERATURE REVIEW: Reports of spontaneous regression of a herniated lumbar disc were identified. MATERIALS AND METHODS: We conservatively treated 3 patients who were diagnosed with a herniated lumbar disc. During outpatient follow-up, radiating pain improved in all patients, but they complained of chronic lower back pain. Magnetic resonance imaging (MRI) was performed for diagnostic purposes. RESULTS: On MRI, spontaneous regression of the herniated lumbar discs was observed, but loss of disc height was also found. CONCLUSIONS: A herniated lumbar disc may be a risk factor for loss of disc height. It is important to recognize that a patient with a herniated lumbar disc can struggle with chronic lower back pain even if spontaneous regression of the herniated lumbar disc occurs.
Follow-Up Studies ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Outpatients ; Risk Factors

STUDY DESIGN: Case report. OBJECTIVES: To document unilateral biportal endoscopy (UBE) as a treatment for acute radiculopathy after osteoporotic vertebral fracture. SUMMARY OF LITERATURE REVIEW: Acute radiculopathy after osteoporotic vertebral fracture leads to claudication. Treatment of osteoporotic vertebral fractures with accompanying radiating pain is challenging. MATERIALS AND METHODS: A 74-year-old woman was diagnosed with an osteoporotic vertebral fracture at L3 after slipping and falling. Vertebroplasty was performed for the osteoporotic vertebral fracture at L3. She still complained of right lower extremity radiating pain. UBE was performed to treat acute radiculopathy. RESULTS: Foraminal decompression using UBE was performed at the L3–4 right foraminal area. Her symptoms resolved after surgery. CONCLUSIONS: UBE is a useful treatment method for acute radiculopathy after osteoporotic vertebral fracture.
Accidental Falls ; Aged ; Decompression ; Endoscopy ; Female ; Fractures, Compression ; Humans ; Lower Extremity ; Methods ; Radiculopathy ; Vertebroplasty

BACKGROUND: This study evaluated postoperative changes in the supraspinatus from time-zero to 6 months, using magnetic resonance imaging (MRI). We hypothesized that restoration of the musculotendinous unit of the rotator cuff by tendon repair immediately improves the rotator cuff muscle status, and maintains it months after surgery. METHODS: Totally, 76 patients (29 men, 47 women) with rotator cuff tears involving the supraspinatus tendon who underwent arthroscopic rotator cuff repairs were examined. MRI evaluation showed complete repair with intact integrity of the torn tendon at both time-zero and at 6 months follow-up. All patients underwent standardized MRI at our institution preoperatively, at 1 or 2 days postoperative, and at 6 months after surgery. Supraspinatus muscular (SSP) atrophy (Thomazeau grade) and fatty infiltrations (Goutallier stage) were evaluated by MRI. The cross-sectional area of SSP in the fossa was also measured. RESULTS: As determined by MRI, the cross-sectional area of SSP significantly decreased 11.41% from time-zero (immediate repair) to 6 months post-surgery, whereas the Goutallier stage and Thomazeau grade showed no significant changes (p<0.01). Furthermore, compared to the preoperative MRI, the postoperative MRI at 6 months showed a no statistically significant increase of 8.03% in the cross-sectional area. In addition, morphological improvements were observed in patients with high grade Goutallier and Thomazeau at time-zero, whereas morphology of patients with low grade factors were almost similar to before surgery. CONCLUSIONS Our results indicate that cross-sectional area of the initial repair appears to decrease after a few months postoperatively, possibly due to medial retraction or strained muscle.

OBJECTIVES: We report 3 cases of loss of disc height after spontaneous regression of a herniated lumbar disc.SUMMARY OF LITERATURE REVIEW: Reports of spontaneous regression of a herniated lumbar disc were identified. MATERIALS AND METHODS: We conservatively treated 3 patients who were diagnosed with a herniated lumbar disc. During outpatient follow-up, radiating pain improved in all patients, but they complained of chronic lower back pain. Magnetic resonance imaging (MRI) was performed for diagnostic purposes. RESULTS: On MRI, spontaneous regression of the herniated lumbar discs was observed, but loss of disc height was also found. CONCLUSIONS A herniated lumbar disc may be a risk factor for loss of disc height. It is important to recognize that a patient with a herniated lumbar disc can struggle with chronic lower back pain even if spontaneous regression of the herniated lumbar disc occurs.

OBJECTIVES: To document unilateral biportal endoscopy (UBE) as a treatment for acute radiculopathy after osteoporotic vertebral fracture.SUMMARY OF LITERATURE REVIEW: Acute radiculopathy after osteoporotic vertebral fracture leads to claudication. Treatment of osteoporotic vertebral fractures with accompanying radiating pain is challenging. MATERIALS AND METHODS: A 74-year-old woman was diagnosed with an osteoporotic vertebral fracture at L3 after slipping and falling. Vertebroplasty was performed for the osteoporotic vertebral fracture at L3. She still complained of right lower extremity radiating pain. UBE was performed to treat acute radiculopathy. RESULTS: Foraminal decompression using UBE was performed at the L3–4 right foraminal area. Her symptoms resolved after surgery. CONCLUSIONS UBE is a useful treatment method for acute radiculopathy after osteoporotic vertebral fracture.

The latent nystagmus seems to be absent when both eyes are open, but on covering one eye, bilateral jerky nystagmus is evoked with the fast phase toward the uncovered eye. The confirmed diagnosis of latent nystagmus can be made with the aid of the Electro-oculography (EOG). On EOG recording, we experienced a case of latent nystagmus in light, which showed the characteristics of infantile nystagmus in darkness.
Darkness ; Diagnosis ; Electrooculography

We performed experimental surgery with Tisseel in rabbit models, to determine whether Tisseeling can replace the classic suture technique. 30 albino rabbits were divided into two groups-one group was Tisseel group(15 rabbits) and the other was Vicryl group(15 rabbits). The superior rectus and inferior rectus were recessed and resected 5mm. Both groups were killed 2,4, and 6 weeks after the surgery respectively and the eyes were enucleated. The tensile strength and pathological findings were compared between the two groups. From this study, we found that Tisseeling had good tensile strength and minimal tissue reaction. Thus Tisseeling is considered to be good method in strabismus surgery.
Fibrin Tissue Adhesive* ; Polyglactin 910 ; Rabbits ; Strabismus ; Suture Techniques ; Tensile Strength