PURPOSE: To report the result of Fresnel prism application and adaptation for visual field relocation and functional vision improvement in homonymous hemianopsia patients. METHODS: Fifteen homonymous hemianopsia patients were prescribed Fresnel prism. To expand the visual field, Fresnel prism was placed base-out toward the defective field and patients were given an adaptation period of 1 month. The effects of the prism on field expansion was evaluated using Goldmann perimetry. In addition, the NEI-VFQ25 questionnaire was utilized asking patients regarding their subjective functional vision and satisfaction in daily life before and after using the Fresnel prism. RESULTS: After 1 month of Fresnel prism prescription, 53% of patients showed objective visual field expansion to the defective field of 12.5 degrees on average. Monocular or macular splitting hemianopsia patients showed more visual field expansion than binocular macular sparing hemianopsia patients. The NEI-VFQ25 score increased significantly and abnormal head position decreased or disappeared after 1 month of using the prism. However, 47% of patients failed to adapt to the prism. CONCLUSIONS: Using Fresnel prism in homonymous hemianopsia patients effectively expands the visual field, corrects abnormal head position, and improves functional vision. However, to improve the success rate, for certain patients the proper choice of prism application method, prism diopters, and constant management are necessary.
Head ; Hemianopsia* ; Humans ; Prescriptions ; Telescopes ; Visual Field Tests ; Visual Fields*

Secondary eyeball injury can be caused by head injury as well as direct injury of the eyeball or the orbit. Authors of this report have researched on 117 patients who were applied for ophthalmic examination which in care of the neurosurgical department and have researched frequency of secondary eyeball injury, association between the eyeball injury and the head injury, and favourable frequency of the eyeball injury which were developed without direct injury of the eyeball. There were 21 eyes(9.0%) with external ocular abnormality in 18 patients which included lagophthalmos, ptosis, paralytic strabismus, and there were 14 eyes(6.0 %) with posterior segment abnormality which were vitreoretinal hemorrhage, option. injury and papilledema in 11 patients. In association between the head injury and the eyeball injury, there were many external paralytic injury in basal skull injury and many posterior segment injury in cerebral parenchymal injury. After their injury, follow-up was executed in 3 month interval for 12 month. 15 eyes with external ocular abnormality and 8 eyes with posterior segment abnormality showed favourable progression. Posterior segment abnormality improved statistically significant at 3 month after injury(p<0.05). Secondary ophthalmic injury can be caused by various head injuries. Based on periodic observation, external ocular abnormality improved frequently at more than 9 months after injury. In cases of posterior segment abnormality, there was statistically significant improvement at 3 month after injury(p<0.05). Thus careful observation and treatment should be made in its early stage.
Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hemorrhage ; Humans ; Orbit ; Papilledema ; Skull ; Strabismus

Phthisis bulbi, resulting from repeated ocular inflammation and infection or ocular trauma, causes various degeneration of ocular tissue as well as changes in ocular external shape. It shows the impression of scleral thickening with calcification of ocular tissue and an unusual ossification as well. Having observed 31-year-old patients of phthisis bulbi and band keratopathy caused by repeated operation after ocular trauma years ago, we extracted the tan brown colored shell-like firm tissue in posterior segment and report sclerotic impression of some of ocular tissue and histopathologic finding of the typical ossificationof ocular tissue during the course evisceration.
Adult ; Humans ; Inflammation ; Triacetoneamine-N-Oxyl

PURPOSE: To confirm the utility of cuff palpation for the verification of the correct endotracheal tube position. METHODS: One hundred and one intubated patients were selected randomly every three days among the 344 intubated patients in the emergency room of a tertiary care hospital between July 2006 and March 2007. After endotracheal intubation was confirmed, we recorded the probability of successful cuff palpation. We also measured the patient's weight, height and neck length; the distance from ETT tip to the incisors, and distance from ETT tip to the carina of the patients. Sedatives or muscle relaxants that used were used were noted as well. RESULTS: In the cuff palpated group (n=61), 40 patients' had the ETT tip at 3~5cm from the carina while in the nonpalpated group (n=40), 35 patients had the ETT tip placed at less than 3 cm or more than 5 cm from the carina (p value <0.001). The cuffs of the ETTs inserted in patients whose neck lengths were below 10 cm were less palpable than in patients whose neck lengths were more than 10 cm.(p=0.004) There was no relation between cuff palpability and height, BMI and use of muscle relaxant or sedatives. In addition, 9 of 10 cases whose cuffs were non-palpable, which were randomly chosen among the non-palpated group (n=40) with incorrectly positioned cuff became palpable after the repositioning of the ETT. CONCLUSION: We concluded that cuff palpation is a simple and reproducible way to verify the correct depth of endotracheal tubes.
Emergencies ; Humans ; Hypnotics and Sedatives ; Incisor ; Intubation, Intratracheal ; Muscles ; Neck ; Palpation ; Tertiary Healthcare

Cardiac rupture is a rare but fatal complication among patients undergoing cardiopulmonary resuscitation (CPR). Myocardial rupture can manifest as a discontinuity in the myocardial wall, communication between the ventricle or atrium and the pericardium, hemopericardium, or active extravasation of contrast into the pericardium. It can also occur alongside pericardial rupture or hemothorax. Diagnosing myocardial rupture via imaging is uncommon due to its clinical urgency and high mortality rate. We present a rare case of a 50-yearold man who developed a right atrial rupture, as seen on CT angiography, following CPR and venoarterial extracorporeal membrane oxygenation (VA-ECMO) for sudden cardiac arrest.

Cardiac rupture is a rare but fatal complication among patients undergoing cardiopulmonary resuscitation (CPR). Myocardial rupture can manifest as a discontinuity in the myocardial wall, communication between the ventricle or atrium and the pericardium, hemopericardium, or active extravasation of contrast into the pericardium. It can also occur alongside pericardial rupture or hemothorax. Diagnosing myocardial rupture via imaging is uncommon due to its clinical urgency and high mortality rate. We present a rare case of a 50-yearold man who developed a right atrial rupture, as seen on CT angiography, following CPR and venoarterial extracorporeal membrane oxygenation (VA-ECMO) for sudden cardiac arrest.

Cardiac rupture is a rare but fatal complication among patients undergoing cardiopulmonary resuscitation (CPR). Myocardial rupture can manifest as a discontinuity in the myocardial wall, communication between the ventricle or atrium and the pericardium, hemopericardium, or active extravasation of contrast into the pericardium. It can also occur alongside pericardial rupture or hemothorax. Diagnosing myocardial rupture via imaging is uncommon due to its clinical urgency and high mortality rate. We present a rare case of a 50-yearold man who developed a right atrial rupture, as seen on CT angiography, following CPR and venoarterial extracorporeal membrane oxygenation (VA-ECMO) for sudden cardiac arrest.

The horseshoe kidney is one of the most common type of fusion anomaly and a non fatal anomaly of renal development. It is characterized by fusion of either the upper or the lower poles of the kidneys. We report a case of horseshoe kidney with renal stone and hydronephrosis in a 24 year old man and the literatures are reviewed.
Humans ; Hydronephrosis* ; Kidney* ; Young Adult

No Abstract available.
Academic Medical Centers* ; Infection Control*

No abstract available.
Animals ; Antigen-Antibody Complex* ; Bacteria* ; Mice*