PURPOSE: To report a case of IgG4-related sclerosing disease involving the eyelid in an idiopathic sclerosing myositis patient. CASE SUMMARY: A 51-year-old woman presented with swelling, redness, and tenderness of the left lower eyelid of 1 month duration had taken an immunosuppressant for idiopathic sclerosing myositis. Eye movements showed limitation all directions but there was no exophthalmos. A palpable mass was noted in the left lower eyelid. The left extraocular muscles were hypertrophied but the lacrimal gland was normal on orbital magnetic resonance imaging. IgG4-related sclerosing disease was confirmed by immunostained biopsy from the left lower eyelid, showing infiltration of IgG4-positive lymphoplasmacytic cells. The patient was given oral steroids and an immunosuppressant and the symptoms did not recur for at least 7 months. CONCLUSIONS: IgG4-related sclerosing disease involving ocular adnexa usually consists of bilateral lacrimal gland involvement. Additionally, the orbital soft tissue involvement without dacryoadenitis is rare. The authors of the present study report a case of IgG4-related sclerosing disease involving the left lower eyelid in an idiopathic sclerosing myositis patient and should be considered in the differential diagnosis of eyelid masses.
Biopsy ; Dacryocystitis ; Diagnosis, Differential ; Exophthalmos ; Eye Movements ; Eyelids* ; Female ; Humans ; Lacrimal Apparatus ; Magnetic Resonance Imaging ; Middle Aged ; Muscles ; Myositis* ; Orbit ; Steroids

PURPOSE: This study investigates both the current situation and future trends in the field of refractive surgery in Korea. METHODS: Members of the Korean Society of Cataract and Refractive Surgery (KSCRS) have been annually surveyed regarding cataract and refractive surgery since 1995. The 2004 annual survey, which consisted of 58 multiple-choice questions, was mailed in May 2004 to 322 KSCRS members; fifty-four (16.8%) members responded. Data from the 2004 survey was compared with that of previous annual surveys and similar studies from the USA. RESULTS: The respondents indicated that patients in their forties accounted for the highest percentage (57%) of subjects, and LASIK accounted for the highest percentage (82%) of refractive surgeries. Degeneration of corrected vision, night halo, and glare accounted for a high proportion of the complications arising after refractive surgery. LASIK was the preferred method for treating myopia less than -12 diopters, while phakic IOL was preferred for myopia more than -12 diopters. Lastly, more respondents indicated that they had experienced legal problems associated with PRK or LASIK than the previous year. CONCLUSIONS: LASIK remains the refractive surgery procedure of choice, although wavefront-guided ablation is gaining in popularity. Approximately half of the respondents indicated they used MMC in their refractive surgeries.
Cataract ; Surveys and Questionnaires ; Glare ; Humans ; Keratomileusis, Laser In Situ ; Korea* ; Myopia ; Night Vision ; Postal Service ; Refractive Surgical Procedures*

BACKGROUND AND OBJECTIVE: TDI is known to be the most prevalent cause of occupational asthma ( OA ) in Korea. However, the pathogenesis of TDI - induced occupational asthma still remains to be further clarified. So, we evaluated clinical significance of serum specific IgG and IgE antibodies to TDI - HSA conjugate in TDI - induced occupational asthma. Subjects and METHODS: Serum specific IgG and IgE antibodies to TDI - HSA conjugate were measured by enzyme linked immunosorbent assay. Serum was collected from 50 TDI- induced OA patients ( classified as group I ), and was compared with that from 13 asthmatic subjects with negative TDI - bronchoprovocation test ( BPT, group II ), allergic asthmatics ( group III ), and unexposed healthy controls ( group IV ). RESULTS: The prevalence of specific IgG was significantly higher in group I than in group II (p = 0.01) or group III (p <0.01). No significant difference was noted between group II and group III (p> 0.05). However, the prevalence of specific IgE was not different between group I and group II (p> 0.05 ) or group II and group III( p> 0.05 ). There was no significant difference in prevalence of specific IgG according to the asthmatic response during TDI bronchoprovocation test ( p> 0.05 ). No statistical significance was noted between specific IgG and IgE antibodies in group I subjects ( p> 0.05 ). CONCLUSION: These findings demonstrate that presence of specific IgG to TDI - HSA conjugate is closely related to TDI - BPT results and it may contribute to the development of TDI - induced asthma.
Antibodies* ; Asthma ; Asthma, Occupational* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunoglobulin E* ; Immunoglobulin G* ; Korea ; Prevalence ; Serum Albumin* ; Toluene 2,4-Diisocyanate* ; Toluene*

To report the association of a unilateral serous macular detachment with severe postoperative pain. A 71-year-old woman presented with a sudden decrease in vision in the right eye, seven days after a total knee replacement arthroplasty. The patient's history was unremarkable except for a severe pain greater than the visual analog scale of 8 points for about 2 days after surgery. Retinal examination showed a well differentiated serous detachment that was about 3.5 disc diameter in size and located in the macular area. Fluorecein angiography and indocyanine green angiography showed delayed perfusion of the choriocapillaris without leakage points in the early phase and persistent hypofluorescence with pooling of dye in the subretinal space in the late phase. There was a spontaneous resolution of the serous detachment and the choroidal changes with residual pigment epithelial changes. Severe postoperative pain may influence the sympathetic activity and introduce an ischemic injury with a focal, choroidal vascular compromise and secondary dysfunction of overlying RPE cells in select patients.
Aged ; *Arthroplasty, Replacement, Knee ; Choroid/*blood supply ; Coloring Agents/diagnostic use ; Female ; Fluorescein Angiography ; Humans ; Indocyanine Green/diagnostic use ; Ischemia/diagnosis/*etiology ; Pain Measurement ; *Pain, Postoperative ; Retinal Detachment/diagnosis/*etiology ; Serum ; Vision Disorders/etiology

PURPOSE: To describe the early experience of analyzing variations and time trends in bladder volume of the rectal cancer patients who received bladder ultrasound scan. MATERIALS AND METHODS: We identified 20 consecutive rectal cancer patients who received whole pelvic radiotherapy (RT) and bladder ultrasound scan between February and April 2012. Before simulation and during the entire course of treatment, patients were scanned with portable automated ultrasonic bladder scanner, 5 times consecutively, and the median value was reported. Then a radiation oncologist contoured the bladder inner wall shown on simulation computed tomography (CT) and calculated its volume. RESULTS: Before simulation, the median bladder volume measured using simulation CT and bladder ultrasound scan was 427 mL (range, 74 to 1,172 mL) and 417 mL (range, 147 to 1,245 mL), respectively. There was strong linear correlation (R = 0.93, p < 0.001) between the two results. During the course of treatment, there were wide variations in the bladder volume and every time, measurements were below the baseline with statistical significance (12/16). At 6 weeks after RT, the median volume was reduced by 59.3% to 175 mL. Compared to the baseline, bladder volume was reduced by 38% or 161 mL on average every week for 6 weeks. CONCLUSION: To our knowledge, this study is the first to prove that there are bladder volume variations and a reduction in bladder volume in rectal cancer patients. Moreover, our results will serve as the basis for implementation of bladder training to patients receiving RT with full bladder.
Humans ; Observer Variation ; Rectal Neoplasms ; Ultrasonics ; Urinary Bladder

PURPOSE: BioSorbFX(R)(BIONX Implant Inc.) and Macropore(R)(Medtronics Inc.) are mesh-type resorbable copolymer plate. This report presents a new model necessary for orbital wall reconstruction, accoding to the operative outcomes of orbital fracture with its use. METHODS: A follow-up on 11 patients was performed to ascertain the operative effects of the mesh-type resorbable material for 6 months. RESULTS: The patients were 7 males and 4 females. The patients' average age was 29.7 years and the mean follow-up period was 8.1 months. The most common site of fracture was inferior wall. In these cases, simultaneous fracture of the medial wall and floor was frequently observed. One case showed limitation of ocular movement, diplopias and enophthalmos simultaneously; 3 cases, enophthalmos and diplopia; 5 cases showed limitation of ocular movement and diplopia; and 2 cases, considerable possibility or the presence of enophthalmos due to extended fracture size. The cases improved remarkably after being operated and none were observed to have worsened. Moreover, serious complications, such as visual loss, the infection of implants, dislocation, exposure, etc., were not observed. CONCLUSIONS: Altogether, it is considered that the mesh-type resorbable copolymer plate may be safely used in orbital wall reconstruction without conspicuous complication.
Diplopia ; Dislocations ; Enophthalmos ; Female ; Follow-Up Studies ; Humans ; Male ; Orbit* ; Orbital Fractures

Holt-Oram Syndrome is an autosomal dominant disorder characterized by the association of upper-limb abnormalities and congenital heart disease. A woman with no family history of genetic disease underwent antenatal sonography at 27 weeks' menstrual age to screen for fetal anomalies. Ultrasonography revealed abnormalities in the upper limbs. The limb abnormalities included abscence of bilateral thumbs and radius: the left humus was short. Pregnancy termination was performed. The postnatal chromosomal analysis revealed a normal 46XX karyotype and the autopsy finding confirmed the Holt-Oram syndrome. We report a case of Holt-Oram Syndrome in fetus with unaffected parents with brief of the literatures.
Autopsy ; Extremities ; Female ; Fetus ; Heart Defects, Congenital ; Humans ; Karyotype ; Parents* ; Pregnancy ; Radius ; Soil ; Thumb ; Ultrasonography* ; Upper Extremity

PURPOSE: The authors experienced a case of orbital emphysema causing eye movement disorder following conjunctival tear without any orbital wall fractures after exposure to compressed air. CASE SUMMARY: A 28-year-old man's left periorbital area was injured while working with compressed air. There was marked lid swelling on the left side with palpable crepitus. The patient had an exotropia and hypertropia of the left eye. In addition, the extraocular movement of the left eye was restricted on upgaze without nausea and vomiting. On slit-lamp examination, conjunctival partial laceration and subconjunctival air bubbles adjacent to the conjunctival laceration could be seen. Orbital computed tomography showed air in the periorbital and retrobulbar region of the left eye and no evidence of orbital fracture. On examination 4 days after the primary repair of the conjunctival laceration, the patient completely recovered without any complication. CONCLUSIONS: Orbital emphysema following a conjunctival laceration caused by compressed air without any orbital wall fractures can cause restriction of eye movement.
Adult ; Compressed Air* ; Emphysema* ; Exotropia ; Eye Movements* ; Humans ; Lacerations ; Nausea ; Ocular Motility Disorders ; Orbit* ; Orbital Fractures* ; Strabismus ; Vomiting

PURPOSE: To evaluate the effects of conjugated hormone replacement therapy (HRT) on dry eye syndrome in postmenopausal women. METHODS: Thirty-six healthy postmenopausal women (72 eyes) were included in this three-month prospective study. Schirmer test, tear film break-up time (BUT), fluorescein staining score and symptom score were performed on all patients at the time of enrollment, one month and three months after initiation of HRT. All patients received HRT consisting of conjugated estrogen and progesterone taken orally in a continuous combined regimen. RESULTS: Symptom score significantly decreased from 2.10+/-0.79 before HRT to 1.32+/-0.84 after one month and to 0.88+/-0.67 after three months (p<0.001). In addition, tear film BUT measurements significantly increased from 6.04+/-2.54 seconds to 7.99+/-2.43 seconds after one month and to 8.93+/-2.20 after three months (p<0.001). The fluorescein staining score was 0.94+/-0.71 before HRT and decreased to 0.42+/-0.60 after one month and to 0.22+/-0.42 after three months (p<0.001). CONCLUSIONS: Hormone replacement therapy consisting of conjugated estrogen and progesterone significantly improved the symptoms and signs of dry eye syndrome in postmenopausal women.
Dry Eye Syndromes ; Estrogens ; Female ; Fluorescein ; Hormone Replacement Therapy ; Humans ; Progesterone ; Prospective Studies ; Tears

PURPOSE: We analyzed the difference in values between noncycloplegic and cycloplegic autorefraction and refraction, as measured by ophthalmologist, in children according to age. METHODS: We classified the 84 children (153 eyes) whose best corrected visual acuity was better than 0.6 into four groups according to age. The first age group ranged from 29 to 57 months (36 eyes); the second age group ranged from 58 to 75 months (47 eyes); the third age group ranged from 76 to 95 months (36 eyes); and the fourth age group ranged from 96 to 121 months (34 eyes). The children were examined with an autorefractometer (Canon Auto Ref RK-2) and a retinoscope before and after cycloplegia. RESULTS: The children in all age groups tend to show more myopia in autorefraction than refraction regardless of cycloplegia. Also, differences in spherical component and spherical equivalents in noncycloplegic autorefraction and cycloplegic refraction were regarded as significant statistically (P<0.05) in all age groups. However, in all groups, none of the refractive values in cycloplegic autorefraction and refraction were statistically significant. CONCLUSION: Refraction measurement should be recommended for cycloplegic refraction in children. It is suggested that cycloplegic autorefraction could be useful for the refraction partially.
Child* ; Humans ; Myopia ; Retinoscopes ; Visual Acuity