No abstract available.

Anophthalmos associated with optic nerve aplasia in the contralateral eye is extremely rare. To our knowledge, this is the first case report in Korea. A 3-day-old girl had anophthalmos in the right eye and optic nerve aplasia in the left. Except for the ocular findings, she was relatively healthy. Her sibling had also anophthalmos and expired 4 days after birth. But we could not take her siblings history in detail. We report this case with a brief review of literatures.
Anophthalmos* ; Female ; Humans ; Korea ; Optic Nerve* ; Parturition ; Siblings

PURPOSE: Occasionally, in nonglaucomatous optic atrophy, the optic nerve head may appear to be cupped to such a degree that normal tension glaucoma is suspected. We report such a case of visual field defects from schizencephaly in a patient initially suspected to have normal tension glaucoma, using ophthalmoscopic examination only. METHODS: An 18-year-old male patient visited our clinic because of bilateral visual disturbance which had developed 5 years previously. Ophthalmoscopic examination revealed an increased cup to disc ratio, peripapillary atrophy, and loss of temporal neuroretinal rim tissue. The authors suspected normal tension glaucoma in both eyes. However, because the patient was too young and the visual field test revealed atypical field defects of the left superior quadrants in both eyes, we performed MRI. The results showed right schizencephaly with an absence of septum pellucidum. In order to rule out hypothalamic- pituitary dysfunction which can coexist with the absence of septum pellucidum, we conducted combined pituitary function test (cocktail test) which revealed normal results. RESULTS: The patient was initially suspected to have normal tension glaucoma on ophthalmoscopic examination alone. However, because the patient was too young and showed nonglaucomatous visual field defects, MRI was performed and revealed right schizencephaly.
Adolescent ; Atrophy ; Humans ; Low Tension Glaucoma* ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development* ; Optic Atrophy ; Optic Disk ; Pituitary Function Tests ; Septum Pellucidum ; Visual Field Tests ; Visual Fields

The Asian face is generally shorter and wider than western face whose face is dolichocephaly. Therefore the reduction malarplasty is one of the common aesthetic surgery performed in Asians. As the number of cases of aesthetic reduction malarplasty including osteotomy technique of zygoma body increase, the complications related to the osteotomy also increase. Among the various complications, if the ostotomized zygoma body does not heal or reunite, it may cause a serious problem not only to the surgeon but also to the patients. From June 2002 to July 2003, the authors experienced 5 patients whose zygoma body did not reunite after reducing their malar prominence at other clinic. Their major complains were subjective discomfort at the operated site, depression on malar eminence, abnormal click sound on mouth opening, etc. None of them had any evidence of rigid fixation on their osteotomy of the zygoma body. The Rib bone was harvested and grafted to the bone gap due to the nonunion of zygoma body. All grafted bones were rigidly fixed and survived. In conclusion, bone to bone contact without soft tissue impingement should be preserved for the bone healing after zygoma body osteotomy. Therefore the rigid fixation method of osteotomy is the fundamental element during the operation. The rib bone interpositional graft can be one of the solution methods in the unfortunate nonunion cases.
Asian Continental Ancestry Group ; Depression ; Humans ; Mouth ; Osteotomy ; Ribs ; Transplants ; Zygoma*

PURPOSE: This study was designed to investigate the effects of information sharing between students on results of clinical performance examination (CPX). METHODS: 143 third-year students, who completed their core clinical clerkship, were randomly assigned to one day of a 3-day, 6 station CPX. Station checklists, scored by the SP(s), consisted of history taking, physical examination, information sharing, clinical courtesy and patient-physician interaction. We compared the CPX station scores, CPX domain scores, self assessment scores and GPA of the three groups tested on different days with ANOVA, and analyzed the differences in CPX scores, after controlling for GPA, with ANCOVA. The correlations among the CPX total and domain scores, self assessment and the GPA of the 3rd year students were calculated. Data regarding information sharing between students and self-assessment were obtained through student questionnaires. RESULTS: CPX total scores, self assessment scores and GPA of 3rd year students from day-2 were significantly higher than scores from day-1 or day-3. Checklist analysis showed that PE, CC and PPI scores were significantly higher on day-2, but Hx and IS scores were not significantly different. Results from questionnaires showed that 43% of students shared evaluation information. And CPX total scores had little correlation with self assessment scores. GPA of 3rd year students showed a similar pattern with the CPX totalscore. CONCLUSION: There is information sharing occurring between students during clinical performance examinations. Although there are significant differences in CPXscores for the treatment group, it seemed that CPX scores are not affected by information sharing between students. Reliability of information sharing from other students is low. The generalization of this study should be interpreted carefully.
Checklist ; Clinical Clerkship ; Generalization (Psychology) ; Humans ; Information Dissemination* ; Physical Examination ; Self-Assessment ; Surveys and Questionnaires

Purpose: To report a case of multiple retinal capillary hemangioma associated with neurofibromatosis type 1 and resulting neovascularglaucoma.Case summary: A 13-year-old boy was admitted with complaint of visual disturbance and dull pain in his left eye which had beguntwo weeks prior. Lisch nodules were observed in his left iris and corneal opacity with neovascularization of the iris and anglewere detected in the same eye. Multiple retinal capillary hemangiomas with increased tortuosity and congestion of feeding retinalvessels were observed on the upper equator of the left retina; in addition, vitreous hemorrhage was observed. There were noother abnormalities except iris mammillations in the right eye. Numerous café au lait macules were observed on the patient’s entirebody. He also exhibited axillary freckling. On brain magnetic resonance imaging, T2-weighted signal intensity was increasedin the basal ganglia, left thalamus, and cerebellar white matter; however, no vessel abnormalities were observed on magneticresonance angiography. High intraocular pressure (IOP) persisted despite the use of IOP lowering agents and IOP was normalizedafter trabeculectomy with mitomycin C administration. Conclusions This case shows that multiple retinal capillary hemangiomas can be accompanied by neurofibromatosis type 1,which may result in neovascular glaucoma.

Purpose: To evaluate the intraocular pressure (IOP) reduction, success rate and prognostic factors after trabecular micro-bypassstent implantation in patients with open-angle glaucoma. Methods: We retrospectively reviewed 33 eyes of 33 patients with open-angle glaucoma who were followed-up for more than6 months after trabecular micro-bypass stent implantation. The success of surgery was defined as an IOP ≤ 21 mmHg and anIOP reduction ≥ 20% from baseline, regardless of whether glaucoma medication was used. Results: During the follow-up at 6 months after trabecular micro-bypass stent implantation, the IOP was significantly decreasedfrom 23.70 ± 6.26 mmHg before surgery to 18.03 ± 4.64 mmHg after 6 months, and the glaucoma medication was significantlydecreased from 3.73 ± 0.67 before surgery to 3.43 ± 0.67 after 6 months (p < 0.001 and p = 0.027, respectively). The successrate at 6 months was 33.7 ± 5.5% in patients with only trabecular micro-bypass stent implantation. Using multiple regressionanalyses of the risk factors, age was associated with success rate (odds ratio, 1.076; 95% confidence interval, 0.996-1.164;p = 0.045). Conclusions In patients in the Republic of Korea, trabecular micro-bypass stent implantation was an effective surgery for IOPreduction, and showed a better surgical success rate in younger patients.

In this study, we developed MobileNurseTM; a prototype of mobile nursing information system using PDA. MobileNurseTM is designed to communicate with hospital information system(HIS) via mobile support station(MSS) which interchanges and stores clinical data. MobileNurseTM consists of 3 components. The first component is medical order checking module. It enables nurses to retrieve patients' information such as physicians' orders and test results at anywhere or anytime. The second component is nursing recording module which helps nurses to record the results of their practices at bedside. On the autosynchronization of MSS and PDA, the data in PDA and MSS can be interchanged and updated respectively. The last component is nursing unit care planing module. It is helpful for retrieving the nursing care plans of patients that are expected to be done, such as patients' discharge, consultation, or transfer. With use of PDA in clinical environment, nurses can spend more time on caring for patients by reducing time-consuming, redundant paperwork. It is promising that this 'point-of-care system enables nurses to improve the quality of nursing care.
Humans ; Information Systems* ; Nursing Care ; Nursing Records ; Nursing* ; Patient Care Planning

Purpose: We report ocular manifestations in two patients with 7q microdeletion. Case summary: (Case 1) A 62-day-old male infant was admitted to the ophthalmology outpatient department for ocular examination after being diagnosed with microdeletion of chromosome seven (7q36.2q36.3 deletion) in DNA microarray comparative genomic hybridization (DNA microarray CGH) and fluorescence in situ hybridization (FISH) tests. Fundus examination showed optic disc hypoplasia in both eyes and retinopathy of prematurity, accompanied by retinal hemorrhage in his right eye. Around the age of 24 months, the patient was diagnosed with intermittent exotropia with anisometropia and was prescribed spectacles. (Case 2) A 3-year-old male infant was referred to the ophthalmology clinic to evaluate poor fixation, which was found during rehabilitation therapy for cerebral palsy and developmental delay. Fundus examination showed an increased cup/disc ratio bilaterally. A flash visual evoked potential test indicated a decrease in amplitude in his right eye. Intermittent exotropia of forty prism diopters was observed. DNA microarray CGH and FISH tests performed at another hospital revealed microdeletion of chromosome seven (7q35 microdeletion) and CNTNAP2 gene loss. Conclusions When genetic anomalies associated with ocular development are identified, it is necessary to detect the ophthalmic abnormalities early and provide the appropriate treatment to allow for the development of normal visual function.

Purpose: We report ocular manifestations in two patients with 7q microdeletion. Case summary: (Case 1) A 62-day-old male infant was admitted to the ophthalmology outpatient department for ocular examination after being diagnosed with microdeletion of chromosome seven (7q36.2q36.3 deletion) in DNA microarray comparative genomic hybridization (DNA microarray CGH) and fluorescence in situ hybridization (FISH) tests. Fundus examination showed optic disc hypoplasia in both eyes and retinopathy of prematurity, accompanied by retinal hemorrhage in his right eye. Around the age of 24 months, the patient was diagnosed with intermittent exotropia with anisometropia and was prescribed spectacles. (Case 2) A 3-year-old male infant was referred to the ophthalmology clinic to evaluate poor fixation, which was found during rehabilitation therapy for cerebral palsy and developmental delay. Fundus examination showed an increased cup/disc ratio bilaterally. A flash visual evoked potential test indicated a decrease in amplitude in his right eye. Intermittent exotropia of forty prism diopters was observed. DNA microarray CGH and FISH tests performed at another hospital revealed microdeletion of chromosome seven (7q35 microdeletion) and CNTNAP2 gene loss. Conclusions When genetic anomalies associated with ocular development are identified, it is necessary to detect the ophthalmic abnormalities early and provide the appropriate treatment to allow for the development of normal visual function.