The authors observed 4 cases of retinitis punctata albescens presented in a family, namely, a sister and 3 brothers of 6 siblings. Typical fundus findings were found in all four patients. Under ordinary illumination, the perripheral visual field was within the limit of normal, but concentrically contracted in 5 to 30 degrees under the reduced illumination.
Humans ; Lighting ; Retinitis* ; Siblings ; Visual Fields

The use of succinylcholine chloride(Anectin(R)) prior to intubation, can cause increased contracture of ocular muscles. Therefore the authors studied the change of the squint angle under general anesthesia using pancronium bromide (Myoblock(R)) in 81 horizontal strabismus patients who had no neurologic disease and mechanical restrictions of eye movement. We used the alternative cover test and Krimsky method to measure the eye position under general anesthesia.
Anesthesia ; Anesthesia, General* ; Contracture ; Eye Movements ; Humans ; Intubation ; Muscles ; Strabismus* ; Succinylcholine

Glaucoma screening is an important means of detecting early cases of glaucoma. It is particularly valuable if targeted either at groups who otherwise do not have access to the health care system or at groups who have the risk factors for glaucoma such as aging, being male and having a medical history of diabetes or vascular diseases. We conducted glaucoma screenings by tonometry and direct ophthalmoscopy in the outpatient department of ophthalmology at Korea University Haewha Hospital and in the homes for the aged that are located in Seoul between Sep. 1987 and Sep. 1989. A total of 282 subjects were screened in the outpatient department and 198 subjects were screened in the homes for the aged. Referral rate was 6.7% and 3.0%, respectively. Groups who have the risk factors showed greater referral rates than groups who have not, but they are not statistically significant(p>0.05).
Aged ; Aging ; Delivery of Health Care ; Glaucoma* ; Homes for the Aged ; Humans ; Korea ; Male ; Manometry ; Mass Screening* ; Ophthalmology ; Ophthalmoscopy ; Outpatients* ; Referral and Consultation ; Risk Factors ; Seoul ; Vascular Diseases

Glaucoma screening is an important means of detecting early cases of glaucoma. It is particularly valuable if targeted either at groups who otherwise do not have access to the health care system or at groups who have the risk factors for glaucoma such as aging, being male and having a medical history of diabetes or vascular diseases. We conducted glaucoma screenings by tonometry and direct ophthalmoscopy in the outpatient department of ophthalmology at Korea University Haewha Hospital and in the homes for the aged that are located in Seoul between Sep. 1987 and Sep. 1989. A total of 282 subjects were screened in the outpatient department and 198 subjects were screened in the homes for the aged. Referral rate was 6.7% and 3.0%, respectively. Groups who have the risk factors showed greater referral rates than groups who have not, but they are not statistically significant(p>0.05).
Aged ; Aging ; Delivery of Health Care ; Glaucoma* ; Homes for the Aged ; Humans ; Korea ; Male ; Manometry ; Mass Screening* ; Ophthalmology ; Ophthalmoscopy ; Outpatients* ; Referral and Consultation ; Risk Factors ; Seoul ; Vascular Diseases

Reducing inflammation after photo refractive keratectomy may decrease postoperative pain and reduce corneal haze intensity. We evaluated the effect of the therapeutic lens(T-lens) and collagen shield on stromal inflammation. Adult New Zealand white rabbits were subjected to excimer laser PRK. Polymorphonuclear leukocytes(PMNs) of ablated corneal stroma were counted 10 hours after surgery with a microscope. The number of PMNs in the central cornea was lower in the T-lens group (29.77 +/- 11.6) and collagen shield group(36.77 +/- 5.9) than in the tarsorrhaphy group (75.33 +/- 14.6). Of all the groups, the eyes which were left unpatched showed the most marked infiltration of PMNs into the wound(226.83 +/- 18.2). The T-lens and collagen shield may reduce postoperative corneal haze intensity better than a pressure patch by suppression of stromal inflammation.
Adult ; Collagen* ; Cornea ; Corneal Stroma ; Humans ; Inflammation* ; Lasers, Excimer ; Pain, Postoperative ; Photorefractive Keratectomy* ; Rabbits

The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows ; (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and inpatient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity. (3) In case of physician's inpatient and adjusted-patient service, nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.
Censuses ; Efficiency* ; Health Planning ; Hospitals, General* ; Hospitals, Teaching ; Humans ; Inpatients ; Korea ; Nursing ; Outpatients ; Physician's Role

PURPOSE: To evaluate the MR findings of embolized cerebral arteriovenous malformations according to various embolic materials. MATERIALS AND METHODS: We performed the endovascular embolization using four different kinds of embolic materials in 33 patients. Embolization related changes in the nidus and surrounding brain parenchyme were analyzed and the results were compared with pre- and postembolization MRI, CT and anglographic findings in all patients. RESULTS: Embolized vessels with N-buthyl-2-cyanoacrylate(NBCA) mixture showed some artifact in CT due to metallic character of tantalum powder or fatty nature of lipiodol. But in MRI, it was represented by fatty signals without artifact. In cases of using polyvinyl alcohol and ethylene vinyl alcohol copolymer(EVAL), there were no specific signal by the embolic material except for the disappearance of flow related signals in feeding arteries and shrinkage of venous ectasis. CONCLUSION: MRI is a valuable imaging modality for analysing the morphology and hemodynamics of cerebral AVMs, especially after embolization of pathologic vessels. Recognition of the signal of embolic agents and thus the thrombosed portion could lead to more precise analysis before surgery or radiosurgery.
Arteries ; Artifacts ; Brain ; Ethiodized Oil ; Hemodynamics ; Humans ; Intracranial Arteriovenous Malformations ; Magnetic Resonance Imaging* ; Polyvinyl Alcohol ; Radiosurgery ; Tantalum

The tendency toward significantly higher mean tensions in myopic eyes compared with eyes with emmetropia and hyperopia has been believed. The patients with high myopia have an unusually high risk of the development of open angle glaucoma. But there is little information in the literature concerning the range of refractive error in relation to intraocular pressure. This study was designed to provide this information in Koreans and to assess the possible prognostic value of the refraction in glaucoma. The results of this study were as follows: 1. The mean IOP of all the patient were 15.29 +/- 2.61mmHg. 2. The mean IOP of emmetropic patients with +2.0 to -2.0 diopters, myopic patients with -2.25 to -4.75 diopters, and high myopic patients with greater than -5.0 diopters were each 14.99 +/- 2.62mmHg, 5.64 +/- 2.38mmHg, 16.21 +/- 2.56mmHg, respectively, suggesting that as the degree of myopia became higher, so did the IOP became greater, as supported by a statistical analysis showing significance(p<0.001). 3. The mean IOP of hyperopic patients with greater than +0.5 diopters, emmetropic patients with +0.25 to -0.25 diopters, and myopic patients with greater than -0.5 diopters were each 14.41 +/- 2.61mmHg, 14.94 +/- 2.57mmHg, and 15.60 +/- 2.56mmHg, respectively, suggesting that as the refractive error showed a myopic status, it was accompanied by an increase of IOP, as was also supported by the statistical analysis showing significance(p<0.001). 4. In correlating sex with IOP, it was found that both sexes showed an increase of IOP as the refractive status changed from hyperopia to myopia, also supported by a significant statistical analysis(p<0.001). 5. In correlating age with IOP, each age group showed a general increase in IOP as the refractive status changed from hyperopia to myopia. As the age increased, however, it was not accompanied by an increase in IOP(p<0.001). 6. As the Cup/Disk ratio increased the mean IOP also tended to increase; this finding, however, showed no significance in the statistical analysis(p>0.01).
Emmetropia ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hyperopia ; Intraocular Pressure* ; Myopia ; Refractive Errors

PURPOSE: The most common problem in pterygium operation is recurrence ; recurrence rate is higher in recurrent pterygium than primary one. Effects on recurrence rate of combination therapy of intraoperative mitomycin C soaking method with postoperative beta-irradiation (strontium 90) along with its complications were investigated in primary and recurrent pterygium. Recurrence rate of the combination therapy was compared with that of the pterygium excision, postoperative beta-irradiation, and intraoperative mitomycin C soaking, respectively. METHODS: Fifty-three patients (fifty-nine eyes) with primary pterygium and twenty-three patients (twenty-four eyes) with recurrent pterygium received surgery. Mitomycin C in a concentration of 0.2 mg/ml soaked in a 2 x 2 mm Weckcel sponge was applied on the bare sclera intraoperatively after pterygium excision. Forty-five seconds of beta irradiation was done on the first and sixth postoperative days. RESULTS: During the mean follow-up period of 15 months, recurrence rate was 3.4% (2 eyes) in primary pterygium and 4.2% (1 eye) in recurrent one, respectively. Compared to the recurrence rate of 22.5% in primary and 35.0% in recurrent pterygium, respectively when removal of pterygium alone was performed and 14.3% in primary and 20.0% in recurrent, respectively with postoperative beta-irradiation and 12.8% in primary and 15.0% in recurrent, respectively with intraoperative mitomycin C soaking. These differences were statistically significant (P<0.05). One eye showed symblepharon in recurrent pterygium with combination therapy. CONCLUSION: Combination therapy of intraoperative administration of mitomycin C and postoperative beta irradiation (strontium 90) is considered an effective and safe adjunct for prevention of the recurrence of recurrent pterygium as well as primary.
Follow-Up Studies ; Humans ; Mitomycin* ; Porifera ; Pterygium* ; Recurrence* ; Sclera

Cancer, including gastric cancer, occurs predominantly in older patients. Although there is no single internationally accepted standard chemotherapy regimen for unresectable or metastatic gastric cancer (MGC), doublet combination chemotherapy using fluoropyrimidine and platinum is regarded as the reference treatment. However, most of the clinical trials that were based on the current treatment guidelines were performed in patients < 70 years of age with good performance status (PS). Therefore, the clinical application of these guidelines to elderly individuals is limited. The available data suggest that older patients with good PS are able to tolerate the same chemotherapy regimens as younger patients with MGC, and that they achieve a similar efficacy. In contrast, some studies showed that the same efficacy was achieved at the expense of increased toxicity in older patients, emphasizing the importance of patient selection. Many studies have actively investigated elderly patients with MGC, including randomized phase 3 studies comparing fluoropyrimidine and platinum doublets with fluoropyrimidine alone. Although an advanced age alone should not preclude the use of effective chemotherapy in MGC, more data regarding age-specific clinical trials are needed to guide optimal treatment in elderly patients.
Aged* ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Patient Selection ; Platinum ; Stomach Neoplasms*