LASIK procedure was introduced recently for the correction of high myopia because of many complications in high-myopic PRK. The characteristic procedures such as hinged flap formation and stromal ablation may increase decentration. We evaluated the amount of decentration relative to the pupil center in 80 eyes of LASIK and 52 eyes of PRK using corneal topography(Corneal Analysis System: EyeSys Laboratories). All treatments were performed using excimer laser, Aesculap-Meditec, MEL 60-94 and corneal light reflex was used for centering. The vacuum ring was used for globe fixation. Mean amount of decentration in LASIK(0.65+/-0.42mm) was statisticallysignificantly increased compared with 0.49+/-0.29mm in PRK(p=0.01). Under -12D of attempted correction, mean amount of decentration in LASIK was 0.54+/-0.38mm which was not significantly different from 0.49+/-0.29mm in PRK(p=0.07). No correlation was observed between the magnitude of decentration and the frequency of loss of best cerrected visual acuity and night glare(p>0.05). The decentration more than 1mm was associated with increased amount of attempted correction (p=0.003) and low preoperative best corrected visual acuity(p=0.01). We considered that the differencee of the magnitude of decentration was attributed to some difference in procedures between LASIK and PRK. When vaccum ring is not used in other reports with other device, the decentration of LASIK was approximately twice as much as in PRK. The use of vacuum ring for the maintenance of globe may be effective in LASIK in which patients self fixation during ablation is more difficult than in PRK because the ablation time is longer and the ablation is performed on the stroma after flap formation.
Humans ; Keratomileusis, Laser In Situ ; Lasers, Excimer ; Myopia ; Pupil ; Reflex ; Vacuum ; Visual Acuity

OBJECTIVES: To investigate the work-relation of the asthma of a 51-year old aircraft maintenance worker and his working environment METHODS: For 2 weeks, the patient went back into his workplace. The pulmonary function test including FEV1 was performed every other day morning in the hospital and peak expiratory flow rate(PEFR) self-monitoring was done 6 times a day. RESULTS: The patient has been worked as aircraft maintenance worker in line maintenance department since 1968. The pulmonary function test(PFT) with bronchodilator confirmed the asthma of the patient. He showed positive response to 2-weeks workplace challenge test. On 3rd day after stopping challenge exposure, FEV 1.0 was 1.04 L(55 % of baseline measurement). The result of PEFR self-monitoring showed progressively deteriorating pattern, baseline PEFR was 6.02 L/min but PEFR on 3rd day after stopping exposure was 2.43 L/min. CONCLUSIONS: The present case could be occupational asthma based on positive results of PEFR monitoring. Further research will be needed to find the specific agent to cause asthma in aircraft maintenance workers exposed to aviation fuel and jet stream exhausts.
Aircraft ; Asthma* ; Asthma, Occupational ; Aviation ; Formaldehyde ; Humans ; Kerosene ; Middle Aged ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Rivers

In order to compare the clinical results of Epikeratoplasty (EPK) with Laser in situ keratomileusis(LASIK) to be corrected of high myopia above -9 diopters, the effect of the procedure on 74 patients following EKP and 63 patients following LASIK who were followed up at least 1 year were analyzed retrospectively. Postoperative mean uncorrected visual acuity was reached 0.56 until 3 month in EKP group and 0.53 until 1 month in LASIK group. LASIK group recovered and stabilized more rapidly than EKP guoup(p<0.01). Also LASIK group had more rapid recovery in keratometryp(p<0.01) and mean refractive error than EKP group(p<0.01). But there was no significant difference between two groups in uncorrected visual acuity(p=0.62), keratometry(p=0.41) and mean refractive error(p=0.32) at postoperative 1 year. LASIK seems to have more rapid and effective visual recovery than EKP for high myopia treatment.
Epikeratophakia* ; Humans ; Keratomileusis, Laser In Situ ; Myopia* ; Refractive Errors ; Retrospective Studies ; Visual Acuity

Purpose: The greatest concern in the androgen replacement therapy (ART) is the possible side effects to the prostate. We evaluated the effects of ART focusing on the prostate specific antigen (PSA). Materials and Methods: From 2003 to 2006, 47 patients 44 to 75 years old (mean age 60.1) received ART. At baseline and after ART, digital rectal examination, serum testosterone and PSA measurement and transrectal ultrasonography were evaluated. Mean follow-up was 7.9 months (range 1 to 41). Patients were classified into two groups based on the initial PSA level, as PSA levels of 2.5 ng/ml or greater (group 1) (n=29) and PSA levels of less than 2.5 ng/ml (group 2) (n=18). Results: ART significantly increased serum testosterone, PSA and free PSA levels. However, prostate volume did not change significantly. When serum PSA was compared, the increase of PSA levels was greater than in high PSA group (group 1) than in group 2, although the ratio between the two groups in PSA increase was 38.3% for group 2 and 18.2% for group 1, respectively. A total of 4 patients (16.7% of group 1 and 3.4% of group 2) with a serum PSA level greater than 4 ng/ml after ART underwent a prostate biopsy but no patients were found to have prostate carcinoma. Conclusions: Rates of PSA elevation (>4 ng/ml) and prostate biopsies were higher in patients with high baseline PSA level (> or =2.5 ng/ml) than in those with PSA level less than 2.5 ng/ml who received ART. However, our findings suggest that an increased risk of prostate cancer was not associated with ART.
Biopsy ; Digital Rectal Examination ; Follow-Up Studies ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Testosterone

We performed 3 cases of epikeratoplasties on two pediatric aphakic patients who were intolerable to contact lenses & spectacles. These epikeratoplasties were performed in accordance with the Kaufman-McDonald Epikeratophakia Method using the commercially available frozen and dried Kerato-Lens (Allergan Medical Optics), the lenticule of which was rehydrated at the time of surgery. The cataract extractions were performed at 3 months after birth on both eyes of the congenital cataract & at 18 months after birth on the traumatic cataract that had developed at 14 months after birth. The epikeratoplasties for the eyes with congenital cataract were performed at 24 months on the right eye and at 16 months after birth on the left eye respectively. The epikeratoplasty for the traumatic cataract eye was performed at 28 months after birth. The 3 grafts have remained successful over the follow-up period of 4 to 6 years. The right eye of congenital cataract case had myopic shift of 3.75D and best corrected visual acuity of 0.2 during 5-year of follow-up period and the other left eye had myopic shift of 4.75 D and best corrected visual acuity of 0.7 during 6-year of follow-up period. The traumatic cataract case had myopic shift of 1.0 D and best corrected visual acuity of 0.05 during 4-year of follow up period. In view of this, it is considered that the epikeratoplasty is of an effective treatment in correcting the refractive error in the pediatirc aphakia patients who intolerable to contact lens and in whom difficulty exists in determining whether an intraocular lens implantation is appropriate or not.
Aphakia* ; Cataract ; Cataract Extraction ; Contact Lenses ; Epikeratophakia* ; Eyeglasses ; Follow-Up Studies* ; Humans ; Lens Implantation, Intraocular ; Parturition ; Refractive Errors ; Transplants ; Visual Acuity

Patients with chronic myeloid leukemia (CML) in lymphoid blast phase can present clinical characteristics resembling Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). It is crucial to distinguish between two diseases since their treatments differ. We present two cases of children who presented with CML lymphoid blast crisis, who were initially difficult to distinguish from Ph+ ALL.

Cluster headache is a severe pain syndrome with a piercing, tearing sensation, nicknamed the suicide headache. It is associated with an autonomic symptom. No effective therapy is available in approximately 4-15% of patients with cluster headache. One of the treatment methods is occipital nerve block. It is conventionally performed with local anaesthetics, and in this case we used the botulinum toxin type A. Botulinum toxin is an effective therapeutic agent for various disorders, and has recently been discovered to be an effective treatment for chronic migraine. The efficacy of Botulinum toxin in headache invokes possible neurogenic effects that may reduce or even prevent sensitization of both the peripheral and central nervous system. Therefore, we describe a case of a 45-year-old male with a cluster headache that could not be controlled with conventional therapy. We performed botulium toxin type A therapy. Cluster headache VAS showed improvement after occipital nerve block using the botulinum toxin A.
Botulinum Toxins ; Botulinum Toxins, Type A ; Central Nervous System ; Cluster Headache ; Headache ; Humans ; Male ; Middle Aged ; Migraine Disorders ; Nerve Block ; Sensation ; Suicide

No abstract available.
Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Paralysis ; Prognosis

No abstract available.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Bacteremia/blood/*diagnosis/microbiology ; C-Reactive Protein/analysis ; Cholecystitis/blood/cerebrospinal fluid/microbiology ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus faecium/drug effects/isolation & purification/metabolism ; Humans ; Male ; Microbial Sensitivity Tests ; Microscopy, Electron, Scanning ; Ochrobactrum/drug effects/isolation & purification/*metabolism ; RNA, Ribosomal, 16S/analysis/genetics/metabolism ; Sequence Analysis, DNA ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Pelvic actinomycosis is a chronic suppurative and granulomatous disease with multiple abscess and draining sinus tracts caused by Actinomyces, a Gram-positive, anaerobic, non-acid-fast bacterium. Pelvic actinomycosis is a rare disease, but it is more common with intrauterine device users than others. The symptoms and signs of pelvic actinomycosis are variable, from asymptomatic to mimicking the symptoms and signs of pelvic mass or acute peritonitis, and sometimes it is difficult to discriminate pelvic malignancy from actinomycosis. Identifying the typical "sulfur granule" with hematoxylin-eosin stain and detecting the actinomycotic colony in Gram stain may suggest the diagnosis. We have experienced a case of pelvic actinomycosis complicated by right tuboovarian abscess in a 39-year-old woman using intrauterine device and report it with brief review of literatures.
Abscess* ; Actinomyces ; Actinomycosis* ; Adult ; Diagnosis ; Female ; Humans ; Intrauterine Devices ; Peritonitis ; Rare Diseases