Computerized image analysis of simultaneous stereoscopic videographic images has been used to study structural parameters of the optic nerv head. Although these instruments are of great interest as research tools, the current economic climate and the great cost make their utility for the average ophthalmologist unlikely. Seventy unselected optic nerve heads of 44 normal subjects(22 men, 22 women, mean age 45.8) were evaluated by magnification-corrected morphometry of optic disc photographs. The radius and angle were measured by a computer graphic program(Adobe Photoshop(TM)). The mean disc area(2.48 +/- 0.46 mm2), the mean cup area(0.59 +/- 0.25mm2), and the mean rim area(1.90 +/- 0.35mm2) were evaluated. The coefficients of variation of intraobserver determination were as follows: vertical disc diameter 0.92%. horizontal disc diameter 1.40%, vertical cup diameter 3.64, horizontal cup diameter 3.14%, disc area 1.33%, cup area 3.28%, and neuroretinal rim area 1.82%. The median interobserver percentage differences were as follows: vertical disc diameter 0.80%, horizontal disc diameter 0.83%. vertical cup diameter 3.75%, horizontal cup diameter 1.59%, disc area 1.57%. cup area 3.03%, and neuroretinal rim area 2.53%. While it is similar to the method of measuring the manual planimetry. the measuring of optic nerve head can be done directly on the monitor of personal computer by scanning the photograph. This method of measurement can be used clinically since it has a high reproducibility.
Climate ; Computer Graphics* ; Female ; Head ; Humans ; Male ; Microcomputers ; Optic Disk ; Radius

Mitomycin C may change the time course for effective releasable scleral-flap suture removal. The authors evaluated the safety and efficacy of releasable scleral-flap sutures in 83 eyes of 61 patients undergoing mitomycin C(MMC) filtering operation. Of these eyes, 38 underwent scleral-flap suture removal and these eyes were divided into three groups according to the timing of suture removal(Group 1: within 3 days after trabeculectomy, Group 2: from 4 to 14 days, Group 3: from 15 to 30 days). The pre-release IOP was 26.0 +/- 7.6, 23.8 +/- 8.5 and 18.4 +/- 4.6 mmHg, respectively. Immediately after releasable suture removal, the percent IOP reduction was 46 +/- 18, 46 +/- 17 and 30 +/- 20%, respectively. The percent IOP reduction after releasable suture removal was greater in the group 1 and group 2 compared with group 3(p<0.05). Mean follow-up period was 9.0 +/- 5.3, 14.4 +/- 7.2 and 12.6 +/- 7.6 months, respectively. Twelve eyes(80%), 12 eyes(100%), 10 eyes(91%) achieved successful control of final IOP of 21 mmHg or less with or without topical antiglaucoma medications, respectively. After releasable suture removal, the shallow anterior chamber was noted in 1 eye, 2 eyes and 1 eye, respectively. One eye developed a hypotony in the group 3. Adjunctive MMC therapy extended the period that releasable scleral-flap suture removal is effective beyond first 2 postoperative weeks. Also these results indicate that this method is efficient for IOP reduction and relatively safe.
Anterior Chamber ; Follow-Up Studies ; Humans ; Mitomycin* ; Sutures* ; Trabeculectomy*

No abstract available.
Family Practice* ; Hospitals, Community* ; Humans

The use of mitomycin C as an adjunct improves the success rate of filtering surgery. Blebs after trabeculectomy with mitomycin C tend to be relatively transparent, thin-walled and cystic. Such a bleb is associated with low intraocular pressure but tends to leak and may predispose an eye to endophthalmitis. However, the incidence and risk factors associated with this complication are not known. To determine the incidence and possible risk factors for the development of thin-walled blebs, case records of 160 eyes of 112 patients who received mitomycin C during trabeculectomy were reviewed. Thin-walled, cystic blebs developed postoperatively in 38 (23.8%) of 160 eyes that underwent trabeculectomy with mitomycin C between 1992 and 1995. As the postoperative follow-up time became longer, a greater development of thinwalled cystic blebs was noted. Characteristics of patients after trabeculectomy with mitomycin C in whom thin-walled blebs developed were compared with those of patients in whom thin-walled blebs did not develop. Factors associated with increased risk were: thin conjunctiva and Tenon's capsule (odds ratio 12.7, 95% confidence interval 2.2 to 73.4, P=0.002), uncomplicated glaucoma (primary open-angle glaucoma >or=50 years, primary angle-closure glaucoma) (odds ratio 3.3, 95% confidence interval 1.5 to 7.0, P=0.002), and systemic hypertension (odds ratio 3.8, 95% confidence interval 1.7 to 8.6, P=0.001).
Blister* ; Conjunctiva ; Endophthalmitis ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hypertension ; Incidence ; Intraocular Pressure ; Mitomycin* ; Risk Factors* ; Tenon Capsule ; Trabeculectomy*

Persistent remnants of the pupillary membrane are common but a thick dense persistent pupillary membrane covering all or most of pupil is not often encountered. The authors have recently experienced a case of extensive persistent pupillary membrane in a 4 year-old Korean boy. A well-formed membrane run out from the lesser circle may strectch across the pupil it to a greater exent. This may be provided with five to six irregular apertures. Optical iridotomy was performed in left eye with improvement of vision from L.P to 20/30.
Child, Preschool ; Humans ; Male ; Membranes* ; Pupil

Saccular coronary artery aneurysm, associated with coronary artery fistula, is a very rare condition. A 48-year-old woman was referred to our hospital for the evaluation of an abnormal shadow on the left cardiac border from a chest X-ray film during regular medical health examination. A huge saccular aneurysm with organized thrombi in the proximal left anterior descending artery (LAD) and coronary artery fistulae from LAD and conus branch of the right coronary artery to pulmonary artery was diagnosed by transthoracic echocardiography, multi-detector computer tomography (MDCT), and coronary angiography. The patient received surgical treatment, including thrombectomy of aneurysm, ligation of the inlet and outlet of aneurysmal sac, coronary artery bypass graft (left internal mammary artery-to-distal LAD), and ligation of fistulae. The postoperative course was uneventful, and postoperative echocardiography and MDCT revealed patent bypass graft; however, a small fistula from proximal LAD across aneurysmal sac to pulmonary artery was observed.
Aneurysm ; Arteries ; Coronary Aneurysm ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Echocardiography ; Female ; Fistula ; Humans ; Ligation ; Pulmonary Artery ; Thorax ; Thrombectomy ; Transplants ; X-Ray Film

Saccular coronary artery aneurysm, associated with coronary artery fistula, is a very rare condition. A 48-year-old woman was referred to our hospital for the evaluation of an abnormal shadow on the left cardiac border from a chest X-ray film during regular medical health examination. A huge saccular aneurysm with organized thrombi in the proximal left anterior descending artery (LAD) and coronary artery fistulae from LAD and conus branch of the right coronary artery to pulmonary artery was diagnosed by transthoracic echocardiography, multi-detector computer tomography (MDCT), and coronary angiography. The patient received surgical treatment, including thrombectomy of aneurysm, ligation of the inlet and outlet of aneurysmal sac, coronary artery bypass graft (left internal mammary artery-to-distal LAD), and ligation of fistulae. The postoperative course was uneventful, and postoperative echocardiography and MDCT revealed patent bypass graft; however, a small fistula from proximal LAD across aneurysmal sac to pulmonary artery was observed.
Aneurysm ; Arteries ; Coronary Aneurysm ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Echocardiography ; Female ; Fistula ; Humans ; Ligation ; Pulmonary Artery ; Thorax ; Thrombectomy ; Transplants ; X-Ray Film

Ulcerative colitis (UC) is a chronic inflammatory disorder of the colonic mucosa that characteristically affects the rectum and involves the large bowel in a contiguous distribution. Upper gastrointestinal inflammation was not believed to be present in UC, but a few recent studies have reported a high incidence of gastroduodenal inflammation in patients with UC, although such occurrences are apparently rare and the stomach and duodenum are not generally considered target organs in UC. Here, we present the case of a 29.year.old man with UC who was found to have diffuse ulcerative duodenitis with endoscopic and histologic features identical to UC
Colitis, Ulcerative ; Colon ; Duodenitis ; Duodenum ; Humans ; Incidence ; Inflammation ; Mucous Membrane ; Rectum ; Stomach ; Ulcer

PURPOSE: We investigated the effectiveness and safety of DA-3030 for prophylatic use in patients receiving chemotherapy for malignant disease. MATERIALS AND METHODS: Seventy cancer patients were randomized to receive chemotherapy alone (36 patients) or with DA-3030 administered (34 patients) after stratified block randomization according to chemotherapeutic regimen. DA-3030 was subcutaneously administered at the dose of 100 pg/m/day for 10 days from 24 hours after the completion of chemotherapy. RESULTS: Of the 70 enrolled patients, 62 patients were evaluable. The neutropenia (absolute neutrophil count [ANC] <1,000/mm) occurred in 9 of 32 (28.1%) of the DA-3030 group and 21 of 30 (90.0%) of the control group, giving relative risk for control group of 0.154 (95% confidence interval [CI], 0.05 to 0.45; p-0.0001). Severe neutropenia (ANC 500/mm') occurred in 4 of 32 (12.5%) of the DA-3030 group and in 20 of 30 (66.7%) of the control group (relative risk for control group of 0.316 [95% CI, 0,18 to 0.55]; p=0.0001). The mean duration of neutropenic period (+/-standard error) was 1.13+/-0.34 days in the DA-3030 group and 6.73+/-0.69 days in the control group respectively, and was significantly shorter in the DA-3030 group (p<0.0001). And, there was higher nadir ANC in the OA-3030 group than that in the control group (p=0.0001); the mean nadir ANC was 2,547+/- 343/mm and 442+/-120/mm, respectively. The DA-3030 group had significantly higher incidence of myalgia in comparison to the control group (43.8% compared with 3.3%; p=0.001). However, it was tolerable and was easily managed by conservative therapy CONCLUSION: The use of DA-3030 was effective in preventing chemotherapy-induced neutropenia.
Drug Therapy* ; Humans ; Incidence ; Myalgia ; Neutropenia* ; Neutrophils ; Random Allocation

PURPOSE: To report a case of recovery of bilateral cortical blindness in a patient with posterior reversible encephalopathy syndrome. CASE SUMMARY: A 46-year-old female visited the ophthalmology department due to abrupt visual acuity decrease. Ten days earlier, she had received conservative management due to anemia caused by menorrhagia and uterine prolapse. She underwent a gynecological operation to remove a uterine myoma two days previously, and was given a blood transfusion postoperatively because of excessive bleeding. After the transfusion, she complained of acute blurred vision. Her best corrected visual acuity (BCVA) was hand motion 10 cm in both eyes. There were no abnormal specific findings except retinal dot hemorrhage at the temporal side in the left eye on fundus examination. Her pupillary light reflex was normal and optical coherence tomography examination was unremarkable in both eyes. However, flash visual evoked potential findings showed reduced P100 amplitude in both eyes and she was diagnosed with posterior reversible encephalopathy syndrome based on brain magnetic resonance imaging. After close observation without any treatment, the symptoms gradually improved. Finally, her BCVA recovered to 1.0 and P1 and P100 amplitudes were restored to normal range in both eyes at 16 weeks from the first diagnosis. CONCLUSIONS: A patient complained of bilateral visual loss without other neurological symptoms after chronic blood loss and blood transfusion. She recovered visual acuity completely with prompt diagnosis of posterior reversible encephalopathy syndrome and close observation only.
Anemia ; Blindness, Cortical ; Blood Transfusion ; Brain ; Diagnosis ; Evoked Potentials, Visual ; Female ; Hand ; Hemorrhage ; Humans ; Leiomyoma ; Magnetic Resonance Imaging ; Menorrhagia ; Middle Aged ; Ophthalmology ; Posterior Leukoencephalopathy Syndrome* ; Reference Values ; Reflex ; Retinaldehyde ; Tomography, Optical Coherence ; Uterine Prolapse ; Vision Disorders* ; Visual Acuity