Cyclic strabismus is now well recognized, but remains a rare entity. This heterotropia represents an interesting ocular motility problem in which the ocular deviation is present on a rhythmic basis, usually a 48 hour cycle. On the strabismic day, constant heterotropia is large and associated with suppression and no diplopia. On the nonstrabismic day, no deviation or only a small heterophoria is present with good binocular function. Most of these strabismus were presented with esotropia, but in our case, the pattern of deviation is cyclic exotropia. This is a very rare and unique feature.
Diplopia ; Esotropia ; Exotropia* ; Strabismus ; Telescopes

The alterations in the localization of keratinocyte membrane glycoconjugates in allergic contact dermatitis were investigated in guinea pig skin treated with topical application of 2.4-dinitro-chlorobenzene. We employed the avidin-biotin complex(ABC) method for the detection of localization of 10 commercially available lectins labelled with biotin: Con-A, SBA, WGA, DBA, UEA-1, RCA-1, PNA, HP, MPA, and ECA. Staining with WGA showed a remarkably decreased intensity in basal and spinous layers of the allergic skin in comparison to those of the control skin, suggesting loss of terminal sialic acids in cell membrane glycoconjugates. The other lectins showed no remarkable difference in the staining patterns between the normal and the allergic ski. The results suggest that epidermal cell membrane glycoconjugates undergoes selective perturbations in acute allergic contact dermatitis, and that the keratinocytes might be an active part of the cutaneous immune system.

PURPOSE: The pharmacologic effect of atropine on HPS can be considered to control pyloric muscle spasm. Therefore, we studied the effects of intravenous atropine sulfate on the clinical course of HPS, and periodically observed the ultrasonographic appearance of the pyloric muscles after atropine treatment. METHODS:From April 1998 to May 1999, 14 infants who were diagnosed with HPS were treated with intravenous atropine sulfate. Intravenous atropine sulfate was administered at an initial dose of 0.04mg/kg/day, which was divided into 8 equal doses. The daily dose was increased by 0.01 mg/kg/day until vomiting was controlled for an entire day while infants received unrestricted oral feeding. Ultrasonographic examinations were performed during hospitalization and repeated at least every 2 months until normalization of pyloric muscles was confirmed. RESULTS: Intravenous atropine was effective in 12 of 14 infants with HPS and the conditions of 9 of them improved. Two infants who were not free from vomiting despite a week of intravenous atropine sulfate treatment underwent pyloromyotomy. A series of ultrasonographic examinations were done after vomiting had improved with intravenous atropine sulfate. The ultrasonographic findings showed good passage of gastric contents through pyloric canals despite thickening of the pyloric muscles. CONCLUSION: Intravenous administration of atropine sulfate is an effective therapy for HPS and can be an alternative to pyloromyotomy. (J Korean Pediatr Soc 2000;43:763-768)
Administration, Intravenous ; Atropine* ; Hospitalization ; Humans ; Infant ; Muscles ; Pyloric Stenosis, Hypertrophic* ; Spasm ; Vomiting

Tuberous sclerosis is a rare, autosomal dominant syndrome, in which tumors of the brain, skin, viscera,and eye are found. The classical diagnostic triad included epilepsy, mental retardation, and adenoma sebaceum. Retinal harmatomas are the most common ocular abnormalities in patients with tuberous sclerosis. We experienced one case of tuberous sclerosis that showed adenoma sebaceum of the face, history of epilepsy. The 18 year old male patient also had optic nerve phakoma in his right eye, retinal harmatomas in his left eye, Shagreen patch on the left lumbar area, subependymal nodules along the lateral ventricle and cortical tuber of frontal lobe.
Adolescent ; Brain ; Epilepsy ; Frontal Lobe ; Humans ; Intellectual Disability ; Lateral Ventricles ; Male ; Optic Nerve ; Retinaldehyde ; Skin ; Tuberous Sclerosis*

PURPOSE: Developing a curriculum(DACUM) is a method of analyzing job focused competency, which is obtained from the data of an expert belonging to a certain career. In this study the DACUM method was used to analyze the jobs of operating room nurses. METHOD: Through the DACUM workshop which was arranged by two DACUM facillitators, a definition of the role of operating room nurses was developed and then duties and tasks of operating room nurses' were identified. For the workshop, a DACUM committee with 10 operating room nurses was organized. Finally, the duties and tasks which were identified were validated by 422 nurses for importance, difficulty, and frequency. RESULTS: Thirteen duties and 105 tasks were identified on the DACUM chart, where importance, difficulty, and frequency of tasks were represented by alphabet letters A, B, and C as higher degree of importance. The determinant coefficient(DC) showed that the most important duty was assisting with operations(DC=6.61), and the least, managing operating materials(DC=4.22). For tasks, the most important ones were assisting in orthostatic surgery(DC=7.60), and assisting in thoracic surgery(DC=7.38), and the least important making gauze ball(DC=2.39), and saving of operation site((DC=3.27). CONCLUSION: The results suggest a need to develop an education program using the DACUM chart as a basis for the development and as a clinical career ladder and for curriculum of operating room nursing.
Career Mobility ; Curriculum ; Job Description ; Operating Room Nursing ; Operating Rooms

-D- is a very rare haplotype which determines D without C, c, E or e and exalted D activity. The extremely rare homozygote propositi(-D-/-D-) are usually ascertained through their immune antibodies which react with red cells of all common Rh phenotypes. Authors experienced a woman with -D- phenotype for the first time in Korea. She had a history of abortion and intrauterine fetal death. She delivered a baby with severe hemolytic disease of the newborn at the third pregnancy. In spite of intensive medical interventions, the baby died of hydrops fetalis. An immune antibody to high incidence Rh antigen, namely anti-Hro, was demonstrated in the woman's serum. Family study revealed that all of the family had -D- gene complex and one of her sisters also was -D-homozygote. The sister also had anti-Hro in the serum.
Antibodies ; Female ; Fetal Death ; Haplotypes ; Homozygote ; Humans ; Hydrops Fetalis ; Incidence ; Infant, Newborn* ; Korea ; Phenotype* ; Pregnancy ; Siblings

PURPOSE: The purpose of this study was to investigate health management state during pregnancy, childbirth, and postpartum of immigrant women. METHODS: A descriptive research design was employed. Data were collected from 182 immigrant women who lived in four provinces and D city. Subjects were completed the following questionnaires: demographic, medical service use, pregnancy and childbirth, and health management during the ante-postpartum. RESULTS: The average age of subjects was 28.96 and 83 subjects (45.6%) were coming from Vietnam. 55 Subjects (30.2%) were within the low-income group with less than 4 million won per month. So, 62 subjects were uninsured women because of the expensive costs. Subjects mainly visited a health care center with their husband. On the using a health care center, subjects complained about communication difficulties and transportation problems. 42 Subjects were pregnant but 21.4% of pregnant subjects did not receive antenatal care. Subjects got information about pregnancy and childbirth through their husbands and husband's family. CONCLUSION: Nursing intervention to manage the pregnancy, childbirth, and the postpartum of immigrant women need to be developed and should include strategies to take care of themselves after delivery and provide knowledge and information about ante-postpartum.
Cultural Diversity ; Delivery of Health Care ; Delivery, Obstetric ; Emigrants and Immigrants ; Female ; Humans ; Medically Uninsured ; Parturition ; Postpartum Period ; Pregnancy ; Research Design ; Spouses ; Transportation ; Vietnam

PURPOSE: To determine the factors that affect glaucomatous change and the clinical course of patients with Posner-Schlossman syndrome. METHODS: A retrospective analysis of 52 eyes of 51 patients who had been diagnosed with Posner-Schossman syndrome between January 1995 and June 2003 was performed. We analysed the factors by the age of onset, the duration of disease, the number of attacks, the highest intraocular pressure, the cup/disc ratio of affected eye and unaffected fellow eye during attacks, and visual field change. RESULTS: Twelve (23.1%) of 52 eyes revealed significant glaucomatous change. The number of attacks showed statistically significant difference between the two groups who had developed glaucoma and who had not (P=0.021). But the age of onset, the duration of disease, and the highest intraocular pressure during attack did not show statistically significant difference (P>0.1). CONCLUSIONS: From this study, we observed that the only factor influencing glaucomatous change in patients with Posner-Schlossman syndrome was the number of attacks. So in case of recurrent attacks, close observation and aggressive treatment is mandatory.
Age of Onset ; Glaucoma ; Humans ; Intraocular Pressure ; Retrospective Studies ; Visual Fields

Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.
Alligators and Crocodiles ; Early Diagnosis ; Endoscopy ; Female ; Foreign Bodies ; Hand Strength ; Humans ; Jaw ; Middle Aged ; Mucous Membrane ; Stomach ; Surgical Instruments

Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.
Alligators and Crocodiles ; Early Diagnosis ; Endoscopy ; Female ; Foreign Bodies ; Hand Strength ; Humans ; Jaw ; Middle Aged ; Mucous Membrane ; Stomach ; Surgical Instruments