No abstract available.
Incus* ; Malleus*

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

No abstract available.
Atrial Fibrillation* ; Heart* ; Thoracic Surgery*

Purpose: To report a case with corneal decompensation in a patient of pseudoexfoliation syndrome.Case summary: A 70-year-old woman was referred to our clinic to evaluate decreased visual acuity in the right eye. She had no history of previous ocular surgery or laser treatment. The best corrected visual acuity was 0.5 in both eyes. The patient had diffuse corneal edema in the epithelium and stroma in the right eye. The left eye showed diffuse endothelial pigment deposits. Deposition of pseudoexfoliation material on the iris and anterior lens capsule was observed in both eyes. The intraocular pressure was 15 mmHg in both eyes without treatment. Specular microscopy was limited in the right eye due to the corneal edema and the left eye showed endothelial cell loss, increased pleomorphism, and atypical guttata. Anterior segment optical coherence tomography revealed irregular thickening of the corneal stroma and protrusion of Descemet’s membrane in the right eye. Conclusions In patients with pseudoexfoliation syndrome, corneal decompensation can occur without intraocular pressure elevation and glaucomatous damage.

Purpose: To report a case with corneal decompensation in a patient of pseudoexfoliation syndrome.Case summary: A 70-year-old woman was referred to our clinic to evaluate decreased visual acuity in the right eye. She had no history of previous ocular surgery or laser treatment. The best corrected visual acuity was 0.5 in both eyes. The patient had diffuse corneal edema in the epithelium and stroma in the right eye. The left eye showed diffuse endothelial pigment deposits. Deposition of pseudoexfoliation material on the iris and anterior lens capsule was observed in both eyes. The intraocular pressure was 15 mmHg in both eyes without treatment. Specular microscopy was limited in the right eye due to the corneal edema and the left eye showed endothelial cell loss, increased pleomorphism, and atypical guttata. Anterior segment optical coherence tomography revealed irregular thickening of the corneal stroma and protrusion of Descemet’s membrane in the right eye. Conclusions In patients with pseudoexfoliation syndrome, corneal decompensation can occur without intraocular pressure elevation and glaucomatous damage.

OBJECTIVE: To evaluate the efficacy of prenatal multiplex PCR with chorionic villi, in the case of family history of DMD due to exon deletion. METHODS: DNA was extracted when cells' size are 1x 106 on T- flask surface area reach to 25 cm2 after 2 weeks from sex confirmation. Average DNA concentration was 50-100 ng and multiplex PCR test was performed from DNA extraction. RESULT: PCR was done for 17 exons devided into 4 groups. Seventeen exons were all amplified with their right size. CONCLUSIONS: This method is DNA analysis for prenatal diagnosis of DMD with chorionic villi in the family of DMD. This is useful when preimplantation genetic diagnosis is not available.
Chorion* ; Chorionic Villi* ; DNA ; Exons ; Humans ; Multiplex Polymerase Chain Reaction* ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction ; Preimplantation Diagnosis ; Prenatal Diagnosis*

The results of rotation chair test were known to variable by many parameters such as eye opening and alertness, etc. The situational change in rotation chair test must be considered to interpretation of its result. But in Korea, there were no reports or articles about parameters which influence the result of rotation chair test. So, we assumed that eye opening and alertness were main parameters and took rotation chair test in neurotologically normal subjects. For evaluation of the effect of eye-open or eye-closure and alertness on the rotational vestibular stimulation, we have taken sinusoidal harmonic acceleration test in 30 otoneurologically normal subjects. The maximal slow phase eye velocity, gain and asymmetry were obtained and compared with each other in four different conditions with properly fixed conditions such as in darkness and 0.05Hz frequency. At least five minutes interval was given between the tests and recalibrations were done before each tests. The results of this test were as follows. 1) Vestibular-ocular reflex(VOR) changes according to eye open or closure. In cases of examinees which were given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, and that was statistically significant(p<0.05). In cases of examinees which were not given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, but that was not statistically significant(p>0.05). 2) VOR changes according to alertness. In cases of examinees which opened their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(p<0.05). In cases of examinees which closed their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(p<0.05). 3) There was no significant changes of asymmetry according to the conditions. Therefore, from above results, we recommend the condition in which examinees open their eyes and be given alerting tasks as one of the optimal condition in sinusoidal harmonic acceleration test.
Acceleration* ; Darkness ; Korea ; Plastics* ; Reflex, Vestibulo-Ocular*

BACKGROUND: Since 1992, we developed the technique for video endoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Compensatory hyperhidrosis, however, is the main cause of patient dissatisfaction after video-assisted thoracoscopic sympathectomy. According to many authors, initial satisfaction rate was high(94-98%), but it was declined with time (66%) due to mainly to embarrassing side effects. MATERIAL AND METHOD: From January 1992 to February 1998, the thoracoscopic T2 sympathicotomy, T2 sympathectomy and T2-4 sympathectomy were performed in 315 patients suffering from Essential hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Eighty-nine patients underwent T2 sympathicotomy, and Eighty-eight patients underwent division T2 sympathectomy. RESULT: All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis. The global rate of compensatory sweating were ; 64.0% in T2 sympathicotomy, 73.8% in T2 sympathectomy and 87.8% in T2-4 sympathectomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathicotomy 15.7%(14/89) and in T2 sympathectomy 32.8%(28/88) than in T2-4 sympathectomy 58.0%(80/138) with significancy in statistic analysis(p<0.05). Video- assisted thoracoscopic sympathectomy is an effective minimally invasive and effective procedure. CONCLUSION: We suggest that the incidence and degree of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy.
Humans ; Hyperhidrosis* ; Incidence ; Korea ; Respiratory Center ; Seoul ; Sweat ; Sweating ; Sympathectomy*

In recent years, an increasing number of patient with AOVMs have been recognized using MRI. When an AOVM is located in a region associated with an unacceptable surgical risk, stereotactic radiosurgery offers an alternative treatment. We treated 21 patients with AOVM using gamma knife radiosurgery from June, 1990 to December, 1993 at Asan Medical Center. The indications for radiosurgery were as follows:1) Patients who had episodes of hemorrhage from a lesion that had the characteristic images of AOVM in MRI. 2) Patients who had seizures and the focus of these seizures corresponded to the lesions. 3) Patients were excluded if the lesions were located superficially or were accessible to microsurgery. Nine patients presented with hemorrhages and twelve with seizures. The marginal dose was ranged from 10 to 25 Gy at or above the 50% isodose line. Of eight patients followed 12 months or less after radiosurgery, two patients had improved neurologic deficits and one had decreased the seizure frequency with mediciation. Among seven patients followed 12-24 months, MRI showed a reduction of the lesion in one patient and no change in five patients. One patient had perifocal edema. In two patients with seizures, one patient was seizure free without medication and one patient was controlled with medication. In six patients between 24 and 44 months, two patients had smaller lesions and three patients had perifocal edema. Among four patients who had seizures, one patient was seizure free without medication and three had decreased the seizure frequency with medication. Postoperative complications developed two patients, but one patient showed improvement of neurologic deficits after a short period of steroid medication. Stereotactic radiosurgery offers a treatment to a selective patients with intracranial AOVMs.
Chungcheongnam-do ; Edema ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Microsurgery ; Neurologic Manifestations ; Postoperative Complications ; Radiosurgery* ; Seizures

BACKGROUND: With the increasing age of the population, coronary artery bypass grafting in the elderly patients is becoming common. Off-pump coronary artery bypass grafting (OPCAB) has been proven to be less morbidity and to facilitate early recovery. The elderly patients may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The purpose of this study is to evaluate our results of OPCAB in elderly patients. MATERIAL AND METHOD: A retrospective chart review was carried out for 12 patients aged over 80 years who underwent isolated OPCAB from January 2001 and March 2004. Data were collected risk factors for disease, extent of coronary disease, and in-hospital outcomes. Postoperative graft patency was evaluated in 9 patients by multi-slice computed tomography. RESULT: Eleven patients had triple vessel disease or left main disease. Four patients were suffered from preoperative CVA, and 4 patients had chronic obstructive pulmonary disease. Two patients had myocardial infarction (MI), among them 1 patient was suffered from pulmonary edema after preoperative MI. There was no perioperative death, perioperative MI, and no ventricular arrhythmia. Also there was no perioperative stroke and renal failure. But there was one deep sternal infection who recovered by treating of muscle flap. Atrial fibrillation was newly developed in 1 patient, but was well controlled by medication. Mean intubation time was 15.9+/-4.4 (8~20 hrs) hrs and mean ICU stay was 2.9+/-0.8 (2~4 days) days. Mean hospital day was 21.6+/-14.3 (13~56 days) days. Postoperative mean CK-MB was 11.3+/-14.1 ng/mL. Early postoperative graft patency rate was 100% (24/24). Follow-up was completed in all patients. In this time, there was no patients with angina or death. CONCLUSION: The results of this study suggest that OPCAB reduces morbidity and favors hospital outcomes. Therefore, OPCAB is safe, reasonable and might be preferable operative strategy in elderly patients.
Age Factors ; Aged ; Aged, 80 and over* ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Coronary Disease ; Follow-Up Studies ; Humans ; Intubation ; Myocardial Infarction ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Edema ; Renal Insufficiency ; Retrospective Studies ; Risk Factors ; Stroke ; Transplants*