A 62-year-old woman without vascular risk factors presented with left-sided weakness and numbness. Magnetic resonance imaging (MRI) brain depicted acute right hemispheric infarcts in the cortical and subcortical white matter. Initial MR angiography (MRA) showed large thrombus at the right carotid bifurcation. Valvular atrial fibrillation (vAF) with severe tricuspid regurgitation (TR) was found on two-dimensional echocardiography. Serial follow-up computed tomography angiography (CTA) or MRA at 3, 9, and 15 days after anticoagulation alone showed complete resolution of the thrombus with no neurological deterioration. Our case suggests that prompt institution of anticoagulantion alone may result in radiologic resolution of the thrombus with improvement in patient’s clinical status.
Carotid Arteries

Sodium nitroprusside(SNP) is used to induce hypotension for a wide variety of indica- tions. Ordinarily, blood pressure responds sensitively to infusion of SNP in low doses, but occasioally resistance is seen, and actual tachyphylaxis during SNP infusion has been reported. To investigste the continuous infusion rates of SNP, we retrospectively reviewed 144 cases of spinal fusion operations which had been performed under deliberate hypotensive anesthesia (mean arterial pressure at 50-60 mmHg). To produce deliberate hypotension, The mean dose of SNP was 17.16 mg, the mean infusion time 283.85 minutes, and the average infusion rates 1.05 ug/kg/min. Patients who received csptopril required less SNP than untreated patients(0.95 vs 1.23 ug /kg/min., p<0.05). Isovolemic hemodilution also reduced aversge infusion rates of SNP (0. 87 vs 1.22ug/kg/min., p<0.05). There were, however, no significant differences in preoperative hypertention vs normotension, mild hypothermia vs. normothermia during the operation, and male vs. female. In addition, the average infusion rates of SNP were significantly correlated with body mass index(r=0.3329, p<0.01). But those were not correlated with age, infusion time of SNP, weight, volume of transfusion, height/age, and height.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Female ; Hemodilution ; Humans ; Hypotension ; Hypothermia ; Male ; Nitroprusside ; Retrospective Studies ; Sodium* ; Spinal Fusion ; Tachyphylaxis

We report a case of sarcoidosis in a 4-year-old girl. She showed the involvements of the skin and eye, which are the characteristics of sarcoidosis in very young patients, and also showed an unusual finding of hepatosplenomegaly. Because the diagnosis of childhood sarcoidosis is difficult and serious sequelae can develop from sarcoidal uveitis, an early skin biopsy and regular ophthalmologic assessment are essential.
Biopsy ; Child, Preschool ; Diagnosis ; Female* ; Humans ; Sarcoidosis* ; Skin ; Uveitis

No abstract available.
Humans

The results of 54 consecutive patients with intermittent exotropia treated with surgery at least 6 months follow-up are reviewed. The purpose of this paper was to study retrospectively the course of patients who had overcorrective treatment of intermittent exotropia and the specific parameters examined included the age of the patient at the time of onset; age of patient at the time of the initial surgery; length of time between the onset of the exodeviation and initial surgery; and distance: near deviation effect on surgical result. The results were as follows; 1. Average age of onset was 3.7 years and the average age of operation was 6.7 years. 2. Mean duration between the first hospital visit and operation was 6.3 months. 3. The angle of deviation less than 30 delta was found in 72.2% of cases. 4. Average degree of refractive errors was -1.187 in cycloplegic refraction. 5. The final satisfactory surgical result was achieved in 76% of the cases. The cases showing 5~15 delta overcorrection immediate postoperatively showed the most satisfactory final outcome and this was statistically significant. (P<0.05) 6. The age at the time of onset and the age at the time of the initial surgery did not significantly influence the surgical result(P>0.05).
Age of Onset ; Exotropia* ; Follow-Up Studies ; Humans ; Refractive Errors ; Retrospective Studies

Immediate implant placement is one of the treatment options in postextraction sites in anterior region. This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior maxilla using a flapless approach and modifying a provisional restoration. The case reported illustrates the practical procedure involved in developing natural esthetics with modifying a provisional restoration. The technique provides an accurate impression of the soft tissue through the intraoral use of provisional restoration. The final restoration uses a custom-made titanium abutment and porcelain fused gold crown. The technique is relatively simple and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores and white esthetic scores after 1 year.
Crowns ; Dental Implants, Single-Tooth ; Dental Porcelain ; Esthetics ; Humans ; Maxilla ; Titanium

The hyperimmunoglobulinemia E (Jobs) syndrome (HIES) is characterized by marked elevated levels of IgE, recurrent cutaneous and systemic staphylococcal infections, atopic-like dermatitis, and defective neutrophil chemotaxis. Three cases of HIES have been reported in Korea, but not in the dermatology literature. We report a case of HIES with cutaneous infections and MRSA (methicillin-resistant Staphylococcus aureus). A 15-month-old girl presented with intractable pruritic excoriated papular pustular skin lesions and multiple subcutaneous abscesses. Surgical drainage of the abscesses and a course of antibiotic treatment in addition to topical steroids for about 7 weeks resulted in a remarkable improvement.
Abscess ; Chemotaxis ; Dermatitis ; Dermatology ; Drainage ; Female ; Humans ; Hypergammaglobulinemia* ; Immunoglobulin E ; Infant ; Job Syndrome* ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Neutrophils ; Skin ; Staphylococcal Infections ; Staphylococcus ; Steroids

In 1874, Hansen(Norway) identified Mycobactererium leprae as the causative organism of leprosy, thus enabling man to battle this disease. Since Bull and Hansen(1873) published the report on the ocular complication of leprosy, there has been many articles on the ocular disease associated with leprosy. We visited to St. Heart In Ae Hospital in Sanchung from the 1977 to the 1982 for 5 yrs. We were throuhgly examined to find out who ther they have ocular complications and operation to every year for 5 yrs. The ocular complications have been observed in 169 leprosy patients. Among the examined 338 eyes, 1) The observed ocular complications were corneal disease, secondary cataract, phthisis bulbi in that order of frequency, 2) The visual acuity of operated group is improved in year of 1982 in comparing to year of 1977. The visual prognosis is showed better in tuberculoid type than that of leprosy type, 3) In the group of V.A under 0.1 correction, the operated group showed small rate better in comparing to that of nonoperated group, By operations such as cataract extraction and optical iridectomy, the blindness could be prevented.
Blindness ; Capsule Opacification ; Cataract Extraction ; Corneal Diseases ; Follow-Up Studies* ; Heart ; Humans ; Iridectomy ; Leprosy* ; Prognosis ; Visual Acuity

The objectives of this study were to investigate and compare the efficacy for glycopyrrolate and atropine in the suppression of the OCR. Preoperative medication of the glycopyrrolate and atropine were studied in 114 pediatric patients for adequate prevention of the OCR. The results obtained were summarized as follows. 1) OCR occurred in 31.8% in Group I(use of atropine) and in 31.3% in Group II(use of Glycopyrrolate). 2) Traction on the extraocular muscles, particularly the medial or lateral rectus muscles most likely elicit the OCR, but there was not a significant difference in occurance of the PCR during each muscle traction. 3) There is great individual variation in response to muscle traction with in each group, no group was fully protected from marked slowing in heart rate. 4) The use of intramuscular administration of atropine or glycopyrrolate prior to induction has not been found to decrease the incidence of the reflex. 5) The dysrhythmias of the OCR were bradycardia, bigeminy, nodal rhythms, and ectopic beats.
Atropine* ; Bradycardia ; Glycopyrrolate* ; Heart Rate ; Humans ; Incidence ; Muscles ; Polymerase Chain Reaction ; Reflex ; Traction

From May, 1985 to July, 1986, 500 cases of intraocular lenses were implanted, and all 500 cases had been followed up for more than 2 months. The results were as follows: 1. In the 500 cases of intraocular lens implantation, the number of patients were 318 men and 115 women. Patient's age was largely distributed to fifth decade in men and fourth decade in women. 2. IOL power ranged from +13.5D to +23.0D in PCL and ranged from +12.5D to +20.0D in ACL. The most frequently used IOL poeer was +19.5D in PCL and +18.0D in ACL. 3. Postoperative corrective vision with IOL was improved up to 0.8 or better in 446 cases(89.2%). 4. During operation, some complications were developed and those were posterior capsular rupture in 19 cases(3.8%), hyphema in 15 cases(3.0%), Descemet's membrane stripping in 2 cases(0.4%), and corneal edema in 1 case(0.2%). More frequently developed postoperative complications were clinical cystoid macular edema in 26 cases(5.2%), secondary glaucoma in 18 cases(3.6%), and distorted pupil in 13 cases(2.6%). 5. Postoperative corrective vision lower than 0.4 was observed in 22 cases(4.4 %), and the causes were diabetic retinopathy, cystoid macular edema, vitreous opacity, congenital cataract, phacoanaphylactic uveitis, endophthalmitis, amblyopia, optic nerve atrophy, corneal opacity, glaucoma, hypertensive retinopathy, and others.
Amblyopia ; Atrophy ; Cataract ; Corneal Edema ; Corneal Opacity ; Descemet Membrane ; Diabetic Retinopathy ; Endophthalmitis ; Female ; Glaucoma ; Humans ; Hypertensive Retinopathy ; Hyphema ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Macular Edema ; Male ; Optic Nerve ; Postoperative Complications ; Pupil ; Rupture ; Uveitis