The purpose of this study is to compare the diagnostic accuracy and usefulness of three-dimensional CT, two-dimensional CT in case of blow-out fracture. Two-dimensional CT, three-dimensional CT images of twenty-four blow-out fracture and soft tissue incarceration. Two dimensional CT was superior to three-dimensional CT in evaluating orbital bone fracture and soft tissue incarceration. But, three-dimensional CT was more useful to identify of orbital bone fracture than two-dimensional CT in associated facial bone fracture. Coexamination with two-dimensional axial & three-dimensonal CT was useful not only in the detection of fracture but in the evaluation of soft tissue incarcerated blow-out fracture.
Facial Bones ; Fractures, Bone ; Orbit ; Orbital Fractures*

As noe of causes of epipora, anatomic abnormality of nasolacrimal duct, has been treated with dacryocystorhinostomy. Recently, the development of nasal endoscopy has made it easy to observe the intranasal sturcture. Thus, authors investigated the effect of nasal endoscopic dacryocystorhinostomy used in combination with microdrill and nasal endoscopy in those patients, with nasolcrimal obsturction at the time of dacryocystorhinography. From 1995 to April 1997, twenty-four patients have been treated by the intranasal dacryocystorhinostomy using the microdrill with follow up more than six months. All patients had been tested by preoperative intranasal exam and was measured radiologically preoperative`s size of lacrimal sac. The nasal endoscopy using microdrill had shown success rate of 83.3 percent and the surgerywas more successful as the size of preoperative lacrimal sac was larer without any complication. The formation of accurate bone foramen did not remarkably differ from the skin incisio at the time of operation. Therefore, dacryocystorhinostomy using microdrill can be useful for the treatment of lacrimal canal obstruction, especially with the proper operating equipment.
Dacryocystorhinostomy* ; Endoscopy ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Skin

Few have reported fungal sinusitis confined in only sphenoidal sinus which caused orbital complication. Reportedly, early surgical treatment can lead to visual recovery especially in its involvement of optic nerve. We report a patients who was hospitalized due to sudden decrease in visual acuity and headache, and was histopathologically diagnosed as having aspergillosis confined in sphenoid sinus, but failed to show restoration of visual acuity after the operation using nasal endoscope.
Aspergillosis ; Endoscopes ; Headache ; Humans ; Optic Nerve* ; Orbit ; Sinusitis ; Sphenoid Sinus ; Sphenoid Sinusitis* ; Visual Acuity

No abstract available.
De Lange Syndrome*

A Macular hole may change in size of the hole; may increase in size with time and an epiretinal membrane may form. Rarely, a rhegmatogenous retinal detachment may occur with time and long term visual acuity usually remains stable or progressively worse. But to our knowledge spontaneous disappearance of a macular hole caused by development of an epiretinal membrane with improvement in vision rarely occurs. The traumatic, full-thickness macular hole in a 15-year-old man during 3 month follow-up period, changed its biomicroscopic appearance and fluorescein angiographic finding. Furthermore, visual acuity showed some improvement. The authors believe this spontaneous disappearance of macular hole is probably occured as a result of epiretinal membrane formation.
Adolescent ; Epiretinal Membrane ; Fluorescein ; Follow-Up Studies ; Humans ; Retinal Detachment ; Retinal Perforations* ; Visual Acuity

PURPOSE: The purpose of this study is to examine the level of understanding of hospice palliative care (HPC) and shared decision making (SDM) among middle-aged adults. METHODS: Data were collected from 90 middle-aged adults living in D city using a self-reported questionnaire. The SPSS program was used to analyze the data. RESULTS: Among the participants, 76.7% were aware of the HPC while 82.2% of the participants were not aware of SDM. Among all, 85.6% responded positively for needs of HPC, and 77.8% of participants for SDM. Participants with Christian faith (Protestants and Catholics), high income level and present illness were better aware of HPC than others. The most needed services were nursing care and treatment along with systematic counseling and explanation provided by the medical staff. There was also a significant relationship between the HPC factors, gender, income, current health status and current illness status. Participants with high income level were well aware of SDM. Stronger SDM needs were observed among participants with professional jobs or current illness. CONCLUSION: For continued discussion on HPC and SDM, it is necessary to implement and promote various education programs for medical staff and the public.
Adult* ; Counseling ; Decision Making* ; Education ; Health Services Needs and Demand ; Hospice Care ; Hospices* ; Humans ; Medical Staff ; Middle Aged ; Nursing Care ; Palliative Care*

Retinal arteriovenous crossing sites are important because they are generally the points at which. in branch retinal obstruction, a blockage of venous blood flow occurs. We evaluated retrospectively the cases of 54 patiens wIth a recent temporal branch retinal vein occlusion to determine the relative anatomic position of the obstructed vein in relation to its crossing artery. In 54 (100%) of 54 eyes, the artery lay antenor to the vein, toward the vitreous cavity. In the control corssing site, the artery lay anterior to the vein 41.3% (J9/46) of the time (p<0.01) The second control group, which was obtained by examining all of the first-and second-order, without BRVO, consisted of 103 crossing sites. In this second control group's artenovenous crossmgs, the arteries were situated anteriorly in 83 (80.6%) of 103 crossing sites (p<0.005). Our observation that the artery lies anterior to the vein at the all of BRVO crossing sites contributes further evidence that mechanical factors play a prominent role in the causing BRVO.
Arteries ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Veins

Surgical method for blow out fracture of medial orbital wall is performed by medial canthotomy and subciliary incision or transconjunctival incision. However, these approaches can leave cosmetic problem due to skin incision and have a risk of infection and absorption of prosthetic implant for a large medial wall fracture. The authors performed endoscopic intranasal reconstruction of the isolated medial wall fracture in a case with significant functional impairment of extraocular muscle. After the incision of the middle turbinate, medial wall fracture was reconstructed with muco-periosteal flap under endoscopic control. We had a good result without intraoperative or postoperative complications caused by prosthetic implant. There was no disadvantage seen with the traditional approaches by medial canthotomy. Endoscopic intranasal reconstruction with muco-periosteal flap appears to be a new safe method for especially large defect.
Absorption ; Orbit* ; Postoperative Complications ; Skin ; Turbinates

Hydroxyapatite is generally used as an orbital implant which is biocompatible. It is considered esthetically and functionally better than traditional measure. We performed hydroxyapatite implantation using autogenous temporalis muscle fascia for 4 eyes of 4 phthisis patients by truma. Hydroxyapatite implants wrapped with autogenous temporalis muscle fascia were inserted into all eyes after enucleation. Follow-up for 12-15 months [mean:13.4 months] showed less inflammatory reaction. There were has no wound dehiscence, implant protrusion and migration. MRI showed a goodfibrovascular proliferation at 4-5 months postoperatively, so we performed drilling. Temporalis muscle fascia is easily obtained and there is no esthetic problem because scar at scalp is covered by hair.
Cicatrix ; Durapatite* ; Fascia* ; Follow-Up Studies ; Hair ; Humans ; Magnetic Resonance Imaging ; Orbital Implants ; Scalp ; Wounds and Injuries

We did clinical analysis on the macular circulatory state in 34 patients(34 eyes)who were diagnosed to have branch retinal vein occlusion and followed for over 6 months. After dividing them into two groups according to their occlusion sites, we evaluated the differences of foveal capillary ring state and size of macular ischemic area between the ones who had vein occlusion in their first retinal branches and the others in their second and the rest retinal branches. We were unable to find any differences between them. However, we could find statistical correlation between their visual acuities in acute stage of the disease and macular circulatory states even though we could not find any differences between their final visual acuities or degree of their visual improvement and circulatory states during follow up period.
Capillaries ; Follow-Up Studies ; Retinal Vein Occlusion ; Retinaldehyde ; Veins ; Visual Acuity