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*

No abstract available.
De Lange Syndrome*

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

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

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

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

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*

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

Anatomical examinations on Bruch's membrane have almost been by light microscopy or transmission electron microscopy. Scanning electron microscopy allowed us to evaluate surface features topographically. Each layer of Bruch's membrane was exposed sequentially to mechanical or enzymatic treatment of the retinal pigment epithelium choroid complex from human cadavar eye. The authors examined the surface features of the membrane by dry-cracking scanning electron microscopy. The basement membrane of retinal pigment epithelium appeared like a smooth thin plastic membrane which was framed by collagen fibers. The inner collagenous layer was composed of many collagen fiber bundles which were placed in order and the ground substance between them was not visible. Elastic layer of Burch's membrane appeared to be coarse and fine fibers matted together by some amorphous substance. This layer had many openings on its solid sheet and the outer collagenous zone was visible though these openings.
Basement Membrane ; Bruch Membrane* ; Choroid ; Collagen ; Humans* ; Membranes ; Microscopy ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Plastics ; Retinal Pigment Epithelium

PURPOSE: To investigate postoperative visual acuities of patients who underwent vitrectomy for their dense nondiabetic vitreous hemorrhage, and in addition to assess postoperative visual results of the group who underwent early vitrectomy. METHODS: Included in the study were 52 patients (52 eyes) who had undergone vitrectomy and been followed up for longer than 4 months after surgeries. Authors investigated the underlying diseases of vitreous hemorrhage, surgical outcomes, and the rate of complications. In addition, we evaluated the results of the group who had undergone vitrectomy between 4 weeks and 6 weeks after development of hemorrhage. RESULTS: The most common cause of vitreous hemorrhage was branch retinal vein occlusion followed by macular hole, ocular trauma, central retinal vein occlusion, age related macular degeneration, Terson`s syndrome, and unknown cases. Visual acuity before operation is less than light perception to 0.3 and improved in 44 eyes (84.6%) after operation. The rate of more than 5 lines' improvement is 63.4% (33 eyes) and 51.9% (27 eyes) obtained their visual acuity of 0.5 or better. In the group which had been operated 4 to 6 weeks after the development, visual acuity improved in 100% (16 eyes). Thirteen eyes (81.2%) showed more than 5 lines' improvement of their visual acuity and 12 eyes had 0.5 or better (75.5%). The most common complication after surgeries is cataract in 5 eyes (10.8%), others were macular hole in 3 eyes (5.7%), retinal detachment in 2 eyes (3.8%), macular hole in 1 eye (6.2%). CONCLUSIONS: Pars plana vitrectomy is a good procedure to improve visual acuity for the patients who have suffered persistent visual disturbances due to non-diabetic vitreous hemorrhage. Also, early vitrectomy should be considered for early visual rehabilitation.
Cataract ; Hemorrhage ; Humans ; Macular Degeneration ; Rehabilitation ; Retinal Detachment ; Retinal Perforations ; Retinal Vein ; Retinal Vein Occlusion ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage*