Existing methods of stereoacuity testing need specific glasses or optical device for use. We have designed a new stereoacuity test for the digitalized, random-dot stereogram and researched its clinical usefulness. A digitalized, random-dot, stereoacuity test card was created with a computer program that used a preferred symbol and the designed system was tested along with the Randot preschool stereoacuity, Titmus-fly and Lang tests to compare their sensitivity and specificity. The mean success rate of the digitalized, random-dot test was 98.2%, while the rates of the Randot preschool stereoacuity, Titmus-fly and Lang tests were 89.3%, 74.2% and 86.1%, respectively. Sensitivity and specificity of the new test were 100% and 95.3%, respectively, which were not that different from those of the Randot preschool stereoacuity, Titmus-fly and Lang tests. We found that the digitalized, random-dot, stereoacuity test has a high success rate and can be appropriately used in medical examinations and follow-up tests for strabismus patients.
Age Distribution ; Child, Preschool ; Comparative Study ; Computer Graphics ; Depth Perception/*physiology ; Female ; Humans ; Male ; Reproducibility of Results ; Research Support, Non-U.S. Gov't ; Sensitivity and Specificity ; Software ; Vision Disorders/*diagnosis ; Vision Tests/*instrumentation/methods ; Vision, Binocular

Intertrochanteric fractures are common in older age group. Recently better implant design and surgical technique have improved clinical results. But still many patients suffer from high morbidity and mortality, because of accompanying osteoporosis and various senile diseases. From January 1991 to June 1994, we treated 54 patients older than 70 years with intertrochanteric fractures of femur. Among them, 23 patients were followed up at our hospital and the other patients were informed from police station. Lost follow up was ten patients and final follow up were 44 patients. Mortality was analyzed for the detection of causative factors, such as age, sex, associated medical problems. type of fracture, degree of osteoporosis, type of operation, internal between injury and operation and duration of admission. The results were as follows; 1. 26 patients survived and 18 patients died(Mortality rate :40.9%) 2. 10 patients died within 1 year(Mortality rate :22.7%) 3. Mortality was related to associated medical problems, interval between in jury and operation and type of fracture, which were statistically significant(P < 0.05).
Aged ; Femur ; Follow-Up Studies ; Hip Fractures ; Humans ; Mortality ; Osteoporosis ; Police

BACKGROUND: Normal saline is used to dilate the epidural space to provide a focal length for the lens and to wash the epidural adhesive neural tissue in an epiduroscopy. Saline infusion into the epidural space during an epiduroscopy might affect pressure-volume compliance of the CSF which has a high compliance; therefore, it might cause neurological sequelaes. The purpose of this study was to investigate the change of cervical epidural pressure according to the volume of infused saline during epiduroscopy. METHODS: Twenty-one patients who complained of low back pain with radiculopathy that did not respond to conservative pain management and underwent an epiduroscopy were included in this study. The epidural catheter was placed between the 5th and 6th cervical epidural space under fluoroscopic guidance and cervical epidural pressure was monitored. Next, an epiduroscopy via caudal route was performed and cervical epidural pressure was measured after each 10 ml of infused saline. We also checked neurological sequelaes that might be resulted from increased epidural pressure. RESULTS: All patients except two showed no difference in basal cervical epidural pressure. One patient who had failed back surgery syndrome complained of a headache and dizziness when the cervical epidural pressure was rapidly increased from 90 mmHg to 5 mmHg following an infusion of 27 ml of saline. One patient who had a herniated disc showed posterior nuchal pain and stiffness following an infusion of 48 ml of saline despite a stable cervical epidural pressure (range: 0 - 3 mmHg) during the procedure. There were no residual neurological sequelaes in this study. CONCLUSIONS: There are variable patterns in cervical epidural pressure according to the volume of infused saline. Close monitoring of intracranial pressure is therefore neccessary during an epiduroscopy.
Adhesives ; Catheters ; Compliance ; Dizziness ; Epidural Space ; Failed Back Surgery Syndrome ; Headache ; Humans ; Intervertebral Disc Displacement ; Intracranial Pressure ; Low Back Pain ; Pain Management ; Radiculopathy

Behcet's disease is a chronic inflammatory disease of an unknown etiology, and it is characterized by recurrent oral and genital ulcerations, eye lesions skin lesions, and other involvement such as gastrointestinal ulcerations and lesions of the central nervous system and major vessels. The vascular lesions include deep vein thrombosis, superficial thrombophlebitis, arterial aneurysm and arterial occlusion. Aortic aneurysm or pseudoaneurysm is a rare complication, but it is one of the most common causes of death in Behcet's disease. We report here on a case of a 43 year old female with Behcet's disease that was complicated by an abdominal aortic pseudoaneurysm, and this was all successfully treated with percutaneous endovascular stent graft insertion, steroid pulse therapy and azathioprine.
Aneurysm ; Aneurysm, False ; Aortic Aneurysm ; Azathioprine ; Cause of Death ; Central Nervous System ; Eye ; Female ; Humans ; Skin ; Stents ; Thrombophlebitis ; Transplants ; Ulcer ; Venous Thrombosis

Coccidioidomycosis is a disease by airborne exposure of Coccidioides(C.) immitis, and endemic in the Southwest United States. Primary infection site is lung, and dissemination of the disease can occur depending on the host factors: race, immune status, pregnancy, etc. We report a Korean man with coccidioidomycosis disseminated to the skin, presenting the granulomatous papules on the face and trunk in addition to the pulmonary symptoms. Fungal spherules in the dermis were detected on the skin tissue section, and C. immitis were cultured from the skin tissue. The clinical symptoms were gradually improved with the systemic treatment of antifungal agents (amphotericin B and caspofungin). After more than 6 months of treatment, all of the pulmonary and cutaneous lesions were cleared, but fever persisted.
Antifungal Agents ; Coccidioidomycosis* ; Continental Population Groups ; Dermis ; Fever ; Humans ; Lung ; Pregnancy ; Skin ; United States

Bilateral sensorineural hearing loss (SNHL) is a relatively well-recognized complication of bacterial meningitis, but is a rare initial manifestation in acute cryptococcal meningitis. We report a case of cryptococcal meningitis initially presenting with bilateral SNHL. Cryptococcal meningitis should be included in the differential diagnosis of abrupt-onset bilateral SNHL.
Diagnosis, Differential ; Hearing Loss, Sensorineural* ; Meningitis, Bacterial ; Meningitis, Cryptococcal*

PURPOSE: The purpose of this study was to observe and compare the changes in the patterns of hemodynamic and blood profiles on the circuit of Extra-corporeal life support system (ECLS) by using a dual pulsatile pump (T-PLS). METHODS: An acute heart failure model using partial pulmonary artery banding was constructed in 12 piglets (20 -25kg). The animals were divided into centrifugal (n=6) and dual pulsatile pump (n=6) group. Each animal was placed on an ECLS system with a membrane oxygenator bypassing the right atrium and the aorta for 2 hours under general anesthesia. The parameters mainly observed were intra-circuit pressure changes, arterial pulsatility (pulse pressure), plasma free hemoglobin, hemodynamic changes, and other blood profiles. The parameters obtained just prior to the bypass were compared with the corresponding parameters obtained two hours after the bypass. RESULTS: Before bypass, the parameters were statistically the same between the groups. Two hours after the bypass, no significant differences were observed between the groups in ABGA, VBGA, AST/ALT, BUN/Cr, and electrolytes; the plasma free hemoglobin was 14.8+/-4.7 g/dl in the dual pulsatile group and 19.1+/-9.1 g/dl in the centrifugal group (p=NS). The pulse pressure was higher in the dual pulsatile pump than in the centrifugal pump group (35+/-8 vs. 11+/-7 mmHg, p=0.0253 mmHg). The highest circuit pressure was generated at the inlet of the membrane oxygenator and was higher in the dual pulsatile group than in the centrifugal group (173+/-12 mmHg vs. 222+/-8 mmHg, p=0.0000). CONCLUSION: The results demonstrate that a dual pulsating mechanism lessens blood cell trauma while providing physiologic pulsatile blood flow. The ECLS system using a dual pulsatile pump (T-PLS) can be useed as an effective and safe driving motor for an ECLS.
Anesthesia, General ; Animals ; Aorta ; Bays ; Blood Cells ; Blood Pressure ; Cardiopulmonary Resuscitation ; Electrolytes ; Heart Atria ; Heart Failure ; Hemodynamics ; Life Support Systems* ; Oxygenators, Membrane ; Plasma ; Pulmonary Artery

Juvenile xanthogranuloma (JXG) is a benign, normolipaemic, self-healing condition and a type of histiocytosis that occurs most frequently in infants and children, although adults may also be affected. This condition usually presents with a solitary or multiple cutaneous lesions and occasionally with extracutaneous lesions, especially the eye, lung, liver, kidney and pericardium. Histologically, JXG represents an accumulation of histiocytes lacking Birbeck granules (non-Langerhans cell), which can be differentiated from the Langerhans cells by specific staining techniques. The lesions may be excised for diagnostic, cosmetic or symptomatic reasons. We report a case of juvenile xanthogranuloma that occurred in the nasal cavity and testis for the first time.
Adult ; Child ; Histiocytes ; Histiocytosis ; Humans ; Infant ; Kidney ; Langerhans Cells ; Liver ; Lung ; Nasal Cavity* ; Pericardium ; Testis* ; Xanthogranuloma, Juvenile*

Objective: This study examined the validity of the European Quality of Life-5 dimensions, 3-Level version (EQ-5D-3L) in patients with osteoporotic vertebral compression fractures (OVCF) and compared the health-related quality of life (HRQOL) of these patients with that of the general population in Korea. Methods: Study participants completed several questionnaires, such as the EQ-5D-3L, 12-item short-form health survey version 2.0 (SF-12v2), Roland-Morris disability questionnaire (RMQ), and Pain Numeric Rating Scale (Pain NRS). Spearman’s correlation analyses of the questionnaire results were conducted to examine the discriminant and convergent validity of the EQ-5D-3L. Finally, EQ-5D-3L results from study participants were compared with those from the comparison group of the general population that were match-sampled according to age and sex from the 2013 Korean National Health and Nutritional Examination Survey. Results: Spearman’s correlation coefficients between EQ-5D-3L and pain NRS, SF-12v2, and RMQ were statistically significant. The coefficients between the relevant dimensions, such as mobility in the EQ-5D-3L and physical functioning in the SF-12v2, were higher than those between irrelevant ones. Problems reported by study participants in each dimension of EQ-5D-3L showed statistically significant lower scores in pain NRS, PCS, and MCS from the SF-12v2 and RMQ scores. In comparison with the general population, the problems reported in the patient group were statistically higher than those reported by the general population. Conclusion This study showed that EQ-5D-3L will be useful for patients with OVCF in Korea because it could be valid. The HRQOL of patients with OVCF was very low in all dimensions of the EQ-5D-3L.