Cranocsynostosis is the term that designates premature fusion of one or more sutures in either the cranial vault or cranial base. Especially scaphocephaly, brachycephaly and trigonocephaly are included in simple symmetric craniosynostosis. In simple symmetric craniosynostosis, the functional deformity is rare, but deformity in external appearance is always a serious problem. The purpose of forehead reshaping in simple symmetric craniosynostosis is recovery of normal cerebral growth and improvement of cranial cosmetic problem by restoration of normal calvarial anatomic structure. Various surgical methods have Bbeen developed in an effort to correct craniosynostosis. Cranial vault remodeling with or without supraorbital band advancement is a widely accpeted method of correcting simple symmetric craniosynostosis. However, the standardized surgical method has not yet been estabilished in reshaping the forehead during cranial vault remodeling of simple symmetric craniosynostosis. The authors developed a new osteotomy method, the bull's osteotomy, which is a limited osteotomy for cranial vault remodeling. It produces posterior tilting of a prominant forehead as well as increased biparietotemporal distance for effective forehead reshaping. We applied this techriaue in 8 scaphocephaly and 2 brachycephaly patients under 5 years of age who have not yet reached bony consolidation. All patinets obtained satisfactory results with properly corrected deformity and no relapse was observed during the follow-up period. This new osteotomy method is simple and effective and a consistant surgical outcome is expected. particularly the contour of the forehead on the frontotemporal area is corrected to have a smooth and natural curvature. Based on our experience using bull's osteotomy, we offer this new surgical technique for managing simple symmetric cranoisynostosis patients.
Congenital Abnormalities ; Craniosynostoses* ; Follow-Up Studies ; Forehead* ; Humans ; Osteotomy* ; Recurrence ; Skull Base ; Sutures

No abstract available.
Lower Extremity* ; Melanoma*

A 14-year-old female patient was seen with a nodular lesion on her left shoulder which developed one month after BCG vaccination. Physical examination revealed a thumb tip sized, irregular surfaced, erythematous scar-like plaque on the left shoulder, and a 2.5cm diameter, movable, subcutaneous nodule without surface change on the left axilla. Histopathologic examination of the plaque on the left shoulder and axillary nodule showed tubercles composed of mononuclear cells, epithelioid cells and giant cells of the Langhans type in the dermis. Caseation necrosis within the typical tubercles was noted. Prominent resolution of the lesion was observed 4 months after oral medication with isoniazid and ethambutol. The subcutaneous axillary nodule which developed after BCG vaccination was thought to be an unusual manifestation of skin tuberculosis.
Adolescent ; Axilla ; Dermis ; Epithelioid Cells ; Ethambutol ; Female ; Giant Cells ; Humans ; Isoniazid ; Mycobacterium bovis* ; Necrosis ; Physical Examination ; Shoulder ; Skin* ; Thumb ; Tuberculosis, Cutaneous* ; Vaccination*

PURPOSE: We evaluated the effect of Mitomycin C (MMC) applied by different methods, on corneal healing after excimer laser phototherapeutic keratectomy (PTK) in rabbits. METHODS: PTK was performed on 34 eyes of 17 New Zealand white rabbits. The control group underwent PTK alone, while the experimental groups underwent PTK with intraoperative application of either annular or discoid filter paper soaked with 0.02% MMC for 2 minutes. At postoperative 4, 12, and 24 weeks, the degree of corneal haziness was determined using a slit lamp biomicroscope, and the proliferation of keratocytes was observed histologically. RESULTS: At 4 weeks, the degree of corneal haziness was significantly lower in both MMC-treated groups than in the PTK-alone group (P<0.001). The two MMC-treated groups also showed decreased corneal haziness at 12 and 24 weeks, although the change was not statistically significant. In addition, the MMC-treated groups showed less proliferation of keratocytes at 4 and 12 weeks. At 24 weeks, the group that received annular application of MMC showed a significant decrease of keratocytes compared with the control group(p=0.026), while the group with discoid application showed no significant difference. CONCLUSIONS: In this study, we found that the annular application of MMC after PTK not only shows similar effect on wound healing but also reduces the side effects of MMC by minimizing the application surface.
Cornea* ; Lasers, Excimer* ; Mitomycin* ; Rabbits ; Wound Healing

PURPOSE: To describe a low-grade infection of hydroxyapatite orbital implant diagnosed by 99mTc-labeled leukocyte scintigraphy. METHODS: A 34-year-old man diagnosed as phthisis bulbi due to corneoscleral laceration on left eye had been treated with evisceration and hydroxyapatite orbital implant insertion. After drilling for ocular prosthesis, the patient did not have any symptom for 3 years and 5 months. He presented with socket pain, erythematous lid swelling, severe conjunctival discharge. There was no improvement of symptom despite conservative treatment for 3 weeks. MRI revealed no abnormalities so 99mTc-labeled leukocyte scintigraphy was performed. RESULTS: Scintigraphy showed a dense accumulation of labeled leukocyte at the implant site. After diagnosed as hydroxyapatite orbital implant infection, orbital implant was removed and silicon sphere implantation was done. After operation, the inflammation signs disappeared. CONCLUSIONS: 99mTc-labeled leukocyte scintigraphy is a useful technique in diagnosing low-grade infection of hydroxyapatite orbital implant undetected using conventional imaging method such as MRI.
Adult ; Durapatite* ; Eye, Artificial ; Humans ; Inflammation ; Lacerations ; Leukocytes* ; Magnetic Resonance Imaging ; Orbital Implants ; Radionuclide Imaging* ; Silicones ; Technetium*

PURPOSE: To study the effect of spherical lens induced aniseikonia on stereopsis and fusion. METHODS: One hundred subjects, with normal binocular function without any ophthalmic disease or surgery history, were examined. The aniseikonia was induced with spherical lenses in 1 diopter (D) stepwise manner from -2 D to +2 D. The amount of aniseikonia was measured by Awaya's New Aniseikonia Test. Stereopsis and fusion were determined with Titmus Stereo Test and fusion card of major amblyoscope respectively. RESULTS: As the amount of aniseikonia was increased, the stereopsis and fusion were decreased. The change was statistically significant (ANOVA, p<0.001). Aniseikonia was more correlated to fusion than stereopsis. A significant decline in the stereopsis was detected when the size of aniseikonia changed from 1% to 2%. A significant decline in fusion was noticed when aniseikonia changed from 2% to 3% (Independent t-test, p<0.01). CONCLUSIONS: Our study suggests that binocular function can be disturbed by experimentally induced aniseikonia in normal subjects and that stereoacuities and fusional amplitude can be decreased as the degree of aniseikonia becomes larger.
Aniseikonia* ; Depth Perception ; Telescopes*

This study was designed to compare the relationships of premenstrual symptom patterns, stress perception, and coping style between women with premenstrual change and women without premenstrual change, using prospective methods. Fifty one women older than 20 years and in healthy state were asked to complete the Daily Rating Form and Daily Stress Scale(6-point Likert scale) during one menstrual cycle. They were also instructed to respond to the Ways of Coping Checklist. Fifty-percent-change method was used to identify women with premenstrual change, and methods of chisquare, t-test, paired t-test, and correlation were employed to analyze their responses. The results are as follow. 1) 47.1% of the subjects were classified into premenstrual change group. 2) No significant difference between women with premenstural change and women without premenstrual change was found in demographic characteristics(e.g., age, education, job, marriage) and menstrual characteristics(e.g., ages of menarche, regularity of menstruation, interval and duration of menstruation, amount of menstruation, dysmenorrhea). 3) There was no significant difference in coping style between women with premenstural change and women without premenstrual change. However, we observed relationships between some of premenstrual symptoms(i.e., depressed mood, lability, difficulty in concentrating, changes in appetite, being overwhelmed) and coping style, among women with premenstrual change during premenstrual phase. No association was observed between premenstrual symptoms and coping style among women without premenstrual change. 4) Women with premenstrual change reported more stressfulness premenstrually than post-menstrually(t=5.09, df=22, p=.000) as compared to women without premenstrual change(t=0.59 df=26, p=.56). Our findings suggest that, among women with premenstrual change, there exists significant relationship between premenstrual symptom patterns and coping style. Also, the ways stressors are perceived are likely to be affected by the menstrual cycle phase, only among women with premenstrual change. These findings are consistent with the state-dependent model of premenstrual syndrome. Therefore, we should consider stress management as an important therapeutic strategy for those with premenstrual change, because of their high vulnerability to stressors.
Appetite ; Checklist ; Education ; Female ; Humans ; Menarche ; Menstrual Cycle ; Menstruation ; Premenstrual Syndrome ; Prospective Studies

We have experienced a 14 year old female patient who had suffered from headache, dizziness, exertional dyspnea and chest pain during 6 months. She was diagnosed as primary pulmonary hypertension by ultrasonogram and cardiac cathererization. On the cardiac catheterization, there was elevated pulmonary artery pressure and normal pulmonary wedge pressure. We report this case with related literature review.
Adolescent ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dizziness ; Dyspnea ; Female ; Headache ; Humans ; Hypertension, Pulmonary* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Ultrasonography

The authors statistically analysed 349 industrial ocular injuried cases(435 eyes) among 51,643 patients seen in the Dept. of Ophthalmology, Wonju Christian Hospital, Wonju Medical College, Yonsei University from Jan. 1981 to Dec. 1985. 1. Industrial ocular injuries occupied 0.82% of all ocular patients, and 12.73% of all industrial injuries. 2. Bilateral ocular injury(24.36%) has relatively high proportion due to the explosive injury. 3. The most common cause of industrial ocular injuries was explosives(20.63%) and stone(18.62%), iron(17.19%), coal(11.17%) and dust(10.32%) were in the order. 4. Corneal(10.51%) and conjunctival foreign bodies(9.03%) were the common diseases of all industrial ocular injuries. 5. The final visual acuity of 260 eyes(59.77%) was 0.7 or more, and 75 eyes(17.25%) was below the 0.05. 6. The average period of treatment required for ocular industrial injuries was about 55 days.
Gangwon-do* ; Humans ; Ophthalmology ; Visual Acuity

It is not uncommon for children and adolescents with learning disabilities to have neurologically based disorders and other associated psychosocial problems. Those children have learning disorder need systematic psychiatric and neuropsychological evaluations for proper managements. Moreover many educational test instruments and special educational literatures use an information processing model for understanding learning and learning disabilities. Any learning disorders can involve more than one area in various dysfunctional processes; input disabilities (visual and auditory perceptions, and other sensory integrations), integration disabilities (sequencing, abstraction, and organization), memory disabilities, and output disabilities (language and motor). Individuals with learning disability require appropriate interventions, whether they are clinical or educational. They must be screened primarily by family physicians, pediatricians, and psychiatrists, and have psychosocial supports for themselves and their family, and then be referred to child and adolescent psychiatrists for optimal treatment planning and multimodal managements.
Adolescent ; Auditory Perception ; Automatic Data Processing ; Child ; Combined Modality Therapy ; Humans ; Learning ; Learning Disorders* ; Memory ; Physicians, Family ; Primary Health Care ; Psychiatry