There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

Lower urinary tract symptoms (LUTS) are a cluster of voiding symptoms, such as weak stream, hesitancy, intermittency, urinary frequency, urgency, and nocturia. LUTS are frequent in elderly men and it considered the ultimate clinical symptoms of benign prostatic hyperplasia. With aging, male hypogonadism is increased which is defined as decreased ability of the testes to produce sperm and sex steroids because of a pituitary/hypothalamic, or testicular deficiency. In academic andrology associations, the term “male hypogonadism” is commonly used to categorize testosterone deficiency. Testosterone deficiency syndrome (TDS) is defined as a decrease in serum testosterone accompanied by symptoms such as libido decrease, depressive disorder, erectile dysfunction, and fatigue. Although the mechanism about testosterone-replacement therapy (TRT) effects on men with hypogonadism is not yet identified, TRT has been shown to effectively relieve the symptoms of TDS as well as LUTS by several studies. Although the present review demonstrates the effectiveness and safety of TRT in men with TDS by prior studies, future large scale of clinical trials should be conducted to present more high-quality evidence to clinicians and patients.

Lower urinary tract symptoms (LUTS) are a cluster of voiding symptoms, such as weak stream, hesitancy, intermittency, urinary frequency, urgency, and nocturia. LUTS are frequent in elderly men and it considered the ultimate clinical symptoms of benign prostatic hyperplasia. With aging, male hypogonadism is increased which is defined as decreased ability of the testes to produce sperm and sex steroids because of a pituitary/hypothalamic, or testicular deficiency. In academic andrology associations, the term “male hypogonadism” is commonly used to categorize testosterone deficiency. Testosterone deficiency syndrome (TDS) is defined as a decrease in serum testosterone accompanied by symptoms such as libido decrease, depressive disorder, erectile dysfunction, and fatigue. Although the mechanism about testosterone-replacement therapy (TRT) effects on men with hypogonadism is not yet identified, TRT has been shown to effectively relieve the symptoms of TDS as well as LUTS by several studies. Although the present review demonstrates the effectiveness and safety of TRT in men with TDS by prior studies, future large scale of clinical trials should be conducted to present more high-quality evidence to clinicians and patients.

OBJECTIVES: To assess the distribution of social support, and explore its effects on self-rated health status in a low income neighborhood of Seoul, Korea. METHODS: In September 2001 we conducted a survey in a low income neighborhood of Seoul, Korea, in which 862 residents, aged 18 years or over, participated. We measured the general sociodemographic characteristics, self-rated health status and social support with the instrument developed from Korean translation of the Medical Outcomes Study Social Support Survey (MOS-SSS) scale of the US. Logistic regression was used to identify the determinants of social support, and explore its effects on self-rated health status. RESULTS: Lower social class, women or divorced people had much less social support compared to higher social class, men or those never married, respectively. Those families on much lower income also received less social support. Social support has a positive impact on the self-rated health status, which remains statistically significant even when other relevant variables are adjusted. CONCLUSIONS: This study suggests that social support has an important role in health, and the socially disadvantaged have lower social support. Therefore, to improve the health status of the poor, it is necessary to encourage community participation, and develop strategies that could strengthen their provision of social support.
Consumer Participation ; Divorce ; Female ; Humans ; Korea* ; Logistic Models ; Male ; Residence Characteristics* ; Seoul* ; Single Person ; Social Class ; Vulnerable Populations

OBJECTIVES: Laryngomicrosurgery (LMS) is used to manage most vocal fold lesions. However, the functional voice outcome of the LMS might be diverse due to the influence of various factors. We intend to evaluate the incidence and etiologic factors of persistent dysphonia after LMS for benign vocal fold disease (BVFD). METHODS: We performed a retrospective review of 755 patients who underwent LMS for BVFD. We analyzed the clinical characteristics, preoperative and postoperative two onths voice studies. Postsurgical dysphonia was defined as grade 1 or above in GRBAS (grade, roughness, breathiness, asthenia, and strain) scale. Thirty nine patients (5.2%; 25 males and 14 females; average, 42.9 years; range, 21 to 70 years) were diagnosed with postsurgical dysphonia. RESULTS: There was no correlation between the diagnosis, coexistence with laryngopharyngeal reflux disease, habit of smoking, or occupational voice abuse and voice outcome. The patients with a worse preoperative acoustic parameter had aworse voice outcome. Stroboscopic findings showed excessive scarring or bowing in 21 cases, presence of lesion remnant in eight cases, prolonged laryngeal edema in five and no abnormal findings in three. CONCLUSION: Great care should be taken in patients with worse preoperative jitter. With a few exceptions, postoperative dysphonia can be avoided by the use of an ppropriate surgical technique.
Acoustics ; Asthenia ; Cicatrix ; Dysphonia ; Humans ; Incidence ; Laryngeal Edema ; Laryngopharyngeal Reflux ; Male ; Retrospective Studies ; Smoke ; Smoking ; Vocal Cords ; Voice

Tumors that develop from external auditory canal (EAC) are very rare. Adenoma that originates from apocrine is also a rare entity found in the EAC. Nevus sebaceous, syringocystadenoma papilliferum (SCAP), tubular apocrine adenoma (TAA), and fibroadenoma are known to originate from apocrine. Among them, SCAP is believed to be a benign tumor that is manifested as papule and plague on the scalp and the face. However, TAA is a rare intradermal eccrine tumor and it mostly manifests as an isolated single nodule within the scalp area. Generally, these tumors are considered as two separate entities. Many articles have reported on the prevalence of TAA or SCAP with nevus sebaceous on the body, extremities, and scalp; but only 2 articles were reported on tumors that developed from EAC. In this article, we report on a patient who presented a mass in EAC, with both SCAP and TAA pathohistologic finding without nevus sebaceous.
Adenoma ; Aminocaproic Acids ; Apocrine Glands ; Ear Canal ; Extremities ; Fibroadenoma ; Humans ; Nevus ; Plague ; Prevalence ; Scalp

Thyroid antibodies are frequently observed in urticaria patients, but their roles in urticaria are not clearly elucidated. We investigated the role of serum specific IgE to thyroid peroxidase (TPO) in patients with aspirin intolerant acute urticaria (AIAU) and aspirin intolerant chronic urticaria (AICU). We recruited 59 AIAU and 96 AICU patients with 69 normal controls (NC). Serum specific IgE to TPO was measured by manual direct ELISA, and CD203c expressions on basophil with additions of TPO were measured to prove a direct role of TPO in effector cells. The prevalences of serum specific IgE to TPO were significantly higher in AIAU (15.2%) and AICU groups (7.5%) compared to NC (0%, P=0.018: P=0.013, respectively). Flow cytometry showed CD203c induction in a dose dependent manner with serial additions of TPO in some AIAU and AICU patients having high specific IgE to TPO. Our findings show that the prevalence of serum specific IgE to TPO was significantly higher in both AIAU and AICU patients than in NC. It is suggested that specific IgE to TPO play a pathogenic role in AIAU and AICU.
Adult ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Aspirin/*adverse effects ; Autoantibodies/immunology ; Basophils/drug effects/*immunology ; Humans ; Immunoglobulin E/blood/*immunology ; Iodide Peroxidase/blood/*immunology ; Urticaria/*chemically induced/*immunology/pathology

Persistent eosinophil activation in both the upper and lower airway mucosa is a central feature of aspirin-exacerbated respiratory disease (AERD). Eosinophil activation and survival are profoundly influenced by interleukin 5 (IL-5) and its receptor, IL-5R. In patients susceptible to allergic disorders, IL-5 receptor alpha (IL5RA) polymorphisms have been reported; however, an association with AERD remains unclear. We hypothesize that IL5RA polymorphisms may contribute to eosinophil activation in AERD patients. We recruited 139 AERD patients, 171 aspirin-tolerant asthma patients and 160 normal controls. IL5RA polymorphisms (-5993G>A, -5567C>G and -5091G>A) were genotyped and functional activity of polymorphism was assessed by luciferase reporter assay and electrophoretic mobility shift assay (EMSA). There was no significant difference in the genotype frequency of the three polymorphisms among the three groups. AERD patients carrying the AA genotype at -5993G>A had a significantly higher presence of serum-specific immunoglobulin E (IgE) to staphylococcal enterotoxin A (P=0.008) than those with the GG/GA genotype. In vitro, the -5993A allele had a higher promoter activity compared with the -5993G allele in human mast cell (HMC-1; P=0.030) and human promyelocytic leukemia (HL-60; P=0.013) cells. In EMSA, a -5993A probe produced a specific shifted band than the -5993G had. These findings suggest that a functional polymorphism in IL5RA may contribute to eosinophil and mast cell activation along with specific IgE responses to staphylococcal enterotoxin A in AERD patients.
Adult ; Aspirin/*adverse effects ; Electrophoretic Mobility Shift Assay ; Female ; Gene Frequency/genetics ; Humans ; Interleukin-5 Receptor alpha Subunit/*genetics ; Male ; Middle Aged ; Phenotype ; Polymorphism, Single Nucleotide/*genetics ; Respiration Disorders/*chemically induced/*genetics ; Transcription, Genetic

Cases of acute myocardial infarction (AMI) that occurs during pregnancy or postpartum are rarely reported. Ergot derivatives were known to induce spasmodic contraction of coronary arteries. Administration of ergot derivatives can cause AMI even in normal healthy people. Several cases are also reported that ergot derivatives may trigger severe AMI in postpartum period. Here, we report a case of a forty-year-old pregnant woman who was succeeded to be pregnant by artificial fertilization died after treatment with ergot derivatives. Examinations of autopsy have revealed AMI with severe coronary atherosclerosis. This case is the first report which shows aggravation of preexistent severe coronary atherosclerosis after postpartum infusion of ergot derivatives.
Autopsy ; Coronary Artery Disease ; Coronary Vessels ; Ergot Alkaloids ; Female ; Fertilization ; Humans ; Myocardial Infarction* ; Postpartum Period* ; Pregnancy ; Pregnant Women

OBJECTIVES: Kyung Hee-Frankfurter Beschwerde-Fragebogen(K-FBF) is a representative subjective symptom measuring tool of schizophrenic patients. We performed psychopathology measurements using K-FBF, Positive and Negative Syndrome Scale(PANSS) and Symptom Checklist-90-Revised(SCL-90-R) in patients with schizophrenia and then compared the results of these three examinations one another, in order to examine which psychopathologic aspects K-FBF might reflect and to measure the possibility whether this instrument reflect the negative symptoms or cognitive impairments, which are difficult to measure by conventional objective instruments measuring psychopathology. METHODS: All 66 patients satisfying DSM-IV criteria for schizophrenia, were approached. Their education level was more than high school and they were not in the acute stage of schizophrenia. They performed K-FBF and SCL-90-R, and at the same day, they were interviewed by one of both psychiatirsts using PANSS. We examined the patterns of K-FBF response and performed facor analysis about 10 subscales. We examined the correlation between K-FBF and age, sex and insight. Also, we performed correlation analysis among the K-FBF, PANSS and SCL-90-R. RESULTS: As for K-FBF, with increasing age, the number of positive response items and the symptom severity were decreased. Even when controlling prevalence period as control variable, the correlation remained unchanged. Performing factor analysis to the K-FBF subscales, we created 2 factors, ie summation subscales. We named those recognized distress(RD) and perceptual alteration(PA) each. Using K-FBF standardized total scores as controlling variable, we performed partial correlation between PA and PANSS negative symptom scale. The result was PA and PANSS have statistically significant correlation. This correspons with the view that Huber's basic symptoms are reflecting subjective approach of negative symptoms of schizophrenia. While K-FBF standardized total scores and PANSS total scores had statistically strong correlations, SCL-90-R total scores and PANSS total scores had statistically significant, but very mild correlations. So, we had the judgement that the correlations among the psychopathology measurement tools are more influenced by the rater than the contents of tools. CONCLUSION: We concluded that Huber's basic symptoms, measured by K-FBF, reflect more negative symptoms of schizophrenia than other symptoms. And K-FBF has more correlation with the PANSS, objective psychopathology measuring tool, than the SCL-90-R, self-report quetionnaire. But, more studies using patients with another disease stages and another demographic variables are needed in order to generalize the results of this study.
Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Prevalence ; Psychopathology* ; Schizophrenia*