BACKGROUND: Since the first report of a rapidly resolved subdural hemorrhage (SDH) in 1986, few additional case reports have been presented in the literature. CASE REPORT: An 82-year-old female patient presented with a SDH over the left convexity. The SDH was removed via catheter drainage through a burr hole trephination. Post-operative computed tomography (CT) following 300 mL drainage from the chronic SDH demonstrated a newly developed SDH along the right convexity. A follow-up CT performed 2 hours later revealed an unexpected significant resolution of the acute SDH. CONCLUSION: The spontaneous resolution of acute SDH is believed to result from redistribution by washout of the hematoma by cerebrospinal fluid dilution. However, its exact pathophysiology is not well understood. When surgical evacuation is considered in acute SDH, conservative management should also be considered because spontaneous resolution of hemorrhage remains a possibility.
Aged, 80 and over ; Catheters ; Cerebrospinal Fluid ; Drainage ; Female ; Follow-Up Studies ; Hematoma ; Hematoma, Subdural ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Trephining

Purpose: To evaluate the prevalence of dry eye symptoms after endoscopic dacryocystorhinostomy (EDCR) for patients with primary acquired nasolacrimal duct obstruction (PANDO) combined with dry eye syndrome. Methods: The patients diagnosed with PANDO combined with dry eye syndrome who underwent EDCR were divided into two groups according to the questionnaire about dry eye symptoms after surgery. The medical records were retrospectively analyzed. Before and after surgery, we compared the tear meniscus height, tear breakup time, and the presence of corneal punctuate epithelial erosion. The level of dry eyes of patients after surgery was assessed by using the Korean guidelines for the diagnosis of dry eye. Results: At 6 months after EDCR, the proportion of patients with dry eye symptoms was 30% in a total of 80 patients. The duration of epiphora and tear breakup time after EDCR were higher in the group without dry eye symptoms and the proportion of eyes with corneal punctuate epithelial erosion after EDCR was higher in the group with dry eye symptoms. About 15% of total patients started treatment with a dry eye of level 2 or higher. Conclusions About 15% of patients who underwent EDCR for PANDO combined with dry eye syndrome developed significant dry eye syndrome after surgery. The short onset of epiphora was associated with the development of the dry eye symptoms. Therefore, it is necessary to evaluate dry eye syndrome before surgery, and surgeons should be careful about this.

PURPOSE: To discriminate the visual symptoms and signs of Meares-Irlen syndrome (MIS) and nonspecific dyslexia from other ophthalmologic diseases (NODs). METHODS: Forty-five patients were enrolled. Thirty four of the patients with MIS whose symptoms improved with tinted lenses comprised MIS group. The other 11 patients whose reading difficulty improved with other ocular therapy and did not require tinted lenses comprised NODs group. The main symptoms causing dyslexia and associated ocular diseases were evaluated. RESULTS: The mean age was 17.9 +/- 9.5 years in MIS group, and 19.3 +/- 11.0 years in NODs group. In MIS group, the most common symptoms while reading were difficulty to move lines (85%), doubling (53%), and difficulty in bright condition (27%). On the other hand, blurring was the most common symptom in NODs group (45%). The associated ocular diseases in the two groups were refractive error (79% and 73%), dry eye (29% and 18%), and exophoria (6% and 27%), respectively. CONCLUSIONS: Doubling, difficulty to move lines, and difficulty in bright condition while reading are main specific symptoms in MIS compared to nonspecific dyslexia from other ophthalmologic disorders.
Adolescent ; Adult ; Child ; Color ; Diagnosis, Differential ; Dyslexia/*diagnosis ; Eyeglasses ; Female ; Humans ; Male ; Night Vision ; Perceptual Disorders/*diagnosis/therapy ; Reading ; Refractive Errors/diagnosis/therapy ; Republic of Korea ; Retrospective Studies ; Syndrome ; Vision Disorders/*diagnosis/therapy ; Young Adult

PURPOSE: To evaluate the accuracy of preoperative keratometers used in cataract surgery with toric intraocular lens (IOL). METHODS: Twenty-five eyes received an AcrySof toric IOL implantation. Four different keratometric methods, a manual keratometer, an IOL master, a Pentacam and an auto keratometer, were performed preoperatively in order to evaluate preexisting corneal astigmatism. Differences between the true residual astigmatism and the anticipated residual astigmatism (keratometric error) were compared at one and three months after surgery by using a separate vector analysis to identify the keratometric method that provided the highest accuracy for astigmatism control. RESULTS: The mean keratomeric error was 0.52 diopters (0.17-1.17) for the manual keratometer, 0.62 (0-1.31) for the IOL master, 0.69 (0.08-1.92) for the Pentacam, and 0.59 (0.08-0.94) for the auto keratometer. The manual keratometer was the most accurate, although there was no significant difference between the keratometers (p > 0.05). All of the keratometers achieved an average keratometric error of less than one diopter. CONCLUSIONS: Manual keratometry was the most accurate of the four methods evaluated, although the other techniques were equally satisfactory in determining corneal astigmatism.
Analysis of Variance ; Astigmatism/complications/*surgery ; *Cataract Extraction ; Female ; Humans ; Lens Implantation, Intraocular/*methods ; *Lenses, Intraocular ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Refraction, Ocular ; Reproducibility of Results ; Treatment Outcome ; Visual Acuity

STUDY DESIGN: This is a prospective study. PURPOSE: To develop a methodological approach for conducting ultrasound-guided lumbar facet nerve block by defining essential ultrasound-guided landmarks in order to assess the feasibility of this method. OVERVIEW OF LITERATURE: The current role of ultrasound guidance for musculoskeletal intervention treatments has been reported upon in previous literature. METHODS: Ultrasound-guided facet nerve block was done in 95 segments for 50 patients with chronic back pain by facet arthropathy. After the surface landmarks of the spinous process and iliac crest line were confirmed, longitudinal facet views were obtained by a curved array transducer to identify the different spinal segments. The spinous process and facet joint with transverse process were delineated by transverse sonograms at each level and the target point for the block was defined as lying on the upper edge of the transverse process. The needle was inserted toward the target point. After a contrast injection, the placement of the needle and contrast was checked by fluoroscopy. RESULTS: Eighty-seven segments (91.6%) could be guided successfully to the right facet nerve block by using ultrasound. After fluoroscopic control, 8 needles had to be corrected because of problems with other segments (3 cases) and lamina placements (5 cases). For the 42 patients who underwent successful block by ultrasound, however, the mean visual analogue score for back pain was improved from 6.2 +/- 0.9 before the block to 4.0 +/- 1.0 after the block (p = 0.001). CONCLUSIONS: Ultrasound-guided longitudinal facet view and the surface landmarks of the spinous process and iliac crest line seems to be a promising guidance technique for the lumbar facet nerve block technique.
Back Pain ; Deception ; Fluoroscopy ; Humans ; Lumbosacral Region ; Needles ; Nerve Block ; Prospective Studies ; Transducers ; Zygapophyseal Joint

Chronic granulomatous infection of the skin and soft tissue by nontuberculous mycobacteria in patients with normal immune system is rarely reported. This case was about a child patient, with normal immune system, whose lower leg was lacerated after a slip down in the Philippines and it was previously treated at a hospital in the Philippines. After a couple of surgical debridement of the wound, the cause of the soft tissue infection was found to be a combined infection of nontuberculous mycobacteria and mycobacterium tuberculosis. We present a case that has been rare in Korea, but common overseas.
Child ; Debridement ; Humans ; Immune System ; Korea ; Leg ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Philippines ; Skin ; Soft Tissue Infections

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

PURPOSE: To compare the clinical outcome between Tecnis ZM900 and Tecnis ZA9003. METHODS: We reviewed 20 eyes of 11 patients implanted with Tecnis ZM900 and 20 eyes of 20 patients implanted with Tecnis ZA9003. The clinical outcomes of these two intraocular lenses were evaluated one month after operation and consisted of distant, intermediate, and near visual acuity; depth of focus; contrast sensitivity; wavefront aberration; and patient satisfaction. Six months after the operation a reevaluation was performed for the group who had received the Tecnis ZM 900 implant. RESULTS: Near and intermediate vision was better in the Tecnis ZM900 group. There were no statistical differences between the two groups with respect to distant vision and wavefront aberration. Contrast sensitivity was better in the Tecnis ZA9003 group and depth of focus was deeper in the Tecnis ZM900 group. There were no statically significant differences in the result between one month and six month after the operation. CONCLUSIONS: The Tecnis multifocal ZM900 IOL can be effective at improving patient satisfaction after cataract surgery as well as for correcting presbyopia.
Cataract ; Contrast Sensitivity ; Eye ; Humans ; Lenses, Intraocular ; Patient Satisfaction ; Presbyopia ; Vision, Ocular ; Visual Acuity

The most common complication of coil embolization for cerebral aneurysms is thrombo-embolic stroke; in rare cases, these strokes, can present with central retinal artery occlusion. At our institution, a 53-year-old woman underwent stent-assisted coiling of the aneurysm. The patient's vision was improved immediately after intra-arterial thrombolysis and had further improved 8 months later. This report describes our experience of a rare case of central retinal artery occlusion after coil embolization that was successfully treated by intra-arterial thrombolysis.
Aneurysm* ; Embolization, Therapeutic* ; Female ; Humans ; Intracranial Aneurysm ; Middle Aged ; Retinal Artery Occlusion* ; Retinal Artery* ; Stroke

OBJECTIVE: People often evaluate others using fragmentary but meaningful personal information in recent days through social media. It is not clear that whether this process is implicit or explicit and what kind of information is more important in such process.We examined the effects of several meaningful fragmentary information onattitude. METHODS: Thirty three KAIST students were provided four fragmentary information about four virtual people that are meaningful in evaluating people and frequently seen in real life situations, and were asked to imagine that person during four follow-up sessions. Explicit and Implicit attitudes were measured using Likert scale and Implicit Association Test respectively. Also, eye tracking was done to find out the most important information. RESULTS: Strong explicit attitudes, were formed toward both men and women, and weak but significant implicit attitudes, were generated toward men only. Eyetracking results showed that people spent more time reading morality information. CONCLUSION: Our results indicate that explicit attitudes are made by propositional learning, which is the main component for evaluating others with several meaningful fragmentary information, and implicit attitudes are formed by top down process. And as well as those of previous studies, morality information was suggested as the most important factor in developing attitudes.
Female ; Follow-Up Studies ; Humans ; Learning ; Male ; Morals ; Social Media