We evaluated 38patients with orbital wall fracture, who were repaired surgically after its diagnosis from January 1986 to October 1995. We analysed its clinical symptoms and signs, ocular motlity disturbances and strabismus remaining after reduction. All the aptients showed diplopia due to ocular motility disturbance, it was greater in the patients with large fracture size and inferior wall fracture. The ocular motility disturbance remaining after the reduction was proportional to the fracture size and the time between trauma and its reduction. The exotropia and hypertropia of the fracturd eye were the main types of strabismus remaining after reduction. It was more severe in the patients with large fracture size and upper grade of ocular motility disturbance. The weakening procedure of horizontal and vertical muscle resulted in good correction for the strabismus.
Diagnosis ; Diplopia ; Exotropia ; Humans ; Orbit* ; Strabismus

The authors examined the effect and concentration dependency of bromocriptine on the inhibition of axial length elongation in the experimentally induced myopic chicken. Two day-old white Leghorn chicken was monocularly deprived of form vision by lid suture. We measured the axial length of chicken's eye by ultrasonography at 2 day, 2 week, 4 week, and 6 week following repeated ophthalmic dosing beginning at 2 day. The first group was instilled with 0.1 cc of Tris buffer solution, whereas the second, third, and fourth groups were instilled with 0.1cc of 0.01 %, 0.02%, 0.04% bromocriptine solution respectively. All solutions were instilled twice daily for 6 weeks. In the inhibition of axial length elongation, the third group (0.02% bromocriptine) was most effective at 2 week (p<0.05), whereas the second group (0.01% bromocriptine) was most effective at 4 and 6 week (p<0.05). In summary, the axial length elongation of eyeball was effectively retarded by bromocriptine with the best efficacy at 0.02% in short-term dosing while at 0.01% in long-term dosing.
Bromocriptine* ; Chickens* ; Sutures ; Tromethamine ; Ultrasonography

Authors performed horizontal transposition of superior and inferior rectus muscle in 3.0 mm, to eliminate excyclotorsion of the 5 degrees which remained after Harada-Ito procedure in two patients with superior oblique palsy. The medial and lateral edges of the proximal part of tendon were reattached at the temporally and the inferior retus nasally. This operation was performed 3 or 4 months ater Harada-Ito procedure in 2 patients, respectively. The amount of horizontal transposition was made according the degree of excyclotorsion measured by double maddox rod test. The results showed no cyclotorsion at head tilt to the right and double maddox rod test. In conclusion, the horizontal transposition of vertical rectus muscles is effective in the elimination of excyclotorsion remained after Harada-Ito procedure for superior oblique palsy.
Head ; Humans ; Muscles ; Paralysis ; Tendons

The therapeutic strategy of the left main disease is quite different frorn usual coronary artery disease. Therefore, the diagnostic evaluation should be done carefully. Eventhough coronary angiography has been considered as a gold standard for the diagnosis of left main disease, its diagnosis is not possible in all cases. In questionable situation, direct visualization of the left main coronary artery and Doppler measurements of coronary blood flow by transesophageal echocardiography may give some diagnostic aids. We report a case of suspected isolated ostial left main stenosis, which was helped diagnotically by perfoming transesophageal Doppler echocardiography.
Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Echocardiography, Doppler* ; Echocardiography, Transesophageal

PURPOSE: The morphologic characteristics and adhesion complex formation of cultured limbal epithelium of rabbit on amniotic membrane, in vitro and in vivo. METHODS: Rabbit limbal explants were cultured in vitro on amniotic membrane for 4 weeks. In the in vivo culture, the rabbit corneal epithelium was removed. Next, a tunnel was created at the limbus and, the edge of amniotic membrane was secured in the tunnel and cultured for 4 weeks. The proliferation of epithelium on the amniotic membrane was observed for 4 weeks at 1 week intervals. RESULTS: AE-5 immunohistochemical staining was positive and PAS staining was negative for cultured rabbit limbal epithelium, in vitro and in vivo. Hematoxylin and Eosin staining showed the morphologic characteristics of normal rabbit corneal epithelium in both groups. Transmission electron microscopy performed at an interval of 1 week showed adhesion complex by 3 weeks of in vitro culture, and no significant change was seen until week 4. The formation of the adhesion complex was shown starting at week 1 of in vivo culture and increased until week 4. CONCLUSIONS: The morphology of corneal limbal epithelium of rabbits cultured on amniotic membrane in vitro and in vivo, did not differ significantly compared with normal rabbit epithelium. In vivo culture resulted in more a normal-looking adhesion complex compared with the in vitro culture.
Amnion* ; Eosine Yellowish-(YS) ; Epithelium* ; Epithelium, Corneal ; Hematoxylin ; Microscopy, Electron, Transmission ; Rabbits

Anomalous origin of the left circumflex coronary artery(LCx) from the right sinus of Valsalva is the most common coronary anomaly and, generally, is considered to be benign. Nevertheless, myocardial infarction or sudden death in young patients with this coronary anomaly has infrequently been described. The LCx arises from the right sinus of Valsalva or proximal right coronary artery, courses posterior to the aorta to enter the left atrioventricular groove, and provide branches to the left lateral wall of heart. Transthoracic or transesophageal echocardiography may provide a useful diagnostic clue although coronary angiography is the standard diagnostic method. We report 2 cases of anomalous origin of the LCx from right aortic sinus with typical echocardiographic images.
Aorta ; Coronary Angiography ; Coronary Vessels* ; Death, Sudden ; Echocardiography* ; Echocardiography, Transesophageal ; Heart ; Humans ; Myocardial Infarction ; Sinus of Valsalva

BACKGROUND: Thrombus-containing lesions (TCL) are associated with lower initial success rates and higher restenosis rates after balloon dilation. Furthermore, it has been considered as an absolute contraindication of coronary stenting. With advances in antithrombotic regimens and implantation techniques, coronary stenting has been widened to lesions with adverse morphologic features or to patients with acute coronary syndrome. Here we report the early clinical and angiographic results of coronary stenting in TCL. METHODS: We studied 24 consecutive patients (58+/-8 years, 18 males) undergoing coronary stenting in TCL. Fifteen patients (63%) were treated for acute myocardial infarction (AMI) and 9 (37%) for unstable angina. Stenting was performed as the primary therapy in 23 patients (96%) and secondary after angioplasty failure in I patient (4%). RESULTS: 1) Twenty-five stents were deployed successfully in all 24 patients with TCL. Distal flow with TIMI grade 3 was obtained immediately in 21 patients (88%). Ventricular fibrillation occurred in 3 patients (13%) during the procedure-related death or emergency bypass surgery did not occur. Marked CK elevation (over 5000U/L) was observed in 5 patients (21%) with AMI who underwent primary stenting. Two of these 5 patients (8%) had distal flow with TIMI grade 2 consistent with distal embolization, and one (4%) had distal flow with TIMI grade 0, suggesting acute stent occlusion. All 24 patients (100%) were event-free and showed clinical improvement at the last follow-up visit (71+/-15 days). 2) Quantitative angiography demonstrated excellent angiographic results after stenting (minimal luminal diameter 0.3+/-0.3 vs. 3.4+/-0.3mm, diameter stenosis 90.1+/-10.7 vs. -13.3+/-8.1%, p<0.005 respectively). Acute gain was 3.1+/-0.3mm (p<0.005). CONCLUSIONS: With low incidents of complications, coronary stenting could be used successfully for select patients with TCL as a primary therapeutic option under aggressive antithrombotic therapy. Although early clinical results were excellent, the long-term benefits remain to be established.
Acute Coronary Syndrome ; Angina, Unstable ; Angiography ; Angioplasty ; Constriction, Pathologic ; Emergencies ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Phenobarbital ; Stents* ; Ventricular Fibrillation

Symmetrical Digital Gangrene (SDG) is characterized by the sudden onset of peripheral, symmetrical gangrene in the absence of any major vascular occlusive disease. Catecholamine inotropes are frequently used for the treatment of septic shock combined with an unstable hemodynamic state, and their usage can rarely induce SDG. There is no standard treatment for the SDG. Early recognition and prompt management of sepsis and expeditious process of weaning off of the inotropes are necessary to prevent progression of SDG. To the best of our knowledge, this is the first report in Korea regarding the treatment of SDG induced by catecholamine inotropes.

PURPOSE: Transsexualism is considered to be the extreme end of the spectrum of gender identity disorders characterized by, among other things, a pursuit of sex reassignment surgery(SRS). We evaluated psychologic status, health-related quality of life in female-to-male (FTM), male-to-female(MTF) transgender individuals. METHODS: We used the Minnesota Multiphasic Personality Inventory, Beck Anxiety Inventory, Beck Depression Inventory, Moudsley obsessive-compulsive Inventory, SCL-90-R, Short-Form 36-Question Health Survey version 2(SF-36v2). We enrolled 40 transsexual participants. RESULTS: Analysis of quality of life health concepts demonstrated statistically significant(p<0.01) diminished quality of life among the transsexual participants as compared to the Korea male and female population. FTM transgender participants reported more higher hostile, phobic than MTF transgenders. Overall, in all psychologic status examination, Transgender individuals are within normal population boundary. On all category, result is improved post-operatively. CONCLUSION: Transgender participants reported mental status within normal boundary. SRS improved their quality of life and mental stability.
Anxiety ; Depression ; Female ; Gender Identity ; Health Surveys ; Humans ; Korea ; Male ; MMPI ; Quality of Life ; Transgender Persons ; Transsexualism

Acute myocardial infarction (AMI) with simultaneous occlusion of two or three coronary arteries is extremely rare, but may cause devastating events unless immediate revascularization strategies are undertaken. We report an unusual case of AMI with ST-segment elevation in precordial leads. Thrombolysis was achieved successfully 2 hours after the onset of chest pain. Coronary angiography revealed residual heavy fresh thrombi at right coronary artery (RCA) as well as patent residual stenosis at left anterior descending coronary artery (LAD). Akinesia was demonstrated at anterolateral, apical, diaphragmatic, and posterobasal segments on left ventriculography. Large perfusion defects were proven at LAD and RCA territories on myocardial SPECT.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels* ; Myocardial Infarction* ; Perfusion ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon