The results of 54 consecutive patients with intermittent exotropia treated with surgery at least 6 months follow-up are reviewed. The purpose of this paper was to study retrospectively the course of patients who had overcorrective treatment of intermittent exotropia and the specific parameters examined included the age of the patient at the time of onset; age of patient at the time of the initial surgery; length of time between the onset of the exodeviation and initial surgery; and distance: near deviation effect on surgical result. The results were as follows; 1. Average age of onset was 3.7 years and the average age of operation was 6.7 years. 2. Mean duration between the first hospital visit and operation was 6.3 months. 3. The angle of deviation less than 30 delta was found in 72.2% of cases. 4. Average degree of refractive errors was -1.187 in cycloplegic refraction. 5. The final satisfactory surgical result was achieved in 76% of the cases. The cases showing 5~15 delta overcorrection immediate postoperatively showed the most satisfactory final outcome and this was statistically significant. (P<0.05) 6. The age at the time of onset and the age at the time of the initial surgery did not significantly influence the surgical result(P>0.05).
Age of Onset ; Exotropia* ; Follow-Up Studies ; Humans ; Refractive Errors ; Retrospective Studies

The eruptive collagenoma is a connective tissue nevus without family history. We report a case of eruptive collagenoma in a 5 year old boy, who had multiple, variable sized orange colored nodules on his back since birth. The histopathologic finding showed increased number and size of collagen fiber and increased dermal thickness.
Child, Preschool ; Citrus sinensis ; Collagen ; Connective Tissue ; Humans ; Male ; Nevus ; Parturition

Acute appendicitis is the most common operative disease in general surgery, but it is not also rate disease to see in other clinical department such as Internal Medicine and Obstetric and Gynecology, because it reqnires to differenciate from many other diseases which have similar symptoms. Expecially, because the clipical aymptoms of acute appendicitis are not typieal in children, elderly, and women, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease. We performed colonoscopy due to be interpretated aa one of the colon diseases rather than acute appendicitis. But in colonoscopic findings, there were hyperemie and edematous change on the appendiceal orifice of cecum(cherry or acorn shape). So we report 5 cases of acute appendicitis diagnosed br colonoscopy.
Aged ; Appendicitis* ; Child ; Colon ; Colonoscopy* ; Female ; Gynecology ; Humans ; Internal Medicine

BACKGROUND: We performed electrical cardioversion for the patients with chormic nonvalvular atrial fibrillation under the transesophageal echocardiographic guidance after anticoagulation to evaluate the safety of this procedure and the effects of electrical cardioversion on the atrial function. METHODS: After anticoagulation therapy with coumadine for three weeks, we tried chemical cardioversion with amiodarone first. Failed cases were included in this study. Pre-cardioversion transesophageal echocardiographic parameters were measured after exclusion of thrombi. After sedation with intravenous midazolam, direct-current cardioversion was done with the transesophageal echocardiographic probe in situ. Immediately after sinus conversion, we measured echocardiographic parameters again. Spontaneous echo contrast(SEC), left atrial appendage flow velocity, pulmonary vein flow velocity and time-velocity-integral(TVI), transmitral flow velocity, TVI and deceleration time were measured. All patients were anticoagulated for at least 4 weeks after cardiovesion. RESULTS: The total number of patients was forty one(24 males, 17 females) with the mean age of 58 years(range : 39-70). Mean duration of atrial fibrillation was 65 months(range : 1-360). Hypertension(12), dilated cardiomyopathy(10), cerebrovascular accidents(6), ischemic heart disease(2) and chronic lung disease(1) were associated. There were no complications. SEC increased or newly appeared in 18(43.9%) patients after sinus conversion. The left atrial appendage emptying velocity decreased(32.8+/-17.4 vs. 22.1+/-11.4cm/sec, p=0.020) and systolic TVI of both upper pulmonic vein increased significantly after sinus conversion. In two cases, early systolic forward flow(S1) of pulmonic vein appeared after sinus conversion. Transmitral E velocity decreased(86.9+/-28.8 vs. 76.3+/-30.6cm/sec, p=0.006) and the deceleration time increased(164+/-49 vs. 206+/-53msec, p=0.000) after sinus conversion. Transmitral A velocity was still low(34.9+/-19.5cm/sec) and E/A ratio was high(2.6+/-1.4) immediately after sinus conversion. CONCLUSION: After appropriate anticoagulation therapy and exclusion of left atrium and left atrial appindage thrombi with TEE we could perform electrical cardioversion safety without complications. The changes in transesophageal echocardiographic parameters after sinus conversion revealed the appearance of atrial mechanical activity in concordance with electrical activity. But these findings suggested atrial stunning or electromechanical dissociation which necessitates extended anticoagulation therapy until the full recovery of atrial mechanical function.
Amiodarone ; Atrial Appendage ; Atrial Fibrillation* ; Atrial Function ; Deceleration ; Echocardiography* ; Echocardiography, Transesophageal ; Electric Countershock* ; Heart ; Heart Atria ; Humans ; Lung ; Male ; Midazolam ; Pulmonary Veins ; Veins ; Warfarin

No abstract available.

No abstract available.
Fructosamine*

We used to measure keratometric readings for IOL calculation as obtained by keratometer (Javal ophthalmometer) and recently computer assisted videokerato graphy (C.V.K.). To compare with accuracy of two different instruments we analyzed 100 eyes using Javal ophthalmometer and 100 eyes using C.V.K. in phacoemulsification procedures. Postoperative two months later, we had conclusion which had no significant difference in predicted refraction between two groups and there are a little tendency in myopic pattern in C.V.K. group. Also we found less dioptric power difference between the two groups in younger age, male, irregular astigmatism and small wound.
Astigmatism ; Corneal Topography* ; Humans ; Male ; Phacoemulsification ; Reading ; Wounds and Injuries

Melanoacanthoma is an extremely rare pigmented benign mixed epithelial tumor of both melanocytes and keratinocytes. A 52-year-old female presented an asymptomatic, slightly elevated, 1. 2 cm x 0. 8 cm, dark black-colored plaque on her right buttock of 2 years' duration. Histopathologic finding of the plaque shows hyperkeratosis, focal parakeratosis, follicular plugging, acanthosih, papillomatosis and pseudo-horn cyst in the epidermis. The tumor is composed of basaloid and squarnous cells with many foci of clusters and whorls of melanin pigment-laden cells. Electron microscopic finding reveals many scattered melanocytes in the entire epidermis. Melanin granules are found mostly in the melanocytes but can also be found in a few keratinocytes.
Buttocks ; Epidermis ; Female ; Humans ; Keratinocytes ; Melanins ; Melanocytes ; Middle Aged ; Papilloma ; Parakeratosis

As increasing demands for CCC (Continuous Curvilinear Capsulorhexis) fincreases, the incidence of capsule contraction syndrome is also increasing in cataract surgery. We tried to classify and treat this syndrome with 44 eyes who have capsule contraction. It is known that the basic mechanism of capsule contraction is fibrotic dysplasia of anterior capsule, and we found that capsular contraction can arise with glaucoma, diabetes mellitus, uveitis, retinitis pigmentosa, psuedoexfoliation syndrome and old aged group as ordered. It can also be frequently can be found in age 50 to 60. In order to decrease the complication of capsule contraction(IOL dislocation, retinal detachment, etc.), we incised the anterial capsule with Nd:Yag laser at the time of fibrotic change. For the case of weak zonules, we made a radial incision in the 12 o'clock direction after IOL insertion.
Cataract ; Diabetes Mellitus ; Dislocations ; Glaucoma ; Incidence ; Retinal Detachment ; Retinitis Pigmentosa ; Uveitis

A herniated lumbar intervertebral disc has been the most common cause of low back pain and sciatica since Mixter and Barr reported it in 1934. Our methods of treatment were the conservative treatment and the excision of the herniated disc for a limited number of carefully selected cases. The results of disc surgery relate to a number of factors, unquestionably the most important being patient selectivity. We emplopyed Finneson's lumbar disc surgery predictive score card to determine the relationship between patient selection and the outcome of lumbar disc surgery in operative cases. This report is to give a clinical review of 46 cases of the herniated disc upon which surgical removal were performed at Eul-Ji General Hospital from March 1981 to July 1982. The results were obtained as follows: 1. The most common age group were 21 to 40 year old. 2. In 46 surgically treated cases, 34 cases were male (74%) and 12 cases were female (26%). 3. The bulging of disc was found in 25 cases and the ruptured disc was found in 14 cases. The most common site of the lesion was L4-5 intervertebral disc with 30 cases (65%) and the next L5-Sl intervertebral disc with 10 cases (22%). 4. The outcomes of lumbar disc surgery were evaluated at follow-up as good in 77 per cent, fair in 11 per cent, marginal in 7 per cent and poor in 5 per cent of the patients. 5. The predictive scores of each result category were averaged and were as follows; Good: 77.1, Fair: 67.3, Marginal: 58.0, Poor: 40.0 6. The average predictive scores of each result category fell within the anticipated parameters of the score card. 7. The score card may be utilized as reliable system for presurgical patient selection.
Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Low Back Pain ; Male ; Patient Selection ; Sciatica