Adjustable sutures increased the rate of success with a single procedure, but sometimes fails because of changes in the angle of deviation which develops a few days after surgery. Therefore, the delayed adjustment was attempted;however, the postoperative adhesion following strabismus surgery make delayed adjustment impossible. We studied 45 eyes of 25 rabbits; adjustable strabismus surgery underwent a hang-back technique in the superior rectus muscle. In experimental group, a sponge was soaked in 5-Fluorouracil, and the sponge was placed between the conjunctiva and the sclera for 5 minutes during the operation. We studied the possible time of delayed adjustment and estimated the minimal forces required for the adjustment. The experimental group A (5-Fluorouracil, 50mg/ml) allowed for a 6 day delayed adjustment after surgery, control group allowed for a 2 day delayed adjustment after surgery. These results suggest that 5-Fluorouracil may valuable resource to delayed adjustment strabismus surgery by reduce postoperative adhesion.
Conjunctiva ; Fluorouracil* ; Porifera ; Rabbits ; Sclera ; Strabismus* ; Sutures

The widespread use of diagnostic radiography, especially using magnetic resonance imaging, has helped to increase the diagnosis of paralabral cysts in patients with chronic shoulder pain. These paralabral cysts are frequent in the anterior, the superior, and the posterior compartment of the shoulder joint but are rare in the inferior compartment. Paralabral cysts in the shoulder appear particularly in men in their third and fourth decades but rarely in elderly patients. We report a case of an inferior paralabral cyst in an elderly patient whom we treated through arthroscopic decompression.
Aged* ; Arthroscopy ; Decompression* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Shoulder Joint ; Shoulder Pain ; Shoulder*

Authors examined 30, 000 minifilms(boys and girls each 15, 000) which were taken for survey of pulmonary tuberculosis for the students of the first grade, middle school in Seoul(average 13 years old), to determine the ineidence rates of scoliosis. It was considered lateral curvature of spine more than 10 degrees as non-postural scoliosis, which were analyzed for the presence of bony abnormality, sex incidence, degree of curvature, distribution of size of curvature, patterns of curvature, and direction of curvature. Following results were obtained. 1. The overall incidence of scoliosis was 1. 46%; female 1. 86% and male 1.07%. 2. Scoliosis due to bony abnormality was found in 4 cases. 3. Degrees of curvature; 10°-19°
Female ; Humans ; Incidence ; Korea ; Male ; Scoliosis ; Spine ; Tuberculosis, Pulmonary

PURPOSE: To compare the effect of an intravitreal injection of triamcinolone acetonide with bevacizumab in the treatment of diabetic macular edema (DME). METHODS: For this study, the medical records of patients with diabetic macular edema, who received intravitreal triamcinolone injection (IVTA) or intravitreal bevacizumab injection (IVB), were reviewed. Best corrected visual acuity (BCVA), central macular thickness (CMT) and total macular volume (TMV) were evaluated before injection and at 1 week, 1 month, 2 months, 3 months, and 6 months after injection. The adverse events, such as increased intraocular pressure, and progression of cataract, were also reviewed. RESULTS: A total of 72 eyes from 72 patients, (IVTA: 40 eyes, IVB: 32 eyes) were included in this study. In the IVTA group, BCVA improved significantly at 1 week after injection and was maintained until 3 months after injection. In the IVB group, BCVA improved significantly at 1 week after injection and was maintained until 2 months after injection. In the IVTA group, CMT and TMV decreased significantly at 1 week after injection and were maintained until 3 months after injection, while in the IVB group CMT and TMV were maintained until 2 months after injection. The IVTA group showed significantly better results in visual improvement, CMT and TMV reduction compared to the results of the IVB group, from 1 month to 3 months after injection. In the IVTA group, intraocular pressure increased to more than 25 mmHg in 12.5% of patients during the follow-up period. CONCLUSIONS: While the functional and anatomical improvements are achieved by both IVTA and IVB for diabetic macular edema, the effect of IVTA is more prominent with longer duration than IVB.
Antibodies, Monoclonal, Humanized ; Cataract ; Eye ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema ; Medical Records ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab

PURPOSE: To compare the effect of an intravitreal injection of triamcinolone acetonide with bevacizumab in the treatment of diabetic macular edema (DME). METHODS: For this study, the medical records of patients with diabetic macular edema, who received intravitreal triamcinolone injection (IVTA) or intravitreal bevacizumab injection (IVB), were reviewed. Best corrected visual acuity (BCVA), central macular thickness (CMT) and total macular volume (TMV) were evaluated before injection and at 1 week, 1 month, 2 months, 3 months, and 6 months after injection. The adverse events, such as increased intraocular pressure, and progression of cataract, were also reviewed. RESULTS: A total of 72 eyes from 72 patients, (IVTA: 40 eyes, IVB: 32 eyes) were included in this study. In the IVTA group, BCVA improved significantly at 1 week after injection and was maintained until 3 months after injection. In the IVB group, BCVA improved significantly at 1 week after injection and was maintained until 2 months after injection. In the IVTA group, CMT and TMV decreased significantly at 1 week after injection and were maintained until 3 months after injection, while in the IVB group CMT and TMV were maintained until 2 months after injection. The IVTA group showed significantly better results in visual improvement, CMT and TMV reduction compared to the results of the IVB group, from 1 month to 3 months after injection. In the IVTA group, intraocular pressure increased to more than 25 mmHg in 12.5% of patients during the follow-up period. CONCLUSIONS: While the functional and anatomical improvements are achieved by both IVTA and IVB for diabetic macular edema, the effect of IVTA is more prominent with longer duration than IVB.
Antibodies, Monoclonal, Humanized ; Cataract ; Eye ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema ; Medical Records ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab

PURPOSE: To evaluate the repeatability of macular thickness measurements using time domain (TD) OCT and spectral domain (SD) OCT in diabetic macular edema. METHODS: In 42 eyes of 42 patients with diabetic macular edema, three consecutive macular measurements were performed with TD OCT and SD OCT, and measurements for macular thickness and total macular volume obtained by the two OCTs were compared. The within-subject standard deviation (Sw), coefficient of variation (CVw), and intraclass correlation coefficient (ICC) were calculated to assess repeatability, with agreement between measurements assessed with Bland Altman plots. The correlations were also evaluated via the Pearson's correlation coefficient. RESULTS: The Sw of TD OCT and SD OCT for foveal thickness, total macular volume were 29.67 micrometer/16.44 micrometer, 1.26 mm3/0.23 mm3, respectively, and were significantly lower in SD OCT. The ranges of the respective CVw and ICC values were 1.10-2.78%, 0.78~0.96 for TD OCT, and 0.29~0.94%, 0.92~0.99 for SD OCT. The SD OCT showed better repeatability for macular thickness measurements (all p< or =0.001). The 95% limits of agreement for foveal and total macular volume were 88.9 micrometer, 2.4 mm3, respectively. The Pearson's correlation coefficients of macular thickness and total macular volume between the two OCT methods were statistically significant (p=0.88-0.99). CONCLUSIONS: Although both OCTs proved reliable for macular thickness measurements in diabetic macular edema, SD OCT shows better repeatability than TD OCT. Although macular thickness measurements obtained from the two OCTs cannot be used interchangeably, there were statistically significant correlations between measurements obtained using the two OCTs.
Eye ; Humans ; Macular Edema

Wegener's granulomatosis is an uncommon condition characterized by necrotizing vasculitis of unknown cause. The classic clinical triad consists of necrotizing granulomatous inflammation of the respiratory tract, necrotizing glomerulonephiritis, and necrotizing vascultitis affecting predominantly small vessels. The skin manifestations are frequent, and the most common lesion is purpura distributed on the limbs and trunk. However, severe skin involvement is not common. A 20-year old female presented with purpuric macules on the whole body, which became necrotic. The lungs or kidneys were not affected. However, the histopathologic findings of the skin and nasal mucosa revealed the features of necrotizing vasculitis and granulomatous inflammation. Therefore, we diagnosed Wegener's granulomatosis, which showed unusually severe skin necrosis. She was treated with systemic corticosteroids and cyclophosphamide, but leukopenia, sepsis, and infective endocarditis continuously developed. She died of a cerebral hermorrhage due to overdose of coumadin, which had been used following a cardiac operation for infective endocarditis.
Adrenal Cortex Hormones ; Cyclophosphamide ; Endocarditis ; Extremities ; Female ; Humans ; Inflammation ; Kidney ; Leukopenia ; Lung ; Nasal Mucosa ; Necrosis* ; Purpura ; Respiratory System ; Sepsis ; Skin Manifestations ; Skin* ; Vasculitis ; Warfarin ; Wegener Granulomatosis* ; Young Adult

Miliary osteoma cutis of the face is a form of primary osteoma cutis. We report a case of miliary osteoma cutis on the jaw of a 55-year-old female. She presented with several 2~3 mm sized, skin-colored firm papules over both lower jaws for 5 years. Skin biopsy was performed and the specimen showed numerous osteocytes and osteoblasts in the bony tissue which was located in the deep dermis.
Biopsy ; Bone Diseases, Metabolic ; Female ; Humans ; Jaw ; Middle Aged ; Ossification, Heterotopic ; Osteoblasts ; Osteocytes ; Osteoma ; Skin ; Skin Diseases, Genetic

Stroke is a rare but serious complication of acute myocardial infarction (AMI). Currently, glycoprotein (GP) IIb/IIIa inhibitor is used in clinical practice for acute coronary syndromes and percutaneous coronary interventions (PCIs). The incidence of stroke in patients receiving GP IIb/IIIa inhibitor during PCIs is very low. We report the case of a 47-year-old man who presented with AMI and suffered an acute cerebral infarction after infusion of a GP IIb/IIIa inhibitor following primary PCI.
Acute Coronary Syndrome ; Cerebral Infarction ; Glycoproteins ; Humans ; Incidence ; Middle Aged ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stroke

OBJECTIVE: To describe factors associated with the severity of post-stroke dysphagia. METHODS: We reviewed retrospectively medical records of patients having dysphagia following stroke in Seoul National University hospital from April 2002 through Dec 2009. A total of 578 patients (male and female, 331 and 247) were included. The following parameters were recorded and analyzed: patient's sex, age, type of stroke, onset of dysphagia, location of lesion and the American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale (ASHA NOMS). Using Binary logistic regression and multiple regression analysis, the relationship between dysphagia severity and other factors were analyzed. RESULTS: Their average duration between onset of stroke and the date of videofluoroscopic swallowing study (VFSS) was 32.3 +/- 18.4 days. Patients with hemorrhagic stroke (172 patients, ASHA 4.06 +/- 1.98) showed poorer swallowing function than those with ischemic stroke (406 patients, ASHA 4.49 +/- 2.02, p=0.013). Binary logistic regression analysis showed that patients who had longer duration from onset to the first study, hemorrhagic stroke, bilateral lesion and older age were at higher risk for dysphagia requiring non-oral supplements (p=0.031, 0.039, 0.042, and 0.043, respectively). Multiple regression analysis revealed that longer duration from onset to study, older age and hemorrhagic stroke were associated with the lower ASHA NOMS (p=0.006, 0.009 and 0.021, respectively). Bilateral lesion, sex, history of previous stroke and involvement of the brainstem, however, were not significant factors. CONCLUSION: Hemorrhagic stroke, longer duration from stroke onset to the initial evaluation, and older age were identified as associated factors with the poorer swallowing function after stroke. Further prospective studies will be required to evaluate the prognostic value of these characteristics.
American Speech-Language-Hearing Association ; Brain Stem ; Deglutition ; Deglutition Disorders ; Female ; Humans ; Logistic Models ; Medical Records ; Regression Analysis ; Retrospective Studies ; Stroke