The authors experienced a case of the monomorphic adenoma of lacrimal gland. Monomorphic adenoma is an extremely rare salivary gland tumor. A fifty eight year old Korean female was admitted to our Dept. of Ophthalmology because of multiple small nodular masses on her right upper eyelid and a large hard solitary mass in the supraorbital area since one year ago. On B-scan ultrasonogtaphy, round echo-free zone was detected in the superiortemporal orbit. Well defined hyperdense, enhanced round extraconal mass in the superiororbital area was detected by orbital CT scan. Two large well encapsulated, dark brown colored masses were extracted by supraorbital approach and lateral orbitotomy under general anesthesia. After removal of the masses, histopathologic examination confirmed the lacrimal monomorphic adenoma.
Adenoma* ; Anesthesia, General ; Eyelids ; Female ; Humans ; Lacrimal Apparatus ; Ophthalmology ; Orbit ; Salivary Glands ; Tomography, X-Ray Computed

To assess the likelihood of procedural success in patients with multivessel coronary artery disease, 46 consecutive patients (male 34, female 12, mean age 60+/-9 years) umderwent single or multiple site angioplasty. The clinical diagnosis of unstable angina was in 20(44%), stable angina in 10 and acute or old myocardial infarction in 16. Coronary angiographic findings of 2 vessel disease was in 38(83%), triple vessel disease in 8. Left ventricular function was generally well preserved (mean ejection fraction 65+/-12%, range 30-82%) and mean 2.0 stenosis per patient angic, lasty had attempted. Single vessel angioplasty (SVA) was performed in 13 and multivessel angioplasty (MVA) in 33. Procedural success was achieved in 79(86%) out of total 92 stenoses. Sixty-six(88%) out of 75 stenoses in MVA and 13(76%) out of 17 stenoses in SVA had procedural success respectively. According to angiographic morphology of lesions, procedural success of type A stenoses was 17/17(100%), type B stenoses 57/66(86%) and type C stenoses was 5/9(33%). In 13 failures included inability to pass the guide wire cross the lesion in 7, inability to guide the griding catheter in 2 and inability to dilate lesions in 4. Before and after angioplasty, treadmill test (modified Bruce protocol)could be performed in 29 patients. Total duration of exercise and maximal double product improved significantly from 8.5+/-2.3 minute 5188+/-2403 to 12.2+1.3 min., 23,062+/-4111 respectively (p<0.001). 17 out of 24 patients who had positive treadmill test before angioplasty showed negative conversion after procedure. Complications included dissection in 29, prolongd chest pain in 5, acute closure in 3, cardiac tamponade in 1 and ventricular fibrillation due to side branch oclusion in 1. Thus, coronary angioplasty in selected paients with multivessel coronary artery disease might be useful and have relatively good immediate results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Cardiac Tamponade ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Exercise Test ; Female ; Humans ; Myocardial Infarction ; Ventricular Fibrillation ; Ventricular Function, Left

BACKGROUND: The cerebellum and its neural circuitry have been assumed to play a major role in the pathophysiology of essential tremor (ET). In this study, we sought to find associations between ET and cerebellar dysfunction. METHODS: We performed tandem gait test in 41 ET patients and 44 age-matched controls. Investigators assessed tandem gait by counting the number of missteps during ten-step tandem walk and each subject repeated the trial three times. RESULTS: ET patients had a higher average and total numbers of missteps during tandem gait tests than control subjects (p<0.05). Sex-adjusted odds ratio of the association between tandem gait abnormality and ET was 3.40 (95% confidence intervals 1.06-10.85). According to age stratification, aged ET patients (age > or =70 years) showed significantly higher prevalence of tandem gait abnormality than young ones. Interaction terms determined by a likelihood ratio test was also statistically significant (p<0.05). CONCLUSIONS: Dysfunction of cerebellar neural circuitry may be associated with the pathophysiological mechanism of ET. In addition, aging may be an important factor modifying the association.
Aging ; Cerebellar Diseases* ; Cerebellum ; Essential Tremor* ; Gait ; Humans ; Odds Ratio ; Prevalence ; Research Personnel

Blepharospasm is a focal dystonia that consists of repetitive involuntary spasmodic contractions of the orbicularis oculi muscle. A 27-year-old man was admitted with ptosis and involuntary blinking in both eyes. He was diagnosed as having schizophrenia when he was 15 years old and medicated with chlorpromazine for 12 years. After excluding all the possible etiopathological causes of the blepharospam, the offending drug was discontinued and changed to an atypical antipsychotic, clozapine. Clozapine was increased up to 75 mg in the 7th day of admission, and the symptoms were slowly ameliorated.
Adolescent ; Adult ; Blepharospasm* ; Blinking ; Chlorpromazine ; Clozapine ; Dystonic Disorders ; Humans ; Schizophrenia

Choridal osteomas are benign, ossified peripapillary lesions occurring predominantly in healthy young women, They appear as yellow-white to yellow-red lesions with well-defined geographics borders. On radiologic examination, bony lesion is shown. We report herein a case of choroidal osteoma located at the posterior pole of the left eye in a 27-years-old woman the chief complaint of decreased visual acuity.
Choroid* ; Female ; Humans ; Osteoma* ; Visual Acuity

Preretinal hemorrhage, which is located between the retina and vitreous face and is commonly developed on the macula, causes impaired central vision and if it persists, it may cause complications, such as epimacular membrane. A 49-year-old male who had dry type of age-related macular degeneration in both eyes and had an oval shaped premacular hemorrhage of unknown etiology in his left eye. We applied Q-switched Nd:YAG laser on membrane anterior to preretinal hemorrhage and ruptured it. Preretinal hemorrage was drained to inferior vitreous cavity and his central vision was rapidly improved.
Hemorrhage* ; Humans ; Macular Degeneration ; Male ; Membranes ; Middle Aged ; Punctures* ; Retina

Purpose: We evaluated the efficacy and safety of a 0.05% cyclosporine ophthalmic nanoemulsion and a 0.1% cyclosporine ophthalmic cationic emulsion in patients with moderate-to-severe dry-eye syndrome. Methods: This was a multi-center, double-blinded, comparative, prospective, randomized clinical trial. Three ophthalmological institutions enrolled a total of 105 patients with moderate-to-severe dry eye who were randomly assigned to a 0.05% cyclosporine nanoemulsion group (the test group) and a 0.1% cyclosporine cationic emulsion group (the control group). The corneal staining scores were obtained, and the tear film breakup time (TBUT) and Schirmer test performed, at the initial visit and after 1 and 3 months of eyedrop use. The safety results were compared by recording discomfort and compliance during drug instillation. Results: The corneal staining scores and the TBUT and Schirmer test results showed that both groups showed significant improvements. The corneal staining scores significantly (and similarly) decreased in both groups. In the test group, the TBUT showed significant prolongation after 1 month of treatment and the Schirmer test score increased significantly after 3 months. Both groups reported less ocular discomfort and better compliance with drug use at 3 months than 1 month; the control group demonstrated a significant decrease in ocular discomfort at 3 months. Conclusions Both drugs improved the dry eye symptom index and relieved eye discomfort. No patient complained of serious discomfort or side-effects. The drugs were equivalent in terms of efficacy and safety.

BACKGROUND: To minimize the side effects of radiofrequency trigeminal rhizotomy by making a more selective minimal lesion for the target division of a trigeminal rootlet, we performed this study to evaluate the effectiveness and the selectivity of radiofrequency trigeminal rhizotomy using a 2 mm active tip electrode as compared to a 5 mm active tip electrode. METHODS: The authors evaluated 36 cases, in which radiofrequency thermocoagulation of a trigeminal rootlet was performed using a 2 mm active tip electrode or a 5 mm active tip electrode at 75oC for 60 seconds in patients suffering from trigeminal neuralgia. One month after each operation, we assessed the clinical effects, selectivity, and the side effects of these operations. RESULTS: Of the 36 patients, 34 patients experienced loss of tic pain. In terms of effectiveness, no difference was found between the two groups. In terms of selectivity, some superiority was shown by the 2 mm active tip electrode, but this was not statistically significant. Masseter weakness or dysesthesia occurred in six patients who suffered from tic pain in the V3 region, and who were operated upon with a 5 mm active tip electrode. Major complications like anesthesia dolorosa, and corneal anesthesia were absent in any patients. CONCLUSIONS: For target specific lesion generation of trigeminal rootlets, single lesion generation using a 2 mm active tip electrode may be as clinically effective as a 5 mm tip and is more selective in use.
Anesthesia ; Electrocoagulation ; Electrodes* ; Humans ; Paresthesia ; Rhizotomy* ; Tics ; Trigeminal Neuralgia*

A clinical obsevation was made on 8 patients with Corrected Transposition of the Great Arteries who visited seoul National University Hospital during the period of Feb., 1979-Sep., 1982. 1. Sex distribution was 5 male and 3 female patients. 2. Age distribution was from 16 to 39 years and the mean age was 24 years. 3. Symptoms were exertional dyspnea in all cases, cyanosis in 3 cases. Other symptoms were palpitation, chest pain, growth retardation and chest deformity. Duration of illness was from 6 to 16 years and N.Y.H.A. functional class was between II and III. 4. On physical examination, cardiac mumurs were heard in all cases. Cyanosis on the lips and nail beds were noticed in 3 cases and clubbing of fingers was seen in 1 case. 5. Situs inversus was noticed in 1 case, mesocardia in 3 cases, dextrocardia in 1 cases and right sided aortic arch in 1 case by simple Chest PA. 6. Electrocardiographic findings were Biventricular hypertrophy in 3 cases, Left ventricular hypertrophy in 2 cases, Right ventricular hypertrophy in 2 cases and Incomplete right bundle branch block in 1 case. No arrhythmias were observed. Septal Qwave was not observed on the left precordial leads in all cases. 7. CTGA were suspected or diagnosed by Echocardiography in 7 cases. 8. The diagnosis of CTGA and its associated anomalies were confirmed in all cases by cardiac catheterization and angiocardiography. There were one case of I.D.D. type CTGA and seven cases of S.L.L. type CTGA's. Associated anomalies were ventricular septal defect in 5 cases, pulmonary stenosis in 5 cases, patent foramen ovale in 3 cases, atrial septal defect in 2 cases, patent ductus arteriosus in 1 case, dextrocardia in 1 case, left sided A.V. valve regurtation in 2 cases, and right sided aortic arch in 1 case. 9. Operation was done in the case associated with patent ductus arteriosus, and corrective surgery was done in the another case associated with ASD, VSD, PS and TR with C-TGA.
Age Distribution ; Angiocardiography ; Aorta, Thoracic ; Arrhythmias, Cardiac ; Arteries ; Bundle-Branch Block ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Congenital Abnormalities ; Cyanosis ; Dextrocardia ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography ; Electrocardiography ; Female ; Fingers ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Lip ; Male ; Physical Examination ; Pulmonary Valve Stenosis ; Seoul ; Sex Distribution ; Situs Inversus ; Thorax

This is a case report of complete mouth rehabilitation in a patient with generalized attrition and loss of posterior support. After analyzing the condition of the temporomandibular joint, multiple implants were placed to restore collapsed occlusion. Fixture/abutment level intraoral scanning was done instead of using conventional impression materials which entail multiple bite registration for cross-mounting. A ‘jaw motion tracking’device, ‘digital face-bow transfer’, and ‘double scan technique’ which enables duplicating temporary restoration to definitive restoration were used to fabricate definitive prostheses. By using various digital techniques, complete mouth rehabilitation was done with minimal chair time in a patient with unstable occlusion.