PURPOSE: To evaluate the characteristics and surgical outcomes of children with intermittent exotropia whose preoperative angle of deviation changed on the day of surgery. METHODS: The medical records of 323 children with intermittent exotropia who underwent lateral rectus recession in both eyes were reviewed. The records were classified according to the difference of 8 prism diopters (PD) or more between the largest angle of deviation measured within 3 months prior to the operation and that on the day of surgery into the increased, same, or decreased groups. The frequency, characteristics, and surgical outcomes of each group were analyzed. The surgical amount was determined based on the largest angle of deviation measured at distance within 3 months before surgery. RESULTS: The angle of deviation at distance on the day of surgery was increased in 5 patients (1.5%) and decreased in 6 (1.9%). The near angle was increased in 19 (5.9%) and decreased in 22 (6.8%) patients. The groups in which distant deviation was changed had a greater distant angle and more patients with anisometropia. The group in which near deviation decreased was older than the same group and 81.8% of the patients were school-aged. In the group with changes in either distant or near deviation, the angle on the day of surgery changed toward decreasing disparity of near-distant deviation. On the last follow-up, the rate of overcorrection of 10 PD or more was 13.6% in the decreased near deviation group, which was significantly high (p = 0.039). CONCLUSIONS: The angle of deviation on the day of surgery could be different compared to the largest preoperative angle in some patients with intermittent exotropia. In patients with decreased near deviation, the rate of postoperative overcorrection might be high.
Anisometropia ; Child ; Exotropia* ; Follow-Up Studies ; Humans ; Medical Records

PURPOSE: To report two patients with positive ice tests who had diplopia and blepharoptosis caused by something other than ocular myasthenia gravis. CASE SUMMARY: A 35-year-old female presented with a one-week history of inability to adduct the left eye and left blepharoptosis. Although the ice test was positive, serum anti-acetylcholine receptor binding antibody and the repetitive nerve stimulation test were negative. Brain angiography showed an aneurysm of the left posterior communicating artery, leading to the diagnosis of left pupil-sparing oculomotor nerve palsy. A 25-year-old female presented with an 8-month history of intermittent horizontal diplopia and blepharoptosis in the right eye. The ice test was positive, however serum anti-acetylcholine receptor binding antibody and the repetitive nerve stimulation test were negative. Anti-nuclear antibody was positive (titer 1:160). CONCLUSIONS: The ice test is a useful screening test for myasthenia gravis. However, a series of differential diagnoses including blepharoptosis and ocular motility disorder should be considered because these conditions also show a positive result in the ice test.
Adult ; Aneurysm ; Angiography ; Arteries ; Blepharoptosis ; Brain ; Diagnosis ; Diagnosis, Differential ; Diplopia ; Female ; Humans ; Ice* ; Mass Screening ; Myasthenia Gravis* ; Ocular Motility Disorders ; Oculomotor Nerve Diseases

OBJECTIVE: The purpose of this study was to understand the differences in masseter muscle (MM) between the shifted and non-shifted sides in facial asymmetry patients, and the changes shown by MM after mandibular surgery. METHODS: Pre- and post-operative CT scans were performed on 12 Class III patients with facial asymmetry who were treated by intraoral vertical ramus osteotomy and 10 subjects with normal occlusion. Using the V-works 4.0 program (Cybermed, Seoul, Korea), 3-dimensional images of the mandible, and MM were reconstructed, and evaluated. RESULTS: In the asymmetry group, the MM angle between the shifted and non-shifted sides was only significantly different (p < 0.05). Compared with normal occlusion, the asymmetry group showed a significantly smaller volume and maximum cross-sectional area in both sides of MM (p < 0.05). After mandibular surgery, the angle of MM (p < 0.01) and differences in angle between the shifted and non-shifted sides of MM (p < 0.05) were significantly decreased. The thickness in the maximum cross-sectional area was significantly increased (p < 0.01). After surgery, MM in facial asymmetry patients was similarly changed to those in the normal occlusion group except for widths. CONCLUSIONS: MM in facial asymmetry was definitely different from those in normal occlusion. However, this study suggests that MM changed symmetrically in conjunction with the mandible after proper mandibular surgery.
Facial Asymmetry ; Humans ; Mandible ; Masseter Muscle ; Orthognathic Surgery ; Osteotomy

Objective: We investigated the agreement between anti-Müllerian hormone (AMH) levels measured with revised Gen II (rev-Gen II) and automated AMH (Access) assays and evaluated the reproducibility of each method under various blood/serum storage conditions. Methods: AMH levels in blood samples from 74 volunteers were measured by rev-Gen II and Access assays under various conditions: immediate serum separation and AMH measurement (fresh control); serum stored at –20 °C and AMH measured after 48 hours, 1 week, and 2 years; serum stored at 0 to 4 °C and AMH measured after 48 hours and 1 week; and blood kept at room temperature and delayed serum separation after 48 hours and 1 week, with immediate AMH measurement. Results: In fresh controls, all rev-Gen II-AMH values were higher than comparable Access-AMH values (difference, 8.3% to 19.7%). AMH levels measured with the two methods were strongly correlated for all sample conditions (r=0.977 to 0.995, all p<0.001). For sera stored at –20 °C or 0 to 4 °C for 48 hours, Access-AMH values were comparable to control measurements, but rev-Gen II-AMH values were significantly lower. AMH levels in sera stored at –20 °C or 0 to 4 °C for 1 week were significantly lower than in fresh controls, irrespective of method. Across methods, long-term storage at –20 °C for 2 years yielded AMH measurements significantly higher than control values. When serum separation was delayed, rev-Gen II-AMH values were significantly lower than control measurements, but Access-AMH values varied. Conclusion The rev-Gen II and Access-AMH assays showed varying reproducibility across blood/serum storage conditions, but automated Access yielded superior stability to rev-Gen II.

OBJECTIVE: The purpose of this experimental study was to evaluate the effect of immediate orthodontic loading on the stability at the bone-implant interface of titanium miniscrews in a rabbit model. METHODS: Forty titanium miniscrews (1.6 mm diameter, 8 mm length) were inserted in the tibiae of 10 rabbits. Twenty test group miniscrews were subjected to continuous orthodontic forces of 200 g immediately after implantation for a period of 6 weeks. The remaining 20 control group miniscrews were left unloaded for the same follow-up interval. Removal torque values were recorded using a digital torque gauge. An independent t-test was performed. RESULTS: All the miniscrews were stable, and exhibited no mobility or displacement throughout the experimental period. Histologically, miniscrews were well-integrated into bone. No statistically significant differences in removal torque data were found between the loaded test and the unloaded control groups. CONCLUSIONS: These findings suggest that titanium miniscrews can be used as anchoring units for orthodontic tooth movement immediately after insertion.
Follow-Up Studies ; Rabbits ; Tibia ; Titanium ; Tooth Movement ; Torque*

The changes of higher-order aberrations (HOAs) after bilateral lateral rectus muscle recession were evaluated. Forty eyes of 20 children were enrolled and their wavefront information was assessed until postoperative 3 months. Even though the root mean square (RMS) of total aberration was not changed, the RMS of HOA was transiently increased at postoperative 1 week and returned to baseline level after 1 month. Among individual Zernike coefficient, secondary astigmatism, quadrafoil, secondary coma, secondary trefoil, and pentafoil showed similar tendency with the RMS of HOA. However, coma, trefoil, and spherical aberration were not changed. Regarding recession amount, it did not correlate with any Zernike coefficient. In summary, our data imply that the HOAs are transiently increased after lateral rectus recession surgery. These results are in collusion with previous reports that strabismus surgery induced transient corneal astigmatism.
Adolescent ; Astigmatism/*etiology ; Child ; Child, Preschool ; Exotropia/*surgery ; Female ; Humans ; Male ; Postoperative Care ; *Postoperative Complications/epidemiology/pathology ; Vision Tests

PURPOSE: To evaluate the usefulness of serum prealbumin concentration for the nutritional assessment of acute diarrhea. METHODS: From February 1997 to August 1997, ninety patients with acute diarrhea(age, 4-24 months) were randomly assigned into two groups on the basis of their intakes for 2 days prior to admission : liquid diet group(N=56, clear liquid and/or oral electrolyte solutions), and formula and soft diet group(N=34). Serum prealbumin concentrations were measured by rate nephelometric microassay. RESULTS: Serum prealbumin concentration in the liquid diet group with acute diarrhea was 13.1+/-4.5mg/dL which was significantly lower than 15.5+/-5.0mg/dL of the formula and soft diet group (P<0.05) and 17.0+/-4.0mg/dL of the control group(P<0.05). Serum prealbumin concentration was less influenced by dehydration than serum albumin concentration. The duration of diarrhea and admission were not significantly shorter in the liquid diet group than in the formula and soft diet group. CONCLUSION: Serum prealbumin concentrations in patients with acute diarrhea reflected their current nutritional status and was less influenced by dehydration than serum albumin concentrations. Serum prealbumin concentration might be used to monitor short-term nutritional deprivation and the adequacy of dietary supply.
Dehydration ; Diarrhea* ; Diet ; Humans ; Nutrition Assessment* ; Nutritional Status ; Prealbumin* ; Serum Albumin

PURPOSE: To evaluate the usefulness of serum prealbumin concentration for the nutritional assessment of acute diarrhea. METHODS: From February 1997 to August 1997, ninety patients with acute diarrhea(age, 4-24 months) were randomly assigned into two groups on the basis of their intakes for 2 days prior to admission : liquid diet group(N=56, clear liquid and/or oral electrolyte solutions), and formula and soft diet group(N=34). Serum prealbumin concentrations were measured by rate nephelometric microassay. RESULTS: Serum prealbumin concentration in the liquid diet group with acute diarrhea was 13.1+/-4.5mg/dL which was significantly lower than 15.5+/-5.0mg/dL of the formula and soft diet group (P<0.05) and 17.0+/-4.0mg/dL of the control group(P<0.05). Serum prealbumin concentration was less influenced by dehydration than serum albumin concentration. The duration of diarrhea and admission were not significantly shorter in the liquid diet group than in the formula and soft diet group. CONCLUSION: Serum prealbumin concentrations in patients with acute diarrhea reflected their current nutritional status and was less influenced by dehydration than serum albumin concentrations. Serum prealbumin concentration might be used to monitor short-term nutritional deprivation and the adequacy of dietary supply.
Dehydration ; Diarrhea* ; Diet ; Humans ; Nutrition Assessment* ; Nutritional Status ; Prealbumin* ; Serum Albumin

PURPOSE: To compare the sedation outcome according to the dose of per os chloral hydrate in children who underwent laceration repair in the emergency department (ED). METHODS: This retrospective study was performed to the children who underwent sedation using chloral hydrate for laceration repair in the ED from January 2015 through November 2015. A total of 370 children aged younger than 6 years underwent the sedation. We compared the induction time, duration of sedation, and ED length of stay (EDLOS) between the single dose (50 mg/kg) and additional dose (plus 25 mg/kg) groups. RESULTS: Of 370 children, 335 (90.5%) were sedated successfully, 284 (76.8%) were sedated with initial dose (the single dose group), and 51 (13.8%) were sedated with additional dose (the additional dose group). The induction time and EDLOS were longer in the additional dose group (induction time: 31.0 ± 17.2 minutes vs. 96.2 ± 25.4 minutes, P < 0.001; EDLOS: 137.2 ± 35.5 minutes vs. 193.0 ± 36.0 minutes, P < 0.001). The duration of sedation showed no difference between the 2 groups (44.4 ± 24.0 minutes vs. 42.0 ± 20.8 minutes; P = 0.500). No one had serious adverse reactions. CONCLUSION: Additional dose of chloral hydrate can increase the induction time and EDLOS without increasing the duration of sedation and causing serious adverse reactions. This information may improve the efficiency of ED workflow when shared with parents of the children.
Child* ; Chloral Hydrate* ; Conscious Sedation ; Emergency Service, Hospital ; Humans ; Lacerations* ; Length of Stay ; Parents ; Retrospective Studies

Expanding cells ex-vivo is very important in tissue- engineering. Culture medium is usually supplemented with fetal bovine serum(FBS) in most of the experiments. However, cells grown in bovine serum media may posses the possibilities of disseminating bovine diseases and/or stimulating the patient's immune reactions. To overcome these problems, autologous or homologous serum should be used instead of the FBS. The purpose of this study is to compare cell proliferation and collagen synthesis depending on the kind of sera mixed on media and to provide a guideline on applying established experimental data to clinical cases. Human dermal fibroblasts were obtained from four patients. Five thousand cells per well in 96-well plates were incubated DMEM/F- 12 Nutrient with varying serum mixture; 10% autologous serum, 10% homologous serum, and 10% FBS. Five days after incubation fibroblast proliferation and collagen production were determined by MTT assay and CICP enzyme immunoassay. The mean cell number were; 3.95x104/well, 2.97x104/well and 2.30x104/well, respectively. The average amounts of collagen synthesized were; 238.13ng/ml, 204.88ng/ml, and 163.88ng/ml in each. These results show that the use of human serum mixture may contribute to, not only preventing disseminated infection of bovine diseases. but also increase cell proliferation and collagen synthesis without simulating the patient's immune reactions.
Animals ; Cattle ; Cattle Diseases ; Cell Count ; Cell Proliferation ; Collagen* ; Fibroblasts* ; Humans ; Immunoenzyme Techniques