Intermittent exotropia at times is completely controlled by the convergence mechanisms and at other times escapes this control and becomes a manifest exotropia. The treatment of choice is surgical and the treatment is directed at normalization of binocular functions, and recurrence and overcorrection are frequently seen after surgery. Therefore it is important to decide the time and the type of surgery. The author experienced 66 cases of intermittent exotropia in which surgery was done. Surgery was indicated in the cases with deviation of 20 PD or more, deviation of less than 20 PD with asthenopia, exotropia occurred during more than 40% of waking hours, and deterioration of stereoacuity even at early age. Bilateral recession was initial procedure regardless type of intermittent exotropia. In the case with amblyopia, however, R and R was done on the amblyopic eye and in convergence insufficiency type bimedial resection. Lateral Incomitancy was present in 37.9%. The basic type which was shown in 68.2% was the most frequent one. The amount of esodeviation was 15 to 10 PD in 43.9% and 11 to 15 PD in 21.2% on the first postoperative day. The phoria within 10 PD was shown in 95.4% 6 weeks after surgery, in 98.5% 3 months after surgery, and in 93.9% 6 months after surgery. Six months after surgery, 4 cases revealed exodeviation above 16 PD and no case esodeviation. Stereopsis was tested in 54 cases who understood the test before operation and 43 cases(79.6%) showed stereopsis. Nine out of 11 cases who had no stereopsis showed stereopsis after operation. In this study, success rate of first surgery was as high as 93.9% in 6 months follow-up and stereopsis was restored in considerable number of cases in intermittent exotropia compared to other types of strabismus and binocular function could also be restored and improved after surgery.
Amblyopia ; Asthenopia ; Depth Perception ; Esotropia ; Exotropia* ; Follow-Up Studies ; Ocular Motility Disorders ; Recurrence ; Strabismus ; Telescopes ; United Nations

Following both tenotomy and tenectomy of the homolateral superior oblique muscle as surgical tnatment for isolated paresis of inferior oblique muscle, iatrogenic progressing paralysis of the superior oblique muscle can occur. But tenotomy of the superior oblique muscle resulted in a far lower rate of superior oblique palsy than that of the tenectomy. The authors experienced a case of left superior oblique muscle(LSO) palsy and moderate limitation of left eye in left down gaze after superior oblique tenotomy in left inferior oblique(LIO) paresis and we performed adhesiolysis at tenotomy site and modified Harada-Ito procedure on reconnected superior oblique muscle which had been tenotomized. After surgery, right head tilting disappeared and diplopia remained in left down gaze with minimal limitation of left eye in that direction.
Diplopia ; Head ; Paralysis* ; Paresis* ; Tenotomy*

From 1985 to 1995, 13 children with neurogenic bladder underwent augmentation cystoplasty. Diagnosis in these 13 children included Meningomyelocele in 11 and unknown origin in 2. Indications for augmentation cystoplasty were persists incontinence in 6 patients and progressive upper urinary tract deterioration in Bowel segments were used for augmentation included sigmoid colon in 1 patient, ileocecal segments incontinence in 6 patients stomach in 3. Dilated ureter also was used in 1 patient. Postoperatively, all the patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 12 require clean intermittent catheterization to empty bladder and 10 are completely continent. After operation, bladder capacity increased from 155 ml to 305 ml and there were significant increases in bladder compliance. Hypereflexia was present in 5 patients before operation and in 3 patients after operation. There has been no surgical mortality. Postoperative complications occurred in 4 patients included mild ileus in 2 patients, mucus obstruction in 1, mild hematuria in 1, metabolic alkalosis in 1 and superficial wound infection in All complications were transient and managed medically. the kind of bowel segments did not seem to influence results. We think that augmentation cystoplasty is a therapeutic modality that should be considered as a viable treatment option in selected patients with neurogenic bladder dysfunction.
Alkalosis ; Child ; Colon, Sigmoid ; Compliance ; Diagnosis ; Hematuria ; Humans ; Ileus ; Intermittent Urethral Catheterization ; Meningomyelocele ; Mortality ; Mucus ; Postoperative Complications ; Stomach ; Ureter ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Tract ; Wound Infection

Vernet syndrome involves the IX, X, and XI cranial nerves and is most often attributable to malignancy, aneurysm or skull base fracture. Although there have been several reports on Vernet's syndrome caused by fracture and inflammation, cases related to varicella-zoster virus are rare and have not yet been reported in South Korea. A 32-year-old man, who complained of left ear pain, hoarse voice and swallowing difficulty for 5 days, presented at the emergency room. He showed vesicular skin lesions on the left auricle. On neurologic examination, his uvula was deviated to the right side, and weakness was detected in his left shoulder. Left vocal cord palsy was noted on laryngoscopy. Antibody levels to varicella-zoster virus were elevated in the serum. Electrodiagnostic studies showed findings compatible with left spinal accessory neuropathy. Based on these findings, he was diagnosed with Vernet syndrome, involving left cranial nerves, attributable to varicella-zoster virus.
Aneurysm ; Cranial Nerves ; Deglutition ; Ear ; Emergencies ; Herpesvirus 3, Human ; Inflammation ; Laryngoscopy ; Neurologic Examination ; Republic of Korea ; Shoulder ; Skin ; Skull Base ; Uvula ; Vocal Cord Paralysis ; Voice

The objective of this study was conducted to investigate growth and development status of infants fed soy-based formulas over 3 months. The height and weight were measured and Z-scores were calculated by using standard of the same age groups. Their mothers were interviewed using questionnaires including general and environmental characteristics, total food intakes, soy based formula intakes and Ewha infant development screening test. Main results were as follows: 1) Nutrient intake levels of subjects were similar to or more than the level of Korean Recommended Dietary Allowances except for intakes of vitamin E (79.89% RDA), and the average status of nutrient intakes of infants were fairly good. 2) Z-scores of height for age (HAZ) and Z-scores of weight for age (WAZ), Kaup index, WLI and Ewha Infant Developmental Screening Test score of subjects were in the normal growth range. 3) There were no significant differences among soy based formula intake percentile groups in HAZ, WAZ, Kaup index, WLI and Ewha Infant Developmental Screening Test score. 4) Total energy intake was positively correlated with HAZ (p < 0.01), WAZ (p < 0.01), and WLI (p < 0.05) in infants less than 12 month. Also, soy based formula energy intake was positively correlated with HAZ (p < 0.05) in infants less than 12 month. However, energy and soy based formula intake levels of infants over 12 month were not significant among variables. Considering results of this study, infants fed soy-based formulas over 3 months showed normal growth and development status. Further studies are needed to evaluate long-term growth and development in infants fed soy based formulas.
Child ; Child Development ; Energy Intake ; Growth and Development* ; Humans ; Infant* ; Mass Screening ; Mothers ; Recommended Dietary Allowances ; Vitamin E ; Vitamins

We describe herein a case of life-threatening hypoglycemia due to spurious elevation of glucose concentration during the administration of ascorbic acid in a type 2 diabetic patient. A 31-year-old female was admitted for proliferative diabetic retinopathy treatment and prescribed high dose ascorbic acid. During hospitalization, she suddenly lost her consciousness and her glucose concentration was 291 mg/dL, measured using self-monitoring blood glucose (SMBG) device, while venous blood glucose concentration was 12 mg/dL. After intravenous injection of 50% glucose solution, the patient became alert. We reasoned that glucose measurement by SMBG device was interfered by ascorbic acid. Physicians should be aware of this interference; high dose ascorbic acid may cause spurious elevation of glucose concentration when measuring with SMBG devices.
Adult ; Ascorbic Acid/administration & dosage/adverse effects/contraindications/*therapeutic use ; Blood Glucose ; Blood Glucose Self-Monitoring/instrumentation/standards ; Diabetes Mellitus, Type 2/blood/drug therapy ; Female ; Humans ; Hypoglycemia/*diagnosis ; Renal Dialysis

Tuberculosis is an infectious disease that can be treated using a combination of antitubercular drugs. First-line antitubercular agents such as isoniazid and rifampin are considered pivotal to successful treatment. However, they are also known to have relatively high rates of adverse events including hypersensitivity reactions. Discontinuing the first-line agents in the event of hypersensitivity may significantly compromise the cure rate of tuberculosis. Drug desensitization can be an effective method allowing continued use of the first-line agents and achieving successful cure of tuberculosis. A 70-year-old man was diagnosed with culture proven pulmonary tuberculosis and treated with first-line antitubercular agents (isoniazid, 300 mg; rifampin, 600 mg; pyrazinamide, 1,500 mg; and ethambutol, 800 mg). After 2 weeks of treatment, generalized erythematous papular rash and fever developed, for which all drugs were discontinued. Since he had hypersensitivity to all 4 first-line antitubercular agents, we tried desensitization for all 4 drugs one by one to resume antituberculosis treatment. After successful desensitization of all 4 first-line antituberculosis drugs, 6 months-antitubercular therapy was completed without any complications. We report here a case of multiple desensitization in a pulmonary tuberculosis patient having hypersensitivity to all of the 4 first-line antitubercular drugs, successfully completing 6-month antitubercular therapy without any complications.
Aged ; Antitubercular Agents* ; Communicable Diseases ; Drug Hypersensitivity ; Ethambutol ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Isoniazid ; Pyrazinamide ; Rifampin ; Tuberculosis ; Tuberculosis, Pulmonary

In July 2012, philometrid nematodes were discovered in cultured rockfish (Sebastes schlegeli) in Cheonsuman (Bay), the Republic of Korea. The nematodes were detected in the epithelial tissues of the rockfish and were identified as Clavinema mariae based on morphological studies using light and scanning electron microscopy. They revealed the characteristics same as previously identified C. mariae, notably having a long body with narrow posterior half, no caudal projection, a cylindrical-shaped esophagus, a well-developed anterior bulbous part of the esophagus, cephalic papillae, and a dorsal esophageal gland. This is the first confirmation of C. mariae infection in rockfish in Korea.
Esophagus ; Korea ; Microscopy, Electron, Scanning ; Republic of Korea*

Granular cell tumors of the gastrointestinal tract are uncommon, and the esophagus is the gastrointestinal site most frequently affected. Such tumors are rarely seen in the stomach, colon, or rectum. Azzopardi first described a granular cell tumor of the stomach in 1956. Since then a few gastric granular cell tumors have been reported in corresponding literature. It is believed that there have been no reported case of a granular cell tumor of the stomach in Korea. Subsequently one case of a granular cell tumor of the stomach in 38 year-old female who complained epigastric soreness is herein reported, and was successfully managed by endoscopic resection.
Adult ; Colon ; Esophagus ; Female ; Gastrointestinal Tract ; Granular Cell Tumor* ; Humans ; Korea ; Rectum ; Stomach*

PURPOSE: This study was designed to determine the relationship of cigarette smoking to the frequency and qualitative differences among KRAS mutations in lung adenocarcinomas from Korean patients. MATERIALS AND METHODS: Detailed smoking histories were obtained from 200 consecutively enrolled patients with lung adenocarcinoma according to a standard protocol. EGFR (exons 18 to 21) and KRAS (codons 12/13) mutations were determined via direct-sequencing. RESULTS: The incidence of KRAS mutations was 8% (16 of 200) in patients with lung adenocarcinoma. KRAS mutations were found in 5.8% (7 of 120) of tumors from never-smokers, 15% (6 of 40) from former-smokers, and 7.5% (3 of 40) from current-smokers. The frequency of KRAS mutations did not differ significantly according to smoking history (p=0.435). Never-smokers were significantly more likely than former or current smokers to have a transition mutation (G-->A or C-->T) rather than a transversion mutation (G-->T or G-->C) that is known to be smoking-related (p=0.011). In a Cox regression model, the adjusted hazard ratios for the risk of progression with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) were 0.24 (95% CI, 0.14-0.42; p<0.001) for the EGFR mutation and 1.27 (95% CI, 0.58-2.79; p=0.537) for the KRAS mutation. CONCLUSION: Cigarette smoking did not influence the frequency of KRAS mutations in lung adenocarcinomas in Korean patients, but influenced qualitative differences in the KRAS mutations.
Adenocarcinoma/drug therapy/etiology/*genetics/pathology ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/genetics ; Female ; Humans ; Incidence ; Lung Neoplasms/drug therapy/etiology/*genetics/pathology ; Male ; Middle Aged ; *Mutation ; Mutation Rate ; Proportional Hazards Models ; Proto-Oncogene Proteins/*genetics ; Receptor, Epidermal Growth Factor/antagonists & inhibitors/genetics ; Smoking/adverse effects/*genetics ; Treatment Outcome ; ras Proteins/*genetics