PURPOSE: To report a case of corneal edema caused by an iatrogenic lidocaine injection into the corneal stroma created while performing a local anesthetic (lidocaine) injection into the eyelid for a blepharoplasty procedure. CASE SUMMARY: A 15-year-old female visited our clinic after the onset of severe pain and decreased visual acuity while receiving a local anesthetic injection in the upper blepharon for a blepharoplasty procedure. At the first clinical visit, visual acuity was hand motion and an accurate anterior chamber examination was difficult because of corneal edema. The Seidel test was negative. On corneal optical coherence tomography, the corneal thickness was 1,580 µm without any sign of Descemet's membrane detachment. We prescribed 5% NaCl four times a day and prednisolone acetate eight times a day. On the next day after injury, the corneal edema was significantly improved (central corneal thickness: 660 µm), and Descemet's membrane detachment was still not observed. One week after injury, the naïve visual acuity was 20/20, the central corneal thickness was 560 µm, and the endothelial cell count was 3,260 cells/cm². Three weeks after injury, the corneal edema was fully resolved and only slight temporal corneal haziness remained. After 2 months, the cornea was clear without any subjective discomfort. CONCLUSIONS: Corneal edema without Descemet's membrane detachment can be resolved spontaneously without aggressive treatment such as gas or air injection. However, endothelial cell count and corneal opacity need to be monitored on follow up exam. This clinical experience suggests that severe corneal edema in anterior stromal layer could be spontaneously resolved without severe complication.
Adolescent ; Anesthesia, Local ; Anterior Chamber ; Blepharoplasty ; Cornea ; Corneal Edema ; Corneal Opacity ; Corneal Stroma ; Descemet Membrane ; Edema ; Endothelial Cells ; Eyelids ; Female ; Follow-Up Studies ; Hand ; Humans ; Lidocaine ; Prednisolone ; Tomography, Optical Coherence ; Visual Acuity

No abstract available.

No abstract available.
Lung*

PURPOSE: To evaluate long-term outcomes of surgery for intermittent exotropia. METHODS: The authors evaluated 78 patients who underwent surgery for intermittent exotropia and were available for a follow-up over a 5-year period. According to distant exodeviation and fusion control at the last visit, the patients were classified into either the stable group (distant exodeviation < or =10 PD) or the recurrent group (distant exodeviation >10 PD). The recurrent group was reclassified into the clinical success group (distant exodeviation >10 PD, <20 PD with good fusion control) or the clinical failure group (distant exodeviation > or =20 PD or distant exodeviation >10 PD, <20 PD with poor fusion control). We analyzed recurrence rate, success rate, and clinical outcome. RESULTS: Recurrence rate was 65.3% (n = 51), and the surgical success rate calculated as the rate of stable group and clinical success group was 73% (n = 57). The postoperative angle of exodeviation was more decreased than the preoperative angle in 93.6% of patients. When comparing postoperative with preoperative sensory function, only 2.6% of patients demonstrated worse distant fusion control grades, 66.7% of patients remained the same, 30.8% improved, and 5.1% of patients demonstrated poorer near stereopsis. The rest of patients had better or equal fusion control and stereoacuity. Age at surgery in the recurrent group was less than in the stable group (p = 0.004) and the recurrent group had worse preoperative distant fusion control (p = 0.021). Exodeviation angle of the recurrent group at postoperative 1 month, 3 months and 6 months was greater than that of the stable group (p < 0.005). CONCLUSIONS: Despite a high recurrence rate, surgery for intermittent exotropia showed a high clinical success rate and good long-term efficacy and safety in both deviation angle and sensory function.
Depth Perception ; Exotropia ; Follow-Up Studies ; Humans ; Recurrence ; Sensation

The purpose of this study was to identify the factors influencing health promoting behavior of college students to develop health promoting interventions of young adults. The subjects of this study were 176 women college students, living in a small city in Korea. The data were collected by interviews and a self-report questionnaire, during the period from September, 1999 to December, 1999. The instruments for this study were the PRQ-II by Weinert(1988), the scale of Locus of Control by Wallstone et al.(1978), the scale of self efficacy by Sherer & Maddux(1982), 10 points visual analogue scale for perceived health status and the importance of health, the health promoting behavior scale by Walker et al.(1987), and the scales developed by the authors for the perceived benefits of health promoting behavior, and perceived barriers to health promoting behavior. Cronbach 's alpha of these scales were .68 ~.89. The data were analyzed using descriptive statistics, Pearson's correlation coefficients, and stepwise multiple regression. The results of this study were as follows: 1. Among cognitive perceptual factors of the Health Promotion Model by Pender(1987), the scores of the importance of health, the perceived internal control of health, self efficacy, the perceived health status, and the perceived benefits had a significantly positive correlation with the scores of the health promoting behavior of college students. In addition, the scores of the perceived barriers had a significantly negative correlation with the scores of the health promoting behavior of college students. 2. Among modifying factors of the Health Promotion Model by Pender(1987), the extent of religious activities of college students and the scores of social support had a significantly positive correlation with the scores of health promoting behavior of college students. 3.Stepwise multiple regression analysis revealed that the most powerful predictor of health promoting behavior was self-efficacy. A combination of self-efficacy, the perceived benefits, the perceived barriers, the perceived health status, and the importance of health accounted for 45.1% of the variance in health promoting behavior in college students From the results of this study, we concluded that the Health Promotion Model by Pender can be used to explain health promoting behavior of college students. In addition, we suggested that the results of this study be considered in developing health promoting programs of young adults.
Female ; Health Promotion ; Humans ; Internal-External Control ; Korea ; Self Efficacy ; Weights and Measures ; Young Adult

No abstract available.

No abstract available.
Humans ; Infant* ; Intussusception*

Purpose: We evaluated the 3-month, postoperative clinical outcomes of patients implanted with refractive, aspheric, bifocal, Lentis Comfort (LS313-MF15, Oculentis) intraocular lenses (IOLs). Methods: Eighty-two eyes of 51 cataract patients underwent phacoemulsification and were implanted with LentisComfort IOLs. The uncorrected distant visual acuity (UCDVA), the 80-cm uncorrected intermediate visual acuity (UCIVA), the 40-cm uncorrected near visual acuity (UCNVA), and refractive values were evaluated 1 and 3 months postoperatively. At the latter time, defocus curves were drawn, contrast sensitivity tested, and satisfaction surveyed. Results: At the 3-month postoperative follow-up, the mean spherical equivalent was -0.12 ± 0.21 D; and the mean LogMAR UCDVA, 80-cm UCIVA, and 40-cm UCNVA were 0.02 ± 0.03, 0.13 ± 0.07, and 0.42 ± 0.10 respectively. The defocus curves revealed visual acuities in excess of 0.2 LogMAR at points between the distant and intermediate targets. The mean contrast sensitivity fell in the range of 90% of a normal population under both photopic and mesopic conditions. In terms of satisfaction, 71.8% of patients were satisfied or very satisfied, but about 20% reported dysphotopsia. Conclusions Implantation of the refractive, aspheric, bifocal, intraocular, LentisComfort in patients with cataracts improved both the distant and intermediate visual acuities by 3 months after surgery and the visual quality was comparable to that afforded by other IOLs both objectively and subjectively.

Intraportal islet transplantation (IPIT) may potentially cure Type 1 diabetes mellitus; however, graft failure in the early post-transplantation period presents a major obstacle. In this study, we tested the ability of nicotinamide to prevent early islet destruction in a syngeneic mouse model. Mice (C57BL/6) with chemically-induced diabetes received intraportal transplants of syngeneic islet tissue in various doses. Islets were cultured for 24 h in medium with or without 10 mM nicotinamide supplementation. Following IPIT, islet function was confirmed by an intraperitoneal glucose tolerance test (IPGTT) and hepatectomy. The effects of nicotinamide were evaluated by blood glucose concentration, serum monocyte chemoattractant protein-1 (MCP-1) concentration, and immunohistology at 3 h and 24 h after IPIT. Among the various islet doses, an infusion of 300 syngeneic islets treated with nicotinamide exhibited the greatest differences in glucose tolerance between recipients of treated and untreated (i.e., control) islets. One day after 300 islet equivalent (IEQ) transplantation, islets treated with nicotinamide were better granulated than the untreated islets (P = 0.01), and the recipients displayed a slight decrease in serum MCP-1 concentration, as compared to controls. After 15 days, recipients of nicotinamide-pretreated islets showed higher levels of graft function (as measured by IPGTT) than controls. The pretreatment also prolonged graft survival (> 100 days) and function; these were confirmed by partial hepatectomy, which led to the recurrence of diabetes. Pretreatment of islet grafts with nicotinamide may prevent their deterioration on the early period following IPIT in a syngeneic mouse model.
Animals ; Blood Glucose/metabolism ; Chemokine CCL2/blood ; Diabetes Mellitus, Experimental/blood/*therapy ; Diabetes Mellitus, Type 1/blood/*therapy ; Glucose Tolerance Test ; Graft Rejection ; Graft Survival/drug effects ; Insulin-Secreting Cells/metabolism ; *Islets of Langerhans Transplantation ; Mice ; Niacinamide/adverse effects/*pharmacology ; Time Factors ; Transplantation, Homologous ; Vitamin B Complex/adverse effects/*pharmacology

PURPOSE: Many researchers have tried to develop animal models that mimic the human immune system, e.g. a humanized mouse model, to improve the engraftment of hematopoietic stem cells and develop human immune cells in an animal model. This study evaluated the feasibility of the cultured human umbilical cord blood (hUCB)-derived CD34(+) cells for cell expansion, in Rag2(-/-)gamma(c)(-/-) mice, and establish co-transplantation with human fetal thymus/liver tissue (Thy/Liv) under the kidney capsule. METHODS: Co-transplantation of hUCB-derived CD34(+) cells with Thy/Liv was performed. The hUCB-derived CD34(+) cells were prepared by freshly thawing (G1) and culturing for 7 days with two types of cytokine combinations (G2, G3). The CD45(+) cell populations were measured at 6, 8, 10 and 16 weeks in the peripheral blood. The splenocytes were cultured with mitogenic stimuli (PHA -L or IL-2) at 20 weeks post- transplantation, and the proliferation of human immune cells was evaluated. RESULTS: There were no significant differences in the human CD45(+) cell populations at 6, 8, 10 and 16 weeks post-transplantation between the groups. In the cultured splenocytes at 20 weeks post-transplant with PHA-L or IL-2, there was remarkable expansion of CD3(+) cells in the three groups. Although no CD19(+) cells were detected in the spleen, human Ig G was detected in the sera of these mice. CONCLUSION: The cultured and expanded hUCB-derived cells with cytokine combinations might be a feasible cell source in humanized mouse modeling. In addition, human immune cells can be reconstituted from the co-transplantation of Thy/Liv and cultured hUCB-derived CD34(+) cells.
Animals ; Fetal Blood ; Hematopoietic Stem Cells ; Humans ; Hydrazines ; Immune System ; Interleukin-2 ; Kidney ; Mice ; Models, Animal ; Phytohemagglutinins ; Spleen ; Transplants ; Umbilical Cord