The purpose of the present study is to find out whether the ophthalmotonic consensual reaction really exists and through what channel the reaction is brought about in rabbits. Twenty-eight pigmented male rabbits were divided into four groups of seven rabbits each, and the intraocular pressure of each eye was measured at designated times in each group with a Mueller electronic tonometer under topical anesthesia (0.5% tetracaine hydrochloride). Retrobulbar anesthesia and compression were performed in each group as follows: Group 1: From 56 minutes to 60 minutes after the experiment had begun, the right eye was compressed for 4 minutes with a 50 gm weight by means of a Baillart ophthalmodynamometer Group 2: About one hour after the experiment had begun, 1.0 cc of 2% procaine hydrochloride was given by retrobulbar injection on the right side. Digital massage after retrobulbar injection was avoided and epinephrine was not employed, because they might influence the intraocular pressure. Group 3: After retrobulbar anesthesia had been performed for the right eye at 40 minutes, this eye was compressed by the above described method from 85 minutes to 90 minutes after the experiment had begun. Group 4: After retrobulbar anesthesia had been performed in the left eye at 40 minutes, the right eye was compressed by the above described method from 86 minutes to 90 minutes after the experiment had begun. The data of each experimental group were analyzed statistically by means of the t-test. Four groups of tonometric studies were done with the following results: 1. After the right eye had been compressed with a 50 gm, weight for 4 minutes, the right intraocular pressure was found to be lowered and then immdiately elevated. The intraocular pressure in the left eye was lowered beginning about 20 minutes after the right eye compression, and this phenomenon may be considered as the ophthalmotonic consensual reaction. 2. After retrobulbar anesthesia with 1.0 cc of 2% procaine hydrochloride had been performed for the right eye, the intraocular pressure was found to be lowered, but that of the left eye showed a slight rise and maintenance of the elevated pressure. 3. When the right eye was compressed after retrobulbar anesthesia had been performed, the grade of rising of the intraocular pressure was lower than when retrobulbar anesthesia had not been performed. The intraocular pressure in the left eye showed no significant change, so it can be postumted that the afferent pathway of the ophthalmotonic consensual reaction was blocked by the retrobulbar anesthesia in the compressed right eye. 4. When the right eye was compressed after retrobulbar anesthesia had been performed previously in the left eye, the change of the intraocular pressure in the right eye showed no difference as when retrobulbar anesthesia had not been performed in the left eye. The intraocular pressure in the left eye showed a similar change as when the right eye had not been compressed, so it can be postulated that the efferent pathway of the ophthalmotonic consensual reaction was blocked by the retrobulbar anesthesia in the non-compressed left eye.
Afferent Pathways ; Anesthesia ; Efferent Pathways ; Epinephrine ; Humans ; Intraocular Pressure ; Male ; Massage ; Procaine ; Rabbits* ; Tetracaine

Epikeratophakia is a newly developed refractive corneal surgery for the correction of aphakic vision. Two aphakic patients have received hyperopic epikeratophakia grafts. Three months postoperatively, two patients had visual acuities of 0.6 without spectacle overcorrection. Epikeratophakia appears to be effective for the correction of adult aphakia.
Adult* ; Aphakia* ; Epikeratophakia* ; Humans ; Transplants ; Visual Acuity

No abstract available.
Dermatitis*

No abstract available.
HIV* ; Syphilis*

Canavan disease(CD) is a rare autosomal recessive leukodystrophy caused by the deficiency of aspartoacylase and the accumulation in brain of N-acetylaspartate(NAA). CD has been reported mainly Ashkenazi Jews but also occurs in other ethnic groups. Usually it presents as early as the third month of life with megalencephaly, hypotonia later progressing to hypertonia, psychomotor and mental retardation, blindness, occasionally deafness and seizure. Diagnosis is based on the clinical feature, N-acetylaspartic aciduria, radiologic and pathologic findings. Histologically, the affected white matter shows extensive vacuolation and demyelination. There is no treatment for CD and the only prevention is through genetic counselling and prenatal diagnosis. We experienced a case of Canavan disease that was presented with hypotonia and developmental delay. Diagnosis was confirmed histologically. Radiologic findings are extensive high signal throughout the white matter on T2-weighted MRI and increased NAA peak and decreased choline peak of the white matter on MR spectroscopy.
Blindness ; Brain ; Canavan Disease* ; Choline ; Deafness ; Demyelinating Diseases ; Diagnosis ; Ethnic Groups ; Humans ; Intellectual Disability ; Jews ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Muscle Hypotonia ; Prenatal Diagnosis ; Seizures

Familial dysautonomia, first described by Riley and co-workers in 1949, is a congenital, heritable syndrome. It is transmitted by a recessive autosomal gene which is generally limited to persons of Jewish extraction; however, rare occurrences among non-Jewish Caucasians and in a black girl have been reported. An eight-year old Korean boy was admitted to Severance Hospital with bulbar conjunctival injection OU for 1 month and visual disturbance OS for 10 days. Examination revealed exfoliated epithelium in an area of about 3mm in diameter in the center of the left cornea, multiple punctate erosions and edema of the corneal epithelium. Yet, he experienced no discomfort, blepharospasm, nor photophobia. He had decreased corneal sensation, decreased lacrimation by Schirmer test and miosis was induced biJaterally by 0.25% pilocarpine (equivalent to 2.5% methacholine). The patient had decreased deep tendon reflexes and postural hypotension, and showed emotional lability, indifference to pain, and abnormal temperature control. He also had marked anorexia, swallowing difficulty, cyclic vomiting, abdominal pain, headache, intermittent vascular hypertension and one episode of convulsive seizure. He was positive to histamine intradermal injection test and had abnormal EEG. EMG was suggestive of some form of neuropathy. He was treated with toplca 0.5% chloramphenicol solution and 10% dextran solution alternatively q.2 hrs., terramycin ophthalmic ointment q.h.s. and bilateral patching; he also received 50,000 units of vitamin A for 10 days. He showed marked improvement of his ocular symptoms in 6 days. The above patient shows many of the essential features of the familial dysautonomia syndrome as outlined by Riley; however, he also lacks some of the most important features. Therefore, we feel that the patient has a case of some other type of autonomic dysfunction simulating Riley-Day svndrome.
Abdominal Pain ; Anorexia ; Blepharospasm ; Chloramphenicol ; Cornea ; Deglutition ; Dextrans ; Dysautonomia, Familial* ; Edema ; Electroencephalography ; Epithelium ; Epithelium, Corneal ; Female ; Headache ; Histamine ; Humans ; Hypertension ; Hypotension, Orthostatic ; Injections ; Injections, Intradermal ; Male ; Miosis ; Oxytetracycline ; Photophobia ; Pilocarpine ; Primary Dysautonomias* ; Reflex, Stretch ; Seizures ; Sensation ; Vitamin A ; Vomiting

To evaluate the efficacy of optimizing of A-constant, the error in prediction was analyzed in three groups of eyes after posterior chamber lens implantation ; 102 eyes with bag placed, 66 eyes with simple sulcus places, and 25 eyes with sulcus placed with transscleral fixation suture. We compared the predictive accuracy of the SRK/T formula using optimized A-constant (bag-placed, sulcus-placed) derived from the 300 eyes with Holladay and SRK/T using original surgeon factor and A-constant. The SRK/T formula with optimized A-constant has a better mean relative, absolut, and standard error and has a better range of IOL prediction error, which was more accurate than other formulas without optimizing. In this study it is our recommendation that each surgeon use a different optimized A-constants for sulcus or bag placement to enhance the predictability of the postoperative refraction.
Sutures

Among cystic tumors arising in the pancreas, microcystic adenoma is relatively uncommon; it is usually benign, and is comprised of cysts that vary in size from microscopic to 2cm in diameter. It has recently been reported to be associated with other pancreatic tumors with malignant potential; in particular, microcystic adenoma with coexistent islet cell tumor has been reported in von Hippel-Lindau disease. We report a case of microcystic adenoma of the pancreas associated with coexistent surgically-proven islet cell tumor. On spiral CT, the islet cell tumor was seen as a highly enhanced inhomogeneous solid mass in the pancreatic head, and microcystic adenoma as numerous small cysts throughout the pancreas.
Adenoma* ; Adenoma, Islet Cell* ; Head ; Islets of Langerhans* ; Pancreas* ; Tomography, Spiral Computed ; von Hippel-Lindau Disease

BACKGROUND/AIMS: We compared the accuracy in the diagnosis of hepatic masses such as hepatocellular carcinoma (HCC), metastasis and hemangioma using enhancing pattern alone with using additional findings, and determined whether the additional findings could improve the diagnostic accuracy. METHODS/MATERIALS: Triphasic spiral CT images were retrospectively analyzed in 83 cases of hepatic lesions,' 40 HCC, 21 metastases, and 22 hemangiomas. Three observers made the diagnosis first by the enhancement pattern of the mass alone, and then, by the whole information. The diagnosis of a lesion was considered correct if the lesion was correctly categorized by at least two observers. Diagnostic accuracies of two sessions were compared with McNemar test. RESULTS: Using enhancing patterns alone, 31/40 HCC (78%), 8/21 metastases (38%), 21/22 hemangiomas (95%) were correctly diagnosed. The frequency of correct diagnosis was significantly improved when all images with additional findings were used: 36/40 (90%) HCC, 20/21 (95%) metastases, 22/22 (100%) hemangiomas (P=0.00006). Metastasis showed most prominent and statistically significant improvement in the diagnostic accuracy (P=0.0004). The number of correct diagnoses for HCC increased without statistical significance (P=0.17). However, the images with additional findings did not significantly contribute to the diagnosis of hemangiomas. The additional finidngs those led to correct diagnosis of metastases were multiple mass (7 cases), coexistence of primary malignancy (6 cases), and metastasis to other organ (1 case). The findings of liver cirrhosis were helpful to diagnose HCC correctly in 5 cases. CONCLUSION: The enhancing pattems of tumors were important in the diagnosis of hepatic masses in spiral CT. However, the additional finidngs were also helpful for the diagnosis of hepatic masses especially for the masses with atypical enhancement pattern. In metastases, the additional findings such as multiple masses or detection of primary malignant focus were useful to diagnose correctly.
Carcinoma, Hepatocellular ; Diagnosis ; Hemangioma ; Liver Cirrhosis ; Liver Neoplasms ; Neoplasm Metastasis ; Retrospective Studies ; Tomography, Spiral Computed*

The authors present a family with two members affected by hereditary corneal dystrophy of Schnyder. A 45-year-old mother and her 15-year-old son visited our hospital with bilateral opacities which affected the center of the cornea symmetrically. They stated that they had found the abnormalities about one month previously, and had have no visual disturbances or inflammatory symptoms. The blood cholesterol of the two patients was essentially in the normal range, and no other systemic abnormalities were found. This is the first family with hereditary crystalline corneal dystrophy of Schnyder to be reported in Korea.
Adolescent ; Cholesterol ; Cornea ; Corneal Dystrophies, Hereditary ; Crystallins* ; Humans ; Korea ; Middle Aged ; Mothers ; Reference Values