From May, 1982 to Aug. 1984, authors analyzed the clinical results of the evaluation of 43 esotropic patients who underwent surgery, except the patients with congenital esotropia. The obtained results were as follows; 1. Male occupied 46.5% and female 53.5%. Partially accommodative cases were 2.8 times as many as nonaccommodative cases. 2. Common age of onset was 2 years and common operative age was 4 years. Above a half of cases underwent operation within 2 years after onset. 3. Common age of the first hospital visit was 4 years and all cases underwent operation within 2 years after that time. 4. The angle of deviation between 21 delta - 30 delta was found in 34.9% of cases. 5. Refraction after instillation of cycloplegic agent showed that 46.5% of cases were over +2.0D and 37.2% between + 2.0D and 0D. 6. Type of surgery was monocular medial recession with lateral resection in 34.9 % of cases. 7. Postoperative fusion was achieved 3.5 times as high as non-fusion in the cases who underwent operation before the age of 4 years and in the cases who underwent operation after that age the ratio were about the same. 8. Postoperative angle of deviation were orthophoric in 44.2% of cases. Undercorrection was noticed in 48.8% of cases and overcorrection in 7% of cases. 9. Postoperative nonsurgical methods of treatment for remained abnormalities were wearing of glasses, the occlussive therapy and the use of miotics, etc. Among them, the wearing of glasses was most available.
Age of Onset ; Esotropia* ; Eyeglasses ; Female ; Glass ; Humans ; Male ; Miotics

Giant cell tumor of the spine is a rare and potentially malignant condition which presents rather difficult clinical problems in treatment because of their localization and unpredictable clinical course. Authors experienced a case of giant cell tumor involving third lumbar vertebra which was successfully treated by ea bloc resection and anterior interbody fusion of the adjoining vertebrae with iliac bone graft. At eighteen months follow up, there is no evidence of recurrence and solid union of the bone graft was noted.
Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Recurrence ; Spine ; Transplants

BACKGROUND AND OBJECTIVES: Qualitative oculomotor abnormalities have been reported in parkinsonian patients for many years, but conflicting results have been obtained. This study was performed to evaluate the correlation between the severity of the disease and the abnormalities of the ocular movements in idiopathic parkinson's disease. METHODS: We gave the vestibular function tests in patients with idiopathic parkinson's disease and normal controls. Eye movement recordings were made with automated electronystagmography and rotation test was performed. A total of 46 patients (mean age : 61.2+/-6.7) and 24 controls (mean age : 60.5+/-4.3) were studied. The severity of the disease was divided into two groups by modified Hoehn & Yahr staging ; H-Y stage 1 and 2 as a mild group and stage 3 and 4 as a severe group. RESULTS: Saccadic latency and accuracy, pursuitic gain and velocity, vestibulo-ocular reflex (VOR) suppression by vision were significantly altered in patients, whereas mean velocity of optokinetic nystagmus (OKN) and VOR gain in darkness were normal. Alteration of saccadic latency and accuracy, pursuitic gain and velocity, VOR suppression by vision were profound in the severe group compared with a mild group and controls, but the above parameters did not differ between a mild group and controls. In a hemiparkinson's group, saccadic latency and accuracy, pursuitic gain, OKN mean velocity and gain was not different between the both sides. CONCLUSION: The results indicate that severe Parkinson's disease damages nigrostriatal or other specific pathways which were involved in the regulation of the saccadic, pursuitic and pursuitic-mediated visual fixation system. In a hemiparkinson's group asymmetric damage of dopaminergic innervation which was involved in the regulation of ocular movements was not found.
Darkness ; Electronystagmography ; Eye Movements ; Humans ; Nystagmus, Optokinetic ; Parkinson Disease* ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests

BACKGROUND/AIMS: To investigate the drug survival rate of tacrolimus (TAC) and analyze the potential predictors of this rate in patients with rheumatoid arthritis (RA) in routine care. METHODS: 2018-01-16: In this retrospective longitudinal study, we enrolled 102 RA patients treated with TAC from April 2009 to January 2014 at a tertiary center in South Korea. The causes of TAC discontinuation were classified as lack of efficacy (LOE), adverse events (AEs), and others. The drug survival rate was estimated using the Kaplan-Meier method and the predictors of this rate were identified by Cox-regression analyses. RESULTS: TAC was discontinued in 27 of 102 RA patients (26.5%). The overall 1-, 2-, 3-, and 4-year TAC continuation rates were 81.8%, 78.4%, 74.2%, and 69.1%, respectively and the median follow-up period from the start of TAC was 32.5 months. The number of TAC discontinuations due to LOE, AEs, and others were 15 (55.6%), 11 (40.7 %), and 1 (3.7%), respectively. The baseline high disease activity was a significant risk factor for TAC discontinuation after adjusting for confounding factors (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.16 to 5.35; p = 0.019). In addition, underlying interstitial lung disease was significantly associated with TAC withdrawal due to AEs (HR, 3.49; 95% CI, 1.06 to 11.46; p = 0.039). CONCLUSIONS In our study, TAC showed a good overall survival rate in patients with RA in real clinical practice. This suggests that the long-term TAC therapy has a favorable efficacy and safety profile for treating RA.

A thyrotropin (TSH)-secreting pituitary adenoma is a rare cause of hyperthyroidism, with an incidence of one case per million. Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease of the axial skeleton. Extra-articular manifestations, such as anterior uveitis, may also be prominent features in AS but little is known about the association between AS and thyroid diseases including TSH-secreting pituitary adenomas. We present a case study of a 26-year-old male AS patient who was diagnosed with a TSH-secreting pituitary adenoma using a thyrotropin releasing hormone stimulation test, measurement of the TSH alpha-subunit, and magnetic resonance imaging, and subsequently treated with a transsphenoidal tumor resection.
Adult ; Humans ; Hyperthyroidism ; Incidence ; Magnetic Resonance Imaging ; Male ; Pituitary Neoplasms* ; Rheumatic Diseases ; Skeleton ; Spondylitis, Ankylosing* ; Thyroid Diseases ; Thyrotropin* ; Thyrotropin-Releasing Hormone ; Uveitis, Anterior

No abstract available.
Cystadenocarcinoma, Mucinous* ; Female* ; Humans ; Mucins*

A 40-year-old female previously diagnosed with primary biliary cirrhosis was referred to the hospital complaining of muscle weakness, arthralgia, Raynaud's phenomenon, and thick skin. After work-up, she was diagnosed with both mixed connective tissue disease (MCTD) and papillary thyroid cancer (PTC), based on the Alarcon-Segovia criteria and pathological examination, respectively. High-dose glucocorticoid and azathioprine were introduced to treat active myositis of MCTD, and total thyroidectomy was performed to treat PTC. This report highlights the possible association between MCTD and thyroid cancer, and suggests that MCTD is associated with PTC, similar to other autoimmune diseases including Sjögren's syndrome, systemic sclerosis, and systemic lupus erythematosus.
Adult ; Arthralgia ; Autoimmune Diseases ; Azathioprine ; Female ; Humans ; Liver Cirrhosis, Biliary* ; Lupus Erythematosus, Systemic ; Mixed Connective Tissue Disease* ; Muscle Weakness ; Myositis ; Scleroderma, Systemic ; Skin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: This purpose of this study is to analyze the results of resection, reconstruction and functional results for malignant humeral lesions. MATERIALS AND METHODS: Thirty-five cases were eligible to this study. There were stages IB (3) , IIB (26) , and IIIB (6) . Resection type varied from extraarticular humeral resection (3) , intraarticular humeral resection (31) , to humeral segmental resection (1) . Reconstruction consisted of spacer arthroplasty (18) , shoulder fusion (4) , composite arthroplasty (8) , fibular graft (2) , intercalary reconstruction with autogenous recycled bone (1) , and tumor prosthesis (2) . RESULTS: 138 months actual/continuous disease free survival rate for 16 osteosarcomas were 47/25%. Complications needed operation were local recurrence (4) , failure of distal fixation (1) . Overall functional score of the 35 cases was 24, spacer arthroplasty (23) , composite arthroplasty (25) and shoulder fusion (22) , respectively. CONCLUSION: There were no functional difference among reconstructive options and shoulder fusion and arthroplasty. More biologic reconstructions such as living fibula or autogenous recycled bone are recommendable options for cases which nesessitate resection up to 3/4 of humerus.
Arthroplasty ; Disease-Free Survival ; Fibula ; Humerus* ; Osteosarcoma ; Prostheses and Implants ; Recurrence ; Shoulder ; Transplants

OBJECTIVES: The role of rheumatoid factor (RF) in vascular stiffness and cardiovascular risk in subjects without joint symptoms remains unclear. We investigated vascular stiffness in subjects without joint symptoms using pulse wave velocity (PWV), calculated Framingham risk scores (FRS), an estimator of cardiovascular risk, and analyzed whether vascular stiffness and FRS were affected by RF. METHODS: Two hundred forty-two subjects were included in this population-based study. RF was quantified with turbid immunometry using a cut-off of RF > 15 IU/ml to denote RF positivity. Information was then obtained on joint symptoms. Brachial-ankle PWV (baPWV) was measured using an automated device. RESULTS: Of the 242 subjects, 15 were RF-positive. RF-positive subjects without joint symptoms had a higher baPWV and FRS than RF-negative subjects without joint symptoms, but the difference did not reach statistical significance. However, when we stratified the subjects into two groups (group A – high RF: RF ≥ 40 IU/ml; group B – low RF: RF < 40 IU/ml), group A showed significantly higher baPWV (1640.7 ± 179.6 ㎝/s vs. 1405.7 ± 225.7 ㎝/s, P = 0.008) and FRS (25.7 ± 4.87 vs. 11.8 ± 9.6, P < 0.001). Multiple regression analysis was used to examine potential confounders, and RF exhibited significant but modest effects on baPWV (adjusted R-squared = 0.038, P = 0.030). CONCLUSIONS: In a sample of the general population without joint symptoms, higher levels of RF were associated with increased vascular stiffness, suggesting a pathophysiologic link between RF and endothelial dysfunction.
Joints* ; Pulse Wave Analysis ; Rheumatoid Factor* ; Vascular Stiffness*

In systemic sclerosis, digital ulcers and gangrene are somewhat common clinical characteristics of obliterative vasculopathy. These manifestations increase morbidities, such as pain, infections, and acroosteolysis. However, patient responses to the appropriate treatments are often inadequate. We treated a patient with systemic sclerosis who had a refractory digital ulcer and gangrene with bosentan, an endothelin receptor antagonist, and observed improvement. Here we systematically review this case.
Acro-Osteolysis ; Gangrene* ; Humans ; Receptors, Endothelin ; Scleroderma, Systemic* ; Ulcer*