The commonly used tests for stereopsis are Titmus-fly, Randot, and TNO tests. In this study, 50 normal subjects were tested with these tests in order to set a criterion for normal stereopsis. The value of mean, mode and 75% point of these three tests were derived and compared.These three tests were also performed in 23 intermittent exotropes and 32 accommodative esotropes who showed gross stereopsis in the range of 60 to 400 seconds of arc by Titmus-fly testing. The aim was to obtain standards for clinical applicability and accuracy of these tests.This study cincludes that the appropriate criteria for normal stereopsis are less than 60 seconds of arc for Titmus-fly or Randot test, and 120 seconds of arc fot TNO test. Accurate testing for stereopsis in patients with gross stereopsis requires both Titmus-fly and Randot tests together. TNO test was inferior to the other two tests in terms of the accuracy and clinical applicability.
Depth Perception ; Humans

Endoscopic variceal ligation(EVL) is newly developed method to manage esophageal variceal bleeding. This study asse initial control rate of active variceal bleeding, incidence of rebleeding and complications in EVL. From June in l992 to December in 1994, this study was performed on 70 patients who had visited to our medical center for melena or hematemesis by acute esophageal variceal bleeding. In all of 70 cases, eradication of esophageal varix was performed and variceal bleeding was controlled well. And first session was performed successfully with EVL. But rebleeding was occured in 12 cases(11 cases caused by esoyhageal varix and 1 case caused by esophageal ulcer) during follow-up period, so EVL therapy was performed repeatedly and 8 cases were eradicated and 4 cases were uncontrolled and died, and then 94% hemostatic effect was achieved during follow-up period. Complications of EVL therapy were mild(substernal discomfort in 12 cases, substernal pain in 4 cases, fever in 3 cases, mild dysphagia in 2 cases) and well controlled. Superficial esaphageal ulcer was shown in 18 cases by follow-up endoscopy after 1 week. These results show that EVL is a good therapeutic method to control active variceal bleeding and eradication of varix with repeat treatment. In conclusion, EVL is an effective and safe method of treatment and prevention for esophageal variceal bleeding.
Deglutition Disorders ; Endoscopy ; Equidae ; Esophageal and Gastric Varices* ; Fever ; Follow-Up Studies ; Hematemesis ; Humans ; Incidence ; Ligation* ; Melena ; Ulcer ; Varicose Veins

Many methods are available for monitoring spinal cord conductian during operation. It is essential for the anesthesiologist to the know potential interactions between the drugs used during the operation and the neurophysiologic response. The purpose of the present study was to experimentally examine the effects of ketamine and fentanyl used in the operating room. Twenty-three patients, 23 to 68 years of age, ASA I-II, free of neurologic disease and scheduled for elective operations were randomly selected for the study. Averaged somatosensory evoked potentials to stimulation of the posterior tibial nerve at the ankle were recorded. After baseline recording of the somatosensory evoked potential, ketamine (1.5 mg/kg) or fentanyl (3u/kg) was administered by bolus injection in each patient. Additional somatosensory evoked potential after the drug injection was recorded. ECG, blood pressure and heart rate were monitored throughout the measuring procedure. 1) The mean values of latency (Pl, Nl, P2) and amplitude (Pl-N1, Nl-P2) were 39.58, 48.36 and 60. 74 msec and 7.88 and 10.30uV respectively. Those values were changed to 38.54, 46.67 and 60.50 msec and 6.55 and 9.85uV in patients in the ketamine injected group. 2) The mean values of latency and amplitude were 37.90, 45.93 and 61.01 msec and 7.35 and 7.21uV respectively in the baseline state. Each value changed to 38.10, 47.06 and 61.88 msec and 6.67 and 8.49uV respectively after fentanyl injection. There was no statistical difference in latencies and amplitudes between the pre-injection state and post-injection state in both the ketamine and fentanyl groups. Therefore, we suggested that the use of ketamine or fentanyl could be administered successfully during intraoperative somatosensory evoked potential monitoring without much influence on tibial nerve stimulation.
Ankle ; Blood Pressure ; Electrocardiography ; Evoked Potentials, Somatosensory* ; Fentanyl* ; Heart Rate ; Humans* ; Ketamine ; Operating Rooms ; Spinal Cord ; Tibial Nerve

Olfactory neuroblastoma is a rare malignant tumor of the nasal cavity arising from the olfactory neuroepithelium. It usually present as a polypoid mass in the superior nasal cavity including the cribriform plate, superior turbinate, and superior portion of nasal septum. The development of olfactory neuroblastoma outside of the region, in which olfactory epithelium exists, is exceedingly rare. In this report, we present an interesting case of an isolated sphenoid sinus olfactory neuroblastoma with a brief review of the literature.
Esthesioneuroblastoma, Olfactory ; Ethmoid Bone ; Nasal Cavity ; Nasal Septum ; Olfactory Mucosa ; Sphenoid Sinus ; Turbinates

Various vascularized flaps have been used for oral reconstruction after ablative cancer surgery. Among these, the radial forearm flap, rectus abdominis flap and anterolateral thigh perforator flap are the most popular options. In cases of tongue and mouth floor reconstruction, radial forearm fasciocutaneous flap has been the empirical choice for many years. However, it often carries cosmetic and functional problems on the donor site and limitations in flap size and volume. Considering these drawbacks, the anterolateral thigh perforator flap could be a good alternative. Generally, anterolateral thigh perforator flap has been used for tongue reconstruction due to the favorable flap thickness compared to the radial forearm flap. Furthermore, if a thin flap should be required solely for lining purpose, the flap thickness can be controlled through thinning procedures without circulatory compromise. For large composite tissue defects after cancer ablation surgery, the flap can be designed in a 3-dimensional plane and used for volumetric reconstruction as well as for adequate lining. Between September 2002 and September 2003, the authors used 15 anterolateral thigh perforator flaps for reconstruction of oropharyngeal defects after cancer ablation surgery in 15 patieints and analyzed the clinical data acquired retrospectively. Based on the results, we propose the indications and drawbacks of the anterolateral thigh flap in oropharyngeal reconstruction.
Forearm ; Humans ; Mouth Floor ; Mouth* ; Perforator Flap* ; Rectus Abdominis ; Retrospective Studies ; Thigh* ; Tissue Donors ; Tongue

This study was aimed to assess the free calcium status with or without its direct measurement in patients on hemodialysis(HD: n=27) and malnourished ones from extrarenal diseases(MN: n=14). It was performed by the comparison of measured free calcium (Ca++m) levels by gas analyzer and calculated free calcium(Ca++c) levels based on those of total calcium (TCa), albumin, and pH with the modified algorithm invented by Moore(J Clin Invest. 49:318, 1970). Of 27 HD pts, 14(5296) had low[Ca++m] below 1.05mmol/L despite only 2(796) with low [TCa] below 2.05mmoV L, whereas 14 MN pts had similar numbers between low[Ca++m] and low[TCa]. Compared to MN pts, HD pts showed significantly lower mean levels(SE) of pH(7.37 0.01 vs. 7A4 0.01, p<0.01), higher[TCa](2.33 0.04 vs. 1.83 0.08mmol/L, p<0.01), and higher albumin (4.33 0.06 vs. 2.59 0.17mg/dL, p<0.01).However, [Ca++m] between 2 groups did not reveal any significant difference. Furtherrnore, in total 41 pts of 2 groups, no similarity was observed between the values of [Ca++ml and [Ca++c] but with their significant difference(p<0.05). Only[TCa] was significantly corre- lated with albumin level(r=0.73, p<0.01). Furthermore, multiple regression analysis between [Ca++m] and other factors including pH and albumin didn't show any correlation. In conclusion, this data suggests that relatively high prevalence of low values of physiologically important free ionized calcium in chronically ill pts, especially on maintenance HD, could be missed when predicted on total calcium level, and pH without its direct measurement.
Calcium* ; Chronic Disease* ; Humans ; Hydrogen-Ion Concentration* ; Prevalence

BACKGROUND AND OBJECTIVES: The bacteriology of chronic sinusitis helps us to understand sinusitis and plays an important role in selecting appropriate antibiotics. In recent studies, a good correlation was found between middle meatus and maxillary sinus cultures. We correlate middle meatus, ethmoid sinus and maxillary sinus microbiology in patients with chronic sinusitis and try to determine whether middle meatus cultures can replace maxillary sinus and ethmoid sinus cultures as noninvasive alternative methods. STUDY DESIGN: Prospective study. PATIENTS AND METHODS: 32 patients with chronic sinusitis who didn't respond to medical therapy and received endoscopic sinus surgery were selected. Intraoperative middle meatus, anterior ethmoid and maxillary sinus samples from 32 patients under endoscopic visualization using sterile cotton swabs (BBL Culture Swab(R), BBL, USA) were collected. RESULTS: The overall correlation rate of middle meatus and ethmoid sinus cultures was estimated to be 84.4%. The overall correlation rate of middle meatus and maxillary sinus cultures was estimated to be 84.4%. The most frequently isolated bacteria were coagulase negative Staphylococci in middle meatus and Staphylococcus aureus in ant. Ethmoid and maxillary sinus. CONCLUSION: This study demonstrates that middle meatus cultures correlate well with anterior ethmoid and maxillary sinus cultures and can be used to guide antibiotics selection in chronic sinusitis.
Anti-Bacterial Agents ; Ants ; Bacteria ; Bacteriology ; Coagulase ; Ethmoid Sinus* ; Humans ; Maxillary Sinus* ; Prospective Studies ; Sinusitis* ; Staphylococcus aureus

Pseudotumor cerebri syndrome is characterized clinically by raised intracranial pressure without ventriculomegaly. Several conditions known to interfere with CSF absorption pathways at the level of the arachnoid villi can produce the pseudotumor cerebri syndrome. Systemic lupus erythematosus (SLE) is an autoimmune, inflammatory and chronic disorder characterized by multi-organ involvement including the nervous system. Clinical evidence of central nervous system involvement includes headache, seizure, psychosis and altered mental status. However, pseudotumor cerebri syndrome has been reported infrequently as a primary feature of central nervous system involvement or a complication of SLE. A 19 year-old female was admitted with seizure preceded by headache and blurred vision. Ophthalmoscopic examination showed papilledema. The diagnosis of pseudotumor cerebri syndrome was confirmed by increased intracranial pressure(>550mmH2O) in the absence of any abnormal radiological findings of the brain. We described a 19-year-old girl whose first clinical manifestation was pseudotumor cerebri syndrome, which was diagnosed as SLE later. Therefore pseudotumor cerebri syndrome may be the part of the spectrum of clinical manifestation of SLE.
Absorption ; Arachnoid ; Brain ; Central Nervous System ; Diagnosis ; Female ; Headache ; Humans ; Intracranial Pressure ; Lupus Erythematosus, Systemic* ; Nervous System ; Papilledema ; Pseudotumor Cerebri* ; Psychotic Disorders ; Seizures ; Young Adult

Pseudotumor cerebri syndrome is characterized clinically by raised intracranial pressure without ventriculomegaly. Several conditions known to interfere with CSF absorption pathways at the level of the arachnoid villi can produce the pseudotumor cerebri syndrome. Systemic lupus erythematosus (SLE) is an autoimmune, inflammatory and chronic disorder characterized by multi-organ involvement including the nervous system. Clinical evidence of central nervous system involvement includes headache, seizure, psychosis and altered mental status. However, pseudotumor cerebri syndrome has been reported infrequently as a primary feature of central nervous system involvement or a complication of SLE. A 19 year-old female was admitted with seizure preceded by headache and blurred vision. Ophthalmoscopic examination showed papilledema. The diagnosis of pseudotumor cerebri syndrome was confirmed by increased intracranial pressure(>550mmH2O) in the absence of any abnormal radiological findings of the brain. We described a 19-year-old girl whose first clinical manifestation was pseudotumor cerebri syndrome, which was diagnosed as SLE later. Therefore pseudotumor cerebri syndrome may be the part of the spectrum of clinical manifestation of SLE.
Absorption ; Arachnoid ; Brain ; Central Nervous System ; Diagnosis ; Female ; Headache ; Humans ; Intracranial Pressure ; Lupus Erythematosus, Systemic* ; Nervous System ; Papilledema ; Pseudotumor Cerebri* ; Psychotic Disorders ; Seizures ; Young Adult

BACKGROUND/OBJECTIVES: Stromal cell-derived growth factor 1 (SDF-1), also known as chemokine ligand 12, and chemokine receptor type 4 are involved in cancer cell migration. Compound K (CK), a metabolite of protopanaxadiol-type ginsenoside by gut microbiota, is reported to have therapeutic potential in cancer therapy. However, the inhibitory effect of CK on SDF-1 pathway-induced migration of glioma has not yet been established. MATERIALS/METHODS: Cytotoxicity of CK in C6 glioma cells was determined using an EZ-Cytox cell viability assay kit. Cell migration was tested using the wound healing and Boyden chamber assay. Phosphorylation levels of protein kinase C (PKC)α and extracellular signal-regulated kinase (ERK) were measured by western blot assay, and matrix metallopeptidases (MMP) were measured by gelatin-zymography analysis. RESULTS: CK significantly reduced the phosphorylation of PKCα and ERK1/2, expression of MMP9 and MMP2, and inhibited the migration of C6 glioma cells under SDF-1-stimulated conditions. CONCLUSIONS: CK is a cell migration inhibitor that inhibits C6 glioma cell migration by regulating its downstream signaling molecules including PKCα, ERK1/2, and MMPs.
Blotting, Western ; Cell Movement ; Cell Survival ; Gastrointestinal Microbiome ; Glioma* ; Matrix Metalloproteinases ; Metalloproteases ; Panax ; Phosphorylation ; Phosphotransferases ; Protein Kinase C ; Wound Healing