The authors present a case of Marcus Gunn syndrome associated with paresis of the superior rects muscle. This 25 yrs. old R.O.K Soldier had hypotropia and Complete ptosed eye lid of the right side which was elevated in association with Opennig of the mouth and lateral movement of the jaw to the left side since birth. We have treated him surgically, such as complete resection of the levator muscle and then attachment of the upper eye lid to the frontalis muscle with the technic of Friedenwald-Guyton.
Humans ; Jaw ; Military Personnel ; Mouth ; Paresis ; Parturition

No abstract available.
Acute Kidney Injury*

PURPOSE: Racemose hemangiomas of the retina are rare developmental vascular anomalies with abnormal arteriovenous anastomoses. We report our observations of a retinal racemose hemangioma with marked dilation and tortuosity of the retinal vessels in the entire left retina. METHODS: In a 9-year-old boy with loss of vision and mild esotropia who presented with hugely dilated and tortuous retinal vessels in left retina, we examined fundus, fluorescein angiography, cerebral angiography, brain CT and MRI. RESULTS: Fundus and fluorescein angiography of the left eye showed marked dilation and tortuosity of the retinal vessels. Angiographic finding showed rapid filling of all vessels and no dye leakage. MRI finding revealed small tortuous vessels around left optic nerve, optic chiasm and tract. Brain CT and cerebral angiography showed nothing abnormal.
Arteriovenous Anastomosis ; Brain ; Cerebral Angiography ; Child ; Esotropia ; Fluorescein Angiography ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Male ; Optic Chiasm ; Optic Nerve ; Retina ; Retinal Vessels ; Retinaldehyde*

Percutaneous transluminal coronary angioplasty (PTCA) is often used in the management of coronary artery disease and the advances in equipment, technichal skill and acquisition of operator experiences have improved initial success rates and reduced the frequency of complications. However, acute coronary occlusion is the most common and serious complication related to angioplasty and its several potential mechanisms are intracoronary thrombus, coronary artery spasm and coronary artery dissection. Accordingly,heparinization, intracoronary thrombolysis, re-PTCA, stent implantation and emergency coronary artery bypass grafting have been previously used for reopening of an occluded coronary artery during angioplasty. In this report we describe our experience in the management of acute coronary occlusion of left anterior descending artery caused by dislodgement of thrombotic material during PTCA by means of aspiration thromboembolectomy instead of medical therapy,re-PTCA and stent implantation.
Angioplasty* ; Angioplasty, Balloon, Coronary ; Arteries ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Occlusion* ; Coronary Vessels ; Emergencies ; Spasm ; Stents ; Thrombosis

No abstract available.

The cataract extraction in vitrectomized proliferative diabetic retinopathy(PDR) may be different from the ordinary non-vitrectomized patients in several points. We tried to know what`s the problems during the operation, how`s the visual outcomes and the postoperative complications in these eyes. In 18 previously vitrectomized PDR patients(25 eyes), we performed the extracapsular cataract extraction(ECCE) in 7 eyes and the phacoemulsification in 18 eyes. The intraoperative problems were insufficient dilation of pupil, unstability of (anterior and posterior) chamber depth, and difficulty in removal of cortex, which is firmly adherent to the posterior lens capsule. Opacity of posterior lens capsule, elevation of intraocular pressure, exudative pupillary membrane, posterior synechia and corneal edema were the major postoperative complications. In 22 eyes(88%), the visual acuity was increased more than 2 lines, Cataract extraction was easier and less postoperative complications these cases.
Cataract Extraction* ; Cataract* ; Corneal Edema ; Diabetic Retinopathy* ; Humans ; Intraocular Pressure ; Membranes ; Phacoemulsification ; Postoperative Complications ; Pupil ; Visual Acuity

The authors reviewed the charts of 128 patients(160 eyes) who underwent vitrectomy for the proliferative diabetic retinopathy from January 1993 to December 1995 and the results were analyzed in terms of visual efficiency. At the conclusion of the study, visual acuity improved in 96 eyes(60%), unchanged in 33 eyes(21%) and in 31 eyes(19%) became worse. Visual efficiency was increased from 11.9% preoperatively to 37.2% postoperatively in all patients. Patients under the age of 40 showed better results than the patients above the age of 40. The factors which affected the change in visual efficiency were age and preoperative intraocular conditions. The patients who had non-clearing vitreous hemorrhage without proliferative membrane revealed better prognostic results than the other patients. In 50 eyes (31.3%) of cases, maximal postoperative visual acuity was achieved in 4 weeks to 3 months after operation.
Diabetic Retinopathy* ; Humans ; Membranes ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason for the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium irate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.
Hand ; Health Expenditures ; Humans ; Insurance ; Insurance Carriers ; Insurance, Health* ; Korea* ; Outpatients ; Public Health ; Tertiary Healthcare

BACKGROUND & OBJECTIVE: Recent studies suggest that anticoagulation, or antiplatelet therapy is safe and effective for the prevention of cardiogenic embolic stroke. However it has not been studied in Korea how the patients with cardioembolic source were managed in practice for the prevention of stroke. This study was done to assess the current status of primary and secondary prevention of cardioembolic stroke. METHODS: Retrospective study was undertaken in 124 patients with cardiogenic embolic stroke, following items were examined, previous anticoagulation or antiplatelet therapy, previous stroke, Insight of the heart disease, and International Normalize Ratio(INR) value on arrival at the hospital. RESULTS: In 124 patients cardioembolic sources were constituted of non-valvular atrial fibrillation (NVAF) in 54, rheumatic heart disease In 40, prosthetic cardiac valve In 14, dilated cardiomyopathy(D-CMP) in 6, left ventricular akinetic segment in 7(including 3 cases of LV thrombi), recent myocardial infarction in 3. In 93 patients with no previous stroke, 44 patients had regular medical follow-up because of his/her cardiac problems and primary prevention of stroke was made only in 12 (27%) patients (8 on anticoagulation and 4 on antiplatelet therapy). The rate of primary prevention varied according to the type of cardioembolic source; 100% with mechanical prosthetic valve, 33.3% with valvular atrial fibrillation, 6.7% with NVAF, and none with D-CMP and bioprosthetic valve. Previous stroke was found in 31 patients, among whom 24 had been followed regularly. Twenty patients(83%) were under secondary prevention of cardioembolic stroke (anticoagulation in 11 and antiplatelet agents in 9). Among 19 patients who developed stroke in spite of anticoagulation, INR values were lower than 1.5 in 12(63%), between 1.5 and 2.0 in 5(26%), and above 2.0 in 2(11%). CONCLUSION: Our results suggest that cardioembolic strokes have not been prevented properly. Many physicians seem to be reluctant to anticoagulate their patients with cardioembolic source, and even with anticoaguation the dosage is frequently insufficient to prevent stroke.
Atrial Fibrillation ; Follow-Up Studies ; Heart Diseases ; Heart Valves ; Humans ; International Normalized Ratio ; Korea ; Myocardial Infarction ; Platelet Aggregation Inhibitors ; Primary Prevention ; Retrospective Studies ; Rheumatic Heart Disease ; Secondary Prevention ; Stroke*

This study aimed to assess the potential usefulness of optical coherence tomography[OCT]for the diagnosis of central serous chorioretinopathy. OCT was used to examine 50 patients[50 eyes]whose initial examination disclosed the clinical diagnosis of central serous chorioretinopathy. Optical coherence tomographic section acquired directly through the fovea showed an increase of the neurosensory retina above an optically clear space corresponding to a fluid-filled cavity. Serial OCT were able to demonstrate a decrease in the sensory retina elevation from[900~120]micrometer t o [130~0]micrometer for 3 months of period. This resolution correlated with an improvement in the patient's visual acuity. OCT is potentially useful as a new, noninvasive diagnostic technique for quantitative examination by objectively monitoring the degree of serous retinal detachment in patients with central serous chorioretinopathy.
Central Serous Chorioretinopathy ; Diagnosis* ; Humans ; Retina ; Retinal Detachment ; Tomography, Optical Coherence ; Visual Acuity