The human papillomavirus(HPV) has been implicated in the pathogenesis of human conjunctival papilloma, becauses it has clinically viral nature and pathologically koilocytosis, typically found in other papilloma-induced tumors. To evaluate the association of HPV with conjunctival papilloma, 3 recurrent conjunctival papiloma were removed through cryo-excision and examined for the presence of human papillomavirus by polymerase chain reaction. All 3 cases were positive reactions to papillomavirus serotype 6/11, but koilocytosis was present in 2 cases.
Humans* ; Papilloma* ; Polymerase Chain Reaction

Children with mature visual functions can suffer from diplopia when overcorrection after strabismus surgery occurred. If the patients are willing to undergo the adjustment procedure under a topical anesthesia, we feel that it is also possible to perform the strabismus surgery in the same manner. We operated 58 strabismic children (male 37, female 21) aging from 6 to 14 under topical anesthesia using only 0.5% proparacaine (Alcaine). After bow tie suture around end of the surgery, patients were assisted in sitting upright on the operating table, asked to fixate on a 20/40 accomodative target. Subsequently, we adjusted ocular alignment to nearly orthophoria. The overall success rate was 67.2% (39/58) ; horizontal strabismus with fusion potential (74.4%) was more successful than horizontal and/or vertical combined strabismus without fusion potential (52.6%) and one muscle surgery in horizontal strabismus regardless of fusion potential (36.4%). In conclusion, this study revealed that strabismus surgery under topical anesthesia had many advantages including day surgery, decreased complications and decreased the number of surgery.
Aging ; Ambulatory Surgical Procedures ; Anesthesia* ; Child ; Diplopia ; Female ; Humans ; Operating Tables ; Strabismus* ; Sutures

We performed clinical evaluations on 26 patients who were prescribed glasses with full correction and Fresnel prism for correction of abnormal head posture and/or diplopia due to incomitiant paralytic strabismus. There were 12 cases(46.2%) of superior oblique muscle palsy and 8 cases(30.8%) of lateral rectus palsy in order. Trauma was the most common cause, but non-traumatic cases were mostly caused by vascular disease of diabetes mellitus and/or hypertension. Abnormal head posture with diplopia and/or dissociated diplopia may be one of the causes of less satisfaction level than interval of prescription of Fresnel prism. Decreased visual acutiy happened when prescribed above ten prism prescription on one eye, and patients accepted with more ease when prescription wasdivided on both eyes, in spite of low prism power. We concluded that it is necessary to explain dimness due to decreased visual acuity when above ten prism power prescription is given on one eye even though prism was more effective method for diplopia gteatment.
Abducens Nerve Diseases ; Diabetes Mellitus ; Diplopia ; Eyeglasses ; Glass ; Head ; Humans ; Hypertension ; Paralysis ; Posture ; Prescriptions ; Strabismus* ; Vascular Diseases ; Visual Acuity

PURPOSE: Exercise-induced bronchospasm (EIB) is widely prevalent in asthmatic patients. Recently, eosinophilic airway inflammation and atopy (defined as skin sensitivity to common aeroallergens) are considered to be a important factors in the pathogenesis of asthma. Thus we studied to find out the effect of atopy and airway eosinophilic inflammation on exercise- induced bronchospasm. METHODS: We followed up the cases of 132 mild asthmatics for 2 years. On their first visit, skin prick tests, with 29 common allergens including dust mites antigen, and sputum induction were performed. And 3 days later, methacholine challenge was done. 24 hours after methacholine challenge, treadmill test was performed and the positive EIB was defined as a 15% reduction or more in FEV1 from baseline after exercise. RESULTS: EIB was observed in 54 (40.9%) of 132 asthmatic subjects. There was no significant difference in atopy between EIB positive and EIB negative asthmatics. Eosinophil and eosinophil cationic protein in induced sputum were significantly higher in EIB positive asthmatics. We also found the significant correlation between bronchial responsiveness (BR) index and maximal % fall in FEV1. CONCLUSION: The severity of bronchospasm evoked by exercise was more closely related to eosinophilic airway inflammation and airway hyperresponsiveness to methacholine than atopy.
Allergens ; Asthma ; Asthma, Exercise-Induced* ; Bronchial Spasm ; Dust ; Eosinophil Cationic Protein ; Eosinophils* ; Exercise Test ; Humans ; Inflammation* ; Methacholine Chloride ; Mites ; Skin ; Sputum

There are many factors that influence the response of strabismus surgery. This study was undertaken to evaluate the influence of axial length on the response to strabismus surgery. Axial length was determined preoperatively on 156 non-paralytic horizontal strabismus patients undergoing strabismus surgery from February, 1993 to April, 1994. The mean axial length in all patients was 22.29+/-1.35mm. In esotropia the mean axial length was 21.24+/-1.12mm and in exotropia the mean axial length was 22.68+/-1.23mm. A statistically significant inverse correlation was found between axial length and surgery response (prism diopters per millimeter of recuts recession) in esotropic patients (R=-0.51 p=0.0006). Especially in aquired esotropia, a more significant correlation was found between axial length and surgery respinse (R=-0.73 P=0.0001). The relationship in esotropia was linear and could be written as the approximate regression formula : surgery response=9.51-0.29* axial length (R=-0.454 P=0.03). However, a poor correlation was found between axial length and surgery response in exotropia. Therefore it is regraded as being effective that the amount of recession in esotropia should be graduated according to axial length.
Esotropia ; Exotropia ; Humans ; Strabismus*

Fusion loss or anomaly of eye muscle and its nerve is a cause of strabismus. This induces adaptation of vergence and muscle length, the mechanisms of which are normally responsible for long-term maintenance of ocular alignment and orthophorization. To determine variability of muscle length adaptation according to age, we divided white rabbits into three groups: Group I(less than 8 weeks of age and 15000gm of body weight), Group II(10~14 weeks and 1500~2000gm), GroupIII(more than 16 weeks and 2500gm). Under local anesthesia with intravenous pentobarbital sodium, the right eyeball was fixed in exotropic position by suturing through the periosteum of the lateral canthal region with 5-o polypropylene. The muscles of left eye were not operated and served as a control. We examined electron microscopically the changes in sarcomere of the experimental right medial rectus(RMR) and right lateral rectus(RLR) after sacrificing four rabbits of each group at 1, 2 and 4 weeks, respectively. Regardless of age, when the muscle(RLR) was immobilized in the lengthened position, sarcomeres were added on and its length decreased, and when the muscle(RMR) was immobilized in the shortened position, sarcomeres were lost and its length increased. In conclusion, the study revealed that experimental extraocular muscle of rabbit is adapted in the direction to produce maximal power of its muscle and maintain ocular alignment constantly.
Anesthesia, Local ; Exotropia* ; Muscles ; Pentobarbital ; Periosteum ; Polypropylenes ; Rabbits ; Sarcomeres ; Strabismus

PURPOSE: This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). METHODS: Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. RESULTS: There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in PaCO2. However, the control group showed a slight CO2 retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. CONCLUSIONS: Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.
Apnea ; Continuous Positive Airway Pressure ; Humans ; Infant ; Surface-Active Agents ; Ventilators, Mechanical* ; Weaning*

We studied the utility of hand held autorefractometer on the cycloplegic refraction for poor coorperated children by analyzing the data taken from hand held autorefractometer(Retinomax) and Canon R-10 autorefractometer. Seventy patients(140 eyes) were studied. We divided them into two groups according to the age: Group I included patients less than 4 years, Group II over 4 years. There were no statistic significant differences in the spherical and cylindrical values regardless of age and cooperability in cases of less than 6 diopter but statistic significant difference in cases of high refractive errors (>6 diopter) or cylindrical axis values. In Conclusion, this study revealed that hand held autorefractometer was useful for checking refraction of the poor coorperated children and the spherical and cylindrical values of Retinomax have no differences from the values of R-10 in the cases of less than 6 diopter.
Axis, Cervical Vertebra ; Child* ; Hand* ; Humans ; Refractive Errors

This study was undertaken to evaluate the relationship between eye positions in the awake state and in the surgical plane of anesthesia induced with anesthetics and muscle relaxants in 167 non-paralytic horizontal strabismus patients. All 27 patients with esotropia demonstrated divergence under general anesthesia when compared with their pre-anesthetized state. In 140 patients with exotropia, 107 patients(76.4%) demonstrated convergence under general anesthesia, 6 patients(4.3%) demonstrated divergence, 27 patients demonstrated no change of the eye position. A statistically significant relationship was found between the preanesthetized position of the eyes(P) and the eye position under general anesthesia(A). The relationship is linear and can be written as the approximate regression fomula: A=0.44P+6.34, R=0.73(p<0.01). When surgical success was defined as an eso- or exodeviation within 10 delta of orthotropia at postoperative 12 weeks, final success rate revealed statistically significant difference between the following two groups of exotropic patients(p<0.05). The patients whose amount of vergence were under 15 delta had a success rate of 96.6%, while those over 16 delta had a success rate of 86.3%. In esotropia, surgical success was not satisfactory in patients whose amount of deviation were over 41 delta. These results suggest the significant relationship between eye positions in the awake state and those under general anesthesia, which could be clinically applied in deciding the surgical amount and predkting the success of strabismus surgery.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Esotropia ; Exotropia ; Humans ; Strabismus

PURPOSE: Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. METHODS: We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. RESULTS: Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. CONCLUSION: Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.
Continuous Positive Airway Pressure ; Gestational Age ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Intubation, Intratracheal ; Mortality ; Parturition ; Retrospective Studies ; Ventilation ; Ventilators, Mechanical*