When nasolacrimal duct obstruction in children cannot be treated with probing, the fracture of inferior turbinate and/or silicone intubation can be performed, prior to dacryocystorhinostomy So far, there have been many reports and controversies regarding the methods and duration of intubation. The authors report the clinical results of treatment with silicone intubation on the nasolacrimal duct obstruction in children. In seven eyes of seven cases with nasolacrimal duct obstruction, the silcone intubation was performed. In four eyes of four cases, the fracture of infeior turbinate was accompanied by silicone intubation. The ages of the patients ranged from 1 to 9 years, and the duration of intubation ranged from 2 weeks to 5.5 months, averaging 3 months. The follow-up period ranged from 1 to 26 months after the tube removal. In 6 eyes of 6 cases(86%), the symptoms were resolved. The authous recommend that the tube be removed within 3 months after insertion.
Child* ; Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Intubation* ; Lacrimal Duct Obstruction ; Nasolacrimal Duct* ; Silicones* ; Turbinates

In congenital third nerve palsy, the function in four of the six extraocular muscles is compromised, and its treatment is the most difficult problem in paralytic strabismus. In general, either large recession and resection on horizontal rectus muscles or superior oblique muscle transposition is used for treatment. We compared the results of the two methods of surgical therapy. A Total of nine eyes in nine cases underwent surgical correction for ocular alignment in the primary position, In four eyes of four cases horizontal rectus muscle surgery was performed. In five eyes of five cases superior oblique muscle transposition was performed. Postoperatively, one of four cases who underwent horizontal rectus muscle surgery and four of five cases who underwent superior obique muscle transposition resulted in acceptable ocular alignment, in which the angle of deviation at the primary position was within 2 delta. Therefore, in the treatment of congenital third nerve palsy, superior oblique muscle transposition is more effective than horizontal rectus muscle surgery for the correction of ocular alignment.
Muscles ; Oculomotor Nerve Diseases ; Oculomotor Nerve* ; Strabismus*

For many years it has been known that the dosage of thiopental required to induce anesthesia depends on the age of the patient, but this information ha resulted from clinical experience with the drugs rather than from planned study. In our study, to elucidate the influence of age on the size of the sleeping dosage of thiopental, 144 patients who underwent minor orthopedic and gynecological operations were studied. This patients had no evidence of a disease other than that scheduled for operation and were within normal values in hematologic examination, liver function and kidney function. Using a simple "yes" or "no" verbal command response, as sleeping response, to a single bolus of thiopental in mg/kg body weight, we have attemted to minimize uncontroliable factors such as cerebral perfusion, circulation time and plasma protein binding which would alter response to thiopental infusions continued to the end points. The results were as follows: 1) There was no statistical difference in verbal command response to thiopental according to age in age groups below 59 years. 2) Compared with age groups below 59 years, 60~79yrs, group failed to respond to the verbal command in 33% by 2.2mg/kg and 100% by above 2.6mg/kg.(p<0.05) 3) The mean time for loss of verbal command response after thiopental injection was 27.4+/-10.3 seconds and 80.4% of theses patients lost lid reflex with a mean time of 41.7+/-9.1 seconds after thiopental injection. 4) All groups showed statistically non-significant alterations of systolic blood pressure and heart rate after injection of thiopental.
Anesthesia ; Blood Pressure ; Body Weight ; Heart Rate ; Humans ; Kidney ; Liver ; Orthopedics ; Perfusion ; Plasma ; Protein Binding ; Reference Values ; Reflex ; Thiopental*

Although its high successability in numerous corneal diseases, penetrating keratoplasty in certain conditions, such as chemical burn, ocular pemphigoid, Stevens-Johnson syndrome, severe dry eye, and recurrent graft rejection still has had poor outcomes. So far, many keratoprostheses have been developed, but none of them showed consistent successful results. The authors made two models of keratoprosthesis using expanded polytetrafluoroethylene (PTFE) as a skirt and these models were implanted to 30 and 5 rabbit corneas by intralamellar fixation respectively. Expanded PTFE was well-known for its biocompatibility and porous structure which fibrovascular tissue can grow in. However, both of the models extruded from the cornea in all cases and retention period was 1 month in average. These poor results are thought to be mainly due to previously known enzymatic degradation. To obtain better result, modification of the models and surgical techniques are needed. Several possible modifications are described in this article.
Burns, Chemical ; Cornea ; Corneal Diseases ; Graft Rejection ; Keratoplasty, Penetrating ; Pemphigoid, Bullous ; Polytetrafluoroethylene ; Stevens-Johnson Syndrome

Background: Several studies have suggested that the spinal cord may be an important site of anesthetic action and have established that general anesthetics potentiate the effects of GABA at the GABAA receptor. It was, therefore, hypothesized that the suppression of nocifensive movements during anesthesia is due to an enhancement of GABAA receptor-mediated transmission. Therefore, the aim of this study was to determine behaviorally whether intrathecal GABA, glycine, or opioid receptor antagonists may change the anesthetic effect of isoflurane and enflurane. Methods: The minimal alveolar concentration (MAC) of isoflurane and enflurane was determined in Sprague-Dawley rats, by the tail-clamp technique. First, MAC was determined and then concentration of each inhalation agent was increased by 0.2% from the sub-MAC level. Moving latencies were observed after the intrathecal administration of each receptor antagonist. Rectal temperature was measured and maintained at a steady level during the experiment. Results: The spinal antinociceptive effects of isoflurane and enflurane were significantly reversed by the GABAA receptor antagonist bicuculline and picrotoxin (P < 0.05). The rectal temperature was well maintained within the range of 37-39 degrees C. Conclusions: Our results suggest that the general anesthesia induced by isoflurane and enflurane, which are similar in terms of their action mechanism, is likely to be related to the spinal GABAA receptor system.
Anesthesia ; Anesthesia, General ; Anesthetics ; Anesthetics, General ; Animals ; Bicuculline ; Enflurane* ; gamma-Aminobutyric Acid ; Glycine ; Inhalation ; Isoflurane* ; Picrotoxin ; Rats* ; Rats, Sprague-Dawley ; Receptors, Opioid ; Spinal Cord

Primary hemangioma of the heart is very rare and is difficult to be diagnosed during life. We present a case of pericardial hemangioma with spontaneous hemopericardium, which was diagnosed by operation and confirmed histologically by excisional biopsy. This 58-yr old patients had pericardial effusion on echodardiography. After evacuation of bloody pericardial effusion by pericardiocentesis, his symptoms were subsided. After then, he uneventfully convalesced. On the 32th day, sudden dyspnea developed with narrow pulse pressure. So exploratory pericardiotomy was done under the impression of cardiac tamponade. At operation, we noticed diffuse hemangiomatous lesion at epicardium and large amount of bloody pericardial effusion. We performed only diagnostic excisional biopsy because the lesion was too extensive and location was not suitable for total excision. The lesion was confirmed to be pericardial hemangioma histologically.
Biopsy ; Blood Pressure ; Cardiac Tamponade ; Dyspnea ; Heart ; Hemangioma* ; Humans ; Pericardial Effusion* ; Pericardiectomy ; Pericardiocentesis ; Pericardium

PURPOSE: Cytomegalovirus (CMV) retinitis is common in patients with immunodeficient conditions caused by acquired immunodeficiency syndrome (AIDS), cytotoxic chemotherapy and immunosuppresive treatment. The purpose of this study was to assess the clinical manifestations and prognosis of CMV retinitis cases. METHODS: Thirty-one eyes of 21 patients who were diagnosed with CMV retinitis were retrospectively reviewed. The clinical manifestations and prognosis of all patients were analyzed. RESULTS: The average age of patients was 24.4+/-19.8 years. Eight patients were female and 13 patients were male. The predisposing conditions of patients were leukemia (nine patients), immunosuppressed conditions due to organ transplantation (three patients), AIDS (two patients) and other (seven patients). Eleven patients exhibited bilateral disease. The mean follow-up period was 31.3 months, and there were no differences between mean initial visual acuity (0.70+/-0.31) and mean visual acuity (0.77+/-0.20) at final visit. The major causes of visual loss were retinitis and atrophic changes involving the macula. Although retinitis was successfully treated with anti-viral agents in all cases, cataract (10 eyes, 31.3%), cystoid macular edema (four eyes, 12.5%), retinal detachment (two eyes, 6.3%), epiretinal membrane (two eyes, 6.3%) and immune recovery uveitis (two eyes, 6.3%) developed after the initial treatment. CONCLUSIONS: Although the visual prognosis of CMV retinitis was relatively good after administration of appropriate antiviral therapy, clinicians should remain alert for the development of late complications, including retinal detachment, cystoid macular edema and immune recovery uveitis.
Acquired Immunodeficiency Syndrome ; Cataract ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Epiretinal Membrane ; Eye ; Female ; Follow-Up Studies ; Humans ; Leukemia ; Macular Edema ; Male ; Organ Transplantation ; Prognosis ; Retinal Detachment ; Retinitis ; Retrospective Studies ; Transplants ; Uveitis ; Visual Acuity

PURPOSE: To investigate the effects of repeated photodynamic therapy (PDT) for subfoveal choroidal neovascularization secondary to age-related macular degeneration (AMD) in Korean patients. METHODS: Clinical data of patients who were treated with repeated (3 times or more) PDT for subfoveal choroidal neovascularization secondary to AMD and followed up for more than 6 months were collected from 17 hospitals around the country. Visual outcomes at 12 and 24 months, follow-up were compared between subtypes of choroidal neovascularization. The factors related to final visual prognosis and PDT-related adverse effects were evaluated. RESULTS: 244 patients (244 eyes) were recruited (male: 60%, age: 67.7+/-9.1 years). The portion of patients with predominantly classic, minimally classic, and occult without classic choroidal neovascularization was 57%, 13%, and 24%, respectively and that of patients with visual improvements or less than moderate visual loss at 24 months follow-up were 28%, 38%, 30% and 47%, 56%, and 65%, respectively. Baseline visual acuity and age were significantly related to the final visual prognosis (p<0.05). PDT-related adverse events developed in 15 (6.1%) patients, but most were mild and transient. CONCLUSIONS: Repeated PDT for subfoveal choroidal neovascularization secondary to AMD has effects comparable to those of previous prospective, controlled trials without any significant safety concerns in Korea.
Choroid* ; Choroidal Neovascularization* ; Follow-Up Studies ; Humans ; Korea ; Macular Degeneration* ; Photochemotherapy* ; Prognosis ; Visual Acuity