Persistent trigeminal artery is an embryonic remnant of the anastomotic channel linking the internal carotid artery and the basilar artery. Cases of vertebrobasilar insufficiency caused by the persistent trigeminal artery with internal carotid artery stenosis has been described previously, but vertebrobasilar insufficiency entirely due to in situ stenosis of the persistent trigeminal artery has not been reported. A 71-year-old man presented with frequent dizzy episodes. The brain MRI showed no parenchymal lesions. MR angiography showed poor visualization of vertebrobasilar system. He was diagnosed as having vertebrobasilar insufficiency. Cerebral angiography revealed that there was complete occlusion at the vertebrobasilar junction, and the basilar artery was supplied by the persistent trigeminal artery which had severe stenosis at its origin. There was no stenosis of the internal carotid artery of both sides. We believe that this is the first report of vertebrobasilar insufficiency due to stenosed persistent trigeminal artery, without internal carotid artery stenosis.

A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis, treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant tuberculous meningitis. She remained well with medical management.

Mural nodules in ovarian mucinous tumors, whether benign, borderline, or malignant, have been described by several authors since Prat and Scully first described sarcoma or sarcoma-like mural nodules occurring in association with mucinous epithelial neoplasia in 1979. Three distinct types of the mural nodule have been identified; i. e., 1) sarcoma-like lesion, 2) true mesenchymal sarcome, and 3) anaplastic carcinoma simulating a sarcoma. Mural nodules of sarcomatous and carcinomatous foci associated with mucinous ovarian tumors should be separated from sarcoma-like nodules because of the poor prognosis of the former compared to the favorable prognosis of the latter. We experienced a case of ovarian mucinous cystadenocarcinoma with sarcoma-appearing mural nodule of anaplastic carcinoma occurred in a 59-year-old woman and reported with brief review of the literatures.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Middle Aged ; Mucins* ; Ovary ; Prognosis ; Sarcoma

No abstract available.
Extremities* ; Sarcoma*

PURPOSE: This study assesses the surgical results of inferior oblique myectomy on the degree of overaction in patients with overaction greater than +2 of the inferior oblique muscle. METHODS: Seventy eyes of 54 patients underwent an inferior oblique myectomy and at least 6 months of follow-up. Patients with contracture of the superior rectus muscle or dissociated vertical deviation were excluded. The chief complaints, preoperative and postoperative degrees of overaction of the inferior oblique muscle, the angle of hypertropia, and head tilt were analyzed. RESULTS: Deviation of the eyeball (38.9%) and head tilt (25.9%) were the most common complaints. Overall, the success rate was 91.4%, and the likelihood of success decreased with increasing severity of overaction of the inferior oblique muscle. The angle of hypertropia reduced from 11.9 (Prism diopters, PD) preoperatively to 2.2PD postoperatively (p=0.000). Preoperative head tilting was seen in 20 patients (37%) and all saw postoperative improvement. CONCLUSIONS: Inferior oblique myectomy is effective in treating the overaction of the inferior oblique muscle without contracture of the superior rectus muscle or dissociated vertical deviation, especially in patients with greater than +2 overaction of the inferior oblique muscle.
Contracture ; Follow-Up Studies ; Head ; Humans ; Strabismus

To evaluate croneal haze related to amount of correction, age and sex following excimer laser photorefractive keratectomy(PRK) in myopic eyes, 39months follow-up study on 358 eyes was performed prospectively. The preoperative spherical equivalent refraction ranged from -1.0D to 11.25D(mean -6.18D). The subjective corneal haze grading showed a maximum with mean grading of 0.92 at 2 months and a gradual decrease to 0.14 at 24 months after PRK. The degree of haze was statistically greater with higher amount of correction(p<0.05). No difference was found related to age and sex(p>0.05). Clinically significant corneal haze and scarring was frequent in higher myopia group(p<0.05). Individual variation in corneal haze after PRK was found. However, high myopia is a risk factor of the corneal haze following PRK, and further study to decrease the corneal haze after PRK is necessary.
Cicatrix ; Follow-Up Studies ; Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Risk Factors

PURPOSE: To determine the efficacy of Mini Monoka silicone stent insertion in treating nasolacrimal duct obstruction in children. METHODS: In 67 eyes of 61 children with nasolacrimal duct obstruction, the Mini Monoka silicone stent was inserted after probing under general anesthesia. The duration of epiphora or discharge, the age at the time of surgery, and probing history were recorded. The surgical results and postoperative complications were analyzed for the cases herein of Mini Monoka silicone stent insertion. RESULTS: The technical success rate of Mini Monoka silicone stent insertion was 91% in children with nasolacrimal duct obstruction, and the success rate for children without probing history was much higher than for those with probing history (81.5 : 97.5%, p=0.035). Postoperatively, the symptoms were resolved in 54 of 61 eyes (88.5%). The duration of preoperative symptoms was shorter in the successful group than in the failed group (15.9+/-7.1 : 21.9+/-8.8 months, p=0.044). Mini Monoka silicone tube was easily removed at 5.6 months after insertion in the clinic. Dacryocystitis was found to be a complication in two eyes yet was resolved without recurrence. Of the seven eyes with spontaneous extrusion of the stent, symptoms subsided in five eyes. CONCLUSIONS: Mini Monoka silicone stent insertion is an effective and relatively easy method, with a low risk of complication, to treatment children with nasolacrimal duct obstruction.
Anesthesia, General ; Child* ; Dacryocystitis ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Postoperative Complications ; Recurrence ; Silicones* ; Stents*

PURPOSE: To determine the efficacy of Mini Monoka silicone stent insertion in treating nasolacrimal duct obstruction in children. METHODS: In 67 eyes of 61 children with nasolacrimal duct obstruction, the Mini Monoka silicone stent was inserted after probing under general anesthesia. The duration of epiphora or discharge, the age at the time of surgery, and probing history were recorded. The surgical results and postoperative complications were analyzed for the cases herein of Mini Monoka silicone stent insertion. RESULTS: The technical success rate of Mini Monoka silicone stent insertion was 91% in children with nasolacrimal duct obstruction, and the success rate for children without probing history was much higher than for those with probing history (81.5 : 97.5%, p=0.035). Postoperatively, the symptoms were resolved in 54 of 61 eyes (88.5%). The duration of preoperative symptoms was shorter in the successful group than in the failed group (15.9+/-7.1 : 21.9+/-8.8 months, p=0.044). Mini Monoka silicone tube was easily removed at 5.6 months after insertion in the clinic. Dacryocystitis was found to be a complication in two eyes yet was resolved without recurrence. Of the seven eyes with spontaneous extrusion of the stent, symptoms subsided in five eyes. CONCLUSIONS: Mini Monoka silicone stent insertion is an effective and relatively easy method, with a low risk of complication, to treatment children with nasolacrimal duct obstruction.
Anesthesia, General ; Child* ; Dacryocystitis ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Postoperative Complications ; Recurrence ; Silicones* ; Stents*

In children with horizontal strabismus, we observed and analysed binocular fixation pattern (BFP) pf each eye and the results of BFP were compared with visual acuity of each eye to evaluate the effect of BFP examination for diagnosis of the preferred eye. In BFP of the esotropes and intermittent exotropes with or without amblyopa, most of patients showed grade I of BFP in the preferred eyes and grade IV of BFP in the non-preferred eyes. The exotropes showed no significant amblyopia, and BFP of the preferred eyes were variable from grade I to IV while most of the non-preferred eyes showed grade IV of BFP. In the patients with visual improvement after occlusion therapy, about half of them showed an improvement in BFP. Therefore, the preferred and non-preferred eyes may be distinctive according to BFP in strabismic patients with amblyopia or not. The measurement of BFP may be an eefective method for diagnosis of the preferred eye in children with horizontal strabismus if it is combinded with the examination for visual acuity.
Amblyopia ; Child* ; Diagnosis ; Humans ; Strabismus* ; Telescopes* ; Visual Acuity

In children with horizontal strabismus, we observed and analysed binocular fixation pattern (BFP) pf each eye and the results of BFP were compared with visual acuity of each eye to evaluate the effect of BFP examination for diagnosis of the preferred eye. In BFP of the esotropes and intermittent exotropes with or without amblyopa, most of patients showed grade I of BFP in the preferred eyes and grade IV of BFP in the non-preferred eyes. The exotropes showed no significant amblyopia, and BFP of the preferred eyes were variable from grade I to IV while most of the non-preferred eyes showed grade IV of BFP. In the patients with visual improvement after occlusion therapy, about half of them showed an improvement in BFP. Therefore, the preferred and non-preferred eyes may be distinctive according to BFP in strabismic patients with amblyopia or not. The measurement of BFP may be an eefective method for diagnosis of the preferred eye in children with horizontal strabismus if it is combinded with the examination for visual acuity.
Amblyopia ; Child* ; Diagnosis ; Humans ; Strabismus* ; Telescopes* ; Visual Acuity