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.

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.

PURPOSE: The epicanthal fold in Korean children is a common cause of pseudoesotropia. Therefore, the present study was undertaken to evaluate the clinical characteristics of strabismus in children diagnosed with pseudoesotropia. METHODS: We reviewed the charts of children diagnosed with strabismus from February 2004 to January 2005. Strabismic children with a history of pseudoesotropia were included in this study. We recorded the age and chief complaints at the time of pseudoesotropia diagnosis as well as the type of strabismus, the visual acuity, chief complaints, and refractive error at the time of strabismus diagnosis. RESULTS: One hundred and two of 734 children with strabismus (13.9%) had a history of pseudoesotropia. The mean age at the time of pseudoesotropia diagnosis was 2.9 years. The mean age at the time of strabismus diagnosis was 4.4 years. The type of strabismus was exotropia in 58 (56.9%) and esotropia in 39 (38.2%) cases. Refractive accommodative esotropia was seen in 89.7% of esotropia cases and the basic type was seen in 86.2% of exotropia cases. The concurrence rate between chief complaints of pseudoesotropia and the type of strabismus diagnosed was lower in exotropia than in esotropia. There was hyperopia in all the esotropia cases, and the distribution of refractive error was variable in exotropia. The frequency of amblyopia was 19.6%. CONCLUSIONS: The incidence of strabismus is high in the case of children diagnosed with pseodoesotropia. Therefore, regular examinations for strabismus, refractive error and amblyopia may be necessary.
Amblyopia ; Child* ; Diagnosis ; Esotropia ; Exotropia ; Humans ; Hyperopia ; Incidence ; Refractive Errors ; Strabismus ; Visual Acuity

The purpose of this study is to reveal how the road traffic noise influences on the response of teachers and students, which composed of conversation, studying, relation, and physical disturbances. The research method used in this study was self- administrated questionnaire. Samples of the survey were composed of 420 persons(l14 teachers and 306 students) who are exposed to traffic noise less than 65 dB(A) from two junior high schools and 410 persons(140 teachers and 270 students) from two noisy junior high schools which the road traffic noise above 65 dB(A). In the response of both of the teachers and students in noisy(above 65 dB) schools complaints of disturbances of conversation, studying, relaxation, and physical disturbances are much higher than that of less noisy schools' teachers and students(p<0.01 ). On the occasion of time and season, the subjects answered the traffic noise cause high troublesome and stresses in the afternoon(12:00-17:00) and summer respectively. It is necessary to provide governmental comprehensive and fundamental measures to improve the noisy school environments.
Humans ; Noise* ; Surveys and Questionnaires ; Relaxation ; Seasons

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*

Benzene and toluene, which are widely used aromatic hydrocarbons in workplace, are recently proved to cause health hazards due to their toxic effects. This study investigated the influence of toluene on the urinary excretion of benzene metabolite by administering short term exposure limit(STEL) of these compounds(i.e., 13.8mg/kg of benzene and 108.8mg/kg of toluene) intraperitoneally into Sprague-Dawley rats. After administration, urinary phenol concentration of rat was measured by gas chromatography for every three hours. Data were analyzed by non-parametric statistical methods using Kruskal-Wallis multi-sample test and Mann-Whitney U test. The following results were obtained: 1. Administration of STFL-benzene increased urinary phenol concentration in rats. 2. Urinary phenol concentration was increased logarithmically according to the dosage of benzene. 3. Excretion of phenol in urine was decreased when benzene and toluene were administered simultaneously compared with administering benzene alone. In Summary, these results reveal that administration of STEL of toluene has antagonistic effect of urinary excretion of benzene metabolite in rats.
Animals ; Benzene* ; Chromatography, Gas ; Hydrocarbons, Aromatic ; Metabolism* ; Phenol ; Rats* ; Rats, Sprague-Dawley ; Threshold Limit Values ; Toluene

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

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