No abstract available.

No abstract available.
Alcoholism* ; Mass Screening*

No abstract available.
Abscess* ; Bacteria, Aerobic* ; Quinolones* ; Virulence*

PURPOSE: To report a case of endophthalmitis treated with surgical removal of the inflammatory endothelial plaque. CASE SUMMARY: A 61-year-old male was transferred to our clinic due to corneal laceration of the left eye. An emergency operation for the lacerated cornea was performed. After the operation, the patient had no specific symptoms for 8 months but then visited our clinic with sudden decreased visual acuity. On slit lamp examination, the patient had some chamber reactions. Anterior chamber reactions exacerbated after 2 months and the best corrected visual acuity was decreased from 1.0 to 0.08. An inflammatory corneal endothelial plaque and endothelial precipitates had developed. The posterior segment was not visualized due to the severe anterior chamber inflammatory reaction. No growth was observed on bacterial or fungal cultures. However, administration of eye drops and oral voriconazole were initiated based on a clinical impression suspicious of fungal infection. Despite the treatment, the infection did not respond. Voriconazole was then directly injected into the vitreous and anterior chamber. Although the patient's best corrected visual acuity slightly improved, the inflammatory reactions of the anterior chamber and vitreous did not. The inflammatory endothelial plaque on the patient's cornea was then surgically removed and the best corrected visual acuity improved to 1.0. Mycelium was detected on the KOH smear of the endothelial plaque. There were no further inflammatory reactions in the anterior chamber or vitreous after surgical removal of the endothelial plaque.
Anterior Chamber ; Cornea ; Emergencies ; Endophthalmitis ; Endothelium, Corneal ; Eye ; Humans ; Lacerations ; Male ; Middle Aged ; Mycelium ; Ophthalmic Solutions ; Pyrimidines ; Triazoles ; Visual Acuity

PURPOSE: To evaluate the surgical results of vitrectomy for macular hole, according to the hole size. METHODS: Fifty-six patients (58 eyes) who had macular hole surgery without any complication influencing visual acuity were included in this study. They were divided into three groups by the size of the hole: Group 1 (smaller than 1/4 disc diameter), Group 2 (1/4 disc diameter or larger but smaller than 1/2 disc diameter), and Group 3 (1/2 disc diameter or larger). We compared the anatomical and functional results of these groups. RESULTS: The mean follow-up durations after surgery were 14.4 months (Group 1), 15.9 months (Group 2), and 27.5 months (Group 3) months. In 3, 6, and 3 cases in each group respectively, the holes were re-opend and among them, 2, 4, and 3 cases were closed by reoperation. Mean pre-operative visual acuity was 0.15, 0.09, 0.08 and the percentage of the cases achieving 2 lines or more improved visual acuity after surgery was 69.2%, 76.5%, and 72.7%, but the mean post-operative best corrected visual acuity was 0.45, 0.30, 0.17 for the three groups, respectively. This shows that smaller holes had the better post-operative visual acuity. The percentage of hole-occlusion in the three groups was 84.6%, 94.1%, and 90.9%, and that of invisible holes was 76.9%, 82.4%, and 72.7% respectively. CONCLUSIONS: This study shows that the size of macular holes does not significantly influence surgical results. but large-sized macular holes lead to poor post-operative visual acuity.
Follow-Up Studies ; Humans ; Reoperation ; Retinal Perforations* ; Visual Acuity ; Vitrectomy*

PURPOSE: To report a case of subconjunctival foreign body migration in both eyes after collagen-containing filler injection. CASE SUMMARY: A 51-year-old female, who had been treated with collagen-containing filler in her eyelid, nose, and forehead for cosmetic complaints four months earlier, presented to our clinic with decreased visual acuity and foreign body sensation in both eyes. Slit lamp examination revealed moderate nucleosclerosis and subcapsular opacity in her crystalline lens, in addition to scattered subconjunctival foreign body infiltration in both eyes. Cataract extraction with posterior chamber lens implantation was performed, and the subconjunctival foreign body was also partially removed. Biopsy of the remaining foreign body was performed, and examination revealed foreign material and multivacuolated cells in the conjunctiva. CONCLUSIONS: Clinicians and patients should be aware of the risk of migration of collagen-containing filler inject at or near the eyelid, to the eyeball, including the conjunctiva.
Biopsy ; Cataract Extraction ; Collagen ; Conjunctiva ; Cosmetics ; Eye ; Eyelids ; Female ; Forehead ; Foreign Bodies ; Foreign-Body Migration ; Humans ; Lens, Crystalline ; Middle Aged ; Nose ; Sensation ; Visual Acuity

We report a case of Waardenburgs syndrome in 18-year-old male patient who has total deafness of the right ear, heterochromia irides, hypopigmented patches on the face and trunk, and disseminated lentigines on the entire body surface since birth. His 51-year-old mother also has total deafness, heterochromia irides, white foreloek, and disseminated lentigines on the entire body surface. The patient with this disorder may complain of pigmentary abnormalities, and we believe dermatologists should pay more attention to systemic signs of the congenital pigmentary disorders.
Adolescent ; Deafness ; Ear ; Humans ; Lentigo ; Male ; Middle Aged ; Mothers* ; Parturition ; Waardenburg Syndrome*

BACKGROUND: Crucial to the success of fiberoptic awake tracheal intubation is proper preparation of the patient; this technique will work well in most patients when they are quiet and cooperative and have a larynx nonreactive to physical stimuli. We have attempted to ascertain how well these conditions are achieved with a low-dose infusion of propofol, because of its pharmacological profile. METHODS: Thirty patients, physical status by American Society of Anesthesiologists (A. S. A.) I-II, scheduled for oral and maxillofacial surgery, were randomly assigned to receive either propofol infusion 1 mg kg-1 h-1 preceded by a 1 mg kg-1 bolus (Group P) or intravenous fentanyl 1ug kg-1 and midazolam 0.05 mg kg-1 (Group F). These two groups were compared in terms of hemodynamic profile, sedation score, condition for intubation, coughing and swallowing. RESULTS: There were no statistically significant differences in mean arterial blood pressures according to time between two groups. But in Group F, heart rates were significantly increased in immediately after transtracheal injection of lidocaine, immediately before the fiberoscopy was started, 1, 2 minutes after start of fiberoscopy, compared to Group P (p<0.05). The patients in Group P were more sedated than those in Group F (p<0.05) but there were no significant differences in condition for intubation, reflex of coughing and swallowing, duration of fiberoptic intubation. CONCLUSIONS: We conclude that propofol is useful sedative agent in fiberoptic awake intubation with similar efficacy to midazolam and fentanyl but with more profound sedation and stable hemodynamic profile. These represent significant advantages for severe anxious or hypertensive patients and prolonged procedure of intubation.
Arterial Pressure ; Cough ; Deglutition ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation* ; Larynx ; Lidocaine ; Midazolam* ; Propofol* ; Reflex ; Surgery, Oral

In order to study the efficacy of a 0.2% ciprofloxacin-soaked collagen shield for the treatment of Staphylococcus aureus keratitis, an experimental study was performed on 40 eyes of 20 rabbits. Twenty hours after intrastromal injection with S. aureus, the rabbits were divided into four groups: Group 1(10 eyes) was treated with a 0.2% ciprofloxacin-soaked collagen shield with an additional instillation of 0.2% ciprofloxacin drops every 30 minutes for 4 hours; Group 2 (10 eyes) was treated with a 0.2% ciprofloxacin-soaked collagen shield for 4 hours; Group 3 (10 eyes) was treated with 0.2% ciprofloxacin drops every 30 minutes for 4 hours; Group 4 (10 eyes) received BSS every 30 minutes for 4 hours as a control. Bacterial killing was quantitated by culturing corneal homogenates and calculating the number of viable bacteria (colony-forming units) per cornea. Groups 1, 2, and 3 showed significantly reduced numbers of bacteria compared with the control (p<0.01). The order of efficacy in the treatment for S. aureus keratritis were groups 1, 2 and 3, respectively, but the statistical difference was not significant among groups 1, 2, and 3(p>0.05). These results suggested that a 0.2% ciprofloxacin-soaked collagen shield may be an effective and convenient mode of therapy for S. aureus keratitis.
Bacteria ; Ciprofloxacin ; Collagen* ; Cornea ; Homicide ; Keratitis* ; Rabbits* ; Staphylococcus aureus* ; Staphylococcus*

A 63 Year-old-lady has had substernal chest pain on exertion for 8 years. The chest pain has been increased over the last 3 years. A continuous murmur was heard at the left second to third inercostal spaces along the left sternal border. The electrocardiogram showed the inverted T-waves in the precordial leads. The right heart catheterization revealed 5% oxygen step up between RV and PA. The right sided pressures were normal. The coronary arteriography revealed markedly tortuous vessels starting shortly after the left main stem coronary artery was normally originated. One of the large vessel was shown to be drained into the pulmonary artery. In the operation room, without using heart-lung machine this abnormally drained vessel was simply ligated at it's draining site into pulmonary artery. After the operation the patient is feeling well with little symptoms and the continuous murmur is no longer heard.
Angiography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Vessels* ; Electrocardiography ; Heart-Lung Machine ; Humans ; Middle Aged* ; Oxygen ; Pulmonary Artery*