Asymmetric Bilateral Inferior Oblique Transposition of a Bilateral Inferior Oblique Overaction Associated with Dissociated Vertical Deviation

Purpose@#Inferior oblique overaction with a dissociated vertical deviation occurs secondary to infantile exotropia or esotropia. In terms of correction, asymmetric bilateral inferior oblique transposition has been the treatment of choice, but the surgical amount depended largely on the surgeon’s experience. We report successful bilateral inferior oblique transposition using our own standard methods. @*Methods@#We performed a retrospective medical chart review of patients with bilateral inferior oblique overaction and dissociated vertical deviation who underwent bilateral inferior oblique transposition at the Korea University Medical Center from January 2013 to December 2020. We performed either symmetric or asymmetric transposition; the reattachment sites of the bilateral inferior obliques were determined according to preoperative differences of the inter-eye deviations of dissociated vertical deviation. When the differences were < 5 prism diopters, correction was considered successful. To avoid the development of anti- elevation syndrome, the inferior oblique muscles were re-attached near the equator. @*Results@#Twenty-three patients were analyzed, all of whom underwent bilateral inferior oblique transposition; 12 required additional horizontal muscle surgery. The deviation difference (both eyes) and inferior oblique overaction grade were significantly lower postoperatively. We did not encounter any case of anti-elevation syndrome. @*Conclusions@#The surgical extent of asymmetric bilateral inferior oblique transposition should reflect the difference in dissociated vertical deviation the two eyes.

Estimated Magnitude of an Outbreak of Vibrio parahaemolyticus Enteritis in Inchon, Korea / 감염

BACKGROUND: There are several reports on outbreaks of V. paraphaemolyticus enteritis, however, these are only complicated cases or microbiologic surveillance in marine environment. We experienced an outbreak associated with eating flavored crabs and investigated the magnitude of the outbreak on a large scale located in Inchon. METHOD: We took medical history and stool cultures from patients with diarrhea, visited the Inha University Hospital from September 14 to September 30, 1998. Pulsed-field gel electrophereis of isolates from stool culture performed to identify the relation. We counted the number of diarrheal patients visited the emergency rooms of 5 other general hospitals and 9 private clinics in Inchon from August 16 to September 30, 1998. We bought 6 crabs and 2 flavored crabs at a nearby market and cooked 6 crabs flavored at our hospital. Cultures from the flavored crabs stored at a refrigerator were done daily for consecutive 5 days. RESULTS: The outbreak began on September 5 and ended on September 29, 1998. The numbers of patients visiting ERs of 6 general hospitals and private clinics during outbreak were estimated 1,033 and 4,530, respectively. All 8 crabs revealed Vibrio spp., but identification up to species level was not possible. Pulsed-field gel electrophoresis of 12 isolates showed different patterns and suggested different sources. CONCLUSION: In 1998, an outbreak estimated more than 5,000 patients of V. parahaemolyticus enteritis occurred in Inchon, Korea. Because the magnitude of food-associated enteritis is enormous, that surpass the number which we assumed from clinical practice, early report and prompt investigation of such cases are necessary.

A Case of Stent Migration into Right Ventricle after Percutaneous Transluminal Angioplasty for Budd-Chiari Syndrome

No abstract available.

Clinical Course and Visual Prognosis of Vitreous Hemorrhage in Children

The authors performed a retrospective review on 27 eyes of 23 children with vitreous hemorrhage, to assess the natural history, the outcome of vitrectomy and the important prognostic factors. Mean age was 3. 7 years(range: birth~13.5 years). The causes of vitreous hemorrhage included trauma(6 patients), retinopathy of prematurity(5 patients), persistent hyperplastic primary vitreous(4 patients)and others(8 patients). Spontaneous absorption of vitreous hemorrhage in 11 of 27 eyes was observed and took mean 2. 5 months. Sixteen eyes had undergone vitrectomy for persistent vitreous hemorrhage(mean duration: 3. 4 months). Follow up period was mean 32. 8 months(range: 20~79 months). Visual improvement was achieved in 70%of all patients and there was no statistical significance between spontaneous absorption group and vitrectomy group. Deprivation amblyopia was complicated in 7 of 9 patients whose visual acuity could be measured in both eyes. anisometropic myopia(> OR =2. 0 diopter)was observed in 7 of 14 patients. Our results supported that causes of vitreous hemorrhage in children was variable and early vitrectomy and postoperative correction with occlusion therapy might be essential in treatment of childhood vitreous hemorrhage.