We reviewed the medical records of 201 patients who were admitted between January 1980 and March 1992 with a diagnosis of traumatic hyphema to define risk factors associated with the development of rebleeding. Rebleeding occurred in 18 patients (9.0%), and took place on day 1 to 6 after injury with a maximum occurrence on day 2. A group of 32 patients who were examined more than 24 hours after injury were found to have a rebleeding rate of 18.8% (six of 32 patients). It was higher than the rebleeding rate (6.8%) in patients examined within 24 hours. When the amount of blood is more than 1/3 of anterior chamber at the time of initial examination, rebleeding was shown to occur more frequently. Children had a rebleeding rate similar to adults, and males showed approximately the same rate of rebleeding compared to females. This review suggests that patients examined more than 24 hours after injury and injured severely represent unique population that deserves special consideration.
Adult ; Anterior Chamber ; Child ; Diagnosis ; Female ; Humans ; Hyphema* ; Male ; Medical Records ; Risk Factors*

Septo-optic dysplasia is diagnosed when optic nerve hypoplasia is combined with dysgenesis of the septum pellucidum and nearly two-thirds of them have hypothalamic-pituitary dysfunction. A number of these patients have schizencephaly and usually present seizures. The migrational disorders including schizencephaly, lissencephaly, heterotopia and polymicrogyria are a rare group of congenital malformations of the brain Septo-optic dysplasia-schizencephaly complex is frequently associated with endocrinolo gic, ophthalmologic, and neurologic symptoms and signs. We recently experienced a case of septo-optic dysplasia-schizencephaly, who showed severe visual impairment associated nystagmus and bilateral optic nerve hypoplasia agenesis of septum pellucidum with schizencephaly and hypsarrythmia. Because some forms of migrational disorders and septo-optic dysplasia can be inherited, parental counseling is essential for the accurate diagnosis.
Brain ; Counseling ; Diagnosis ; Humans ; Lissencephaly ; Malformations of Cortical Development ; Neurologic Manifestations ; Optic Nerve ; Parents ; Seizures ; Septo-Optic Dysplasia ; Septum Pellucidum ; Vision Disorders

Aortic dissection is caused by longitudinal dissection of weakened aortic media by blood stream and associated with hypertension, Marfan's syndrome, congenital vascular anomaly such as bicuspid aortic valve or coarctation of aorta and pregnancy. Aortic dissection has a very high mortality of over 90% without treatment. In Korea, it is easily anticipated that the frequency of aortic dissection maybe increased probably due to the westernization of life style and increasing tendency of hypertension and lift expectancy. But there are lack of detailed reports about aortic dissection in Korea till now. The author reviewed 28 cases of aortic dissection for 15years and compared them with other countries in aspects of etiological diseases, clinical presentations, complications, laboratory data, diagnostic modalities, treatments and hospital courses. The results were as folowings: 1) The most frequent age group was seventh decade and there was slightly higher incidence in female. 2) According to the DeBakey classification, type I was found in 25%, type II in 43%, and type III in 32%. 3) Hypertension was the most frequent cause, comprising 71% (20 cases) and Marfan's syndrome was found in 3 cases and cardiovsascular syphilis, chest trauma and unknown in each 2 cases respectively. 4) The frequent symptoms were pain in 79%, dyspnea in 46%, headache in 32%, and nausea & vomiting in 21%. Diastolic murmur was heard in 21%. 5) Aortic rupture was complicated in 32%, vascular obstruction in 32%, shock in 25%, aortic regurgitation in 21% and congestive heart failure in 18%. 6) According to the age of dissection, acute dissection was found in 61% and chronic dissection in 39%. Aortic rupture, heart failure and vascular obstruction were more common in acute dissection. The patients who died in hospital were exclusively in acute dissction. In marfan's syndrome aortic dissection occurred suddenly during hospitalization. 7) Chest x-ray film showed cardiomegaly in 46%, dilatation of aortic arch in 39% and diffuse mediastinal widening in 31%. 8) Laboratory data showed leukocytosis in 36%, anemia in 25%, increased total bilirubin in 18%, increased SGOT or SGPT in 32%, increased BUN or creatinine in 18%, hematuria in 39% and proteinuria in 46%. 9) ECG showed left ventricular hypertrophy in 42%, old myocardial infarction or myocardial ischemia in 25%, ventricular arrhythmia in 18%, atrial arrhythmia in 11% and heart block in 11%. 10) The first recognition of aortic dissection was made by aortography in 32%, echocardiography in 32%, C.T. in 29% and abdominal sonography in 7%. 11) The hospital death rate was 21% and the causes of death were aortic rupture in 4 cases and congestive heart failure and D.I.C. in each one. The higher mortality was observed in acute dissection, combined hypertension, intially hypotensive patient, old age, congestive heart faiulre, aortic rupture and myocardial ischemia or infarction. The authors have found that, comparing with those of other countries, aortic dissection was more common in female, proximal type were more frquent, dyspnea and aortic rupture were more common and aortic regurgitation was less common. And renal and hepatic dysfunction were more common.
Alanine Transaminase ; Anemia ; Aorta, Thoracic ; Aortic Coarctation ; Aortic Rupture ; Aortic Valve ; Aortic Valve Insufficiency ; Aortography ; Arrhythmias, Cardiac ; Aspartate Aminotransferases ; Bicuspid ; Bilirubin ; Cardiomegaly ; Cause of Death ; Classification ; Creatinine ; Dilatation ; Dyspnea ; Echocardiography ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Headache ; Heart ; Heart Block ; Heart Failure ; Heart Murmurs ; Hematuria ; Hospitalization ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Incidence ; Infarction ; Korea* ; Leukocytosis ; Life Style ; Marfan Syndrome ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Nausea ; Pregnancy ; Proteinuria ; Rivers ; Shock ; Syphilis ; Thorax ; Vomiting ; X-Ray Film

Rarely, break in the non-pigmented epithelium in the pars plicata can occur and sometimes develop into retinal detachment. We experienced a case of retinal detachment associated with lens coloboma in 34-year-old male. A break in the non-pigmented epithelium in pars plicata was found with retinal detachment. We treated the break by cryoapplication, scleral buckling and encircling.
Adult ; Coloboma* ; Epithelium ; Humans ; Male ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling

The abnormalities of left ventricular ejection patterns have been studied using echocardiography, contrast angiography, radionuclide angiography, and apex cardiography in patients with various heart disease. Recently it has been recognized that diastolic impairment may occur in the absence of abnormal systolic performance in hypertension, valvular heart disease, ischemic heart diseases, and cardiomyopathies. In order to identify whether diastolic dysfunction can develop without systolic dysfunction, we evaluated patterns of left ventricular filling and ejection by echocardiography in 10 chronic mitral regurgitations without pulmonary congestion symptom, who were confirmed by cardiac catheterization. Indices of left ventricular systolic function, including ejection fraction, fractional shortening, ejection rate, mean velocity of circumferential fiber shortening, and preejection period/left ventricular ejection time revealed no significant difference in mitral regurgitation patients compared with normal control group. Diastolic parameters, including atrial emptying index,mean velocity of circumferential fiber lengthening, rapid filling period, and rapid filling velocity were changed significantly in mitral regurgitation. There were no significant alterations in blood pressure and heart rate between two groups. It is concluded that impaired diastolic performance may be frequently encountered in patients with chronic mitral regurgitation and intact systolic function.
Angiography ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathies ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart Diseases ; Heart Rate ; Heart Valve Diseases ; Humans ; Hypertension ; Kinetocardiography ; Mitral Valve Insufficiency* ; Myocardial Ischemia ; Radionuclide Angiography ; Ventricular Function, Left*

The clinical trial was carried out with carteolol in 30 patients with essential hypertension. The results were as follows : 1) Before medication and after 2,4,6 and 8 weeks of medications, the overall average systolic and diastolic blood pressure were 175+/-17.7/105+/-9.3, 144+/-8.9/92+/-6.9, 143+/-11.2/90+/-6.6, 141+/-8.4/88+/-6.9, and 142+/-9.0/88+/-7.1 mmHg. As a result, blood pressure significantly fell with carteolol treatment. 2) In 80+/- of all cases, marked or moderate degree of hypotnesive effect was observed within 2 weeks of treatment. 3) Before medication and after 2, 4, 6 and 8 weeks of medication, the overall average heart rates were 75+/-11.8, 73+/-9.0, 71+/-8.7, 71+/-8.2 and 71+/-8.6 beats/minute. There was no significant changes in heart rates before and after treatment. 4) Dizziness or fatigability were complained in 4 patients (13+/-) each while receiving carteolol. These side effects were mild in 3 patients, but one patient discontinued treatment due to dizziness. On the basis of these results, carteolol was evaluated to be promising hypotensive drug.
Blood Pressure ; Carteolol* ; Dizziness ; Heart Rate ; Humans ; Hypertension

It has been well known that dilated cardiomyopathy (D-CMP) has characterized by systolic dysfunction of left ventricle (LV). But there are few studies about LV diastolic and right ventricular (RV) dysfunction in D-CMP. The purpose of this study is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The purpose of this tudy is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The gated blood pool scan (GBPS) was undertaken in 14 patients with D-CMP and 14 normal controls. The results are as follows : 1) Compared to normal controls, the global and regional ejection fraction of LV were significantly reduced (P<0.001) in D-CMP. But, there was no significant difference in LV ejection time between the two groups. 2) Peak filling rate and peak filling time were significantly reduced (P<0.001, P<0.05) in D-CMP 3) Global ejection fraction of RV was also significantly reduced in D-CMP compared to normal controls (P<0.001) But there was no significant difference in ejection rate of right ventricle between the two groups. 4) There was close correlation (R=0.802) between ejection fraction and filling rate of LV : filling rate was also reduced as ejection fraction decreased. And LV filling rate was also reduced with reduction of ejection rate. It is concluded that D-CMP shows diastolic impairment as well as systolic pumping failure and this systolic dysfunction is accounted for the diastolic impairment in D-CMP. And D-CMP shows also right ventricular dysfunction in almost all cases, as well as left ventricular dysfunction.
Cardiomyopathy, Dilated* ; Heart Ventricles ; Humans ; Ventricular Dysfunction, Left ; Ventricular Dysfunction, Right

Ventricular performance was evaluated in 21 patients with uncomplicated acute transmural myocardial infarction (10 anterior and 11 inferior). Left ventricular global and regional ejection fraction, ejection rate and right ventricular ejection fraction were assessed using radionuclide ventriculography. The results were as follows : 1) In anterior infarction, left ventricular global ejection fraction was more significantly depressed than in inferior infarction(mean+/-SD : 33. 0+/-15.4% versus 48.6+/-7.0%, P<0.01). 2) In inferior infarction, right ventricular global ejection fraction was more depressed than in anterior infarction(33.3+/-9.8% versus 45.0+/-13.2%, P<0.05). 3) Regional ejection fraction of septal, apico-inferior and posterolateral wall were found to be depressed in anterior infarction than in inferior infarction, but no significant differences were present. It is concluded that the magnitude of right and left vnetricular dysfunction was affected by the location of acute transmural infarction.
Humans ; Infarction ; Myocardial Infarction* ; Radionuclide Ventriculography ; Stroke Volume

No abstract available.
Consolidation Chemotherapy* ; Induction Chemotherapy* ; Leukemia, Promyelocytic, Acute*

BACKGROUND: About 60~80% of previously untreated patients with acute myelogenous leukemia (AML) achieve complete remission (CR) when treated with cytarabine and anthracycline. Anthracycline is one of the most important chemotherapeutic agents in AML. It has been claimed that idarubicin showed superior complete remission rate than daunorubicin, which is not completely established. We evaluated idarubicin in combination with cytarabine (AI) as an induction chemotherapy in patient with AML. METHODS: Thirty one patients with newly diagnosed acute myelogenous leukemia were enrolled. Remission induction emotherapy was consisted of cytarabine (100mg/m2 IV over 24 hours on day 1~7) and idarubicin (12mg/m2 IV over 30 minutes on day 1~3). After achievement of CR, patients underwent consolidation therapy with high- dose cytarabine and/or bone marrow transplantation. RESULTS: Median age of the patients was 43 years (range; 17~62) and M2 was the most common subtype. The CR rate was 71% (22/ 31). The median overall and disease-free survival were 67 weeks (95% confidence interval, CI; 43~91) and 65 weeks (95% CI; 26~104), respectively with a median follow-up of 48 weeks. Major toxicities were fever and infection during the neutropenic period. There were three treatment-related mortalities. Causes of death were refractory AML in 1 patient and infection in 2 patients. CONCLUSION: AI induction chemotherapy seems to be effective and safe regimen as an induction chemotherapy in AML.
Bone Marrow Transplantation ; Cause of Death ; Cytarabine* ; Daunorubicin ; Disease-Free Survival ; Fever ; Follow-Up Studies ; Humans ; Idarubicin* ; Induction Chemotherapy* ; Leukemia, Myeloid, Acute* ; Mortality ; Remission Induction