Alice in wonderland syndrome (AWS) is a paroxysmal disorder with distorted body image, including altered perceptions of size, mass, or shape. In fact, altered body image is the classic symptom of AWS. However, young children and adolescents younger than 15 years with AWS usually show visual symptoms, including micropsia or teleopsia. The most common visual symptom with AWS is micropsia. There are several theories of the etiology of AWS, the most popular of which is migraine. The second most frequently mentioned etiologic theory of AWS is that it is infection-induced. Finally, abnormal brain electrical activity, such as epilepsy, is another possible cause of AWS. We herein report a case of 9-year-old boy who was admitted with visual disturbances characterized by microteleopsia and pelopsia. He denied headache, but his mother had a history of migraine. His general physical examination was unremarkable. Brain magnetic resonance imaging did not show any abnormal findings, but an electroencephalogram showed abnormal discharges. The patient was prescribed an antiepileptic drug, which improved his symptoms.
Adolescent ; Alice in Wonderland Syndrome* ; Body Image ; Brain ; Child* ; Electroencephalography ; Epilepsy ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Mothers ; Physical Examination ; Vision Disorders

Fourteen cases of double chambered right ventricle were diagnosed angiographically and of these nine caseswere confirmed after operation and autopsy at Seoul National University Hospital in recent four years since 1979.The clinical and radiological findings with the emphasis on the cinecardiographic findings were analysed. Thesummaries of the analysis are as follows; 1. Among 14 cases, 6 cases were male and 8 cases were female. Agedistribution was from 4 years to 36 years. 2. In chest X-ray findings, pulmonary vascularity was increased in 8cases, decreased in 4 cases, and nomral in 2 cases. Cardiomegaly was observed in 8 cases and other showed normalheart size. 3. In cinecardiography, 11 cases had interventricular septal defect. Among these 11 cases, VSD locatedin proximal high pressusre chamber was in 2 cases and located in distal low presssure chamber was in 9 cases. 4.The location of aberrant muscle bundle in sinus portion of right ventricule was in 8 cases. In the rest cases, andaberrant muscle bundle was located below the infundibulum of right ventricle. 5. For accurate diagnosis anddifferential diagnosis with other congenital cardiac anomalies such as Tetralogy of Fallot or isolated pulmonicstenosis, biplane cineangiography and catheterization is an essential procedure.
Autopsy ; Cardiomegaly ; Catheterization ; Catheters ; Cineangiography ; Diagnosis ; Female ; Heart Ventricles ; Humans ; Male ; Pituitary Gland ; Seoul ; Tetralogy of Fallot ; Thorax

9 cases of criss-cross heart anomaly, diagnosed by angiography from April, 1979 to Feb. 1985 at Seoul National University Hospital were reviewed. The results were as follows: 1. Of 9 cases, 6 cases were male and 3 cases werefemale and the age ranged from 2 months to 16 years of age. 2. Of 9 cases, 7 cases were concordant (D-loop) and 2cases were discordant (L-loop). segmental approaches are 2 cases of SDD(TGV) and each one case of SLD(TGV),SDD(DORV), SDL(DORV), SDD(DOLV), SLL(corrected TGV), and normal one. 3. Associated anomalies are small sized rightventricle (7 cases), especially inflow tract and sinus portion, pulmonary outflow tract obstruction(5 cases),VSD(9 cases), ASD( 7 cases), PDA(2 cases) and visceroatrial situs solitus was observed in all 9 cases but 1dextrocardia.
Angiography ; Crisscross Heart ; Humans ; Male ; Seoul

Chediak-Higashi syndrome is a rare autosomal recessive disease characterized by partial oculocutaneous albinism, photophobia, nystagmus, immunodeficiency with increased susceptibility to bacterial and viral infection. We experienced a 2-year old boy who presents photophobia, hypopigmentation of retinal pigment epithelium, partial cutaneous albinism, systemic findings including recurrent fever and respiratory infection, hepatosplenomegaly and pathognomic giant cytoplasmic granules in peripheral blood cells and bone marrow, and diagnosed it as a Chediak-Higashi syndrome. We present our experience of Chediak-Higashi syndrome with brief review of the literatures related to it.
Albinism, Oculocutaneous ; Blood Cells ; Bone Marrow ; Chediak-Higashi Syndrome* ; Child, Preschool ; Cytoplasmic Granules ; Fever ; Humans ; Hypopigmentation ; Male ; Photophobia ; Piebaldism ; Retinal Pigment Epithelium

We studied the retinal complication of systemic alpha-interferon in 52 patients who had chronic myelogenous leukemia of chronic phase. 32 patients of them were systemically injected with alpha-interferon for 6 months or more, and 20 patients who were not injected were used as a control. In the injected group, 10 of the 32 patients(31%) showed retinopathies such as yellowish white subretinal deposits, multiple blot shaped hemorrhages, and cotton wool spots. However in the control group, there was only one patient who showed blot shaped hemorrhage. The injected group had significantly much higher chance to have retinopathy than the control group(p<0.05). Majority of the retinal findings were yellowish white subretinal deposits rather than retinal hemorrhage or cotton wool spots. The possibility of interferon related retinopathy increased in older patients and in the patients with longer use of systemic alpha-interferon (p>0.05). The sex and hematologic factor did not affect the development of retinopathy(p<0.05). Since the patients under long term treatment of systemic alpha-interferon are at higher risk of retinopathy, their fundus should be examined periodically.
Hemorrhage ; Humans ; Interferon-alpha ; Interferons* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Retinal Hemorrhage ; Retinaldehyde ; Wool

Retinoblastoma is the most common intraocular malignant tumor in childhood. The early diagnosis can be made in children having strabismus, decreased visual acuity, or family history of retinoblastoma. As the tumor grows larger, it produces leukocoria, iris heterochromia, secondary neovascular glaucoma due to rubeosis iridis, ocular protrusion due to mass, optic nerve extension and distant metastasis. Rarely, this tumor shows spontaneous regression to induce phthisis. We recently experienced a case of bilateral retinoblastoma in a 2 year old girl who presented with the protruded right eyeball due to the massive growth of retinoblastoma, simultaneously with the phthisicae left eyeball due to spontaneous regression of retinoblastoma.
Child ; Child, Preschool ; Early Diagnosis ; Female ; Glaucoma, Neovascular ; Humans ; Iris ; Neoplasm Metastasis ; Optic Nerve ; Retinoblastoma* ; Strabismus ; Visual Acuity

Laryngoscopy and endotracheal intubation undergoing general anesthesia cause hypertension and tachycardia with concomitant increases in plasma catecholamine concentration. These transient stress responses are greatly exaggerated in patients with hypertension and cardiovascular diseases and can lead to cardiac arrhythmia, pulmonary edema, cardiac failure and cerebral hemorrhage. Therefore, several attempts have been made to attenuate the hypertensive and tachycardiac responses, but none has been satisfactory. This study was made to alleviate the hemodynamic responses to tracheal intubation using ultra-short acting cardioselective beta-blocker, Esmolol. Following get informed consent in ASA physical status 1 and 2, 28 patients were randomly divided into two groups. Group 1(n=16), control group, and group 2(n=12), esmolol treatment group. Patients on alpha or beta-blockers or agonists were excluded from the study. 12 patients received an infusion of 500 mcg/kg/min esmolol loading dose for 3 min before induction with thiopental and 300 mcg/kg/min for maintenance for 6 additional minutes during the endotra- cheal intubation. The control patients, group 1(n=16), received 5% D/W infusion in place of esmolol with infusion pump. The patients received hydroxyzine 1 mg/kg, nalbuphine 0.1 mg/kg, and glycopyrroate 0.2 mg i. m. 60 minutes before anesthesia. Patients were induced with sodium thiopental 4-5 mg/kg until the disappearance of lid-refex. Succinylcholine 1.0 mg/kg i. v. was used to facilitate endotracheal intubation. As soon as relaxation was complete, laryngoscopy was initiated. After the completion of intubation, nitrous oxide/oxygen=2: 2 L/min with 0.5-1.5 % halothane or enflurane was administered. The blood pressure and heart rate were measured using noninvasive automatic blood pressure manometer Accutorr 1A (Datascope) for 30 minutes per l minute. Blood pressure and heart rate were evaluated at 6 key points; 1) baseline, 2) anesthetic induction, 3) tracheal intubation, 4) I minute postintubation, 5) 2 minutes postintu- bation, and 6) 3 minutes postintubation, Data were analyzed with paired t-tests within the groups. P<0.05 was considered significant. Esmolol infusion significantly prevented the increases in heart rate and rate pressure product caused by laryngoscopy and endotracheal intubation. Esmolol also moderated the increases in pressures. Esmolol infusion may offer an important role in patients in whom an increase in heart rate, blood pressure and/or rate pressure product should be avoided during the endotracheal intubation.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiovascular Diseases ; Cerebral Hemorrhage ; Enflurane ; Halothane ; Heart Failure ; Heart Rate ; Hemodynamics* ; Humans ; Hydroxyzine ; Hypertension ; Informed Consent ; Infusion Pumps ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy* ; Nalbuphine ; Plasma ; Pulmonary Edema ; Relaxation ; Sodium ; Succinylcholine ; Tachycardia ; Thiopental

Electroretinogram(ERG), widely used to diagnose and prognose the retinal dysfunctions, is known to be affected by the various testing conditions, such as the amount and color of the stimulating light, adaptation time and background light intensity. We have recorded the ERG in 39 cataract patients(50 eyes)without retinal abnormalities in order to evaluate the effect of intraocular lens(IOL)on the ERG and to compare clear-IOL inserted eye with colored-IOL inserted eye. The insulting effect of IOL material did not affect the results of the ERG. However the rod response in IOL inserted eye showed shortening in implicit time, which was probably due to the increase of inputting light by the removal of opaque lens. Additionally, there was no difference between the ERG of colored-IOL(yellow-tinted IOL)eyes and that of clear-IOL eyes. We found that ERG might be used in the IOL inserted eyes without modification of data values.
Cataract ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Retinaldehyde

Retrospective study was conducted in 13 eyes of 9 Behcet's disease patients who have undergone cataract extraction with or without intraocular lens implantation. According to Shimizu's criteria, 5 eyes(55.6%) were classified as incomplete type and 3 eyes(33.3%) as suspect type. Among 13 eyes, only 3 eyes achieved final visual acuity of 0.1 or better and 4 eyes resulted in final visual acuity of 0.01 or worse. Postoperative complications included after-cataract in all 11 eyes which had undergone extracapsular cataract extraction(ECCE) and vitreous opacity in 10 eyes. Our results shows that the visual prognosis after cataract extraction is poor in general, although it may be improved in selected cases if inflammation has been controlled for a sufficient duration.
Behcet Syndrome* ; Cataract Extraction* ; Cataract* ; Humans ; Inflammation ; Lens Implantation, Intraocular ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Visual Acuity

Air bag has gained increasing acceptance as a device that reduce serious head and chest injury in vehicle accident. Although air bag reduces incidence and severity of facial and periorbital trauma, the possibility of ocular trauma by air bag inflation itself cannot be trivialized. We experienced a patient who developed hyphema, angle recession and macular hemorrhage after air bag inflation, and reviewed the available literatures regarding this type of injury.
Air Bags* ; Head ; Hemorrhage* ; Humans ; Hyphema* ; Incidence ; Inflation, Economic ; Thoracic Injuries