M-mode, pulsed Doppler and Doppler color flow mapping, in addition to two-dimensional echocardiography, have greatly improved imaging of the fetal heart through identification of abnormal cardiac anatomy and rhythm in utero. The early detection of cardiac disturbance in utero permits alteration in obstetric management such as delivery in a high-risk center for optimal neonatal care and/or decision in optimal delivery time. We report two cases of the neonatal arrhy-thmia which were observed by fetal echocardiography. In the first case, female baby showed neonatal arrhythmias including tachycardia and brady-cardia until 3 days after birth, and then turned to bradyarrhythmia due to non-conducted atrial bigeminy. These events lead us to review the fetal echocardiographs of the patient carefully. Premature atrial contractions were observed in her fetal echocardiography. At 2 months after birth, the patient's electrocardiogram showed normal sinus rhythm. Severe neonatal bradycardia of the second case was due to congenital complete heart block, identified clearly by electrocardiogram after birth. This case also showed complete heart block in her fetal echocardiography. After insertion of the temporary pacemaker, cardiomegaly was improved. Both the neonate and the mother had positive anti-SSA/Ro autoantibody. But any other symptoms and signs of neonatal lupus did not appear in the neonate. Patient's mother also did not show any symptoms and signs of systemic lupus erythematosus. Since the prognosis depends upon the cause of bradyarrhythmia in fetus and neonates, differential diagnosis is important in obstetric management and optimal neonatal treatment.
Arrhythmias, Cardiac* ; Atrial Premature Complexes ; Bradycardia ; Cardiomegaly ; Diagnosis, Differential ; Echocardiography* ; Electrocardiography ; Female ; Fetal Heart ; Fetus ; Heart Block ; Humans ; Infant, Newborn ; Lupus Erythematosus, Systemic ; Mothers ; Parturition ; Prognosis ; Tachycardia

Trabeculectomy, as an operation precedure for glaucoman, decrease intraocular pressure(IOP)effectively. But the amount of decrease in IOP is different according to the etiology of glaucoma. Thirty four primary angle-closure glaucoma patients (37 eyes)who had undergone trabeculectomy only or trabeculecomy combined with cataract surgery and had been subsequently followed up for least 6 months, were enrolled in this study. In 12 patients(14 eyes) among 16 patients (18 eyes, Group 1) who had undergone trabeculecto-my only, IOP was controlled without glaucoma medication, while glaucoma medication was needed in the other 4 patients (4 eyes). Among 18 patients (19 eyes, Group 2) who had undergone trabeculectomy combined with cataract surgery, IOP were controlled without glaucoma medication 9 patients (10 eyes); controlled with medication in 8 patients (8 eyes); and not controlled even with 1 patient (1 eye). The amount of decrease in IOP was no statistically different between the two groups. Group 2 had deeper anterior chamber than Group 1 (p<0.01). The above results suggest that the combined pro-cedure may benefit in primary angle-closure glaucoma patients, especially old complicated patients.
Anterior Chamber ; Cataract* ; Glaucoma ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Trabeculectomy

A 4-year-old boy has had a solitary sclerotic depressed plaque on the right anterior chest since birth. The histopathologic findings are consistent with morphea profunda: thickening, hyalinization, and homogenization of collagen bundles in the dermis and subcutaneous tissues, admixture with a prominent lymphocytic and plasma cell infiltrate, and sweat glands en-trapped between the thickened collagen bundles. We report a case of congenital solitary morphea profunda.
Child, Preschool ; Collagen ; Dermis ; Humans ; Hyalin ; Male ; Parturition ; Plasma Cells ; Scleroderma, Localized* ; Subcutaneous Tissue ; Sweat Glands ; Thorax

We used argon laser peripheral iridoplasty to reduce intraocular pressure[IOP] in acute angle-closure glaucoma[ACG] which is unrelieved by medical and physical treatments and could not be treated by peripheral iridotomy due to edematous cornea and turbid aqueous. Eight of 16 eyes [16 patients] were successfully treated. These successfully treated eyes had a mean duration of angle closure of 4.1 days and 8 unsuccessfully treated eyes 9.2 days. The 6 eyes of 8 eyes with successful reduction of IOP after argon laser peripheral iridoplasty were treated peripheral iridotomy at average 1.7 day later and had deep anterior chamber. After a mean follow-up period of 2 months, 7 of these 8 successfully treated eyes had an IOP less than or equal to 21mmHg. Argon laser pripheral iridoplasty may be successful in treating ACG which is unrelieved by medical and physical treatments and could not be treated by pripheral iridotomy, especially in cases that are recognized and treated soon after onset.
Anterior Chamber ; Argon* ; Cornea ; Follow-Up Studies ; Glaucoma, Angle-Closure*

Many surgeons have noted that when the visual field is markedly constricted, immediate and permanent loss of central vision may follow otherwise successful glaucoma surgery. The present study was undertaken to assess the relative risk of surgical therapy in the loss of central vision in patients with advanced glaucoma. We reviewed the records of 44 eyes(including 8 macular split eyes) of 36 patients who had undergone trabeculectomy. The patients were followed for a minimum of 4 months with an average follow-up of 4.1 years. None of the patients suddenly lost visual field following surgery when central vision was spared at the time of the operation. There was good preservation of preoperative visual acuity except in 3 eyes which developed lens opacity. There was no progression of visual field loss when the intraocular pressure was controlled below 21 mmHg. There was good control of intraocular pressure in 43 out of 44 operated eyes. However, in one of the 2 reoperated eyes, we could not control the intraocular pressure below 21 mmHg.
Cataract ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Prognosis* ; Trabeculectomy ; Visual Acuity ; Visual Fields

PURPOSE: To evaluate the effects of needle revision (NR) with and without mitomycin C (MMC) for failed filtering blebs after trabeculectomy, and to identify risk factors for failure. METHODS: Thirty-one eyes whose intraocular pressure (IOP) did not decrease after cutting of scleral flap sutures were recruited. NR was performed with a 26-gauge needle under a slit-lamp. Immediately following NR, 15 eyes received subconjunctival injection of 0.002 mg (0.02 mg/ml) MMC at the adjacent conjunctiva. RESULTS: First NR was done at 1.3+/-1.2 months (range, 0.2~6.5 months) after trabeculectomy, and a mean of 1.6+/-1.6 NRs per patient were done. The follow-up period was 24.4+/-20.4 months (range, 6.0~87.4 months) after the last NR. Pre-NR mean IOP was 27.9+/-11.6 mm Hg and post-NR final IOP was 18.8+/-13.0 mm Hg (p=0.005). The success rate, defined as IOP < or =18 mm Hg with or without medication, was 80.3% (25 eyes of 31 eyes). The success rate was higher in the group receiving NR with adjunctive MMC (100%) than in the group receiving NR without MMC (62.5%) (p=0.018). Patients who underwent trabeculectomy without adjunctive MMC and those who had pre-NR IOP >25 mm Hg showed a higher failure rate, though with no statistical significance (p=0.141 and p=0.173, respectively). CONCLUSIONS: NR followed by subconjunctival injection of MMC is an effective and safe method for the treatment of the failed filtering blebs after trabeculectomy. Trabeculectomy without adjunctive MMC and pre-NR IOP higher than 25 mmHg were risk factors for failure of NR.
Blister* ; Conjunctiva ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Mitomycin* ; Needles* ; Risk Factors ; Sutures ; Trabeculectomy*

Twin reversed arterial perfusion (TRAP) sequence is a rare specific anomaly of twin gestation with fused placenta and umbilical anastomosis. This syndrome occurs once in about 34,600 births and reported first by Beneditti in 1533. We report on prenatal diagnosis of a case of TRAP sequence with color Doppler sonography, this case is presented with a brief review of the literature.
Humans ; Parturition ; Perfusion ; Placenta ; Pregnancy ; Prenatal Diagnosis*

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

Tubocurarine ; Vecuronium Bromide

OBJECTIVE: To report the pregnancy which was made by in vitro fertilization using recombinant follicle stimulating hormone and gonadotropin releasing hormone antagonist. MATERIAL AND METHOD: Case report. RESULTS: Six oocytes were retrieved and all were fertilized by intracytoplasmic sperm injection. Six embryos were transferred and the pregnancy was confirmed. CONCLUSION: It is envisaged that the availability of recombinant gonadotropins and gonadotropin releasing hormone antagonists will ultimately lead to shorter, cheaper and safer treatments, using reduced dosages.
Pregnancy ; Female ; Humans