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*

To investigate the effects of postoperative mitomycin C (MMC) eyedrop as an adjunct to intraoperative MMC in refractory glaucomas, 15 eyes of 14 glaucoma patients (age; 47.0 +/- 15.5 years) in need of trabeculectomy were studied. Preoperative diagnoses were secondary glaucoma to uveitis in seven patients, neovascular glaucoma in four, pseudophakic glaucoma in three, and aphakic glaucoma in one. Six patients who had neovascular glaucoma or history of a failed trabeculectomy with intraoperative 0.2 mg/ml MMC received intraoperative 0.4 mg/ml MMC. The others received 0.2 mg/ml MMC for 3 minutes. During the follow-up period, postoperative MMC eyedrop was applied, depending on the condition of the filtration bleb. The eyedrop was 0.2 or 0.4 mg/ml, applied four times a day for one week. The follow-up period was 18.1 +/- 7.4 months. The success rates were 93.3%, 86.7%, and 78.0% at postoperative 1, 4, and 18 months, respectively. There was neither early hypotony nor wound leak. Corneal epithelial defects (26.7%), corneal ulcers (6.7%), and cataracts (6.7%) were, however, observed. Postoperative MMC eyedrop application was a convenient and effective adjunct to intraoperative MMC in refractory glaucomas.
Adult ; Antibiotics, Antineoplastic/*administration & dosage ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Glaucoma/drug therapy/*surgery ; Humans ; Male ; Middle Aged ; Mitomycin/*administration & dosage ; Ophthalmic Solutions ; Postoperative Care ; Retrospective Studies ; *Trabeculectomy

No abstract available.
alpha-Fetoproteins* ; Chorion* ; Chorionic Gonadotropin* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, First*

We evaluated the ability of selective suture cutting to reduce postoperative astigmatism due to tight corneo-scleral(C-S) suture in 65 eyes undergone posterior chamber lens implantation. Under operating microscope, two-planned beveled C-S incision was made from 10:00 position to 2:00 position. At the end of operation. C-S wound was sutured at 11:20 position and 12:40 position with 8-0 Vicryl(R), 'X'-shaped suture at 10:40 position. 12-o'clock, and 1:20 position with 10-0 nylon. We cut the C-S suture with 26G disposable needle under slit lamp after local anesthetics(Alkaine(R)) instillation. Keratometric and refractive measurements were obtained before and at selective intervals(group A:4-6 weeks, group B:7-9 weeks, Group C:10-12 weeks) after surgery. Our analysis demonstrated the followings: 1. Remained astigmatism below 1.5 Diopter at 4th week after selective suture cutting were 87.5% in group A, 86.5% in group B, 83.8% in group C. 2. complications due to suture cutting were C-S wonnd disruption(cutting at 5th week after surgery), mild anterior chamber reaction(cutting at 8th week after surgery), and aganinst-the-rule astigmatism(average 1.25D iopter, Group A:18.8%, Group B:13.5%, Group C:16.7%). 3. Selective suture cutting at postoperative 7-9th weeks can correct the postoperative astigmatism.
Anterior Chamber ; Astigmatism* ; Cataract Extraction* ; Cataract* ; Needles ; Nylons ; Sutures* ; Wounds and Injuries

As the anterior chamber tube shunt to an encircling band(ACTSEB) is a complicated procedure, extended polytetafluoroethylene(e-PTFE)-silicone tube implant is being attempated as a new glaucoma drainage implant in Korea. Anterior chamber tube shunt to a two-fold e-PTFE surgical membrane(ACTSSM) has better intraocular pressure(IOP) control than ACTSEB and kept the postoperative anterior chamber depth deep. ACTSEB and ACTSSM procedures were done in normal, colored rabbit eyes in order to compare the tissue response to each shunt. The rabbits were sacrificed 3 and 6 weeks later and the eyes were prepared for light microscopy. In general, foreign body responses were similar. Fibrous capsules lining the e-PTFE were thicker, less dense fibroblast, and less collagen than that lining the silicone encircling band. These findings seem to be related to the difference of the IOP lowering effect between ACTSEB and ACTSSM.
Anterior Chamber ; Capsules ; Collagen ; Fibroblasts ; Foreign Bodies ; Glaucoma Drainage Implants ; Korea ; Membranes* ; Microscopy ; Rabbits ; Silicones*

Transvaginal bladder neck suspension by Raz is an acceptable procedure for the treatment of stress urinary incontinence with high cure rate, operative simplicity, short hospitalization and little morbidity. Recently we experienced 8 cases of stress urinary incontinence treated with Raz's procedure and 2 cases with coexisting cystocele were treated with 4-corner operation. All cases have been assessed prior to and following operation and the results were satisfactory. Herein, we report 10 cases of stress urinary incontinence treated by Raz's procedure and 4-corner operation with review of literatures.
Cystocele ; Hospitalization ; Neck* ; Urinary Bladder* ; Urinary Incontinence*

PURPOSE: This study is to evaluate the visual prognosis according to the ocular morbidity of the fellow eye in a national university hospital located in rural area. METHODS: We retrospectively reviewed the medical records of 390 eyes of 315 patients who had undergone cataract surgery. We assessed the change of postoperative visual acuity and the state of preoperative fellow eye. RESULTS: The age at cataract surgery was the highest in the sixties (29.2%) and seventies (27.7%). The patients older than 80 of age were 10.0%. Preoperative ocular co morbidities (23.3%) were diabetic retinopathy, glaucoma, corneal opacity, uveitis, etc. Preoperatively, 91.3% of all cases had a visual acuity of 0.4 or lower, but 3 months after surgery, 72.1% of all had 0.5 or better. At postoperative 3 months, 27.9% showed visual acuity of 0.4 or less and the ocular co morbidities were found in 67.0%. Preoperative visual acuity of less than 0.1 in the fellow eye was 10.2%. Preoperatively, 97.5% of these cases had a visual acuity of 0.4 or lower, but only 40% had 0.5 or better postoperatively. Preoperative and postoperative visual acuity were poor in patients whose preoperative visual acuity was less than 0.1 in the fellow eye. CONCLUSIONS: The age at cataract surgery was the highest in the sixties (29.2%) and seventies (27.7%). The patients older than 80 of age were 10.0%. Preoperative ocular co morbidities (23.3%) were diabetic retinopathy, glaucoma, corneal opacity, uveitis, etc. Preoperatively, 91.3% of all cases had a visual acuity of 0.4 or lower, but 3 months after surgery, 72.1% of all had 0.5 or better. At postoperative 3 months, 27.9% showed visual acuity of 0.4 or less and the ocular co morbidities were found in 67.0%. Preoperative visual acuity of less than 0.1 in the fellow eye was 10.2%. Preoperatively, 97.5% of these cases had a visual acuity of 0.4 or lower, but only 40% had 0.5 or better postoperatively. Preoperative and postoperative visual acuity were poor in patients whose preoperative visual acuity was less than 0.1 in the fellow eye.
Cataract Extraction* ; Cataract* ; Corneal Opacity ; Diabetic Retinopathy ; Glaucoma ; Humans ; Medical Records ; Prognosis* ; Retrospective Studies ; Uveitis ; Visual Acuity