Acute posterior multifocal placoid pigment epitheliopathy usually occurs in young or middle-aged adults and is usually bilateral. This syndrome is characterized by the acute onset of multiple, flat, yellow-white lesion of the posterior pole at the level of the retinal pigment epithelium and by the rapid loss of vision. These lesions resolve spontaneously, leaving extensive degeneration of pigment epithelium within a few weeks and visual acuity spontaneously improves in most cases. In the acute stage, fluorescein angiographic appearance of condition is characterized by placoid lesions blocking transmission of choroidal fluorescence in the initial phase, which are gradually stained and fluorescence faintly in the late phase. Older lesions represent residual defects in the pigment epithelium and appear as transmission defect without late staining or leakage of dye. Authors experienced and treated a case of acute posterior multifocal placoid pigment epitheliopathy in 19-years old male patient, and had a good visual improvement.
Adult ; Choroid ; Epithelium ; Fluorescein ; Fluorescence ; Humans ; Male ; Retinal Pigment Epithelium ; Visual Acuity ; Young Adult

Various ophthalmic complications can occur after intranasal sinus surgery due to closed anatomic relation between orbit and paranasal sinuses. A study was undertaken to identify those patients with ophthalmic complication after intranasal sinus surgery. A consecutive series of 80 cases undergoing sinus surgery at department of ENT between Jan. 1992 and Jul. 1992 was studied prospectively. We recorded preoperative and postoperative best corrected visual acuity, intraocular pressure, exophthalmometric measurement, levator function, funding, lacrimal excretory function, extraocular muscle motility. Several patients were noticed a variety of ophthalmic problems after intranasal sinus surgery: 1 case of orbital hematoma and transient blepharoptosis, 2 cases of diplopia with limited duction, 4 cases of subcutaneous hemorrhage, tearing and blurring, 5 cases of conjunctival injection with chemosis, 7 cases of ocular discomfort, 42 cases of lid swelling. Orbital hematoma was treated with puncture and aspiration but other problems were recovered spontaneously within several days.
Blepharoptosis ; Diplopia ; Financial Management ; Hematoma ; Hemorrhage ; Humans ; Intraocular Pressure ; Orbit ; Paranasal Sinuses ; Prospective Studies ; Punctures ; Tears ; Visual Acuity

Exact understanding of the upper eyelids is essential to the success of an anterior surgical approach for the correction of blepharoptosis. Therfore, we undertook this study using cadaver dissection, histologic sections, surgical observations, and review of MRI findings to gain a better understanding of the anatomical characteristics of the orbital septum and associated connective tissue structures which are important in ptosis surgery. The basic distinction of the upper eyelid structures between Oriental and Occidental is the relationship of the orbital septum and the levator aponeurosis. The orbital septum appears as a thick multilayered connective tissue originating just inside the superior orbital rim, but its inferior extension become thin progressively and blends with levator aponeurosis on an average of 1.6mm below the superior tarsal horder. Therefore the preaponeurotic fat is allowed to proceed to the anterior tarsal surface, resulting in a characteristic appearance of oriental eyelids. The levator aponeurosis maintains its thick and obvious structure continuously to the anterior tarsal surface near the lower margin of the upper lid. We resected levator aponeurosis with Muller's muscle which plays a important role in lid elevation for the correction of congenital htepharoptosis, and obtained excellent results.
Blepharoptosis ; Cadaver ; Connective Tissue ; Eyelids* ; Magnetic Resonance Imaging ; Orbit

Purpose: The objective of this study was to determine the optimal timing of inguinal herniorrhaphy in preterm infants to reduce the risks of preoperative incarceration and postoperative complications. Methods: Preterm infants with gestational age (GA) of <37 weeks who had ingui­nal herniorrhaphy before the age of 6 months were enrolled. Early repair was defined as undergoing herniorrhaphy before discharge from the neonatal intensive care unit (NICU), and late repair was defined as undergoing herniorrhaphy as an outpatient after discharge from the NICU. Results: The incidence rates of preoperative incarceration and recurrence were not significantly different between the two groups. Postoperative apnea and mechanical ventilation were more frequent in the early-repair group than in the late-repair group.Postoperative apnea was more frequent in the early-repair group after adjustments for GA and birth weight. However, no significant difference in postoperative mechanical ventilation was found between the two groups after adjustments for GA and birth weight. The incidence of postoperative apnea was associated with small weight at repair, early repair, general anesthesia, younger GA, small weight at birth, and bron chopul­monary dysplasia. Contralateral metachronous hernia was most frequent in infants with small weight at repair, early repair, very low birth weight (VLBW), male sex, and right-sided hernia. Conclusion Late repair was safe and did not increase the risk of incarceration or recurrence, but decreased the risks of postoperative apnea and metachronous hernia.Regional anesthesia could reduce the risk of postoperative apnea. Male infants born with VLBWs and right-sided hernia should be followed up carefully for metachronous hernia.

PURPOSE: Meconium-related ileus is common in preterm infants. Without proper management, it can cause necrotizing enterocolitis and perforation requiring emergent operation. This study was conducted to describe the efficacy and safety of ultrasound-guided Gastrografin enema at bedside for preterm infants with meconium-related ileus. METHODS: Between March 2013 and December 2014, this study enrolled preterm infants with birth weight < 1,500 g, who were diagnosed with meconium-related ileus requiring ultrasound-guided Gastrografin enema refractory to glycerin or warm saline enemas. Gastrografin was infused until it passed the ileocecal valve with ultrasound guidance at bedside. RESULTS: A total of 13 preterm infants were enrolled. Gestational age and birth weight were 28.6 weeks (range, 23.9–34.3 weeks) and 893 g (range, 610–1,440 g), respectively. Gastrografin enema was performed around postnatal day 8 (range, day 3–11). The success rate was 84.6% (11 of 13 cases). Three of these 11 infants received a second procedure, which was successful. Among 2 unsuccessful cases, one failed to pass meconium while the other required surgery due to perforation. The time required to pass meconium was 2.8±1.5 hours (range, 1–6 hours). The time until radiographic improvement was 2.8±3.4 days (range, 1–14 days) after the procedure. CONCLUSION: Ultrasound-guided Gastrografin enema at bedside as a first-line treatment to relieve meconium-related ileus was effective and safe for very low birth weight infants. We could avoid unnecessary emergent operation in preterm infants who have high postoperative morbidity and mortality. This could also avoid transporting small preterm infants to fluoroscopy suite.
Birth Weight ; Diatrizoate Meglumine ; Enema ; Enterocolitis, Necrotizing ; Fluoroscopy ; Gestational Age ; Glycerol ; Humans ; Ileocecal Valve ; Ileus ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Meconium ; Mortality ; Ultrasonography

Congenital pancreatic cysts are rare in newborn babies, and this makes prenatal diagnosis difficult. Diagnosis can be delayed for a few months after birth until the infant presents with an abdominal mass, abdominal distension, or vomiting due to gastric outlet obstruction. Excision of the cyst is the treatment of choice. A congenital pancreatic cyst should be considered if the fetus has an abdominal cyst without a definite origin. A prompt diagnosis is crucial to prevent fatal complications such as cholangitis, pancreatitis, cyst rupture, and peritonitis. We report a case of neonate with multiple congenital pancreatic cysts suspected prenatally to be stomach diverticulum or duplication cysts of the intestine.
Cholangitis ; Diagnosis ; Diverticulum, Stomach ; Fetus ; Gastric Outlet Obstruction ; Humans ; Infant ; Infant, Newborn ; Intestines ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pancreatitis ; Parturition ; Peritonitis ; Prenatal Diagnosis ; Rupture ; Vomiting

Strongyloidiasis is caused by Strongyloides stercoralis and is one of the most neglected tropical diseases in tropical and subtropical regions. Although several strongyloidiasis cases have been reported in Korea, genetic analysis of Korean isolates is still incomplete. In this study, a parasite was isolated from a 61-year-old man diagnosed with strongyloidiasis during the treatment of lymphoma on his retroperitoneal lymph node. Diffuse symmetric wall thickening from the ascending to descending colon and a nematode-infected intestine was observed following microscopic examination. Genomic DNA was isolated from a patient tissue block, and S. stercoralis was identified by PCR and sequencing (18S rDNA). In order to determine phylogenetic location of a Korean isolate (named KS1), we analyzed cox1 gene (500-bp) and compared it with that from 47 previous S. stercoralis isolates (28 human isolates and 19 canid isolates) from Asian countries. Our results showed that phylogenetic tree could clearly be divided into 5 different groups according to hosts and regions. KS1 was most closely related with the Chinese isolates in terms of genetic distance.

Strongyloidiasis is caused by Strongyloides stercoralis and is one of the most neglected tropical diseases in tropical and subtropical regions. Although several strongyloidiasis cases have been reported in Korea, genetic analysis of Korean isolates is still incomplete. In this study, a parasite was isolated from a 61-year-old man diagnosed with strongyloidiasis during the treatment of lymphoma on his retroperitoneal lymph node. Diffuse symmetric wall thickening from the ascending to descending colon and a nematode-infected intestine was observed following microscopic examination. Genomic DNA was isolated from a patient tissue block, and S. stercoralis was identified by PCR and sequencing (18S rDNA). In order to determine phylogenetic location of a Korean isolate (named KS1), we analyzed cox1 gene (500-bp) and compared it with that from 47 previous S. stercoralis isolates (28 human isolates and 19 canid isolates) from Asian countries. Our results showed that phylogenetic tree could clearly be divided into 5 different groups according to hosts and regions. KS1 was most closely related with the Chinese isolates in terms of genetic distance.