Horizontal incomitancy is a difference of deviation angle between right and left gaze and monocular recession-resection operation may cause horizontal incomitancy. We reviewed 85 patients of intermittent exotropia without oblique dysfunction and vertical deviation who underwent monocular recession-resection operation. The preoperative horizontal in comitancy was 1.0 delta in average with a range of 0 delta to 5 delta. The postoperative horizontal incomitancy after 7 months (mean) was 4.8 delta in average with a range of 0 delta to 17 delta. The postoperative remained deviation and horizontal incomitancy were significanty smaller in the group of patients who had fusion with worth 4-dot test (p Exotropia ; Humans

Gastric tuberculosis is a rare disease and the diagnoeis of gastric tuberculosis is based on either positive histological or bacteriological study. We experienced a case of gastric tuberculosis with pleural effuaion in 59 year-old woman, diagnosed by the histological study of the endoscopic biopsy specimen. Follow up endoscopic finding revealed marked improvement of gastric lesion after anti-tubercadoua medication. We reported the case with review of literature.
Biopsy ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Rare Diseases ; Tuberculosis*

Twenty patients were operated on under the diagnosis of congenital nystagmus(CN). Of these, nineteen were motor CN and one was sensory CN. Head turning was toward the leftside in 13 patients(65.0%) and the rightside in 7(35.0%). Preoperatively, the degree of head turn ranged from 20 degrees to 45 degrees with a mean of 34.5 degrees. Primarily, modified Kestenbaum procedures were performed and, if necessary, 2nd and/or 3rd operations(Anderson's procedure, Goto's procedure) were performed additionally. The degrees of head turn after the 1st operation ranged from -5 degrees to 30 degrees with a mean of 11.5 degrees. On an average, 23.5 degrees was corrected by 14.8mm of operation on muscles(resection plus recession) for each eye. By these procedures, seventeen patients(85.0%) showed improvement or cure(75% after 1st operation and 10% after 2nd and/or 3rd operation).
Diagnosis ; Head ; Humans ; Nystagmus, Congenital*

Although hypoglycemia may be common among neonates, brain injuries resulting from isolated neonatal hypoglycemia are rare. The condition may cause neurological symptoms such as stupor, jitteriness, and seizures, though in their absence, diagnosis is delayed or difficult. Hypoglycemia was diagnosed in a three-day-old neonate after he visited the emergency department with loose stool, poor oral intake, and decreased activity, first experienced two days earlier. Two days after his visity, several episodes of seizure occurred. T2 and diffusion-weighted magnetic resonance (MR) scanning, performed at 11 days of age, revealed bilateral and symmetrical high signal intensity lesions in occipital, parietal, and temporal lobes. We report the MR findings of hypoglycemic encephalopathy in a neonate.
Brain Injuries* ; Brain* ; Diagnosis ; Emergency Service, Hospital ; Humans ; Hypoglycemia* ; Infant, Newborn ; Rabeprazole ; Seizures ; Stupor ; Temporal Lobe

We experienced one case of an unusual acute osteomyelitis of orbital margin, of which frontal, zygomatic and maxillary bone was involved in 10-month old infant. His clinical symptomes were similar to the acute osteomyelitis of superior maxilla but the primary site seemed to be in the frontal bone by history. We treated him with massive antibiotics and surgery (anterior approach). The causative organism was staphylococcus sureus, being very sensitive to penicillin. Also we reviewed the literatures of the orbital osteomyelitis comparing with thia case.
Anti-Bacterial Agents ; Frontal Bone* ; Humans ; Infant ; Maxilla* ; Orbit* ; Osteomyelitis* ; Penicillins ; Staphylococcus

No abstract available.
Humans ; Physicians, Family*

BACKGROUND: There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty (SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. MATERIAL AND METHOD: Between 1986 and 1998, a total of 25 patients less than 1 year of age (12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0+/-3.0 months (mean +/- standard deviation); mean weight was 5.0+/-1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one (84%) of 24 hospital survivors were followed for 26.0+/-24.0 months. The risk of recoarctation in neonates (33.3%) was a little greater than infants (25.0%) without statistical significance. CONCLUSION: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment (combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.
Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Constriction ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Ischemia ; Paraplegia ; Prevalence ; Recurrence ; Replantation ; Subclavian Artery ; Survivors

BACKGROUND: Minimally invasive techniques for open heart surgery are widely accepted in these days. There are minimally invasive approaches by the right or left parasternal incision and another approaches by mini-sternotomy of upper or lower half or sternum. We report the safety and efficacy of minimally invasive technique with right parasternal incision compared with the routine full sternotomy. MATERIAL AND METHOD: From April 1997 through February 1999, 20 patients (Group A) underwent minimally invasive cardiac operations. We chose 41 patients (Group B) whose preoperative diagnosis were the same and general conditions were similar and who underwent routine full sternotomy before April 1997. We compared A group and B group in many aspects. We performed routine full median sternotomy in B group but we did a minimally invasive technique through a small right parasternal incision in A group. RESULT: mean age was 36.1 years in both groups. In disease entities, there were 11 cases of ASD, 9 cases of mitral valve disease in group A, and 16 cases of ASD, 25 cases of mitral valve diseases in group B. In ASD, operation time, cardiopulmonary bypass time of aortic occulusion time were 263 min, 82 min, and 41 min in group A and 180 min, 53 min, and 32 min in group B. In mitral valve disease, operation time, cardiopulmonary bypass time and aortic occlusion time were 267min, 106 min, and 70min in A group and were 207 min, 82 min, and 69 min in group B. There were significant differences in operation time, CPB time, and ACC time between group A and group B. There was a significant difference in the amount of bleeding in postoperative day 1 between group A and group B of mitral diasease. However, there was no significant difference in the amount of bleeding in other comparisons. Mean length of incision was 8.7 cm in group A. There was no significant difference in postoperative complications between A group and B group. There was no mortality in either group. CONCLUSION: We conclude that this minimally invasive technique with right parasternal incision is cosmetically excellent but it is not effective in reducing operative time and there was no significant difference in recovery time and postoperative complications compared with routine full sternotomy.
Cardiopulmonary Bypass ; Diagnosis ; Hemorrhage ; Humans ; Mitral Valve ; Mortality ; Operative Time ; Postoperative Complications ; Sternotomy ; Sternum ; Thoracic Surgery*

The major purpose of this study was to assess the post-operative quality of life after performing a pylorus-preserving gastrectomy (PPG) in early gastric cancer patients, comparing the results with patients who underwent a conventional gastrectomy (CG). There were 48 patients with gastric cancer who underwent surgical intervention at the Department of Surgery, Taejon St. Mary's Hospital, The Catholic University of Korea School of Medicine from November 1995 through June 1996. Out of 48 gastric cancer patients, 13 patients (27.1 %) were early gastric cancers. Seven patients of these 13 patients underwent a PPG and the others underwent a CG. The indications for PPG were ; 1) a lesion at least 5 cm proximal to the pyloric ring, 2) a lesion in the middle third of the stomach, 3) a lesion less than 40 mm in maximum length, and 4) especially a lesion located at the greater curvature. Localization of the lesion was precisely performed through a gastrotomy during the operation. Dissections of the No. 7, 8, and 9 nodes (D1 +) were performed in cases of ulcerated lesions (type III) or poorly differentiated lesions. The proximal and distal portions of the stomach were anastomosed together 2-3 cm proximal to the pyloric ring to preserve the pyloric function. Gastrografin studies were performed on the sixth or the seventh day following PPG, and disclosed that the pylori were almost normal in appearance and function. Compared to a CG, the duration of nasogastric decompression was longer by one day, the start of oral feeding was delayed by two days, and the duration of the hospital stay was longer by five days after PPG. Three months following PPG, the amount of food taken in a meal was 70-90 % compared to that of the pre-operative amount, oral feedings took place three to four times a day, and the performance status was excellent (grade 0). Endoscopic examination revealed two cases of food stasis without subjective symptoms and a case of bile reflux with minimal mucosal edema after the PPG. After the CG, three out of the six cases had bile reflux with mucosal redness and erosion. In conclusion, it seemed that for early gastric cancer a pylorus-preserving gastrectomy, with selective lymphnodal dissection, was superior to the standard operation in terms of post-operative quality of life.
Bile Reflux ; Daejeon ; Decompression ; Diatrizoate Meglumine ; Edema ; Gastrectomy* ; Humans ; Korea ; Length of Stay ; Meals ; Quality of Life ; Stomach ; Stomach Neoplasms* ; Ulcer

BACKGROUND: The aim of this study is to define the cardioprotective effects (hemodynamic, cytochemical and ultrastructural of the newly developed Histidine-Tryptophan-Ketoglutarate (HTK) cardioplegia compared to DelNido cardioplegia. MATERIAL AND METHOD: Seventy-nine isolated rat hearts were divided into three groups on the basis of techniques of cardioplegia infusion. Twenty-eight hearts (Group 1) were flushed with cold DelNido cardioplegia with every 40 minutes for 2 hours. Twenty-seven hearts (Group 2) were flushed with cold HTK cardioplegia for once during the 2 hours. Twenty-four hearts (Group 3) were flushed with cold HTK cardioplegia with every 40 minutes for 2 hours. Heart rate, left ventricular developed pressure (LVDP), changes of +dp/dt max, coronary flow, and rate-pressure product value were measured at pre-ischemic, post-reperfusion 15 minutes, 30 minutes, and 45 minutes for hemodynamic study. Aspartate aminotransferase (AST), lactate dehydrogenase (LD), creatine kinase (CK), CK- MB, troponin-I, myoglobin, and lactate were measured at pre-ischemic and post-reperfusion 45 minutes for cytochemical parameters. Mitochondrial scores were counted in 3 cases from each group for ultrastructural assessment. RESULT: In hemodynamic study, there were no significant differences among group 1, group 2, and group 3. However, the decrease values of heart rate in group 2 and 3 exhibited significantly lower values than in group 1. In cytochemical study, there were no significant differences among group 1, group 2, and group 3. However, the increase values of lactate in group 2 and 3 exhibited significantly lower values than in group 1. In ultrastructural assessment, the mean myocardial mitochondria scores in group 1, group 2, and group 3 were 2.14+/-0.10, 1.52+/-0.57, and 2.10+/-0.16. CONCLUSION: HTK solution provides adequate myocardial protection with some advantages over DelNido solution in isolated rat hearts.
Animals ; Aspartate Aminotransferases ; Cardioplegic Solutions ; Creatine Kinase ; Heart Arrest, Induced* ; Heart Rate ; Heart* ; Hemodynamics ; L-Lactate Dehydrogenase ; Lactic Acid ; Mitochondria, Heart ; Myoglobin ; Rats* ; Troponin I