PURPOSE: The purpose of this study is to provide useful clinical information for proper diagnosis of the superior oblique muscle palsy (SOP) associated with horizontal deviation. METHODS: The records of 186 patients with SOP treated surgically were reviewed. The patients who underwent surgery for horizontal deviation more than 10 PD were classified into SOP associated with horizontal deviation. RESULTS: Of 186 patients with SOP, 96 (51.6%) patients also showed horizontal deviation. In 59 patients (61.5%) of these 96 patients, chief complaint was horizontal deviation only and 24 patients (25.0%) knew their hyperdeviation. Compensatory head-tilt was shown in 52 patients (54.2%), however only 11 (11.5%) patients complained their head-tilt posture. Of 96 patients, 72 (82.3%) had horizontal deviation in the eye contralateral to the paretic eye and amblyopia occurred in the horizontally deviated eye. The frequency of exodeviation was 82.3 % and was more than that of esodeviation. The mean amount of hyperdeviation was 12.6 +/- 6.77 PD, and that of horizontal deviation was 22.9 +/- 8.13 PD in exodeviation and 22.5 +/- 9.17 PD in esodeviation, respectively ninety three patients (96.9%) showed positive Bielschowsky head-tilt test. All 83 patients who had fundus examination showed foveal extorsion. CONCLUSIONS: This study reveals that Bielschowsky head-tilt test and fundus examination for foveal extorsion are needed to diagnose SOP which is masked by prominent horizontal deviation.
Amblyopia ; Diagnosis ; Esotropia ; Exotropia ; Humans ; Masks ; Paralysis ; Posture

No abstract available.

No abstract available.
Diaphragmatic Eventration* ; Humans ; Infant, Newborn*

In this study, 63 patients underwent unilateral or bilateral medial rectus recession for nonaccommodative portion of partially accommodative esotropia and were followed up for more than 2 years after surgery.The nonaccommodative portion was measured by wearing the least hyperopic glasses for the best corrected visual acuity.The amount of recession of medial rectus was determined considering the patients'characteristics such as fusional ability, amount of hyperopia, AC/A ratio, visual acuity, and quality of muscle at forced duction test. The mean follow-up period was 5.2 +/-2.53 (2~13)years.Seven (11.2%) patients underwent surgery for recurrent esotropia due to deterioration. Consecutive exotropia did not occur.At the last visit all eyes were aligned with favorable stereopsis.Forty eight patients (76.2%)had deviation up to 8 PD of orthophoria and 15 patients showed esophoria greater than 8 PD, with fusional ability and stereoacuity of 40~400 seconds of arc (sec).Preoperatively, only 28.1%of the patients had gross stereopsis of 200~3000 sec.Postoperatively, 98.6%of the patients showed good stereopsis better than 800 sec : 75.5%better than 200 sec and 76%normal stereopsis more than 40 sec. This study revealed that individualized surgery for nonaccommodative component, and meticulous pre-and postoperative management resulted in good alignment and binocularity during long-term follow-up.Recurrent esotropia due to detrioration occurred more than consecutive exotropia after surgery.
Depth Perception ; Esotropia* ; Exotropia ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Hyperopia ; Telescopes* ; Visual Acuity

PURPOSE: To obtain the normal standard of the electrocardiogram(ECG) in newborn infants, METHODS: Standard 12-lead ECG recordings of 146 healthy neonates of gestational age above 30 weeks recorded in 24 hours after birth were analyzed for the following parameters: heart rate, QRS axis, PR interval, QTc interval, R and S wave amplitude. RESULTS: The mean gestational age of preterm(between 30 and 37 weeks) and term infants was 33.2 +/-2.4 and 38.4+/-3.2 weeks, and the mean birth weight was 2,168+/-371 g and 3,254+/-436 g, respectively. There was no meaningful difference between two groups in heart rate, PR interval, QTc interval, and QRS axis. Amplitudes of R waves in V1>-V6 leads and S waves in V2, V3 and V5 leads in term baby group were significantly larger than those in preterm baby group. The sum of amplitudes of R and S waves was largest in V2. The amplitude of combined R+S waves in V2 and V3 leads was significantly larger than that in V5 and V6 leads in both groups. This difference was more prominent in tbaby group. CONCLUSION: The results suggest that the increase in cardiac muscular mass and progressive right ventricular predominance are in accordance with the increase in gestational age.
Axis, Cervical Vertebra ; Birth Weight ; Electrocardiography* ; Gestational Age ; Heart Rate ; Humans ; Infant ; Infant, Newborn* ; Parturition

PURPOSE: The incidence of bronchopulmonary dysplasia(BPD) may further increase in the coming decade as advances in neonatal intensive care enable clinicians to save even smaller, younger and more critically ill infants. The purpose of this study was to evaluate risk factors and prognosis associated with BPD in premature infants. METHODS: The retrospective review on RDS infants admitted to the neonatal intensive care units at the Chonnam University Hospital was done from Jan. 1995 to July. 1997. These infants were divided into two groups, BPD group(n=25) and non-BPD group(n= 112). The incidence, risk factors and therapeutic results of BPD were analyzed. RESULTS: Infants in the BPD group had lower birth weight, gestational age, and lower 1 min Apgar score compared to that of infants in the control group. The incidence of BPD was 18.2Yo and was higher in male infants. Longer duration of oxygen, ventilatory support and higher PIP were noted in the BPD group. There were no significant differences between the two groups concerning duration of postnatal requirement of oxygen supplementation, ventilatory support, and ventilatory parameters such as FiO2 and PEEP. The incidences of PDA and pneumothorax mean fluid volume and weight loss were similar in two groups. Frequent episodes of respiratory infection occurred(31.6%) in BPD group and one patient expired during 6 to 12 month follow up. 22 infants(88%) received dexamethasone in BPD group. Side effects of dexamethasone including hypertension and hyperglycemia occurred in 59.1% and 31.8%, respectively. CONCLUSION: The overall incidence of BPD was 18.2% and the risk factors for BPD included lower birth weight and gestational age, lower Apgar score at 1 minute, longer duration of oxygen and ventilatory support with higher PIP.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia* ; Critical Illness ; Dexamethasone ; Follow-Up Studies ; Gestational Age ; Humans ; Hyperglycemia ; Hypertension ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Jeollanam-do ; Male ; Oxygen ; Pneumothorax ; Prognosis* ; Retrospective Studies ; Risk Factors* ; Weight Loss

PURPOSE: It is known that single umbilical artery is frequently associated with gastrointestinal or urogenital anomaly, however, routine renal sonography has been debated in healthy neonate with isolated single umbilical artery. This study is designed to determine the usefulness of routine renal sonography in apparently healthy infants with an isolated single umbilical artery. METHODS: Thirty healthy neonates with a single umbilical artery without a major anomaly from January 1995 to July 2002 were enrolled. The authors investigated the clinical background of babies and their mothers after renal sonography after 72 hours of age. When the abnormalities were found at the first renal sonography, the severity of hydronephrosis and degree of obstruction and renal function were analyzed by follow up renal sonography, voiding cystourethrography(VCUG) and technetium-99m-dimercaptosuccinic acid(DMSA) scan or technetium-99m-mercaptoacetyl-triglycerine (MAG3) scan. RESULTS: Among the 30 healthy patients with isolated single umbilical artery, five patients(16.7%) showed abnormalities on first renal sonography with one major(3.3%) and four(13.4%) minor renal anomaly(minimal or mild hydroneohrosis). One major renal anomaly(severe hydronephrosis) showed severe decreased renal function on MAG3 scan without reflux, and the other four minor regressed spontaneously on follow up study. CONCLUSION: The value of routine early renal sonograpy for detecting renal anomaly in healthy infants with an isolated single umbilical artery remained unclear because most of the anomalies would regress spontaneously in the follow up study.
Follow-Up Studies ; Humans ; Hydronephrosis ; Infant* ; Infant, Newborn ; Mass Screening* ; Mothers ; Single Umbilical Artery*

No abstract available.

PURPOSE:We investigated the production of oxygen hydroxyl radicals in the striatum of neonatal rat brain after intrastriatal injection of dopamine (DA) and the effect of growth hormone (GH) on the apoptosis of striatal neurons injured by hypoxia-ischemia. METHODS:The extracellular striatal levels of 2,3-dihydroxybenzoic acid (DHBA) and 2,5-DHBA as indicators of hydroxyl radical(OH-) production were measured by in vivo microdialysis in the striatums of 7 day-old newborn rats (n=10) after direct intrastriatal infusion of dopamine hydrochloride (1.0 micromol/microL). The samples of perfused artificial cerebrospinal fluid (CSF) were collected every 10 minutes interval. The levels of DA, 2,3-DHBA and 2,5-DHBA of CSF were analysed by HPLC (high performance liquid chromatography). Also, the brains were removed at 24 hour after hypoxic-ischemic injury by Rice-Vannucci method. The coronal sections (12 micrometer) of paraffin-fixed brains were stained by TUNEL (terminal transferase-mediated dUTP nick-end-labelling) technique, and the neuronal cells undergoing apoptosis in the striatum were observed by fluorescent microscopy and compared between GH-treated (50 mg/kg, Dong-Ah Pharmacy Co.) and saline-treated rats. RESULTS:The extracellualr striatal levels of 2,3-DHBA and 2,5-DHBA increased abruptly in the first 10 minutes samples after intrastriatal injection of DA. After then, the levels declined slowely. The levels of striatal extracelluar 2.3-DHBA increased up to 621.8+/-508.7% of basal levels (P<0.05), and the levels of 2.5-DHBA increased up to 262.8+/-198.1% of basal levels (P<0.05). GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury. CONCLUSION: The level of hydroxyl radicals increased abruptly after intrastriatal injection of DA and GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury.
Animals ; Apoptosis* ; Brain Injuries ; Brain* ; Cerebrospinal Fluid ; Chromatography, High Pressure Liquid ; Dopamine* ; Growth Hormone* ; Humans ; Hydroxyl Radical* ; In Situ Nick-End Labeling ; Infant, Newborn* ; Microdialysis ; Microscopy ; Neurons* ; Oxygen ; Pharmacy ; Rats*

A 50-year-old man with a 20-year history of migraine with aura was admitted due to a headache followed by right hemiplegia and speech disturbance. However, there were no abnormalities on brain MRIs and EEG at that time. His hemiparesis continued for one month. We report on a case of persistent hemiplegia and speech disturbance as migraine aura without an evidence of infarction on brain MRI.
Brain ; Electroencephalography ; Epilepsy ; Headache ; Hemiplegia ; Humans ; Infarction ; Middle Aged ; Migraine Disorders ; Migraine with Aura ; Paresis