PURPOSE: This study was designed to determine the relationship between binocular function and the surgical outcome of intermittent exotropia. METHODS: The surgical outcome and binocular function were retrospectively investigated in 44 patients who had undergone surgery for intermittent exotropia with at least 6 months of post-operative follow-up. We evaluated visual acuity, age at operation, angle of exodeviation, fusional status with Worth-4-dot test and stereoacuity with Titmus test before and after surgery. RESULTS: A 'surgical success' defined as a final alignment of orthophoria, esotropia less than 5PD or exotropia less than 10PD at far primary position, was achieved in 31 patients (70%). The surgical outcome according to preoperative stereopsis and fusional status was not statistically significant. Whereas, there was a tendency toward more surgical success in patients with central fusion and the first postoperative day diplopia but statistically indifferent. There was an improvement of stereoacuity in 34 out of 44 patients after surgery. The fusional status was improved in 9 patients out of 44 patients. There was an improvement of postoperative binocular function regardless the surgical outcome. But the achievement of fine stereopsis below 100 seconds of arc and central fusion increased only in success group. CONCLUSIONS: The preoperative binocular function did not contribute significantly to the surgical outcome (p>0.05) and postoperative binocular function could be improved by surgical correction in both surgical success and failure group. But the better binocular function was achieved by successful surgical alignment.
Depth Perception ; Diplopia ; Esotropia ; Exotropia* ; Follow-Up Studies ; Humans ; Retrospective Studies ; Telescopes* ; Visual Acuity

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

To study the site of release and factors affecting the release of the atrial natriuretic peptide(ANP) in the pediatric patients, we measured the plasma ANP concentrations in 23 normal healthy children, 19 patients with congestive heat failure and 16 patients with cardiac disease undergoing diagnostic cardiac catheterization. The following results were obtained. 1) The plasma ANP concentrations of the vein(226.3(74.9pg/ml)in patients with congestive heart failure were significantly higher than those(p<0.01)of the mormal healthy children(13.4 (7.9pg/ml)and those(43.3 40(.7pg/ml)in patients undergoing cardiac catheterization. The plasma ANP concentrations of the femoral vein in patients undergoing cardiac catheterization were also significantly higher than that of the peripheral vein in the normal healthy children(p<0.01). 2) The plasma ANP concentrations of the pulmonary artery(110.9( 80.7pg/ml)were 2 to 3 times higher than that of the femoral vein(43.3( 40.3pg/ml, p<0.01). However there were no significant differences of the plasma ANP concentrations between pulmonary artery and aorta(65.4 (36.1pg/ml),and between aorta and femoral vein. 3) There was a significant correlations of the plasma ANP concentrations vetween pulmonary artery and femoral vein, and pulmonary artery and aorta, but no correlation of those between femoral vein and aorta. 4) The plasma ANP concentrations of the vein were over 3 times more higher in cases of left atrial area over 20 cm2/M2 measured by 2-dimensional echocardiography(213.2 (292.9pg/ml)than those in cases of left atrial area under 20(65.0 66.9pg/ml, p<0.05). The plasma ANP concentrations of the vein were over 3 times more highger in cases of left atrial area over 20 cm2/M2(88.6(19.1pg/ml) than those in cases of left atrial area under 14(57.1 (39.5pg/ml,p<0.05), and in cases of the sum of both atrial mean pressure over 11mmHg(189.5( 42.8pg/ml) than those in cases of the sum under 11(79.3 (52.3pg/ml, p<0.01). The plasma ANP cocentrations of the aorta were significantly higher in cases of left atrial area over 14 cm2/M2(88.6 (19.1pg/ml)than those in cases of left atrial area under 14(57.1 (39.5pg/ml;p 0.05), in cases of the sum of both atrial area over 25cm2/M2(93.9 (21.7pg/ml)those in cases of the sum under 25(46.6 (33.8pg/ml, p<0.01), in cases of sum of mean atrial pressure over 11 mmHg(90.5 (30.3pg/ml)than those in cases of under 11(53.8( 24.6pg/ml, p<0.05),in cases of the sum of both atrial wall stress over 190 mmHg.cm2/M2(101.4 (23.5pg/ml) than those in cases of the sumunder 190(57.5 (26.4pg/ml, p<0.01), and also in cases of pulmonary artery mean pressure over 20mmHg(83.3( 18.2pg/ml) than those in cases o pulmonary artery under 20(47.8( 39.8pg/ml, p<0.05). In conclusion, the plasma ANP concentrations of the pulmonary artery were significantly higher than those of the frmoral vein and the aorta, which indicater that the ANP is predominantly secreted via coronary sinus into the right atrium. The plasma ANP concentrations of the peripheral and femoral vein, the pulmonary artery and the aorta, especially that of the aorta, correlated well with the atrial pressure, the area and the wall stress. This suggests that the arterial blood may be the most appropriate sample for measurement of the ANP.
Aorta* ; Atrial Natriuretic Factor ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Coronary Sinus ; Estrogens, Conjugated (USP) ; Femoral Vein ; Heart Atria ; Heart Diseases ; Heart Failure ; Hot Temperature ; Humans ; Plasma* ; Pulmonary Artery* ; Veins*

Purpose: Preterm infants are known to be at a risk of neurodevelopmental delay; however, limited data are available on the outcomes of moderate-to-late preterm (MLPT) infants (born at 32 to 36 weeks’ gestation). The Korean Developmental Screening Test (K-DST) for infants and children is a recently designed screening test for Korean infants and children. The current study aimed to evaluate the neurodevelopmental outcomes of MLPT infants and investigate the risk factors associated with neurodevelopmental delay. Methods: A total of 119 MLPT infants admitted to a neonatal intensive care unit (NICU) of a tertiary hospital in Korea were enrolled. The infants were assessed during two follow-up periods (first: 16 to 24 months of corrected age; second: 24 to 41 months of corrected age). The perinatal factors in the NICU that were associated with delayed development were analyzed. Results: In all sections of the K-DST, the proportion of infants with developmental delay was higher in the second period (5.6% to 9.3%) than in the first period (0.9% to 5.4%). A total of 10% to 17% of the infants presented with persistent delay throughout the two periods based on five sections of the K-DST. Male sex, oxygen therapy duration, and younger maternal age were the risk factors affecting at least one section during the second period. Conclusion MLPT infants showed greater developmental delay than the general infant population. Considering that early intervention is important for good longterm outcomes, close observation of male MLPT infants and MLPT infants who received oxygen therapy is warranted.

Purpose: Preterm infants are known to be at a risk of neurodevelopmental delay; however, limited data are available on the outcomes of moderate-to-late preterm (MLPT) infants (born at 32 to 36 weeks’ gestation). The Korean Developmental Screening Test (K-DST) for infants and children is a recently designed screening test for Korean infants and children. The current study aimed to evaluate the neurodevelopmental outcomes of MLPT infants and investigate the risk factors associated with neurodevelopmental delay. Methods: A total of 119 MLPT infants admitted to a neonatal intensive care unit (NICU) of a tertiary hospital in Korea were enrolled. The infants were assessed during two follow-up periods (first: 16 to 24 months of corrected age; second: 24 to 41 months of corrected age). The perinatal factors in the NICU that were associated with delayed development were analyzed. Results: In all sections of the K-DST, the proportion of infants with developmental delay was higher in the second period (5.6% to 9.3%) than in the first period (0.9% to 5.4%). A total of 10% to 17% of the infants presented with persistent delay throughout the two periods based on five sections of the K-DST. Male sex, oxygen therapy duration, and younger maternal age were the risk factors affecting at least one section during the second period. Conclusion MLPT infants showed greater developmental delay than the general infant population. Considering that early intervention is important for good longterm outcomes, close observation of male MLPT infants and MLPT infants who received oxygen therapy is warranted.

PURPOSE: The purpose of this study was to analyze the radiologic findings of primary epiploic appendagitis, with particular attention to the correlation of ultrasonographic, clinical, CT, MR and surgical findings. MATERIALS AND METHODS: Among 14 patients with primary epiploic appendagitis who presented with the rapid onset of a very localized pain and tenderness, we performed ultrasonography in all, CT in eight, and MRI in four of these eight. Surgery was performed in two patients. Follow-up examinations were performed using US, CT and MRI (n=2), US and CT (n=2), US alone (n=2), and with regard to clinical features (n=12). RESULTS: US performed in 14 patients revealed the presence in all of small, well-defined, ovoid, noncompressible hyperechoic (n=12) or isoechoic (n=2) solid masses attached to the colonic wall, without bowel wall change and without communication with bowel lumen. CT performed in 8 patients showed varying hyperattenuating fatty lesions in the same location in the abdomen, without other inflammatory process. MRI findings of four patients were helpful for further evaluation of internal architecture. CONCLUSION: In primary epiploic appendagitis, US findings were sufficiently characteristic to allow accurate diagnosis and valuable for the differential diagnosis of other acute conditions of the abdomen.
Abdomen ; Colon ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

PURPOSE: To evaluate the visual outcome of combined phacoemulsification, intraocular lens implantation, and vitrectomy for macula-sparing rhegmatogenous retinal detachment. METHODS: The results of combined vitrectomy with cataract extraction were retrospectively analyzed in patients with preexisting cataracts and new-onset rhegmatogenous retinal detachment. To qualify, patients must also have had macular sparing in a region 6,000 microm in diameter on optical coherence tomography. The anatomical success rate, visual outcomes, and postoperative complications relating to visual acuity were evaluated. RESULTS: In 56 patients followed postoperatively for more than 12 months, the initial and final surgical success rate was 96.4% and 100%, respectively. The mean preoperative logarithm of the minimum angle of resolution visual acuity was 0.05 and decreased to 0.11 postoperatively (p < 0.001). Of the 56 patients, 20 (35.7%) had worse visual acuity postoperatively, compared with preoperatively (0.06 vs. 0.27, p < 0.001); these cases were comprised of six patients with epiretinal membranes, 12 patients with a posterior capsule opacity, and two patients with cystoid macular edema. In the remaining 36 patients, there were no significant differences in visual acuity preoperatively and postoperatively (0.04 vs. 0.03, p = 0.324). CONCLUSIONS: In patients with cataracts who develop macula-sparing rhegmatogenous retinal detachment and whose visual prognosis is excellent assuming the retina can be reattached successfully, combined phacoemulsification, intraocular lens implantation, and vitrectomy might be an effective treatment. However, the visual prognosis is significantly affected by postoperative complications such as an epiretinal membranes, posterior capsule opacity, and cystoid macular edema. Therefore, further studies should examine methods to prevent these postoperative complications.
Adult ; Female ; Humans ; *Lens Implantation, Intraocular/adverse effects ; Male ; Middle Aged ; *Phacoemulsification/adverse effects ; Postoperative Complications/prevention & control ; Retinal Detachment/physiopathology/*surgery ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; *Vitrectomy/adverse effects

Malacoplakia is an uncommon granulomatous inflammatory disease, which predomina- ntly affected the urinary tract, particularly the urinary bladder. The prostatic involve- ment of malacoplakia is extremely rare and may clinically mimic prostate cancer. A correct diagnosis of malacoplakia can be made by histopathologic findings characterized by accumulations of macrophages containing typical intracytoplasmic inclusions(Michael is-Gutmann bodies). We report a case of prostatic malacoplakia, which was incidentally found in prostate biopsy performed to confirm clinically suspected prostate cancer.
Biopsy ; Diagnosis ; Macrophages ; Malacoplakia* ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Tract

PURPOSE: Fractures of trapezium are uncommon carpal bone fractures and often unrecognized lesions. We investigated about operative treatment of trapezium fracture. MATERIALS AND METHODS: Seven patients with fractures of trapezium were evaluated after surgical treatment with a mean follow up time of 18 months (12 months~3 years). Functional assessment (pain, limitation in activities of daily living, satisfaction), physical examination (range of motion, grip strength), and radiographic evaluation were performed. Traumatic arthritis and carpometacarpal joint subluxation were confirmed by radiograph. RESULTS: During study period, 122 cases were carpal bone fractures, and seven of 122 cases were fractures of trapezium. All cases were intra-articular fractures of trapezium. 1st carpometacarpal joint dislocation at 4 patients, Bennett's fracture at 1 patient, hamate hook fracture at 1 patient, and base of 4th proximal phalanx fracture at 1 patient were associated with fracture of trapezium. Open reduction and internal fixation were performed at 6 cases and 1st carpometacarpal joint arthrodesis was performed at 1 case because of neglected fracture. One of 6 cases which were performed to open reduction and internal fixation was reoperated to external fixation due to reduction loss. Clinically 6 patients revealed good results. one of 7 patients experienced limitation of thumb opposition. CONCLUSION: Based on the good results obtained with surgical intervention, we advocated open reduction and internal fixation for fractures with intraarticular depressed more than 2 mm or combined with Bennett's fracture or carpometacarpal subluxation.
Activities of Daily Living ; Arthritis ; Arthrodesis ; Carpal Bones ; Carpometacarpal Joints ; Dislocations ; Follow-Up Studies ; Hand Strength ; Humans ; Intra-Articular Fractures ; Physical Examination ; Thumb