Cycloplegic refraction with 1% cyclopentolate and I % atropine was performed in esotropic children younger than 6 years. The purpose of this study was to find clinical factors related with differencs in refractive changes between cyclopentolate and atropine Additionally, the periodic refractive changes at the first, second and third day during performing traditional atropinization were evaluated. The results were as follows: The refractive state after using 1 % cyclopentolate was + 5.00 diopters in average and that after using 1% atropine was +5.77 diopters in average (p Atropine* ; Child* ; Cyclopentolate ; Esotropia ; Humans ; Hyperopia

Kawasaki disease or mucocutaneous lymph node syndrome is an acute inflammatory illness of childhood characterized by systemic panvasculitis. It presents with high fever, dramatic changes of the skin and mucous membranes, and lymphadenopathy. Adult-onset Kawasaki disease is rare and reports on coronary involvement in adult are even rarer. Herein, we report a case of adult-onset Kawasaki disease complicated by splenic infarction and development of coronary aneurysm even despite of treatment with intravenous gamma globulin. A 20-year-old man presented with fever, erytheatous rash, induration and desquamation of hands and feet, pulmonary edema and shock due to cardiomyopathy, splenic infarction, bilateral conjunctivitis, jaundice, and cervical lymphadenopathy. After Kawasaki disease was suspected, intravenous gamma globulin (2 g/kg once) and aspirin (6 g/day) were administered. On the 30th hospital day, transesophageal echocardiography showed one coronary aneurysm and coronary angiography showed three aneurysms. Eight months after the first admission, follow-up coronary angiography showed normalization of the previous coronary abnormalities.
Adult ; Aneurysm ; Aspirin ; Cardiomyopathies ; Conjunctivitis ; Coronary Aneurysm* ; Coronary Angiography ; Echocardiography, Transesophageal ; Exanthema ; Fever ; Follow-Up Studies ; Foot ; gamma-Globulins ; Hand ; Humans ; Jaundice ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome ; Mucous Membrane ; Pulmonary Edema ; Shock ; Skin ; Splenic Infarction* ; Young Adult

No abstract available.

BACKGROUND: Hypertension is the most common cause of left ventricular hypertrophy(LVH). Increased left ventricular mass(LVM) carries independent risk for congestive heart failure, coronary artery disease, sudden death, reduction of coronary reserve. The importance of treatment in systemic hypertension for cardiovascular morbidity and mortality has been estabilished. Regression of LVM occurs with a number of antihypertensive drugs. This study was designed to explore the relation between blood pressure control, LVM and left ventricular filling dynamics. METHODS: Twenty five patients (12 men, 13 women) with estabilished hypertension were studied. No patients had a previous history of antihypertensive therapy. We obtained the basal echocardiography at the diagnosis which were disclosed no definite LVH, and the follow-up echocardiography after 6 months antihypertensive therapy with angiotension converting enzyme inhibitor, fosinopril, in patients with untreated essential hypertension. RESULTS: 1) Baseline blood pressure was 150/125mmHg and fell to 104/85mmHg (p<0.001). There was no siginificant reduction in heart rate. LVM were reduced from 153gr/m2 to 129gr/m2. 2) Peak E velocity and Peak A velocity was 82.9cm/sec, 74.9cm/sec and reduced to 67.2cm/sec, 62.3cm/sec, (p<0.001). 3) Time velocity integral dimension E (Ei) and time velocity integral dimension A (Ai) was 13.0cm, 9.0cm and reduced to 8.6cm, 4.5cm respectively. But there was no significant inteval change in peak E/A velocity. Ei/Ai was increased from 1.7 to 2.1 (p<0.01). CONCLUSIONS: These results suggested that antihypertensive therapy with ACE inhibitor for 6 months reduced significantly the left ventricular mass in patients with untreated essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Coronary Artery Disease ; Death, Sudden ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Fosinopril ; Heart Failure ; Heart Rate ; Humans ; Hypertension* ; Male ; Mortality

OBJECTIVES: To integrate the results of studies which assess an association between blood lead and blood pressure. METHODS: We surveyed the existing literature using a MEDLINE search with blood lead and blood pressure as key words, including reports published from January 1980 to December 2000. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers exposed to lead, and 2) both blood pressure and blood lead must have been measured and presented with sufficient details so as to estimate or calculate the size of the association as a continuous variable. Among the 129 articles retrieved, 13 studies were selected for quantitative meta-analysis. Before the integration of each regression coefficient for the association between blood pressure and blood lead, a homogeneity test was conducted. RESULTS: As the homogeneity of studies was rejected in a fixed effect model, we used the results in a random effect model. Our quantitative meta-analysis yielded weighted regression coefficients of blood lead associated with systolic blood pressure and diastolic blood pressure results of 0.0047 (95% confidence interval [CI]: -0.0061, 0.0155) and 0.0004 (95% CI: -0.0031, 0.0039), respectively. CONCLUSIONS: The published evidence suggested that there may be a weak positive association between blood lead and blood pressure, but the association is not significant.
Blood Pressure*

PURPOSE: Patients with Turner syndrome have been frequently suspected to have associated various otologic disorders and hearing loss. The purpose of this study was to evaluate the otologic problems in children with Turner Syndrome. METHODS: Twenty patients aged 5 to 20 years who were diagnosed as Turner syndrome were evaluated audiologically. RESULTS: Five subjects (25.0%) had previous histories of otitis media. An audiological examination was performed for all subjects and revealed normal hearing in 13 patients (65.0%), unilateral hearing loss in 3 patients (15.0%) and bilateral hearing loss in 4 patients (20.0%). Type of the hearing loss was conductive in 3 ears (7.5%), mixed in 2 ears (5.0%) and sensorineural in 6 ears (15.0%). Degree of hearing loss was mild in 9 ears, moderate in 1 ear and moderately severe in 1 ear. The incidence of hearing loss according to the karyotype revealed 10 ears (41.7%) in total deletion of Xp but only 1 ear (6.3%) in partial deletion of Xp. CONCLUSION: Our results demonstrated that the otitis media and hearing loss were one of the common findings in children with Turner syndrome. These results emphasize the importance of regular otological examinations and audiological evaluation in children with Turner syndrome for quality of life.
Child* ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Loss, Unilateral ; Humans ; Incidence ; Karyotype ; Otitis Media ; Quality of Life ; Turner Syndrome*

STUDY DESIGN: A retrospective study OBJECTIVES: To introduce the technique of minimally invasive transforaminal lumbar interbody fusion and examine its clinical and radiologic results. SUMMARY OF LITERATURE REVIEW: Transforaminal lumbar interbody fusion with a mini-incision using a tubular retractor was recently developed. The aim of this procedure is to reduce the approach-related morbidity and achieve better results in an effective and safe manner. MATERIALS AND METHODS: Thirty eight patients were followed up for more than 1 year. Their mean age was 57 years and the mean follow-up was 19 months. The diagnosis was spinal stenosis, spondylolisthesis and recurred herniated nucleus pulposus in 22, 14 and 2 patients, respectively. The Oswestry disability index, intervertebral disc space height, fusion rate and complications were evaluated. RESULTS: The Oswestry disability index improved from 30 points (range, 50~16 points) to 10 points (range, 2-24 points) at the last follow-up. Thirty-four patients (90%) showed excellent or good results. The intervertebral disc space height increased from 8.7 mm to 10.8 mm. Two cases showed nonunion but the clinical results were good. Complications included one case of infectious spondylitis requiring antibiotics, one case of cage dislodgement requiring additional surgery and one case of a pedicle screw malposition showing no clinical symptoms. CONCLUSIONS: Minimally invasive transforaminal lumbar interbody fusion reduced the soft tissue injury and blood loss and shortened the recovery period compared to the traditional open techniques.
Anti-Bacterial Agents ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Retrospective Studies ; Soft Tissue Injuries ; Spinal Stenosis ; Spondylitis ; Spondylolisthesis

PURPOSE: The formation of a liposarcoma is Known to be associated with a mutation of the p53 and MDM2 genes, and the histopathological subtypes of a liposarcoma are related to the prognosis of the patient. This study was performd to examine the relationship between the histopathological subtypes, the type of p53 mutation, and the proliferative rate. METHODS: Immunohistochemistry was used to measure the p53 protein and Ki-67 (Mib-1 labeling index) expression levels in 24 liposarcomas cases in which the liposarcoma developed primarily in the abdominal cavity. RESULTS: p53 expression was observed in 11.1% of the well- differentiated liposarcoma cases, 27.3% of the myxoid and round cell liposarcoma cases, and 50% of the pleomorphic liposarcoma cases. There were significant differences between the Ki-67 expression level according to the histopathological subtypes. There were significant differences between p53 positive or negative group and the Ki-67 expression level, and there was a quantitative correlation between them. CONCLUSION: The p53 protein was expressed in 25% of all liposarcomas, particularly in pleomorphic liposarcomas because it was expressed more frequently than in the other liposarcoma subtypes (in 2 cases out of 4 cases). The survival rate was much higher in the mucinous round cell liposarcomas which had high p53 and Ki-67 expression levels. The p53 expression level might be a prognostic predictor of a liposarcoma.
Abdominal Cavity ; Humans ; Immunohistochemistry ; Liposarcoma* ; Mucins ; Prognosis ; Survival Rate

PURPOSE: The GlideScope video laryngoscope (GL) has been known to help inexperienced health care providers become able to manage even difficult airways. The purpose of this study was to compare foreign body removal efficacies between the Macintosh laryngoscope (ML) and the GL in a setting of airway obstruction. METHODS: Participants were asked to remove the simulated foreign body (2x2 cm rice cake) from the supraglottic area of a freshly embalmed cadaver. This simulated a normal airway and a difficult airway with cervical spine immobilization. Participants performed the removal maneuver 4 times in random order using a Magill forceps with both the ML and the GL. We measured the time to removal (sec) and preference of the participant (5-point scale) and compared results according to the type of laryngoscope. Successful removal was defined as a removal time that was less than 120 sec. RESULTS: Forty participants were enrolled in this simulation experiment. The success rate, time to removal and provider preference were not significantly different betweeh the two types of laryngoscope. In subgroup analysis for experienced providers, the time to removal was significantly shorter in the ML group than the GL group (14 vs 20 sec, p<0.05). The preference of experienced provider was also significantly higher for ML than GL. CONCLUSION: This study suggests that ML has comparable efficacy for foreign body removal to GL and is acceptable to experienced providers.
Airway Obstruction ; Cadaver ; Foreign Bodies ; Health Personnel ; Humans ; Immobilization ; Laryngoscopes ; Spine ; Surgical Instruments

BACKGROUND: Voglibose is an alpha-glucosidase inhibitor. The purpose of this study was to evaluate the pharmacodynamic characteristics of voglibose for determining the appropriate study design and parameters for a pharmacodynamic equivalence study of voglibose. METHODS: This study consisted of two studies. The single dose study had an open and single sequence design. Nineteen subjects received placebo and then one tablet of voglibose on two consecutive days with sucrose. The multiple dose study was performed with the similar design, except that it was a multiple dose of the single dose study. Nine subjects who showed an effective response in the single dose study received placebo three times and then voglibose 4 times on two consecutive days. Serial blood samples for pharmacodynamic parameters were taken until 180 mins after each administration. The baseline adjusted maximum serum glucose level (G(max)) and area under the serum glucose level-time profiles were determined and compared. RESULTS: In the single dose study, the difference in G(max) was -10.6 +/- 28.7 mg/dL. The area under the serum glucose concentration-time curve (AUGC(0-1h)) of placebo and voglibose were 7825.0 +/- 1145.3 mg.min/dL, 7907.5 +/- 917.2 mg.min/dL, respectively. In the multiple dose study, the difference in G(max) was 46.6 +/- 16.1 mg/dL. The AUGC(0-1h) of placebo and voglibose were 8138.6 +/- 721.9 mg.min/dL and 6499.7 +/- 447.2 mg.min/dL, respectively. The G(max) and AUGC(0-1h) of the multiple dose study was significantly different between placebo and voglibose in paired t-test. CONCLUSION: The differences in G(max) and AUGC(0-1h) are suitable for pharmacodynamic parameters to evaluate bioequivalence of voglibose.
alpha-Glucosidases ; Glucose ; Inositol ; Sucrose ; Therapeutic Equivalency