PURPOSE: The purpose of this study was to evaluate clinical manifestation, etiology and prognosis of hypocalcemic infants who were admitted with seizure. METHODS: We reviewed medical records of 32 infants admitted at the Asan Medical Center with hypocalcemic seizure retrospectively. We classified patients into vitamin D deficiency group(n=7, 21.9%), transient hypoparathyroidism group(n=4, 12.5%), relative hypoparathyroidism with hyperphosphatemia group(n=16, 50%), and others(n=5, 15.6%) according to the laboratory results. RESULTS: Of the 32 patients, 29 patients were improved. There were no differences in gestational age and birth weight among the three groups. In the vitamin D deficiency group, age of onset was later than those of the transient hypoparathyroidism group and relative hypoparathyroidism with hyperphosphatemia group(51.6+/-2.7 vs 8.3+/-.5, 8.2+/-.6 days). In the age when all laboratory results were normalized, transient hypoparathyroidism group was younger than those of vitamin D deficiency group and relative hypoparathyroidism group(33.2+/-4.6 vs 93.6+/-8.5, 77.1+/-2.4 days). In the total treatment period, relative hypoparathyroidism with hyperphosphatemia group was longer than those of vitamin D deficiency group and transient hypoparathyroidism group(68.9+/-3.5 vs 42.0+/-5.0, 25.0+/-4.3 days). Others included two 22q11.2 deletion syndrome patients, a congenital hypoparathyroidism, a pseudohypoparathyroidism, and an early neonatal hypocalcemia. CONCLUSION: Transient hypoparathyroidism and hyperphosphatemia were major causes of neonatal hypocalcemia. And high calcitonin and peripheral organ resistance to parathyroid hormone act on hypocalcemia. In infants after one month, vitamin D deficiency was also an important cause of hypocalcemia. Most of the patients were improved within 1-2 months after proper management, but relative hypoparathyroidism with hyperphosphatemia group needed longer treatment. So, it is necessary to perform a systematic study for several complex causes that explain above fact.
Birth Weight ; Calcitonin ; Chungcheongnam-do ; DiGeorge Syndrome ; Gestational Age ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Infant* ; Medical Records ; Parathyroid Hormone ; Prognosis ; Pseudohypoparathyroidism ; Retrospective Studies ; Seizures ; Vitamin D Deficiency

The Sjogren-Larsson syndrome is genetically determined syndrome with autosomal recessive inheritence and characterized by the three cardinal signs: congenital ichthyosis, spastic di/tetraplegia, and mental retardation. Ocular signs include ectropion, blepharitis, conjunctivitis, keratitis, and macular glistening spot. The authors have experienced a case of Sjogren-Larsson syndrome that showed classical triad and macular glistening spot in a 16 month old boy.
Blepharitis ; Conjunctivitis ; Ectropion ; Humans ; Ichthyosis ; Infant ; Intellectual Disability ; Keratitis ; Male ; Muscle Spasticity ; Sjogren-Larsson Syndrome*

Cystoid macular edema (CME) is a relatively common cause of temporary or permanent visual impairment after cataract extraction. Fluorescein angiography is indispensable to diagnose the CME. Intravenous fluorescein angiography is asscciated with a high incidene of minor adverse effects but a very low incidence of life-threatening serious reactions. There are no reports of oral fluorescein causing a senous reaction, and minor adverse effects are uncommon. We had Performed the oral fluorescein angiography in 30 consecutive cases (31 eyes) to detect the CME after cataract extraction. Two eyes (6.45%) had definite evidence of CME on the fluorograms. The typical angiogram of CME were obtained at 30 or 40 minutes after they had taken the fluorescein sodium. A dose of 20mg/Kg body weight produced good quality angiograms in 71% of the patients. There was no serious reaction but a mild pruritus was noted in one patient(3.3%). Therefore, we have concluded that the oral fluorescem agniography is very useful method because the oral fluorogram may avoid the adverse effect that could occur in intravenous fluorescein injection and be comparable in quality with those produced by intrvenous fluorescein.
Body Weight ; Cataract Extraction* ; Cataract* ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Incidence ; Macular Edema* ; Pruritus ; Vision Disorders

No abstract available.
Humans

PURPOSE: To evaluate the surgical result and complications of scleral fixation of foldable intraocular lenses. METHODS: We reviewed the medical records of 17 patients who had undergone scleral fixation of acrylic three-piece foldable intraocular lens. RESULTS: Uncorrected visual acuity were improved in all eyes with time. Postoperative best corrected visual acuity were better than preoperative best corrected visual acuity in 14 eyes from 1.18+/-0.84 to 0.26 +/-0.25 in logMAR visual acuity. Estimated refractive error were 0.01+/-0.34 diopter in spherical equivalent preoperatively and .0.59+/-1.00 diopter postoperatively (p=0.02, paired t-test). The corneal astigmatic changes (dK) of mild against-the-rule astigmatism decreased as time passed. There was no intraoperative bleeding. There were postoperative complications such as increased intraocular pressure in 2 eyes, corneal epithelial defect in 1 eye. CONCLUSIONS: In cases of scleral fixation, by using acrylic foldable intraocular lens through small incision, we were able to reduce corneal astigmatism and complications due to large incision and therefore, improve visual acuity instantly.
Astigmatism ; Hemorrhage ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Medical Records ; Postoperative Complications ; Refractive Errors ; Visual Acuity

The prevalence of myopia, strabismus and amblyopia in premature children is higher than in the full-term population.And the higher incidence of ophthalmic abnormalities was found in the group with retinopathy of prematurity. The authors determined the prevalence of ophthalmic abnormalities in 31 premature children without retinopathy of prematurity compared with 31 full-term children.The children were examined when they were 3 years of age from 1993 to 1996. Uncorrected visual acuity of 0.6 or better was noted in 27(43.55%)eyes of the premature children and 35(56.45%)eyes of the full-term children. A total of 17(27.42%)eyes of preterm and 8(12.9%)eyes of full-term children had myopic refractive error(0.25 diopters or greater). And 6(9.68%)eyes of preterm and 11(17.74%)eyes of full-term children had hyperopic refractive error(2.0 diopters or greater). The astigmatism(1.0 diopter or greater)was found in 21(33.87%)eyes in preterm as compared with 10(16.13%)eyes in full-term children. Binocularity was evaluated from Titmus and TNO stereo test. 15(48.4%), 12(38.7%)premature children and 25(80.6%), 23(74.2%)fullterm children passed the Titmus 200 seconds of arc and TNO 240 seconds of arc each. Strabismus was not found in full-term children and 4(6.45%)of premature group. Premature infants without retinopathy of prematurity had higher rates of ocular abnormalities than full-term children. The authors conclude that visual development of premature children should be carefully examined including visual acuity, refractive errors, strabismus etc.
Amblyopia ; Child ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Myopia ; Prevalence ; Refractive Errors ; Retinopathy of Prematurity ; Strabismus ; Telescopes ; Visual Acuity

BACKGROUND: Recent randomized studies have shown a reduction of restenosis rate after denovo coronary stenting as compared to classical PTCA. The purpose of this study was to evaluate a new medication protocol using antiplatelet therapy(ticlodipine, aspirin) and heparin in conjunction with routine high pressure ballooning after stenting. METHODS AND RESULTS: Seventy two patients(47 males and 25 females, mean age : 58+/-11 years) underwent Palmaz-Schatz coronary stenting in 76 coronary lesions. Their clinical characeristice were ; 38 cases(63%) of unstable angina, 14 cases(19%) of stable angina and 20 cases(28%) of acute myocardial infarction(MI, Q : 16 cases, non-Q : 4 cases). In 15 out of 20 acute MI cases, stents were implanted in the infarct-related arteries. Primary elective stenting was indicated for 40 lesions(53%) ; 34 for de novo and 6 for restenosis after PTCA. Stents were implanted in 27 lesions(35%) with suboptimal result after PTCA and 9 lesions(12%) as a bailout procedure ; 8 threatened closures and 1 acute closure. All patients were treated with heparin for 48 hours and antiplatelet agents(aspirin 100-200mg/day and ticlopidine 200-500mg/day) after the procedure. All stents were greater than 3.0mm in size. Postdilatation was obtained with a max balloon diameter of 3.5+/-0.6mm(balloon-to-vessel ratio of 1.12+/-0.20) at a max inflation pressure of 14.4+/-2.8 atm. Percent diameter stenosis decreased from 70.4+/-15.5% to -1.2+/-4.8%(p<0.0001), and minimal luminal diameter increased from 0.94+/-0.57mm to 3.15+/-0.51mm(p<0.0001) after stenting. During mean follow-up duration of 5.1+/-3.0 months there were 3 cases(4.2%) of myocardial infarction, 2(2.7%) of repeat angioplasty, 1(1.4%) of CABG and 1(1.4%) of death. CONCLUSION: Palmaz-Schatz coronary stenting with poststenting routine high pressure ballooning appears to be safe and feasibile without anticoagulation and without use of intravascular ultrasound in selected patients.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Female ; Follow-Up Studies ; Heparin ; Humans ; Inflation, Economic ; Male ; Myocardial Infarction ; Phenobarbital ; Stents* ; Ticlopidine ; Ultrasonography

Stickler`s syndrome is a progressive, connective tissue disease which has an autosomal dominant trait with variable penetrance. Ocular changes include vitreoretinal degenera- tion, retinal pigmentary changes, retinal detachment, chori- oretinal atrophy, cataract and high myopia. Systemically, characteristic facial appearances, musculoskeletal abnormal- ities and hearing loss may be associated. We experienced a sporadic case of Stickler`s syndrome in a neonate and report with a review of the literatures.
Atrophy ; Cataract ; Connective Tissue Diseases ; Hearing Loss ; Humans ; Infant, Newborn ; Myopia ; Penetrance ; Retinal Detachment ; Retinaldehyde

BACKGROUND: The characterization of normal coronary blood flow dynamics should provide crucial guidelines for the accurate functional assessment of diseased coronary artery. However, the regional characteristics of coronary blood flow dynamics in normal human coronary artery have not been fully evaluated. METHODS: We performed proximal and distal segment velocity measurement of angiographically normal left anterior descending(LAD) and right coronary artery(RCA) in 25 patients(14 males, 12 females, age 50+/-10 yesre) with atypical chest pain. Spectral flow velocity parameters including average peak velocity(APV), average diastolic peak velocity(ADPV), average systolic peak velocity(ASPV), and diastolic-to-systolic velocity ratio(DSVR) were measured using 0.014 inch 15MHz Doppler wire at baseline and intracoronary adenosine-induced maximal hyperemic state. Coronary flow reserve(CFR) was calculated from the ratio of hyperemia to baseline APV. RESULTS: Comparison between LAD with RCA. LAD showed significantly higher APV than RCA at baseline(proximal ; 18+/-6cm/s vs 14+/-4cm/s, p<.005, and distal ; 17+/-6 cm/s vs 12+/-4cm/s, p<.005. LAD showed significantly higher ADPV and lower ASPV than RCA, therefore significantly higher DSVR than RCA> CFR was significantly lower in LAD than in RCA(proximal ; 301+/-0.9 vs 3.8+/-1.0 , p<3001, and distal ; 3.1+/-0.7 vs 3.6+/-0.8, p<.05). Comparison between proximal with distal segment. There was significant reduction in APV and ASPV from proximal to distal segment in RCA, but not in LAD. There was significant increase in DSVR from proximal to distal segment in RCA, but not in LAD. There was no difference in CFR between proximal and distal segment in both coronary arteries. CONCLUSION: We measured coronary blood flow velocities in angiographically normal coronary artery to characterized normal coronary blood flow dynamics and provide the reference values for the assessment of coronary artery disease. Significant regional differences of coronary blood flow velocities should be considered when we assess the diseased coronary artery.
Blood Flow Velocity ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels* ; Female ; Humans ; Hyperemia ; Male ; Reference Values

Tuberculosis and lymphoma, these 2 diseases can present with lyphadenopathy in anywhere of the body. Therefor differentiation of tuberculosis from lymphoma is often difficult. CT scans of 17 patients with tuberculosis and 23 patients with lymphoma were retrospectively reviewed to evaluate the efficacy of CT scans in differentating adenopathy between tuberculosis and lymphoma, All the patients underwent abdominal CT scans with contrast enhancement before treatment. The size, internal architecture, distribution of lymph nodes, and associated findings on CT scans were analyzed. As compared with lymphoma, tuberculous lymphadenopathy showed 1) female preponderance (65%), 2) predilection for portocaval lymph nodes (47%), 3) internal low attenuation in lymph nodes (82%), 4) cold abscess formation (24%). Characteristics of lymphoma on CT scans included 1) male prepondrance (78%), 2) conglomeration of lymph nodes (39%), 3) homogenous internal lymph node structure (83%). These results suggest that evaluation of the characteristics of lymphadenopathy on CT scans is helpful for differentiating between tuberculosis and lymphoma.
Abscess ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis*