We implanted aniridia intraocular lenses (aniridia IOL) on three cases with complaint of glare caused by traumatic or congenital aniridias combined with cataract or aphakia. Aniridia IOLs were fixed by scleral fixation on one aphakia with traumatic aniridia, and at the ciliary sulcus on one aphakia with traumatic aniridia and one congenital aniridia with cataract. After follow-up of at least 2 months, visual improvement, absence of glare and cosmetic acceptance was observed without any complication in all cases.
Aniridia* ; Aphakia ; Cataract ; Follow-Up Studies ; Glare ; Lenses, Intraocular*

No abstract available.
Arthroplasty, Replacement, Hip*

PURPOSE: Febrile seizure affects 2 to 5% of children, but 30 to 40% of the children who already had febrile seizure experience another febrile seizure. We researched to define a high risk group of recurrent febrile seizures through investigating several risk factors. METHODS: We evaluated 342 patients who were admitted to our hospital or treated in the emergency room for their first febrile seizure from March, 1995 to August, 2001. We assessed various risk factors, such as age, the type of seizure, body temperature, serum sodium concentration, sex, neurologic abnormalities, and family history of febrile seizure or epilepsy. RESULTS: Age at the first febrile seizure(< or =18 months) and family history of febrile seizure were significant risk factors for recurrence of febrile seizure. The study showed that 21.9% of the children who had none of these risk factors, 36.4% of the children who had one, and 57.1% of the children who had both factors had recurrent febrile seizures. Thus, the recurrence rates clearly increase as the number of these factors increase. CONCLUSION: Two major risk factors for recurrent febrile seizures were identified:early onset(< or =18 months) and family history of febrile seizure. The risk of recurrent febrile seizures increased with the number of these risk factors increased. Consequently, children with both risk factors were considered to belong to a high risk group of recurrent febrile seizures.
Body Temperature ; Child ; Emergency Service, Hospital ; Epilepsy ; Humans ; Recurrence ; Risk Factors* ; Seizures ; Seizures, Febrile* ; Sodium

No abstract available.
Hernia, Inguinal* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Radionuclide Imaging*

Endovascular treatment of isolated bilateral common iliac artery aneurysm (CIAA) requires salvage of at least one internal iliac artery to prevent complications such as ischemic buttock claudication. We treated a case of bilateral CIAAs using an internal iliac branched stent graft. We report a case of a 58-year-old man who presented with bilateral CIAAs. The left internal iliac artery was occluded with coil embolization. The right internal iliac artery was saved by using a branched stent graft. The aneurysms were excluded with conventional endovascular aneurysm repair. Completion angiography showed technical success. Follow up computed tomography angiogram at three months showed complete exclusion of bilateral CIAAs, no endoleaks, and patent right internal iliac artery. There was no pelvic ischemic complication. We treated successfully a case of isolated bilateral CIAAs using an iliac branched stent graft.
Aneurysm* ; Angiography ; Blood Vessel Prosthesis* ; Buttocks ; Embolization, Therapeutic ; Endoleak ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Iliac Artery* ; Middle Aged

To evaluate the efficacy and safety of intravitreally removing the crystalline lens completely dislocated into the vitreous cavity with intact capsule, we reviewed the patients undergone pars plana vitrectomy for the treatment of intravitreal crystalline lens. The crystalline lenses were spontaneously dislocated in 4 and traumatically dislocated in 10 of all 14 eyes. Combined ocular conditions were 10 eyes of cataract, 5 of vitreous hemorrhage, 5 of increased intraocular pressure (IOP) and 2 of iridodialysis. All 14 eyes had undergone pars plana vitrectomy, intravitreal removal of the crystalline lens and scleral fixation of the intraocular lens whereas 3 had undergone trabeculectomy, 2 retinal cryopexy and injection of sulfur hexafluoride intraocular gas, and 1 iridoplasty. The lens was aspirated only with vitrectomy cutter in 1 eye; phacofragmentor was used in 13 eyes and perfluorocarbone liquid was injected in 5 eyes. Mean follow-up time was 7.42 months. On the last follow-up, visual acuity was 0.5 or better in 11 eyes and counting fingers in 1 eye with optic nerve atrophy. Retinal detachment was never found, and increased IOP sustained in 1 eye. The result suggests intravitreal removal of the crystalline lens combined with pars plana vitrectomy seems effective and safe.
Atrophy ; Cataract ; Crystallins* ; Fingers ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lens Subluxation ; Lens, Crystalline* ; Lenses, Intraocular ; Optic Nerve ; Retinal Detachment ; Retinaldehyde ; Sulfur Hexafluoride ; Trabeculectomy ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

This study was undertaken to evaluate the relationship between eye positions in the awake state and in the surgical plane of anesthesia induced with anesthetics and muscle relaxants in 167 non-paralytic horizontal strabismus patients. All 27 patients with esotropia demonstrated divergence under general anesthesia when compared with their pre-anesthetized state. In 140 patients with exotropia, 107 patients(76.4%) demonstrated convergence under general anesthesia, 6 patients(4.3%) demonstrated divergence, 27 patients demonstrated no change of the eye position. A statistically significant relationship was found between the preanesthetized position of the eyes(P) and the eye position under general anesthesia(A). The relationship is linear and can be written as the approximate regression fomula: A=0.44P+6.34, R=0.73(p<0.01). When surgical success was defined as an eso- or exodeviation within 10 delta of orthotropia at postoperative 12 weeks, final success rate revealed statistically significant difference between the following two groups of exotropic patients(p<0.05). The patients whose amount of vergence were under 15 delta had a success rate of 96.6%, while those over 16 delta had a success rate of 86.3%. In esotropia, surgical success was not satisfactory in patients whose amount of deviation were over 41 delta. These results suggest the significant relationship between eye positions in the awake state and those under general anesthesia, which could be clinically applied in deciding the surgical amount and predkting the success of strabismus surgery.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Esotropia ; Exotropia ; Humans ; Strabismus

We retrospectively evaulated the frequency and risk factors of glaucoma after penetrating keratoplasty by reviewing charts of 96 patients(112eyes) who received the penetrating keratoplasty from May 1992 to Novermber 1995 at Chonnam Universty Hospital. Intraocular pressure was increased over 21mmHg in 18 eyes after surgery. Underlying disease of them were graft failure (5 eyes), bullous keratoplasty(5 eyes), corneal ulcer(5 eyes), trauma(3 eyes). Ten eyes(55.5%) were glaucomatous preoperatively. Eight eyes(44.4%) were phakic, 7 eyes(38.9%) aphakic, and 3 eyes(16.7%) pseudophakic. Ten eyes(55.5%) underwent only penetrating keratoplasty, 4 eyes(22.2%) vitrectomy at the time of penetrating keratoplasty, and 4 eyes(22.2%) combined cataract extraction. The eyes with previous history of glaucoma(19 eyes) had higher incidence of increased intraouclar pressure than those 93 eyes with no glaucoma history(P<0.0001). Aphakic eyes(21 eyes) had higher incidence of glaucoma than phakic eyes(80 eyes)(p<0.05).
Cataract Extraction ; Glaucoma* ; Incidence ; Intraocular Pressure ; Jeollanam-do ; Keratoplasty, Penetrating* ; Retrospective Studies ; Risk Factors ; Transplants ; Vitrectomy

Neuromyelitis optica(NMO) or Devic's syndrome is an uncommon clinical syndrome associating with unilateral or bilateral optic neuritis and transverse myelitis. It is rarely found in children and usually reported in adults with serious neurologic manifestations. We report a case of an 8-year-old girl with neuromyelitis optica whose first clinical manifestation was acute visual loss of both eyes. Initially the patient had been diagnosed with central retinal artery occlusion and optic neuritis by ophthalmologic examination, a brain magnetic resonance imaging, and cerebrospinal fluid findings. She was treated with intravenous methylprednisolone pulse therapy and heparinization. Then the treatments were replaced with oral prednisolone and warfarin. At the fifteenth day after the start of oral prednisolone tapering, she visited our emergency room for voiding difficulty and paresthesia on both legs. A spinal magnetic resonance imaging revealed increased signal intensity in T2-weighted images from cervical to lumbar level, and neuromyelitis optica- IgG(NMO-IgG) was detected in the patient's serum. After we diagnosed her as having neuromyelitis optica, intravenous methylprednisolone and nine courses of daily plasmapheresis were tried. However, the patient still had visual loss, pain, and sensory loss below the sixth thoracic dermatome, and we tried maintenance therapy with intravenous rituximab. We report our case with reviews of the related literatures.
Adult ; Antibodies, Monoclonal, Murine-Derived ; Brain ; Child ; Emergencies ; Eye ; Heparin ; Humans ; Leg ; Magnetic Resonance Imaging ; Methylprednisolone ; Myelitis, Transverse ; Neurologic Manifestations ; Neuromyelitis Optica ; Optic Neuritis ; Paresthesia ; Plasmapheresis ; Prednisolone ; Retinal Artery ; Retinal Artery Occlusion ; Warfarin ; Rituximab

BACKGROUND: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. MATERIAL AND METHOD: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. RESULT: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. CONCLUSION: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.
Aorta ; Aortic Valve ; Arrhythmias, Cardiac ; Cardiopulmonary Bypass ; Catheterization ; Chest Tubes ; Coronary Disease ; Drainage ; Female ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hematoma ; Humans ; Intensive Care Units ; Intracranial Embolism ; Male ; Mammary Arteries ; Mitral Valve ; Mortality ; Myxoma ; Postoperative Complications ; Reoperation ; Respiration, Artificial ; Rupture ; Sternotomy ; Sternum ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery* ; Transplants ; Wounds and Injuries ; Wounds, Stab