No abstract available.
Asthma*

Retinal vein occlusion(RVO)is the second most common form of retinal vascular disease next to diabetic retinopathy. Systemic risk factors such as hypertension, diabetes, cardiovascular disease, blood dyscrasia and ocular risk factors such as short axial length, glaucoma, papilledema, thyroid ophthalmopathy have been shown to be associated with RVO. It is usually unilateral disease, and bilateral occurrene of RVO is relatively uncommon. CRVO rarely occurs bilaterally with a short interval between two eyes. Having experienced a case of bilateral CRVO within one month in a 75-year-old female with short axial length, primary open angle glaucoma, hypertension and hypercholesterolemia, we report this case with literature review.
Aged ; Cardiovascular Diseases ; Diabetic Retinopathy ; Female ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hypercholesterolemia ; Hypertension ; Papilledema ; Retinal Vein* ; Retinaldehyde ; Risk Factors ; Thyroid Gland ; Vascular Diseases

Fungal infection of the central nervous system tends to occur mostly in immunosuppressed patients. In the pediatric population, it is usually seen in severely immunocompromised patients, particulary in children with chronic granulomatous disease and hematopoietic malignancies. Although aspergillosis is considered one of the most frequent agents of mycotic infection of the brain, it is especially rare in the neonatal period, and overwhelming multisystem infection is usually diagnosed postmortem. Manifestations include meningitis, meningoencephalitis, granulomata formation, brain abscess, vasculitis, aneurysm formation, infarct and intracranial hemorrhage. We present a neonate who had brain abscess diagnosed by MRI, and aspergillus was found at surgical exploration. There are very few reported survivors of neonatal aspergillosis. We reported a case of primary multiple brain abscess caused by aspergillus associated with severe hypernatremic dehydration and prerenal azotemia. The patient was treated with amphotericin B combined with flucytosine and itraconazole.
Abscess* ; Amphotericin B* ; Aneurysm ; Aspergillosis ; Aspergillus ; Azotemia ; Brain ; Brain Abscess ; Central Nervous System ; Child ; Dehydration ; Flucytosine* ; Granulomatous Disease, Chronic ; Hematologic Neoplasms ; Humans ; Immunocompromised Host ; Infant, Newborn ; Intracranial Hemorrhages ; Itraconazole* ; Magnetic Resonance Imaging ; Meningitis ; Meningoencephalitis ; Survivors ; Vasculitis

Atlantoaxial joint is a complex and unique structure which promotes rotation of head. Disruption of the transverse ligament and odontoid process fracture caused by trauma result in atlantoaxial instability. The instability must be corrected to relieve pain and to reduce the risk of neural damage and possibility of sudden death. The most recent and technologically advanced fixation method of C1-2 instability is the use of C1-2 transarticular screw fixation. The transarticular screw fixation augmented with interspinous wiring technique provide immediate multidirectional rigid fixation and increase the fusion rate of atlantoaxial instability. It can be employed in situations where the posterior arch of C1 is absent or fractured and in situations where standard wiring techniques pose risky posterior subluxation of C1 on C2, or for congenital odontoid anomalies. Twenty-one patients with atlantoaxial instability were operated with posterior transarticular screw fixations augmented with interspinous C1-2 strut graft and posterior wire fixation technique. All patients restored C1-2 stability without complication. This technique seems to be superior biomechanically when compared with other posterior fixation methods. Precaution is needed to avoid the vertebral artery injury.
Atlanto-Axial Joint ; Death, Sudden ; Head ; Humans ; Ligaments ; Odontoid Process ; Transplants ; Vertebral Artery

The unilateral megalencephaly is a rare brain malformation characterized by cerebral asymmetry and cortical dysplasia caused by faulty migration of the subependymal neuroblasts. We experienced a case of unilateral megalencephaly in a two day-old male with the chief complaint of asymmetric head appearance. Large left hemisphere with agyria, pachygyria, dilatation of lateral ventricle, and the thick cortex of the ipsilateral hemisphere were showed in brain MRL, Clinical findings in this case were intractable seizure, hemiparesis, and psychomotor retardation. A review of literatures was also presented briefly.
Brain ; Dilatation ; Head ; Humans ; Lateral Ventricles ; Lissencephaly ; Male ; Malformations of Cortical Development ; Paresis ; Seizures

A patient was admitted for catheter ablation of atrial fibrillation. Cardiac computed tomography and transesophageal echocardiography revealed the absence of the left atrial appendage. However, the right atrial appendage looked normal and the level of pro B-natriuretic peptide was within normal limits. Successful catheter ablation was performed without any procedural complications and the sinus rhythm was appropriately maintained for 10 months with an antiarrhythmic drug.
Atrial Appendage* ; Atrial Fibrillation ; Catheter Ablation ; Echocardiography, Transesophageal ; Humans

PURPOSE: To report a case of Klebsiella pneumoniae endogenous endophthalmitis secondary to renal or urinary tract infection such as emphysematous pyelonephritis. METHODS: A-56-year-old woman with diabetes mellitus and emphysematous pyelonephritis was reterred to us in consultation for visual loss in her right eye for 5 days. Ophthalmologic evaluation and intervention were performed. RESULTS: Culture revealed Klebsiella pneumoniae from vitreous tap of the right eye. Systemic antibiotics, intravitreous antibiotics injection and vitrectomy were performed, but the eye showed progressive worsening to phthisis. CONCLUSIONS: A high index of suspicion of Klebsiella pneumoniae endogenous endophthalmitis must be carried in patients with renal or urinary tract infection such as emphysematous pyelonephritis as well as hepatobiliary disease such as pyogenic liver abscess.
Anti-Bacterial Agents ; Diabetes Mellitus ; Endophthalmitis* ; Female ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess, Pyogenic ; Pyelonephritis* ; Urinary Tract Infections ; Vitrectomy

Thymic size can be affected by both exogenous and endogenous glucocorticoids. Development of the respiratory distress syndrom (RDS) is influenced by adernal cortical function. thus, thymic size in RDS is considered to been larged due to decreased adrenal cortical function. To find whether the presence of RDS correlates with thethymus, the size and shape of the thymus were evaluated in the radiographs of premature infants with RDS, without RDS(control prematurity) and normal infants. The subjects were consisted of chest films of Korean premature infants, 120 with RDS, 60 without RDS, and 60 of normal infants taken at the Departement of Radiology, Our Lady of Mercy Hospital during the period of 62 months since January 1978. Relative size of the thymus was determined bycardiothymic/thoracic ratio(CT/T ratio). Grading and locaiton of the thymic prominence as well as incidence of the shape were examined. And all the relations among the radiographs of RDS, control prematurity and normal infants were analyzed. The results were as follows; 1. The CT/T ratio of premature infants with RDS was significantly greater than that of control prematurity and normal infants (P<0.01). 2. The incidence of bilateral thymicprominence was more frequent in premature infants with RDS than in control prematurity and normal infants(P<0.05).3. The frequency of thymic prominence was greater in the right than left side in all the three groups (P<0.05). 4.As in the shape of the thymus, a rounded type was most frequent, and a triangular type was least frequent in allthe three groups. 5. Incedence of RDS was very low(9.8%) when the CT/T ratio is below 0.3 and it was very high(90.9%) when the CT/T ratio is above 0.49.
Glucocorticoids ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Thorax ; Thymus Gland

Marfan syndrome is an inheritable connective tissue with protean clinical manifestations involving the ocular, skeletal and cardiovascular system. It is well estabalished that a clinical hall marker and the major cause of morbidity in Marfan syndrome is aortic root dilatation and associated aortic dissection which begins just above the coronary ostia in ascending aorta. We report a rare case of Marfan syndrome with aortic dissection which began just below left subclavian artery in descending aorta. A 20-years old woman was admitted to Soonchunhyang hospital because of sudden onset of back pain. On phsical examination, she had characteristic Marfanoid feature. Chest X-ray and Echocardiography showed cardiomegaly and severe dilatation of ascending aorta. Chest CT and aortography showed severe aneurysm of ascending aorta and aortic dissection of descending aorta with intimal flap. she was treated with medical treatment because of poor general condition.
Aneurysm ; Aorta ; Aorta, Abdominal* ; Aorta, Thoracic ; Aortic Aneurysm* ; Aortography ; Back Pain ; Cardiomegaly ; Cardiovascular System ; Connective Tissue ; Dilatation ; Echocardiography ; Female ; Humans ; Marfan Syndrome* ; Subclavian Artery ; Thorax ; Tomography, X-Ray Computed ; Young Adult

Marfan syndrome is an inheritable connective tissue with protean clinical manifestations involving the ocular, skeletal and cardiovascular system. It is well estabalished that a clinical hall marker and the major cause of morbidity in Marfan syndrome is aortic root dilatation and associated aortic dissection which begins just above the coronary ostia in ascending aorta. We report a rare case of Marfan syndrome with aortic dissection which began just below left subclavian artery in descending aorta. A 20-years old woman was admitted to Soonchunhyang hospital because of sudden onset of back pain. On phsical examination, she had characteristic Marfanoid feature. Chest X-ray and Echocardiography showed cardiomegaly and severe dilatation of ascending aorta. Chest CT and aortography showed severe aneurysm of ascending aorta and aortic dissection of descending aorta with intimal flap. she was treated with medical treatment because of poor general condition.
Aneurysm ; Aorta ; Aorta, Abdominal* ; Aorta, Thoracic ; Aortic Aneurysm* ; Aortography ; Back Pain ; Cardiomegaly ; Cardiovascular System ; Connective Tissue ; Dilatation ; Echocardiography ; Female ; Humans ; Marfan Syndrome* ; Subclavian Artery ; Thorax ; Tomography, X-Ray Computed ; Young Adult