Long-Term Results of Reconstruction of Orbital Wall Fracture With Resorbable Copolymer Mesh

PURPOSE: This study examined the postoperative long-term results of the reconstruction of orbital wall fracture using Macropore(R). METHODS: The long-term results for 10 patients who were diagnosed with orbital wall fracture and received the repair of orbital wall fracture using Macropore(R), were examined postoperatively after an average of 23.5 months. RESULTS: The mean difference in orbital volume between the fractured orbit and the unaffected orbit after an average of 23.5 months postoperatively was 1.01+/-0.70 cm3 (4.75+/-2.92%), which slightly increased compared to 0.70+/-0.52 cm3 (3.26+/-2.10%) immediately after the operation, although the difference was not statistically significant (p-value=0.190). At the last follow-up, the shape of Macropore(R) was not observed in 3 out of the 10 patients, and intense ossification was observed at the site of fracture in 6 patients. At the last follow-up, one patient showed 1.5 mm enophthalmos, and the other patients did not show the occurrence of diplopia or the progress of enophthalmos. CONCLUSIONS: According to the long-term results of the reconstruction of orbital wall fracture, Macropore(R) is considered an implant that produces a safe and satisfactory effect without notable complications.

Acellular Dermal Allograft Transplantation in Patients with Scleromalacia After Pterygium Excision

PURPOSE: To report two cases of successful acellular dermal allograft transplantation for scleromalacia following pterygium excision. CASE SUMMARY: A 72-year-old female patient developed scleromalacia on the nasal side of the right eye, and a 79-year-old female patient developed scleromalacia with inflammation on the nasal side of the left eye. They had previous histories of pterigia removal on the sites of scleromalacia. Acellular dermal allograft (AlloDerm(R), Lifecell, NJ, USA) transplantations were done. After the operations, inflammation and pain ameliorated and the grafts survived without any particular complications. CONCLUSIONS: In treating scleromalacia, the transplantation of acellular dermal allografts produced relatively satisfactory results without undesirable problems commonly encountered when using conventional materials.

Growth Patterns of Breast Fed and Formula Fed Infants / 소아과

PURPOSE: The purpose of this study is to compare the growth pattern of breast fed and formula fed infants in the first 1 year of life. METHODS: Anthropometric data (weight, length, head circumference) of at birth, 1, 3, 6, 9 and 12 months were collected by chart review and characteristics of subjects were collected by questionnaires. Among 358 infants, breast fed infants were 161 (84 males, 77 females) and formula fed infants were 90 (42 males, 48 females). Neither group was given solid foods before 4 months. The weight for age, length for age and head circumference for age were calculated. Breast fed infants were separated into 2 groups (breast fed for 4-11 months and breast fed for more than 12 months). RESULTS: Characteristics of infants and mothers were similar in both groups except for maternal age. Mean weight of breast fed group was lower than that of formula fed group at 12 months of age (male: P=0.004, female: P=0.004). However, mean weight of 12 months breast fed group was below formula fed groups weight at 9 and 12 months (P< 0.05). Mean length and head circumference were similar between groups. CONCLUSION: The growth indices of breast fed and formula fed infants are similar at birth, but weight curves of two groups differ in the first 1 year.

Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies / 대한소아소화기영양학회지

PURPOSE: To evaluate the safety, efficacy and technical problems of the endoscopic balloon dilatation of esophageal anomalies in children. METHODS: The medical records of 8 children treated by endoscopic balloon dilatation for esophageal anomalies over a 10-year period at Pusan National University Hospital were reviewed retrospectively. The balloon catheter (Maxforce TTS or CRE, Boston Scientific Co., USA) was positioned across the area of narrowing by direct visualization. The balloon was slowly inflated with normal saline to specified pressures for each balloon and maintained for 60 seconds and then deflated. After 60 seconds pause, the procedure was repeated with a larger sized balloon (increments of 1 mm for each subsequent dilation) till effective dilatation was confirmed by direct visualization without complications. RESULTS: Three male and five female were included and their mean age was 4.2 years. A total of 27 (average of 3.2 per patient) dilatation were performed. Underlying diseases of patients are postoperative stricture of esophageal atresia in 3 cases, esophageal ring in 2 cases, achalasia, corrosive esophagitis and hypertensive LES in one case respectively. The size of initial dilating balloon was chosen on the basis of the diameter of the narrowing determined by endoscopy. The first dilation in patients with severe esophageal stricture was made with a 6 mm sized balloon. Complications observed were esophageal perforation and respiratory holding during the procedure in one case respectively. Successful outcome was seen in 6 patients (75%). CONCLUSION: Endoscopic balloon dilatation can provide a safe and effective mean of treating esophageal anomalies in children and should be considered the treatment of choice in the initial management of those cases.

Isolated 3-Methylcrotonyl CoA Carboxylase Deficiency Detected by Newborn Screening Program Using Tandem Mass Spectrometry / 소아과

Isolated deficiency of 3-methylcrotonyl CoA carboxylase is a rare disorder of the catabolic pathway for leucine and many patients have mild symptoms or no symptom. However, the introduction of tandem mass spectrometry in newborn screening has revealed an unexpectedly high incidence of this disorder. We report an asymptomatic premature infant with isolated 3-methylcrotonyl CoA carboxylase deficiency detected by newborn screening program using tandem mass spectrometry. She was born at preterm, 36 weeks of gestation and her birth weight was 1,912 gm. She was delivered by Cesarian section due to maternal preeclampsia and oligohydramnios. An elevation of 3-hydroxyisovalerylcarnitine in a blood sample obtained at Seven days was detected by tandem mass screening. Massively elevated excretion of 3-hydroxyisovalerate and 3-methylcrotonylglycine was detected in the urine collected at 15 days. L-carnitine(100 mg/kg/day) was administrated orally to correct sencondary carnitine deficiency. Carnitine is conjugated with metabolites, to decrease the potential toxic effects. She is asymptomatic to date, and her growth and development are within normal limits.

Autogenous Temporalis Fascia Grafting and Conjunctival Flap Transposition in Scleromalacia after Pterygium Excision

PURPOSE: To evaluate the result and complications of autogenous temporalis fascia grafting and conjunctival flap transposition as a treatment of scleromalacia after pterygium excision. METHODS: We used autogenous temporalis fascia and conjunctival flap to treat scleromalacia of 9 patients(9 eyes) who underwent pterygium excision and checked the postoperative result and complications. RESULTS: We could keep the temporalis fascia graft without necrosis during follow-up examination. Pain, inflammation and scleral discoloration were disappeared after temporalis fascia grafting in all cases. Postoperative complications were included 2 cases of progression of cataract and 1 case of mild chamber inflammation. CONCLUSIONS: We obtained good surgical result of scleromalacia after pterygium excision by autogenous temporalis fascia grafting with conjunctival flap transposition.

Silicone Intubation for Treatment of Punctal Stenosis

PURPOSE: To evaluate the surgical results and complications of silicone intubation in patients with epiphora by punctal stenosis. METHODS: We reviewed the records of 35 eyes of 23 patients who had undergone silicone intubation from 1998 to 2002 and followed more than 1 year postoperatively. RESULTS: Following 1 year postoperatively, 33 eyes (94.3%) showed no epiphora, 2 eyes (5.7%) showed intermittent epiphora. Complications after silicone intubation included prolapse of tube in 3 eyes, punctal slitting in 1 eye, itching in 6 eyes, foreign body sensation in 2 eyes, discharge from punctum in 3 eyes and intranasal discomfort in 1 eye. CONCLUSIONS: Silicone intubation seemed to be an alternative method in patient with epiphora due to punctal stenosis and also a useful method to treat upper and lower punctum.