The Associations of Conjunctival Vasculature and Serum Hemoglobin in the Moderate Anemia

PURPOSE: This study was conducted to determine the correlation of anemia and conjunctival vasculature on slit lamp biomicroscopy. METHODS: Through random sampling, 118 subjects who were either inpatients or outpatients in the hematology department were selected for examination. Palpebral conjunctival hue (PCH) and bulbar conjunctival blood column (BCBC) were observed by a single physician to whom the diagnosis and hemoglobin level of the patient were strictly masked. Three different threshold levels were defined for anemia : <10 mg/dl, <11 mg/dl, and <12 mg/dl. RESULTS: Mean hemoglobin concentration was 10.39+/-2.9 mg/dl. Sensitivity of the BCBC and PCH for anemia was 86% and 41%, respectively. Specificity of BCBC improved with increasing hemoglobin threshold level for anemia. BCBC was significantly associated only with anemia of hemoglobin <12 mg/dl (p<0.02). PCH was significantly associated only with anemia of <11 mg/dl (p<0.05). BCBC showed a significant association with anemia: sensitivity was higher and specificity was slightly less than PCH. CONCLUSIONS: It was not easy to detect moderate anemia solely on slit lamp biomicroscopic findings unless hemoglobin concentration was given. In conclusion, BCBC was useful in detecting moderate anemia than PCH.

Surgical Results of Inferior Tarsotomy for Diffuse Lower Lid Trichiasis

PURPOSE: To evaluate the functional and cosmetic results of trichiasis treatment between the argon laser epilation(Group A) and tarsotomy(Group B). METHODS: Twenty-seven patients with diffuse lower lid trichiasis, whose post-treatment follow-up periods were longer than 3 months, were reviewed retrospectively. Functionally, 14 of 16 patients(89.6%) in group A were satisfied, whereas 9 of 11 patients(84.0%) were in group B. And cosmetically, 10 of 16 patients(62.9%) in group A were satisfied, whereas 8 of 11 patients(79.0%) were in group B. The functional results were similar between the two groups(p>0.05), but the cosmetic results were better in group B than in group A(p<0.05) CONCLUSIONS: The inferior tarsotomy appears to be an effective surgical procedure in patients with diffuse lower lid trichiasis.

Wernicke's Syndrome Induced by Hyperemesis Gravidarum

PURPOSE: Wernicke's syndrome, which is characterized by nystagmus, abducent and conjugate gaze palsies, ataxia, mental confusion, and amnesia, is caused by a deficiency in levels of thiamine and is observed mainly in persons who abuse alcohol. Recognized predisposing conditions other than alcoholism include chronic dietary deprivation(imbalanced diet, prolonged intravenous feeding.) and impaired absorption or intake of dietary nutrients. METHODS: We have experienced a 31-year-old female presented 15 weeks into pregnancy who complained of icteric skin color, diplopia, and gait disturbance after prolonged vomiting for 2 months. Neurologic examination demonstrated obtunded sensations, nystagmus and ataxia of gait. EEG showed a mild degree of slowly diffuse activity. The neurological signs pointed to a diagnosis of Wernicke's encephalopathy. RESULTS: We report a case of Wernicke's syndrome induced by hyperemesis gravidarum with the review of literature.

Atypical Congenital Hypertrophy of the Retinal Pigment Epithelium in Gardner's Syndrome

Congenital hypertrophy of the retinal pigment epithelium (CHRPE)is a well circumscribed, flat, pigmented fundus lesion that have a variety of shapes. It is the most common extracolonic manifestation of Gardner's syndrome. The number and shape of CHRPE should arouse suspicion of increased risk of polyposis.We experienced one case of Gardner's syndrome in a family history of colonic carcinoma that showed atypical congenital hypertrophy of the retinal pigment epithelium, osteoma, epidermal cyst and polyposis combined with colonic carcinoma.A total colectomy and ileostomy were performed.So we reported it with the review of literature of clinical value of CHRPE as a predictive marker of Gardner's syndrome.