Ocular Findings in Children with Cortical Visual Impairment

The epidemiology of children with cortical visual impairment(CVI)has been poorly defined till now, so the purposes of this study were to define the visual prognosis and prevalence of ophthalmologic problems in Korean children. The 20 children with follow-up of over 3 months were included out of 24 children diagnosed with CVI. The causes of CVI were periventricular leukomalacia in 7, congenital malformation in 4, and cerebral infarct or atrophy. Twelve of 19 children who had visual impairment at their initial visit showed visual improvement with follow-up. There were strabismus in 14, nystagmus in 6, and abnormal optic disc in 8 of the 20 children. All visualevoked response results were abnormal, but were not providing a more reliable prognosis in vision. The children who had abnormal electroencephalogram had poor visual prognosis as well as delayed developmental level. In conclusion, this study identified that children with CVI may be presented with a variety of ocular abnormalities, including strabismus, nystagmus, and abnormal optic disc. These findings suggest that a better understanding of the natural course will be required in children with CVI.

A Case of a Solid and Papillary Epithelial Neoplasm of the Pancreas with Local Invasion into the Duodenum / 대한소화기내시경학회지

A solid and papillary epithelial neoplasm of the pancreas is a very rare and low-grade type of malignancy, although an increasing number of cases have been reported in recent years. Patients with a solid and papillary epithelial neoplasm of the pancreas have a good prognosis and may be cured if the disease is diagnosed before metastasis and diffuse local invasion. A 23-year-old female who had a 4-year history of recurrent abdominal pain, was admitted due to lower abdominal pain. Incidentally a calcified, 6 4 cm sized ovoid mass was found in the right upper quadrant, from a simple abdominal X-ray. An ERCP, abdominal sonography, and CT were performed, as well as a pylorus preserving pancreatoduodenectomy. Gross pathologic examination revealed a well encapsulated mass with cystic degeneration and hemorrhagic necrosis. Microscopically, the tumor had papillary fronds with a fibrovascular connective tissue core. There was focal infiltration of tumor cells into the duodenal wall and heterotropic pancreatic tissue in the submucosa. Immunohistochemistry revealed positivity for neuron-specific enolase. The patient maintained a healthy status for one year since the operation.

A Clinical Analysis of an Esophageal Hiatal Hernia and Reflux Esophagitis - The relationship with weight, alcohol, smoking, coffee, H. pylori infection / 대한소화기내시경학회지

BACKGROUND AND AIMS: The importance of esophageal hiatal hernias in the pathogenesis of gastroesophageal reflux disease has been debated. It has been reported that a variety of factors are associated with hiatal hernias and esophagitis. The purpose of this study was to determine the correlation between hiatal hernia, reflux esophagitis and weight, alcohol, smoking, coffee and H. pylori infection. METHODS: 660 consecutive patients who had undergone an esophagogastroduodenoscopy due to upper gastrointestinal symptoms were reviewed. A diagnosis of hital hernia was made when the distance between the diaphragmatic crus and the tubular esophagus exceeded 1.5 cm, and the presence of a hernia sac at the U turn of the scope. RESULTS: Among the 660 cases, 71 cases (10.8%) of hiatal hernia and 30 cases (4.5%) of reflux esophagitis were noted. The male-to-female ratio was 1.6:1 and 4.3:1, respectively. The most common age group involved the fifth decade and sixth decade. Reflux esophagitis was found in 13 (18.3%) of 71 patients with hiatal hernias. Hiatal hernias were found in 36 (17.9%) of 201 patients who were overweight (BMI>23) and in 43 (23%) of 187 patients who were smokers. Reflux esophagitis was found in 23 (11.9%) of 194 patients who were alcohol drinkers and in 21 (11.2%) of 187 patients who were smokers. H. pylori infection was present in 36 (50.7%) of 71 patients with hiatal hernias, and 17 (56.2%) of 30 patients with reflux esophagitis. CONCLUSIONS: The rate of the hiatal hernia was significantly higher in patients who were overweight and smokers. The rate of reflux esophagitis was significantly higher in patients who were alcohol drinkers and smokers. But in multivariate analysis, none were risk factors associated with hiatal hernias or reflux esophagitis.