Intravitreal Tissue Plasminogen Activator and Gas Injection in Submacular Hemorrhage

Tissue plasminogen activator(tPA) has been used as useful adjunct in the submacular hemorrhage due to age-related macular degeneration, which was injected and able to dissolve clotted blood. It was also known that intravitreal injection of tPA was effective as much as subretinal injection for lysis of blood. Recently, the rationale was introduced that residual dissolved subretinal blood with tPA was displaced from fovea away by intravitreal injection of an expanding gas. We have experienced the improvement of vision in an 83-year old woman with submacular hemorrhage, treated with intravitreal tPA and gas injection.

Spontaneous Resolution of Sub-Retinal Pigment Epithelial Hemorrhage

Sub-retinal pigment epithelial hemorrhage, located between sub-retinal pigment epithelial space and Bruchs membrane, develops from various etiology and usually is associated with subretinal hemorrhage. When sub retinal pigment epithelial hemorrhage occurs with choroidal neovascularization(CNV) within macular area, it generally has a poor visual prognosis. We report the case of a 54-years old man who initially had large sub-retinal pigment epithelial hemorrhage with presumed CNV. Without treatmetn, visual improvement with spontaneous resolution of hemorrhage occured.

Comparison of The Efficacy of the Fiberoptic Phototherapy and Conventional Phototherapy for Neonatal Hyperbilirubinemia

PURPOSE: We performed this study in order to compare the feasibility and efficacy of the fiberoptic phototherapy with conventional phototherapy and double phototherapy with single phototherapy for the treatment of neonatal hyperbilirubinemia while watching for any possible side effects of the system. METHODS: During the period of February 1994 till June 1995, randomized controlled study was performed. 130 healthy term infants with non-hemolytic hyperbilirubinemia were enrolled, 45 patients received fiberoptic phototherapy, 40 patients received conventional phototherapy and 45 patients received double phototherapy. Criteria for inclusion in the study were 1) after 37 weeks of gestation 2) negative result of a direct coombs test 3) normal hemoglobin and hematocrit 4) no Rh or ABO incompatibility 5) plasma total bilirubin concentration exceed 10mg/dl during the first 3 days of life. RESULTS: 1) The mean total bilirubin decline level after 24 hours was 0.03 2.03mg/dl and the mean indirect bilirubin decline level after 24 hours was 0.12+/-1.35mg/dl in conventional phototherapy group(p0.01). 2) The mean total bilirubin decline level after 48 hours was 1.25 2.71mg/dl and the mean indirect bilirubin decline level was 1.17+/-1.52mg/dl in conventional phototherapy group (p0.01). 3) The mean decline levels of 24 hours-total and indirect bilirubin were 0.01+/-1.23mg/dl and 0.09+/-1.13mg/dl, and the mean decline levels of 48hours-total and indirect bilirubin were 0.92+/-1.85mg/dl and 0.99+/-1.08mg/dl (p0.01) or diarrhea(p>0.01) among three groups. CONCLUSIONS: We conclude that fiberoptic phototherapy has less efficacy comparable to that of conventional phototherapy and double phototherapy has no significant differences in effectiveness compared with conventional phototherapy. So we hope further studies on the effects of the fiberoptic phototherapy in preterm infants and in after 48 hours will be done.

Availability of IgE MAST for Diagnosis of Asthmatic Children

PURPOSE: The Skin prick test is simple and cheap in diagnosis of allergic diseases. So the skin prick test has been widely used as the initial diagnostic method of IgE-mediated allergic diseases with the merit of fast detection of causative allergens. But the skin test has some difficulties in application for the infants and young children. IgE MAST(multiple antigen simultaneous test) and IgE RAST(radioallergosorbent test) are representative in vitro diagnostic tests in allergic diseases. IgE MAST has several merits, such as cheap price, simultaneous detection of many allergens, and needlessness of gamma counter, but it has been known to have less sensitivity and specificity. We performed this study to know the differences between the availability of IgE MAST and that of IgE RAST in allergic patients who were diagnosed by clinical findings and skin prick test. METHODS: We have studied 35 asthmatic children (over 3 years of age) who visited allergy clinic from September 1993 to May 1995. All of them were positive in skin prick test on one more allergens among 6 allergens(D.p, D.f, house dust, dog, egg, ragweed). IgE MAST and IgE RAST were evaluated simultaneously. RESULTS: The results were as follows 1) Sensitivity of RAST was 87.1% in D.p, 87.1% in D.f, 68% in house dust and the specificity of RAST was 94.1%, 97.1% and 87.5% respectively. 2) Sensitivity of MAST was 90.3% in D.p, 93.5% in D.f, 80% in house dust and the specificity of MAST was 94.1%, 94.1% and 85% respectively. 3) Total sensitivity of RAST was 70.5% and that of MAST was 73.2%, but there were no significant differences between them(p>0.05). 4) Total specificity of RAST was 91.4% and that of MAST was 89.9%, but there were no significant differences between them(p>0.05). 5) The stronger positive skin reaction, the higher sensitivity and specificity of the two in vitro tests. CONCLUSIONS: There was no significant differences between the two in vitro tests for the diagnosis of asthmatic children, and the both test results correlated well. IgE MAST system is easier, faster and has more cost benefit than IgE RAST. So we conclude that the MAST system is available as a screening test in the diagnosis of allergic diseases.

A Case of Combined Congenital Deficiency of Factor V and Factor VIII

Hemorrhagic disease of newborn by combined blood clotting factor deficiencies is very rare. Combined deficiency of factor V and factor VIII is the most common form among these cases, and inherited by autosomal recessive trait. Clinical findings are easy bruising, post-traumatic bleeding and bleeding after tooth extractions, and the main laboratory findings are prolonged partial thromboplastin time (PTT) and prothrombin time (PT) that are different from hemophilia A only with prolonged PTT. We experienced a case of combined congenital deficiency of factor V and factor VIII in a 1-day-old boy. We report the case with brief review of literature.

Visual Outcome in Bilateral Hyperopic Amblyopia

We reviewed records of 50 bilateral hyperopic amblyoic patients who visited ophthalmologic clinic at Yeungnam University Hospital between December 1984 and October 1993, and investigated the effect of age at initial correction, magnitude of hyperopia and duration of correction on corrected visual acuity with the lapse of time. Criteria for selection included the followings; hyperopia of 3.50 diopters or more, astigmatism of 2.50 diopters or less, and anisoametropia of 1.25 diopters or less. Full cycloplegic corrections were prescribed at the initial visit to all subjects. The distribution of initial corrected visual acuity was 0.1 to 0.5. Age at initial correction varied from 2 years to 8 years(mean 3.98 years). The magnitude of hyperopia appeared to have the greatest influence on the visual outcome at initial correction. Duration of correction also influenced on the visual outcome, showing continuous visual improvement during 4 years after initial correction. The age at initial correction did not appear to influence on the initial and final corrected visual acuity. A comparision between initial and final corrected visual acuity showed a sigificant difference, irrespective of age at the intial correction or magnitude of hyperopia.

Etetinate Induced Cardiovascular Malformations in Mouse Embryo

No abstract available.

Analysis of Radiologic Findings in Children with Urinary Tract Infection

No abstract available.

Two Cases of Conjoined Twins

No abstract available.

Fiberoptics Assisted Lacrimal Surgery

The endonasal laser lacrimal surgery has provided many advantages. However, the success rate of the primary endonasal DCR has been lower than the established 90% or greater success rate of conventional DCR. Endonasal fiberoptics-assisted lacrimal surgeries(108 DCR and 149 CDCR) were performed with conventional lacrimal surgical instruments and endoscope. The thick bone of the anterior lacrimal crest and half segment of the lacrimal sac were removed with Kerrison punch, and silicone tube intubation was performed. After 8 to 33 months(average 15.6 months) of follow up, intranasal mucosal ostium measured 1.85 mm in diameter. Of the 108 eyes with primary endonasal DCR, the ostium of 86 eyes(79.6%) remained patent. After revision of the failed DCR, the success rate was 96.3%(104 eyes). Of the 61 eyes with primary endonasal DCR which were performed during recent 8 to 20 months, 54 eyes(88.5%) were satisfactory. Of the 149 eyes with CDCR, Jones tubes in 141 eyes(94.6%) functioned well.

A case of 7q-syndrome

No abstract available.

A case of Addison's disease

No abstract available.

Trapezial Osteosynthetic Plate Fixation Technique for Anterior Interbody Fusion in Cervical Spin Injury

Cases of cervial spine injury are increasing recently dure to traffic and injustrial accidents. Currently surgical approach is preferred in stabilizing cervical spin injuries which enables early mobilization, easy nursing care and early rehabilitation. The authors have experienced 23 cases of fracture-dislocation of cervical spine since May, 1987. All patients were treated with anterior interbody fusion using trapezial osteosynthetic plate after subtotal or total corpectomy and autogenous iliac bone graft. In overall patients, at average follow-up 6 months, stability of cervical column were maintained and graft were fully incorporated. There were no operative complications except only one case of screw ioosening.

A Clinical Analysis of Surgically Treated 145 Cases of Intracranial Anterior Circulating Aneurysms

We had clinically reviewed 145 cases of surgically treated intracranial anterior circulating aneurysms admitted to the neurosurgical service at Masan Koryo General Hospital between March, 1986 and December, 1990. The results obtained were as follows : 1) Over 60% of the patients were in their 6th and 7th decade. 2) The male to female ratio was 1 : 1.07 but male was predominant below the age of 40. 3) The location of aneurysm was below ; anterior communicating artery(54 cases, 37.2%), internal carotid artery(37 cases, 25.5%), middle cerebral artery(31 cases, 21.4%). 4) On admission, 102 patients were in Grade I or II of neurological scale(Hung & Hess Classification). 5) 38 patients had arterial hypertension prior to SAH. 6) Clinical vasospasm was found in 41 cases(28.3%). 7) Aveerage interval between ictus and vasospasm was 4-10 days. 8) A poor outcome was correlated with arterial hypertension and vasospasm. 9) Post operative mortality was 10.3%(15 cases) and common cause of the deaths was cerebral vasospam.

Clinical Consideration on Pneumonia caused by Mycoplasma Pneumoniae in Children

No abstract available.

A Case of Congenital Megakaryoblastic Leukemia Accompanied by Down Syndrome Which was Diagnosed by Autopsy Findings

No abstract available.

A Case of Congenital Megakaryoblastic Leukemia Accompanied by Down Syndrome Which was Diagnosed by Autopsy Findings

No abstract available.