Two Cases of Serous Retinal Detachment Following Vitrectomy in Patients with Proliferative Diabetic Retinopathy

PURPOSE: In the present study, 2 cases of serous retinal detachment in patients diagnosed with proliferative diabetic retinopathy after pars plana vitrectomy are reported. CASE SUMMARY: (Case 1) A 38-year-old female diagnosed with high-risk proliferative diabetic retinopathy underwent pars plana vitrectomy and cataract surgery due to intravitreal hemorrhage. One day after the operation, fundus photograph and optical coherence tomography (OCT) revealed serous retinal detachment. After ensuring that no retinal hole was present based on fundus examination, the patient was diagnosed with serous retinal detachment and antimicrobial and steroid eye drops were applied. After 1 week, subretinal fluid disappeared. (Case 2) A 63-year-old male diagnosed with proliferative diabetic retinopathy underwent pars plana vitrectomy due to right vitreous hemorrhage. On postoperative day 1, focal subretinal fluid under the macula was observed using OCT. Intravitreal triamcinolone injection was performed during surgery and steroid eye drops were applied. Subretinal fluid collection was absorbed 5 days postoperatively. CONCLUSIONS: Two cases of serous retinal detachment that occurred postoperatively in patients with diabetic retinopathy are reported. Serous retinal detachment was resolved after several days without specific management.

Learning Curve for Strabismus Surgery

PURPOSE: In the present study, we evaluated the learning curve of strabismus surgery performed by a single surgeon. METHODS: We reviewed the data of 62 patients with exodeviation who underwent strabismus surgery and were followed up for at least 3 months between March 2011 and November 2014. Patients were divided into 3 groups classified chronologically and the success rate in each group was investigated. Additionally, the results of exotropia surgery were analyzed using cumulative sum (CUSUM) analysis. We compared 5 m distal angle deviation preoperatively and 3 months after strabismus surgery. RESULTS: The overall surgical success rate of 62 patients was 72.6% (45/62). Success rates were 70% (14/20) in the first group, 71.4% (15/21) in the second group and 76.2% (16/21) in the third group. CUSUM analysis indicated that a surgeon's performance begins to improve at attempt number 11 and cumulative failure chart suggested the surgeon had achieved acceptable level of performance after 44 surgeries. CONCLUSIONS: A novice strabismus surgeon showed performance improvement after 11 cases and achieved acceptable level of performance after 44 strabismus surgeries. Although additional statistical data using more cases is needed, we suggest surgeons should perform at least 50 strabismus surgeries to ensure a high success rate.

Long-standing Asymptomatic Intralenticular Foreign Body

No abstract available.

Multiple Fistula Emptying into the Left Ventricle through the Entire Left Ventricular Wall

Coronary artery fistulae are usually identified during invasive coronary angiographies. However, in this case, we made the early detection of coronary artery fistulae during non-invasive transthoracic echocardiography, by demonstrating diastolic multiple abnormal color Doppler flows on the entire left ventricular walls including left ventricular free wall, interventricular septum and apex, which were mimicking firecracker on the whole left ventricle. Fistulous communication from the coronary artery to the left ventricle is rare. Moreover, a case of multiple coronary fistulae emptying into the left ventricle through the entire left ventricular walls including left ventricular free wall, interventricular septum and apex is uncommon. We report a case of a 31-year-old woman who was diagnosed with multiple fistula communicating with entire left ventricular wall.

Thyroid Dysfunction Detected in Intensively Cared Neonates for More than 1 Month / 대한소아내분비학회지

PURPOSE: To evaluate the incidence, time of detection, classification, and risk factors of thyroid dysfunction in neonates at a neonatal intensive care unit. METHODS: This is a retrospective study reviewing medical records of 67 infants (including 40 very low birth weight infants, VLBW), who were admitted for more than 1 month at Chungbuk National University Hospital from July 2006 to June 2009. Initial screening and repeat thyroid function tests were performed before and after two weeks of age. RESULTS: 1) In the thyroid dysfunctional group (42/67, 62.7% including 30 VLBW), only 9 infants (including 8 VLBW) were abnormal at screening. Among 57 infants with normal screening, 33 infants (57.9%, including 22 VLBW) changed to abnormal at follow-up. The detection times at the repeat test were 2-4 weeks of age (WA) (n = 15), 4-6 WA (n = 15), and 6-8 WA (n = 3). 2) The types of dysfunction were primary hypothyroidism (PH) with marked TSH rise (n = 7), mild PH (n = 3), hyperthyrotropinemia (n = 11), hypothyroxinemia (n = 7), and non-thyroidal illness (n = 14). 3) Compared to the normal group (n = 25), the dysfunctional group (n = 42) had lower birth weight, shorter gestational age, and more morbidity of respiratory distress syndrome (P < 0.05). 4) Thyroxine was prescribed in 15cases (35.7%) in the dysfunctional group except non-thyroidal illness. CONCLUSION: Thyroid dysfunction was common in the intensively cared neonates, especially in VLBW, and many cases were detected at the repeat test. The thyroid function test should therefore be repeated at least from 2 WA to 8 WA, and a proper management plan established by investigate the characteristics and long-term prognosis of these neonates.

Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn / 소아과

PURPOSE: The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. METHODS: Medical records of severe hyperbilirubiemia in newborns (serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment: Group I (phototherapy only, n=42), Group II (exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis. RESULTS: A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2 (2, 852+/-1, 085 g) compared to Group 1 (3, 137+/-437 g) (P< 0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2 (45+/-16 mg/dL) compared to Group 1 (29+/-6 mg/dL) (P< 0.05). But there were no significant differences in neurologic outcome. CONCLUSION: Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.

Comparison among Diagnostic Methods of Rotaviral Gastroenteritis in Children / 대한소아소화기영양학회지

PURPOSE: The purpose of this study was to evaluate the clinical efficacy of reverse transcription- polymerase chain reaction (RT-PCR) in detecting rotaviral gastroenteritis in children comparing with that of commercial immunoassays. METHODS: Stools from 79 children admitted Korea University Hospital due to diarrhea were collected from December 1999 to February 2000. Immunoassays were done using commercial rotavirus Latex kit and Rotatec (ELISA) kit. RT-PCR was performed to amplify group A rotavirus, most commonly pathogenic to human, using VP4- and VP7-specific primers. The detection rates of immunoassays and RT-PCR were compared. RESULTS: ELISA assay was superior to LA assay and moderately concordant with RT-PCR in detecting rotaviral gastroenteritis. CONCLUSION: Although RT-PCR is known very sensitive, it does not have significant advantage over immunoassay in detecting rotaviral gastroenteritis.

A Case of Nedocromil Sodium Withdrawal Due to Headache and Dizziness / 소아알레르기및호흡기학회지

Nedocromil sodium is an anti-inflammatory medication for the treatment of mild to moderate asthma. The most common side effect of the nedocromil sodium is an unpleasant and bitter taste. However it is rare, less than 3%, to stop the treatment because of this side effect. Other side effects includes cough, headache, throat irritation and nausea which are reported as mild and transient. A 7-year-old female had a severe headache and dizziness during the treatment of asthma with nedocromil sodium. The symptoms subsided after nedocromil sodium was replaced by budesonide. We experienced a case of a severe headache and dizziness due to nedocomil sodium that lead to withdraw of the nedocromil sodium.

A Model of Game Program for Childhood Asthma / 소아알레르기및호흡기학회지

PURPOSE: The increased prevalence of childhood asthma in Korea from 3.4% in 1964 to 15% in 1995 might be very important for morbidity and mortality in children. Recognition of this led to consider the necessity of new management strategies emphasizing patient education. We developed the educational program including asthma-specific play game called 'Malgunsum asthma game' to improve the child's interest and evaluated its educational effect. METHOD: Twenty asthmatic children between the age seven to fifteen were attended Malgunsum Asthma Camp. The Children were randomly assigned to 5 groups, and each player had to move the horse by answering the questions on the card. The first one who reaches the goal wins the game. RESULTS: All the children well followed the play rule and were interested to the game. CONCLUSION: This educational game model will achieve better control of asthma by leading the patients to understand the nature of asthma, how to identify and control the aggravating factors, how to recognize symptoms and appropriate steps for asthma, and the importance of daily maintenance therapy with anti-inflammatory medications.

Coexistence of Bronchial Atresia and Bronchogenic Cyst: A Case of Report / 대한흉부외과학회지

We report very rare case of concurrent bronchial atresia and bronchogenic cyst. Morphologic apical segment of right upper lobe directly stemmed from right main bronchus. Bronchogenic cyst was communicating with atretic segmental bronchus and both were filled with mucus. The etiology is not well known, however it is likely that a single insult arround the 5th~6th week causes both malformations.

Tricuspid Regurgitation Due to Rupture of a Chordae in Newborn: A Report of One Cases / 대한흉부외과학회지

Tricuspid regurgitation due to rupture of a chorda is a rare disease in newborns. Recently, we experienced one day old male with tricuspid regurgitation due to rupture of a chorda of anterior papillary muscle, and who had suffered from severe hypoxemia, acidosis, cyanosis, and bradycardia. Preoperative diagnosis was pulmonary atresia with intact ventricular septum, massive tricuspid regurgitation, and patent ductus arteriosus by echocardiogram, which demonstrated no flow through the pulmonic valve. At operation, the pulmonic valve was intact and a chorda of anterior papillary muscle was ruptured. Tricuspid regurgitation was corrected successfully with reconstruction of the chorda. Postoperative course was complicated by pneumonia and sepsis, but the infant recovered and discharged at postoperative 20 days.