The Result of Full Tendon Transposition in Paralyzed Strabismus

Nine patient with paralyzed strabismus of large deviation(Seven patients with lateral rectus or medial rectus muscle palsy and two patients with double elevator palsy) had full tendon transposition procedure. If remained strabismus was large postoperatively, recession of anatagonist of paralyzed muscle and botulinum toxin infection was performed respectively. Five patients achieved single binocular vision within central 10 degree of visual field. And six patients achieved less than 10 prism diopter of deviation in primary position. Our method compares favorably with previously descrived transposition procedure for muscle palsy in terms of the amount of correction and the extent of the window of single binocular vision with low risk of anterior ischemia syndrome.

The Use of Vertical Offsets with Horizontal Strabismus Surgery

Vertical deviation may sometimes coexit with a large horizontal strabismus. If the vertical component is small and comitant, it may be treated by vertical displacement of the horizontal rectus insertions during a monocular recession-resection procedure. A series of 17 patients had vertical displacement of horizontal rectus muscle insertion monocularly combined with recession-resection surgery. Using a surgical plan of 1mm displacement of both medial and lateral rectus insertion to correct each prism diopter of vertical deviation, 12 patients had no residual vertical strabismus. Minimum follow-up period was 3 months. The linear correlation equation between the amount of corrected vertical strabismic angle and that of vertical displacement of medial and lateral rectus muscle is Y=0.67X+0.22(Y=Prism diopter of correction by vertical displacement, X=millimeter of vertical displacement of medial and lateral rectus muscle). These surgical results showed unsatisfactory effect on vertical deviation of more than 6 prism diopters.

Digitalized Videographic Measurement of Strabismic Angle

Current using strabismic angle measurement techniques require examiners experience and subjective decision. The accuracy between observers and intra-observer is limited by the minimum eye movement that the examiner can detect with naked eye. Horizontal strabismic angles with 35 comitant strabismus patients were measured using precise digital signals converted by digital frame grabber and image processing software in a 32 bit microcomputer. Strabismic angle calculated using digital method was compared with that of prism-cover method. The slope of the regression line was 1.1054; the Y-intercept was 1.3870PD. The coefficiency of variation to verify its reproducibility for measurements of total variability in 35 strabismic patients was 3.71%. The strabismic angle measurement with digital frame grabber seems to be relatively precise and clinical application will be available in measuring horizontal and vertical strabismic angel.

Pegnancy Outcomes in Women with Unexplained Midtrimester Elevation of Maternal Serum Human Chorionic Gonadotropin Level / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to determine whether unexplained elevation in maternal serum human chorionic gonadotropin without abnormal elevation in matemal serum alpha-fetoprotein (MSAFP) in the second trimester may be associated with adverse pregnancy outcomes. METHODS: Between January 1997 and December 1997, we evaluated 906 pregnant women undergoing second trimester triple marker screening tests who delivered at our hospital. Multiple pregnancy, fetal anomaly, intrauterine fetal death before 20 completed weeks of gestational age, insulin dependent diabetes mellitus and maternal serum alpha-fetoprotein level greater than 2.0 multiple of the median (MoM) were excluded fiom the study. Seventy-two women with hCG level greater than 2.0 MoM were included in the study group while 809 women with hCG level less than 2.0 MoM served as the control group. Adverse pregnancy outcomes were obtained from hospital delivery records and neonatal records. Statistical analysis were performed by students t-test and chi square test. RESULTS: Women with unexplained elevation of human chorionic gonadotropin level showed increased risks for intrauterine growth retardation (P<0.01) and pregnancy induced hypertension (P<0.05). There were no significant differences between study and control groups with respect to preterm delivery, placental abruption, fetal anomaly and intrauterine fetal death. CONCLUSION: Unexplained elevation of human chorionic gonadotropin in the second trimester was associated with intrauterine growth retardation and pregnancy induced hypertension.

The Clinical Significance of Apgar Score and Umbilical Arterial Blood Gas Analysis on Preterm Infant Delivered Vaginally / 대한산부인과학회잡지

OBJECTIVE: The Apgar score has long been used to determining birth asphyxia and assessing early neonatal status and long-term outcome. Unfortunately, some components of this system depend upon subjective interpretation. Also, although, low Apgar score, Most of newborns are relatively healthy. The objective of our studt is attempt to assure the linical significance of Apgar score and umbilical cord blood gas analysis on assessing status of uncomplicated preterm infants delivered vaginally. METHODS: The present study was performed in attempt to compare umbilical arterial blood gas values for uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (7), each other, The present study included 82 uncomplicated term infants delivered vaginally and 24 preterm infants. Inclusion criteria of our study is as follows: 1) Singleton neonate with vertex presentation, 2) No congenital malformation, 3) Infants whose mother had no obstetrical and medical complications, 4) Immediately after delivery, umbilical arterial blood was sampled, before first breathing of neonate, 5) Infants applied Apgar score at I minute and again 5 minutes after birth, and 6) Infants whose mothers gestational age was estimated by ultrasonography during first-trimester of pregnancy. The statistical analysis was performed by Mann-Whitney U test and Fishers exact test. RESULTS: 1) There was no significant difference in umbilical arterial blood gas values between uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (7). 2) There was no significant difference in umbilical arterial blood gas values between uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (7). 3) There was significant difference in frequency of lower Apgar score (<7) between term (2%[2/82]) and preterm infants (38%[9/24]), but not in frequency of acidemia (defined as less than pH 7.2) (28%[23/82] Vs 33%[8/24]). CONCLUSION: The Apgar score is not a reliable indieator of well-being in preterm neonate. We recommend umbilical arterial blood sampling at delivery of preterm infant with low Apgar score, because umbilical cord blood gas indices on objective means of assessing birth status of the newbarn and more useful than Apgar score in ruling out birth asphyxia.

Abruptio Placenta: Perinatal Outcome in Pregnancy-induced Hypertensive and Normotensive Pregnant Women / 대한산부인과학회잡지

OBJECTIVE: The objective of this study was to compare perinatal outcomes of pregnancy-induced hypertensive and normotensive women experiencing abruptio placentae, Our hypothesis is that pregnancy-induced hypertensive women have a less favorable perinatal outcome than do normotensive women. METHODS: Women with the diagnosis of abruptio placentae delivered between August 1, 1989 and December 1, 1996, composed the study group (n=92) in this case-control study. The women with abruptio placentae were divided according to their hypertensive (n=37) or normotensive (n=55) status. Maternal and neonatal medical records were reviewed and abstracted for demographic variables, antepartum complications, delivery route, abruptio placentae grade, neonatal gender, birth weight, Apgar score and perinatal mortality. We compared these perinatal outcome variables between the pregnancy-induced hypertensive and normotensive pregnant women. RESULTS: The incidence of abruptio placentae was 0.35%. The two groups of woman wne similar with regard to age and parity. Abruptio placentae grades 2 occurred more often in hypertensive women (P=0.0053). Pregnancy-inducedhypertensive women were similar to normotensive women with regard to antenatal complications. The mean gestational age of delivery, delivery route, neonatal weight and sex were similar between two groups of women. Neonates from pregnancy-induced hypertensive women were no more likely to have low 1 and 5-minute Apgar score or to die than those from normotensive women. Statistical analysis was performed with two-tailed independent t-test and Kruskal-Wallis analysis. CONCLUSION: Although pregnancy-induced hypertensive women experiencing abruptio placentae are more likely to have grade 2 abruptio placentae with fetal distress, the overall perinatal outcome was not significantly different from that of normotensive women experiencing abruptio placentae.

A Clinical Study about the Risk Factors of the Neonatal Clavicular Fracture / 대한산부인과학회잡지

No abstract available.

Traumatic Exotropia Following Partial Laceration of Medial Rectus Muscle

Direct trauma to extraocular muscles is usually the result of penetrating injuries. Contusion, avulsion, or laceration of the extraocular muscles may occur. We have treated a 3-year-old boy with what appeared to be nasal conjunctival laceration by scissors. The injured eye showed approximately 50 prism diopter exotropia and slight limitation of adduction of the left eye. In orbital MRI focal hemorrhage and adhesion around left medial rectus muscle was noted but the discontinuity of left medial rectus muscle was not found in orbital MRI. After 6 months, the child underwent strabismus surgery under general anesthesia. We detected that the upper portion of the left medial rectus muscle was lacerated about 25% of total width of muscle from the insertion to 4mm distal to the insertion. We performed a recession-resection procedure to the left eye. 3 month after the operation, duction movement showed no limitation. The prism and cover test at near revealed orthophoria. We suggest that a strabismus following after a periocular laceration can be accompanied with a injury of extraocular muscle.

Prenatal ultrasonic detection of endocardial cushion defect in 1 case / 대한산부인과학회잡지

No abstract available.

A case of immature teratoma of uterus / 대한산부인과학회잡지

No abstract available.

Clinical survey on total abdominal hysterectomy / 대한산부인과학회잡지

No abstract available.