• Title/Summary/Keyword: 안과검진

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Visually evoked potential in children with mitochondrial respiratory chain defects (소아 사립체 질환에서 시각 유발전위검사의 유용성)

  • Song, Ji Eun;Kim, He Min;Lee, Sang-Chul;Park, Yoon-Gghil;Byeon, Suk-Ho;Lee, Young-Mock;Lee, Joon-Soo;Kim, Heung-Dong
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.471-475
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    • 2009
  • Purpose : Mitochondrial disorders are a clinical entity characterized by diverse symptoms and signs of involvement of various systems. Furthermore, the disorders are known to show ophthalmologic manifestations as well as neurological findings. Visually evoked potential is a sensitive measure to check the integrity of the visual pathway. In this study, we have investigated the value of visually evoked potential in mitochondrial disorders with respiratory chain defects. Methods : Nineteen patients diagnosed with mitochondrial respiratory chain complex I defect as confirmed by spectrophotometric enzyme assay in muscle samples were enrolled for this study. The patients underwent a visually evoked potential study. We classified the results into four groups and compared these with clinical ophthalmologic findings. Results : Among the 19 patients, 14 showed abnormal visually evoked potential findings. Seven patients showed abnormal clinical ophthalmologic findings. All patients with abnormal ophthalmologic findings showed abnormal visually evoked potential findings. Among the 12 patients with normal ophthalmologic findings, seven showed abnormal results in visually evoked potential. Conclusion : Visually evoked potential study could be used as an effective screening tool for mitochondrial disorders to detect ophthalmologic and neurological abnormalities.

The Reliability of Eye Screening Physical Examination in School and Living Environment Characteristics of Young Children with Amblyopia (유소년 약시환자의 생활환경 특성과 학교신체검사 안검진의 신뢰성)

  • Oh, Won-Geon;Kim, Sung-Chul
    • The Journal of the Korea Contents Association
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    • v.14 no.6
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    • pp.262-270
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    • 2014
  • Considering that few studies had paid attention to the living characteristics and social environment surrounding amblyopes, the present study surveyed the parents of children aged 3 to 12 and diagnosed-with amblyopia to analyse the time when the children were first diagnosed-with amblyopia, the characteristics of their living environment and the socio-environmental factorsand to delve into correlations. For the purpose of this study, 104 parents of patients in 4 hospitals in Seoul, Gyeonggi and Incheon consented to participate in the survey from September 2 to November 23: 2013. As for the time when the children were first diagnosed with amblyopia: the age of 4 accounted for the highest percentage(28.8%). The older the parents were: the later the children were diagnosed with amblyopia (p<.01). The higher the education of parents, the earlier the diagnosis of amblyopia(p<.05). The present findings-will be conducive to decreasing the number of patients who have no choice but to live-with low vision for life by missing some timely visual acuity tests and ophthalmological examination and particularly to developing a social safety net that can realize national medical welfare for the low-income families and the socially disadvantaged class.With the help of information technology.

A Prediction Model for the Development of Cataract Using Random Forests (Random Forests 기법을 이용한 백내장 예측모형 - 일개 대학병원 건강검진 수검자료에서 -)

  • Han, Eun-Jeong;Song, Ki-Jun;Kim, Dong-Geon
    • The Korean Journal of Applied Statistics
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    • v.22 no.4
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    • pp.771-780
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    • 2009
  • Cataract is the main cause of blindness and visual impairment, especially, age-related cataract accounts for about half of the 32 million cases of blindness worldwide. As the life expectancy and the expansion of the elderly population are increasing, the cases of cataract increase as well, which causes a serious economic and social problem throughout the country. However, the incidence of cataract can be reduced dramatically through early diagnosis and prevention. In this study, we developed a prediction model of cataracts for early diagnosis using hospital data of 3,237 subjects who received the screening test first and then later visited medical center for cataract check-ups cataract between 1994 and 2005. To develop the prediction model, we used random forests and compared the predictive performance of this model with other common discriminant models such as logistic regression, discriminant model, decision tree, naive Bayes, and two popular ensemble model, bagging and arcing. The accuracy of random forests was 67.16%, sensitivity was 72.28%, and main factors included in this model were age, diabetes, WBC, platelet, triglyceride, BMI and so on. The results showed that it could predict about 70% of cataract existence by screening test without any information from direct eye examination by ophthalmologist. We expect that our model may contribute to diagnose cataract and help preventing cataract in early stages.

The Epidemiological Study on the Cataract of the Rural Aged Population Using a Simplified Screening System (간편한 선별검사법에 의한 농촌 노인인구의 백내장에 대한 역학조사)

  • Park, Eun Kyoo
    • Journal of Korean Ophthalmic Optics Society
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    • v.5 no.1
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    • pp.165-171
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    • 2000
  • The purpose of this study is to determine the prevalence of cataracts in a rural area of Kyung-Buk province. Cataract is the main cause of blindness and visual impairment in the world. Recently, the number of age-related cataract surgeries has increased remarkably. In spite of such an increase in the number of patients, there are still many cataract patients with highly deteriorated visual function who have had no occasion to receive an ocular examination. In order to screen such patients the author assessed 636 individual(1272 eyes) aged 50 years or more who had wanted to be examined generally in two area. Chilgok and Munkyung, Kyung-Buk province using a simplified cataract screening system recently proposed by Sasaki et al. Kanazawa Medical University in Japan. The results obtained are as follows. The number of visual impairment patients in this study group was 493(77.5%). They were screened by cataract screening system. Primary screening examination detected 448 subjects to be suspected of cataract while the subsequent secondary examination narrowed this number of subjects to 308(48.4%). Final number of subjects to be diagnosed of cataract was 421(66.2%). The rate of incidence, according to the age, was 27.5% in the 50 year-olds age group, 62.5% in the 60's age group, 86.1% in the 70's age group and 94.3% in the 80's age group and upwards. This results concluded that cataract is the main cause of blindness and visual impairment and is an important public eye health care problem of aged population in rural Korea. Methods of tackling the cataract problem(both backlog and incident), and other eye health needs are recommended. The need to extend eye health service to the rural areas is emphasized.

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AXENFELD-RIEGER SYNDROME WITH DENTAL PROBLEM : A CASE REPORT (Axenfeld-Rieger Syndrome 환자의 증례보고)

  • Seong, Min-Kyoung;Shin, Teo-Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.2
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    • pp.113-117
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    • 2012
  • Axenfeld-Rieger syndrome (ARS) is a rare disorder with variable morphology characterized by malformations of the anterior segment of the eye such as iris hypoplasia, iridocorneal adhesions, corectopia and polycoria. Craniofacial and dental anomalies are also regularly reported in connection with ARS. Dental features include hypodontia in primary and permanent dentition, microdontia, short roots and abnormally shaped teeth. The patient in this case is a 14-year-old girl who has visited Seoul National Dental Hospital in 2002 for the first time. A panorama was taken on the day of her first visit, and total absence of maxillary anterior dentition and mandibular premolars were observed. The patient was on a treatment schedule by the department of ophthalmology at Seoul National Hospital for a morphological dyplasia of the pupil and she was diagnosed with ARS. Periodic panoramic observations were performed followingly, and she was finally diagnosed of congenital missing of maxillary anteriors and mandibular second premolars. In 2009, composite resin build-ups of maxillary primary central incisors were performed, and she has been on her regular follow-ups until now.

Discordant Congenital Cytomegalovirus Infection in Twins (쌍생아에서 선천 거대세포바이러스 감염 증례)

  • Kim, Yi-Seul;Kang, Ji-Man;Lee, Ji-Hoon;Chang, Yoon Sil;Park, Won Soon;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.65-70
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    • 2017
  • Cytomegalovirus (CMV) infection is one of the most common congenital infections. The first case of discordant congenital CMV infection in twins occurred in Korea. A 31-year-old woman became pregnant with twins (dichorionic-diamniotic). An elective caesarean section was performed at 37 weeks. The first baby was male, weighing 2,410 g with an Apgar score of 8/9. The second baby was female, weighing 1,380 g with an Apgar score of 5/8. She had experienced intrauterine growth retardation, and presented with microcephaly, micrognathia, and joint stiffness. During the work-up for discordant twins, the second baby's serum test was positive for CMV immunoglobulin M. Her urine, blood, and cerebrospinal fluid (CSF) were CMV polymerase chain reaction positive. The first baby's CMV tests were negative. Ophthalmologic exam and audiometry performed on the second baby showed CMV retinitis and bilateral sensorineural hearing loss. She was treated with intravenous ganciclovir. Currently, she is bed-ridden and has significant developmental delay. Although the causes of discordant congenital CMV infection in twins are unclear, this case shows that discordant congenital CMV infection should be considered in twins with significant differences in intrauterine growth or clinical symptoms after birth.

A Case of Cytomegalovirus Retinitis during Maintenance Chemotherapy for Acute Leukemia

  • Ahn, Bin;Song, Seungha;Han, Mi Seon;Oh, Baek Lok;Choi, Jae Hong;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.27 no.3
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    • pp.198-204
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    • 2020
  • Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy. Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit (신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생)

  • Park, Na-Ri-Mi;Na, Ji-Youn;Joung, Kyoung-Eun;Lee, Ji-Na;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Seong-Joon;Song, Jung-Suk;Oh, Hyang-Soon;Lee, Hoan-Jong;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.44-53
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    • 2008
  • Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

Clinical characteristics and courses of congenital muscular torticollis (선천성 근육성 사경의 임상적 특징과 경과)

  • Choi, Kyong Eun;Lee, Hee Chul;Youn, So Young;Chun, Jung Mi;Shin, Son Moon;Han, Byung Hee;Lee, Yong Taek
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1273-1278
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    • 2009
  • Purpose:Congenital muscular torticollis (CMT), a common musculoskeletal disorder in infants, is characterized by the rotation and flexion deformity of the neck caused by sternocleidomastoid muscle shortening. We investigated the clinical courses and perinatal risk factors of CMT. Methods:Less than 6-month-old patients (98; M:F = 60:38) diagnosed with CMT between February 2007 and August 2008 were classified into 2 clinical subgroups, namely, SMT (sternocleidomastoid tumor) and POST (postural torticollis). All the patients were physically and neurologically examined prospectively and their cervical X-rays and ultrasonographies were obtained. Their medical histories about perinatal problems were recorded. Of the 98 patients, 45 with normal range of motion were taught passive physical exercises and 43 were referred to the Department of Rehabilitation for undergoing manual stretching therapy. Results:The mean age at initial assessment was 2.2 months (SMT: $1.4{\pm}1.0$, POST: $2.7{\pm}1.6$). SMT presented earlier than POST. All ophthalmologic examinations and cervical X-rays were normal. SMT was associated with higher incidence of caput succedaneum and cephalhematoma. POST was highly associated with plagiocephaly. Mean duration of rehabilitative physical therapy was 3.7 months (SMT: $4.6{\pm}2.5$, POST: $2.6{\pm}1.9$). POST resolved earlier than SMT. Of the 88 patients with follow-up, 87 had total resolution and only 1 had residual torticollis. Conclusion:All the patients received early treatment with passive stretching exercises. CMT was associated with perinatal problems and had various risk factors such as obstetrical problems.