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Insulin resistance syndrome (IRS) of schoolchildren may contribute to cardiovascular diseases (CVD) of young adults. The investigation of different steps, baseline screening parameters and treatment of IRS may help the prevention.Schoolchildren (53 boys and 61 girls age 5-17 years) because of adverse family history of CVD, hypertension, and obesity were investigated. Patients were divided into 3 groups according to baseline plasma glucose level (PGL) 120 and 180 min. after glucose consumption (GC): (1) PGLor = 5.5 mmol/L 180 min. after GC, (2) PGLor = 5.5 mmol/L 180 min. butor = 7.8 mmol/L 120 min. after GC (3) PGLor = 7.8 mmol/L 120 min. after GC. Body mass index (BMI), blood pressure (BP) and parameters of glucose and lipid metabolism were measured at baseline and after two year's lifestyle modification.No significant difference was found in the prevalence of cardiovascular risk factors (CRF) between groups 2 and 3. Fasting PGL5.5 mmol/L was found in 1, 2, and 6 cases; HOMA index4.4 in 7 (24%), 21 (37%), and 9 (35%) subjects; OGIS index400 in 3(10%), 29(51%) and 11 (42%) schoolchildren of groups 1, 2, 3, respectively. Lifestyle modification significantly improved BMI, systolic BP, serum triglyceride and HDL-cholesterol levels and insulin sensitivity.PGL measured 180 minutes after GC may define an important subgroup of pre-diabetic children. The similar prevalance of CRF in both praediabetic groups underlines the importance of this subgroup. Lifestyle modification for two years improves CRF in this population.

Purpose Chronic progressive external ophthalmoplegia (CPEO) is a rare mitochondrial myopathy characterized by slowly progressive paralysis of the extraocular muscles with onset around the age of 20. Patients usually experience bilateral ptosis before developing symmetric, multidirectional external ophthalmoplegia. Methods 31-year-old woman with 10 year history of slowly progressive paralysis of the extraocular muscles was referred to our institute. Every action of extraocular muscles was reduced in both eyes. She could not adduct and elevate, there was only a slight abduction and depression function in both eyes. Patient had no ptosis or exophthalmus. BCVA was 20/20 in both eye. Slit lamp examination was normal. Dilated funduscopic examination revealed slight pigment disturbance in the periphery. Visual field and color vision tests were normal. Electroretinography showed lower borderline scotopic b-wave amplitudes. Laboratory tests showed increased lactic acid and creatine phosphokinase values. The results of liver and kidney function, autoimmun and serologic tests were normal. All thyroid function tests yielded negative results. Urinalysis, chest x-ray, heart ultrasound, brain and orbital magnetic resonance, nasal sinus CT scans were normal. Tensilon test excluded myasthenia gravis. Results We considered the case as CPEO clinically, mitochondrial DNA analysis is in process. Conclusion In CPEO, slowly progressive paralysis of the extraocular muscles may develop without ptosis. A careful differential diagnosis is very important.

PURPOSE. Macular anatomic abnormalities were examined by optical coherence tomography (OCT) imaging in premature children and compared with those of full-term children. METHODS. In a prospective case-control study, premature patients 7 to 14 years of age were divided into three groups (group I, laser-treated retinopathy of prematurity [ROP]; group II, spontaneously regressed ROP; group III, no ROP), and age-matched children (group IV). All the eligible 74 eyes had normal-appearing posterior pole, myopia ≤3 D, and best corrected visual acuity 1.0. When both eyes of a subject were eligible for the study, one eye was randomly selected (10 eyes of 10 children in each group). Retinal thicknesses of the macula measured by OCT3 were compared. The correlation between central foveal thickness and prematurity (gestational age at birth ≤ 30 weeks; birth weight ≤ 1250 g) or ROP was determined. RESULTS. The mean foveal and central retinal thicknesses decreased significantly in group I (laser-treated ROP) and group IV (term birth). Significant differences in central retinal thickness were found between the premature groups and full-term children (Mann-Whitney U test). The cutoff point of central retinal thickness, determined by receiver operating characteristic curve was 209 μm. The general estimating equation model statistics found a significant effect of ROP severity (P = 0.003), P value for the category of prematurity was 0.063. CONCLUSIONS. The central retinal thickness was significantly higher in the preterm groups than in the full-term group. This subtle macular modification may be related mainly to ROP. Prematurity had only a marginally significant role.