No abstract available in English.
Dislocations ; Hip

PURPOSE: To evaluate the surgical results and clinical characteristics of congenital lacrimal fistula. METHODS: Fourteen patients were diagnosed with congenital lacrimal fistula and received simple fistulectomy. Three patients received anterior lamella reposition operation simultaneously due to epiblepharon. We retrospectively reviewed the medical records and conducted telephone interviews. RESULTS: In 15 eyes of the 14 patients, epiphora through lacrimal fistula disappeared. Two eyes of 2 patients showed a little epiphora only outdoors but there was no need of further treatment. All patients accepted the surgical results cosmetically. Histologically, stratified squamous epithelial change with keratinization was remarkable by aging. In adults, hair follicles with increased keratinization were contained and the result with skin was similar. CONCLUSIONS: Simple fistulectomy was a useful technique for congenital lacrimal fistula.
Adult ; Aging ; Fistula* ; Hair Follicle ; Humans ; Interviews as Topic ; Lacrimal Apparatus Diseases ; Medical Records ; Retrospective Studies ; Skin

OBJECTIVE: The present study was performed to investigate whether apoptosis occur in human embryos by annexin staining and detect the expression of Fas, Fas-ligand (FasL), Bax, and Bcl-2 in human fragmented embryos derived from IVF-ET by immunofluorescence and Western blot analysis. MATERIALS AND METHODS: Using annexin staining, immunofluorescence and Western blot analysis on normal and fragmented embryos, we were able to detect apoptotsis and apoptotic gene products in fragmented embryos. RESULTS: Phosphatidylserine (PS) translocation, the marker for apoptosis, were detected frequently in fragmented embryos. Bcl-2 and Bax protein were detected in both fragmented and non-fragmented embryos. When fragmented embryos compared to normal embryos, immunofluorescent intensity of Bcl-2 tended to be lower in fragmented embryos. Bax gene expression increased in the fragmented embryos compared to the normal embryos. This result supports a model in which the molar ratio of Bcl-2 to Bax determines whether apoptosis induced or inhibited in human embryo. Fas was highly expressed in human preimplantation embryos but not FasL. It suggests that embryo may undergo apoptosis by binding with FasL produced by follicular or immune cells. CONCLUSION: The over expression of Bax and Fas will trigger apoptosis to lead embryo fragmentation and change embryo to be nonviable.
Apoptosis* ; bcl-2-Associated X Protein ; Blastocyst ; Blotting, Western ; Embryonic Structures* ; Fluorescent Antibody Technique ; Gene Expression ; Humans* ; Molar

PURPOSE: This study nasolacrimal duct (NLD) stenosis in adult, evaluated the clinical results of treatment with topical 0.04% mitomycin C (MMC) eyedrops after silicone tube intubation. METHODS: Prospectively, we analysed the clinical results from 29 eyes of 25 adult patients with epiphora due to NLD stenosis who underwent this procedure. RESULTS: The mean follow-up periods was 9.3 months. Twenty-two eyes (76%) showed no epiphora and complete passing into the cavity by lacrimal irrigation. Four eyes (13.7%) showed intermittent epiphora but improvement relative to preoperative state. Three eyes (10.3%) showed persistent epiphora and no improvement. In total, 26 eyes (89%) showed improvement of symptoms. Complications were silicone tube prolapse in 5 eyes (17.2%) and dacryocystitis in 2 (6.9%) CONCLUSIONS: Silicone tube intubation with topical MMC eyedrops for treatment of patients with tearing due to NLD stenosis is effective, safe and easy. This technique can be tried before DCR if the surgeon has a thorough of nasal cavity anatomy and probing.
Adult* ; Constriction, Pathologic ; Dacryocystitis ; Follow-Up Studies ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Methods ; Mitomycin* ; Nasal Cavity ; Nasolacrimal Duct* ; Ophthalmic Solutions ; Prolapse ; Prospective Studies ; Silicon* ; Silicones* ; Tears

In this article, the sixth author's affiliation was misprinted unintentionally.

It has been known that the usual findings of SPECT in patients with Todd's paralysis is the hypoperfusion of the corresponding hemisphere. We experienced a patient who developed transient hemiparesis after a seizure attack with hyperperfusion rather than hypoperfusion over the corresponding hemisphere on brain SPECT. A 36-year-old female presented with left hemiparesis after a secondarily generalized tonic seizure. No additional seizure-like attack was noted during admission. EEG showed intermittent focal slow waves over the right frontotemporal area on admission and returned to a normal pattern 72 hours after admission. Tc-99m ECD SPECT showed hyperperfusion on the right frontoparietal area in spite of the normalization of EEG. The degree of hyperperfusion was diminished as time passed for at least 72 hours. We report a patient who had Todd's paralysis associated with contralateral frontoparietal hyperperfusion. Todd's paralysis may be explained as the result of focal discharges that lead to local vasomotor changes.
Adult ; Brain ; Electroencephalography ; Female ; Humans ; Paralysis* ; Paresis ; Seizures ; Tomography, Emission-Computed, Single-Photon

The role of neoadjuvant chemoradiation therapy in locally advanced pancreatic cancer (LAPC) is still controversial. The aim of this study was to evaluate surgical downstaging after concurrent chemoradiation therapy (CCRT) for LAPC by measuring the objective changes after treatment. From January 2003 through July 2011, 54 patients with LAPC underwent neoadjuvant CCRT. Computed tomography findings of the tumor size, including major vessel invasion, were analyzed before and after CCRT. Among the total recruited patients, 14 had borderline resectable malignancy and another 40 were unresectable before CCRT. After CCRT, a partial response was achieved in four patients. Stable disease and further disease progression were achieved in 36 and 14 patients, respectively. Tumor size showed no significant difference before and after CCRT (3.6 +/- 1.1 vs. 3.6 +/- 1.0 cm, P = 0.61). Vessel invasion showed improvement in two patients, while 13 other patients showed further tumor progression. Thirty-nine patients with unresectable malignancy and 11 patients with borderline resectable malignancy at time of initial diagnosis remained unchanged after CCRT. Four patients with borderline pancreatic malignancy progressed to an unresectable stage, whereas one unresectable pancreatic malignancy improved to a borderline resectable stage. Only one patient with borderline resectable disease underwent operation after CCRT; however, curative resection failed due to celiac artery invasion and peritoneal seeding. The adverse events associated with CCRT were tolerable. In conclusion, preoperative CCRT in LAPC rarely leads to surgical downstaging, and it could lower resectability rates.
Adenocarcinoma/radiography/therapy ; Adult ; Aged ; Aged, 80 and over ; Antimetabolites, Antineoplastic/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Capecitabine/therapeutic use ; Carcinoma, Pancreatic Ductal/*radiography/*therapy ; Chemoradiotherapy/adverse effects/*methods ; Combined Modality Therapy ; Deoxycytidine/analogs & derivatives/therapeutic use ; Disease Progression ; Female ; Fluorouracil/therapeutic use ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Pancreas/blood supply/pathology ; Pancreatic Neoplasms/*radiography/*therapy ; Retrospective Studies ; Treatment Outcome

Chromogranin A (CgA) is widely used as an immunohistochemical marker of neuroendocrine neoplasms and has been measurable in plasma of patients. We assessed the clinical role of plasma CgA in diagnosing pancreatic neuroendocrine neoplasm (PNEN). CgA was checked in 44 patients with pancreatic mass who underwent surgical resection from 2009 through 2011. The cutoff value for diagnosing PNEN and the relationships between CgA and clinicopathologic variables were analyzed. Twenty-six patients were PNENs and 18 patients were other pancreatic disorders. ROC analysis showed a cutoff of 60.7 ng/mL with 77% sensitivity and 56% specificity, and the area under the curve (AUC) was 0.679. Among PNEN group, the sensitivity and specificity of diagnosing metastasis were 100% and 90% respectively when CgA cutoff was 156.5 ng/mL. The AUC was 0.958. High Ki-67 index (160.8 vs 62.1 ng/mL, P = 0.001) and mitotic count (173.5 vs 74.6 ng/mL, P = 0.044) were significantly correlated with plasma CgA, but the tumor size was not. In conclusion, CgA has a little value in diagnosing PNEN. However, the high level of CgA (more than 156.5 ng/mL) can predict the metastasis. Also, plasma CgA level correlates with Ki-67 index and mitotic count which represents prognosis of PNENs.
Adolescent ; Adult ; Aged ; Area Under Curve ; Chromogranin A/*blood ; Female ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors/blood/*diagnosis/pathology ; Pancreatic Neoplasms/blood/*diagnosis/pathology ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Young Adult

PURPOSE: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. METHODS: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. RESULTS: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), PaCO2<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and PaCO2<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). CONCLUSION: Overall, dizziness, time interval between onset of symptoms and ingestion, DeltaDBP and PaCO2<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and PaCO2<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.
Adult* ; Dizziness ; Eating ; Humans ; Logistic Models ; Poisoning* ; Respiration, Artificial ; Retrospective Studies ; Tetraodontiformes* ; Tetrodotoxin

Wegener's granulomatosis is a necrotizing,granulomatous vasculitis that involves multiple organs including the upper and lower respiratory tract and the kidney.The kidney initially exhibits focal necrotizing glomerulonephritis,which progresses to crescentic glomerulonephritis in Wegener's granulomatosis.We experienced a case of Wegener's granulmatosis which was associated with a thin glomerular basement membrane disease.The patient suffered from nasal stuffiness,recurrent serous otitis media,and tinnitus.Despite antibiotic therapy and ventral tube insertion,symptoms did not improve and hearing difficulty was aggravated.Ulcerative,necrotizing granulomatous inflammations with multinucleated giant cells were seen on nasal biopsy.She had recurrent microscopic hematuria and the renal biopsy findings by light and immunofluorescent microscopy did not reveal any abnormalities but diffuse thinning of the glomerular basement membrane (226nm)was observed by electronmicroscopy. With the above clinical findings and biopsy results,we diagnosed Wegener's granulmatosis with thin glomerular basement membrane disease.Thin glomerular basement membrane disease,also called benign recurrent hematuria,is characterized by diffuse thinning of the glomerular basement membrane and hematuria. Weekly low-dose methotrexate together with prednisone was used as treatment regimen because nonglomerular microscopic hematuria may be the first sign of cyclophosphamide-induced renal toxicity.With the above combination therapy, she felt well-being sense and her hearing difficulty was also much improved. She has been treated as an outpatient with glucocorticoid.
Biopsy ; Giant Cells ; Glomerular Basement Membrane* ; Glomerulonephritis ; Hearing ; Hematuria ; Humans ; Inflammation ; Kidney ; Methotrexate ; Microscopy ; Otitis ; Outpatients ; Prednisone ; Respiratory System ; Vasculitis ; Wegener Granulomatosis*