Traumatic implantation cyst of the conjunctiva has often been reported. We have observed two cases of conjunctival cyst following surgery of retinal detachment. A small vesicular lesion developed at the operation site of the conjunctiva about 5 weeks after the surgery. The cyst filled with clear fluid was located deep in the subconjunctival connective tissues. The wall of the cyst consisted of a few layers of epithelial cells very similar to the conjunctival epithelium and had not any direct connection with the overlying conjunctival epithelium. In order to prevent it a great care must be taken during surgery. A careful accurate apposition of the conjunctival wound will be required. An excessive and forceful retraction of the conjunctival flap for exposure of the operation field should be avoided. And also, an appropriate suture material (i.e. a round, tapered needle with smooth surfaced suture) seems to be necessary.
Conjunctiva ; Connective Tissue ; Epithelial Cells ; Epithelium ; Needles ; Retinal Detachment* ; Retinaldehyde* ; Sutures ; Wounds and Injuries

This study was undertaken to clarify the effects of glucocorticosteroids on intraocular pressure and the combined effects of acetazolamide and glucocorticosteroid on ocular pressure. Male and female rabbits, weighing 1.7-2.2kg, were divided into 5 groups: 1) saline-treated group, 2) hydrocortisone (0.5 %)-treated group, 3) prednisolone (0.5 %)-treated group, 4) fludrocortisone (0.1% )-treated group, 5) dexamethasone (0.1% )-treated group. Drugs were instilled 4 times a day for 3 weeks, and ocular pressure was checked in each group on second and third week. Following 3 weeks instillation of glucocorticoids, ocular pressure was checked in each animal at 15, 30, 60, and 120 minutes after intravenous administration of acetazolamide (10mg/kg). Under 0.5% tetracaine anesthesia, facility of outflow and flow rate of the aqueous humor were also measured with a tonometer. The results of the experiments were as follows: 1) The mean ocular pressure rose significantly in all glucocorticoid-treated groups, and the rise was especially marked in the dexamethasone-treated group. 2) The mean facility of outflow of the aqueous humor decreased significantly in the dexamethasonetreated group, but it remained with little change in the other glucocorticoidtreated group. 3) The ocular pressure-lowering action of acetazolamide was suppressed significantly at 30 minutes after the treatment with acetazolamide in the hydrocortisone and prednisolonetreated groups, but it was not suppressed in the fludrocortisone and the dexamethasonetreated groups. 4) The flow rate of the aqueous humor was suppressed significantly (36.2 %) at 30 minutes after the treatment with acetazolamide in the control group, but it was not suppressed significantly in g]ucocorticoid-treated groups.
Acetazolamide* ; Administration, Intravenous ; Adrenal Cortex Hormones* ; Anesthesia ; Animals ; Aqueous Humor ; Dexamethasone ; Female ; Fludrocortisone ; Glucocorticoids ; Humans ; Hydrocortisone ; Intraocular Pressure* ; Male ; Prednisolone ; Rabbits ; Tetracaine

A large osteoma arising from the ethmoid sinus produced exophthalmos and diplopia. The troublesome symptoms disappeared after surgical removal of the lesion. The osteoma was an ivory type.
Diplopia ; Ethmoid Sinus ; Exophthalmos ; Orbit* ; Osteoma*

Recently, various tube-shunt implants have been used in treating refractory glaucomas.They have large volumed reservoir portion made of hard materials.We made a new implant with soft and freely malleable membrane[expanded polytetrafluoroethylene, e-PTFE]as a reservoir portion attached to the conventional silicone tube. Based on the encouraging result from experimental animal study, we performed a clinical trial for the membrane-tube implant.We performed Glaucoma Tube-Shunt Implant surgery using double layers of e-PTFE membrane and silicone tube with its one end fixed between the two layers.The subjects had refractory glaucomas without useful vision who visited our hospital from May 1991 to Sep.1995. There were 40 eyes of 37 patients and their mean follow-up period was 32.6 months.We could control the IOP within 6~21 mms of mercury in 26 eyes[65.0%, Success].In remaining 14 eyes, we could not control the IOP or additional surgery was needed to control the IOP or treat severe complications[35.0%, Failure].The Kaplan-Meier Survival for IOP control was 78.4% at 1 yr, 71.6%at 2 yr, and 60.3%at 3 yr.The complications were similar to those of other commercially available Glaucoma implants. This new implant is made of soft, freely malleable membrane for the reservoir portion with small volume which can be inserted with smaller incision on the conjunctiva with less complication.We have obtained comparable result from this membrane-tube implant to other implants, and it may be considered as an another substitute for the treatment of refractory glaucomas.
Animals ; Conjunctiva ; Follow-Up Studies ; Glaucoma* ; Humans ; Membranes* ; Polytetrafluoroethylene ; Silicones

A patient complying with the clinical criteria for brain death was studied by preenhanced computed tomography (CT). Preenhanced CT showed apparent increased density at the base of the brain along the course of the major arterial vessels, and abnormally dense-appearing deep venous structures, like those of contrast-enhanced CT. There was a diffuse decrease in brain density with a poorly delineated ventricular system. These CT findings were very characteristic. CT as a non-invasive method seems to be valuable in the diagnosis of brain death. The relevant literature is reviewed and mechanisms showing those CT findings are discussed.
Brain Death/*radiography ; Humans ; Infant ; Male ; Perfusion ; *Tomography, X-Ray Computed

Intracranial hypoglossal neurinomas are rare and only about fifty cases have been reported worldwidely. They usually present with hypoglossal nerve palsy preoperatively. The authors experienced, however, two cases of intracranial hypoglossal neurinomas without preoperative hypoglossal nerve palsy. One patient was operated using transcondylar retrosigmoid approach with C1 laminectomy and the other using midline suboccipital craniectomy with C1 laminectomy. Postoperatively hypoglossal nerve palsy was developed in both cases. Absence of preoperative hypoglossal palsy seemed to be related to somewhat different growth pattern in these two cases. When the tumor shows typical radiological findings of hypoglossal neurinoma, it must be included in differential diagnosis despite absence of preoperative hypoglossal nerve palsy.
Diagnosis, Differential ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Laminectomy ; Neurilemmoma* ; Paralysis

No abstract available.
Behcet Syndrome* ; Renal Insufficiency*

BACKGROUND: Allergic rhinitis is often associated with bronchial asthma, and intranasal treatment with topical corticosteroids reduces bronchial responsiveness. OBJECTIVE: In this study, it was evaluated that the bronchial responsiveness to methacholine increased in non-asthmatic adults with house dust mites (HDM)-sensitive allergic rhinitis compared to those without, chronic nasal symptoms. SUBJECTS AND METHODS: A questionnaire, skin prick t,est to common inhalant allergens, and methacholine bronchial provocation test (MBPT) were performed in a total of 216 subjects, who were composed of 40 non-asthmatic subjects with HDM-sensitive allergic rhinitis (HAR), 63 HDM-sensitive subjects without nasal symptoms (HS), and 113 non-atopic subjects without nasal symptoms (NHS). The bronchial responsiveness was evaluated by positive rate of MBPT (PC,-methacholine200mg/ml), provocative concentration of methacholine at which FEV, decline to 15% compared to baseline value (PC,-methacholine), and slope of dose-response curve (%fall of FEV, / log[last concentrat,ion of methacholine, mg/ml]). RESULTS: Positive rate of MBPT was significantly increased in HAR than in HS and NHS, and there was no difference between HS and NHS (77.9% vs. 50.7% vs. 38.0%). Log PC[5- methacholine was lower in HAR than in HS and NHS, and lower in HS than in NHS (mean+ SE, 1.568+0.126 vs. 2.05+0.085 vs. 2.277+0.047). Slope of dose-response curve was higher in HAR than in HS and NHS, and there was no difference bet,ween HS and NHS (mean+SE, 22.7 + 11.3 vs. 7.3+ 1.2 vs. 4.9+ 0.5%/mg/ml); CONCLUSION: In non-asthmatic adults with HDM-sensitive allergic rhinitis, the bronchial responsiveness to methacholine increased compared to those without chronic rhinitis.
Adrenal Cortex Hormones ; Adult ; Allergens ; Asthma ; Bronchial Provocation Tests ; Dust* ; Humans ; Methacholine Chloride* ; Pyroglyphidae* ; Rhinitis ; Skin ; Surveys and Questionnaires

When retroperitoneal leiomyosarcoma develops in pelvic cavity, it often presents similar symptoms and radiological findings to adnexal tumor, therefore obscures diagnostic approaches until an exploratory laparotomy is performed. We report an unusual presentation of retroperitoneal leiomyosarcoma mimicking an adnexal tumor with extremely elevated serum CA-19-9. Though the most of the prominent mass was removed during surgery, there was massive bleeding due to tearing of internal iliac vein while dissecting the ureter close to vessels. This case focuses on the significance of considering retroperitoneal tumor even if the mass is located in ovarian fossa and has highly elevated serum level of CA-19-9. And in attempt of tumor removal, the excision needs to be clean-cut without damaging nerves or vessels around the mass and avoid causing any prospective complications.
Hemorrhage ; Iliac Vein ; Laparotomy ; Leiomyosarcoma* ; Ureter

Upper thoracic vertebral bodies are difficult to access using standard anterior approaches. It may require sternotomy and claviculectomy, which carries significant possibility of morbidities. We report a case of inferiorly migrated cervicothoracic junction disc treated successfully by anterior upper-vertebral transcorporeal approach. This specific technique obviated the need of sternotomy, created favorable working space and saved the motion segment at cervicothoracic junction. This report is the first transcorporeal approach to a disc fragment at T1-2 space without fusion.
Intervertebral Disc ; Sternotomy