AIM: To report the clinical manifestations of localized peripapillary detachment in pathologic myopia and to evaluate its underlying associations and causes.METHODS: From December 2002 to January 2004, 10eyes from 7 patients with high myopia were identified to have localized peripapillary detachment by optical coherent tomography (OCT). The features were described together with the fundus fluorescein angiography, indocyanine green angiography and multifocal electroretinogram.RESULTS: Localised peripapillary detachments did not cause any symptoms by themselves and all the lesions were recognized because of other ocular problems. The areas of peripapillary detachment were all located within the posterior staphyloma. In the 5 eyes with type 1 staphyloma, the locations of detachment were all in the nasal half of the peripapillary area. In the other 5 eyes with type 2 and 3 staphyloma, the locations of detachment were all in the non-nasal peripapillary area. The difference between these two groups was statistically significant (Fisher's exact test, ,P= 0.01).CONCLUSION: Peripapillary detachment is probably a benign complication of posterior staphyloma in pathologic myopia. The site of peripapillary detachment is affected by the location of staphyloma and OCT is important in making the diagnosis.

Home respiratory support for patients in the home care setting can range from simple oxygen supplementation, non-invasive ventilation, to home ventilation support via a tracheostomy. A home care doctor may not be able to know everything about ventilator support, but he should be familiar with the medical care of patients requiring one, and know who to refer to should patients require ventilator adjustments or troubleshooting. The management of such patients is challenging outside the hospital setting and usually requires a multidisciplinary team effort from the doctors, nurses, medical social worker, respiratory therapists, vendor of the ventilator and, most importantly, dedicated and well-trained caregivers. This article will cover two other important topics that Family Physicians should know when managing patients who require home respiratory support: home oxygen therapy and tracheostomy care.

Irritant skin reactions can be evaluated by several techniques. Using different scores for the degree of erythema, edema, scaling and fissuring is the time-honored approach but implies t,he disadventagrs of lacking objectivity and pararretric properties. This paper describes the objective nteasurement of irritant. skin responses to various concentrations of Sodium Lauryl Sulfate(SLS) and Ethanol by a color reflectance meter(Chroma Meter) and compares with visual scoring The results are summarized as follows : 1. Pretreatment assessments by a Chroma Meter on normal forearm area showed an average score of 7.70+1.53 for Chroma Meter value a*(rediies:; score). 2. Skin responses to SLS in various concentrations of 0.5, 1.0, 2.0, 3.0, 4.0, 5.0, 7.5% under occlusion for 24 hours were assessed by visual scoring system. They are measured 0.56+1.10, 0.74+1.29, 1.19 1.36, 2.11+1.69, 2.19+1.91, 2.56+1.50 2.81+2.16 respectively. 3. Skin responses to SLS in various concentrations of 0.5, 1.0, 2.0, 3.0, 4.0, 5.0, 7.5% under occlusion for 24 hour were assessed by a Chroma Meter valu a*(redness score). They are measured 8.29+1.98, 8.37+2.47, 9.31+2.27, 10.34+2.97, 10.35+3.18, 10.51+2.47, 11.61+3.45 respectively. 4. Skin responses to Ethanol in various concentrations were nearly negligible. 5. We have demonstrated there is a highly significant correlation between skin redness measured by the Chroma Meter and visually assessed erypthma(p<0.0001). It yields reproducible, objective, quantitative measurements of iryhema that parallel the subjective visual assessments.
Edema ; Erythema* ; Ethanol* ; Forearm ; Humans ; Male ; Skin* ; Sodium Dodecyl Sulfate* ; Sodium*

STATEMENT OF PROBLEM: Titanium-Nickel alloy might be used in various prosthetic restorations since it has a unique property such as super-elasticity and high fatigue resistance. However, little is known about the casting ability of this alloy. PURPOSE: This in vitro study compared the casting accuracy and the porosity made with different investments and various sprue designs to ascertain what casting condition would be better for the fabrication of Ti-Ni cast restorations. MATERIAL AND METHODS: A total of 70 Ti-Ni alloy crowns were made and divided into 7 groups of 10 copings on a metal master die. For measuring the effect of the sprue numbers, two groups with one and two 8-gauge sprues were compared. Moreover, the results of the conventional sprue and the double thickness sprues were compared. Three investments were used; carbon free phosphate bonded investment, titanium investment and gypsum bonded investment. The cast restorations were evaluated at 48 points on the entire circumferential margin with a stereomicroscope measuring in micrometers. Each crown was radiographically examined for casting defects and porosity. Data on casting accuracy were analyzed using two-way and Post hoc Scheffe's comparison to determine whether significant differences existed at the 95% confidence level. Student-Newman-Keuls test were performed to identify significant differences in the number of voids. RESULTS: The double sprueing group and double thickness group had significantly less marginal discrepancy than the single sprueing group (P<.05 and P<.01, respectively). The castings with phosphate bonded investment showed the least marginal discrepancy and the smoothest surface. The castings invested in the gypsum bonded investment had the greatest gaps in margin and the largest failure rate. The double sprueing group and phosphate bonded investment group had significantly smaller void numbers and smaller void size than the other groups. CONCLUSION: Within the limitations of this in vitro study, the casting accuracy of the groups using thicker, double sprue design and the phosphate bonded investment was significantly superior. Moreover, void number and size were less than other groups.
Alloys ; Calcium Sulfate ; Carbon ; Celiac Disease ; Crowns ; Fatigue ; Investments ; Porosity* ; Titanium

It is well known that histologic grade and tumor stage are important prognostic factors, and that the monoclonal antibody to proliferating cell nuclear antigen(PCNA) can recognize S-phase cells. The PCNA index of 53 transitional cell carcinomas(TCCs) of the urinary bladder was studied to evaluate its prognostic validity. The PCNA indices of TCCs ranged from 38 to 92, whih were quite different from that of normal transitional epithelium(9.4). The PCNA indices were significantly higher in tumors of the higher histologic grade and/or tumor stage(correlation coefficient 0.64 and 0.43; P=0.00). The PCNA index was particularly valuable in discriminating the superficial TCCs from the deeply invasive TCCs(67.1+/-15.46 and 79.9+/-9.70; P=0.000). Among TCCs of the same tumor stage, the histologic grade affected the PCNA index. However, TCCs of the same histologic grade revealed similar PCNA indices regardless of tumor stage. These results indicate that the PCNA index is an objective and reliable prognostic factor in TCCs, which is superior to the conventional histologic grade.

Objective To construct nursing needs scale for school-age children with acute leukemia (AL) during lumbar puncture by using Delphi technique.Methods A certain number of experts were chosen for consulting to form a consulting scale.Two-round consultations were conducted and the results were analyzed.Results The effective response rate of the experts' questionnaire for 2 rounds was 100％ (17/17).The specialist group authority coefficient was 0.85.The coordination coefficients for 2 rounds were 0.437 and 0.516 respectively (P ＜ 0.01).The nursing needs scale for school-age children with AL during lumbar puncture comprised of 5 first-level indicators and 30 second-level indicators.Conclusions This scale can scientifically and quickly evaluate the nursing needs of school-age children with AL during lumbar puncture,it provides a research tool to develop individualized interventions with demand as the direction.

Pedunculated lipofibroma is a rare disorder characterized by ectopic deposits of mature adipose tissue in the dermis. It is a dorne shaped or sessile papule which occurs at any site and develops later in life. We, herein, report two cases of pedunculated lipofibroma which have developed on the chin of a 64-year-old man and the buttock of a 47-year-old woman.
Adipose Tissue ; Buttocks ; Chin ; Dermis ; Female ; Humans ; Middle Aged

Objective We aimed to explore the real experience of parents of children with acute leukemia during lumbar puncture,so as to provide the theoretical and practice evidence for development of individualized nursing measures.Methods Twenty parents of children with acute leukemia participated in semi-structured interviews regarding their experience of lumbar puncture.The data were colected and analyzed by the Colaizzi phenomenological methodology.Results Three themes were extracted including heavy psychological burden,lack of related knowledge of lumbar puncture and demand of multipolarity.Conclusions Attention should be paid closely to parents of children with acute leukemia during lumbar puncture.The individualized nursing measures should be taken by medical workers in order to truly meet their needs,make them stay in a good state and cooper-ate with medical workers to complete the treatment of children.

OBJECTIVETo investigate the expression of DNA mismatch repair (MMR) genes (MLH1, MSH2, MSH6 and PMS2) in endometrial adenocarcinoma (EC) of patients under 50 years and to explore the relationship between MMR expression and clinicopathological features including body mass index (BMI), histological grade and pathological stage of EC.

METHODSMMR gene expression was investigated by immunohistochemical S-P method in endometrial adenocarcinomas of patients under age of 50. The control groups included complexity atypical hyperplasia endometrium (CAHE), simple hyperplasia endometrium (SHE), normal endometrium (NE) of patients under age of 50 and EC of patients older than 65 years.

RESULTSTwenty seven of 40 EC (67.5%) lost at least one MMR protein expression. Loss of at least one MMR protein expression was seen in 5/15 cases of CAHE, 1/13 SHE and 1/11 NE, respectively (P < 0.01). The rates of loss of expression of MLH1, MSH2, MSH and PMS2 proteins in EC were 52.5%, 12.5%, 35.0%, and 30.0%, respectively. The difference between MLH1 and MSH6 expression among the four groups were significant (P < 0.05), but the expression of MSH2 showed no significant difference among the groups (P = 0.295). The expression of MMR protein had no relationship with histological grade and pathological stage, although loss of MSH6 was more frequently seen in patients of higher BMI.

CONCLUSIONSAbnormal expression of MMR proteins is correlated with the development of EC from complex atypical hyperplasia. With the exception of the correlation of MSH6 expression with higher BMI, the expression of MMR proteins in EC has no significant relationship with histological grade and pathological stage.

Adaptor Proteins, Signal Transducing ; metabolism ; Adenocarcinoma ; genetics ; metabolism ; pathology ; Adenosine Triphosphatases ; metabolism ; Adult ; Body Mass Index ; DNA Mismatch Repair ; DNA Repair Enzymes ; metabolism ; DNA-Binding Proteins ; metabolism ; Endometrial Neoplasms ; genetics ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Mismatch Repair Endonuclease PMS2 ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; metabolism ; Neoplasm Grading ; Neoplasm Staging ; Nuclear Proteins ; metabolism

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer