No abstract available.
Eosinophil Cationic Protein* ; Eosinophils* ; Rhinitis*

PURPOSE: To evaluate the clinical efficacy of amniotic membrane transplantation and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium, the results of 15 eyes of 14 patients were analyzed. METHODS: Total 10 cases of recurrent pterygium and 5 cases of pseudopterygium were surgically managed during June 1998 to July 2000. After excision of pterygium, amniotic membrane was attached on the bare sclera and limbal-conjunctival autograft was transplanted over the amniotic membrane. Mean follow-up period was 47.2 week and all patients were examined for recurrence, which was graded from G0(no vessel) to G3(fibrotic tissue invading the limbus). RESULTS: 12 out of 15 cases(rate 80%) showed no recurrence(grade 0). 1 case of grade 2 recurrence and 2 cases of grade 3(total 3 cases) were observed(rate 20%). Reoperation was performed on 2 cases of grade 3 recurrence. There was no further recurrence necessitating additional reoperation. 1 case of limbal graft was detached and removed. The operation time of this more prolonged than the other procedures, but there were no significant complications. CONCLUSION: Amniotic membrane and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium reconstructed complete ocular surface with less recurrence. Therefore, we recommend this surgical approach as a safe and effective method for the treatment of complicated cases of pterygium.
Amnion* ; Autografts* ; Follow-Up Studies ; Humans ; Pterygium* ; Recurrence ; Reoperation ; Sclera ; Transplants

BACKGROUND: Subarachnoid block is a widely used technique for cesarean section. To improve the quality of analgesia and prolong the duration of analgesia, addition of intrathecal opioids to local anesthetics has been encouraged. We compared the effects of sufentanil 2.5 microg and 5 microg, which were added to intrathecal hyperbaric bupivacaine. METHODS: We enrolled 105 full term parturients were randomly divided into 3 groups: Group 1 (control), Group 2 (sufentanil 2.5 microg), and Group 3 (sufentanil 5 microg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen. We determined the maximum level of sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and side effects. RESULTS: There were no significant differences among the 3 groups in the maximum level of the sensory block and motor block. Recovery rate of the sensory block, however, was significantly slower in Group 3 than Group 1. Quality of intraopertive analgesia, muscle relaxation, and duration of effective analgesia were enhanced by increasing the dosage of intrathecal sufentanil. Frequencies of hypotension, maximum sedation level, and pruritus were directly related to the dosage of intrathecal sufentanil, whereas nausea and vomiting occurred only in the groups using sufentanil. CONCLUSIONS: The addition of sufentanil 2.5 microg for spinal anesthesia provides adequate intraoperative analgesia and good postoperative analgesia with minimal adverse effects on the mother.
Analgesia ; Analgesics, Opioid ; Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine ; Cesarean Section ; Female ; Humans ; Hypotension ; Mothers ; Muscle Relaxation ; Nausea ; Pregnancy ; Pruritus ; Sufentanil ; Vomiting

A 34-year-old female with multiple sclerosis (MS) was scheduled Cesarean section. She had been suffering from MS for 10 years and the symptoms of MS were paraplegia and urinary incontinence. After informed consent, anesthesia was induced with propofol and maintained with nitrous oxide, sevoflurane and fentanyl. Rocuronium was used for muscle relaxation and tracheal intubation. Train of four (TOF) ratio and bispectral index scale were monitored for adequate muscle relaxation and depth of anesthesia. She gave birth to a baby within 7 minutes after skin incision. When operation was over, TOF ratio was 0.8. She emerged from general anesthesia smoothly and was extubated. There was no febrile event or exacerbation of MS after Cesarean section under general anesthesia. We report a safe anesthetic management of the parturient with MS, using sevoflurane.
Adult ; Androstanols ; Anesthesia ; Anesthesia, General ; Cesarean Section ; Female ; Fentanyl ; Humans ; Informed Consent ; Intubation ; Methyl Ethers ; Multiple Sclerosis ; Muscle Relaxation ; Nitrous Oxide ; Paraplegia ; Parturition ; Pregnancy ; Propofol ; Skin ; Stress, Psychological ; Urinary Incontinence

OBJECTIVE: The purpose of this study was to analyze stress distributions in the roots, periodontal ligaments (PDLs), and bones around cylindrical and tapered miniscrews inserted at different angles using a finite element analysis. METHODS: We created a three-dimensional (3D) maxilla model of a dentition with extracted first premolars and used 2 types of miniscrews (tapered and cylindrical) with 1.45-mm diameters and 8-mm lengths. The miniscrews were inserted at 30°, 60°, and 90° angles with respect to the bone surface. A simulated horizontal orthodontic force of 2 N was applied to the miniscrew heads. Then, the stress distributions, magnitudes during miniscrew placement, and force applications were analyzed with a 3D finite element analysis. RESULTS: Stresses were primarily absorbed by cortical bone. Moreover, very little stress was transmitted to the roots, PDLs, and cancellous bone. During cylindrical miniscrew insertion, the maximum von Mises stress increased as insertion angle decreased. Tapered miniscrews exhibited greater maximum von Mises stress than cylindrical miniscrews. During force application, maximum von Mises stresses increased in both groups as insertion angles decreased. CONCLUSIONS: For both cylindrical and tapered miniscrew designs, placement as perpendicular to the bone surface as possible is recommended to reduce stress in the surrounding bone.
Bicuspid ; Dentition ; Finite Element Analysis ; Head ; Maxilla ; Periodontal Ligament