OBJECTIVE: This study was performed to evaluate the effect of cervical cerclage and the clinical characteristics in incompetent internal os of the cervix (IIOC). METHODS: A study was conducted on 170 patients with IIOC, 199 cases of IIOC were admitted and treated with McDonald operation or modified Shirodkar operation at department of Obstetrics and Gynecology Il Sin Christian Hospital from January 1. 1994 to December 31. 1998, of this 14 cases were follow up lost, so 185 cases were analyzed. RESULTS: 1) The incidence of IIOC was 0.43%, 1 in 233 deliveries. 2) The mean age of IIOC patients was 30.54yrs old and the most frequent age group was in 30-34yrs old group (43.78%). 3) The average number of gravida and parity before operation were 4.71 and 1.62. & the success rate of operation was low at high gravida & parity. 4) The predisposing factor was previous history of dilation & curettage (43.75%), Cx. laceration after delivery (6.49%), midtrimester termination (4.32%) etc. 5) The operation methods were McDonald operation (91.35%) and modified Shirodkar operation (8.65%) & the success rate of McDonald operation and modified Shirodkar operation were 85.80% and 87.50%. 6) The successful fetal salvage rate was 85.95% and the highest success rate was 87.50% in 14-16 weeks of gestation group. 7) The more cervix dilate, the more failure occurred. 8) The causes of operation failure were premature rupture of membrane (50.00%), preterm labor (34.62%), FDIU, anomaly, APH etc. 9) The delivery methods after operation were vaginal delivery (65.54%), cesarean delivery (34.46%). CONCLUSION: The 14-16th weeks of gestation group & no cervical dilatation have higher success rate indicating that early diagnosis and appropriate timing of operation is associated with a greater operation success rate.
Causality ; Cerclage, Cervical ; Cervix Uteri* ; Curettage ; Early Diagnosis ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Membranes ; Obstetric Labor, Premature ; Obstetrics ; Parity ; Pregnancy ; Pregnancy Trimester, Second ; Rupture

PURPOSE: To assess the efficacy and safety of selective laser trabeculoplasty (SLT) as initial and adjunctive treatment for ocular hypertension and open angle glaucoma. METHODS: Twenty-four eyes with ocular hypertension and 63 eyes with open angle glaucoma were treated with a frequency-doubled, Q-switched Nd:YAG laser. Intraocular pressure (IOP) was measured prelaser treatment, one week, one, two, three, six, 12, 18, and 24 months after treatment. RESULTS: The average pre-laser IOP of 87 eyes was 21.6 mmHg. The mean IOP percent reductions at 1 week, one, two, three, six, 12, 18, and 24 months were 15.3%, 20.0%, 21.3%, 19.6%, 23.4%, 23.4%, 20.5%, and 20.9%, respectively. The IOP percent reductions in the initial treatment group at one, 12, and 24 months were 21.1%, 24.8%, and 22.8% respectively. The IOP percent reductions in the adjunctive treatment group at 1, 12, and 24 months were 19.6%, 22.9%, and 20.2% respectively. There were no differences in IOP percent reduction between the initial treatment group and the adjunctive treatment group. CONCLUSIONS: Selective laser trabeculoplasty has shown reasonable efficacy in lowering IOP over two-year follow-up period as initial and adjunctive treatment for ocular hypertension and open angle glaucoma.
Eye ; Follow-Up Studies ; Glaucoma, Open-Angle ; Intraocular Pressure ; Ocular Hypertension ; Trabeculectomy

PURPOSE: To assess macular function before and after vitrectomy and membrane removal in epiretinal membranes by means of multifocal electroretinogram (mfERG). METHODS: The mfERGs (RETIscan(R), Roland, Germany) of 28 consecutive patients (28 eyes) with idiopathic epiretinal membranes were recorded before epiretinal membrane surgery and 3 to 6 months after surgery. The average retinal response density and implicit time of each local response were estimated as anatomic macular areas corresponding roughly to 5 rings. Preoperative and postoperative responses of mfERG were compared. The correlation of the change of retinal response density and postoperative macular configuration on optical coherent tomography (OCT) was statistically analyzed. RESULTS: The postoperative value of P1 amplitude and implicit time were not statistically correlated with the preoperative value (p>0.05). There were no significant correlations between the changes of rings 1 and 2 with regard to the retinal response density of the mfERGs and visual acuity. There was no significant correlation between the change of retinal response density and postoperative macular configuration according to OCT. CONCLUSIONS: The use of mfERGs does not seem useful for predicting clinical prognosis after epiretinal membrane surgery. Further studies of influence of internal limiting membrane removal on mfERG response should be conducted.
Epiretinal Membrane ; Humans ; Membranes ; Prognosis ; Retinaldehyde ; Visual Acuity ; Vitrectomy

BACKGROUND: Surgery of the nasolabial area is susceptible to the distortion of lips, commissure and nasal ala. A subcutaneous pedicle flap is suitable for surgical treatment of mid-size facial defects. OBJECTIVE: To evaluate the effectiveness of a subcutaneous pedicle flap for surgical defects of the nasolabial area. METHOD: We reviewed the medical records and evaluated clinical aspects and surgical treatment outcomes. RESULTS: Total number of patients was 13, including 8 males and 5 females. Mean age was 67.7years-old. Surgical defects were present on the alar crease in 9 cases, and upper lip in 4 cases. Mean size of defects was 1.6 by 1.3 cm. Flaps were well adopted, and no surgical scars were visible. No distortion of the adjacent structures were left. However, the alar crease was slightly blunted in one patient. CONCLUSION: A subcutaneous pedicle flap is suitable for reconstruction of nasolabial area defects.
Cicatrix ; Female ; Humans ; Lip ; Male ; Medical Records

BACKGROUND: Thread lift is a minimally invasive procedure for facial rejuvenation, but complications of thread lift have been reported. The purpose of this study was to evaluate outcomes and safety associated with elastic lift in relation to midface and upper mandibular region lifting. METHODS: Thirty-eight patients with sagging and laxity of the facial skin treated with elastic lift from September 2015 to October 2015 were enrolled in this study. Treatment was performed following the manufacturer's recommended protocol that called for 300 treatment lines. To evaluate elastic lift safety, a retrospective chart review was conducted. We used an automatic skin diagnosis system to evaluate the efficacy of elastic lift. RESULTS: Thirty-seven patients were female, and one patient was male. The mean age of the patients was 40.4 years, and their mean follow-up period was 3 months. There were no major complications manifesting in removal of the elastic thread during the follow-up period. The median skin laxity grade score was 5 (3-6) before surgery; the median skin laxity grade score was 3 (2-4) 3 months post-surgery, resulting in a statistically significant difference in skin grade score (P<0.01). CONCLUSIONS: Facial rejuvenation using elastic lift is an effective and safe procedure in select patients with midface ptosis and moderate jowls.
Diagnosis ; Female ; Follow-Up Studies ; Humans ; Lifting ; Male ; Rejuvenation* ; Retrospective Studies ; Skin

A contour change induced by a subcutaneous depleting disorder such as lupus or morphea can be corrected by filling the defect with an artificial or natural materials of the types of fillers, autologous fat is popularly utilized for volumetric correction. Autologus fat has many advantages, such as easy harvesting, free volume, and non-immunogenicity. Herein, we report a case who of a bilateral atrophic scar on the temple area induced by morphea which was successfully treated by autologous fat transplantation.
Cicatrix* ; Scleroderma, Localized*

Pilar sheath acanthoma is one of the benign follicular hamartoma, with a level of differentiation between trichofolliculoma and dilated pore of Winer. It differentiates toward infundibulum, isthmus, and rarely, sebaceous duct, apocrine, inner root sheath, and hair bulb components. It is a dome-shaped, symmetrical, sharply-circumscribed neoplasm that measures about 1cm in diameter. We herein report a case of pilar sheath acanthoma on the forehead of a 62-year-old male patient.
Acanthoma* ; Forehead ; Hair ; Hamartoma ; Humans ; Male ; Middle Aged

No abstract available.
Mucocele*

OBJECTIVE: To evaluate the effect of short coasting, by withdrawing both gonadotropins and GnRH agonist (GnRHa), on the prevention in severe ovarian hyperstimulation syndrome (OHSS) without compromising pregnancy outcome. METHOD: Thirty-seven women who had been coasted during COH for IVF were coasted when > or =20 follicles > 15 mm with serum E2 level of 4,000 pg/ml were detected. Coasting was initiated for one or two days depending on the status of follicle on ultrasound and serum E2 level. Both gonadotropin and GnRHa were withheld for coasting. Retrospective study was carried and changes of serum E2 levels, number of oocytes retrieved, fertilization rate, pregnancy rate were compared and analyzed. RESULTS: The mean serum E2 level fell from 6,993 pg/ml on the onset of coasting to 3,396 pg/ml on the day of hCG administration. The mean number of oocytes retrieved and fertilization rate were 15.7 and 70.0%, respectively. Fifteen patients were pregnant (40.6%) and implantation rate was 15.2%. Twenty-six (70.3%) patients were coasted for one day and 11 (29.7%) were coasted for two days. The mean decrease rate of serum E2 level was 43% in one day coasting group and 15% (1st day) and 81% (2nd day) in two day coasting group. The pregnancy outcome was similar between the two groups. After coasting, no severe or moderate OHSS occurred in any patients and mild OHSS occurred in 3 (8.1%) patients. CONCLUSIONS: Coasting for one or two days can be used successfully in the prevention of OHSS without compromising IVF cycle outcome.
Female ; Fertilization ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Ultrasonography

OBJECTIVE: Ovarian angiogenesis plays an important role in folliculogenesis. However, little is known about the expression of angiogenic factors during follicular development according to female age. Stromal cell derived factor-1alpha (SDF-1alpha) plays a role in granulosa cell survival and embryo quality as an angiogenic chemokine. Leptin is also involved in folliculogenesis and angiogenesis. This study examined expression of SDF-1alpha and leptin, and their effects on the expression of angiogenic factors in the ovary during follicular development according to female age. METHODS: Ovaries were collected from C57BL mice of two age groups (6-9 weeks and 24-26 weeks) at 6, 12, 24, and 48 hours after 5 IU pregnant mare's serum gonadotropin (PMSG) injection. The expression of ovarian SDF-1alpha and leptin mRNA was evaluated by RT-PCR. In the organ culture experiment, the ovaries were cultured in transwell permeable supports with Waymouth's medium treated with various doses of SDF-1alpha (50-200 ng/mL) or leptin (0.01-1 microg/mL) for 7 days. Then, mRNA expression of vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), and visfatin were examined in the cultured ovaries. RESULTS: Expression of SDF-1alpha and leptin in the ovary was significantly lower in the aged mouse group compared to the young mouse group (p<0.05). Expression of these two factors increased with follicular development after PMSG administration. SDF-1alpha treatment stimulated visfatin expression in a dose-dependent manner, while leptin treatment significantly increased eNOS expression. CONCLUSION: These results suggest that decrease of ovarian SDF-1alpha and leptin expression may be associated with aging-related reduction of ovarian function. SDF-1alpha and leptin may play a role in follicular development by regulating the expression of angiogenic factors in mouse ovaries.
Aged ; Aging ; Angiogenesis Inducing Agents ; Animals ; Chemokine CXCL12 ; Embryonic Structures ; Female ; Gonadotropins ; Granulosa Cells ; Humans ; Leptin ; Mice ; Mice, Inbred C57BL ; Nicotinamide Phosphoribosyltransferase ; Nitric Oxide Synthase Type III ; Organ Culture Techniques ; Ovary ; RNA, Messenger ; Stromal Cells ; Vascular Endothelial Growth Factor A