PURPOSE: To evaluate of the range and relationship between intraocular pressure (IOP), and central corneal thickness (CCT) in premature infants. METHODS: To investigate the correlation of IOP and CCT with gestational age and body weight, 58 premature infants 37 weeks-old or younger were examined. Under topical anesthesia, IOP was measured with Tono-Pen(R) XL (Medtronic Solan, Jacksonville, FL) and the CCT with pachymeter (SP-2000, TOMEY(R), Japan). The fundus was examined in infants with a risk of retinopathy of prematurity (ROP). RESULTS: Average gestational age of the subjects was 33 weeks and 6 days and body weight was 1506+/-520 grams (mean+/-standard deviation). Forty-five subjects had oxygen therapy, and 10 patients were found to have any one of the stages of ROP. Average IOP was 15.14+/-4.64 mmHg in the right eye and 15.29+/-3.70 mmHg in the left eye. CCT was 594.72+/-74.87 micrometer in the right eye and 599.78+/-74.17 micrometer in the left eye. No statistically significant correlation was found between IOP or CCT and gestational age or body weight. CONCLUSIONS: Gestational age and body weight did not appear to affect IOP or CCT in the gestational age between 26 and 37 weeks. The maturing eye in the neonate is known for fast development in the first year after birth. There are, however, few reports in the literature regarding the changes in dimensions of ocular structures in the premature neonate. These normative values may aid ophthalmologists in assessing IOP and CCT in premature infants.
Anesthesia ; Body Weight ; Diterpenes ; Eye ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intraocular Pressure ; Oxygen ; Parturition ; Retinopathy of Prematurity ; Toluidines

PURPOSE: To evaluate of the range and relationship between intraocular pressure (IOP), and central corneal thickness (CCT) in premature infants. METHODS: To investigate the correlation of IOP and CCT with gestational age and body weight, 58 premature infants 37 weeks-old or younger were examined. Under topical anesthesia, IOP was measured with Tono-Pen(R) XL (Medtronic Solan, Jacksonville, FL) and the CCT with pachymeter (SP-2000, TOMEY(R), Japan). The fundus was examined in infants with a risk of retinopathy of prematurity (ROP). RESULTS: Average gestational age of the subjects was 33 weeks and 6 days and body weight was 1506+/-520 grams (mean+/-standard deviation). Forty-five subjects had oxygen therapy, and 10 patients were found to have any one of the stages of ROP. Average IOP was 15.14+/-4.64 mmHg in the right eye and 15.29+/-3.70 mmHg in the left eye. CCT was 594.72+/-74.87 micrometer in the right eye and 599.78+/-74.17 micrometer in the left eye. No statistically significant correlation was found between IOP or CCT and gestational age or body weight. CONCLUSIONS: Gestational age and body weight did not appear to affect IOP or CCT in the gestational age between 26 and 37 weeks. The maturing eye in the neonate is known for fast development in the first year after birth. There are, however, few reports in the literature regarding the changes in dimensions of ocular structures in the premature neonate. These normative values may aid ophthalmologists in assessing IOP and CCT in premature infants.
Anesthesia ; Body Weight ; Diterpenes ; Eye ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intraocular Pressure ; Oxygen ; Parturition ; Retinopathy of Prematurity ; Toluidines

There are many reports about causes of corrosive agents such as acids and alkaline and occasionally hot food in either liquid or solid forms as causes of upper gastrointestinal mucosal injury. However, there have been no reports on bowel preparation solutions as a cause of upper gastrointestinal injury. We describe a case of bowel preparation solution (PICOLIGHT powder) induced thermal injury of the gastric mucosa with a review of the literature.
Cathartics ; Gastric Mucosa*

Here, we report a case of newly diagnosed diabetes, with concurrent pancreatic cancer manifested as hyperglycemic crisis, and aggravated by urinary tract infection. We summarize the initial clinical manifestations and pertinent laboratory, radiologic, and clinical findings in an elderly patient with hyperglycemic emergency. A review of the documents involving pancreatic tumors and hyperglycemic hyperosmolar state, which is an acute complication of diabetes mellitus, is presented. In the absence of other identifiable conditions, it is reasonable to speculate that some factor (or factors) produced by the tumor had a role in the metabolic decompensation. In addition, this discussion should be more carefully considered in the aged people group.
Aged ; Diabetes Mellitus ; Emergencies ; Humans ; Pancreatic Neoplasms ; Urinary Tract Infections

PURPOSE: To investigate the influence of the change in medial rectus resection amount caused by traction with muscle hooks on surgical results in exotropia. METHODS: In this prospective study 38 exotropia patients underwent unilateral lateral rectus recession-medial rectus resection (R & R). After isolation of the medial rectus muscle, the length of the muscle was measured with a muscle hook, and the portion to be resected was marked using gentian violet stain with calipers. After the medial rectus was retracted with two muscle hooks in either direction, its length was measured again with the calipers. Group 1 includes the patients with the planned resection amount changed to a more 0.5-1.0 mm when the rectus muscle was retracted, while group 2 did not change with the second muscle hook. The surgical results were compared between the 2 groups at postoperative 6 months. RESULTS: Mean resection amount was changed from 5.07 +/- 0.76 mm to 5.36 +/- 0.73 mm after pulling the second muscle hook. Sixteen patients (42.1%) were included in group 1 and 22 patients (57.9%) in group 2. There was no significant statistical difference in mean preoperative and postoperative deviated angle between the two groups. Success rates defined as the ocular alignment within +/- 10 PD in the primary position at postoperative 6 months were 75.0% in group 1 and 86.3% in group 2, which is not stastistically different (p > 0.05). CONCLUSIONS: Medial rectus resection amounts can be changed with the muscle traction with two muscle hooks, which induced the planned amount of resection less than first measured resection amount. However, there was little influence on surgical outcomes from the change occurred to a maximum 1 mm in resection measurement due to traction with two muscle hooks.
Exotropia ; Gentian Violet ; Humans ; Muscles ; Prospective Studies ; Strabismus ; Traction

PURPOSE: To evaluate the efficacy of preoperative intravitreal bevacizumab (Avastin(R); Genetech, San Francisco, CA, USA) injections of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: Thirty patients (30 eyes) who underwent PPV for treatment of PDR and received a preoperative intravitreal bevacizumab injection of 1.25 mg were retrospectively analyzed. The study group (group 1, 30 patients, 30 eyes) was compared with a control group (group 2, 29 patients, 30 eyes and matched with the study group for preoperative parameters) who underwent PPV without preoperative intravitreal bevacizumab injection. RESULTS: In both groups, visual acuity improved but there was no statistical significance. Intraoperative vitreous hemorrhage occurred in 14 eyes (46.7%) from group 1 and 11 eyes (36.7%) from group 2. There was no statistical significance of intraoperative bleeding occurrence (p=0.3). Postoperative vitreous hemorrhage occurred in 4 eyes from group 1 and 14 eyes from group 2. The group 1 had a lower incidence of postoperative hemorrhage than group 2 (p=0.005). CONCLUSIONS: Preoperative intravitreal bevacizumab injection appears effective in decreasing early postoperative vitreous hemorrhage and maybe technically helpful in PPV for PDR.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Eye ; Hemorrhage ; Humans ; Incidence ; Postoperative Hemorrhage ; Retrospective Studies ; San Francisco ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Bevacizumab

PURPOSE: To evaluate the efficacy of preoperative intravitreal bevacizumab (Avastin(R); Genetech, San Francisco, CA, USA) injections of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: Thirty patients (30 eyes) who underwent PPV for treatment of PDR and received a preoperative intravitreal bevacizumab injection of 1.25 mg were retrospectively analyzed. The study group (group 1, 30 patients, 30 eyes) was compared with a control group (group 2, 29 patients, 30 eyes and matched with the study group for preoperative parameters) who underwent PPV without preoperative intravitreal bevacizumab injection. RESULTS: In both groups, visual acuity improved but there was no statistical significance. Intraoperative vitreous hemorrhage occurred in 14 eyes (46.7%) from group 1 and 11 eyes (36.7%) from group 2. There was no statistical significance of intraoperative bleeding occurrence (p=0.3). Postoperative vitreous hemorrhage occurred in 4 eyes from group 1 and 14 eyes from group 2. The group 1 had a lower incidence of postoperative hemorrhage than group 2 (p=0.005). CONCLUSIONS: Preoperative intravitreal bevacizumab injection appears effective in decreasing early postoperative vitreous hemorrhage and maybe technically helpful in PPV for PDR.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Eye ; Hemorrhage ; Humans ; Incidence ; Postoperative Hemorrhage ; Retrospective Studies ; San Francisco ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Bevacizumab

PURPOSE: To evaluate changes in muscle length when retracting the extraocular rectus muscle with muscle hooks during strabismus surgery. METHODS: Forty-four rectus muscles of 42 patients consecutively resected in two hospitals (A, B) were included in this study. After isolation of the rectus muscle, the length of the muscle was recorded and the portion to be resected was marked using gentian violet stain on the tip of calipers. After the rectus muscle was retracted with two muscle hooks in either direction, its length was measured again with the calipers. RESULTS: The length of the rectus muscle was not changed by retraction in 25 of 44 muscles (56.8%). The length of the muscle was changed by 0.5 mm in 13 muscles (29.5%) and by 1mm in six muscles (13.6%). Changes of rectus muscle length over 0.5 mm were observed in 15 of 27 muscles of patients treated at hospital A (55.5%) and four of 17 muscles of patients treated at hospital B (23.5%). The results for the two hospitals were significantly different (p=0.037). CONCLUSIONS: Small errors in measurement can occur when muscle resections are performed during strabismus surgery. Institutional or clinician related factors may explain variations in error rates between hospitals.
Gentian Violet ; Humans ; Muscles ; Strabismus ; Traction

The inflammation of colonic diverticulum, diverticulitis, is occasionally accompanied by several complications, such as bleeding, bowel obstruction, fistula and abscess formation. Both colo-ovarian fistula and tuboovarian abscess formation, as complications of diverticulitis, are rare. Here, we report a case of colonic diverticulitis which ultimately resulted in colo-ovarian fistula and tuboovarian abscess formation. A 76-year-old female was presented with lower abdominal pain, diarrhea and intermittent hematochezia for about 1 month. According to the abdominal computed tomography, tuboovarian abscess was shown to adhere to the inflamed sigmoid diverticulum. Sigmoidoscopy revealed pus flowing from the opening of the diverticulum at the sigmoid colon. Hence, the patient underwent oophorosalpingectomy and low anterior resection. Thereafter, she was treated with bowel rest and broad spectrum antibiotics, and finally recovered. Although rare, colonic diverticulitis may result in colo-ovarian fistula causing tuboovarian abscess formation in postmenopausal patients. Early recognition of the condition and appropriate treatment, including surgery and antibiotics, are necessary in order to achieve full recovery from complicated diverticulitis.
Abdominal Pain ; Abscess* ; Aged ; Anti-Bacterial Agents ; Colon* ; Colon, Sigmoid ; Diarrhea ; Diverticulitis ; Diverticulitis, Colonic* ; Diverticulum ; Diverticulum, Colon ; Female ; Fistula* ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Inflammation ; Sigmoidoscopy ; Suppuration

A phytobezoar is the most common type of bezoar, which is a gastrointestinal mass composed of vegetable. A persimmon is a common cause of a phytobezoar. The majority of bezoars are found in the stomach, with the small intestine being the next most commonly involved site. The colon is a rare site for a bezoar. Recently, we experienced a colonic bezoar that caused colonic obstruction in a 66-year-old female patient who took persimmons regularly. The patient came to the hospital because of abdominal pain and distension. To differentiate a tumor or other problems that can cause intestinal obstruction, we performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal descending colon. A large impacted bezoar was seen in the sigmoid colon, which was completely obstructed, and it was successfully removed by using colonoscopy.
Abdominal Pain ; Aged ; Bezoars ; Colon ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Diospyros ; Female ; Humans ; Intestinal Obstruction ; Intestine, Small ; Porphyrins ; Stomach ; Vegetables