PURPOSE: The present study evaluated the clinical results of phototherapeutic keratectomy (PTK) for refractory recurrent corneal erosion (RCE). METHODS: A total of 12 eyes from 11 RCE patients who had been initially treated with conservative therapy but suffered from recurrence, were treated using PTK with 193 nm excimer laser. The preoperative and postoperative best corrected visual acuity (BCVA), spherical equivalent, average keratometric value, re-epithelialization time, corneal haze, complications and recurrence were investigated. RESULTS: PTK was combined with photorefractive keratectomy in 1 eye. The mean follow-up time was 11.42 months. All 12 eyes were successfully treated and had no recurrence during the follow-up except 1 eye where the symptoms recurred 9 months postoperatively. Postoperative BCVAs were all better than the preoperative BCVAs. Mild myopic change (average -0.20 diopter) and increased average keratometric values (average 0.27 diopter) were noted in 11 eyes which were treated using PTK alone. The average re-epithelialization time was 5.63 days. No specific complication except mild corneal haze was found. CONCLUSIONS: PTK is a safe and effective treatment for refractory RCE in short-term follow-up.
Eye ; Follow-Up Studies ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy ; Re-Epithelialization ; Recurrence ; Visual Acuity

Background: Although the modified Blalock-Taussig shunt remains the mainstay method of palliation for augmenting pulmonary blood flow in various congenital heart diseases, the shunt must be carefully designed to achieve the best outcomes. This study investigated the effect of shunt configuration on pulmonary artery growth and growth discrepancy. Methods: Twenty patients with successful modified Blalock-Taussig shunt takedown were analyzed. Pulmonary artery and shunt characteristics were obtained using computed tomography scans. Differences in the baseline and follow-up diameter ratios and growth in the ipsilateral and contralateral arteries were calculated. The angle between the shunt and pulmonary artery, as well as the distance from the main pulmonary artery bifurcation, were measured. Correlations between pulmonary arteries and shunt configurations were analyzed. Results: The median interval time between shunt placement and takedown was 154.5 days (interquartile range, 113.25–276.25 days). Follow-up values of the ipsilateral-to-contralateral pulmonary artery diameter ratio showed no significant correlation with the shunt angle (ρ=0.429, p=0.126) or distance (ρ=0.110, p=0.645). The shunt angle and distance from the main pulmonary bifurcation showed no significant correlation (ρ=-0.373, p=0.189). Pulmonary artery growth was negatively correlated with shunt angle (ipsilateral, ρ=-0.565 and p=0.035; contralateral, ρ=-0.578 and p=0.030), but not with distance (ipsilateral, ρ=-0.065 and p=0.786; contralateral, ρ=-0.130 and p=0.586). Conclusion Shunt configuration had no significant effect on growth imbalance. The angle and distance of the shunt showed no significant correlation with each other. A more vertical shunt was associated with significant pulmonary artery growth. We suggest a more vertical graft design for improved pulmonary artery growth.

Holt-Oram Syndrome is an autosomal dominant disorder characterized by the association of upper-limb abnormalities and congenital heart disease. A woman with no family history of genetic disease underwent antenatal sonography at 27 weeks' menstrual age to screen for fetal anomalies. Ultrasonography revealed abnormalities in the upper limbs. The limb abnormalities included abscence of bilateral thumbs and radius: the left humus was short. Pregnancy termination was performed. The postnatal chromosomal analysis revealed a normal 46XX karyotype and the autopsy finding confirmed the Holt-Oram syndrome. We report a case of Holt-Oram Syndrome in fetus with unaffected parents with brief of the literatures.
Autopsy ; Extremities ; Female ; Fetus ; Heart Defects, Congenital ; Humans ; Karyotype ; Parents* ; Pregnancy ; Radius ; Soil ; Thumb ; Ultrasonography* ; Upper Extremity

PURPOSE: To evaluate the complication incidence of 23-gauge pars plana vitrectomy day surgery. METHODS: A retrospective review was conducted on 79 eyes that underwent 23-gauge pars plana vitrectomy day surgery from September 2009 to September 2010. The main outcome measures included changes in best corrected visual acuity (BCVA), intraocular pressure (IOP), and presence of postoperative complications after the day surgery. RESULTS: The mean preoperative log MAR BCVA improved from 1.32 +/- 0.96 to 0.40 +/- 0.41 at 3 months after surgery (p < 0.05). There was no significant differences between the mean preoperative IOP and IOP on the 1st day after surgery (p > 0.05). At the end of surgery, suture placement was required for sclerotomy site leakage in 4 eyes (5.1%). There were 10 eyes (12.7%) with postoperative complications, including 7 eyes with increased IOP (8.9%), hypotony in 2 eyes (2.6%) and vitreous hemorrhage in 1 eye (1.3%), with no case requiring reoperation. CONCLUSIONS: The patients who underwent 23-gauge pars plana vitrectomy day surgery achieved visual improvement without serious complications postoperatively.
Ambulatory Surgical Procedures ; Eye ; Humans ; Incidence ; Intraocular Pressure ; Outcome Assessment (Health Care) ; Postoperative Complications ; Retrospective Studies ; Sutures ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate the complication incidence of 23-gauge pars plana vitrectomy day surgery. METHODS: A retrospective review was conducted on 79 eyes that underwent 23-gauge pars plana vitrectomy day surgery from September 2009 to September 2010. The main outcome measures included changes in best corrected visual acuity (BCVA), intraocular pressure (IOP), and presence of postoperative complications after the day surgery. RESULTS: The mean preoperative log MAR BCVA improved from 1.32 +/- 0.96 to 0.40 +/- 0.41 at 3 months after surgery (p < 0.05). There was no significant differences between the mean preoperative IOP and IOP on the 1st day after surgery (p > 0.05). At the end of surgery, suture placement was required for sclerotomy site leakage in 4 eyes (5.1%). There were 10 eyes (12.7%) with postoperative complications, including 7 eyes with increased IOP (8.9%), hypotony in 2 eyes (2.6%) and vitreous hemorrhage in 1 eye (1.3%), with no case requiring reoperation. CONCLUSIONS: The patients who underwent 23-gauge pars plana vitrectomy day surgery achieved visual improvement without serious complications postoperatively.
Ambulatory Surgical Procedures ; Eye ; Humans ; Incidence ; Intraocular Pressure ; Outcome Assessment (Health Care) ; Postoperative Complications ; Retrospective Studies ; Sutures ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

BACKGROUND: The objective responses of cisplatin and etoposide (PVP) combination chemotherapy as second-line therapy following CAV was high (40~50%) and, in several reports, PVP yields survival results that are at least as good as those obtained with cyclophosphamide or doxorubicin-based regimens and with less host-related toxicity in chemotherapy-naive patients. We conducted a phase II study to evaluate the effect of a combination of cisplatin and etoposide as a first-line therapy in patients with small cell lung cancer. METHODS: Sixty-one previously untreated small cell lung cancer patients with measurable lesion(s) received cisplatin(30 mg/m2 IV, day 1~3) and etoposide(100 mg/m2 IV, day 1~3). In patients with limited disease, after completion of 6 cycles of PVP chemotherapy, chest and prophylatic brain irradiation was performed in case of complete responder, chest irradiation only in partial responder. RESULTS: 1) Of 55 evaluable patients, 13(24%) had a complete response and 29(53%) had a partial response. 2) The median survival time was 55.8 weeks for all patients(N=55), 61.1 weeks for limited disease(N=31), 51.3 weeks for extensive disease(N=24). 3) The response duration was 29.1 weeks for responders(N=42). 4) There was no significant prognostic factors iufluencing response rates. 5) The toxicity was tolerable and there was no treatment-related deaths. CONCLUSION: The PVP combination chemotherapy as a first-line therapy was effective and well-tolerated in patients with small cell lung cancer.
Brain ; Cisplatin* ; Cyclophosphamide ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Humans ; Small Cell Lung Carcinoma* ; Thorax

The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis (CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative 14th day. She was discharged on post operative 52nd day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.
Acute Kidney Injury ; Cardiomyopathy, Dilated ; Female ; Heart Failure ; Heart Transplantation* ; Heart* ; Heart-Assist Devices ; Humans

Leiomyomas of the vagina are rare benign solid tumors. A leiomyoma arises frommuscle in the round ligament and appears as a firm movable tumor deep in the substanceof the labium majus, but minority of these tumors occur in vaginal wall. A case of a 39year old woman with leiomyoma of the vaginal orifice was reported with a brief review ofliterature.
Female ; Humans ; Leiomyoma* ; Round Ligament of Uterus ; Vagina

PURPOSE: One-handed chest compression (OHCC) technique is performed by one hand. Therefore chest compression (CC) depth might decrease rapidly. This study will evaluate the patterns of CC depth decaying in performing OHCC and assess the effects of alternating the hand which performs CC on the patterns of CC depth decaying. METHODS: This study was designed as a prospective randomized manikin simulation trial. Students of medical college participated. First, 10 students performed OHCC (chest compression:ventilation=30:2) in a pediatric manikin lying on a hard floor for 5 minutes (baseline study). After the baseline study, 32 students were recruited and randomized to group A and B. Group A performed OHCC with hand shift every other cycle (test 1). Group B performed OHCC with hand shift when they feel fatigue (test 2). The compression data were collected using the CPRmeter. The mean compression depths (MCD) were calculated at one minute intervals using the Q-CPR review software. The heart rates were monitored and the fatigue scales were collected every 1 minute. RESULTS: The MCD values were decreased significantly after 1 minute in the baseline study (p<0.05). However they were not changed in test 1 and decreased significantly after 4 minutes in test 2 (p<0.05). The heart rate and the fatigue scales were increased significantly with time in all tests (p<0.05). CONCLUSION: When OHCC was performed without shifting the hand which performed CC, the MCD decreased significantly after 1 minute. However, we could delay the time of decreasing MCD by shifting the hand which performed CC.
Cardiopulmonary Resuscitation ; Deception ; Fatigue* ; Hand* ; Heart Arrest ; Heart Massage ; Heart Rate ; Humans ; Manikins* ; Pilot Projects* ; Prospective Studies* ; Thorax* ; Weights and Measures

BACKGROUND: The aim of this study is to evaluate the long term results of creating various right ventricle to pulmonary artery conduits for treating complex congenital heart disease. MATERIAL AND METHOD: Between June 1986 and July 2006, we retrospectively reviewed 245 patients who underwent reconstruction of the right ventricular outflow tract with various kinds of conduits. 410 operations were done in 245 patients, the mean age at operation was 3.2+/-4.9 years (range: 7 days~45 years) and the mean body weight was 12.5+/-8.7 kg (range: 2.4~76.3 kg). RESULT: We used the following conduits: Polystan conduit, Shelhigh conduit, Carpenter-Edward conduit, Dacron graft with an artificial valve, valveless Gore Tex vascular graft, homograft and hand-made bovine or autologous pericardial conduit. The mean follow up duration was 6.3+/-5.2 years. Redo operation for RV-PA conduit dysfunction was performed in 131 patients, a second redo was done in 31 and a third redo was done in 3. The reoperation free rates were 67.3%, 48.5% and 39.4% for 5 years, 10 years and 15 years, respectively. The homograft showed the best durability, followed by the Dacron graft with artificial valve and the Carpentier-Edward conduit. The larger sized conduit showed better durability. CONCLUSION: The homograft showed lowest reoperation rate and a smaller size of conduit showed the highest reoperation rate. The reoperation rate for the RV-PA conduit was about 35% at 5 years, so it is mandatory to develop the more durable conduit for RV outflow.
Body Weight ; Follow-Up Studies ; Heart Diseases ; Heart Ventricles ; Humans ; Polyethylene Terephthalates ; Polytetrafluoroethylene ; Pulmonary Artery ; Pulmonary Atresia ; Reoperation ; Retrospective Studies ; Tetralogy of Fallot ; Transplantation, Homologous ; Transplants