Autosomal dominant polycystic kidney disease (ADPKD) is a hereditary disorder characterized by renal cyst formation, hypertension, and end-stage renal disease. For many years, ADPKD was considered an adult disease. In fact, it may occur at any time in life including in utero. We experienced a case of ADPKD at 34 weeks of gestation. On ultrasound, both kidnies were enlarged and echogenic. Amniotic fluid index was normal. We discovered a family history of paternal origin. Sonographic findings of bilaterally enlarged and echogenic kidnies without oligohydroamniosis may suggest ADPKD. Renal ultrasound examination of parents is useful in the diagnosis of ADPKD.
Adult ; Amniotic Fluid ; Diagnosis* ; Female ; Humans ; Hypertension ; Kidney Failure, Chronic ; Parents ; Polycystic Kidney, Autosomal Dominant* ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography

Emergency cerclage commonly known as that performed in the setting of advanced cervical dilatation with bulging membranes and associated with significantly increased failure rates. We experienced a successful emergency cerclage for advanced incompetent internal os of cervix ( IIOC ). Pregnancy was prolonged and we delivered viable fetus. Hereby we report this case with the brief review of literature.
Cervix Uteri ; Emergencies* ; Female ; Fetus ; Labor Stage, First ; Membranes ; Pregnancy

Purpose: In the present study, we introduced and evaluated the effectiveness of partial lid margin excision including hair follicles in diffuse trichiasis and distichiasis. Methods: A retrospective review of medical records was performed on 21 eyelids of 14 patients with diffuse trichiasis and distichiasis. The patients had trichiasis of more than 1/3 of the eyelid margin and received lid margin excision including hair follicles at our hospital. The patients were followed up for more than 3 months after surgical correction. A telephone survey of the surgical outcomes, including recurrence and cosmetic satisfaction, was conducted for patients who were unable to visit the clinic. Success was defined as complete resolution of symptoms, no recurrence of abnormal cilia, and acceptable cosmesis. Results: The patients included five males (6 eyes) and nine females (15 eyes) with an average age of 61.9 years (range, 39.8-82.4 years). The surgical success rate was 90.5%. Two eyelids showed a recurrence of trichiasis requiring additional electrolysis treatment, and one eyelid exhibited skin pigmentation. Conclusions For patients with diffuse trichiasis and distichiasis, partial lid margin excision including hair follicles showed excellent results with respect to resolving irritating symptoms, with minimal complications, low recurrence, and an easy procedure.

Purpose: In the present study, we introduced and evaluated the effectiveness of partial lid margin excision including hair follicles in diffuse trichiasis and distichiasis. Methods: A retrospective review of medical records was performed on 21 eyelids of 14 patients with diffuse trichiasis and distichiasis. The patients had trichiasis of more than 1/3 of the eyelid margin and received lid margin excision including hair follicles at our hospital. The patients were followed up for more than 3 months after surgical correction. A telephone survey of the surgical outcomes, including recurrence and cosmetic satisfaction, was conducted for patients who were unable to visit the clinic. Success was defined as complete resolution of symptoms, no recurrence of abnormal cilia, and acceptable cosmesis. Results: The patients included five males (6 eyes) and nine females (15 eyes) with an average age of 61.9 years (range, 39.8-82.4 years). The surgical success rate was 90.5%. Two eyelids showed a recurrence of trichiasis requiring additional electrolysis treatment, and one eyelid exhibited skin pigmentation. Conclusions For patients with diffuse trichiasis and distichiasis, partial lid margin excision including hair follicles showed excellent results with respect to resolving irritating symptoms, with minimal complications, low recurrence, and an easy procedure.

In order to evaluate the distribution of the immunoglobulins and complement in the normal conjunctiva, the limbal conjunctiva was incubated with fluorescein-conjugated antisera to IgG, IgM, IgA, C3, C1 and fibrin. The predominant distribution of IgG, IgM, IgA, and C3 within the stroma of the conjunctiva was shown with the presence of IgA within the conjunctival epithelium.
Complement System Proteins ; Conjunctiva* ; Epithelium ; Fibrin ; Immune Sera ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins*

The schwannoma is a benign neoplasm originating from Schwann cell. Solitary nerve sheath tumors such as benign schwannomas arising in the pelvic retroperitoneum are infrequently reported. Those tumors can indeed be misdiagnosed for other more common conditions both clinically and instrumentally. We report a very rare case of a benign retroperitoneal pelvic schwannoma of the obturator fossa, which was incidentally found and misdiagnosed as adnexal mass preoperatively in fifty one-years-old postmenopausal women.
Female ; Humans ; Nerve Sheath Neoplasms ; Neurilemmoma*

PURPOSE: The purpose of this study is to identify the influencing factors of mother-infant attachment and construct a descriptive model that explains mother-infant attachment during the early postpartum period. METHOD: The hypothetical model of this study consisted of 8 variables with 23 constructed paths. The subjects of this study were 152 postpartum women. Data was analyzed to test the hypothetical model using covariance structure analysis. RESULT: The final model which is modified from the hypothetical model improved to Chi-Square 41.92, GFI .95, AGFI .89, RMSR .02, RMSEA .06, NFI .94, and NNFI .95. Mother-infant attachment during the early postpartum period was proven to be influenced directly by neonatal perception, maternal sensitivity, and maternal-fetal attachment and also indirectly by social support, maternal-fetal attachment and maternal identity. These variables accounted for 32% of the variance of the mother-infant attachment during the early postpartum period. CONCLUSION: It is necessary that the nurses provide postpartum women with an intervention using social support for improving maternal identity and alleviating maternal role strain. It can be helpful to improve maternal sensitivity and in the end it will facilitate the mother-infant attachment during postpartum period.
Adult ; Female ; Humans ; Infant, Newborn ; Models, Psychological ; *Mother-Child Relations ; *Object Attachment ; Postpartum Period/*psychology

Actinomycoces is a gram positive, anaerobic, branching and non-acid fast bacterium which is a normal habitant of the skin, oral cavity, tonsil and gastrointestinal tract and its human infection is rare. Pelvic actinomycoses is frequently caused by Actinomycoces israel-ii. It is chronic, progressive, and more suppurative than granulomatous disease, and the symptoms are usually persistent and gradual, therefore the misdiagnosis and improper trea-tment are not uncommon. Actinomycoses is generally classified as cervicofacial, abdominal and thoracic type ac- cording to the site of the primary infection. Many actinomycotic pelvic infections in women used intrauterine device with long du- ration were reported, in contrast, others suggest that actinomycoces developed opportunistic infection irrespective of intrauterine device presence. We have experienced 4 cases of pelvic actinomycoses, one case with IUD(Lippes' loop) in a 47 year old woman, the other case with abdominal wall ctinomycoses in a 34 year old woman, the third case without IUD in a 41 year old woman, the fourth case with IUD(Cu-7) in a 37 year old woman and reported them with a review of literature.
Abdominal Wall ; Actinomycosis* ; Adult ; Diagnostic Errors ; Female ; Gastrointestinal Tract ; Humans ; Intrauterine Devices ; Middle Aged ; Mouth ; Opportunistic Infections ; Palatine Tonsil ; Pelvic Infection ; Skin

BACKGROUND: Intrathecal or epidural neostigmine has a postoperative analgesic effect. In this study we evaluated the effects of epidural neostigmine on postoperative analgesia and stress responses after gastrectomy. METHODS: Eighty, ASA physical status 1 or 2, patients scheduled for gastrectomy were randomly assigned to one (n = 20) of four groups. Patients received 5 ml of 0.25% bupivacaine with either saline (N0 group), neostigmine 5microgram/kg (N5 group), neostigmine 10microgram/kg (N10 group), neostigmine 15microgram/kg (N15 group) epidurally 30 minutes before operation. All patients received identical general anesthesia. Patient-controlled epidural analgesia (PCEA) was provided by bupivacaine (0.05%) and fentanyl (4 microgram/ml) for postoperative analgesia. RESULTS: The N10 and N15 groups showed reduced 24-h PCEA consumptions compared with the N0 and N5 groups (P < 0.05). No differences in visual analog pain scores at rest or during movement were observed between the groups. The concentrations of plasma cortisol, epinephrine, norepinephrine and glucose did not differ among the four groups, and their incidences of postoperative adverse effects were similar. CONCLUSIONS: Epidural neostigmine 10 and 15microgram/kg in bupivacaine produced a postoperative analgesic effect, but did not suppress stress responses after gastrectomy
Analgesia* ; Analgesia, Epidural ; Anesthesia, General ; Bupivacaine ; Epinephrine ; Fentanyl ; Gastrectomy* ; Glucose ; Humans ; Hydrocortisone ; Incidence ; Neostigmine* ; Norepinephrine ; Plasma

Purpose: The purpose of this study was to determine the efficacy and safety of selective intra-arterial thrombolysis in patients with central retinal artery occlusion (CRAO). Methods: Medical records for 44 eyes of 44 patients diagnosed with acute non-arteritic CRAO and thrombolysis between October 2010 and February 2019 were analyzed retrospectively. Based on visual acuity, fundoscopic findings, and fluorescein angiography, the patients were classified into three stages: incomplete, subtotal, and total. The perfusion state using the best-corrected visual acuity (BCVA), arm to retina time, and arteriovenous passage times, after 1 month, 6 months, and at the final visit after the procedure, were compared with baseline readings. Results: Improvement of visual acuity was confirmed in 31 out of 44 patients (70.45%). The mean BCVA of 44 patients changed from 1.65 ± 0.78 logarithmic minimum angle of resolution (logMAR) at the first visit to 1.18 ± 0.91 logMAR at the last visit (p = 0.114). The BCVA according to CRAO stage was 0.08 ± 0.11 logMAR for the incomplete stage at the first visit, 0.06 ± 0.05 logMAR (p = 0.933) 1 month after the procedure, and 0.05 ± 0.07 logMAR (p = 0.933) at the last visit. In the subtotal stage, the results were 1.81 ± 0.54 logMAR at the first visit, 1.63 ± 0.76 logMAR (p = 0.035) 1 month after the procedure, and 1.36 ± 0.85 logMAR (p = 0.014) at the last visit. For the total stage of BCVA, the result at the first visit was 2.36 ± 0.25 logMAR, and it was 2.30 ± 0.30 logMAR (p = 0.510) 1 month after the procedure, and 2.42 ± 0.30 logMAR (p = 0.642) at the last visit. Reperfusion was observed in 40 patients out of the 44 (90.91%). Conclusions Selective intra-arterial thrombolysis can be helpful in patients with subtotal CRAO in terms of visual improvement and retinal arterial reperfusion.