OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Androstenedione ; Biological Availability ; Carrier Proteins* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hyperandrogenism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Luteinizing Hormone ; Ovary* ; Ovulation ; Prolactin ; Somatomedins* ; Testosterone ; Thyrotropin ; Volunteers

Aniridia is a relatively rare congenital anomaly and its incidence is about 1:100, 000.Main features of aniridia include congenitally partial or nearly complete absence of the iris and hypoplasia of optic disc and fovea. It is almost bilateral and occurred as an autosomal dominant trait.However, some patients develop both sporadic nonfamilial aniridia and Wilms 'tumor, and another group of patients is transmitted as an autosomal recessive trait. We observed aniridia in two generations, as mother and two daughters. They had cataract, nystagmus, neovascularization of corneal margin and pannus formation, as well as aniridia.We also found hypoplasia of optic disc and fovea in mother. We have operated on mother with phacoemulsified lens aspiration and posterior chamber IOL implantation in both eyes consecutively.The postoperative visual acuity following lens extraction improved, but was not corrected. In addition, intraocular pressure decreased.
Aniridia* ; Cataract ; Family Characteristics ; Humans ; Incidence ; Intraocular Pressure ; Iris ; Mothers ; Nuclear Family ; Visual Acuity

PURPOSE: To evaluate surgical effect of Medpor(R) Barrier Sheet, by comparing with postoperative outcomes using Medpor(R) Barrier Sheet and Medpor(R) in orbital wall reconstruction. METHOD: We have retrospectively analyzed clinical features and postoperative outcomes in two groups. One group is 29 patients who had undergone orbital wall reconstruction using Medpor(R) Barrier Sheet, the other group is 26 patients who had undergone orbital wall reconstruction using Medpor(R). RESULTS: The violence was the most common cause of the orbital wall fractures, the most common fracture site was inferior wall in the two groups. There were no significant differences between the two groups in improvement of diplopia and limitation of extraocular movement(p>0.05). The mean amount of enophthalmic correction were 1.15 mm in Medpor(R) Barrier Sheet group and 1.39 mm in Medpor(R) group. Three cases of Medpor(R) Barrier Sheet group and two cases of Medpor(R) group caused the infraorbital hypoesthesia, but prolapse or dislocation of implant was not found in the two groups. CONCLUSIONS: In this study, Medpor(R) Barrier Sheet had similar surgical effect to regular Medpor(R); its advantages over regular Medpor(R) were easy intraoperative manipulation and less adherence of extraocular muscle in reconstruction of orbital wall fractures. But when cost- effectiveness is considered, Medpor(R) Barrier Sheet may be a good available implant in orbital wall reconstruction for the selective cases with extraocular muscle exposed.
Diplopia ; Dislocations ; Humans ; Hypesthesia ; Orbit* ; Prolapse ; Retrospective Studies ; Violence

Systolic time interval measurements were made sequentially during second, third trimesters and postpartum period. Recordings were made in the supine position after bed rest for at least five minutes in order to obtain a steady state. In second trimester, pre-ejection period index (PEPI) was significantly shortened and left ventricular ejection period index(LVETI) remained normal while PEP/LVET decreased. Four possible mechanisms may be involved to account for the alterations in hemodynamic changes during this period(late stage of second trimester) : (1) increased metabolic demands of pregnancy: (2) hemodynamic effects of hypervolemia: (3) circulatory adjustments secondary to an arteriovenous shunt-like effect of the placental circulation: (4) cardiovascular effect of steroid hormone. The third trimester was characterized-by a markedly shortened LVETI, a prolonged PEPI and PEP/LVET. This findings are consistent with impaired left ventricular performance and are probably due to decreased left ventricular preload resulting from diminished venous return secondary to inferior vena caval obstruction by the large gravid uterus. In the postpartum period, the PEPI and PEP/LVET remained elevated and the LVETI shortened in the supine position. It is concluded that alterations in systolic time intervals occur normally during the course of uncomplicated pregnancy and persist into the postpartum period.
Bed Rest ; Female ; Hemodynamics ; Humans ; Placental Circulation ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third* ; Supine Position ; Systole* ; Uterus

PURPOSE: We observed the short-term outcome and associated complications of transscleral diode laser photocoagulation (TSDL) for acute proliferative retinopathy of prematurity (ROP) to evaluate the efficacy and safety. METHODS: 20 eyes of 10 infants with acute ROP were treated with transscleral diode laser photo-coagulation through conjunctiva by a single surgeon. Anatomical results and postoperative complications were main outcomes. Follow-up ranged from 11 to 40 weeks. RESULTS: In 1 eye (5%), there was a macular temporal dragging. In 19 eyes (95%), regression occurred after a single laser treatment with a flat retina. No significant anterior or posterior segment complications were occurred, even though there was a small amount of preretinal hemorrhage in 1 eye after laser photocoagulation. CONCLUSIONS: The results suggest that transscleral diode laser photocoagulation is a safe and effective alternative to cryotherapy or transpupillary diode laser photocoagulation in the treatment of ROP.
Conjunctiva ; Cryotherapy ; Follow-Up Studies ; Hemorrhage ; Humans ; Infant ; Lasers, Semiconductor* ; Light Coagulation* ; Postoperative Complications ; Retina ; Retinopathy of Prematurity*

The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2 % HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.
Double-Blind Method ; Facial Bones ; Hot Temperature ; Humans ; Hyaluronic Acid ; Mouth Neoplasms ; Sensation ; Surgery, Oral ; Sutures ; Wound Healing

The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2 % HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.
Double-Blind Method ; Facial Bones ; Hot Temperature ; Humans ; Hyaluronic Acid ; Mouth Neoplasms ; Sensation ; Surgery, Oral ; Sutures ; Wound Healing

A 67-year-old man, with a history of pontine hemorrhage, was admitted because of ocular tremors. Also, tremors in the right upper limb and palates were detected. Oculopalatine tremors showed synchronous vertical oscillations and the limb showed midbrain tremor. Brain MRI revealed high signal intensities of both inferior olivary nuclei and right superior cerebellar peduncle. Electromyogram showed different tremor frequencies in the oculopalate and limb. Clinical, MRI and electromyographic findings indicate that the origins of oculopalatine and limb tremors are different.
Aged ; Brain ; Extremities ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Mesencephalon* ; Palate ; Tremor* ; Upper Extremity*

PURPOSE: We retrospectively reviewed the cases of ureteroscopic stone removal at our institution to define the efficiency of ureteroscopy for treatment of ureteral calculi. MATERIALS AND METHODS: Ureteroscopic stone removal was performed in 376 cases of ureteral stone from August, 1989 to December, 1997. There are 241 males and 135 females, and mean age was 45.6 years. Nine stones were located in the upper ureter, 27 in the mid ureter, 340 in the lower ureter. The stone size was less than 5mm in 125 cases, from 5 to 10mm in 185 cases and more than 10mm in 66 cases. Ureteroscopy was performed with 9.5Fr, 10Fr or 12.5Fr rigid ureteroscope under spinal, general or epidural anesthesia. RESULTS: Overall success rate of ureteroscopic stone removal was 95.1 percent. The success rates of upper, mid and lower ureteral stones were 55.6, 88.9 and 97.1 percents, respectively. According to the stone size, the success rates was 97.6 percent in stones less than 5mm, 94.6 percent in stones of 5 to 10mm and 92.4 percent in stones more than 10mm. Over all complication rate was 9.6 percent. Complications consisted of severe ureteral mucosal tearing(20 cases), ureteral perforation(8 cases), gross hematuria(3 cases), infection(3 cases) and urethral stricture(2 cases). All complications were treated successfully with conservative treatment except 2 cases of urethral stricture that required visual urethrotomies. CONCLUSIONS: Ureteroscopic stone removal could offer rapid relief of obstruction and colic due to mid and lower ureteral calculi with high success rate and minimal complications.
Anesthesia, Epidural ; Calculi ; Colic ; Female ; Humans ; Lithotripsy ; Male ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy ; Urethral Stricture

OBJECTIVE: Morphometric data on dorsal cervical anatomy were examined in an effort to protect the nerve root near the lateral mass during posterior foraminotomy. METHODS: Using 25 adult formalin-fixed cadaveric cervical spines, measurements were taken at the lateral mass from C3 to C7 via a total laminectomy and a medial one-half facetectomy. The morphometric relationship between the nerve roots and structures of the lateral mass was investigated. Results from both genders were compared. RESULTS: Following the total laminectomy, from C3 to C7, the mean of the vertical distance from the medial point of the facet (MPF) of the lateral mass to the axilla of the root origin was 3.2-4.7 mm. The whole length of the exposed root had a mean of 4.2-5.8 mm. Following a medial one-half facetectomy, from C3 to C7, the mean of the vertical distance to the axilla of the root origin was 2.1-3.4 mm, based on the MPF. Mean vertical distances from the MPF to the medial point of the root that crossed the inferior margin of the intervertebral disc were 1.2-2.7 mm. The mean distance of the exposed root was 8.2-9.0 mm, and the mean angle between the dura and the nerve root was significantly different between males and females, at 53.4-68.4degrees. CONCLUSION: These data will aid in reducing root injuries during posterior cervical foraminotomy.
Adult ; Axilla ; Cadaver ; Female ; Foraminotomy ; Humans ; Intervertebral Disc ; Laminectomy ; Male ; Spinal Nerve Roots ; Spine