PURPOSE: To evaluate the surgical results and clinical effectiveness of silicone tube intubation through Hasner's valve under intranasal endoscopic guidance in children with congenital nasolacrimal duct obstruction (CNDO). METHODS: The present study enrolled a total of 58 eyes of 46 children over 12 months of age diagnosed with CNDO in the Department of Ophthalmology, Inje University College of Medicine from 2003 to 2010. Patients who had previously undergone ineffective probing or had a combination of an anatomical abnormality such as secondary nasolacrimal duct obstruction were also included. The silicone tube was intubated through the Hasner's valve and observed with intranasal endoscopy; tube retention time was planned for at least 12 weeks. RESULTS: A total of 20 eyes were previously probed preoperatively (mean 1.7 times). After the average follow-up period of 13.5 months, the overall success of silicone intubation was 57 of 58 eyes (98%). In one failed eye, nasolacrimal obstruction was already combined preoperatively, and unintentional tube removal by the patient occurred within one week. Silicone tube reintubation was performed after four months, and CNDO symptoms improved. CONCLUSIONS: Intranasal endoscopic observation to ensure the passage of a silicone tube through Hasner's valve decreases anatomical injury. When considering patient age and former treatment, silicone tube intubation with intranasal endoscopic observation could produce desirable results with a higher success rate.
Child ; Dietary Sucrose ; Eye ; Follow-Up Studies ; Humans ; Intubation ; Nasolacrimal Duct ; Ophthalmology ; Retention (Psychology) ; Silicones

Alteration in the hormone level associated with menstrual cycle influences the interaction between the urethra and bladder as well as detrusor function, maybe due to the common embryological origin of lower female genital and urinary tract. We tried to investigate the effect of the menstrual cycle on cystometric diagnosis through this retrospective study. 60 women with regular menstruation were enrolled in this study. The study groups were divided into 2 groups, Group I was women whose symptoms were not influenced by the menstrual cycle, Group II was women whose symptoms were adversely affected premenstrually. The majority of normal cystometric diagnosis were made in the luteal phase (Group I: 42.9% vs 4.4%, p<0.05; Group II: 50.0% vs 22.2%, p<0.05). But diagnosis of genuine stress incontinence, detrusor instability, mixed genuine stress incontinence and detrusor instability were frequently made in the follicular phase of mentruation. Normal cystometric diagnosis in the group II were more commom than the group II ( 36.8% vs 19.7%, p<0.05 ). The results of this study reveal that the timing of cystometric evaluation may influence the the detection of a positive diagnosis. In patients whose symptom are influenced by their menstrual cycle, the luteal phase may not be the correct time to make an accurate diagnosis.
Diagnosis ; Female ; Follicular Phase ; Humans ; Luteal Phase ; Menstrual Cycle* ; Menstruation ; Retrospective Studies ; Urethra ; Urinary Bladder ; Urinary Tract

45,X/47,XYY mosaicism is a rare sex chromosomal disorder with clinical information limited to 25 cases in the literature. We report an unusual mosaic Turner syndrome case in a 35-year old Korean woman with a phenotypic female, primary amenorrhea, short stature, immature secondary sexual characteristics. Cytogenetic analysis including G- and Q-banding revealed 45,X/47,XYY mosaicism, and SRY gene was demonstrated by polymerase chain reaction(PCR). Prophylactic bilateral gonadectomy was performed because the presence of Y-chromosomal sequences in Turner stigmata may predispose this patient to gonadoblastoma formation.
Adult ; Amenorrhea ; Christianity ; Chromosome Disorders ; Cytogenetic Analysis ; Female ; Genes, sry ; Gonadoblastoma ; Humans ; Mosaicism ; Turner Syndrome*

BACKGROUND: Intermittent rhythmic delta activity (IRDA) is classified as a nonspecific abnormal EEG pattern. IRDA is clinically associated with alteration of consciousness, hydrocephalus, cerebral edema, deep midline lesions, subcortical lesions, and tumors of the posterior fossa and the third ventricle. Frontal IRDA(FIRDA) is usually seen in patients over age 15 years, whereas occipital IRDA(OIRDA) occurs mainly in children. We have investigated the clinical feature and significance of IRDA in children. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 36 children with IRDA of EEG concerning diagnosis, neurologic examination, classification of epilepsy, and CT & MRI findings. RESULTS: 1) The location of the IRDA was frontal(FIRDA) in 11 of 36(30.5%), occipital(OIRDA) in 20 of 36(55.6%) and mixed in 5 of 36(13.9%) patients. 2) Thirty of 36(83.3%) have epilepsy (including 1 each with MELAS and tuberous sclerosis), 4 of 36(11.1%) have migraine and 2 of 36(11.1%) patients have meningitis. 3) Sixteen of 30(53.3%) have partial or partial with secondary generalized seizure, 10 of 30(33.3%) have generalized seizure and 4 of 30(13.3%) patients with epilepsy have absence seizure. 4) Neuroimaging studies (CT or MRI scan) were performed in 27 cases. Among 27 cases of studies, 6 cases(22.2%) were abnormal including; two cases of infections, and each case of infarction, venous angioma, arachnoid cyst, cortical atrophy, and tuberous sclerosis, respectively. CONCLUSIONS: IRDA may be considered an epileptiform pattern in childhood and FIRDA is frequently seen in children than previous reports.
Arachnoid ; Atrophy ; Brain Edema ; Child* ; Classification ; Consciousness ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Absence ; Hemangioma ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging ; Medical Records ; MELAS Syndrome ; Meningitis ; Migraine Disorders ; Neuroimaging ; Neurologic Examination ; Retrospective Studies ; Seizures ; Third Ventricle ; Tuberous Sclerosis

No abstract available.
Female ; Ovary*

PURPOSE: We report the clinical features of paranasal sinus mucoceles with orbital extension and compare the results of external and transnasal approaches based on the rates of complications and recurrence. METHODS: Thirty-three cases of paranasal sinus mucoceles with orbital extension diagnosed at our hospital from 2003 to 2007 were retrospectively reviewed. RESULTS: The mean age of patients was 48.6 years. The common sites of origin were the frontal, ethmoidal, frontoethmoidal sinuses, and proptosis was the most common presenting feature. Among the mucoceles of frontal and frontoethmoid sinuses, there was no difference in the rates of recurrence or complications between the two different methods. CONCLUSIONS: Mucoceles with orbital involvement generally present with a noninfiltrating mass resulting in many ophthalmic signs and symptoms. Obliteration of the involved sinus is not recommended if there is erosion of the sinus bony wall with extension of the mucocele into the orbit. The mucosa lining the mucocele become adhered to the orbital periosteum and cannot be removed during surgery without significant risk of injury to the adjacent structures. Endoscopic sinus surgery is considered effective for paranasal sinus mucoceles with orbital involvement.
Exophthalmos ; Humans ; Mucocele ; Mucous Membrane ; Orbit ; Periosteum ; Recurrence ; Retrospective Studies

PURPOSE: The objective of this study was to evaluate fracture strength of collarless metal-ceramic FPDs according to their metal coping designs. MATERIALS AND METHODS: Four different facial margin design groups were investigated. Group A was a coping with a thin facial metal collar, group B was a collarless coping with its facial metal to the shoulder, group C was a collarless coping with its facial metal 1 mm short of the shoulder, and group D was a collarless coping with its facial metal 2 mm short of the shoulder. Fifteen 3-unit collarless metal-ceramic FPDs were fabricated in each group. Finished FPDs were cemented to PBT (Polybutylene terephthalate) dies with resin cement. The fracture strength test was carried out using universal testing machine (Instron 4465, Instron Co., Norwood MA, USA) at a cross head speed of 0.5 mm/min. Aluminum foil folded to about 1 mm of thickness was inserted between the plunger tip and the incisal edge of the pontic. Vertical load was applied until catastrophic porcelain fracture occurred. RESULTS: The greater the bulk of unsupported facial shoulder porcelain was, the lower the fracture strength became. However, there were no significant differences between experimental groups (P > .05). CONCLUSION: All groups of collarless metal-ceramic FPDs had higher fracture strength than maximum incisive biting force. Modified collarless metal-ceramic FPD can be an alternative to all-ceramic FPDs in clinical situations.
Aluminum ; Bites and Stings ; Collodion ; Dental Porcelain ; Denture, Partial, Fixed ; Head ; Resin Cements ; Shoulder

Fluorescein angiography(FAG)has been used to identify retinal circulation, but it has limitations to detect any other ocular circulations. Recently new technology developed indocyanine green angiography(ICGA), which allows better enhanced imaging of the ocular structures, such as choroid and other subretinal structure as compared with FAG. The authors investigated the characteristic findings of ICGA in central serous chorioretinopathy, comparing with those of FAG finding. After performing ICGA and FAG in 74 patients(74 eyes)with acute forms of central serous chorioretinopathy, as follows, arterial filling, leaking pattern. ICGA study showed presumed choroidal hyperpermeability in the 42 eyes(56.7%), which are no leak on the FAG. ICGA study showed focal hyperfluorescence detected by FAG, corresponding to presumed choroidal hyperpermeability in 65 eyes(87.8%). Delayed choroidal filling areas were showed in ICGA(49 eyes, 66.2%). ICGA study showed presumed choroidal hyperpermeability in the 32 eyes(43.2%)corresponding leak noted on the FAG. Numbers of hyperfluorescent lesion was two in 40 eyes(54.1%)on the ICGA. Most of focal leaking areas were located in superonasal area. In central serous chorioretinopathy the authors suggest that choroid is the primary pathologic focus, the choroidal circulatory dysfunction and vascular hyperpermeability can be assumed to be a causative role in structural abnormality of the retinal pigment epithelium. In conclusion we think that the ICGA is effective method for diagnosis and treatment of the central serous chorioretinopathy.
Angiography* ; Central Serous Chorioretinopathy* ; Choroid ; Diagnosis ; Fluorescein ; Indocyanine Green* ; Retinal Pigment Epithelium ; Retinaldehyde

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

OBJECTIVES: E-cadherin is a transmembrane protein that is one of the key players involved in cell to cell adhesion. Loss of E-cadherin expression is suggested to promote tumor invasion and distant metastasis in tumor development. Recently, it has been proposed E-cadherin function requires its linkage to the cytoskeleton through catenins. So defects in catenins may cause defective E-cadherin function and promote tumor invasion. We intend to evaluate the expression of E-cadherin and alpha-, beta-, gamma- catenin in tissues of human endometrial carcinoma to analyze the patterns of cell adhesion molecules' expression in endometrial carcinoma and to investigate the relationship between status of cell adhesion molecules and various clinicopathological factors. MATERIALS AND METHODS: The present study investigated the immunohistochemical expression of E-cadherin and alpha-, beta-, gamma- catenin in 33 paraffin embedded formalin fixed tissues of endometrial carcinomas. RESULTS: Aberrant E-cadherin, alpha-, beta-, gamma- catenin expression was observed in 33.3(11 of 33), 27.3(9 of 33), 18.2 (6 of 33), and 51.5(17 of 33) % of the specimens, respectively. Statistically significant correlation was found between aberrant expression of E-cadherin and lymph node metastasis and cell types other than endometrioid adenocarcinoma. Aberrant pattern of gamma- catenin expression also correlated with deep myometrial invasion. But alpha-, beta- catenin expression were not correlated with any clinicopathological parameters. Using Kaplan-Meier curves, abnormal expression of E-cadherin correlated closely with poor survival (p<0.05). CONCLUSION: We revealed aberrant expression of these cell adhesion molecules in part of patients with endometrial carcinoma. Aberrant expression of E-cadherin was correlated with lymph node metastasis and cell types other than endometrioid adenocarcinoma and aberrant expression of gamma-catenin was related with deep myometrial invasion.
Cadherins* ; Carcinoma, Endometrioid ; Catenins* ; Cell Adhesion ; Cell Adhesion Molecules ; Cytoskeleton ; Endometrial Neoplasms* ; Female ; Formaldehyde ; gamma Catenin ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin