BACKGROUND: Our purpose was to assess the utility of prenatal triple-marker (alpha- fetoprotein (AFP), beta-human chorionic gonadotropin (hCG) and unconjugated estriol (uE3) testing for chromosomal abnormalities in women with Down syndrome screen-positive results. METHODS: Total 1,082 women between 15 and 21 weeks' gestation received second trimester Down syndrome risk evaluation by triple marker testing. AFP, beta-hCG and uE3 were measured by Coat-A-Count(R) IRMA (Diagnostic Products Corporation, LA, USA), The risk for Down syndrome was calculated using a commercially available software program (AFP Expert; Benetech Medical System, Toronto, Canada) by use of a Down syndrome risk cutoff value(1:270 at midtrimester). Karyotypes were reviewed for 32 (54.2%) of these patients who received prenatal chromosome analysis. RESULTS: Fifty nine (5.5%) patients of the 1,082 women screened were identified as positive. Two chromosome abnormalities (47,XYY and 46,XX, int (9) ) were found in the 32 patients who underwent prenatal chromosome analysis (6.3%). Any cases on the abnormal serum tests torn out not to be associated with trisomy 21. CONCLUSIONS: Although triple marker screen appears to be an effective method detecting chromosome abnormalities there is a high false positive rate. Therefore, new screening test that reduce false positive rate is need to be introduced.
Chorionic Gonadotropin ; Chromosome Aberrations ; Down Syndrome ; Estriol ; Female ; Fetal Proteins ; Humans ; Karyotype ; Mass Screening ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis*

OBJECTIVE: Duchenne muscular dystrophy(DMD) is a X-linked recessive disease and results from mutation in the dystrophin gene. In this study, we evaluate the efficacy of polymerase chain reaction-restriction fragment length polymorphism in prenatal genetic diagnosis of DMD. METHODS: DNA was isolated from DMD family's blood and fetal amniocyte and used to perform PCR-RFLP. In DMD family(3 cases), linkage analysis was tried with 5 RFLP probes. RESULTS: DMDs of the family A had mutiple exon deletions(6, 8, 12, 13, 17). The mother was a heterozygote of pERT84;MaeIII. The male fetus had a same allele and also same exon deletions with the affected males. The pregnancy was terminated at IUP 18 gestational weeks. Pregnant woman of the family B was heterozygote of both pERT84;MaeIII and pERT87-15;BamHI, and pregnant woman of the family C was of pERT84;MaeIII. The both male fetuses , as compared with the affected male of each family, had a different allele. Thus, the fetuses were probably not affected with a confidence level of 95%. CONCLUSIONS: Prenatal diagnosis in prevention of DMD is most important. PCR-RFLP analysis in DMD family is rapid and useful diagnostic tool.
Alleles ; Diagnosis ; DNA ; Dystrophin ; Exons ; Female ; Fetus ; Heterozygote ; Humans ; Male ; Mothers ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis*

We report a case of corneal deposition of pigments from cosmetic contact lenses after intense pulsed-light (IPL) therapy. A 30-year-old female visited our outpatient clinic with ocular pain and epiphora in both eyes; these symptoms developed soon after she had undergone facial IPL treatment. She was wearing cosmetic contact lenses throughout the IPL procedure. At presentation, her uncorrected visual acuity was 2/20 in both eyes, and the slit-lamp examination revealed deposition of the color pigment of the cosmetic contact lens onto the corneal epithelium. We scraped the corneal epithelium along with the deposited pigments using a no. 15 blade; seven days after the procedure, the corneal epithelium had healed without any complications. This case highlights the importance of considering the possibility of ocular complications during IPL treatment, particularly in individuals using contact lenses. To prevent ocular damage, IPL procedures should be performed only after removing the lenses and applying eyeshields.
Adult ; Coloring Agents/*pharmacokinetics ; Contact Lenses/*adverse effects ; Cornea/*metabolism/pathology/*radiation effects ; Cosmetic Techniques/*adverse effects ; Debridement ; Epithelium, Corneal/surgery ; Female ; Humans ; Phototherapy/*adverse effects ; Postoperative Period ; Treatment Outcome ; Visual Acuity

No abstract available.
Shoes*

PURPOSE: Neisseria gonorrhea is usually identified in neonatal conjunctivitis, but rare in adult keratoconjunctivitis. We report a rare case of bilateral gonococcal conjunctivitis combined with keratitis. METHODS: A 29-year-old male with a history of sexual contact with a prostitute 17 days ago referred to our hospital with acute keratoconjunctivitis. Ocular discharge was examined by Gram stain, culture, and sensitivity test to antibiotics, resulting in the identification of penicillin-resistant Neisseria gonorrhea. RESULTS: This patient was treated with intramuscular ceftriaxone for 5 days and topical cefmenoxime 0.5% for 2 weeks. Following 24 hours after antibiotics medication, the clinical symptoms were improved, and follow-up culture was negative. No evidence of serious complication was left in the cornea and conjunctiva. CONCLUSIONS: As adult gonococcal keratoconjuctivitis is relatively rare, the clinical diagnosis may be delayed. When one suspects an adult gonococcal keratoconjunctivitis, immediate gram staining and confirmatory culture for isolation of gram-negative intracellular diplococci are mandatory. It should be remembered that intramuscular ceftriaxone and topical cefmenoxime are an effective treatment for this condition.
Adult* ; Anti-Bacterial Agents ; Cefmenoxime ; Ceftriaxone ; Conjunctiva ; Conjunctivitis ; Cornea ; Diagnosis ; Follow-Up Studies ; Gonorrhea ; Humans ; Keratitis ; Keratoconjunctivitis* ; Male ; Neisseria ; Sex Workers

PURPOSE: Neisseria gonorrhea is usually identified in neonatal conjunctivitis, but rare in adult keratoconjunctivitis. We report a rare case of bilateral gonococcal conjunctivitis combined with keratitis. METHODS: A 29-year-old male with a history of sexual contact with a prostitute 17 days ago referred to our hospital with acute keratoconjunctivitis. Ocular discharge was examined by Gram stain, culture, and sensitivity test to antibiotics, resulting in the identification of penicillin-resistant Neisseria gonorrhea. RESULTS: This patient was treated with intramuscular ceftriaxone for 5 days and topical cefmenoxime 0.5% for 2 weeks. Following 24 hours after antibiotics medication, the clinical symptoms were improved, and follow-up culture was negative. No evidence of serious complication was left in the cornea and conjunctiva. CONCLUSIONS: As adult gonococcal keratoconjuctivitis is relatively rare, the clinical diagnosis may be delayed. When one suspects an adult gonococcal keratoconjunctivitis, immediate gram staining and confirmatory culture for isolation of gram-negative intracellular diplococci are mandatory. It should be remembered that intramuscular ceftriaxone and topical cefmenoxime are an effective treatment for this condition.
Adult* ; Anti-Bacterial Agents ; Cefmenoxime ; Ceftriaxone ; Conjunctiva ; Conjunctivitis ; Cornea ; Diagnosis ; Follow-Up Studies ; Gonorrhea ; Humans ; Keratitis ; Keratoconjunctivitis* ; Male ; Neisseria ; Sex Workers

No abstract available.
Diskectomy*

A 50-year-old female was referred to our clinic with visual disturbance, hyphema and increased intraocular pressure (IOP) in her right eye 7 days after experiencing blunt trauma in that eye. She had undergone uncomplicated laser in situ keratomileusis (LASIK) on both eyes 10 years earlier. At initial examination, the best corrected visual acuity (BCVA) in her right eye was counting fingers at 2 feet with no correction. Central Goldmann applanation tonometry (GAT) showed an IOP of 7 mm Hg. Peripheral digital tonometry showed the IOPs in her right eye superiorly, nasally, temporally, and inferiorly were 36 mm Hg, 35 mm Hg, 34.5 mm Hg and 36.5 mm Hg, respectively. Slit-lamp examination showed diffuse epithelial and stromal edema and a blood clot 1 mm in height in the anterior chamber. Spectral domain scanning laser ophthalmoscope/optical coherence tomography (SD-SLO/OCT) images showed a pocket of fluid between the LASIK flap and the underlying stroma. The patient was started on anti-inflammatory agent and IOP lowering agents. After 15 days of treatment, IOP measured with GAT was 10 mm Hg, slit-lamp examination showed that epithelial and stromal edema had disappeared, and OCT showed no fluid between the corneal flap and stroma.
Anterior Chamber ; Edema ; Female ; Fingers ; Foot ; Humans ; Hyphema* ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Manometry ; Middle Aged ; Visual Acuity

PURPOSE: To report two cases of trabeculectomy with biodegradable collagen material conducted on two post-vitrectomy patients. CASE SUMMARY: The first patient was a 43-year-old woman with uncontrolled increased intraocular pressure (IOP) after pars plana vitrectomy with scleral buckling for diabetic retinopathy and vitreous hemorrhage. Another patient, a 28-year-old woman with aphakia, also had uncontrolled increased IOP after pars plana vitrectomy with encircling scleral buckling for retinal detachment. For both of these patients, we performed trabeculectomy using mitomycin C and recently developed biodegradable collagen matrix. In the first case, the IOP was increased three months after the surgery, for which needling was done. After needling, the IOP was well controlled in the range of 16 to 19 mmHg up to eight months postoperatively with stilling anti-glaucomatous eyedrops (Cosopt(R), Xalatan(R)). In the second case, IOPwas increased one week after the surgery, but it was well controlled between 14 to 21 mmHg up to nine months postoperatively with anti-glaucomatous eye drops (Combigan(R)). CONCLUSIONS: Biodegradable collagen matrix can possibly reduce the surgical failure of trabeculectomy and it is especially suitable for high risk patients when combined with anti-metabolic agents like MMC.
Adult ; Aphakia ; Collagen ; Diabetic Retinopathy ; Female ; Humans ; Intraocular Pressure ; Mitomycin ; Ophthalmic Solutions ; Retinal Detachment ; Scleral Buckling ; Trabeculectomy ; Vitrectomy ; Vitreous Hemorrhage ; Wound Healing

Corticosteroid, 5-fluorouracil and Mitomycin C(MMC) have been used to suppress proliferation of subconjunctival connective tissue. However, the various complication and undesirable side effects associated with the use of these drugs have prompted the search for alternative drugs with less toxicity. In present study, I have evaluated the effect of corticosteroid(dexamethsone sodium phophate), cyclooxygenase inhibitor(diclofenac sodium) and lipoxygenase inhibitor(nordihydroguaratic acid, NDGA) to inhibit human pterygial fibroblast proliferation in tissue culture. Human pterygial fibroblast were cultured and exposed to various concentration of each drug for 1, 2 and 3 days. Cell viability was measured using MTT assay. There was no different in antiproliferative activity between nonsteroidal antiinflammatory agents(NSAIDs) and steroid. Dexamethasone caused inhibition of proliferation with LD 50 of 0.5mM by day 2, NDGA of 0.5mM by day 3 and diclofenac sodium of 1.0mM by day 3. These results suggest that NSAIDs may be useful as both antiproliferative and less toxicity agents.
Anti-Inflammatory Agents, Non-Steroidal* ; Cell Survival ; Connective Tissue ; Dexamethasone ; Diclofenac ; Fibroblasts* ; Fluorouracil ; Humans* ; Lipoxygenase ; Mitomycin ; Prostaglandin-Endoperoxide Synthases ; Sodium ; Steroids*