Spontaneous perforation of bile duct in adults is very rare, with less than 30 cases described in the literature to date. We repoit a case of a 65-year-old man who presented with severe colicky abdominal pain and fever, just like symptoms of peritonitis. ERCP provided a preoperative noninvasive confirmation of the diagnosis of the rupture of right intrahepatic duct. The patient was performed T-tube choledochotomy and drainage of retroperitoneal bile collection. The etiolgy, diagnosis, and treatment of spontaneous perforation of bile duct is discussed.
Abdominal Pain ; Adult ; Aged ; Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Drainage ; Fever ; Humans ; Peritonitis ; Rupture

No abstract available.
Checklist* ; Child ; Child Behavior* ; Child* ; Conduct Disorder* ; Humans

We evaluated the effect of the reablation on the undercorrected eye after the Laser in-situ keratomileusis [LASIK]. The subjects were 21 eyes of 19 patients, who showed undercorrection after the LASIK. Reablation was done on the stromal bed after lifting the original flap aside. Patients were followed up for 1 to 6 months after the reablation. At the time of first LASIK, the mean spherical equivalent[S/E]was -11.29 +/-2.98D preoperatively, -1.90 +/-1.16D at postopera-tive 3 months, the mean amount of correction was -9.60 +/-1.90D. At the time of reablation, the mean[S/E]was -3.26 +/-1.08D, and the mean amount of correction was -3.31 +/-1.11D. Reablation was done only after the refractive error stabilized and did not change over 3 months. One month after the reablation, the mean[S/E]was +0.15 +/-0.98D and 85.7%of the eyes were within +/-1.0D. Six months after the reablation, the mean[S/E]was -0 .1 0 +/-0.66D and 84.6% were within +/-1.0D. The uncorrected visual acuity of 0.6 or more was achieved in 76.2%of eyes at 1 month, and 84.6%at 6 months. The best spectacle-corrected visual acuity [BSCVA]was lost 2 lines or more in 14.3%at 1 month, but none at 6 months after surgery. The BSCVA did not change or gain 1 line or more in 76.2%at 1 month, and 92.3%at 6 months after surgery. There was no problem when lifting the original corneal flap. In conclusion, reablation using the original flaps without new cuts seems to be a redictable, safe method for retreatment.
Humans ; Keratomileusis, Laser In Situ* ; Lifting ; Refractive Errors ; Retreatment ; Visual Acuity

No abstract available.

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Hypothalamic suprachiasmatic nucleus (SCN) is a circadian pacemaker which controls diurnal behavioral and hormonal rhythms in mammals. The SCN receives environmental light signals through the retinohypothalamic tract, and glutamate is the major excitatory neurotransmitter in the retinohypothalamic tract. In the present study, we investigated the developmental expression of the mRNAs for N-methyl-D-aspartate type glutamate receptor (NR)1, NR2A, NR2B and NR2C subunits in the rat SCN using in situ hybridization with specific riboprobes. At postnatal day 2 (P2), P8, Pl5 and P45, the high level of NRI transcripts was observed in both ventrolateral and dorsomedial subdivisions of the SCN, and the distinct expression of NR2C mRNA was principally found in the dorsomedial SCN. The weak NR2B mRNA expression was clearly found in both subdivisions of the SCN at P2 and P8, whereas specific NR2B hybridization signals were not found at Pl5 and P45. There was no specific hybridization signal of NR2A in the SCN throughout the postnatal life. These findings implicate that NR may play an important role in the neonatal SCN. In addition, this study suggests that NR1, NR2B and NR2C might be the major NR subunits in the developing SCN, whereas NRI and NR2C could be the subunit components of NR in the adult SCN.
Adult ; Animals ; Glutamic Acid ; Humans ; In Situ Hybridization ; Mammals ; N-Methylaspartate* ; Neurotransmitter Agents ; Rats* ; Receptors, Glutamate ; RNA, Messenger* ; Suprachiasmatic Nucleus

No abstract available.
Animals ; Rats* ; Receptor, Nerve Growth Factor* ; Suprachiasmatic Nucleus*

The authors analysed statically 420 Cases of the ocular trauma among 35,460 patients who visited to the emergency department, from Jul. 1995 to Jun. 1996. Ocular trauma is one of the commonest causes of eye diseases and blindness, but its patterns and incidences are variable according to the environment. A large number of patients can be readily treated in the emergency department. Prevention is, of course, the best management, but when an ocular injury occurs, proper emergency treatment can often prevent permanent damage.
Blindness ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Eye Diseases ; Humans ; Incidence

Silicone gel breast implants may induce local(fibrous capsular contracture) or systemic(rheumatoid arthritis, systemic sclerosis, etc) complications. The exact mechanism of fibrous capsular contracture has not been fully understood. In the present study, we tried to find out the effect of silicone gel on the fibroblast proliferation which has been known as a major contributing factor in fibrous capsular contracture formation. In vitro, activated macrophages are known to secrete monokines which affect fibroblast proliferation and collagen synthesis. And tumour necrosis factor-alpha(TNF-alpha) and interleukin-6(IL-6), which were released by macrophages, were reported as potent stimulator of fibroblast proliferation. The goal of this study is to investigate the role of macrophages and tumour necrosis factor-alphaor interleukin-6 in the interaction of fibroblasts and silicone gel. We designed four groups, two experimental and two control, using Institute for Cancer Research(ICR) mouse peritioneal macrophage and silicone gel. For the preparation of the conditioned medium of macrophages, peritoneal macrophages were prepared and cultured for 24 hours on the silicone gel-coated and naked (not coated) surface [silicone gel-macrophage conditioned medium(SCM; experimental group) and normal polystyrene-macrophage conditioned medium(NCM; control group) respectively]. To correct the effect of 10% fetal bovine serum which was included in Rapid Prototyping and Manufacturing Institute (RPMI) 1640 medium and draw the effect only by macrophages, the RPMI 1640 medium with 10% fetal bovine serum was cultured by the same method on the silicone gel-coated and naked surface (silicone gel-macrophage free conditioned medium; SFM and normal polystyrene-macrophage free conditioned medium; NFM respectively). Each conditioned medium was added onto NIH 3T3 fibroblasts culture at a final 25% concentration of total culture medium and followed by the cultivation for 24 hours. For antibody neutralizing experiments, each conditioned medium was preincubated with polyclonal rabbit anti-mouse TNF-alpha antibody or polyclonal rat anti-mouse IL-6 antibody for 1 hour and then, conditioned medium with antibody was added to the culture medium of NIH 3T3 fibroblasts by the same method. After 24 hours cultivation, total number of viable fibroblast(cell growth), DNA synthesis and collagen synthesis of fibroblasts with each medium were measured by sulforhodamine B(SRB) assay, 3H-thymidine and 3H-proline incorporation respectively. The results were as follows: 1. In the experiment about the effect of the conditioned medium on the fibroblast activity, the experimental group(SCM), compared with the control group(NCM), showed a significant increase of the cell growth (p<0.01), a significant decrease of DNA synthesis(p<0.001), but no significant difference in the collagen synthesis. 2. In the experiment about the effect of polyclonal rabbit anti-mouse TNF-alpha antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.01), but no significant difference in the collagen syn thesis. 3. In the experiment about the effect of polyclonal rat anti-mouse IL-6 antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.0001), but no significant difference in the collagen synthesis. In conclusion, culture supernatants (conditioned medium) of peritoneal macrophages, activated by silicone gel, stimulate the NIH 3T3 fibroblast proliferation. TNF-alpha and IL-6, products of macrophage, are involved in the stimulation of NIH 3T3 fibroblast proliferation in an in vitro condition.
Animals ; Arthritis ; Breast Implants ; Collagen ; Contracture ; Culture Media, Conditioned ; DNA ; Fibroblasts* ; Interleukin-6* ; Macrophages ; Macrophages, Peritoneal* ; Mice ; Monokines ; Necrosis ; Rats ; Scleroderma, Systemic ; Silicone Gels* ; Tumor Necrosis Factor-alpha*

Changes of corneal endothelial permeability and corneal thickness after instillation of topical steroid was evaluated. In five rabbits, 0.1%dexamethasone eye solution was dropped into right eyes, and in another five rabbits, 1%prednisolone acetate eye solution was dropped into right eyes, and each left eyes were used as a control with dropping of Tears Naturale(r)II (Alcon-couvreur, Belgium). After dropping eyedrops for seven days, corneal endothelial permeability and corneal thickness were measured. Mean corneal thickness changed from 371.4 micrometer to 334.2 micrometer after dropping eyedrops in 0.1%dexamethasone group, and from 375.8 micrometer to 347.8 micrometer in control group where no statistical difference was noted between the two groups. Corneal endothelial permeability was 3.58x10(-4)cm/min in 0.1%dexamethasone group, and 3.54x10(-4) cm/min in control group(p>0.05). Mean corneal thickness changed from 347.4 micrometer to 323.8 micrometer after dropping eyedrops in 1% prednisolone acetate group, and from 342.4 micrometer to 335.6 micrometer in control group. There was also no statistical difference between the two groups. Corneal endothelial permeability was 4.08x10(-4)cm/min in 1%prednisolone acetate group, and 4.26x10(-4) cm/min in control group(p>0.05). In conclusion, topical application of 0.1%dexamethasone or 1%prednisolone acetate for a short period may have no effect on corneal endothelial permeability and thickness.
Dexamethasone ; Ophthalmic Solutions ; Permeability* ; Prednisolone ; Rabbits