PURPOSE: To investigate the efficacy and the risk factors for failure and complications of mitomycin C (MMC)-augmented needle revision (NR) of failed filtering blebs. METHODS: Thirty eyes whose intraocular pressure (IOP) did not decrease after the cutting of scleral flap sutures were recruited. NR was performed with a 26-gauge needle under a slit-lamp. Immediately following NR, all eyes received a subconjunctival injection of 0.1 ml of 0.02 mg/ml (group A) or 0.1 mg/ml (group B) MMC at the adjacent conjunctiva. The mean follow-up period after the last needle revision was 13.2+/-4.2 months. RESULTS: The mean IOP decreased from 25.7+/-10.6 mmHg before surgery to 13.7+/-2.5 mmHg at the last follow-up in group A and from 24.1+/-6.8 mmHg to 17.7+/-8.6 mmHg in group B (group A: p=0.001, group B: p=0.065). Subconjunctival hemorrhage, hyphema, and a shallow anterior chamber appeared in most cases. However, choridal detachment and avascular changes of the conjunctiva were observed in group B. CONCLUSIONS: IOP decreased in both groups A and B, but severe complications appeared only in group B. NR followed by a subconjunctival injection of 0.02 rather than 0.1 mg/ml is a safe and effective method.
Anterior Chamber ; Blister ; Conjunctiva ; Eye ; Follow-Up Studies ; Hemorrhage ; Hyphema ; Intraocular Pressure ; Mitomycin ; Needles ; Risk Factors ; Sutures

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

Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.
Anemia ; Anemia, Iron-Deficiency ; Deglutition Disorders ; Dilatation ; Esophagus ; Female ; Glossitis ; Humans ; Iron ; Middle Aged ; Mouth ; Plummer-Vinson Syndrome* ; Skin Manifestations ; Tears

Association of the hepatoid and choriocarcinomatous components in adenocarcinoma of the stomach is extremely unusual and raises a possibility of new approach understand the histogenesis of gastric hepatoid adenocarcinoma. This paper describes a Borrmann type III adenocarcinoma of the stomach with both choriocarcinomatous and hepatoid components in composite tumor pattern in a 50-year-old man. Tubular arrangement of differentiated embryonalcarcinoma was encountered in choricarcinomatous and hepatoid areas, which showed strong immunoreactivity to beta-HCG and AFP, respectively. The findings suggest that gastric adenocarcinoma may have a potential of differentiation toward embryonal carcinoma. from which both choriocarcinoma and hepatoid variant of gastric adenocarcinoma may develop by retrodifferentiation.
Adenocarcinoma

No abstract available.
Nortriptyline* ; Pharmacokinetics*

BACKGROUND: Carcinoembryonic antigen (CEA) is a glycoprotein on cellular surface, which is highly condensed in embryonic tissue and tumor of various kinds. Previous study found out that CEA may grow with various cancer or other diseases other than cancer as well. Besides, it is widely known that smoking also influences the rise in CEA. Among the same smokers, some of them show high CEA figures in serum when others remain in normal range. There are those whose pulmonary function is not influenced by smoking when that of others are susceptible to it. Therefore, this study was undertaken with an aim to study the relationship between serum CEA and pulmonary function by investigating how the change in pulmonary function caused by smoking influences serum CEA. METHODS: From Nov, 1997 to Feb, 2001, this study carried out tests on adult male smokers ages 35 to 64 who visited a hospital located in Kang Nung city. The subjects were divided into two groups: one group of 29 subjects with high CEA with over 6.0 ng/ml with normal colon study; the other group, which is the CEA normal group, consisted of 58 subjects selected through age adjusted random sampling. Data on personal information, smoking and clinical history was collected from a questionnaire. CEA was tested using radioimmunoassay of Abott. Pulmonary function was examined using Analyzer assembly Vmax 20C from Sensormedics Company. These examinations was limited to those who have been screened not to have cancer by chest X-ray, abdominal ultrasonography, and duodenofibroscopy. RESULTS: Smoking per day for the group with high serum CEA was 1.3 pack ( 0.4 pack), which was found to be significantly higher compared to that of normal group (P<0.01). Pack-years with high serum CEA group was 32.6 13.5 which was also comparatively higher than that of the normal group with 22.4 10.9 (P<0.01). Pulmonary function test indicated that FEV1 for the group with high serum CEA was 3.0 0.5 L, which marked lower than that of the normal group with 3.4 0.5 L (P<0.05). After compensating for age and pack years, FEV1 decreased in proportion to the rise in CEA. CONCLUSION: This study has established a link between serum CEA and daily smoking, pack years, and pulmonary function and found that FEV1 was inversely proportionate to the rise in CEA regardless of corrected pack years and daily smoking. Consequently, serum CEA alone is thought to be related to the pulmonary function. Therefore, it is advised that smokers with high serum CEA need to take heed of the influence on pulmonary function.
Adult ; Carcinoembryonic Antigen* ; Colon ; Glycoproteins ; Humans ; Male* ; Radioimmunoassay ; Reference Values ; Respiratory Function Tests ; Smoke ; Smoking ; Thorax ; Ultrasonography ; Surveys and Questionnaires

PURPOSE: To identify the clinical features with recurrence of amblyopia after cessation of amblyopic treatment. METHODS: Amblyopic children followed up at least 1 year after successful treatment were evaluated. A recurrence of amblyopia was defined as a reduction of more than 2 levels in visual acuity (VA) of the amblyopic eye after cessation of treatment. The age and VA of the amblyopic eye at the start and during follow-up, type of amblyopia, type and duration of treatment, weaning and stereopsis on cessation of treatment were analyzed. RESULTS: Amblyopia recurred in 5 out of 82 patients with successful treatment, and the period of recurrence varied from 7 to 31 months after cessation of treatment. Two out of 5 recurred patients had only patching therapy and the other 3 patients had atropine penalization after patching therapy. The weaning was performed in the 5 recurred patients at cessation of treatment. There was no remarkable clinical factor associated with recurrence of amblyopia. CONCLUSIONS: The recurrence rate was 6% after cessation of amblyopic treatment and there was no factor associated with recurrence of amblyopia. Therefore, regular follow-up may be required after successful treatment for amblyopia.
Amblyopia ; Atropine ; Child ; Depth Perception ; Eye ; Follow-Up Studies ; Humans ; Recurrence ; Visual Acuity ; Weaning ; Withholding Treatment

PURPOSE: To report a case of bilateral optic disc edema associated with hemolytic anemia and paroxysmal nocturnal hemoglobinuria (PNH). METHODS: A 51-year-old woman visited our ophthalmologic clinic complaining of metamorphopsia. Twenty eight years ago, she had been diagnosed with PNH and hemolytic anemia and had received blood transfusion on an irregular basis. The best corrected visual acuity was initially 0.5 in the right eye and 1.0 in the left eye. Light reflex was intact and no afferent pupillary defect was found. Fundus examination revealed severe optic disc swellings with indistinct margins in both eyes. Papillary and peripapillary retinal hemorrhages were also present. RESULTS: A visual field test revealed the enlarged physiologic scotoma in both eyes. Fluorescein angiograms showed hyperfluorescence of the optic disc and blocked fluorescence due to the papillary hemorrhages. Optical coherence tomograms of the optic disc showed the loss of physiologic disc cupping and severe elevation. There was no evidence of an intracranial lesion upon brain magnetic resonance imaging. These findings were compatible with optic disc edema associated with anemia and the management was oriented towards the anemia. At the 2-months follow-up, the best corrected visual acuity of both eyes had improved to 1.0 and optic disc edema markedly decreased. However, the patient's overall physical condition deteriorated and she expired due to dyspnea and hepatic coma.
Anemia* ; Anemia, Hemolytic ; Blood Transfusion ; Brain ; Dyspnea ; Edema ; Female ; Fluorescein ; Fluorescence ; Follow-Up Studies ; Hemoglobinuria, Paroxysmal* ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Papilledema* ; Pupil Disorders ; Reflex ; Retinal Hemorrhage ; Scotoma ; Vision Disorders ; Visual Acuity ; Visual Field Tests

No abstract available.
Humans ; Korea ; Quality-Adjusted Life Years ; Stroke

OBJECTIVE: We studied the prevalence of abnormal spontaneous activities in hemiplegic upper limbs, its nature and correlation with various clinical features. METHOD: Forty-seven patients with hemiplegia from various central nerve system disease within about four months from disease onset were included in the study. The patients who showed obvious clinical evidence of peripheral nerve system disease were excluded. Motor and sensory nerve conduction studies (NCS) of median and ulnar nerves in hemiplegic limbs and motor nerve conduction studies of axillary nerve in both side were done. The cases demonstrating abnormal NCS were excluded in data analysis. Needle electromyography (EMG) was done in proximal muscles (deltoid, supraspinatus, infraspinatus, biceps brachii) and distal muscles (abductor pollicis brevis, abductor digiti quinti and first dorsal interosseous). Muscle strength of shoulder abduction and mass grasp were measured by manual muscle test. Development of shoulder hand syndrome was investigated through clinical examination. RESULTS: Mean period from onset of hemiplegia to EMG examination was 45.2 23.8 days (8~108 days). Abnormal spontaneous activities were observed in 78% of patients in one of the muscles examined and were found more frequently in distal muscles than proximal muscles. Frequency of spontaneous activities was not significantly related to the time after onset of disease during the first 4 months. Spontaneous activities were more frequently observed in distal muscles with strength of less than good or fair grade. Patients with spontaneous activities showed tendency to higher incidence of shoulder hand syndrome but there was no statistical significance. CONCLUSION: Hemiplegic upper limbs showed frequent abnormal spontaneous activities without definite peripheral nerve involvement. Its unique pattern of distribution should be kept in mind when we meet hemiplegic patients in electromyographic consultation.
Electromyography* ; Extremities ; Hand Strength ; Hemiplegia* ; Humans ; Incidence ; Muscle Strength ; Muscles ; Needles ; Neural Conduction ; Peripheral Nerves ; Prevalence ; Reflex Sympathetic Dystrophy ; Shoulder ; Statistics as Topic ; Ulnar Nerve ; Upper Extremity*