Surgical Technique: The technique involves creating a central crater, flipping the nucleus out into the supracapsular space, and creating another crater through the posterior surface that will eventually connect with the anterior crater to produce a central hole. The donut-shaped nucleus is then chopped and the fragments are aspirated with greater ease. Results: The technique was performed successfully in seven eyes of six patients with only minor problems. Phacoemulsification times were longer than usual because of the additional sculpting, but clinical results were not adversely affected. Conclusion: For dense or hard cataracts for which the surgeon anticipates a tough posterior plate, this technique is a safe alternative to the usual chopping techniques.
Human ; Male ; Female ; Aged ; Middle Aged ; CATARACT ; PHACOEMULSIFICATION ; SCLEROSIS

This case is reported because of the very rare combination of paraneoplastic pemphigus and myasthenia gravis as paraneoplastic manifestations secondary to thymoma. A case of a 37 year old male who presented with skin lesions initially as papules in the face and thighs that evolved into blisters and became widespread, leaving crusted and hyperpigmented patches and plaques. It was associated with cough, dyspnea, ptotis, dysphagia, dysphonia and facial asymmetry. Histopathology and direct immunofluorescence were consistent with paraneoplastic pemphigus. Anticholinerase test confirmed the diagnosis of myasthenia gravis and histologic finidngs of the anterior mediastinal mass confirmed it as thymoma.

Human ; Male ; Adult ; Blister ; Cough ; Deglutition Disorders ; Dysphonia ; Dyspnea ; Facial Asymmetry ; Fluorescent Antibody Technique, Direct ; Hoarseness ; Myasthenia Gravis ; Paraneoplastic Syndromes ; Pemphigus ; Thymoma

No abstract available.
Acrosome* ; Fertilization* ; Humans* ; Male ; Spermatozoa*

No abstract available.
Antigens, Neoplasm/*metabolism ; Antineoplastic Agents/*therapeutic use ; Cell Adhesion Molecules/*metabolism ; Female ; Humans ; Neoplasms, Glandular and Epithelial/*diagnosis ; Organoplatinum Compounds/*therapeutic use ; Ovarian Neoplasms/*diagnosis ; Tumor Markers, Biological/*metabolism

The term minimally invasive cardiac surgery encompasses a number of different techniques, from minimally invasive direct coronary artery bypass grafting without the use of cardiopulmonary bypass to telemanipulation and computer-enhanced robot-directed surgery. The hoped-for benefits from minimally invasive surgery are less pain, less disfiguring, fewer blood transfusions, earlier return to activity, and lower cost. The technology involved in reducing surgical trauma and limiting the physiologic trespass of cardiac surgery on the patients concerns not only surgical instrumentation but also anesthetic management. Anesthetic plan includes one lung isolation, careful monitoring of hemodynamics and gas exchange, fast track technique, appropriate analgesia strategies, and the use of transesophageal echocardiography for evaluation of the heart and positioning of cannulae. A better understanding of these newer, unconventional surgical operations enables cardiac anesthesiologists to contribute to favorable outcomes.
Analgesia ; Blood Transfusion ; Cardiopulmonary Bypass ; Catheters ; Coronary Artery Bypass ; Echocardiography, Transesophageal ; Heart ; Hemodynamics ; Humans ; Lung ; Surgical Instruments ; Thoracic Surgery ; Track and Field

The International Federation of Gynecology and Obstetrics (FIGO) has reported annually for the development and changes of gynecologic cancer classification and staging since 1958. FIGO staging systems in gynecologic malignancies has been reflected on prognostic factors in predicting patients' outcomes and organized patients into several groups. The aim of the FIGO staging system is to afford a classification of gynecologic cancer and to share treatment methods with others. The FIGO staging systems have been updated several times every 3 years according to the latest data, which is responsive and adaptive to scientific development including imaging and treatment modalities. In 2008, the FIGO staging system for carcinoma of the cervix, endometrium, vulva, and uterine sarcomas was revised. After applying the revised staging system in clinical setting, it is need to consider and review problems. As a result, we must make up for the weak points in staging systems continuously.
Cervix Uteri ; Endometrium ; Female ; Gynecology ; Humans ; Obstetrics ; Sarcoma ; Vulva

BACKGROUND: Endotoxin stimulates nitric oxide synthase (NOS) and the free radical nitric oxide (NO) is produced by NOS, which vasodilates the smooth muscle of pulmonary vessels. Otherwise, endotoxemia stimulates the release of cyclooxygenase (COX) products, which may modify hypoxic pulmonary vasoconstriction (HPV). We also observed the effect of nonselective NOS inhibition by NG-nitro-L-arginine methyl ester (L-NAME) on receptor-mediated acetylcholine (Ach)/bradykinin (BK) induced vasoconstriction and receptor independent HPV in E.coli lipopolysaccharide (LPS) induced septic isolated rat lungs. METHODS: Four hours before surgical instrumentation for lung isolation, we administered saline (1 ml) to the control group (n = 15), E.coli LPS (20 mg/kg) to the LPS group (n = 14) and LPS (30 mg/kg) the nitric oxide synthase inhibitor, L-NAME (15 mg/kg) to the LPS + L-NAME group (n = 14), intraperitoneally. In 43 isolated rat lungs perfused with physiologic salt-albumin- blood mixture, angiotensin II 0.2 microgram was injected into the perfusion circuit, to confirm pulmonary vascular reactivity in each isolated lung. HPV responses were induced by three hypoxic challenges for 5 minutes separated by 5 minutes of ventilation with a normoxic gas mixture. We observed the pulmonary arterial pressure at each challenge, ten minutes after the last HPV, 0.01, 0.1, 1.0 microgram of Ach and 1, 3, 10 microgram of BK were injected. PAP and static lung compliance were measured. RESULTS: The baseline pulmonary artery pressure in the LPS group higher than in the controls and HPV in the LPS group was changed compared to the controls but in the LPS + L-NAME it was higher than in the controls. The administration of Ach 0.1, 1.0 microgram and BK 3, 10 microgram causedpulmonary vasoconstriction and the vasoconstrictions of BK were dosage-dependent. Lung stiffness in the LPS and LPS + L-NAME groups were higher than those of the controls. CONCLUSIONS: Vascular constriction of pulmonary vessels and increased lung stiffness by Ach and BK might be the result of the endothelial injury. But pulmonary vasoconstriction and stiffness by Ach and BK were similar in the LPS and LPS + L-NAME groups, showing that factors other rather than excessive NO production might be involved in endothelial injury.
Acetylcholine ; Angiotensin II ; Animals ; Arterial Pressure ; Constriction ; Endotoxemia ; Lung Compliance ; Lung* ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Perfusion ; Prostaglandin-Endoperoxide Synthases ; Pulmonary Artery ; Rats* ; Surgical Instruments ; Vasoconstriction* ; Ventilation

Objective: To investigate the effect of latanoprost in IOP after laser iridectomy or filtering surgery Methodology: Patients of chronic angle closure glaucoma post laser iridectomy or filtering surgery were given latanoprost 0.005 percent eye drop in the evening for 2-6 weeks after a washout period ranging from 5 days - 28 days. IOP was measured at 9:00 a. m., 1:00 p.m. and 5: 00 p.m. per patient using a calibrated goldmann applanation tonometer Results: 29 patients were enrolled in study. There was a significant reduction in IOP among these patients Conclusion: Latanoprost 0.005 percent provides a significant reduction in IOP among patients with residual angle closure after laser iridectomy or filtering surgery. (Author)
Human ; Male ; Female ; LATANOPROST ; INTRAOCULAR PRESSURE/DRUG EFFECTS ; GLAUCOMA, ANGLE-CLOSURE ; GLAUCOMA, ANGLE-CLOSURE/DRUG THERAPY ; HUMANS ; MALE ; FEMALE ;

OBJECTIVE: To investigate the association between reproductive factors and the risk of ovarian cancer among southern Chinese women. METHODS: A hospital-based case-control study was undertaken in Guangzhou, Guangdong Province, between 2006 and 2008. A structured questionnaire was used to obtain information on parity, oral contraceptive use and other reproductive factors in a sample of 500 incident ovarian cancer patients and 500 controls (mean age, 59 years). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression models. RESULTS: High parity was inversely associated with ovarian cancer, with an adjusted OR 0.43 (95% CI, 0.30 to 0.62) for women who had given birth to 3 or more children compared to women who had given no more than one birth. Ever use of oral contraceptives was also protective against ovarian cancer; adjusted OR 0.56 (95% CI, 0.40 to 0.78). No association was found for hormone replacement therapy, menopausal status, hysterectomy and family history of ovarian and/or breast cancer. CONCLUSION: High parity and oral contraceptive use are associated with a lower risk of ovarian cancer in southern Chinese women.
Asian Continental Ancestry Group ; Breast ; Case-Control Studies ; Child ; China ; Contraceptives, Oral ; Female ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Logistic Models ; Odds Ratio ; Ovarian Neoplasms ; Parity ; Parturition ; Surveys and Questionnaires

PURPOSE: To evaluate factors associated with endometrial pathology during tamoxifen use in premenopausal breast cancer (BC) patients.MATERIALS AND METHODS: We reviewed the medical records of premenopausal BC patients treated with tamoxifen who underwent endometrial biopsy with or without hysteroscopy. Clinical characteristics were compared between women with endometrial pathology (endometrial hyperplasia or cancer) and those with normal histology or endometrial polyps.RESULTS: Among 284 endometrial biopsies, endometrial hyperplasia was diagnosed in 7 patients (2.5%), endometrial cancer was diagnosed in 5 patients (1.8%), normal histology was noted in 146 patients (51.4%), and endometrial polyp was present in 114 patients (40.1%). When comparing women with endometrial cancer (n=5) to women with normal histology, abnormal uterine bleeding was more common (p=0.007), and endometrial thickness was greater (p=0.007) in women with endometrial cancer. Chemotherapy for BC was also more common in patients with endometrial cancer (p=0.037). When comparing women with endometrial polyps and those with endometrial hyperplasia or cancer, the presence of abnormal uterine bleeding was more common in patients with endometrial hyperplasia or cancer (p<0.001); however, tamoxifen duration and endometrial thickness did not differ significantly between the two groups.CONCLUSION: In premenopausal BC patients treated with tamoxifen, abnormal uterine bleeding, increased endometrial thickness, and chemotherapy for BC were associated with the occurrence of endometrial cancer. These findings may provide useful information for gynecologic surveillance and counseling during tamoxifen treatment in premenopausal BC patients.