No abstract available.
Prune Belly Syndrome* ; Turner Syndrome*

Purpose: To report a rare case of eyelid lipoma. Case summary: A 41-year-old female presented with a palpable mass in her left upper eyelid. Diffuse hard mass was palpable at preaponeurotic fat layer of left upper eyelid, and there was no inflammatory sign. Under local anesthesia, a left upper eyelid mass partial excision was performed and a biopsy specimen was collected. The mass was yellower and harder than surrounding normal eyelid fat. A lipoma was diagnosed based on histopathological findings such as proliferation of mature adipocytes. Conclusions Lipoma is a benign tumor commonly found around trunk and limbs, but rarely occurs at eyelid. Eyelid lipoma should be considered as a differential diagnosis of diffuse mass at eyelid fat layer. Diagnosis and treatment can be achieved by partial excision and histopathological examination.

Purpose: To report a rare case of eyelid lipoma. Case summary: A 41-year-old female presented with a palpable mass in her left upper eyelid. Diffuse hard mass was palpable at preaponeurotic fat layer of left upper eyelid, and there was no inflammatory sign. Under local anesthesia, a left upper eyelid mass partial excision was performed and a biopsy specimen was collected. The mass was yellower and harder than surrounding normal eyelid fat. A lipoma was diagnosed based on histopathological findings such as proliferation of mature adipocytes. Conclusions Lipoma is a benign tumor commonly found around trunk and limbs, but rarely occurs at eyelid. Eyelid lipoma should be considered as a differential diagnosis of diffuse mass at eyelid fat layer. Diagnosis and treatment can be achieved by partial excision and histopathological examination.

Purpose: Reduced central corneal thickness (CCT) is a risk factor for glaucoma progression and can impact intraocular pressure (IOP) measurement. Therefore, we investigated the glaucoma progression pattern and associated risk factors among individuals with normal-tension glaucoma (NTG) and reduced CCT. Methods: This retrospective study enrolled 187 eyes of 187 NTG patients with an open angle and a baseline IOP < 20 mmHg, adjusted for CCT. Reduced CCT was defined as < 500 µm thickness in both eyes. Patients with a history of corneal disease or surgery affecting CCT were excluded. We used Goldmann tonometry to measure baseline and CCT-corrected IOP (ccIOP; [IOP - [CCT - 545]/50 × 2.5]). The participants were divided into progressing and stable subgroups. Results: The mean CCT was 481.2 ± 17.5 µm and the mean follow-up period was 6.3 ± 2.5 years. The baseline IOP and ccIOP were 13.7 ± 2.4 and 16.6 ± 2.5 mmHg, respectively. The average visual field progression rate was -0.79 ± 1.26 dB/yr. Of the participants, 47 (26.6%) and 140 (73.4%) were in the progressing and stable group, respectively. Participants in the progressing group were older, had a higher baseline ccIOP, and had a higher proportion of pseudophakia than those in the stable group. Multivariate analysis showed that baseline ccIOP was a significant risk factor. Conclusions Individuals presenting with NTG and reduced CCT had a relatively stable glaucoma progression rate. However, glaucoma progression was associated with old age, pseudophakia, and high baseline IOP in individuals with reduced CCT. In particular, the only significant factor associated with glaucoma progression was ccIOP. Therefore, ccIOP is a clinically significant factor in individuals with NTG and reduced CCT.

Pegylated interferon alfa-2a (PEG-IFN) and ribavirin combination therapy is the first line treatment for chronic HCV infection. There are four reports of Bell's palsy associated with interferon-alpha (IFN-alpha) and ribavirin therapy. We report here a case of Bell's palsy that occurred in a patient with chronic HCV infection during combination PEG-IFN and ribavirin therapy. The patient was 49-year-old man with chronic hepatitis C for 2 years. The liver biopsy showed grade 1 and stage 1. Therapy with PEG-IFN (Pegasys) 180 microgram/week and ribavirin 1200 mg/day was initiated. After 3 weeks of treatment, the patient showed a loss of muscular tone on the left side of his face. A diagnosis of Bell's palsy was made, and the PEG-IFN and ribavirin therapy was stopped. Prednisolone 45 mg/d was given and then tapered for 8 weeks. His palsy improved over 6 weeks.
Adult ; Antiviral Agents/*adverse effects ; Bell Palsy/*etiology/immunology ; Hepatitis C, Chronic/complications/*drug therapy/virology ; Humans ; Interferon Alfa-2a/*adverse effects/therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols/*adverse effects/therapeutic use ; Ribavirin/administration & dosage/*adverse effects/therapeutic use ; Treatment Outcome

Since patients with intracranial neoplasms usually represent their neurological symptoms rather early in the course of the disease, sudden unexpected death due to intracranial neoplasms is an uncommon event seen only exceptionally in medicolegal autopsy practice. Although meningiom is one of the most common primary intracranial neoplasms, sudden death due to the tumor is an uncommon event. We report a sudden, unexpected death of a 56-year-old female with an undiagnosed olfactory groove meningioma. It is assumed that peritumoral edema is related to the sudden death among the several mechanisms.
Female ; Humans

OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression.SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.

STUDY DESIGN: Prospective study. OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression. SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS: Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.
Analgesia ; Analgesia, Patient-Controlled ; Decompression ; Humans ; Injections, Epidural ; Methods ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Spinal Stenosis ; Vomiting

OBJECTIVE: The aims of this study were to know the effects of long time bed immobilization on the heart rate variability and to know the correlation between the heart rate variability and other anthropometric parameters. METHOD: The subjects of this study were 60 normal sedentary persons as control group and 22 patients who had been immobilized for a long time because of musculoskeletal problems without any systemic diseases. The heart rate variabilities were measured through the R-R interval variation at rest, deep breathing and valsalva maneuver. These values were compared between control and patient group and were analysed for correlation with age, weight, height, body mass index (BMI), amounts of smoking (pack years), spans of immobilization and physical activity scale (PAS). RESULTS: The mean heart rate variability of patients were 0.132+/-0.072, 0.216+/-0.109, and 0.289+/-0.171 in rest, deep breathing and valsalva maneuver respectively which were lower than the corresponding 0.176+/-0.085, 0.314+/-0.146, and 0.322 +/-0.174 of normal control group. The heart rate variabilities were negatively correlated with age, BMI and amounts of smoking but positively correlated with the height. The physical activity scale of preimmobilization state was negatively correlated with resting heart rate variability but was positively correlated with heart rate variability during deep breathing and valsalva maneuvering state. CONCLUSION: The long bed immobilization significantly decreased the heart rate variability and the heart rate variability could be used as a useful tool to measure the effects of immobilization on the heart.
Body Height ; Heart Rate* ; Heart* ; Humans ; Immobilization* ; Motor Activity ; Respiration ; Smoke ; Smoking ; Valsalva Maneuver

TGF-beta induces IgA class switching by B cells. We previously reported that Smad3 and Smad4, pivotal TGF-beta signal-transducing transcription factors, mediate germline (GL) alpha transcription induced by TGF-beta1, resulting in IgA switching by mouse B cells. Post-translational sumoylation of Smad3 and Smad4 regulates TGF-beta-induced transcriptional activation in certain cell types. In the present study, we investigated the effect of sumoylation on TGF-beta1-induced, Smad3/4-mediated GLalpha transcription and IgA switching by mouse B cell line, CH12F3-2A. Overexpression of small ubiquitin-like modifier (SUMO)-1, SUMO-2 or SUMO-3 did not affect TGF-beta1-induced, Smad3/4-mediated GLalpha promoter activity, expression of endogenous GLalpha transcripts, surface IgA expression, and IgA production. Next, we tested the effect of the E3 ligase PIASy on TGF-beta1-induced, Smad3/4-mediated GLalpha promoter activity. We found that PIASy overexpression suppresses the GLalpha promoter activity in cooperation with histone deacetylase 1. Taken together, these results suggest that SUMO itself does not affect regulation of GLalpha transcription and IgA switching induced by TGF-beta1/Smad3/4, while PIASy acts as a repressor.
Animals ; B-Lymphocytes* ; Cell Line ; Histone Deacetylase 1 ; Immunoglobulin A ; Immunoglobulin Class Switching ; Mice ; Small Ubiquitin-Related Modifier Proteins* ; SUMO-1 Protein* ; Sumoylation ; Transcription Factors ; Transcriptional Activation ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Ubiquitin-Protein Ligases