BACKGROUND: Follow-up studies have shown that although outcomes have improved substantially over time,results of the Fontan operation and its modifications remain suboptimal.In this study,we reviewed our experience with the extracardiac conduit Fontan operation,with a focus early and midterm change of internal diameter of PTFE conduit. MATERIAL AND METHOD: Between April 1997 and July 2000 were reviewed.Twelve patients (M:6,F:6,mean age 42.04 +/- 12.43months,mean body weight 13.80 +/- 1.94kg)underwent extracardiac conduit Fontan operation with expanded PTFE graft.Mean cardiopulmonary bypass time was 109.7 +/- 26.99minute and mean operation time was 455 +/- 89.51minute. Intraoperative fenestration was performed in 10 patients.The aortic cross clamping was not performed in all patients. RESULT: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%)and 4 patients(33.3%).Conduit patency was evaluated by magnetic resonance imaging studies.A 9.84 +/- 3.84%mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019,p=0.955). CONCLUSION: These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia.And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.
Body Weight ; Cardiopulmonary Bypass ; Constriction ; Follow-Up Studies ; Fontan Procedure* ; Humans ; Magnetic Resonance Imaging ; Pleural Effusion ; Polytetrafluoroethylene ; Prevalence ; Protein-Losing Enteropathies ; Transplants

We report a case of the successful anatomical correction of the Taussig-Bing anomaly associated with the interrupted aortic arch and intramural left coronary artery for an 38 day-old infant. Aortic arch and neoaortic reconstructions were conducted without any prosthetic or pericardial patch. Intramural left coronary was separated from right one after partial detachment of aortic commissure and both coronary artery buttons were transferred separately to the proximal main pulmonary artery(neo-aorta). Delayed sternal closure was done 3 days after the operation and hospital discharge was delayed for a month because of postoperative pneumonia. Now he is 5 months old and free of symptoms and cardiac drugs.
Aorta, Thoracic* ; Coronary Vessels* ; Double Outlet Right Ventricle* ; Humans ; Infant ; Pneumonia

The combined cataract operation is increasing nowadays for the achievement of early visual rehabilitation and proper visualization of the retina during vitrectomy in proliferative diabetic retinopathy (PDR). We have ret-rospectively studied visual acuity and complications in 66 consecutive patients (81 eyes)with PDR who underwent phacoemulsification,pars plana vitrectomy and posterior chamber intraocular lens (PCL) implantation from January of 1994 to June of 1997. The age distribution was 28 to 77 years old (mean 56.0 years)and the duration of follow up was 6 to 44 months (mean 12.3 months).The improvement of visual acuity up to 2 lines on the chart was found in 63 eyes (77.8%) after the surgery and the final visual acuity of 0.5 or better was achieved in 36 eyes (44.4%). Postoperatively, rubeosis iridis developed in 5 eyes(6.2%)and reoperation was done in 7 eyes (8.6%).The improvement of visual acuity was significantly higher in eyes without diabetic nephropathy (39 eyes) (p=0.001) and significantly lower in eyes using intraocular substitutes (17 eyes) (p=0.004). The results of this study suggest that combined phacoemulsification, pars plana vitrectomy and PCL implantation are relatively effective procedures for patients with PDR.
Age Distribution ; Aged ; Cataract ; Diabetic Nephropathies ; Diabetic Retinopathy* ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification* ; Rehabilitation ; Reoperation ; Retina ; Visual Acuity ; Vitrectomy*

PURPOSE: To investigate the effect of triamcinolone acetonide (TA) on the survival, nitric oxide (NO) production, and migration of cultured human trabecular meshwork (TM) cells. METHODS: After exposure to TA, indomethacin, and dexamethasone for 2 days, the survival and nitrite production of the primarily cultured human TM cells were assessed with MTT and Griess assays respectively. The effect of co-exposure to the NO donor, sodium nitroprusside, was also assessed. A migration assay was done to evaluate the effect of TA on the activity of TM cells. RESULTS: Cellular survival increased after exposure to TA at low concentration but decreased at high concentration. TA decreased the production of NO significantly (p<0.05). Exposure to indomethacin and dexamethasone revealed similar results. TA reversibly inhibited the migration of TM cells. CONCLUSIONS: TA decreases the production of NO and inhibits the migration of TM cells. TA at high concentration decreases cellular survival accompanied with decreased NO production. These effects of TA on TM cells may result in the elevation of intraocular pressure.
Dexamethasone ; Humans ; Indomethacin ; Intraocular Pressure ; Nitric Oxide ; Nitroprusside ; Tissue Donors ; Trabecular Meshwork* ; Triamcinolone Acetonide* ; Triamcinolone*

BACKGROUND: It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects.We reviewed our recent surgical experiences on congenital heart defect (other than patent ductus arteriosus)in low birth wei ght babi es.Material and METHOD: From September 1994 to February 2001,31 consecutive infants weighing 2500 g or less underwent cardiac surgery with (OHS group n=12)or without cardiopulmonary bypass (CHS group n=19).A retrospective study was carried out to evaluate short-and intermediate-term outcome.Mean gestational age and age at operation were 36.9 weeks(range,32.3-42weeks)and 32.1days (range,0-87days)respectively.Mean body weight at birth and operation were 1972g (range,1100-2500g)and 2105g (range,1450-2500 g)respectively.There was no difference between the two groups in age and body weight.Defects included ventricular septal defect (VSD)(n=3),VSD with arch anomaly (n=2),total anomalous pulmonary venous return (n=2),transposition of the great arteries (TGA)(n=2),truncus arteriosus (n=2),and univentricular heart with cor triatriatum (n=1)in OHS group,and coarctation of aorta (n=7),tetralogy of Fallot (TOF)(n=3),TOF with pulmonary atresia (n=3), multiple muscular VSDs (n=1),double outlet right ventricle (n=1),pulmonary atresia with intact ventricular septum (n=2),tricuspid atresia (n=1),and TGA with multiple VSD (n=1)in CHS group.13 patients (41.9%)were intubated pre-operatively. RESULT: There were 4 early deaths (<30 days);1 (8.3%)in OHS group and 3 (15.8%)in non-OHS group.All these early deaths were related to the pulmonary artery banding(PAB).There was no operative mortality in infants undergoing complete repair and palliative operations other than PAB.Delayed sternal closure was required in 3 patients.Prolonged postoperative mechanical ventilation (>7days)was required in 7 patients (58.3%)in OHS and 7 (38.8%)in CHS group.Late mortality occurred in 3 patients,two of which were non-cardiac.A patient in OHS group was documented to have neurologic sequelae.All the survivors except two are in NYHA class I. CONCLUSION: Complete repair and palliative operations other than PAB can be performed in low birth weight infants with low operative mortality and an acceptable intermediate-term result.However,about a half of the patients required long-term postoperative mechanical ventilation.
Aortic Coarctation ; Arteries ; Body Weight ; Cardiopulmonary Bypass ; Cor Triatriatum ; Gestational Age ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Mortality ; Parturition ; Pulmonary Artery ; Pulmonary Atresia ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Scimitar Syndrome ; Survivors ; Thoracic Surgery* ; Ventricular Septum

Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Bowen's Disease* ; Follow-Up Studies ; Hematoporphyrin Derivative ; Humans ; Lasers, Gas ; Light ; Middle Aged ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin

PURPOSE: To investigate the effect of gas tamponade with vitrectomy for lamellar macular hole. METHODS: This study included 18 eyes of 18 patients with lamellar macular hole who reported visual acuity loss or distorted vision. All patients underwent vitrectomy, epiretinal membrane removal and internal limiting membrane peeling. Intravitreal gas tamponade was performed only in 8 eyes of 8 patients. The patients were divided into 2 groups: 8 eyes in the gas tamponade with vitrectomy group and 10 eyes that did not receive gas tamponade in the control group. The best-corrected visual acuity (BCVA) and appearance based on optical coherence tomography (OCT) were obtained retrospectively. RESULTS: Epiretinal membranes were observed in all cases. Average visual acuity of the gas tamponade group improved from log MAR 0.50 +/- 0.24 to log MAR 0.25 +/- 0.14 (p = 0.041). In the control group, average visual acuity improved from log MAR 0.53 +/- 0.36 to log MAR 0.32 +/- 0.28 (p = 0.041), however, no significant difference was observed in visual acuity between the 2 groups (p = 0.584). Anatomical closure or normalized foveal contour after surgery was confirmed in 6 of 8 eyes in the gas tamponade group and in 7 of 10 eyes in the control group. No significant difference between the 2 groups was observed (p = 1.00). CONCLUSIONS: Gas tamponade combined with vitrectomy for lamellar macular hole did not affect postoperative anatomical and functional recovery.
Epiretinal Membrane ; Humans ; Membranes ; Retinal Perforations* ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy*

Effects of aconitine on the retina and optic nerve were studied in rabbits by means of visual evoked potential(VEP), electroretinogram(ERG), and electron microscopy. Aconitine(0.4mg/kg) was administered intra peritoneally. The effects of aconitine were observed at 1 day, 3 days, 1 week, 2 weeks, 3 weeks, and 3 months after injection, respectively. The amplitude of VEP was decreased significantly at 1 and 2 weeks after injection. However ERG b-wave, c-wave, and the latency of VEP were not significantly changed during the experimental periods. Histopathological changes in the optic nerve and visual streak were characterized by disorganization of the lamellar structures of the myelin sheath, diffuse mitochondrial swelling, and vacuolization in the myelinated nerve fibers, which were increased in degree with time. No perceptible change in the retina including retinal pigment epithelium was observed in the experimental periods. Schwann cells and unmyelinated nerve fibers appeared unaffected, except for mild swelling of mitochondria. Above mentioned electrophysiological and electron microscopic studies indicated that the effect of aconitine on the rabbit eye was toxic myelo-optic neuropathy.
Aconitine* ; Microscopy, Electron ; Mitochondria ; Mitochondrial Swelling ; Myelin Sheath ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Optic Nerve ; Optic Nerve Diseases* ; Rabbits ; Retina ; Retinal Pigment Epithelium ; Schwann Cells

Extranodal lymphoma presents in almost one-third of all non-Hodgkin lymphoma cases. The gastrointestinal tract, skin, and central nervous system are common sites of involvement, whereas the urethra and cervix are very rare. To the best of our knowledge, this is the first report on concurrent extranodal involvement of the uterine cervix and urethra. We report imaging findings of malignant lymphoma involving urethra and cervix concurrently in a 79-year-old female patient with literature review. The magnetic resonance imaging showed huge intermediate to high signal intensity mass on T2 weighted images and strong homogeneous enhancement in uterine cervix and periurethral area, but no surrounding architectural disruption.

The ultrasonographic findings of 49 ovarian cystadenomas were analized. The results were as follows: 1. Themost common age group was 3rd decade and most patients(83%) belong to active reproductive period. 2. In 80% ofserous cystadenoma the size of the tumor was ranged in 6–10cm in diameter. The large tumors of 16–20 cm indiameter were mostly mucinous cystadenomas. 3. Purely cystic appearance was the most common finding(40%) of serouscystadenoma and thick linear septation with and without solid component was the most common finding (38%) ofmucious cystadenoma. 4. Thick linear septation with solid component was not found inserous cystadenoma. 5. Welldefined nodular projection was found in 3 cases of serous cystadenoma but not identified in mucinous cystadenoma.
Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Humans ; Reproduction