No abstract available.
Anus, Imperforate*

While retinal detachment is not rarely associated with posterior staphyloma and macular hole, very few cases of retinal detachment with equatorial scleral staphyloma are reported until recentily. In the course of retinal detachment surgery, an equatorial staphyloma is found unexpectedly and makes surgical treatment difficult. We experienced a 70 year old woman who had retinal detachment due to a hole at the 1 o'clock equator. During the retinal detachment surgery, a large equatorial staphyloma was noted right over the retinal hole. Scleral surface buckling procedure and graft using the preserved human sclera were performed. After the follow up period of 6 months, retina was still reattached.
Aged ; Female ; Follow-Up Studies ; Humans ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Sclera ; Transplants

As the number of diabetic patient increases, it is important to manage diabetic retinopathy. Clinically sufficient pupillary dilatation should be obtained for fundoscopic examination and laser photocoagulation theraphy of diabetic patient but we experienced insufficient and delayed pupillary dilatation after instillation of mydriatics. In order to examine abnormality of pupillary dilatation and its relationship to the stage of diabetic retiniopathy, the course of pupillary diameter was measured with Haab's pupillometer after instillation of one drop of 1% Mydriacyl(R) and 2.5% Mydfrin(R) in 72 patients with diabetes mellitus (40-69 years old) and 11 normal controls (40-69 years old). The following results were obtained. After instillation of 1% Mydracy(R), the maximum pupillary diameter was smaller in diabetic retinopathy group than in controls. As the severity of diabetic retinopathy was increased, maximum pupillary diameter was decreased. After instillation of 2.5% Mydfrin(R), the delay of the average time to reach maximal mydriasis in diabetic group was larger than that in controls. This delay was proportional to the severity of diabetic retinopathy. Therefore it was considered that the abservation of the course of pupillary diameter after instillation of mydriatics would be useful for diagnosis of the severity of diabetic retinopathy.
Diabetes Mellitus ; Diabetic Retinopathy* ; Diagnosis ; Dilatation* ; Humans ; Light Coagulation ; Mydriasis ; Mydriatics*

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

While retinal detachment is not rarely associated with posterior staphyloma and macular hole, very few cases of retinal detachment with equatorial scleral staphyloma are reported until recentily. In the course of retinal detachment surgery, an equatorial staphyloma is found unexpectedly and makes surgical treatment difficult. We experienced a 70 year old woman who had retinal detachment due to a hole at the 1 o'clock equator. During the retinal detachment surgery, a large equatorial staphyloma was noted right over the retinal hole. Scleral surface buckling procedure and graft using the preserved human sclera were performed. After the follow up period of 6 months, retina was still reattached.
Aged ; Female ; Follow-Up Studies ; Humans ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Sclera ; Transplants

Fetal teratomas rarely complicate pregnancy,having an incidance of only 20,000:1 to 40,000:1 of live births. Overthere, cervical teratomas are rare and accounts for only 5.5% of all neonatal teratomas. We have experienced a large cervical immature teratoma and present this case with a brief review of literatures.
Live Birth ; Teratoma*

Thirty-two dacryocystorhinostomies were performed in the chronic dacryocystitis and obstruction of the nasolacrimal duct between 1971 and 1976. A routine dacryocystography was performed prior to operation in all cases. A modified Toti's method was applied as a surgical technique; vaseline gauze was used as a plugging agent and both posterior flaps of sac ans nasal mucous membrane was not sutured because of technical difficuty and for prevention of granulation tissue due to suture materials Ranging in age from 22 to 66 years of age; 3 were men and 29 were women. Success was achieved in 29 of 32 cases initially. One of three initial failured cases, which was due to formation of obstructing granulation tissue by suture materials in posterior flap, was turn into succes by secondary operation. We attempted to make this method in 3 cases of shrunken sac: Two were failed. In these cases, if vaseline gauze should removed after more than 10 days, it will be possible to expansion of shrunken sac and to obtained successful result. We also attempted to make this method in 3 cases of macerted sac, and gained successful result. In such a case, it is possible by suturing of anterior flaps of sac and nasal mucous mem brane only. In conclusion, this operation is simple to do and within the range of any ophthalmic surgeon. It is possible in case of macerated sac and shrunken sac.
Dacryocystitis ; Dacryocystorhinostomy* ; Female ; Granulation Tissue ; Humans ; Male ; Mucous Membrane ; Nasolacrimal Duct ; Petrolatum ; Sutures

Caudal analgesia is a widely accepted technique for providing pain relief. However, both permanent and transient neurologic complications, including paraplegia, have been reported. We report on a patient who developed paraplegia following a caudal block for an epidural mass. The cause of the paraplegia was unknown, but possibly spinal angioma may have taken part in the onset and progression of the paralysis. A mechanism is proposed by which the caudal injection may have caused a change in blood flow through the spinal angioma resulting in cord ischemia.
Analgesia* ; Hemangioma ; Humans ; Ischemia ; Paralysis ; Paraplegia*

The purpose of current experiment is the generation of insulin-producing human mesenchymal stem cells as therapeutic source for the cure of type 1 diabetes. Type 1 diabetes is generally caused by insulin deficiency accompanied by the destruction of islet beta-cells. In various trials for the treatment of type 1 diabetes, cell-based gene therapy using stem cells is considered as one of the most useful candidate for the treatment. In this experiment, human mesenchymal stem cells were transduced with AAV which is containing furin-cleavable human preproinsulin gene to generate insulin-producing cells as surrogate beta-cells for the type 1 diabetes therapy. In the rAAV production procedure, rAAV was generated by transfection of AD293 cells. Human mesenchymal stems cells were transduced using rAAV with a various multiplicity of infection. Transduction of recombinant AAV was also tested using beta-galactosidse expression. Cell viability was determined by using MTT assay to evaluate the toxicity of the transduction procedure. Expression and production of Insulin were tested using reverse transcriptase-polymerase chain reaction and immunocytochemistry. Secretion of human insulin and C-peptide from the cells was assayed using enzyme-linked immunosorbent assay. Production of insulin and C-peptide from the test group represented a higher increase compared to the control group. In this study, we examined generation of insulin-producing cells from mesenchymal stem cells by genetic engineering for diabetes therapy. This work might be valuable to the field of tissue engineering for diabetes treatment.

High ambient Ca2+ at bone resorption sites have been implicated to play an important role in the regulation of bone remodeling. The present study was performed to clarify the mode of high extracellular Ca2+ (Ca2+e)-induced modulation of osteoclastogenesis and the expression of receptor activator of nuclear factor-kB ligand (RANKL) and osteoprotegerin (OPG), thereby to define its role in osteoclast formation. Mouse bone marrow cells were cocultured with osteoblastic cells in the absence or presence of osteoclastogenic factors such as 1,25-dihydroxyvitaminD3 (1,25-(OH)2vitD3) and macrophage colony-stimulating factor/soluble RANKL. Ca2+ concentration in media (1.8 mM) was adjusted to 3, 5, 7 or 10 mM. Osteoclast formation was confirmed by the appearance of tartrate-resistant acid phosphatase (TRAP)-positive multinuclear cells and the expression of osteoclast phenotypic markers (calcitonin receptor, vitronectin receptor, cathepsin K, matrix metalloproteinase-9, carbonic anhydrase 2). High Ca2+e alone significantly stimulated osteoclast formation in a dose-dependent manner. However, in the presence of highly osteoclastogenic factors, high Ca2+e significantly inhibited osteoclastogenesis. High Ca2+e alone continuously up-regulated RANKL expression while only transiently increased OPG expression. However, in the presence of 1,25-(OH)2vitD3, high Ca2+e did not change the 1,25-(OH)2vitD3- induced RANKL expression while increased OPG expression. Taken together, these findings suggest that high Ca2+e alone increase osteoclastogenesis but inhibit in the presence of other osteoclastogenic factors. In addition, high Ca2+e-induced osteoclastogenesis may be mediated by osteoblasts via up-regulation of RANKL expression. Meanwhile up-regulated OPG might participate in the inhibitory effect of high Ca2+e on 1,25-(OH)2vitD3-induced osteoclastogenesis.
Animals ; Bone Marrow Cells/metabolism/physiology ; Bone Remodeling ; Calcium/*metabolism ; Carrier Proteins/biosynthesis ; Cations, Divalent ; Cells, Cultured ; Coculture ; Extracellular Space/*metabolism ; Glycoproteins/biosynthesis ; Membrane Glycoproteins/biosynthesis ; Mice ; Mice, Inbred ICR ; Osteoblasts/*cytology/metabolism ; Osteoclasts/*cytology/metabolism ; Receptors, Cytoplasmic and Nuclear/biosynthesis ; Vitamin D/*analogs & derivatives/pharmacology