M-mode, pulsed Doppler and Doppler color flow mapping, in addition to two-dimensional echocardiography, have greatly improved imaging of the fetal heart through identification of abnormal cardiac anatomy and rhythm in utero. The early detection of cardiac disturbance in utero permits alteration in obstetric management such as delivery in a high-risk center for optimal neonatal care and/or decision in optimal delivery time. We report two cases of the neonatal arrhy-thmia which were observed by fetal echocardiography. In the first case, female baby showed neonatal arrhythmias including tachycardia and brady-cardia until 3 days after birth, and then turned to bradyarrhythmia due to non-conducted atrial bigeminy. These events lead us to review the fetal echocardiographs of the patient carefully. Premature atrial contractions were observed in her fetal echocardiography. At 2 months after birth, the patient's electrocardiogram showed normal sinus rhythm. Severe neonatal bradycardia of the second case was due to congenital complete heart block, identified clearly by electrocardiogram after birth. This case also showed complete heart block in her fetal echocardiography. After insertion of the temporary pacemaker, cardiomegaly was improved. Both the neonate and the mother had positive anti-SSA/Ro autoantibody. But any other symptoms and signs of neonatal lupus did not appear in the neonate. Patient's mother also did not show any symptoms and signs of systemic lupus erythematosus. Since the prognosis depends upon the cause of bradyarrhythmia in fetus and neonates, differential diagnosis is important in obstetric management and optimal neonatal treatment.
Arrhythmias, Cardiac* ; Atrial Premature Complexes ; Bradycardia ; Cardiomegaly ; Diagnosis, Differential ; Echocardiography* ; Electrocardiography ; Female ; Fetal Heart ; Fetus ; Heart Block ; Humans ; Infant, Newborn ; Lupus Erythematosus, Systemic ; Mothers ; Parturition ; Prognosis ; Tachycardia

Trabeculectomy, as an operation precedure for glaucoman, decrease intraocular pressure(IOP)effectively. But the amount of decrease in IOP is different according to the etiology of glaucoma. Thirty four primary angle-closure glaucoma patients (37 eyes)who had undergone trabeculectomy only or trabeculecomy combined with cataract surgery and had been subsequently followed up for least 6 months, were enrolled in this study. In 12 patients(14 eyes) among 16 patients (18 eyes, Group 1) who had undergone trabeculecto-my only, IOP was controlled without glaucoma medication, while glaucoma medication was needed in the other 4 patients (4 eyes). Among 18 patients (19 eyes, Group 2) who had undergone trabeculectomy combined with cataract surgery, IOP were controlled without glaucoma medication 9 patients (10 eyes); controlled with medication in 8 patients (8 eyes); and not controlled even with 1 patient (1 eye). The amount of decrease in IOP was no statistically different between the two groups. Group 2 had deeper anterior chamber than Group 1 (p<0.01). The above results suggest that the combined pro-cedure may benefit in primary angle-closure glaucoma patients, especially old complicated patients.
Anterior Chamber ; Cataract* ; Glaucoma ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Trabeculectomy

A 4-year-old boy has had a solitary sclerotic depressed plaque on the right anterior chest since birth. The histopathologic findings are consistent with morphea profunda: thickening, hyalinization, and homogenization of collagen bundles in the dermis and subcutaneous tissues, admixture with a prominent lymphocytic and plasma cell infiltrate, and sweat glands en-trapped between the thickened collagen bundles. We report a case of congenital solitary morphea profunda.
Child, Preschool ; Collagen ; Dermis ; Humans ; Hyalin ; Male ; Parturition ; Plasma Cells ; Scleroderma, Localized* ; Subcutaneous Tissue ; Sweat Glands ; Thorax

We used argon laser peripheral iridoplasty to reduce intraocular pressure[IOP] in acute angle-closure glaucoma[ACG] which is unrelieved by medical and physical treatments and could not be treated by peripheral iridotomy due to edematous cornea and turbid aqueous. Eight of 16 eyes [16 patients] were successfully treated. These successfully treated eyes had a mean duration of angle closure of 4.1 days and 8 unsuccessfully treated eyes 9.2 days. The 6 eyes of 8 eyes with successful reduction of IOP after argon laser peripheral iridoplasty were treated peripheral iridotomy at average 1.7 day later and had deep anterior chamber. After a mean follow-up period of 2 months, 7 of these 8 successfully treated eyes had an IOP less than or equal to 21mmHg. Argon laser pripheral iridoplasty may be successful in treating ACG which is unrelieved by medical and physical treatments and could not be treated by pripheral iridotomy, especially in cases that are recognized and treated soon after onset.
Anterior Chamber ; Argon* ; Cornea ; Follow-Up Studies ; Glaucoma, Angle-Closure*

Mitomycin C has improved the success rate of glaucoma filtering surgery in patients at high risk for surgical failure. However chronic hypotony is marked by decreased vision and a late-onset leaking bleb after filtration surgery using mitomycin C. Bleb excision and conjunctival advancement is the method of choice to repair bleb leakage and chronic hypotony. Five eyes from five patients were received glaucoma filtration surgery with topical mitomycin C. All of the patients' blebs were avascular and transparent. The reasons for bleb excision were two spontaneous bleb leaks, two traumatic bleb leaks and one case of severe irritation. The mean follow-up period was 18.4 +/- 8.3 months (ten to 29 months). Cataract surgery was combined in one eye. Postoperative intraocular pressure (IOP) increased from 2.3 +/- 1.5 mmHg to 9.5 +/- 3.7 mmHg at nine months postoperatively in four eyes. It went from 28 mmHg to 40 mmHg in one patient with uveitis, for whom a second trabeculectomy with mitomycin C; 0.4 mg/ml for 3 minutes, was performed. After surgery, IOP decreased to 4 mmHg in three months. Postoperative visual acuity improved four snellen lines in three eyes. A partially avascular bleb recurred in three eyes, a corneal bleb in one eye and blepharoptosis, which disappeared spontaneously at four months postoperatively, in one eye. Necrotic bleb excision and advancement of fornical conjunctiva were useful methods to increase IOP and to improve visual acuity for the patient experiencing irritation symptoms, and for leaking blebs, and hypotonic maculopathy.
Adult ; Alkylating Agents/administration & dosage ; Case Report ; Comparative Study ; Conjunctiva/surgery ; Conjunctiva/pathology* ; Female ; Follow-Up Studies ; Glaucoma/surgery* ; Human ; Intraoperative Period ; Male ; Middle Age ; Mitomycin/administration & dosage ; Necrosis ; Ophthalmic Solutions ; Postoperative Complications/surgery* ; Postoperative Complications/pathology ; Reoperation ; Retrospective Studies ; Trabeculectomy/methods*

Hyperkeratosis of the nipple and areola is a rare skin disordr characterized clinically by thickening and discoloration of the skin of the areola and/or nipple and pathoiog cally by papillomaosis or acanthosis-nigricans like changes. We report a case of hyperkeratosis of the nipple and areola occuring in a woman with no underlying endocrinopathy and no other additional hyperkeratotic conditions. Ttie iresent case seems to be the nevoid form by the Levy-Franckel classification. Treatment with topical medications including steroids and keratolytic agents produced no improvement. Therefore we recommeneded surgical excision because the paient was greatly disturbed by the appearance of the lesions. Surgical excision and full thickness skin graft were performed sucessfully.
Classification ; Female ; Humans ; Keratolytic Agents ; Nipples* ; Skin* ; Steroids ; Transplants*

We are reporting a case of 25-year-old male patient with elastosis perforance serpiginosa who showed multipte serpiginous plaques on his neck. Some of the lesions showed hypopigmented, hard, scar-tissue like plaques in the central part. Histologic examination showed hyperplasia and transepidermal elimination of elastic tissue. By electron microscopy, also, we could prove that the elastic fibers were increased in the dermis.
Adult ; Dermis ; Elastic Tissue ; Humans ; Hyperplasia ; Male ; Microscopy, Electron ; Neck

No abstract available.
Cactaceae* ; Dermatitis* ; Humans ; Leprosy*

The authors studied retrospectively the results of mitomycin C (MMC) trabeculectomy in 19 eyes with neovascular glaucoma which could be followed up more than 4 months after surgery. Twelve eyes(63%) were classified as success group and 7 eyes(37%) were classified as failure group. In the success group, the mean intraocular pressure(IOP) was significantly reduced from 52.1+/-10.1mmHg preoperatively to 10.1+/-3.8mmHg at last follow Kaplan-Meier survival analysis, cumulative success rates at 6 and 12 months intervals were 68%, 59% respectively. In the failure group, the mean IOP was reduced significantly from 51.9+/-8.1mmHg preoperatively to 26.6+/-13.4mmHg at last follow up. The mean number of medications to reduce IOP was also reduced from 2.6+/-0.5 preoperatively to 1.3+/-0.8 at last follow up. The causes for failure were inadequate IOP control in 5 eyes(26%), loss of light perception in 1 eye(5%), and reoperation to reduce IOP(5%). Complication included hypotony in 4 eyes(21%), late bleb leakage in 2 eyes(10.5%), spontaneous hyphema in 2 eyes(10.5%), cataract progression needing extraction in 2 eyes(10.5%). We think that MMC trabeculectomy may be the first choice procedure before doing cyclocyro-therapry or cyclodestructive procedure using laser.
Blister ; Cataract ; Follow-Up Studies ; Glaucoma, Neovascular* ; Hyphema ; Mitomycin* ; Reoperation ; Retrospective Studies ; Trabeculectomy*

Since the anterior chamber tube shunt to an encircling band(ACTSEB) is not a simple procedure, an extended polytetrafluoroethylene (e-PTFE)-silicone tube (anterior chamber tube shunt to a surgical membrane; ACTSSM) was attempted as a new glaucoma drainage implant. To see whether the newly-modified, two-fold e-PTFE-silicone tube implant could prevent early hypotony and to compare the tissue response to each implant, ACTSEB and ACTSSM procedures were done in normal colored rabbit eyes. It was found the ACTSSM kept the depth of the postoperative anterior chamber normal. And in general, foreign body responses were light microscopically similar. The fibrous capsule lining the e-PTFE was composed of thicker, less dense fibroblasts, as well as less collagen than that lining the silicone encircling band. These findings seemed to be related to the difference in the pressure-lowering capacity between ACTSEB and ACTSSM.
Animals ; Anterior Chamber/pathology/*surgery ; Cell Adhesion ; Drainage/*instrumentation ; Fibroblasts ; Foreign-Body Reaction/pathology ; Glaucoma/*surgery ; Intraocular Pressure ; *Polytetrafluoroethylene ; Postoperative Complications/prevention & control ; *Prostheses and Implants ; Rabbits ; *Silicone Elastomers