PURPOSE: To evaluate the clinical efficacy of amniotic membrane transplantation and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium, the results of 15 eyes of 14 patients were analyzed. METHODS: Total 10 cases of recurrent pterygium and 5 cases of pseudopterygium were surgically managed during June 1998 to July 2000. After excision of pterygium, amniotic membrane was attached on the bare sclera and limbal-conjunctival autograft was transplanted over the amniotic membrane. Mean follow-up period was 47.2 week and all patients were examined for recurrence, which was graded from G0(no vessel) to G3(fibrotic tissue invading the limbus). RESULTS: 12 out of 15 cases(rate 80%) showed no recurrence(grade 0). 1 case of grade 2 recurrence and 2 cases of grade 3(total 3 cases) were observed(rate 20%). Reoperation was performed on 2 cases of grade 3 recurrence. There was no further recurrence necessitating additional reoperation. 1 case of limbal graft was detached and removed. The operation time of this more prolonged than the other procedures, but there were no significant complications. CONCLUSION: Amniotic membrane and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium reconstructed complete ocular surface with less recurrence. Therefore, we recommend this surgical approach as a safe and effective method for the treatment of complicated cases of pterygium.
Amnion* ; Autografts* ; Follow-Up Studies ; Humans ; Pterygium* ; Recurrence ; Reoperation ; Sclera ; Transplants

A healthy 35-year-old man who was scheduled for closed reduction of nasal bone fracture developed atrial fibrillation during induction of general anesthesia after intravenous glycopyrrolate injection. During emergence of general anesthesia, atrial fibrillation was suddenly changed to paroxysmal supraventricular tachycardia with 200 beat per minute and lasted for about 10 seconds. Because blood pressure was stable, esmolol was used to reduce ventricular response. At recovery room, ventricular response reduction about 55 beat per minute was observed after intravenous injection of verapamil 5 mg. Thereafter, the rhythm was returned to normal sinus rhythm with bradycardia.
Anesthesia, General ; Atrial Fibrillation ; Blood Pressure ; Bradycardia ; Glycopyrrolate ; Injections, Intravenous ; Nasal Bone ; Propanolamines ; Recovery Room ; Tachycardia, Paroxysmal ; Tachycardia, Supraventricular ; Verapamil

No abstract available.

Solitary rectal ulcer syndrome (SRUS) is a rare disorder in children. There are few investigations about the exact incidence and effective treatment of SRUS in children. We describe a 12-year-old male patient who had rectal prolapse for 9 years, hematochezia for 7 months, and was diagnosed with polypoid solitary rectal ulcer syndrome with rectal prolapse by colonoscopy. Anorectal manometry was also performed to evaluate the cause of frequent relapses.
Child ; Colonoscopy ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Male ; Manometry ; Rectal Prolapse ; Recurrence ; Ulcer

Although the apoptosis of chondrocytes plays an important role in endochondral ossification, its mechanism has not been elucidated. In this study, we show that guanosine induces chondrocyte apoptosis based on the results of acridine orange/ ethidium bromide staining, caspase-3 activation, and sub-G1 fraction analysis. The potent inhibitory effect of dipyridamole, a nucleoside transporter blocker, indicates that extracellular guanosine must enter the chondrocytes to induce apoptosis. We found that guanosine promotes Fas-Fas ligand interaction which, in turn, leads to chondrocyte apoptosis. These findings indicate a novel mechanism for endochondral ossification via metabolic regulation.
Tumor Necrosis Factors/metabolism ; Signal Transduction/drug effects ; Receptors, Tumor Necrosis Factor/*metabolism ; Rats, Sprague-Dawley ; Rats ; Nucleoside Transport Proteins/metabolism ; Membrane Glycoproteins/metabolism ; Guanosine/*pharmacology/physiology ; Fas Ligand Protein ; Chondrocytes/*drug effects/metabolism ; Apoptosis/*drug effects ; Antigens, CD95 ; Animals