ABSTRACT
PURPOSE: To compare visual acuity and intraocular straylight after implantation of clear and photochromic intraocular lenses (IOLs) in a mesopic lighting condition. METHODS: Clear IOLs were implanted in 95 eyes of 72 patients (clear IOL group), and photochromic IOLs were implanted in 22 eyes of 16 patients (photochromic IOL group). Best-corrected visual acuity (BCVA) was measured indoors before surgery and 1 month after surgery. Straylight values were measured indoors before surgery and 1 and 2 months after surgery using the C-quant straylight meter (Oculus GmbH, Wetzlar, Germany). RESULTS: There were no significant differences between the 2 groups in BCVA at 1 month postoperatively (p = 0.587). Mean straylight values of clear and photochromic IOL groups were 2.76 +/- 1.89 log (s) and 2.88 +/- 2.04 log (s) preoperatively, 1.39 +/- 0.84 log (s) and 1.32 +/- 0.26 log (s) at 1 month postoperatively, and 1.43 +/- 0.92 log (s) and 1.45 +/- 0.50 log (s) at 2 months postoperatively. There were no significant differences between the 2 groups in indoor straylight values (p = 0.778, 0.709, 0.929, before surgery, 1 and 2 months after surgery respectively). Repeated-measure analysis of straylight values also showed no significant difference between the 2 groups (p > 0.05). CONCLUSIONS: There were no significant differences in BCVA and straylight values between clear and photochromic IOL groups under a mesopic light condition. Therefore, photochromic IOL could be suitable choice for cataract patients who spend significant time under mesopic conditions.
Subject(s)
Humans , Cataract , Lenses, Intraocular , Visual AcuityABSTRACT
PURPOSE: To report the visual outcome and to determine the stability of WIOL-CF(R) (GELMED, Praha, Czech Republic) hydrogel full-optics accommodative intraocular lens (IOL). METHODS: The present study evaluated 20 eyes of 10 patients who underwent routine cataract surgery and WIOL-CF(R) accommodative IOL implantation. Measurement included uncorrected/best corrected visual acuities (VA) at near and distant, degree of IOL decentration, degree of IOL tilting and anterior chamber depth on postoperative day 1, 1 month, 2 months, 6 months and 12 months. RESULTS: Result analysis was performed with 19 eyes of 10 patients, except for 1 complicated eye. At 12 months, the uncorrected distance VA of 11 eyes (57.9%) and 17 eyes (89.5%) were 20/25 and 20/40 or better, respectively. At 12 months, the uncorrected near VA of 12 eyes (63.2%) and 18 eyes (94.7%) were 20/25 and 20/40 or better, respectively. There was no statistically significant difference in anterior chamber depth (p > 0.05), IOL decentration (p > 0.05) and IOL tilting (p > 0.05) on postoperative day 1, 1 month, 2 months, 6 months and 12 months. CONCLUSIONS: The clinical results of cataract surgery with WIOL-CF were relatively satisfactory.
Subject(s)
Humans , Anterior Chamber , Cataract , Eye , Hydrogels , Lenses, Intraocular , Visual AcuityABSTRACT
OBJECTIVE: To evaluate efficacy and safety of local injection of potassium chloride (KCl) and methotrexate (MTX) in the treatment of cornual pregnancy. METHODS: We retrospectively reviewed all cases of cornual pregnancy treated conservatively from 2005 through August 2007. Eight cases were identified and two cases were heterotopic interstitial pregnancy. All cases were managed with local injection of KCl or methotrexate under ultrasound guidance and 2 cases were treated with intra-muscular injection of MTX in combination. After the procedure all cases with cardiac activity was confirmed to be aborted by ultrasound. Also serial follow-up sonographic examination and serum beta-hCG measurement were performed. RESULTS: The mean initial beta-hCG level was 53,331.6 mIU/mL and ranged from 14,332 mIU/mL to 125,721 mIU/mL. Mean gestational age was 48.3 days from 40 to 65 days. All cases were aborted successfully and follow up beta-hCG were declined abruptly. Two cases of heterotopic pregnancy resulted in successful deliveries at full term. CONCLUSION: Cornual resection or hysterectomy should no longer be the first line of treatment for hemodynamically stable patients with cornual pregnancy. They can be successfully treated through local injection of MTX or KCl by ultrasound guidance.
Subject(s)
Humans , Pregnancy , Follow-Up Studies , Gestational Age , Hysterectomy , Methotrexate , Potassium , Potassium Chloride , Pregnancy, Heterotopic , Retrospective StudiesABSTRACT
Fetal bilateral renal agenesis is a lethal congenital anomaly characterized by bilateral pulmonary hypoplasia, deformities and death due to severe oligohydramnios. This syndrome is associated with malformations of genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus in more than half of the affected individuals. An early and reliable prenatal diagnosis is extremely important because it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, empty renal fossae. But poor sonographic resolution of severe oligohydramnios makes it difficult to diagnose the disease. We present a case of bilateral renal agenesis diagnosed at the 18th weeks gestation by using Transvaginal Ultrasonography and Color Doppler.
Subject(s)
Female , Pregnancy , Anal Canal , Cardiovascular System , Congenital Abnormalities , Diagnosis , Oligohydramnios , Prenatal Diagnosis , Ultrasonography , Urinary BladderABSTRACT
OBJECTIVE: This study was performed to understand the influence of the methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) genotypes on the spontaneously aborted embryos. METHODS: DNA was extracted from tissue samples of 95 spontaneously aborted embryos and 100 samples of normal children randomly and 449 samples of normal adults were selected as the controls. MTHFR genotypes were determined by a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. RESULTS: The aborted embryo group had higher frequency of MTHFR 677CC type (p=0.014) and lower 677CT type (p=0.063) than the controlled child group. The frequency of MTHFR 677CT type was drastically lower than that of controlled adult group (p=0.032). In the MTHFR C677T/A1298C combination, 677CC/1298AC genotype of the aborted embryo was significantly higher (p=0.034) than that of controlled child group, but it was not statistically significant in controlled adult group (p=0.063). CONCLUSION: MTHFR 677CC and MTHFR 677CC/1298AC genotypes may represent genetic markers for the risk of spontaneously aborted embryos at least in Koreans.
Subject(s)
Adult , Child , Humans , Aborted Fetus , DNA , Genetic Markers , Genotype , Homocysteine , Methylenetetrahydrofolate Reductase (NADPH2)ABSTRACT
OBJECTIVE: Previous studies have suggested that hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR C677T) mutations are associated with increased risk of recurrent spontaneous abortion (RSA). Recently, a second site polymorphism in MTHFR, 1298A-->C, which changes a glutamic acid into an alanine residue, was shown to be associated with a decreased enzyme activity. We tested whether the variant alleles of MTHFR C677T and A1298C are risk factor (biomarker) for RSA. MATERIALS AND METHODS: We analyzed DNA from a case-control study in the Korean DNA was extracted from blood samples of 118 patients with RSA and 123 healthy fertile patients as the controls. MTHFR variant alleles were determined by a PCR-restriction fragment length polymorphism assay. RESULTS: We found no evidence for an association between 677TT genotype and risk of RSA (OR=1.95, 95% CI=0.84~4.50, p=0.12). However, the MTHFR 1298AC (OR=0.36, 95% CI=0.20~ 0.63, p=0.0004) and 1298AC+CC (OR=0.35, 95% CI=0.20~0.61, p=0.0002) genotypes were lower among 118 RSA cases compared with 123 controls, conferring a 2.8-fold decrease in risk of RSA, respectively. Moreover, the combined genotypes of MTHFR 677CC/1298AC (OR=0.30, 95% CI= 0.10~0.88, p=0.029) and 677CT/1298AC (OR=0.77, 95% CI=0.60~0.99, p=0.043) also showed significantly lower risk than those with MTHFR 677CC/1298AA type. CONCLUSION: MTHFR 1298AC, MTHFR 677CC/1298AC and 677CT/1298AC genotypes may represent genetic markers for the protection of RSA at least in Korean women.
Subject(s)
Female , Humans , Pregnancy , Abortion, Spontaneous , Alanine , Alleles , Case-Control Studies , DNA , Genetic Markers , Genotype , Glutamic Acid , Hyperhomocysteinemia , Methylenetetrahydrofolate Reductase (NADPH2) , Oxidoreductases , Risk Factors , Vascular DiseasesABSTRACT
Campomelic syndrome is a very rare skeletal dysplasia with a characteristic pattern of deformity involving the proximal and distal extremities, pelvic and shoulder girdles, thoracic cage and palate. Respiratory compromise often leads to death in early infancy. Etiology has not been determined although evidence suggests genetic heterogeneity. Cytogenetic study revealed high incidence of a 46,XY karyotype in phenotypic females. Recently, we had experienced a case of campomelic dysplasia at amenorrhea 30weeks and termination was done, so we report with a brief review of literature.
Subject(s)
Female , Humans , Amenorrhea , Campomelic Dysplasia , Congenital Abnormalities , Cytogenetics , Extremities , Genetic Heterogeneity , Incidence , Karyotype , Palate , ShoulderABSTRACT
OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus intracervical dinoprostone (prostaglandin E2 gel) for cervical ripening and labor induction. METHODS: 60 patients with indication for labor induction and unfavorable cervices were randomly assigned to receive either intravaginal misoprostol or intracervical dinoprostone. 50 microgram tablets of misoprostol were placed in the posterior vaginal fornix every 4 hours for a maximum of 3 doses or dinoprostone 0.5mg was placed into the endocervix every 6 hours for a maximum of 2doses. No more medication was given after either spontaneous rupture of membranes or beginning of active labor. RESULTS: Among 60 patients enrolled, 30 received misoprostol and 30 received dinoprostone. The average interval from start of induction to active labor was shorter in misoprostol group (6.5+/-3.2 hours) than in the dinoprostone group (10.7+/-7.3 hours) (p<0.05). Oxytocin augmentation of labor occurred more often in the dinoprostone group (36.7%) than in the misoprostol group (10.0%) (p<0.05). There was a higher prevalence of fetal distress (23.3% versus 3.3%) and tachysystole (16.6% versus 6.6%) in the misorprostol group than in the dinoprostone group(p<0.05). CONCLUSIONS: Vaginally administered misoprostol is an effective agent for cervical ripening and induction of labor. Furthermore, the cost of misoprostol ( 360/200microgram) is much less than that of dinoprostone ( 42,000/0.5mg). Cost benefits from administration of misoprostol are evident, especially in clinics under system of diagnosis-related group (DRG) : however when given at this dosage, it is associated with a higher prevalence of fetal distress and tachysystole than dinoprostone. Further studies to compare the safety of misoprostole to that of dinoprostone and to delineate an optimal dosing regimen for misoprostol are needed.
Subject(s)
Female , Humans , Pregnancy , Cervical Ripening , Cost-Benefit Analysis , Diagnosis-Related Groups , Dinoprostone , Fetal Distress , Membranes , Misoprostol , Oxytocin , Prevalence , Prospective Studies , Rupture, Spontaneous , TabletsABSTRACT
OBJECTIVE: To evaluate the results of second-trimester maternal serum triple-marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived from in vitro fertilization, the screen positive rates and triple-marker level of patients conceiving singleton pregnancies by IVF were compared to those of pregnancies conceived naturally. METHODS: Two hundred singleton pregnancies conceived by IVF and naturally conceived pregnancies who had done maternal serum screening test during the second trimester were analyzed from January 1995 to April 1998. RESULTS: One (0.5%) of the 200 cases of IVF singleton pregnancies had a positive result for Down syndrome compared with 1% of screen positive rate in the 200 cases of naturally conceived pregnancies. The median level of the triple markers were 0.92 multiples of the median(MoM) for alpha-fetoprotein(AFP), 1.44 MoM for unconjugated estriol(E3) and 0.87 MoM for human chorionic gonadotropin(hCG) respectively. CONCLUSION: The positive rate of triple test for Down syndrome and open neural tube defect in the two groups were significantly not different. As additional data are collected, corrected standards should be determined.
Subject(s)
Female , Humans , Pregnancy , Chorion , Down Syndrome , Fertilization in Vitro , Mass Screening , Neural Tube Defects , Pregnancy Trimester, SecondABSTRACT
Fetal cystic hygromas are congenital malformations of the lymphatic system manifested as single or multiloculated fluid-filled cavities in the neck region. Cystic hygroma is characterized by cystic appearance of posterior or lateral portion of the neck. A case of cystic hygroma, diagnosed antenatally by ultrasound at the 11(+1)th week of pregnancy and confirmed by autopsy, is presented with a brief review of literatures.