Indication for Laparoscopically Assisted Vaginal Hysterectomy

When uterine weight is greater than 800 grams, total abdominal hysterectomy is more appropriate than laparoscopic-assisted vaginal hysterectomy

Isolation of Acanthamoeba with Sabouroud's glucose agar plate

Isolation of Acanthamoeba or finding out the cysts from corneal leasions is necessary to confirm the diagnosis of Acanthamoeba keratitis. However, we cannot always find out the cyst from corneal scrapings of the lesions. In these cases the isolation of Acanthamoeba is very important to confirm the diagnosis. Non-nutrient agar plates are generally used to isolate Acanthamoeba, but it is difficult to get them easily at many hospitals. To find out another agar that can be used to isolate Acanthamoeba and got easily, Sabouroud's glucose agar plates were compared with non-nutrient agar plates for the isolation of Acanthamoeba. Both agar plates seeded with Escherichia coli showed a nice growth of trophozoites first and cysts later. A clinical material, stock solution of contact lens used by a suspected patient of Acanthamoeba keratitis, was put on Sabouroud's glucose agar plate seeded with Escherichia coli. After three days of incubation at 25°C Acanthamoeba was found on the plate. Sabouroud's glucose agar plate was a very useful agar plate for the isolation of Acanthamoeba

Two cases of constitutional unconjugated hyperbilirubinemia with marked retention of indocyanine green.

Two cases of chronic unconjugated hyperbilirubinemia and marked retention of indocyanine green (ICG) are described. Since bilirubin uridine diphosphate (UDP)-glucuronyl transferase activities were depressed in their liver, the patients seemed to have bilirubin metabolism similar to that in Gilbert's syndrome. However, the ICG fractional disappearance rates of the cases were rather low (0.018 and 0.019) compared to the rates reported for Gilbert's syndrome. These results suggest that the patients had a new metabolic disorder which results in constitutional unconjugated hyperbilirubinemia and ICG intolerance.</p

トウニョウビョウ モウマクショウ ノ チリョウ

Diabetic retinopaty is a typical diabetic amalgamation. Retinal photocoagulation and vitrectomy are spread, and now those treating to the appropriate time can maintain eyesight and prevent the blindness. The first cause of the midway blind in Japan is diabetic retinopaty. About 4000 people a year have lost their sight by diabetic retinopaty. It is thought that the purpose of this is for the patient of diabetic retinopaty not to have received appropriate treatment. Prevention, an early stage detect, and appropriate management of diabetic retinopaty are necessary for the prevention of blindness and the maintenance of eyesight. I think that it is important to recommend the patient education, close cooperation of the physician and the ophthalmologist, and the consultations at the early stage to the ophthalmology department

Medical significance of cysteine protease inhibitors in mammalian secretory fluids

New cysteine protease inhibitors in human tears and milk and their medical significance are reviewed in this paper. As protective components against bacterial infection in the eyes, we detected four kinds of anti-bacterial proteins in normal human tears including lysozyme and three kinds of cysteine protease inhibitors. Using our reverse zymography of normal tears, three kinds of cysteine protease inhibitors were found to be 78kDa, 20kDa and 15kDa and were determined to be lactoferrin, Von Ebner’s Gland(VEG)protein and cystatin S, respectively. All of them belong to the cystatin super family and VEG protein and cystatin S are well known cysteine protease inhibitors. TheC-terminusarea17mer peptide,Y679-K695,of lactoferrin showed strong homology with a common active domain of the cystatin family and the synthesized peptide showed inhibition of cysteine proteases. Not only were disease-specific changes found in these inhibitor profiles, but also disease-specific new inhibitors in patients tear with certain autoimmune diseases. A 35kDa inhibitor, which was detected specifically in tears with Behcet’s disease, an typical autoimmune disease, was determined to be a lacrimal acidic proline-rich protein based on the N-terminus sequence analysis. A65kDa inhibitor of tears with Harada’s autoimmune disease was determined to be an Ig heavy chain V-III region. In addition, lactoferrin content in Harada’s disease was very low. We found two cathepsin inhibitors in bovine milk using reverse zymography, namely lactoferrinandβ-casein. TheL133-Q151, in the humanβ-casein moleculeis the active inhibitory domain. They may play an important role in antiseptic and anti-infectious functions

Electron microscopic studies of Acanthamoeba : 2 Morphological changes of cultured Acanthamoeba due to anti-amoebic agents

Morphological changes of Acanthamoeba in Peptone-Yeast-Glucose medium containing anti-amoebic agents were studied with transmission electron microscope. In fradiomycin-treated amoeba, decrease of acanthopodia, vacuolar formation in the ectoplasm and cell collapse were observed. In polyhexamethylene biguanide (PHMB)-treated amoeba, rupture of plasma membrane and degeneration of mitochondria were observed at the early stage. These results indicate that PHMB is more effective than fradiomycin for the treatment of Acanthaoeba keratitis

Efficacy of combined photodynamic therapy and sub-Tenon’s capsule injection of triamcinolone acetonide for age-related macular degeneration

Purpose : To evaluate the efficacy of combined photodynamic therapy (PDT) and sub-Tenon’s capsule injection of triamcinolone acetonide (TA) for the treatment of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) at 1-year follow-up. Methods : A total of 117 eyes with subfoveal CNV caused by AMD were included. Sixty-eight eyes were treated with combined PDT and sub-tenon injection of 20 mg TA and compared with a control group of 49 eyes treated with PDT alone. All patients completed 1 year follow-up. The main outcome measures were best-corrected visual acuity (BCVA) and retreatment frequency. Results : There were no significant differences in age, sex, VA, lesion type, and greatest linear dimension between the two groups at baseline. BCVA analysis showed statistically no significant differences between the two groups. The PDT+TA group required a lower mean number of treatments (1.38 versus 1.67, P=0.032). Conclusion : Our study confirms that sub-Tenon’s capsule injection of TA with PDT significantly reduces the retreatment frequency of PDT

Analyses of the characteristics of potential and cross-talk at each electrode in electro-oculogram

We placed negative electrodes on the body and positive electrodes at the medial and lateral canthi, measured their potentials separately, evaluated their characteristics, and analyzed cross-talk. We recorded EOG in 6 normal subjects and found the following. The potential at the medial was lower than that at the lateral canthus in the bilateral eyes. The polarity of waves at the lateral was reverse to that at the medial canthus in the bilateral eyes. We recorded EOG in 6 patients with unilateral anophthalmia and found the following. On the anophthalmia side, the potential at the lateral was considerably lower than that at the medial canthus. The polarity of the potential was the same between the medial and lateral canthi. The mean cross-talk to the medial canthus on the anophthalmia side was 8.7%- 54.0% of the potential at the medial canthus on the normal side. The mean cross-talk to the lateral canthus on the anophthalmia side was 4.4%-16.9%. The influence of cross-talk of the other eye was marked at the medial but slight at the lateral canthus. In EOG recording, results with minimum errors due to cross-talk can be obtained by paying attention to the potential at the lateral canthus