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Purpose@#To report a case of ocular tuberculosis that first manifested as neovascular glaucoma.Case summary: A 76-year-old male visited our hospital complaining of decreased visual acuity in the left eye. He had undergone tuberculosis treatment 1 year prior, and had been cured. At the time of his visit, decreased visual acuity, increased intraocular pressure, and iris neovascularization were observed in the left eye. He was diagnosed with neovascular glaucoma and was started on treatment to lower the intraocular pressure. At the time of the visit, we also noticed vitreous opacity in both eyes. The patient did not attend his scheduled follow-up visit, but returned 2 months later complaining of decreased visual acuity in both eyes. The vitreous opacity in the retinae of both eyes had become aggravated. Diagnostic vitrectomy was performed on both eyes, and multiple yellowish-white circular lesions were observed throughout the retinae. Systemic abnormalities were suspected, and thus additional tests were performed. Bronchoalveolar lavage fluid analysis revealed recurrence of pulmonary tuberculosis, and tuberculosis treatment was recommenced. Temporary increases in ocular inflammation and deterioration were observed but improved after the addition of systemic steroids. The patient has been under observation without recurrence for about 1 year. @*Conclusions@#Ocular tuberculosis can be expressed in the form of neovascular glaucoma, so ocular tuberculosis should be suspected if there is a history of tuberculosis and abnormal retinal findings.
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Purpose@#To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). @*Methods@#Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. @*Results@#Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. @*Conclusions@#These results suggest that neurodegeneration might be an early change in the development of DR.
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Purpose@#To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). @*Methods@#Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. @*Results@#Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. @*Conclusions@#These results suggest that neurodegeneration might be an early change in the development of DR.
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The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5∼6 to 0∼1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.
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The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5∼6 to 0∼1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.
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Purpose@#We investigated the expression levels of 84 genes in dexamethasone-exposed human lens epithelial cells using polymerase chain reaction (PCR) array analysis. @*Methods@#The viability and motility of lens epithelial cells were examined after treatment with dexamethasone at 0.01, 0.1, and 1 mg/mL; Western blot was used to evaluate the expression levels of fibronectin, α-smooth muscle actin (α-SMA), and E-cadherin. After 24, 48, and 72 hours of dexamethasone treatment at 0.1 mg/mL, the expression levels of 84 growth factors were analyzed using PCR array. @*Results@#Cell viability did not change significantly at dexamethasone levels of 0.01 or 0.1 mg/mL, but decreased markedly at 1 mg/mL; motility increased in a concentration-dependent manner at 0.01 and 0.1 mg/mL. Western blot showed that fibronectin levels increased significantly at all dexamethasone concentrations tested; the α-SMA level increased only at 0.01 mg/mL, and E-cadherin levels decreased significantly at all tested concentrations. PCR showed that the levels of FGF1, FGF2, IL-11, regulators of apoptosis (GDNF, IL-1β, and NRG2), and regulators of cell differentiation (BMP5, FGF1, FGF2, and FGF5) decreased more than twofold, whereas the levels of FGF9 and FGF19 increased more than twofold. @*Conclusions@#PCR performed after exposure of lens epithelial cells to dexamethasone may identify the genes involved in the development of steroid-induced cataracts.
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Purpose@#To report a case of bilateral congenital cataract in a patient with triple X syndrome.Case summary: A 9-month-old female was referred to our clinic because of poor fixation and white pupils in both eyes. The patient underwent a performed chromosomal study in the pediatric department due to developmental delay and torticollis. As a result, she was diagnosed with triple X syndrome (47, XXX). Under general anesthesia, the patient underwent lens aspiration with intraocular lens insertion and anterior vitrectomy was performed followed by posterior capsulotomy with optic capture. Intraoperatively, remnant pupillary membrane, posterior embryotoxon, and anterior lenticonus with anterior capsular defect in both eyes were observed. But there was no specific finding on fundus examination. @*Conclusions@#We report the first case of bilateral congenital cataract in a patient with triple X syndrome. It is recommended that clinicians check for cataracts as soon as possible when this chromosome abnormality is confirmed.
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PURPOSE: To investigate the clinical features and prognosis associated with endogenous endophthalmitis (EE) in western Gyeongsangnam-do over an 11-year period. METHODS: This study was a retrospective review of the medical records of 24 patients (33 eyes) who presented with endogenous endophthalmitis at the Gyeongsang National University Hospital from 2007 to 2017. RESULTS: The mean age of onset was 63.2 years, and 58.3% of the patients were men. Bilateral involvement was observed in nine patients (37.5%). Liver abscess (30.3%) and urinary tract infection (24.2%) were the most common extraocular sources of infection. Positive culture result was noted in 72.7% of the patients. The most common causative agents were gram-negative organisms (45.8%); the most commonly isolated microorganism was Klebsiella pneumoniae. Vitreous tapping and intravitreal antibiotic injection were performed in all patients; pars plana vitrectomy with intravitreal injection of antibiotics was performed in 12 eyes (36.4%). Enucleation and evisceration were performed in six eyes (18.2%). Initial visual acuity worse than hand motion was associated with a significantly worse visual outcome (p = 0.001). CONCLUSIONS: In our study, EE showed a poor visual prognosis, irrespective of treatment. Poor initial visual acuity was predictive of poor visual outcome. Liver abscess and urinary tract infections were common extraocular sources of EE and K. pneumoniae was the most common causative organism.
Subject(s)
Humans , Male , Age of Onset , Anti-Bacterial Agents , Endophthalmitis , Hand , Intravitreal Injections , Klebsiella , Klebsiella pneumoniae , Liver Abscess , Medical Records , Pneumonia , Prognosis , Retrospective Studies , Urinary Tract Infections , Visual Acuity , VitrectomyABSTRACT
PURPOSE: To evaluate the changes in anterior chamber depth (ACD) and refractive error after combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe. METHODS: In 20 eyes of 20 patients who underwent combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe, the ACD was measured with Scheimpflug imaging (Pentacam®, OCULUS Optikgeräte GmbH, Wetzlar, Germany) preoperatively and postoperatively. We compared the preoperative desired refraction and postoperative refraction using an autokeratorefractometor. RESULTS: The preoperative ACD was 2.58 ± 0.248 mm; the ACD significantly increased in 1 month postoperatively to 3.65 ± 0.475 mm (p < 0.001), and it was maintained as 3.70 ± 0.452 mm (p = 0.213) at 3 months postoperatively. The preoperative target spherical equivalent was −0.60 ± 0.809 diopters (D). Myopic shifting was noticed at 1 month postoperatively as −1.45 ± 1.252 D, and it changed between 1 month and 3 months postoperatively (−1.48 ± 1.235 D at 3 months postoperatively was not statistically significant). There was no increased intraocular pressure or intraocular lens-related complication. CONCLUSIONS: Phacovitrectomy with posterior capsulotomy using a vitrectomy probe might be a useful way to stabilize the axial position of an intraocular lens without constriction of the capsular bag. However, using this procedure, the surgeon must consider the possibility of myopic shifting in the postoperative refractive error.
Subject(s)
Humans , Anterior Chamber , Constriction , Intraocular Pressure , Lenses, Intraocular , Posterior Capsulotomy , Refractive Errors , VitrectomyABSTRACT
PURPOSE: To report the effects of combined low dose bevacizumab and low dose triamcinolone intravitreal injection compared with single bevacizumab intravitreal injection in patients with macular edema secondary to branch retinal vein occlusion. METHODS: Thirty eyes of 30 patients diagnosed with branch retinal vein occlusion were evaluated. The combined injection group (15 eyes of 15 patients) was treated with intravitreal injection of combined low dose bevacizumab (0.625 mg/0.025 mL) and low dose triamcinolone (1 mg/0.025 mL). The single injection group (15 eyes of 15 patients) was treated with intravitreal injection of bevacizumab (1.25 mg/0.05 mL). The best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) of treated eyes were measured before injection and at 1 month, 2 months, and 3 months after injection. RESULTS: In the combined injection group, the BCVA increased significantly at 1 month, 2 months, and 3 months after injection (p 0.05) in both groups. The BCVA, CMT, and IOP after injection showed no significant differences between the combined injection group and the single injection group (p > 0.05). CONCLUSIONS: The combined intravitreal injection of low dose bevacizumab and low dose triamcinolone may be useful and safe for the treatment of macular edema secondary to branch retinal vein occlusion.
Subject(s)
Humans , Bevacizumab , Intraocular Pressure , Intravitreal Injections , Macular Edema , Retinal Vein Occlusion , Retinal Vein , Retinaldehyde , Triamcinolone , Visual AcuityABSTRACT
OBJECTIVE: To compare tongue thickness, the shortest hyoid-thyroid approximation (distance between the hyoid bone and thyroid cartilage), and the time interval between the initiation of tongue movement and the time of the shortest hyoid-thyroid approximation, by using ultrasonography in healthy controls and patients with Parkinson disease (PD). METHODS: Healthy controls and PD patients with dysphagia were compared. Ultrasonography was performed 3 times for the evaluation of tongue thickness, the shortest hyoid-thyroid approximation, and the time between the initiation of tongue movement and the shortest hyoid-thyroid approximation. RESULTS: A total of 24 healthy controls and 24 PD patients with dysphagia were enrolled. No significant differences were demonstrated between the two groups for the shortest hyoid-thyroid approximation (controls, 1.19±0.34 cm; PD patients, 1.37±0.5 cm; p=0.15) and tongue thickness (controls, 4.42±0.46 cm; PD patients, 4.27±0.51 cm; p=0.3). In contrast, the time to the shortest hyoid-thyroid approximation was significantly different between the two groups (controls, 1.53±0.87 ms; PD patients, 2.4±1.4 ms, p=0.048). CONCLUSION: Ultrasonography can be useful in evaluating dysphagia in patients with PD by direct visualization and measurement of the hyoid bone. Moreover, ultrasonography might contribute to a greater understanding of the pathophysiology of dysphagia in PD.
Subject(s)
Humans , Deglutition Disorders , Hyoid Bone , Parkinson Disease , Thyroid Gland , Tongue , UltrasonographyABSTRACT
No abstract available.
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A histopathological study was performed on nevus sebaceus to observe its aging effect based on 75 cases of neuvs sebaceus those were collected during the past 10 years from three university hospitals in Seoul. The results are as follows: 1) Clinical findings The incidence was most frequent in the teenage group. The 75 cases consisted of 41 males and 34 females with a sex ratio of 1.2:1. Most of cases developed in the head and neck areas with 62.7% on the scalp and 29.3% on the face. 2) Histopathologic findings. The epidermal changes such as acanthosis(40%), papillomatosis(73%), hypergranulosis(44%) were most remarkable in the second decade and gradually decreased with aging. The apparent proliferation of sebaceous gland was observed in 73% and it was most prominent in the second decade. Apocrine glands were absent before the first decade but apparently increased after then. Proliferation of eccrine gland was not significant in all the age groups. Mild increase of immature hair follicles were noted in 49% of our cases with gradually decreasing tendency in the older age. The dermal inflammatory infiltrates were noted from the 2nd decade(28%) and thereafter gradually increased. Associated neoplasms were one apocrine adenoma, one sebaceous adenoma, two trichilemmomas and two arteriovenous hemangiomas. The majority of tumors occured in the third decade. Therefore, it is observed that neuvs sebaceous undergoes dynamic histopathologic changes according to the age of patient and later develop various secondary neoplastic changes. The pathogenesis of the nevus sebaceus is suggested to be closely related with developmental anomalies of primitive hair germ units in fetal stage.
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Adolescent , Male , Female , Humans , IncidenceABSTRACT
Glutathione S-Transferase (GST) is a conjugation enzyme in the metabolism of exogenous and endogenous lipophilic compounds for their excretion and detoxification. Acidic isozyme of GST, GST-Pi, has been recognized as a preneoplastic marker in the experimental hyperplastic nodules of liver in rats, and GST-Pi is abundant in the squamous cells of the skin, also. This histochemical study was carried out to evaluate the distribution and the relationship between the differentiation status of squamous cells in dysplastic or neoplastic epithelium in various organs. The human placental form of glutathione S-transferase (GST-Pi) were stained immunohistochemically with specific anti GST-Pi rabbit antibody in 23 cases of human squamous cell carcinomas. The patients consisted of 14 cases from the uterine cervix, 3 cases from the esopahgus, 3 cases from the lung and 3 cases from the larynx. The results obtained were as follows; 1. Basal cells in normal mucosa were stained negative for GST-Pi while superficial keratinocytes were stained moderately positive. Basal dysplastic cells were stained negatively or weakly positive. Carcinoma cells especially large cells either keratinizing or nonkeratinizing were stained moderately to strongly. Carcinoma cells surrounding keratin pearl were strongly reacted with GST-Pi than other carcinoma cells. 2. Differentiated cells of squamous cell carcinoma showed moderate to strong positive reaction to GST-Pi staining irrespective of its site of origin. 3. Therefore, Immunohistochemical staining pattern of GST-Pi in various squamous carcinoma cells showed similar immunohistochemical reaction to the GST-pi, which is closely correlated to the degree of differentiation, keratinigation and also suggested that squamous carcinoma cells had abundant GST-Pi related detoxifying system.