No abstract available.
Granuloma* ; Leprosy, Lepromatous*

No abstract available.
Candidiasis* ; Paget Disease, Extramammary* ; Vulva

Purpose: To evaluate the long-term results of 2-muscle surgery in children with large-angle intermittent exotropia (IXT), comparing bilateral lateral rectus recession (BLR) with unilateral lateral rectus recession & medial rectus resection (RR). Methods: Ninety-two children with IXT of 40 prism diopter or more, who underwent BLR or RR were included in this retrospective study. Final successful alignment rates, and cumulative probabilities of surgical success at 3 years postoperatively were analyzed and compared using Kaplan-Meier survival analysis between the two groups. Results: At 3 years after surgery, 37 (67.3%) of 55 patients in the BLR group achieved successful alignment; 18 (32.7%) had undercorrection, and none of them had overcorrection. In the RR group, 34 (92%) of 37 patients were successfully aligned, two (5%) had undercorrection, and one (3%) had an overcorrection at 3 years after surgery. There was a statistically significant difference in postoperative results between the two groups (p = 0.0012). The cumulative probabilities of surgical success at 3 years postoperatively analyzed using the Kaplan-Meier survival curve were 63% in the BLR group and 92% in the RR group. Postoperative mean recurrence time was 45 months in the BLR group and 50 months in the RR group, showing a significant difference between the two groups (p = 0.0006). Conclusions The unilateral RR procedure demonstrated more favorable long-term postoperative outcomes than BLR procedure in patients with large-angle IXT.

Infantile digital fibromatosis is a rare benign tumor on the fingers and toes of infants and childhood which is characterized by fibroblastic proliferation. Usually the lesions occur singly or severally on the dorsal or lateral aspects of the distal phalanges of the toes and fingers. The thumb and great toe are usually spared. These asymptomatic, firm, red, smooth nodules, some lcm diameter, occur during the first year of life. Forty-seven percent occur in the first month of life. This disease can occur after trauma. The lesions do not metastasize. Occasionally, spontaneous regression has been reported. After excision, recurrence can be possible. A 2 years old female infant had three large bean sized erythematous masses on the left 2,3,4th fingers. The erythematous aacule was developed at 6 months old and grew slowly. We could find inclusion body stained bright red with Massons trichrome and purple with PTAH in cytoplasm of fibroblast. The patient was treated with a simple excision followed by a skin graft. During 5 rnonths after operation, recurrence was not occurred.
Child, Preschool ; Cytoplasm ; Female ; Fibroblasts ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Infant ; Recurrence ; Skin* ; Thumb ; Toes ; Transplants*

Bowel segments are used either in a tubular or detubular configuration in bladder augmentation and substitutions. The majority of urologists agree that detubularized segments give better clinical results,but detailed studies were not investigated in animals. The present study compared the contractile response of autonomic agonists including carbachol, isoproterenol,alpha, beta-methylene ATP on detubularized and tubularized cystoplastic ileal segments. In addition, histological examinations of cystoplastic ileal segments were performed. Five rats underwent Sham operation as control and eight rats underwent detubularized ileocystoplasty and seven rats underwent tubularized ileocystoplasty. Analysis was done six weeks after surgery. The contractile responses of detubularized cystoplasty ileum to carbachol, alpha, beta-methylene ATP were significantly increased when compared to the responses of tubularized ileum and control ileum. The relaxation responses of detubularized cystoplasty ileum to isoproterenol were significantly higher than control ileum. However, in tubularized ileum, the responses to carbachol, alpha, beta-methylene ATP, isoproterenol were similar for control ileum. The responses of detubularized cystoplasty ileum to carbachol, alpha, beta -methylene ATP were significantly different from control bladder, but detubularized cystoplasty ileum showed responses that resemble control bladder more closely when compared to the responses of tubularized ileum.The histological examination showed urothelialization of cystoplastic ileum with transitional epithelium extending over and covering the junction margin of the cystoplastic ileum. These results suggest detubularized ileocystoplasty induced closer pharmacological changes in the ileal segment towards the bladder than tubularized ileocystoplasty and so we can expect detubularized ileocystoplasty gives better clinical outcome.
Adenosine Triphosphate ; Animals ; Carbachol ; Epithelium ; Ileum* ; Isoproterenol ; Rats* ; Relaxation ; Urinary Bladder

PURPOSE: To evaluate the effect of additional retrobulbar triamcinolone acetonide (TA) injection on early recovery of visual acuity in retrobulbar optic neuritis patients. METHODS: A prospective, randomized clinical study including 30 patients with retrobulbar optic neuritis was conducted between March 2003 and June 2007. Patients were divided into 2 groups: Group 1 (n = 9) with retrobulbar triamcinolone (TA, 40 mg/1 ml) injection on the first day of ONTT protocol, and group 2 (n = 21) with conventional ONTT protocol. The following parameters were measured and analyzed: patient's sex, age, pupillary reactions, color vision, visual field, and best-corrected visual acuity before treatment, and after 1 day, 1 week, 2 weeks, 1 month, and 3 months of follow-up. RESULTS: Mean visual acuity before treatment was 1.00 +/- 0.89 log MAR units in group 1 and 0.98 +/- 0.75 log MAR units in group 2. One day after injection, visual acuity was better in group 1 (0.50 +/- 0.42 log MAR units) than in group 2 (0.73 +/- 0.61 log MAR units), however, there was no statistically significant difference between the 2 groups (p = 0.07). There was no significant difference in visual acuity, recovery of RAPD, color vision, or visual field at 3 months of follow-up. No serious side effect related to retrobulbar TA injection was observed. CONCLUSIONS: Additional retrobulbar TA injection may help optic neuritis patients who have a need for prompt visual recovery. However, further studies are required to ascertain whether this procedure can help early recovery of visual acuity in retrobulbar optic neuritis patients.
Color Vision ; Follow-Up Studies ; Humans ; Optic Neuritis* ; Prospective Studies ; Triamcinolone ; Triamcinolone Acetonide* ; Visual Acuity ; Visual Fields

PURPOSE: The purpose of this study is to compare the magnitude and axis of astigmatism induced by a combined inferior oblique (IO) anterior transposition procedure with lateral rectus (LR) recession versus LR recession alone. METHODS: Forty-six patients were retrospectively analyzed. The subjects were divided into two groups: those having concurrent inferior oblique muscle overaction (IOOA) and intermittent exotropia (group 1, 20 patients) and those having only intermittent exotropia as a control (group 2, 26 patients). Group 1 underwent combined anterior transposition of IO with LR recession and group 2 underwent LR recession alone. Induced astigmatism was defined as the difference between preoperative and postoperative astigmatism using double-angle vector analysis. Cylinder power, axis of induced astigmatism, and spherical equivalent were analyzed at 1 week, 1 month, and 3 months after surgery. RESULTS: Larger changes in the axis of induced astigmatism were observed in group 1, with 4.5° incyclotorsion, than in group 2 at 1 week after surgery (axis, 84.5° vs. 91°; p < 0.001). However, there was no statistically significant inter-group difference thereafter. Relaxation and rapid regression in the incyclotorsion of induced astigmatism were observed over-time. Spherical equivalent significantly decreased postoperatively at 1 month in both groups, indicating a myopic shift (p = 0.011 for group 1 and p = 0.019 for group 2) but did not show significant differences at 3 months after surgery (p = 0.107 for group 1 and p = 0.760 for group 2). CONCLUSIONS: Combined IO anterior transposition procedures caused an increased change in the axis of induced astigmatism, including temporary incyclotorsion, during the first week after surgery. However, this significant difference was not maintained thereafter. Thus, combined IO surgery with LR recession does not seem to produce a sustained astigmatic change, which can be a potential risk factor of postoperative amblyopia or diplopia compared with LR recession alone.
Astigmatism/diagnosis/*etiology/physiopathology ; Child ; Exotropia/diagnosis/physiopathology/*surgery ; Eye Movements/*physiology ; Female ; Follow-Up Studies ; Humans ; Male ; Oculomotor Muscles/*surgery ; Ophthalmologic Surgical Procedures/*methods ; Retrospective Studies ; Treatment Outcome ; Vision, Binocular/*physiology

PURPOSE: To report the effectiveness of home-based pencil push-ups (HBPP) therapy for patients with symptomatic convergence insufficiency. METHODS: Data was collected prospectively on 16 patients who were diagnosed with convergence insufficiency beginning in January 2009. The study group was composed of ten male and six female patients. The duration of symptoms, refractive error, distant and near deviation angles, and near point of convergence (NPC) prior to and after 12 weeks of HBPP therapy were measured in all patients. RESULTS: The mean age of the patients was 19.3 years. The mean deviation angle of exophoria was 3 prism diopters (PD) at distant and 11.2 PD at near. The mean value of NPC prior to HBPP therapy was 36.3 cm; however, the near point of accommodation was within the normal range. After 12 weeks of HBPP therapy, the mean deviation angle of exophoria decreased to orthophoric at distant and 4 PD at near. The mean value of NPC decreased to 14.4 cm. CONCLUSIONS: Twelve weeks of HBPP therapy appears to be an easy, cost-free and effective therapy for patients with symptomatic convergence insufficiency.
Accommodation, Ocular ; Adolescent ; Adult ; Child ; *Convergence, Ocular ; Exotropia/*physiopathology/*therapy ; Female ; Humans ; Male ; Prospective Studies ; *Self Care ; Treatment Outcome ; Young Adult

PURPOSE: To investigate the effect of unilateral medial rectus muscle resection for recurrent exotropia after bilateral lateral rectus muscle recession for intermittent exotropia METHODS: A retrospective analysis was made of thirtypatients who underwent unilateral medial rectus resection for recurrent exotropia. All had prior bilateral lateral rectus recession for intermittent exotropia. Data were collected for age, the preoperative deviation, the postoperative deviation at 2 weeks, 3 months, 6 months and the last visit, and the amount of medial rectus resection performed. RESULTS: The average preoperative deviation was 27.0+/-3.6 PD. After unilateral medial rectus resection, average deviation at distance was 2.8 PD at postoperative 2 weeks, 4.5 PD at 3 months, 5.1 PD at 6 months and 5.8 PD at last visit. The average deviation corrected per millimeter of medial rectus resection was 3.53+/-0.17 PD/mm. CONCLUSIONS: Considering that deviation angles of recurrent exotropia is smaller than those of primary surgery and the possibility of saving the other medial rectus muscle, unilateral rectus muscle resection could be effective surgical method for recurrent exotropia.
Child ; Exotropia/*surgery ; Female ; Humans ; Male ; Oculomotor Muscles/*surgery ; *Ophthalmologic Surgical Procedures ; Recurrence ; Refraction, Ocular ; Retrospective Studies

PURPOSE: To compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery. METHODS: A randomized, prospective clinical study was performed to compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery. Sixty-one patients with intermittent exotropia were included in this study. They were told to apply antibiotic eye drops (ED) and either preservative or preservative-free topical 0.1% fluorometholone (F1) three times a day. Measurements of the degrees of conjunctival injection and corneal toxicity were performed at postoperative 1 week and 3 weeks each. RESULTS: Seventeen patients (34 eyes) were included in group 1 (preservative F1) and twenty patients (40 eyes) were included in group 2 (preservative-free F1). The average pixel value (measured via the Image J software) representing the degree of conjunctival injection was 31,732 ± 9,946 in group 1 and 38,347 ± 12,189 in group 2 at postoperative 1 week, while the average pixel value was 10,150 ± 4,493 in group 1 and 11,836 ± 4,290 in group 2 at postoperative 3 weeks. There was a significant difference between the decrease in pixel value for the two groups (p = 0.040). There was no significant difference in the mean value of the Oxford stain score between the two groups at postoperative 3 weeks, however the mean questionnaire scores in group 2 were significantly lower than in group 1 (p = 0.001). CONCLUSIONS: Preservative-free 0.1% fluorometholone ED demonstrated a larger decrease in the degree of conjunctival injection than for preservative ED after strabismus surgery. Therefore, the use of preservative-free steroid ED may be beneficial for decreasing both conjunctival injection and postoperative discomfort following strabismus surgery.
Clinical Study ; Exotropia ; Fluorometholone* ; Humans ; Ophthalmic Solutions ; Prospective Studies ; Strabismus*