We analyzed retrospectively 58 patinets of retinoblastoma for the first, ocular symptoms, gender, family history, funduscopic findings, treatment modalities and results from 1987 to 1993. Fourteen patients were bilateral, forth-four were unilateral, and seventy-two eyes were affected in sum. The average of age of the patients was 25.6 months. Their first ocular symptoms were leukocoria, squint and etc. Three patients were suspected as familial type of retinoblastoma. We claasified the patients according to the affected degree of the retina;over three-fourths of the retina was affected in 34 eyes. We treated them with enucleation, radiation, chemotherapy, episcleral plaque radiotherapy, laser photocoagulation and cryotherapy. After these treatments, orbital recurrence was observed in one case and among the ten eyes treated with eye-conserving treatments, nine eyes are maintained with periodic examination under general anesthesia and the treatment of laser photocoagulation and cryotherapy until now.
Anesthesia, General ; Cryotherapy ; Drug Therapy ; Humans ; Light Coagulation ; Orbit ; Radiotherapy ; Recurrence ; Retina ; Retinoblastoma* ; Retrospective Studies ; Strabismus

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

PURPOSE: To compare the bleb morphology and surgical outcomes of a limbus-based group with those of a fornix-based group who underwent trabeculectomy with mitomycin C (MMC). METHODS: Sixty-five eyes of 59 patients who had undergone trabeculectomy with MMC and who were observed for one year or more were included in the present study. A limbus-based conjunctival flap was used for 34 eyes of 31 patients and a fornix-based conjunctival flap for the other 31 eyes of 28 patients. The bleb morphologies were classified and compared after one year or more postoperatively according to the Moorfield Bleb Grading System, and intraocular pressure and success rates were evaluated. RESULTS: The central bleb vascularity of the limbus-based group was statistically significantly lower than that of the fornix- based group (1.79 +/- 0.64; 2.16 +/- 0.73, p = 0.042). The risk of cystic bleb formation was higher in the limbus-based group (38.2%; 16.5%, p = 0.047). There were no differences in the IOP or success rate between the two groups. CONCLUSIONS: There were no differences between the two groups with regard to the IOP or cumulative success rate. However, in the fornix-based group, the central bleb vascularity was lower and the risk of avascular cystic bleb formation was higher than those in the limbus-based group.
Blister ; Eye ; Humans ; Intraocular Pressure ; Mitomycin ; Trabeculectomy

PURPOSE: To evaluate the effectiveness of Mitomycin C used as a combined therapy along with limbal-conjunctival autograft for primary pterygium. METHODS: Thirty eyes of 29 patients received Mitomycin C (0.02% MMC 3 minutes) with limbal-conjunctival autograft, and 30 eyes of 28 patients received limbal-conjunctival autograft alone. Recurrence and complications were evaluated in the patients at 2 weeks, 1, 3, 6 and 12 months postoperatively. RESULTS: Mean follow-up periods were 13.4+/-2.1 and 13.9+/-2.9 months, respectively. Between the two groups, recurrence in the conjunctiva or the cornea was not observed during the follow-up period. In the Mitomycin C use group, complications included a granuloma at the donor site (1 eye, 3.3%), wound dehiscence (2 eyes, 6.7%), and subgraft hemorrhage (2 eyes, 6.7%). In comparison, in the group treated with limbal-conjunctival autograft alone, complications included granuloma at the donor site (1 eye, 3.3%), pseudopterygium at the donor site (1 eye, 3.3%), wound dehiscence (3 eyes, 10%), and subgraft hemorrhage (2 eyes, 6.7%). CONCLUSIONS: The use of Mitomycin C as an adjuvant therapy has no significant effect on the recurrence rate in primary pterygium with limbal-conjunctival autograft.
Conjunctiva ; Cornea ; Eye ; Follow-Up Studies ; Granuloma ; Hemorrhage ; Humans ; Mitomycin ; Pterygium ; Recurrence ; Tissue Donors

PURPOSE: To compare central macular thickness (CMT) and visual acuity outcomes after intravitreal injection of triamcinolone acetonide or bevacizumab for the treatment of diabetic macular edema (DME). METHODS: Fifty-one patients were randomly choosen to receive an intravitreal injection of either triamcinolone acetonide or bevacizumab. Patients were retrospectively reviewed, and 28 of 51 received an intravitreal injection of triamcinolone acetonide while the remaining 23 received bevacizumab injection. All patients underwent Snellen visual acuity testing, optical coherence tomography imaging and ophthalmoscopic examination at baseline and at four weeks following the injection. RESULTS: In the triamcinolone group, CMT decreased from 656.71+/-194.37 micrometer at baseline to 312.46+/-102.14 micrometer at the four-week follow-up visit, while in the bevacizumab group, CMT decreased from 582.17+/-151.02 micrometer at baseline to 453.09+/-172.39 micrometer at the follow-up (p<0.05). The LogMAR best-corrected visual acuity converted from the Snellen visual acuity significantly improved in the triamcinolone group (from 0.89+/-0.38 to 0.67+/-0.33) compared to the bevacizumab group (from 0.79+/-0.31 to 0.70+/-0.34) [p<0.05]. CONCLUSIONS: Intravitreal injection of triamcinolone may offer advantages over bevacizumab in the short-term management of DME, specifically with respect to improvement in CMT and visual acuity.
Antibodies, Monoclonal, Humanized ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema ; Retrospective Studies ; Tomography, Optical Coherence ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab

PURPOSE: To compare central macular thickness (CMT) and visual acuity outcomes after intravitreal injection of triamcinolone acetonide or bevacizumab for the treatment of diabetic macular edema (DME). METHODS: Fifty-one patients were randomly choosen to receive an intravitreal injection of either triamcinolone acetonide or bevacizumab. Patients were retrospectively reviewed, and 28 of 51 received an intravitreal injection of triamcinolone acetonide while the remaining 23 received bevacizumab injection. All patients underwent Snellen visual acuity testing, optical coherence tomography imaging and ophthalmoscopic examination at baseline and at four weeks following the injection. RESULTS: In the triamcinolone group, CMT decreased from 656.71+/-194.37 micrometer at baseline to 312.46+/-102.14 micrometer at the four-week follow-up visit, while in the bevacizumab group, CMT decreased from 582.17+/-151.02 micrometer at baseline to 453.09+/-172.39 micrometer at the follow-up (p<0.05). The LogMAR best-corrected visual acuity converted from the Snellen visual acuity significantly improved in the triamcinolone group (from 0.89+/-0.38 to 0.67+/-0.33) compared to the bevacizumab group (from 0.79+/-0.31 to 0.70+/-0.34) [p<0.05]. CONCLUSIONS: Intravitreal injection of triamcinolone may offer advantages over bevacizumab in the short-term management of DME, specifically with respect to improvement in CMT and visual acuity.
Antibodies, Monoclonal, Humanized ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema ; Retrospective Studies ; Tomography, Optical Coherence ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab

We report a very rare case of thoracic epidural cavernous hemangioma in a 69-year-old male. He complained of a three-year history of dull ache at the interscapular region and progressive numbness and weakness of the lower extremities. He had been suffering from gait disturbance and difficulty in urination and defecation for the previous three months. Preoperative magnetic resonance images showed characteristic features: a lobulated epidural mass, which was isointense to the spinal cord on T1-weighted images and hyperintense to the spinal cord on T2-weighted images, in the posterior spinal canal of the upper thoracic spine with contrast enhancement and extension through the intervertebral foramen. A right hemilaminectomy was performed at the T1, T2, T3 and T4 levels. After bilateral flavectomy, using a microsurgical technique, total excision of the mass was successfully achieved. The patient improved dramatically, both in motor strength and sensations, after the operation. Presumptive preoperative diagnosis of epidural cavernous hemangioma could render the surgical approach less invasive to avoid severe intraoperative bleeding.
Aged ; Caves ; Defecation ; Gait ; Hemangioma, Cavernous ; Hemorrhage ; Humans ; Hypesthesia ; Lower Extremity ; Magnetic Resonance Spectroscopy ; Male ; Sensation ; Spinal Canal ; Spinal Cord ; Spine ; Stress, Psychological ; Urination

We report two very rare cases of postoperative acute spinal subdural hematoma (ASSH) and review the literature. ASSH is usually related to trauma or a previous lumbar puncture, and a review of the literature revealed only a few cases of spinal subdural hematomas occurring secondary to an underlying hematological disorder or to an iatrogenic coagulopathy. However, there have been no reports about the occurrence of ASSH as a complication of uneventful spinal surgery. The authors present two cases of postoperative ASSHs after open lumbar microdiscectomy (OLM) and underline the pitfalls in their diagnosis and treatment modalities. Two patients were treated with surgery, which progressed without sequelae, and their preoperative symptoms were resolved. Postoperative ASSH is an extremely rare complication, but precautions for meticulous hemostasis and careful awareness for minimal manipulation of the dura during lumbar surgery should be considered in all patients, even those who do not require multilevel decompressions and/or who have a preoperative coagulopathy.
Diskectomy ; Hematoma ; Hematoma, Subdural, Spinal ; Hemostasis ; Humans ; Postoperative Complications ; Spinal Puncture

Deep wound infection is a serious surgical complication. The majority of patients with pyogenic spondylodiscitis can be treated non-surgically with antibiotics and immobilization. However, although surgical management of pyogenic spondylodiscitis continues to evolve, no consensus has yet been reached regarding the best surgical approaches and techniques. Anterior lumbar interbody fusion (ALIF) followed by percutaneous pedicle screw fixation (PPF) is an effective surgical option for treating postoperative pyogenic spondylodiscitis (PPS). In this report, we describe a case of PPS in a 64-year-old man who underwent ALIF with PPF.
Anti-Bacterial Agents ; Consensus ; Discitis ; Humans ; Immobilization ; Middle Aged ; Wound Infection

This study was performed to evaluate in vitro cytotoxicity of chemotherapeutic agents in established human retinoblastoma cell line, Y79 and to study the possibility of enhancing the cytotoxicity of chemotherapeutic agents by administration of buthionine sulfoximine(BSO) which lowers the intracellular glutathione(GSH) level. IC50 defined as the concentration which inhibits the cell survival rates to 50% compared with control group was used to evaluate cytotoxicity. Intracellular level after 13.50 adminstration were measured and compared with the level prior to administration of BSO. Doxorubicin, cisplatin, and melphalan showed significant decrease of IC50 by administration of BSO(p<0.01). But vincristine did not show significant decrease of IC50 by administration of BSO(p>0.05). Intracellular GSH level prior to the administration of BSO was 0.931nM/mg protein. After the administration of BSO, they were lowered to 0.095nM/mg protein in both BSO concentrations. Results listed above suggest that cytotoxicity of doxorubicin, cisplatin, and melphalan can be enhanced by ESO. This effect may be mediated by decreased intracellualr level of GSH by BSO.
Buthionine Sulfoximine* ; Cell Line* ; Cell Survival ; Cisplatin ; Doxorubicin ; Drug Therapy ; Glutathione ; Humans ; Inhibitory Concentration 50 ; Melphalan ; Retinoblastoma* ; Vincristine