We report a case of Buerger's disease manifested by a scrotal mass, in view of its rarity. A tender bean sized mass was palpated in the left scrotum of a 34 year-old male heavy smoker, who had a history of right pain two years ago which subsided spontaneously. The left testis with the paratesticular tissue was excised. Vessels of the spermatic cord and epididymis showed microscopic changes of Buerger's disease. The involved arteries and veins revealed a predominantly subacute pattern with granulomatous inflammation and Langhans' type giant cells within the thrombi.
Male ; Humans

Experiments show that collaterals that develop and maturate in branch retinal vein occlusion (BRVO) are helpful in the drainage of blood from a blocked area to an adjacent area. Laser treatment on the nonperfusion area can reduce the retinal blood inflow that can impair the formation of collateral vessels. Furthermore, if collaterals were accidentally destroyed by laser photocoagulation, leakage and neovascularization would increase. Forty-five patients with BRVO were reviewed retrospectively. Collateral vessels were noted from angiographic analysis in 27 of 45 (60%) patients. Good visual prognosis was noted in the patients with collaterals. Cases with neovascularization underwent laser treatment. In one case, laser photocoagulation was applied to the collateral vessels accidentally, after which the leakage significantly increased on fluorescein angiography. In conclusion, collateral vessels in BRVO have a favorable effect on visual prognosis. Careful laser treatment is recommended to avoid destroying collaterals in BRVO.
Aged ; Aged, 80 and over ; Collateral Circulation ; Female ; Fluorescein Angiography ; Human ; Male ; Middle Aged ; Prognosis ; Retinal Neovascularization/diagnosis/*physiopathology ; Retinal Vein Occlusion/diagnosis/*physiopathology ; Retrospective Studies ; Visual Acuity

A 21-year-old woman presented with bilateral optic neuritis, combined with central retinal vein occlusion. General physical examination and neurologic consultation revealed no other findings. Laboratory investigation yielded an elevated erythrocyte sedimentation rate, positive LE preparation, elevated ANA titer, and elevated blood urea nitrogen and creatinine levels. Diagnosis of systemic lupus erythematosus (SLE) was made. Renal failure developed quickly and she was treated with hemodialysis, transfusion and subsequently systemic corticosteroid. Anti-phospholipid antibody was positive to lupus anti-coagulant and the titer was normalized after 2-month steroid therapy at which time the visual outcome differed between the eyes. The right eye showed improvement in visual acuity and visual field, but the left eye was not improved and retained a central scotoma. SLE needs to be considered in young women with optic neuritis when other causes of optic neuritis have been excluded, and serologic tests including anti-phospholipid antibody should be conducted.
Adult ; Case Report ; Female ; Fluorescein Angiography ; Human ; Lupus Erythematosus, Systemic/complications/*diagnosis/drug therapy ; Optic Neuritis/*diagnosis/drug therapy/etiology ; Perimetry ; Prednisolone/*therapeutic use ; Treatment Outcome ; Visual Acuity ; Visual Fields

BACKGROUND: Because specific chromosomal abnormalities are associated with certain hematologic disorders, cytogenetic studies can help classifing the diseases, providing the clues of disease progression and being used to monitor remission after chemotherapy. In this study, cytogenetic analysis was performed. In acute and chronic leukemic patients in Korea and the results were compared with foreign cytogenetic reports, and the typical acute lymphocytic leukemia (ALL) and acute myelocytic leukemia (AML) associated chromosome aberrations were analysed by some calculated parameters to clarify if the specific chromosomal abberations in the specific types or subtypes of leukemias had diagnostic value or not. METHOD: Chromosome studies were done in bone marrow or peripheral blood samples by high resolution banding technique. Sensitivity, specificity, and positive and negative predictive values of finding or not finding a given aberration were calculated for followings : for the differential diagnosis between ALL and AML when a patient is known to have acute leukemia, for the differential diagnosis among AML and ALL FAB subtypes in a patient with known AML and ALL. RESULTS: The high positive predictive values (1.0) in the AML versus ALL comparison were found for -7, del(7) (q11-34q22-36), +8s, t(8;21) (q22;q22), t(15;17) (q22;q11), inv (16) (q13;q22) and -Y. Among the AML subtypes, the highest sensitivity, positive and negative predictive values were 0.85, 0.97, 0.94 for t(15;17) (q22;q11) in M3, respectively. The high positive predictive values and specificity in the ALL versus AML comparison were found for t(1;19) (q23;p13) ,t(4;11) (q21 ;23) and t(8; 14) (q24;q32) Among the ALL subtypes, the highest negative predictive value was 0.99 for t (8;14) (q24;q32) in L3. Among 398 CML cases, Philadelphia chromosome positive CML were shown in 81.9% that were classic t(9;22) (q34;all) (94.5%), complex variant traslocation(1.8%) and additional secondary chromosome aberrations (3.7%) . CONCLUSION: Total chromosomal aberration rate in acute and chronic leukemia in Korea was lower than that in foreign reports, but the patterns of chromosome aberrations were similar except for t(15;17) (q22;q11) in AML patients. Quantitativly calculated data of sensitivity, specificity and positive and negative predictive values in the specific chromosomal aberration might be used for diagnostic markers of acute leukemia.
Bone Marrow ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics* ; Diagnosis, Differential ; Disease Progression ; Drug Therapy ; Humans ; Korea* ; Leukemia ; Leukemia, Myeloid, Acute ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sensitivity and Specificity

BACKGROUND: Antioxidants vitamin C and vitamin E may protect against the toxic effect of oxygen free radicals that are preferentially produced after exposures to hyperbaric oxygen (HBO). This study investigated the effect of vitamin C and vitamin E on serum nitric oxide (NO) concentration and intercellular adhesion molecule-1 (ICAM-1) expression on lung after HBO exposure. METHODS: Male Sprague-Dawley rats weighing 200 to 250 g were exposed to HBO at 3 ATA of 100% O2 for 3 hours. The experimental groups were given vitamin C (125 mg/day per rat) and/or vitamin E (50 mg/day per rat) orally, from 5 days prior to the HBO exposure to the day of sacrifice. Serum NO concentrations were determined by measuring NO end product nitrite by non-enzymatic Griess assay. Expression of ICAM-1 on lung was observed by immunohistochemical analysis. RESULTS: The serum nitrite levels were significantly increased after HBO exposure and were higher at 24 hours after HBO exposure than at 0 h (P<0.05). The expression of ICAM-1 was weak immediately after HBO exposure and enhanced at 24 hours. There were no pronounced suppressive effects of vitamins on serum NO production and ICAM-1 expression induced by the 3 hours HBO exposure. CONCLUSION: The 3 hours HBO exposure induces the serum NO production and ICAM-1 expression on lung. The short-term supplementation of vitamin C or/and E do not suppress the NO production and ICAM-1 expression on lung.
Animals ; Antioxidants ; Ascorbic Acid ; Free Radicals ; Humans ; Hyperbaric Oxygenation ; Intercellular Adhesion Molecule-1 ; Lung ; Male ; Nitric Oxide ; Oxygen* ; Rats* ; Rats, Sprague-Dawley ; Vitamin E ; Vitamins*

PURPOSE: We evaluated the safety and efficacy of intrarectal administration of anesthetic agent for transrectal prostate biopsy. MATERIALS AND METHODS: For a double-blind prospective trial, 100 men undergoing transrectal prostate biopsy were randomized into three groups using an established list. In the control group (n=36), 40mL of normal saline was administered transrectally 10 min before the procedure. The lidocaine group (n=31) and the benzocaine group (n=33) were give 40 mL of 1% lidocaine and 0.3% benzocaine, respectively. Patients were asked to score the severity of the pain expected before and after the biopsy procedure using a self-administered verbal rating scale. Pain was assessed using a 10-point linear visual analog scale. RESULTS: The median pain score expected before the transrectal prostate biopsy was 6.7+/-0.3, 7.1+/-0.2, and 6.7+/-0.3 in the control, lidocaine, and benzocaine group, respectively. The median pain score during the biopsy was 6.1+/-0.3, 5.8+/-0.3 (P<0.05), and 5.9+/-0.4 in the control, lidocaine, and benzocaine group, respectively. Ninety seven percent of the control group, 100% of the lidocaine group, and 91% of the benzocaine group complained of severe and bothersome pain, with a score of 5 or greater during the biopsy. No adverse events were noted. CONCLUSIONS: Intrarectal administration of anesthetic agent is a simple, safe, and efficacious method of providing satisfactory anesthesia in patients undergoing transrectal prostate biopsy. We recommend 1% lidocaine solution in the patients to perform transrectal prostatic biopsy.
Anesthesia ; Anesthetics ; Benzocaine ; Biopsy* ; Double-Blind Method* ; Humans ; Lidocaine ; Male ; Prospective Studies ; Prostate ; Visual Analog Scale

BACKGROUND: Formaldehyde (FA) and other volatile organic compounds (VOCs) are considered among the main causes of atopic aggravation. Their main sources include wallpapers, paints, adhesives, and flooring materials. OBJECTIVE: To assess the effects of environmentally friendly wallpaper and flooring material on indoor air quality and atopic dermatitis severity. METHODS: Thirty patients with atopic dermatitis were enrolled in this study. To improve air quality, the wallpaper and flooring in the homes of the subjects were replaced with plant- or silica-based materials. The indoor air concentration of FA and the total VOCs (TVOCs) were measured before remodeling and 2, 6, and 10 weeks thereafter. Pruritus and the severity of atopic eczema were evaluated by using a questionnaire and the eczema area and severity index (EASI) score before and at 4, 8, and 12 weeks after remodeling. The subjects were instructed to continue their therapy for atopic dermatitis. RESULTS: The houses of 24 subjects were remodeled; all subjects completed the study. The concentration of FA in ambient air significantly decreased within 2 weeks after remodeling. The TVOC level showed a decrease at week 2 but increased again at weeks 6 and 10. The reduction of pruritus and EASI score was statistically significant in patients whose baseline EASI score was >3. CONCLUSION: Replacing the wallpaper and flooring of houses with environmentally friendly material reduced FA in ambient air and improved pruritus and the severity of atopic eczema. The improvement of pruritus and eczema was statistically significant in patients whose baseline EASI score was >3.
Adhesives ; Air Pollution, Indoor* ; Dermatitis, Atopic* ; Eczema ; Formaldehyde ; Housing ; Humans ; Paint ; Pilot Projects* ; Pruritus ; Volatile Organic Compounds ; Surveys and Questionnaires

Granulocytic sarcoma is a localized tumor that's composed of immature cells of the granulocytic series. The tumor may be involved anywhere in the body, but we present here a rare case that involved the gastrointestinal tract (and especially the stomach). Granulocytic sarcoma may represent the initial manifestation of blast transformation or it may herald the onset of acute leukemia from myelodysplastic syndrome. We report here on a case of gastric granulocytic sarcoma in a patient with transformed acute leukemia from myelodysplastic syndrome. A 56-year-old male who was suffering with myelodysplastic syndrome (RARS) for 5 years presented with upper abdominal pain. Gastrofiberoscopy revealed an elevated lesion with central erosion at the posterior wall of the gastric upper body, which histologically proved to be a granulocytic sarcoma. The peripheral blood smear and bone marrow examination showed acute myeloid leukemia.
Abdominal Pain ; Bone Marrow Examination ; Gastrointestinal Tract ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Lymphocyte Activation ; Male ; Middle Aged ; Myelodysplastic Syndromes ; Sarcoma ; Sarcoma, Myeloid ; Stress, Psychological

The occurrence of an abdominal wall hematoma caused by abdominal paracentesis in patients with liver cirrhosis is rare. This paper presents a case of an abdominal wall hematoma caused by abdominal paracentesis in a 67-year-old woman with liver cirrhosis with a review of the relevant literature. Two days prior, the patient underwent abdominal paracentesis for symptom relief for refractory ascites at a local clinic. Upon admission, a physical examination revealed purpuric patches with swelling and mild tenderness in the left lower quadrant of the abdominal wall. Abdominal computed tomography revealed advanced liver cirrhosis with splenomegaly, tortuous dilatation of the para-umbilical vein, a large volume of ascites, and a large acute hematoma at the left lower quadrant of the abdominal wall. An external iliac artery angiogram showed the extravasation of contrast media from the left deep circumflex iliac artery. Embolization of the target arterial branches using N-butyl-2-cyanoacrylate was then performed, and the bleeding was stopped. The final diagnosis was an abdominal wall hematoma from the left deep circumflex iliac artery after abdominal paracentesis in a patient with liver cirrhosis.

Purpose: To evaluate visual performance after bilateral implantation of an extended depth of focus (EDOF) intraocular lens (IOL). Methods: This multicenter, prospective, observational study included 100 patients who underwent bilateral cataract surgery with a toric or non-toric EDOF IOL (Tecnis Symfony), and 96 patients completed the final assessment at 4 to 6 months. Binocular corrected distance visual acuity and uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA), spectacle independence, visual symptoms, and patient satisfaction were evaluated. Results: Mean decimal visual acuity results showed a binocular corrected distance visual acuity of 1.10 ± 0.18, UDVA of 1.04 ± 0.17, UIVA of 0.96 ± 0.16, and UNVA of 0.68 ± 0.18. Binocular UDVA and UIVA were 0.8 (decimal) or better in 98% and 94% of patients, respectively. Binocular UNVA was 0.63 (decimal) or better in 76% of patients. Overall, 76% of the patients achieved spectacle independence across all distances, and more than 85% reported no or mild dysphotoptic phenomena. On a scale of 0 to 10, the median patient satisfaction score was 9 for far, 9.5 for intermediate, and 8 for near vision. Conclusions The Symfony EDOF IOL provided excellent distance, intermediate visual outcome, and functional near visual acuity. The visual results were associated with prominent levels of spectacle independence and patient satisfaction.