PURPOSE: Sarcoidosis is a granulomatous inflammation that can affect all organs, and the initial manifestation is sometimes ophthalmologic disease. The purpose of this article is to report the diagnosis of ocular sarcoidosis for a patient whose chief complaint was recurrent eyelid mass without any other ophthalmologic symptoms or signs. METHODS: A 43-year-old female had an 8-month history of bilateral upper eyelid swelling, right upper eyelid mass, and right ptosis. She had received localized steroid injection at a local dermatologic clinic. On physical examination, there were hard and fixed eyelid masses and mechanical ptosis due to an eyelid mass in the right upper eyelid. Mass excision and biopsy were performed, and a pulmonology specialist was consulted to evaluate the nodule on chest X-ray RESULTS: The patient's condition had been diagnosed with multiple chalazia at the first pathologic reading, but it was diagnosed with sarcoidosis at the second pathologic reading, which was requested because of recurrence. The diagnosis of sarcoidosis was based on chest PA, and chest CT, and was confirmed by lung biopsy specimen. CONCLUSIONS: In the case of recurrent eyelid mass, sarcoidosis should first be ruled out.
Adult ; Biopsy ; Chalazion ; Diagnosis ; Eyelids* ; Female ; Humans ; Inflammation ; Lung ; Physical Examination ; Pulmonary Medicine ; Recurrence ; Sarcoidosis* ; Specialization ; Thorax ; Tomography, X-Ray Computed

Splenic artery aneurysms are an uncommon form of vascular disease that carry the risk of rupture and fatal hemorrhage. Precise cause of splenic artery aneurysms are not be established, the most common pathologic finding is defect of the media. Splenic artery aneurysms occur in patient with multiple pregnancies, portal hypertension, splenomegaly, after orthotopic liver transplantation and fibrodysplasia. Most patients who are diagnosised with splenic artery aneurysm are asymptomatic. Arteriography is a confirmed diagnostic method for detecting splenic artery aneurysms and searching the location of aneurysms. Operative treatment and therapeutic catheter embolization have been used for treatment of splenic artery aneurysms.
Aneurysm* ; Angiography ; Catheters ; Diagnosis ; Embolization, Therapeutic ; Female ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Transplantation ; Pregnancy ; Pregnancy, Multiple ; Rupture* ; Splenic Artery* ; Splenomegaly ; Vascular Diseases

PURPOSE: To compare intraoperative parameters and postoperative results between divide-and-conquer and multiple phaco-chop technique. METHODS: Two different techniques were performed by one operator on the patients with bilateral cataract. One eye was phacoemulsified by divide-and-conquer technique (D eye), and the other was performed by multiple phaco-chop technique (M eye). Changes of central corneal thickness during the operation, total phaco-time and phaco-energy were measured. RESULTS: Total 29 patients were included. The change of central corneal thickness were 8.4 +/- 11.8 microm in D eye and 11.5 +/- 16.7 microm in M eye, which showed no significant difference (p = 0.350) and total phaco-time were 70.1 +/- 32.9 seconds in D eye and 71.1 +/- 55.0 seconds in M eye, which also showed no significant difference (p = 0.689). However, phaco-energy were 12.4 +/- 8.3 power x s in D eye and 8.4 +/- 9.9 power x s in M eye, and this result showed significantly larger energy when using divide-and-conquer technique (p < 0.001). CONCLUSIONS: There was no significant difference in change of central corneal thickness and phaco-time between two techniques, divide-and-conquer and multiple phaco-chop technique. However, significantly smaller phaco energy was used by multiple phaco-chop technique compared with divide-and-conquer technique.
Cataract ; Eye ; Humans ; Phacoemulsification

PURPOSE: Thyroid-Associated Orbitopathy (TAO) presents with highly variable clinical characteristics. We hypothesize that the underlying thyroid status predisposes a patient to different clinical characteristics of TAO. METHODS: We retrospectively studied the clinical data of 385 patients from the New York area who were referred to our clinic and diagnosed with TAO from Jan 1990 to Dec 2000. We divided the 385 patients into three groups: Graves' hyperthyroid, euthyroid, and hypothyroid, and analyzed them statistically. RESULTS: Three hundred thirty-one (86%) patients were hyperthyroid, 25 (6.5%) were euthyroid, and 29 (7.5%) were hypothyroid. The average age of TAO presentation in each group was 46.7, 46.1, and 49.9 years, respectively. The female-male ratio in each group was 5.25, 3.17, 13.5:1, respectively (p>0.05). The average time from thyroid disease to TAO in the hyperthyroid and hypothyroid groups was 16.6 and 38 months, respectively (p<0.05). The hyperthyroid group had more proptosis (76.1 vs. 41.4%, p=0.0001<0.05) than the hypothyroid group. CONCLUSIONS: TAO has different clinical characteristics depending on thyroid status. The hyperthyroid group has a short disease interval and more severe clinical course of TAO than the hypothyroid group.
Exophthalmos ; Humans ; Phenotype* ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland* ; Troleandomycin

PURPOSE: To determine the epidemiologic and clinical characteristics of thyroid-associated orbitopathy (TAO). METHODS: We retrospectively studied the clinical data of 385 patients from the New York City area diagnosed with TAO from January 1990 to December 2000. The total cases were divided into male and female groups and age-adjusted relative incidence rates were obtained to plot the incidence curve and clinical characteristics. Statistical analysis was applied to the collected data. RESULTS: The average age of patients with TAO was 46.3 years for females and 50.1 years for males. The female-male ratio was 5.31:1. In 23.3% of patients, the diagnosis of TAO was made simultaneously with their thyroid disease. In 75% of cases, the diagnosis was made within 18 months of the presentation of thyroid disease. Soft tissue involvement was noted most frequently in 311 (80.8%), eyelid retraction in 306 (79.5%), proptosis in 278 (72.2%), restrictive myopathy in 234 (60.8%), and compressive optic neuropathy in 43 (11.2%) of 385 patients. CONCLUSIONS: TAO has variable and different epidemiologic and clinical characteristics according to sex and age.
Diagnosis ; Epidemiology ; Exophthalmos ; Eyelids ; Female ; Humans ; Incidence ; Male ; Muscular Diseases ; Optic Nerve Diseases ; Retrospective Studies ; Thyroid Diseases ; Troleandomycin

No abstract available.
Animals ; Epithelium* ; Gene Expression* ; Laser Capture Microdissection* ; Mice* ; Microarray Analysis* ; Phenobarbital*

Neovascular glaucoma is a subtype of secondary glaucoma that is characterized by proliferation of fibrovascular tissue in the anterior chamber angle. This condition may be acutely aggravated by carotid revascularization therapies. There have been few previous reports of acute aggravation of neovascular glaucoma following carotid artery stenting. We report the case history of a patient who had acute exacerbation of neovascular glaucoma following carotid artery stenting and required surgical management.
Anterior Chamber ; Carotid Arteries ; Carotid Stenosis ; Glaucoma ; Glaucoma, Neovascular ; Humans ; Stents

PURPOSE: For patients with breast carcinoma, immunohistochemical markers are important factors in determining the breast cancer subtype and for establishing a therapeutic plan, including the use of neoadjuvant chemotherapy (NACT). However, it is not clear whether the expression of certain markers changes after NACT. METHODS: We assessed estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, p53, and Bcl-2 expression in specimens from 345 breast cancer cases before and after NACT. We analyzed the association between response to NACT and the expression of the markers in pre-NACT specimens. We also compared the expression between pre- and post-NACT specimens. RESULTS: ER and PR expression was negatively associated with pathological complete response (pCR). HER2 was associated with pCR in all cases, but the association was lost when the cases were subdivided according to hormone receptor status. The pre-NACT tumor size of cases with pCR after NACT was smaller than that of cases with residual disease. HER2-enriched and triple-negative breast cancers were more likely to achieve pCR than luminal A type cancers. PR expression and the Ki-67 index decreased after NACT. A decrease in the Ki-67 index was also demonstrated in hormone receptor positive and HER2-enriched subtypes, but no similar tendency was observed in the triple-negative subtype. CONCLUSION: A patient with breast cancer scheduled for NACT should be assessed for the breast cancer subtype, as this will influence the treatment plans for the patient. The expression of PR and Ki-67 after NACT should be interpreted carefully because NACT tends to reduce the expression of these molecules.
Breast Neoplasms ; Breast* ; Drug Therapy* ; Estrogens ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; Phenobarbital ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone

PURPOSE: To evaluate the stability and optical performance of the newly developed single-piece aspheric intraocular lens (IOL) by comparing the clinical outcome of the aspheric IOL with the new optic profile design (HOYA iSert, HOYA iMics) and the aspheric IOL (Akreos MI60), which has been proven effective and safe. METHODS: iSert, iMics, and MI60 were inserted into 55 eyes, 60 eyes, and 50 eyes, respectively, after microincision phacoemulsification cataract surgery. Best corrected visual acuity (BCVA), refraction in spherical equivalent, anterior chamber depth (ACD), total higher order aberration (HOA), contrast sensitivity, and surgically induced astigmatism (SIA) were measured and each IOL was evaluated on the functional stability, anterior-posterior stability, centration in the capsular bag, and quality of vision. RESULTS: No statistical differences in preoperative and postoperative BCVA among the 3 IOL groups were observed, however, MI60 showed significant myopic shift postoperatively. Anterior-posterior stability assessed with postoperative change in refractive error and ACD was slightly lower in the MI60 group. In terms of vision quality, while total aberration, total HOA, coma aberration, and contrast sensitivity for the 3 IOLs were not different significantly, spherical aberration of the MI60 group was higher than the other groups at 6 months postoperative. SIA was significantly increased in eyes implanted with iSert than in eyes with iMics or MI60 at 1 month postoperatively, however, the differences were no longer evident after 3 months postoperatively. CONCLUSIONS: The new aspheric IOLs, iSert and iMics, showed good stability and visual outcome equal to MI60 at the 6-month postoperative follow-up.
Aniline Compounds ; Anterior Chamber ; Astigmatism ; Cataract ; Coma ; Contrast Sensitivity ; Eye ; Follow-Up Studies ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Phacoemulsification ; Refractive Errors ; Vision, Ocular ; Visual Acuity

PURPOSE: Pediatric burn still generates social problem leading to physical and mental sequelae for ages. We studied to help make a program for the prevention of pediatric burn. METHODS: We analyzed retrospectically 2759 acute burn patients under the age of 15 years in recent 5years (January 2000 - December 2004). RESULTS: 1553 males and 1226 females were investigated, with a male to female ratio of 1.25:1. The greatest number of burn patients were those with an age of 1-2 years(1435, 52%). Scalding burn was the most common cause of injury, which accounted for 1980 (71.8%) patients, followed by contact burns(286, 10.4%), flame burn(229, 8.3%), steam burn(141, 5.1%). Especially steam burn was the second cause of injury in the age under 1 year, while flame burn was the same in the age over 3 years. During recent 5 years, incidence of contact burn increased over twofold despite the others did not changed substantially. Variation of seasonal incidence is minimal and most of the patients(2545 cases, 92.2%) had burns of < = or 20% TBSA. The median hospital stay was 18.3 days, and the rate of operation was 35.4% with an high rate in electrical burn(70.6%), steam burn(68.8%), contact burn(65%). 27 patients died in this series, which yielded a mortality rate of 1%. CONCLUSION: We expect that these data will be used as a basis for prevention of pediatric burn.
Burns* ; Epidemiology ; Female ; Humans ; Incidence ; Length of Stay ; Male ; Mortality ; Seasons ; Social Problems ; Steam