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

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

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

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

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

BACKGROUND/AIMS: Elevated lipoprotein(a) (Lp[a]) level is known to be a risk factor for cardiovascular disease (CVD). However, the data that has been reported on the association between the Lp(a) level and CVD in type 2 diabetes has been limited and incoherent. The aim of this study was to investigate the relationship between the Lp(a) concentration and new onset CVD in type 2 diabetes. METHODS: From March 2003 to December 2004, patients with type 2 diabetes without a prior history of CVD were consecutively enrolled. CVD was defined as the occurrence of coronary artery disease or ischemic stroke. Cox proportional hazards models were used to identify the associations between the Lp(a) and CVD after adjusting for confounding variables. RESULTS: Of the 1,183 patients who were enrolled, 833 participants were evaluated with a median follow-up time of 11.1 years. A total of 202 participants were diagnosed with CVD (24.2%). The median Lp(a) level for 1st and 4th quartile group was 5.4 (3.5 to 7.1) and 55.7 mg/dL (43.1 to 75.3). Compared with patients without CVD, those with CVD were older, had a longer duration of diabetes and hypertension, and used more insulin and angiotensin converting enzyme inhibitors/angiotensin receptor blockers at baseline. A Cox hazard regression analysis revealed that the development of CVD was significantly associated with serum Lp(a) level (hazard ratio, 1.92; 95% confidence interval [CI], 1.26 to 2.92; p < 0.001, comparing the 4th vs. 1st quartile of Lp[a]). CONCLUSIONS: Elevated Lp(a) level was an independent predictable risk factor for CVD in type 2 diabetes. Other cardiovascular risk factors should be treated more intensively in type 2 diabetic patients with high Lp(a) levels.
Cardiovascular Diseases* ; Cohort Studies* ; Confounding Factors (Epidemiology) ; Coronary Artery Disease ; Diabetes Mellitus, Type 2* ; Follow-Up Studies ; Humans ; Hypertension ; Insulin ; Lipoprotein(a)* ; Peptidyl-Dipeptidase A ; Proportional Hazards Models ; Prospective Studies* ; Risk Factors ; Stroke

PURPOSE: Congenital anomalies of the kidneys and urinary tract (CAKUT) are the most common anomalies identified in newborns. This study aims to demonstrate the prevalence of CAKUT including hydronephrosis diagnosed by antenatal and postnatal ultrasound over a five-year period. METHODS: The records of births between May 1st, 2009 and April 30th, 2014 at our hospital were collected. The number of infants who underwent renal ultrasound after birth for the detection of CAKUT was counted. The incidence of each type of CAKUT such as hydronephrosis, size abnormality, horseshoe kidney, and Multicystic dysplastic kidney (MCDK) was retrospectively evaluated for antenatal screening and postnatal follow-up examination. RESULTS: During the study period, 33,276 infants were born and 521 neonates underwent postnatal renal ultrasound. 183 cases of CAKUT were detected prenatally and 140 postnatally using ultrasonographic examinations at the following time: (i) 3-7 days postnatally in 123 newborns (87.9%), (ii) during 1-3 months in 11 newborns (7.9%), and (iii) later than 3 months in 6 newborns (4.3%). Among diagnosed CAKUT, hydronephrosis was the most common anomaly with 113 newborns diagnosed prenatally and 46 postnatally. Duplex kidney was the second most common anomaly followed by horseshoe kidney, simple cysts in the kidney and so on. CONCLUSION: The detection of CAKUT is an important part of the prenatal ultrasound. This study analyzed the prevalence of CAKUT detected on prenatal screening and compared the results to those detected postnatally. Prenatal ultrasound screening fulfills the needs of postnatal examinations and therefore, both antenatal and postnatal sonographic investigations are of vital importance for diagnosis of renal and urinary tract anomalies.
Diagnosis ; Follow-Up Studies ; Humans ; Hydronephrosis ; Incidence* ; Infant ; Infant, Newborn ; Kidney* ; Mass Screening ; Multicystic Dysplastic Kidney ; Parturition ; Prenatal Diagnosis ; Prevalence ; Retrospective Studies ; Ultrasonography* ; Urinary Tract*

A Sengstaken-Blakemore (S-B) tube, when used approximately, still has a place in the management of acute variceal bleeding, and controls bleeding in 40~90% of the cases. However its use is accompanied by number of complications such as esophageal ulcer, pulmonary aspiration, and malfunction of the tube, which requires replacement. We recently observed a very unusual complication: the remaining gastric balloon of a S-B tube was broken off in the fundus of stomach by the patient's traction. The gastric balloon was easily and safely removed using an endoscopic snare after deflating the gastric balloon with a needle puncture.
Gastric Balloon ; Hemorrhage ; Hypogonadism ; Mitochondrial Diseases ; Needles ; Ophthalmoplegia ; Punctures ; SNARE Proteins ; Stomach ; Traction ; Ulcer