This study is designed to determine the frequency of amblyopia and sensory fusional anomaly in intermittent exotropia and the relationship between amblyopia and sensory fusional anomaly. Ninety eight intermittent exotropic patients were selected and using full corrected visual acuity, the selected patients were divided into amblyopia group and non-amblyopia group. Then, refractive errors, Bagolini lens test, Worth 4 dot test and stereoacuity test were measured and these values were statistically analyzed. The frequency of amblyopia among intermittent exotropia group was 14 patients[14.3%]. Anisometropia among amblyopia group was 6 patients[43.9%] and among non-amblyopia group was 6 patients [7.1%]. Anisometropia was statistically meaningful in amblyopia group compared with non-amblyopia group[p<0.002]. Sensory fusional anomaly among amblyopia group showed 50%at near distance and 64.3%at far distance, among non-amblyopia group 10.7% at near distance and 20.2%at far distance in Worth 4 dot test. Therefore, it appeared to be statistically meaningful in amblyopia group compared with non-amblyopia group[p<0.001, p<0.002]. Sensory fusional anomaly among amblyopia group showed 35.7%and among non-amblyopia group 14.3%in Bagolini lens test, it appeared to be statistically not meaningful[p>0.064]. In stereoacuity, it decreased statistically meaningful when amblyopia[p<0.003] or sensory fusional anomaly[p<0.019]were present.
Amblyopia* ; Anisometropia ; Exotropia* ; Humans ; Refractive Errors ; Visual Acuity

Optic neuritis is one of the most important clinical manifestations of multiple sclerosis. We experienced 2 cases of retrobulbar optic neuritis associated with multiple sclerosis. One was a 14-year-old female patient who presented with decreased visual acuity and visual field defect in right eye followed by paralysis of both lower extremities and the other was a 39-year-old female patient who presented with repeated paresthesia and motor weakness of upper and lower extremities then rapid decrease in visual acuity in both eyes. Both patients had relative afferent pupillary defect, color perception abnormality, variable visual field defect and abnormality in VEP. In fundus exam and fluorescene angiography, there was no specific abnormal finding. T2 weighted MRI showed multiple high signals corresponding to plaques. These two patients were diagnosed as multiple sclerosis. We should keep in mind that retrobulbar optic neuritis could be associated with multiple sclerosis as a presenting sign or as a manifestation during its clinical course.
Adolescent ; Adult ; Angiography ; Color Perception ; Female ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Multiple Sclerosis* ; Optic Neuritis* ; Paralysis ; Paresthesia ; Pupil Disorders ; Visual Acuity ; Visual Fields

Purpose: Xanthomatosis of the Achilles tendons is rare. In some patients, however, the lesions in the Achilles tendon need to be removed, which may be painful and disfiguring. While studies of successful surgical outcomes for the total resection and reconstruction of the Achilles tendon have been reported, reconstruction surgery has a technical challenge, and extended surgical exposures are required. This study analyzed five cases of bilateral xanthoma of the Achilles tendon, which was treated surgically using a wedge-shaped tendon-sparing approach to eliminate the need for tendon reconstruction. Materials and Methods: From July 2010 to May 2018, five patients with xanthomatosis in both Achilles tendons underwent wedgeshaped tendon preserving surgery. The average age was 49 years (range, 40–55 years), and the follow-up period was 21.4 months (range, 12–31 months). The patients consisted of three males and two females. Complications related to surgery were recorded. The outcome measures included the range of motion of the ankle joint, American Orthopaedic Foot and ankle Society (AOFAS) ankle/hindfoot score, and visual analogue scale (VAS) for overall satisfaction at the last follow-up. The availability of a single-limb heel raise and returning time to work were also measured. Results: Wound dehiscence that did not require secondary surgery was noted in one patient. At the last follow-up, the range of motion of the ankle joint was normal in all patients. The mean AOFAS ankle/hindfoot score was 91 (range, 85–96) and the VAS for the overall satisfaction ranged from 8 to 10. The average time between surgery and return to work was 27.6 days (range, 17–58 days) and all patients could perform a single-limb heel raise test. Conclusion The tendon-sparing technique, which can preserve the anatomical functioning of the Achilles tendon, could be an excellent surgical approach because it has very promising functional and cosmetic surgical outcomes in patients with Achilles tendon xanthomatosis.

We experienced a case of primary gastric tuberculosis presented with melena. A 61-year-old male was admitted with epigastric pain and melena. Upper endoscopy revealed an irregular shaped gastric ulcer on the posterior wall of the body. Histological examination of endoscopic specimen revealed chronic inflammation with fibrosis, granulomas and acid-fast bacilli. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. There was no evidence of the tuberculous lesion anywhere else. Primary gastric tuberculosis remains an extremely uncommon clinical entity; the definitive diagnosis is made by biopsy and positive culture for the organism. We report a case of primary gastric tuberculosis with review of the literature.
Biopsy ; Diagnosis ; Endoscopy ; Fibrosis ; Granuloma ; Humans ; Inflammation ; Male ; Melena* ; Middle Aged ; Mycobacterium tuberculosis ; Stomach Ulcer ; Tuberculosis*

The percutaneous transfemoral approach has been routinely used for cardiac catheterization and coronary angioplasty. Local vascular complications following angioplasty are seen in 5% to 10% of patients, especially in those who need prolonged anticoagulation. Transradial access for coronary procedures dramatically reduces access site complications. We report a rare case of radial arteriovenous fistula, which developed after coronary angiography perfomed using the transradial approach.
Angioplasty ; Arteriovenous Fistula ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Angiography ; Humans ; Radial Artery

No abstract available.
Cervix Uteri* ; Female

No abstract available.
Cervix Uteri* ; Female

Malignant fibrous histiocytoma is a pleomorphic sarcoma in adults, which occurs principally as a mass on an extremity or in the abdominal cavity or retroperitoneum. It typically involved deep fascia or skeletal muscle and only rarely was confined to the subcutis without fascial involvement. Malignant fibrous histiocytomas developed in the intraabdominal organs are very rare and only few cases have been reported until now. Here, we report a case of malignant fibrous histiocytomar developed in the stomach of a 46-year old male who showed clinical and histologic features of malignant fibrous histiocytoma without any identified etiologic factors. The patient was treated successfully with surgery, and has had no recurrence since, during the ensuring one and a half yars.
Abdominal Cavity ; Adult ; Extremities ; Fascia ; Histiocytoma, Malignant Fibrous* ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; Recurrence ; Sarcoma ; Stomach*

Micronutrient deficiencies in Crohn's disease (CD) patients are not uncommon and usually result in a combination of reduced dietary intake, disease-related malabsorption, and a catabolic state. Decreased serum thiamine levels are often reported in patients with CD. Wernicke's encephalopathy (WE) is a severe form of thiamine deficiency that can cause serious neurologic complications. Although WE is known to occur frequently in alcoholics, a number of non-alcoholic causes have also been reported. Here, we report two cases of non-alcoholic WE that developed in two severely malnourished CD patients who were supported by prolonged total parenteral nutrition without thiamine supplementation. These patients complained of sudden-onset ophthalmopathy, cerebellar dysfunction, and confusion. Magnetic resonance imaging allowed definitive diagnosis for WE despite poor sensitivity. The intravenous administration of thiamine alleviated the symptoms of WE dramatically. We emphasize the importance of thiamine supplementation for malnourished patients even if they are not alcoholics, especially in those with CD.
Administration, Intravenous ; Alcoholics ; Cerebellar Diseases ; Crohn Disease* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Micronutrients ; Parenteral Nutrition, Total* ; Thiamine ; Thiamine Deficiency ; Wernicke Encephalopathy*

Although a pathogenic mechanism of hemolytic anemia complicated with viral hepatitis is unknown, it is suggested that there are four mechanisms; 1) In the individual who has predisposition to hemolytic anemia, viral infection accelerates the red cell destruction & hemolysis become obvious. 2) Directly, virus itself injures to the red cell membrane. 3) The serious liver failure & hypersplenism induce the hemolysis. 4) Autoimmune hemolytic anemia because of immunological abnormality caused by viral infection. We experienced a case of autoimmune hemolytic anemia in 33-year-old male patient who was diagnosed as chronic lobular hepatitis B with biopsy. Diagnosis was estabilished by clinical features, blood cell count, routine urinalysis, direct & indirect Coombs test, liver function test, immunoglobulin quantitations, hepatitis B marker, bone marrow aspiration, and liver biopsy. This case was treated with corticosteroid and transfusion. During follow-up, he has been well tolerated.
Adult ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Biopsy ; Blood Cell Count ; Bone Marrow ; Cell Membrane ; Coombs Test ; Diagnosis ; Follow-Up Studies ; Hemolysis ; Hepatitis B* ; Hepatitis* ; Humans ; Hypersplenism ; Immunoglobulins ; Liver ; Liver Failure ; Liver Function Tests ; Male ; Urinalysis