No abstract available.
B-Lymphocytes* ; Immunoglobulin G*

PURPOSE: In this study we compared the clinical outcomes of idiopathic epiretinal membrane (ERM) surgery according to the use of indocyanine green (ICG) and ICG exposure time. METHODS: The medical records of 76 patients with an idiopathic ERM that underwent vitrectomy and ERM and internal limiting membrane (ILM) removal were reviewed. We compared the results (best corrected visual acuity [BCVA, log MAR] and central macular thickness [CMT, µm]) of idiopathic ERM surgeries using ILM peeling with (group I, 39 eyes) and without ICG (group II, 37 eyes). Additionally, the correlation of ICG exposure time and clinical outcomes in group I was analyzed. RESULTS: Gender, age, lens state, preoperative BCVA, and preoperative CMT were not significantly different between the two groups. The postoperative BCVA was significantly improved in both groups but the difference was not statistically significant. The postoperative CMT was significantly improved in both groups and the change amount of group I was more larger than group II. Additionally, ICG exposure time was not significantly correlated with changes of BCVA and CMT. CONCLUSIONS: Intravitreal ICG-assisted ILM peeling did not significantly affect the recovery of BCVA, however that impaired the recovery of CMT. ICG exposure time did not affect the postoperative visual outcome.
Epiretinal Membrane* ; Humans ; Indocyanine Green ; Medical Records ; Membranes* ; Visual Acuity ; Vitrectomy

BACKGROUND: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). METHODS: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. RESULTS: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. CONCLUSION: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.
Cross Infection ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus

PURPOSE: To report a case of skin infection caused by nontuberculous mycobacterium after external dacryocystorhinostomy. CASE SUMMARY: A 53-year-old female patient presented to our clinic with a tear on the left eye, although a silicone tube was intubated. Two weeks after external dacryocystorhinostomy, swelling and redness were found on the operation wound. Therefore, the patient received oral antibiotics and steroid treatments but did not improve. The mass was irregularly shaped and became larger; thus, excisional biopsy was performed at 2 months after external dacryocystorhinostomy. A chronic granulomatous tissue was detected in the excisional biopsy, and antimycobacterial medications were started in consultation with an internist. A moderate colony was observed, and rod-shaped bacteria Mycobacterium abscessus was found in the culture 47 days after acid-fast culture was performed. The patient was diagnosed with a periocular infection caused by nontuberculous mycobacterium. Finally, the lesion improved. CONCLUSIONS: Although patients with granulomatous tissue receive numerous treatments, if the lesion is not improved, then additional excisional biopsy and culture examination to identify infection by nontuberculous mycobacterium are necessary.
Anti-Bacterial Agents ; Bacteria ; Biopsy ; Dacryocystorhinostomy ; Eye ; Female ; Humans ; Middle Aged ; Mycobacterium ; Nontuberculous Mycobacteria ; Silicones ; Skin ; Tears

We report a case of dedifferentiated liposarcoma of retroperitoneum as a recurrent form in a 41 year old male. The patient received a extirpation for retroperitoneal mass and diagnosed as myxoid liosarcoma 4 years ago. The patient experienced 3 recurrences over a period of 4 years and diagnosed as myxoid liposarcoma in the second, third recurrence also. Histologically, the mass was composed of several clearly distinct elements : well differentiated liposarcoma, myxoid liposarcoma, myxoid malignant fibrous histiocytoma, poorly differntiated sarcoma, and fibrosarcoma. Immunohistochemically, S-100 protein was expressed in the area of spindle cell sarcoma, well differentiated liposarcoma, and malignant fibrous histiocytoma but alpha-1-antichymotrypsin was only expressed in the area of myxoid malignant fibrous histiocytoma.

An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.
Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.
Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

PURPOSE: To analyze the effect of scleral lens application for preventing corneal edema during vitrectomy on postoperative corneal status using anterior segment OCT (RTVue 100, Optovue, Fremont, CA, USA). METHODS: The medical records of 42 eyes (42 patients) who underwent total vitrectomy with no appreciable corneal disease between November 2014 and June 2015 were retrospectively reviewed. Evaluations were performed at 1 day, 1 week, and 1 month after total vitrectomy. Corneal status was noted at every follow-up visit using anterior segment OCT. An analysis was performed to define the changes in corneal status in association with scleral lens application during the surgery. RESULTS: 18 of 42 eyes were treated with a scleral lens during total vitrectomy. The corneal thickness increased after vitrectomy in all cases. The mean corneal thickness increment was 23.9 ± 9.7 µm in the scleral lens group and 43.0 ± 19.5 µm in the non-scleral lens group at 1 day after vitrectomy (p < 0.001). At 1 week after vitrectomy, the mean corneal thickness increment was 8.1 ± 7.2 µm in the scleral lens group and 32.3 ± 19.2 µm in the non-scleral lens group (p < 0.001). The difference in superficial punctate keratitis grade between the two groups was not statistically significant. CONCLUSION: Scleral lens application during vitrectomy seems to prevent postoperative corneal edema. More cases and a longer period of study is needed to draw definitive conclusions.
Corneal Diseases ; Corneal Edema* ; Follow-Up Studies ; Keratitis ; Medical Records ; Retrospective Studies ; Vitrectomy*

PURPOSE: In this study we investigated the histopathologic characteristics of conjunctivochalasis and its association with lymphangiectasis using impression cytology and conjunctival excisional biopsy in patients with conjunctivochalasis. METHODS: This prospective study included 14 outpatients diagnosed with conjunctivochalasis, and who had excisional biopsies performed between March 1, 2012 and November 30, 2012. Preoperative slit-lamp examination, dry eye diagnostic test and impression cytology were also performed. For histological analysis, conjunctival sections were stained with hematoxylin and eosin (H&E), Verhoeff-van Gieson (VVG) elastic staining, and monoclonal antibody D2-40, a lymphatic endothelial marker. RESULTS: Tear break-up time and Schirmer's value were decreased in patients with conjunctivochalasis. Impression cytology showed a decrease in goblet cell density and an increase in nucleoplasmic/cytoplasmic ratio. The patients' conjunctival tissues exhibited an infiltration increase of chronic inflammatory cells on H&E stain, and a decrease in collagen density with degeneration of elastic fibers on VVG stain compared to tissues from the control subjects. D2-40 immunohistochemistry revealed the dilated subconjunctival lymphatics in patients with conjunctivochalasis. CONCLUSIONS: This study suggests that the characteristic histopathological features of conjunctivochalasis include dilated lymphatic vessels as well as decreased goblet cell and collagen densities with degeneration of elastic fibers.
Antibodies, Monoclonal, Murine-Derived ; Biopsy ; Collagen ; Diagnostic Tests, Routine ; Elastic Tissue ; Eosine Yellowish-(YS) ; Eye ; Goblet Cells ; Hematoxylin ; Humans ; Immunohistochemistry ; Lymphangiectasis ; Lymphatic Vessels ; Outpatients ; Prospective Studies

The distribution of pemphigus subclass autoantibodies in a patient with pemphigus vulgaris (PV) has been investigated by semiquantitative indirect immunofluorescence (IIF), using the HP series monoclonal antibodies specific for four human IgG subclasses on human foreskins. IgG1 and IgG4 intercellular substance-specific autoantibodies were detected in the serum of the patient, whereas IgG2 and IgG3 autoantibodies were absent. In addition to foreskins, human tonsillar epithelia were used as substrates of IIF for detecting the PV autoantibodies and it was one of satisfactory substitutes for monkey esophagus.
Antibodies, Monoclonal ; Autoantibodies* ; Esophagus ; Fluorescent Antibody Technique, Indirect ; Foreskin ; Haplorhini ; Humans ; Immunoglobulin G* ; Pemphigus*