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

This study includes 19 cases of complicated low extremity injury to whom underwent microvascular free-tissue transfer in cases of open comminuted fracture, osteomyelitis, and vascular compromise or extensive soft tissue defect from Nov. 1994 to July 1997. The average time after injury to coverage was 25 days. The nineteen patients underwent a total of nineteen free tissue transfers primarily, and eighteen (94.7 per cent) of the transfers survived. Major complications were encountered recurrent failure of the free tissue transfer in one patient and partial necrosis in the other flap, which were successfully treated by flow-through radial forearm free flap and distally based superficial sural artery flap respectively. Two patients were sustained below knee amputation, one above knee amputation, despite of survival of flaps. This reveals limb salvage in 84 percent. The microvascular reconstruction is a versatile and reliable methods in complicated cases after severe trauma. Free tissue transplantation should be considered as a primary treatment in such complicated cases.
Amputation ; Arteries ; Extremities ; Forearm ; Fractures, Comminuted ; Free Tissue Flaps ; Humans ; Knee ; Limb Salvage ; Lower Extremity* ; Necrosis ; Osteomyelitis ; Tissue Transplantation ; Transplants

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.

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*

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

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*

BACKGROUND: For the purpose of early detection of breast cancer, a localization biopsy is necessary in case of mammographically or ultrasonographically suspicious, but nonpalpable, breast lesions. METHODS: One hundred nine consecutive localization biopsies for nonpalpable lesions of the breast were performed upon 101 patients from May 1992 to September 1998. RESULTS: The localizations were done in 48 cases under the guidance of mammography and in 61 cases under the guidance of ultrasonography. Complications occurred in 15 cases (13.7%). The mean volume of the excised specimens was 11.6 cm3. The miss rate was 3.6% (4 cases). Malignant lesions of the breast were found in 16 cases (14.7%). Among the malignant lesions, 10 cases involved invasive ductal cancer. Among the patients diagnosed as having breast cancer, 8 patients were treated with a conservative operation, 5 patients with a modified radical mastectomy, and 2 patients with observation; 1 patient was discharged. The chance of a biopsy containing a malignant lesion was 16.7% if the biopsy was done because of mass, 9.8% for a microcalcification, and 11.1% for an abnormal asymmetric density. CONCLUSIONS: A needle localization biopsy can be performed accurately under local anethesia, and the volume of the excised specimen can be minimized, so the cosmetic effect is excellent and proper early treatment is possible in diagnosed cases of breast cancer.
Biopsy* ; Breast Neoplasms ; Breast* ; Humans ; Mammography ; Mastectomy, Modified Radical ; Needles* ; Ultrasonography