PURPOSE: The most common problem in pterygium operation is recurrence ; recurrence rate is higher in recurrent pterygium than primary one. Effects on recurrence rate of combination therapy of intraoperative mitomycin C soaking method with postoperative beta-irradiation (strontium 90) along with its complications were investigated in primary and recurrent pterygium. Recurrence rate of the combination therapy was compared with that of the pterygium excision, postoperative beta-irradiation, and intraoperative mitomycin C soaking, respectively. METHODS: Fifty-three patients (fifty-nine eyes) with primary pterygium and twenty-three patients (twenty-four eyes) with recurrent pterygium received surgery. Mitomycin C in a concentration of 0.2 mg/ml soaked in a 2 x 2 mm Weckcel sponge was applied on the bare sclera intraoperatively after pterygium excision. Forty-five seconds of beta irradiation was done on the first and sixth postoperative days. RESULTS: During the mean follow-up period of 15 months, recurrence rate was 3.4% (2 eyes) in primary pterygium and 4.2% (1 eye) in recurrent one, respectively. Compared to the recurrence rate of 22.5% in primary and 35.0% in recurrent pterygium, respectively when removal of pterygium alone was performed and 14.3% in primary and 20.0% in recurrent, respectively with postoperative beta-irradiation and 12.8% in primary and 15.0% in recurrent, respectively with intraoperative mitomycin C soaking. These differences were statistically significant (P<0.05). One eye showed symblepharon in recurrent pterygium with combination therapy. CONCLUSION: Combination therapy of intraoperative administration of mitomycin C and postoperative beta irradiation (strontium 90) is considered an effective and safe adjunct for prevention of the recurrence of recurrent pterygium as well as primary.
Follow-Up Studies ; Humans ; Mitomycin* ; Porifera ; Pterygium* ; Recurrence* ; Sclera

The empty sella syndrome is characterized by obesity, frequent pregnancy, headache and high blood pressure, but its exact cause remains unknown. Usually the incomplete diaphragmatic sella has been considered as the cause of the empty sella syndrome, but some authors recently have suggested that the antipituitary antibody way be related to development of pituitary atrophy and the pituitary empty sella syndrome, and thus it may be clinically useful as screening test for the empty sella syndrome. We experienced two empty sella syndromes associated Graves disease and applied the antipituitary antibody as the diagnostic tool of the empty sella syndrome. But none of this two patients had antipituitary antibody and we report these cases with reviews of literatures.
Atrophy ; Empty Sella Syndrome ; Graves Disease ; Headache ; Humans ; Hypertension ; Mass Screening ; Obesity ; Pregnancy

PURPOSE: To compare the degree of pain between photorefractive keratectomy(PRK) and laser in situ epithelial keratomileusis(LASEK) during intraoperative and postoperative period, we used the visual pain analogue scale. METHODS: Forty patients requiring refractive surgery of both eyes were randomized into 2 groups and were studied by double-blind clinical trial prospectively. Each patient had PRK performed on one eye and LASEK on the other on the same day. On half of the patients PRK was performed before LASEK. The other half had LASEK first and then PRK. All surgeries were performed by one surgeon and subjective pain was assessed using analog scale of no pain(0) to worst pain imaginable(10) during the operation, post operatively, and on the first, second, sixth postoperative day. RESULTS: There were no significant carry-over effects in all 5 comparisons(p>0.30) between the two groups of different operation order. There was less discomfort in the PRK group compared with the LASEK group on all days of measurement. The pain felt by the patients was significantly less in the PRK group on the first(mean 3.29 versus 5.46, p<0.0001) and the second(mean 1.39 versus 3.61, p<0.0001) postoperative day. The sum of pain in all measuring days were also significantly less(mean 10.39 versus 16.29, p<0.0001) in the PRK group. CONCLUSION: We concluded that PRK is a more comfortable refractive surgery than LASEK in the aspect of pain.
Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Photorefractive Keratectomy* ; Postoperative Period* ; Prospective Studies ; Refractive Surgical Procedures

PURPOSE: We studied whether the illumination had an influence on the identification of the location of the lacrimal sac and the success rate of endoscopic endonasal dacryocystorhinostomy (DCR). METHODS: Endoscopic endonasal DCR was performed on 85 eyes of 80 patients who had obstruction of nasolacrimal system without illumination. RESULTS: In all patients, identification of the location of the lacrimal sac by detecting the probe tip or the lacrimo-maxillary suture line was accomplished, without illumination. Final success rate was 87.1% in illuminator non-using group. CONCLUSIONS: We considered that endoscopic endonasal DCR without illumination, in the knowledge of lacrimal sac, ethmoid anatomy, and anatomical variations, was a non-invasive, efficient, and satisfactory method.
Dacryocystorhinostomy* ; Humans ; Lighting ; Sutures

Esophageal hematoma is a rare form of esophageal injury. It may occur spontaneously, or in association with direct esophageal damage or a bleeding diathesis. Endoscopy and computed tomography are generally necessary for the establishment of a diagnosis. In this report, we present a case of esophageal hematoma that was discovered via a bedside transthoracic echocardiography. The echocardiography was conducted to evaluate an unexplained shock in a critically ill-patient. After conservative treatment, complete resolution of the esophageal hematoma was documented by a 7-day short-term follow-up of bedside transthoracic echocardiography. To the best of our knowledge, this is the first case report regarding transthoracic echocardiographic detection, differential diagnosis, and follow-up for esophageal hematoma.
Diagnosis ; Diagnosis, Differential* ; Disease Susceptibility ; Echocardiography* ; Endoscopy ; Follow-Up Studies* ; Hematoma* ; Hemorrhage ; Shock

BACKGROUND/AIM: Colonoscopy has been known as the best diagnostic and therapeutic modality for colorectal polyps. However, it has been difficult to assess its accuracy. METHODS: We studied the data from patients who had colonoscopic polypectomy within 30 days after the initial examination. RESULTS: From 218 patients, a total of 362 polyps were found, 51 (14.1%) of which were missed. There were 17 patients with missed polyps among 59 patients who had two or more polyps on the initial examination. According to the location, the missing rates were variable: the splenic and hepatic flexure had the highest missing rates, and the sigmoid colon had the lowest missing rate. In our study, there was no difference of missing rate according to the size and shape. CONCLUSIONS: There is a significant colonoscopic missing rate for colorectal polyps in routine clinical practice, especially in patients with multiple colonic polyps and at the site of the colonic flexure.
Colon ; Colon, Sigmoid ; Colonic Polyps ; Colonoscopy ; Humans ; Polyps*

Castleman's disease or angiofollicular lymph node hyperplasia, is a rare lymphoproliferative disorder. It may be appear as a local or generalized tumor-like condition, usually in chest or abdomen and may involve both lymph nodes and non-nodal tissues. Castleman's disease is an unusal entity which may at times mimic malignancy but is entirely benign in nature. It is topical as it has been noted to occur with AIDS and Kaposi's sarcoma. Careful interpretation of radiogram may help to distinguish Castleman's disease from other tumor condition, such as lymphoma, neurogenic tumor, or even angiofibroma, etc. But exact diagnosis must be made on the basis of histologic confirmation. In addition to histologic features, clinical distinction between the localized and multicentric form is important in selecting appropriate management. Surgical excision of an localized mass is the first choice of treatment. Partial resection, radiotherapy or observation alone may avoid the need for exessively aggressive therapy. Patients with multicentric disease don't benefit by surgical management because of systemic manifestation and rapid deterioration. Thus, antineoplastic agents and steroids may offer an alternative form of therapy. We report a case of female patient with Castleman's disease in oral and maxillofacial region, treated by surgical excision with good results.
Abdomen ; Angiofibroma ; Antineoplastic Agents ; Diagnosis ; Female ; Giant Lymph Node Hyperplasia* ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoproliferative Disorders ; Radiotherapy ; Sarcoma, Kaposi ; Steroids ; Thorax

Pheochromocytoma is a catecholamine producing turnor and raise with less than 0.1% of hypertensive patients. It is developed, most commonly, in sporadic pheochromocytoma or multiple endocrine neoplasia type 2. Therefore, when hypercalcitoninemia is found in a patient with pheochromocytoma, the possibility of multiple endocrine neoplasia type 2 or the ectopic secretion of calcitonin must be considered. Recently we experienced a 45 year old male patient with sporadic pheochrornocytoma. He also had hypercalcitoninemia and normocalcemia. After the removal of pheochromocytoma, serum calcitnnin level returned to normal. Secretion of calcitonin was confirmed by immunohisto- chemical stain.
Calcitonin ; Humans ; Male ; Multiple Endocrine Neoplasia Type 2a ; Pheochromocytoma