Verrucous hemangioma is a variant of a capillary, cavernous, or mixed hemangioma which undergoes a reactive proliferative epidermal change. Most verrucous hemangiomas appear on the lower extremities, and most are present at birth or appear during childhood. We observed two patients who showed typical clinical and histopathological findings of verrucous hemangioma. Treatment was done by wide surgical excision and skin graft. The first rnale patient had a good therapeutic result but the second female patient had a recurrence at one month post-operative.
Capillaries ; Female ; Hemangioma* ; Humans ; Lower Extremity ; Parturition ; Recurrence ; Skin ; Transplants

PURPOSE: We succesfully treated two patients for phlyctenular keratoconjunctivitis which had recurrent episode or was not respond to steroid therapy, with oral tetracycline. METHODS: A 20-year-old girl (Case 1) was referred here because of a two-year history of recurrnet episode of phlyctenular keratoconjunctivitis. There was small pinkish nodule, about 2mm in diameter, and adjacent conjunctival injection in the temporal limbus in her left eye. Corneal opacity and superficial corneal vascularization was located inferiorly. A 12-years-old girl (Case 2) had been followed for 1 years with a recurrent vascularized corneal lesion and infiltration in the right eye. Cultures of the conjunctiva and eyelids were obtained. RESULTS: In case 1, topical steroid treatment led to some improvement but it was only temporarily. She was treated with oral tetracycline at an initial dose of 250mg three times daily for 3 weeks followed by 250mg once daily for 3 weeks. In case 2, doxycycline 100mg twice daily for 2 weeks and tapered 10mg once daily for 3 weeks. All patients experienced rapid relief of symptoms and long term remission of their disease after oral tetracycline or doxycycline treatment. CONCLUSIONS: Oral tetracycline treatment is safe and effective treatment for resistant and recurrent phlyctenular keratoconjunctivitis. In children younger than 10 years of age, doxycycline shluld be recommended alternatively because tetracycline can discolor the teeth.
Child ; Conjunctiva ; Corneal Opacity ; Doxycycline ; Eyelids ; Female ; Humans ; Keratoconjunctivitis* ; Tetracycline* ; Tooth ; Young Adult

PURPOSE: The present study compares, using a new generation high-resolution in vivo confocal microscope, the corneas of patients who underwent photorefractive keratectomy (PRK) 10 years previously with those of healthy persons. CASE SUMMARY: A confocal microscope (Confoscan 4.0, Fortune Technology, Italy) was used to get the data from healthy volunteers and patients. Corneal cross-sectional images of the epithelium, Bowman's layer, stromal layer (anterior, middle and posterior keratocyte), Descemet's membrane, and endothelium were compared. In PRK corneas, the superficial epithelium was nearly intact and the subbasal nerve plexus was visible, but some hyperreflective areas were also found in the nerve plexus. Because of the absence of the Bowman's layer, some ECM and keratocytes were visualized in their optical section. Although anterior keratocytes showed uneven distribution with less cellularity, middle and posterior keratocytes looked unaffected. Likewise, there were no differences in the endothelium between the two groups. CONCLUSIONS: Ten years after PRK, the subbasal nerve plexus and anterior keratocytes showed histologic changes after corneal wound recovery.
Cornea ; Dental Porcelain ; Descemet Membrane ; Endothelium ; Epithelium ; Humans ; Microscopy, Confocal ; Photorefractive Keratectomy

Purpose: The purpose of this study was to evaluate the incidence of deep vein thrombosis (DVT) after various types of knee surgery and to identify patients at high risk. Materials and Methods: This retrospective was conducted using the medical records of knee surgeries conducted by one surgeon at Gachon University Gil Medical Center between May 2019 and December 2020. The occurrence of DVT was determined by venous ultrasonography 4 to 6 days after surgery, and the incidence of DVT was determined for arthroscopic ligament surgery, arthroscopic meniscus surgery, arthroplasty, and osteotomy. Patients diagnosed with DVT were treated with a pharmacological agent for 3 months, and DVT was reevaluated by Doppler sonography at 3 months postoperatively. Results: Among a total of 221 cases, 75 cases (33.9%) were diagnosed with DVT. The incidence of DVT was significantly dependent on type of surgery, that is, anterior cruciate ligament surgery (ACL) 29.4%, meniscus surgery 30.2%, artroplasty 33.3%, and osteotomy 52.4%. In 60 of the 75 cases, DVT was successfully managed without complication by pharmacologic treatment. On the other hand, in 3 cases, pharmacologic treatment was stopped due to side effects. The other 15 cases were managed conservatively. A significant correlation was found between tourniquet application and incidence of DVT, and in the arthroplasty group, age and DVT were significantly correlated. However, surgical time was not correlated with DVT. Conclusion The incidence of DVT after knee surgery is significantly dependent on type of surgery. We believe that the absence of any severe complication, such as systemic or pulmonary embolism, related to DVT was due to early detection and adequate pharmaceutical management. Furthermore, we recommend that tourniquet not to be applied to patients at high risk of DVT.

PURPOSE: To evaluate retinal damage following internal limiting membrane (ILM) peeling in macular hole and diabetic macular edema (DME) surgeries. METHODS: Forty-five eyes with macular holes and thirty-five eyes with DME underwent pars plana vitrectomy with ILM peeling. The structures of the ILM were investigated using transmission electron microscopy, and the grades of retinal tissue damage were analyzed. We additionally observed the clinicopathologic association of retinal damage with the development of retinal hemorrhage during ILM peeling and that seen with indocyanine green (ICG) staining. RESULTS: In all specimens, cellular fragments were observed on the retinal side of the ILM in both macular hole and DME patients. The thickness of the ILM in DME significantly increased (3.13+/-1.12 micrometer compared with that in patients with macular holes (2.41+/-0.77 micrometer, p=0.002). The frequency of minute retinal bleeding during ILM peeling was higher in macular hole patients (46.7%) than in those with diabetic macular edema (22.9%m p=0.028). Twenty-two eyes of 45 macular hole patients (48.9%) and 16 eyes of 35 DME patients (45.7%) had relative retinal damage. Overall, ILM performed in eyes which had minute bleeding during the peeling had more retinal damage (62.1%) than did those without hemorrhage (39.2%, p=0.049). ICG staining did not appear to influence retinal damage (p=0.81). CONCLUSIONS: ILM peeling can cause minor, but demonstrable, damage of the adjacent retina.
Eye ; Hemorrhage ; Humans ; Indocyanine Green ; Macular Edema ; Membranes ; Microscopy, Electron, Transmission ; Retina ; Retinal Hemorrhage ; Retinal Perforations ; Retinaldehyde ; Vitrectomy

PURPOSE: This study evaluated the differences of intraocular pressure (IOP), corneal thickness, and corneal endothelial morphology compared with age-matched, healthy control subjects, as well as the correlation according to the duration of diabetes. METHODS: Goldmann applanation tonometry, ultrasound pachymetry, and non-contact specular microscopy were performed in 200 patients with diabetes and 100 control subjects. RESULTS: The diabetic subjects had higher IOP, thicker cornea and less cell density, less hexagonality, and more irregular cell size of corneal endothelium than the controls (P<0.05). Central corneal thickness and coefficient of variation in cell size were higher in diabetes of over 10 years duration than in diabetes of under 10 years duration (P<0.05), while endothelial cell density and percentage of hexagonal cells were lower in the diabetes of over 10 years group (P<0.05). Central corneal thickness was correlated with duration of diabetes but IOP and corneal endothelial morphologic characteristics were not. CONCLUSIONS: Especially, those with a diabetes duration of over 10 years have more corneal morphological abnormalities and a higher IOP than normal subjects. Therefore, any surgical procedures should be performed carefully in the diabetic cornea that is easily damaged by, for example, phacoemulsification.
Cell Count ; Cell Size ; Cornea ; Endothelial Cells ; Endothelium, Corneal* ; Humans ; Intraocular Pressure* ; Manometry ; Microscopy ; Phacoemulsification ; Ultrasonography

Myoepitheliomas are well-established to occur in the salivary glands, but they have also been described in the breast, upper aerodigestive tract, skin, and soft tissues. We report here on a unique case of primary myoepithelioma that occurred in the right testis of a 28-year-old man. The tumor was entirely confined to the testis and it was clearly separated from the epididymis. Histopathology revealed mixed architectural patterns in which the reticular areas merged into the chondromyxoid stroma. The tumor cells, which were focally immunoreactive to pancytokeratin and S-100 protein, were round to ovoid and spindly arranged in cords, strands, and fascicles. They showed mild nuclear pleomorphism, sparse mitotic figures and a low Ki-67 proliferative index. There was no ductal differentiation in the tumor. To the best of our knowledge, there has been only one case report of a primary testicular myoepithelioma in the English medical literature.
Adult ; Breast ; Epididymis ; Humans ; Male ; Myoepithelioma ; S100 Proteins ; Salivary Glands ; Skin ; Testis

PURPOSE: Surgical excision has been the primary treatment for hepatoblastoma and hepat-ocellular carcinoma. However, at presentation, only one third of such tumors are surgically resectable. Without operation, the disease is fatal. Therefore, neoadjuvant chemotherapy has been introduced for conversion of the unresectable tumors into the resectable ones. We studied th e effects of chemotherapy for hepatic malignancy in children. METHODS: Between November 1986 and August 1993, 30 children presented with hepatoblastomas or heptocellular carcinoma, which were diagnosed by histology. We analysed the laboratory findings of hepatic tumors and the outcome of chemotherapy. RESULTS: Laboratory findings revealed mild anemia, elevated SGOT/SGPT, and extremely increased AFP level. Twenty-six among 30 patients entered into surgery or neoadjuvant chemotherapy. Initial complete resection of tumor was attempted in 11 case, and was successful in 9 cases. Fifteen cases with initially unresectable tumors were treated with chemotherapy including cisplatin and/or doxorubicin. Nine of 15 showed significant reduction in tumor size, and delayed resection of the primary lesion was possible. But one case did not respond to chemotherapy, and 5 cases was droped out due to death(n=2) and refusal of chemotherapy(n=3). Twenty p atients were enrolled in survival analysis. Over-all 3 year survival rate was 61%, and 2 year survival rates of hepatoblastoma and hepatocellular carcinoma were 85% and 33% respectively(P=0.06). According to the stage, 2 year survival rate of stage I and III were 87% and 75% respectively. None of patient with metastasis survived at 16 months. Chemotherapy was tolerable in most patients and its principal toxicities were myelosuppression and fever. Three patients developed decreased left ventricular shortening fraction and their cumulative dose of doxorubicin were 771mg/m2, 557mg/ m2, and 390mg/ m2. CONCLUSIONS: Chemotherapy including cisplatin and/or doxorubicin is an effective treatment in inducing surgical resectability in hepatoblastomas which are unresectable at diagnosis.
Anemia ; Carcinoma, Hepatocellular* ; Child* ; Cisplatin ; Diagnosis ; Disulfiram ; Doxorubicin ; Drug Therapy* ; Fever ; Hepatoblastoma* ; Humans ; Neoplasm Metastasis ; Survival Rate

PURPOSE: To compare the clinical outcome of silicone tube intubation according to the tie methods. METHODS: Eighty-eight eyes of 87 patients who underwent silicone tube intubation were divided into two groups based on the tie method: a silicone silastic sheet group (Group 1, n=59) and a nylon 6-0 suture knot group (Group 2, n=29). The two groups were compared according to their success rates, recurrence rates and complications. RESULTS: No significant difference was found in the success rate between the two groups (83.0% in Group 1 and 82.7% in Group 2). However, Group 2 showed a significantly higher rate of postoperative complications than Group 1. In Group 1, 5/59 (8.4%) eyes had ocular irritation, 2/59 (3.4%) eyes exhibited tube prolapse, conjunctivitis, corneal erosion, and dacryocystitis and 1/69 (1.6%) eyes had a punctal slit after intubation. In Group 2, 3/29 (10.3%) eyes had ocular irritation, 2/29 (6.9%) eyes exhibited tube prolapse, conjunctivitis, a punctal slit, and dacryocystitis, and 1/29 (3.4%) eyes showed corneal erosion, or a granuloma after intubation. A recurrence of symptomatic tearing was found in 6/59 (10%) eyes in Group 1 and 3/29 (10%) in Group 2. CONCLUSIONS: In silicone tube intubation of incomplete NLD obstruction, the usage of silicone silastic sheets to tie both ends of the silicone tube produced a lower complication rate and a higher success rate than that of the suture knot group. Lower tension on the nasolacrimal passage in the silicone silastic sheet group allows for a significantly lower rate of punctal slit development. Therefore, the method of using silicone silasitic sheets can be considered useful in the treatment of NLD obstruction.
Conjunctivitis ; Dacryocystitis ; Dimethylpolysiloxanes ; Eye ; Granuloma ; Humans ; Intubation ; Nasolacrimal Duct ; Nylons ; Postoperative Complications ; Prolapse ; Recurrence ; Silicones ; Sutures

No abstract available.
Acute Kidney Injury* ; Cholesterol* ; Coronary Angiography* ; Embolism, Cholesterol*