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

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 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: The purpose of this study was to evaluate the effect of anti-inflammatory mediators like dexamethasone, nordihyroguaratic acid (NDGA), and diclofenac sodium on proliferation of human corneal keratocytes, and to investigate the cellular morphology of keratocyte. METHODS: Human corneal keratocytes were exposed to 0.05, 0.1, 0.3, 0.8, and 1.0 mM concentration of each drug for period of 24, 48, and 72 hours. MTT based colorimetric assay was performed to assess the metabolic activity and inhibition of cellular proliferation. Cellular morphology was evaluated by inverted phase contrast micrograph and electron microscopy. RESULTS: The higher the concentration of inoculated each drugs was, the more the inhibitory effect of human keratocyte proliferation was found (P<0.05). NDGA, over 0.3 mM and diclofenac, more than 0.1 mM had significant more inhibitory effect on keratocyte proliferation compared with dexamethasone within 48 hours of exposure to each drug. With the concentration and exposure time of each drug, human corneal keratocytes were visible more rounded and swollen rather than spindle shape, and detached from the bottom of the dish. The damaged keratocytes had degenerative changes like cellular membrane disruption, microvilli disappearance, enlarged rough surfaced endoplasmic reticulum and mitochondria, vacuole formation and nuclear membrane damage by TEM. CONCLUSIONS: On basis of this study, the anti-inflammatory mediators such as NDGA and diclofenac sodium have less side effects and stronger inhibitory effects of human keratocyte proliferation than dexamethasone.
Cell Proliferation ; Corneal Keratocytes* ; Dexamethasone ; Diclofenac ; Endoplasmic Reticulum ; Humans* ; Membranes ; Microscopy, Electron ; Microvilli ; Mitochondria ; Nuclear Envelope ; Vacuoles

PURPOSE: To analyze localized RNFL defect cases that were identified in retinal nerve fiber layer (RNFL) fundus photographs but not in optical coherence tomography (OCT). METHODS: Analysis of OCT scans and images was performed for 14 eyes (17 locations) that showed localized RNFL defects in RNFL fundus photographs but not in RNFL thickness average analysis. RESULTS: With respect to the range of RNFL defects, 41.2% were less than 10degrees, 47.0% were 11 to 20degrees, and 11.8% were 21 to 30degrees. In 71.4% of the RNFL cases the defects were less than 10degrees and the decrease of RNFL thickness was not readily observable on the OCT scan images. In all cases of RNFL defects in the 11 to 30degrees range the decrease in RNFL thickness could be assessed on the OCT scan images. Nonetheless, the decrease of RNFL thickness could not be seen on the OCT analysis images in which the results of the RNFL thickness made through an automated computer algorithm were displayed. CONCLUSIONS: The range of localized RNFL defects that were difficult to detect with OCT consisted of those cases that were almost less than 20degrees. The limitations of the OCT scan itself in patients with RNFL with an angular width defect less than 10degrees and the problems of RNFL thickness analysis processing in patients with an angular width of 11 to 30degrees may decrease the sensitivity of OCT in diagnosing RNFL defects.
Eye ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence

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

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

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