The authors experienced a case of falciform retinal fold which occurred congenitally in the right eye of a 13 years old Korean female. This was situated in the inferior nasal quadrant in the extreme periphery of the retina and was associated with abnormal shape and position of disc and macula without foveal reflex. Visual acuity of right eye was 20/50 and refractive error was not present. We described the characteristic fundus findings of this case with brief review of relating literature.
Adolescent ; Female ; Humans ; Reflex ; Refractive Errors ; Retina ; Retinaldehyde* ; Visual Acuity

Paragangliomas are rare among intradural spinal tumors. Most of them are benign, but aggressive behavior and local recurrence can occur. Cases of paraganglioma are, difficult to diagnose radiologically; hence, diagnosis is confirmed histopathologically. Radiologically, paragangliomas are similar to ependymomas, and, histopathologically, they are similar to neuroendocrine tumors. We evaluated the case of a 76-year-old woman with a spinal paraganglioma that was associated with back pain and radiating pain in both the lower extremities. She underwent an operation, and her symptoms were relieved. Here, we describe a rare case of paraganglioma that was adherent to the cauda equina.
Aged ; Back Pain ; Cauda Equina* ; Diagnosis ; Ependymoma ; Female ; Humans ; Lower Extremity ; Neuroendocrine Tumors ; Paraganglioma* ; Recurrence

Intravenous leiomyomatosis is a rare neoplasm characterized by intravenous growth of histologically benign smooth muscle cell tumor. We report a case of intravenous leiomyomatosis with right atrial extension in a 19-year-old woman. Various surgical techniques and approaches have been previously reported. In this case, the tumor was removed with a single-stage approach via laparotomy without cardiopulmonary bypass.
Cardiopulmonary Bypass ; Female ; Heart Atria* ; Humans ; Laparotomy ; Leiomyomatosis* ; Myocytes, Smooth Muscle ; Vascular Neoplasms ; Young Adult

OBJECTIVE: The purpose of this study was to analyze the clinical manifestations, radiological findings, treatment results, and clinical significance of post-traumatic syringomyelia (PTS). METHODS: We retrospectively reviewed the medical charts of nine surgical patients with symptomatic PTS between 1992 and 2012. RESULTS: The most common clinical manifestation was development of new motor weakness. The mean interval between the initial injury and the onset of new symptoms 21.9 years. The mean length of the syringes observed on preoperative magnetic resonance images was 7.8 spinal levels. Shunting procedures were performed in five patients. Four patients underwent arachnoidolysis and duraplasty. Patients developed mechanical shunt failure. Postoperatively, one patient showed clinical improvement, four patients were stable, and four patients showed deterioration. CONCLUSION: PTS is a disabling sequelae of spinal cord injury, which develops months to years after spinal injury. We have to consider that patients with PTS may have poor long-term outcome.
Humans ; Retrospective Studies ; Spinal Cord Injuries ; Spinal Injuries ; Syringes ; Syringomyelia*

Alveolar soft-part sarcoma(ASPS) is a rare, aggressive malignancy of uncertain histologic origin with a propensity for vascular invasion and distant metastasis. ASPS may mimic benign vascular neoplams of malformation but careful evaluation of the unique imaging features on CT scans, MR images, and angiograms lead to the correct diagnosis. ASPS of the tongue is slow-growing, painless mass, especially ASPS of the base the tongue is difficult to be noticed by patient, dentists or oral and maxillofacial surgeons on oral examintion because of its location and clinical resemblance to a benign lesion. And it leads to delayed or inadequate diagnosis. We report radiologic and clinical features of an ASPS of the basal portion of the tongue in a 17-year-old boy, showing normal appearance, but palpation of the tongue and floor of the mouth reveals the tumor. Among the 23 cases of a primary ASPS of tongue reported, 7 cases occured on the basal region of the tongue, inculding the present one. There has been no recurrence or metastasis as of 3 years postoperatively.
Adolescent ; Dentists ; Diagnosis ; Humans ; Male ; Mouth ; Neoplasm Metastasis ; Palpation ; Recurrence ; Sarcoma, Alveolar Soft Part* ; Tomography, X-Ray Computed ; Tongue* ; Viperidae

BACKGROUND: Diabetic neuropathy is one of the most common neuropathies. Although pathologic studies show both segmental demyelination and axonal loss in diabetic neuropathy, the relative importance of segmental demyelination is debated. Conduction block (CB) is a physiologic hallmark of segmental demyelination. If segmental demyelination were a main pathology of diabetic neuropathy, CB should be common. We undertook this study to determine the prevalence of CB in diabetic patients. METHODS: Fifty-two consecutive diabetic patients (M=30, F=22) were referred to EMG laboratory and underwent routine nerve conduction studies (NCS). CB was defined by two methods. One was > 20% drop in peak-to-peak amplitude and < 15% change in negative-peak duration between proximal and distal stimulation sites. The other was > 50% drop in the amplitude and area. Clinical findings, electrophysiological data, and effectiveness of immunomodulating therapy for some patients with CB were reviewed. RESULTS: A total 326 nerves were studied. The criteria for 20% and 50% CB were met in 35 nerves in 19 patients and 7 nerves in 6 patients, respectively (prevalence=10.7%, 2.1%, respectively). Some patients with CB were treated with IVIG or steroid and had a good response. CONCLUSIONS: CB in diabetic neuropathy is not a common finding. The rarity of CB in diabetic neuropathy suggests that segmental demyelination is not a prominent part of the underlying pathology. The presence of CB and good responsiveness to immunomodulating therapy in diabetic neuropathy also suggest alternative or additional causes for neuropathy, such as chronic inflammatory demyelinating polyneuropathy.
Axons ; Demyelinating Diseases* ; Diabetes Mellitus ; Diabetic Neuropathies* ; Humans ; Immunoglobulins, Intravenous ; Neural Conduction ; Pathology ; Polyneuropathies ; Prevalence

OBJECTIVE: Vertebroplasty is an effective treatment for vertebral compression fracture, but may progress gradual vertebral height decrease in spite of vertebroplasty. Gradual vertebral height decrease also may induce aggravation of kyphotic change without severe pain. The purpose of this study was to evaluate risk factors for gradual vertebral height decrease in the absence of recurrent severe back pain. METHODS: A retrospective analysis was performed on 44 patients who were diagnosed with a first osteoporotic compression fracture at a single level at the thoracolumbar junction. All patients were taken vertebroplasty. Possible risk factors for gradual vertebral height decrease, such as sex, age, bone mineral density, body mass index, level of compression fracture, volume of injected cement, cement leakage into disc space, and air clefts within fractured vertebrae, were analyzed. RESULTS: Gradual vertebral height decrease of augmented vertebrae occurred commonly when more than 4 cc of injected cement was used, and when air clefts within fractured vertebrae were seen on admission. In addition, the sagittal Cobb angle more commonly increased during the follow-up period in such cases. CONCLUSION: Injection of more than 4 cc of cement during vertebroplasty and air cleft within fractured vertebrae on admission induced gradual vertebral height decrease in augmented vertebrae. Thus, longer follow-up will be needed in such cases, even when patients do not complain of recurrent severe back pain.
Back Pain ; Body Mass Index ; Bone Density ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphosis ; Retrospective Studies ; Risk Factors ; Spine* ; Vertebroplasty*

PURPOSE: To evaluate the prognostic factors to determine the uncorrected near visual acuity of patients who undergone routine cataract surgery and WIOL-CF(R) (Gelmed international, Kamenne Zehrovice, Czech Republic) accommodative intraocular lens implantation. METHODS: This study evaluated 46 eyes of 27 patients who had undergone routine cataract surgery and WIOL-CF(R) accommodative IOL implantation. We checked visual acuities at near and distant before surgery. And we also checked age and gender of patients and manifest refraction, corneal astigmatism and axial length of eyes at that time. We analyzed association between these factors and uncorrected near visual acuity at postoperative 6 and 12 month. RESULTS: Univariate linear regression analyses between uncorrected near visual acuity and preoperative patients characteristics suggested that the age of patients was the only statistically significant independent variable on uncorrected near visual acuity at postoperative 6 (p < 0.001) and 12 (p < 0.001) month. Multiple regression analyses also revealed the same results (p = 0.021 at postoperative 6 month and p = 0.042 at postoperative 12 month). CONCLUSIONS: This study suggest that the age is the one of the most important prognostic factors of postoperative uncorrected near visual acuity after WIOL-CF(R) accommodative intraocular lens implantation.
Astigmatism ; Cataract ; Eye ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Linear Models ; Vision, Ocular ; Visual Acuity

BACKGROUND: Uncomplicated myocardial infarction is often the harbinger of future cardiac events such as unstable angina pectoris,recurrent myocardial infarction or death. The feasibility and safety of exercise testing performed soon after myocardial infarction have been established but the prognostic value of exercise test after myocardial infarction remain inconclusive. The object of this study is to determine whether exercise test results can be utilized to predict of future cardiac events after uncomplicated myocardial infarction. METHODS: The study group comprised 149 patients with an uncomplicated myocradial infarction. A low level exercise test was performed before discharge from the hospital 8 to 10 days after myocardial infarction. The exercise thst results was considered positive if there was new > or =1mm horizontal or downsloping ST segment depression at 0.08 sec after the J point compared with baseline. The patients were followed for the development of new cardiac events. RESULTS: 1) The exercise test after acute myocardial infarction was performed in 149 patients without complication. The mean duration of exercise test was 14 min(range 1-20 min) and the mean work-load(Metabolic equivalents) was 3.7+/-1.1 METs. 2) 37 patients had ST-segment depression, 13 had ST-segment elevation and 27 had an inadequate blood pressure response to exercise. During the exercise, there were angina in 5 patients, dyspnea in 17 and no symptom in 127 patients. 3) During the follow-up period(1 to 75 month, mean 27.4 month), 29 patients experienced post-myocardial infarction angina, 1 had recurrent myocardial infarction, 4 had revascularization therapy(PTCA 2, CABG 2),5 had ischemic cardiomyopathy and 5 died a cardiac death. 4) The patients with cardiac events such as cardiac death, myocardial infarction and post MI angina had a significantly shorter exercise duration(13.1+/-4.0 and 14.6+/-2.7min, p<0.05), lower exercise tolerance(3.5+/-1.0 and 3.9+/-1.0 METs, p<0.05) and lower peak heart rate(117 +/- and 126+/-5, p<0.05). 5) The ST-segment depression, lower exercise tolerance(<3.0 METs) and history of hypertension were associated significantly with cardiac events(p<0.05) but ST-segment elevation, inadequate blood pressure response to exercise, the use of thrombolytic agents and non-Q wave infarction did not predict future cardiac events. Conclusions: The exercise test after acute myocardial infarction is safe and of limited value for predicting patients at risk of cardiac events in the follow-up period. The ST-segment depression and lower exercise tolerance(<3.0 METs) can predict cardiac events and the prognosis of the patients of this group can be improved with aggressive management and careful follow-up.
Angina, Unstable ; Blood Pressure ; Cardiomyopathies ; Death ; Depression ; Dyspnea ; Exercise Test* ; Fibrinolytic Agents ; Follow-Up Studies ; Heart ; Humans ; Hypertension ; Infarction ; Myocardial Infarction* ; Prognosis