Angiocentric lymphoma is a lymphoma like lesion which has been known as a lethal midline granuloma, lymphomatoid granulomatosis and polymorphic reticulosis. It involves predominantly lungs, and other extranodal sites such as upper respiratory tract, skin, kidneys, peripheral nervous system and CNS. The authors experienced a case of angiocentric lymphoma which was misdiagnosed as orbital cellulitis because there were persistent epiphora, erythematous swelling in dacryocyst area and diffuse edema in upper and lower eyelids which occurred after functional endoscopic sinus surgery. This case was diagnosised as angiocentric lymphoma through multiple tissue biopsies. This disease is rare, especially in orbit and eyelid. It leads to the destruction and inflammation of tissue. To avoid misdiagnosis to orbital cellulitis, accurate biopsy is needed with the interchange of clinical informations with pathologist. We report this case with the review of literatures.
Biopsy ; Diagnosis ; Diagnostic Errors ; Edema ; Eyelids ; Granuloma, Lethal Midline ; Inflammation ; Kidney ; Lacrimal Apparatus Diseases ; Lung ; Lymphoma* ; Lymphomatoid Granulomatosis ; Orbit ; Orbital Cellulitis ; Peripheral Nervous System ; Respiratory System ; Skin

Laser photocoagulation was applied in vitro to organ culture exoplants of porcine retinal pigment epithelium(RPE) attached to Bruch's membrane, choroid, and sclera using the Del Priore method for de-monstrating the proliferation of RPE cells and characterizing the response with respect to power level of treatment. Six-millimetor-round buttons of eyewall were treated with 20-30 spots from the argon bluegreen laser using a 500 micrometer spot size, 0.1s duration, and variable powers(100mW, 300mW, and 500mW). Group 1 is untreated control group and group 2(100mW) and group 4(500mW) showed less active proliferation of RPE than group 3(300mW). In group 3, all RPE cells, Bruch's membrane, and a part of choroid were disrupted and lifted off three hours after laser photocoagulation and then RPE cells began to proliferate actively at third day. The treated area became completely covered with several layers of RPE cells. The proliferation of RPE cells turned out to be larger when the power was moderate(300mW) as compared to the case when the power was too high(500mW) or too low(100mW).
Argon ; Bruch Membrane ; Choroid ; Light Coagulation* ; Organ Culture Techniques* ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Sclera

No abstract available.
Biopsy, Fine-Needle* ; Coinfection* ; Liver Abscess, Amebic*

BACKGROUNDS/AIMS: Complete elimination of intrahepatic duct (IHD) stones is difficult and IHD stone disease is frequently associated with various complications, recurrence and sometimes cholangiocarcinoma. Therefore, we analyzed the long-term surgical results and evaluated the management currently considered appropriate. METHODS: Overall 110 patients who had been diagnosed with benign IHD stone disease and who underwent surgical treatment were enrolled in this study. The patients were categorized into three groups according to the type of surgery performed; liver resection (LR) group, intrahepatic duct exploration (IHDE) group and hepaticoenterostomy (HE) group. We compared and analyzed the results of these three groups. RESULTS: The number of cases in the LR group, IHDE group and HE group were 77, 25 and 8 respectively. The LR group required a longer operation time (p=0.000), more frequent transfusion (p=0.028) and had higher morbidity (p=0.049). However, the LR group had a higher clearance rate (90.9%) (p=0.000) than the other groups. In addition, there were a total of 22 cases of IHD stone recurrence during the follow-up, but there was no statistically significant difference among the three groups. The location of IHD stones was related to a risk factor for incomplete stone removal, but not for recurrence. CONCLUSION: The fundamental principle for the treatment of IHD stone disease should be liver resection. However, it can lead to a longer operative time and higher rate of complications than the other procedures. There is also no difference in the IHD stone recurrence rate among the procedures. Therefore, these alternative and minor procedures could also be taken into account for patients with poor preoperative condition.
Cholangiocarcinoma ; Follow-Up Studies ; Humans ; Liver ; Operative Time ; Recurrence ; Risk Factors

PURPOSE: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. METHODS: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. RESULTS: Among 292 newborns with a gestational age of 35.2±3.0 weeks and a birth weight of 2,428±643 g, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. CONCLUSION: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.
Anti-Bacterial Agents ; Bacterial Infections ; Birth Weight ; C-Reactive Protein ; Diagnosis ; Dyspnea ; Gestational Age ; Humans ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Parturition ; Premature Birth ; Sepsis ; Ventilators, Mechanical

PURPOSE: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. METHODS: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. RESULTS: Among 292 newborns with a gestational age of 35.2±3.0 weeks and a birth weight of 2,428±643 g, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. CONCLUSION: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.
Anti-Bacterial Agents ; Bacterial Infections ; Birth Weight ; C-Reactive Protein ; Diagnosis ; Dyspnea ; Gestational Age ; Humans ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Parturition ; Premature Birth ; Sepsis ; Ventilators, Mechanical

Optic disc neovascularization is known to occur in occlusive vascular diseases or chronic posterior inflammatory conditions. It has been recently reported to occur in chronic anterior uveitis. The authors treated a patient with optic disc neovascularization associated with chronic anterior uveitis with topical and systemic steroid administration. The authors present our experience of optic disc neovascularization in chronic anterior uveitis with a brief review of the literatures related to this disease.
Humans ; Uveitis ; Uveitis, Anterior* ; Vascular Diseases

Cowden syndrome is a rare autosomal dominant disorder characterized by mucocutaneous alterations including multiple facial trichilemmomas, oral mucosal papillomatosis, and acral keratoses. Extracutaneous lesions include polyposis of the gastrointestinal tract, and other multiple hamartoma of the internal organs. A 39 year-old man presented with multiple verruca-like papules and lichenified patches on the face, one year ago. He had been treated for atopic dermatitis for more than 10 years. Although he had been treated in accordance with atopic dermatitis for 1 year, his skin lesions had not improved, so a skin biopsy was performed. The skin biopsy specimen revealed the typical finding of trichilemmoma. Colonoscopy diagnosed diffuse colorectal polyposis. The clinical and hisopathologic findings were consistent with Cowden syndrome. We, herein, report a case of Cowden syndrome with atopic dermatitis.
Adult ; Biopsy ; Colonoscopy ; Dermatitis, Atopic ; Gastrointestinal Tract ; Hamartoma ; Hamartoma Syndrome, Multiple* ; Humans ; Keratosis ; Papilloma ; Skin

Dermatomyositis is a rare disease of unknown origin that combines an inflammatory myopathy with characteristic cutaneous findings. Scalp disease has rarely been considered as a manifestation of dermatomyositis and is often misdiagnosed as being scalp paosiasis or seborrheic dermatitis. We report a case of 27-year-old woman who presented with brownish alopecic patches on the scalp, and chronic proximal muscle weakness.
Adult ; Cicatrix* ; Dermatitis, Seborrheic ; Dermatomyositis* ; Female ; Humans ; Muscle Weakness ; Myositis ; Rare Diseases ; Scalp

Lichenoid drug eruption is a lichenoid skin eruption caused by certain drugs and compounds, and can be similar to lichen planus. A 51-year-old man who had taken antihypertensive drugs (enalapril, dilazep dihydrochloride) and cholesterol lowering drug (atorvastatin) for 4 years had received allopurinol for asymptomatic hyperuricemia for 4 months. He developed pruritic erythematous papules and plaques with silvery scales on the face, trunk and extremities after taking allopurinol for 3 months. He had no fever, no eosinophilia and no systemic abnormalities. Histopathologic findings showed hyperkeratosis, parakeratosis, hypergranulosis, band-like lymphohistiocytic infiltration and perivascular lymphohistiocytic infiltration in the dermis, which were compatible with lichenoid drug eruption. The skin rashes disappeared after he stopped taking allopurinol and was treated with steroids.
Allopurinol ; Antihypertensive Agents ; Cholesterol ; Dermis ; Dilazep ; Drug Eruptions ; Enalapril ; Eosinophilia ; Exanthema ; Extremities ; Fever ; Humans ; Hyperuricemia ; Lichen Planus ; Middle Aged ; Parakeratosis ; Skin ; Steroids ; Weights and Measures