No abstract available.
Paget's Disease, Mammary*

A case of myositis ossificans progressiva is reported. The patient, a 22-year -old progressive ossification for 16 years with severe motion limitation. Bone CT and MRI, bone scanning and muscle biopsy showed multiple ossifying lesions in the connective tissue. All labolatory findings are normal. But serum alkaline pbosphatase become worse with disodium etidronate(EHDP) therapy. The case is presented with the review of literatures.
Biopsy ; Connective Tissue ; Humans ; Magnetic Resonance Imaging ; Myositis Ossificans* ; Myositis*

Since the first description of arteriovenous fistula (AVF) secondary to lumbar disc surgery by Linton and White in 1945, many cases of the accidental injury to the great vessels anterior to the lumbar area have been reported. We experienced a unique case of AVF between the internal iliac artery and internal iliac vein following disc surgery. Diagnosis of traumatic AVF in a patient with multiple varicose dilatation of vein in the left thigh and inguinal area was heralded by the presence of unique, unusual arterial signals in the area of dilated veins during the leg Doppler scan. 3D-CT angiography clearly confirmed the presence of a fistular tract between the internal iliac artery and vein. Using the Seldinger technique, a PTFE stent graft was inserted into the internal iliac artery to cover the fistular site nonsurgically. After the procedure, venous dilatation decreased and the patient felt comfortable. Follow-up 3D-CT angiography one month after procedure showed complete obliteration of fistuar tract and patent blood flow through PTFE stent graft in the internal iliac artery.
Angiography ; Arteriovenous Fistula* ; Blood Vessel Prosthesis* ; Diagnosis ; Dilatation ; Follow-Up Studies ; Humans ; Iliac Artery ; Iliac Vein ; Leg ; Polytetrafluoroethylene* ; Stents* ; Thigh ; Veins

PURPOSE: To report a case series of patients experiencing side effects of 0.25% alcaftadine eye drops and to analyze the possible reasons for the side effects. CASE SUMMARY: Medical records of 90 patients who had a history of alcaftadine eye drop use were retrospectively analyzed. Eight out of the 90 patients (8.9%) showed ocular side effects that required discontinuation of the alcaftadine eye drops. All eight cases of alcaftadine side effects showed palpebral and bulbar conjunctival injection, watery discharge, and lid swelling. During additional history collection, all patients with alcaftadine side effects confessed of overuse (more than twice/day) of the eye drops. Anticipation for fast symptom relief was the main reason for the alcaftadine overuse. In all side effect cases, patients were asked to stop alcaftadine eye drops and use preservative-free artificial tears and steroid eye drops. After discontinuation of 0.25% alcaftadine eye drops, regression of palpebral and bulbar conjunctival injection and lid swelling was observed. CONCLUSIONS: Overuse of 0.25% alcaftadine eye drops can induce ocular surface toxicity possibly due to toxicity of drug itself. The possible side effects of overuse of 0.25% alcaftadine eye drops should be fully explained to all patients before use.
Conjunctivitis ; Humans ; Hypersensitivity ; Lubricant Eye Drops ; Medical Records ; Ophthalmic Solutions ; Retrospective Studies

PURPOSE: Recently, the use of radiosurgery as a local therapy in patients with early stage non-small cell lung cancer has become favored over surgical resection. To evaluate the efficacy of radiosurgery, we analyzed the results of stereotactic body radiosurgery in patients with primary or recurrent non-small cell lung cancer. MATERIALS AND METHODS: We reviewed medical records retrospectively of total 24 patients (28 lesions) with non-small cell lung cancer (NSCLC) who received stereotactic body radiosurgery (SBRT) at Inha University Hospital. Among the 24 patients, 19 had primary NSCLC and five exhibited recurrent disease, with three at previously treated areas. Four patients with primary NSCLC received SBRT after conventional radiation therapy as a boost treatment. The initial stages were IA in 7, IB in 3, IIA in 2, IIB in 2, IIIA in 3, IIIB in 1, and IV in 6. The T stages at SBRT were T1 lesion in 13, T2 lesion in 12, and T3 lesion in 3. 6MV X-ray treatment was used for SBRT, and the prescribed dose was 15~60 Gy (median: 50 Gy) for PTV1 in 3~5 fractions. Median follow up time was 469 days. RESULTS: The median GTV was 22.9 mL (range, 0.7 to 108.7 mL) and median PTV1 was 65.4 mL (range, 5.3 to 184.8 mL). The response rate at 3 months was complete response (CR) in 14 lesions, partial response (PR) in 11 lesions, and stable disease (SD) in 3 lesions, whereas the response rate at the time of the last follow up was CR in 13 lesions, PR in 9 lesions, SD in 2 lesions, and progressive disease (PD) in 4 lesions. Of the 10 patients in stage I, one patient died due to pneumonia, and local failure was identified in one patient. Of the 10 patients in stages III-IV, three patients died, local and loco-regional failure was identified in one patient, and regional failure in 2 patients. Total local control rate was 85.8% (4/28). Local recurrence was recorded in three out of the eight lesions that received below biologically equivalent dose 100 Gy10. Among 20 lesions that received above 100 Gy10, only one lesion failed locally. There was a higher recurrence rate in patients with centrally located tumors and T2 or above staged tumors. CONCLUSION: SBRT using a CyberKnife was proven to be an effective treatment modality for early stage patients with NSCLC based on high local control rate without severe complications. SBRT above total 100 Gy10 for peripheral T1 stage patients with NSCLC is recommended.
Carcinoma, Non-Small-Cell Lung ; Follow-Up Studies ; Humans ; Lung ; Medical Records ; Pneumonia ; Radiosurgery ; Recurrence ; Retrospective Studies

A 36-year-old woman was diagnosed with anaplastic large cell lymphoma (ALCL) by excisional biopsy of a left frontal skin lesion. During the first cycle of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient complained of right ocular pain and inflammation. Cytologic examination using aqueous humor revealed atypical lymphocytes, suggesting intraocular ALCL involvement. Acute angle closure developed in the anterior chamber due to rapid progression of ALCL, causing pupillary block. Laser and surgical interventions were attempted but failed to relieve the pupillary block. Finally, radiation therapy resolved the pupillary block to restore the anterior chamber and normalize intraocular pressure. This is the first case in the English literature of ALCL involving the iris to cause acute secondary angle closure.
Adult ; Anterior Eye Segment/*pathology ; Biopsy ; Diagnosis, Differential ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic/*diagnosis ; Magnetic Resonance Imaging ; *Neoplasm Invasiveness ; Positron-Emission Tomography

A 36-year-old woman was diagnosed with anaplastic large cell lymphoma (ALCL) by excisional biopsy of a left frontal skin lesion. During the first cycle of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient complained of right ocular pain and inflammation. Cytologic examination using aqueous humor revealed atypical lymphocytes, suggesting intraocular ALCL involvement. Acute angle closure developed in the anterior chamber due to rapid progression of ALCL, causing pupillary block. Laser and surgical interventions were attempted but failed to relieve the pupillary block. Finally, radiation therapy resolved the pupillary block to restore the anterior chamber and normalize intraocular pressure. This is the first case in the English literature of ALCL involving the iris to cause acute secondary angle closure.
Adult ; Anterior Eye Segment/*pathology ; Biopsy ; Diagnosis, Differential ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic/*diagnosis ; Magnetic Resonance Imaging ; *Neoplasm Invasiveness ; Positron-Emission Tomography

PURPOSE: To report the outcome of using expandable metallic stent in the management of malignanttracheobronchial stenosis with dyspnea. MATERIALS AND METHODS: Under fluoroscopic and bronchoscopic guidance,seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause ofstenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the tracheain one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the leftmain bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chestradiography(n=7), bronchoscopy(n=5), pulmonary function test(PFT)(n=3), and spirometry(n=1) were performed beforeand after stent placement. RESULTS: In all seven patients, the stent was successfully placed at the lesion sitesand dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed anincrease in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume inone second(FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min.During median follow-up of 67(41-1565)days, one stent migration occurred. In one patient, proximal tumorovergrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. CONCLUSION: For in thepalliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal steuts issafe and effective.
Bronchi ; Bronchoscopy ; Carcinoma, Adenoid Cystic ; Constriction, Pathologic* ; Dilatation ; Dyspnea ; Esophageal Neoplasms ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Neoplasms ; Neoplasm Metastasis ; Palliative Care* ; Radiography ; Stents* ; Thorax ; Trachea ; Vital Capacity

PURPOSE: We report a rare case of unilateral acute macular neuroretinoapthy in a young male. CASE SUMMARY: A 35-year-old male presented with a 2-day history of paracentral scotoma. He had suffered for 2 days from a flu-like illness, and his best corrected visual acuity was 20/20 OD and 20/20 OS. Pupillary reflex was normal and no relative afferent pupillary defects were not found. Ocular movement test was normal and pain on ocular movement was not noticed. Ophthalmoscopic examination of the left eye revealed multiple exudates lining the nasal macula toward the fovea. A Humphrey visual field study identified small paracentral scotoma. Spectral domain optical coherence tomography (SD-OCT, Heidelberg Engineering, Heidelberg, Germany) of the lesions showed a hyper-reflective lesion located in the outer plexiform layer and inflammatory cell infiltration. Fluorescent angiography was normal in the macula but showed late leak at the disc. The multifocal electroretinogram (mfERG) showed decreased foveal P1 amplitude in the left eye. The patient was diagnosed with acute macular neuroretinopathy and was treated with 60 mg of prednisolone. His subjective symptoms were improved, the paracentral scotoma disappeared, and the lesions appeared different upon SD-OCT; specifically, the hyper-reflective lesion disappeared and the outer plexiform layer showed thinning. CONCLUSIONS: Acute macular neuroretinopathy is a rare disease, and we report a case using SD-OCT and mfERG.
Adult ; Angiography ; Exudates and Transudates ; Humans ; Male* ; Prednisolone ; Pupil Disorders ; Rare Diseases ; Reflex, Pupillary ; Scotoma ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

A Dieulafoy's lesion is an uncommon, but important, cause of gastrointestinal bleeding. It is associated with massive, life-threatening hemorrhage and is typically difficult to diagnose. Although originally described in the stomach and rarely found below the proximal stomach, identical lesions have been reported in other gastrointestinal organs, including the duodenum, jejunum, colon, and rectum. Most cases occur with bleeding in the gastrointestinal tract. However, we present an incidental asymptomatic Dieulafoy's lesion in the colon, which was treated successfully by using an endoscopic hemoclipping technique.
Colon ; Duodenum ; Gastrointestinal Tract ; Hemorrhage ; Jejunum ; Rectum ; Stomach