Tangential vitreoretinal traction around fovea is known to be the principal cause in the pathogenesis of idiopathic macular holes. According to the recent study, the internal limiting membrane(ILM) may provide a scaffold for fibroblast proliferation and contraction, therefore play an important role in the enlargement of macular hole. We removed the ILM during macular hole surgery and assessed the anatomical and functional outcome of the macular hole surgery. Twelve consecutive patients with full-thickness macular hole were enrolled in this study. They were examed for best-corrected vision, fundus photography, fluorescein angiography, Humphrey automated perimetry, focal eletroretinogram, before and after surgery. After surgery, vision was improved in 8 eyes(67%), hole was closed in 10 eyes(83%). Macular thresholds on visual field was increased in 8 eyes and peripheral scotomas developed in 3 eyes postoperatively. The amplitude increased in 7 eyes and the implicit time decreased in 8 eyes on focal electroretinograms postoperatively. Out results suggested that the complete removal of ILM should be attempted to improve vision and to close holes during the full-thickness macular hole surgery.
Fibroblasts ; Fluorescein Angiography ; Humans ; Membranes* ; Photography ; Retinal Perforations* ; Scotoma ; Traction ; Visual Field Tests ; Visual Fields

PURPOSE: Optic disc harmatoma is usually seen in tuberous sclerosis patients, but, it may be seen in otherwise normal people. Visual acuity is usually not affected by this lesion. METHODS: We experienced a 40-year-old woman with optic disc hamartoma who presented with acute visual defect. With oral triamcinolone 48mg/day, her visions recovered to normal in 2 weeks. RESULTS: Her age, symptom, and course of disease supported the diagnosis of optic neuritis. CONCLUSION: We report this patient as a case of optic disc hamartoma combined with optic neuritis.
Adult ; Diagnosis ; Female ; Hamartoma* ; Humans ; Optic Neuritis* ; Triamcinolone ; Tuberous Sclerosis ; Visual Acuity

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

Extrapelvic endometriosis is a rare disease. The majority of extrapelvic endometriosis cases involve scar tissue following obstetric and gynecologic procedures. We have treated two cases of extrapelvic incisional endometriosis. A 39 year old female patient with cyclic vaginal spotting after laparoscopic assisted vaginal hysterectomy due to uterine myoma and a 35 year old female patient with a painful palpable abdominal mass after cesarean section. Both underwent complete excision and were proven to have endometriosis by pathology. Here we report on both cases and review the medical literatures.
Adult ; Cesarean Section* ; Cicatrix ; Endometriosis* ; Female ; Humans ; Hysterectomy, Vaginal* ; Leiomyoma ; Metrorrhagia ; Pathology ; Pregnancy ; Rare Diseases

BACKGROUND: Some of the deficiencies in anterior pituitary function identified in subjects with macroadenomas appear to represent irrevemible necrosis of normal pituitary cells, and in addition reversible damage to viable glandular tissue and/or incomplete interruption of local circulation by compression of pituitary stalk may also contribute significantly to hypopituitarism. So anterior pituitary function may actually improve in some patients undergoing successful tumor resection or reduction in tumor size. Although direct comparisons of pituitary function among the various pituitary tumors are not presently available it was reported that there is some difference in the degree of pituitary impairment between patients with nonfunctioning macroadenoma(NFMA) and those with GH-secreting macroadenoma(GHMA).In this study, to investigate the difference in the degree of hypopituitarism we compared anterior pituitary function in subjects with NFMA to that in patients with GHMA. METHODS: In this retrospective study, preoperative and postoperative anterior pituitary function was assessed by clinical findings, basal hormone levels and/or combined pituitary stimulation test in 29 subjects with NFMA and in 24 subjects with GHMA. RESULTS: 1. There was no difference in age, sex, tumor size distribution between the two groups. 2. Preoperatively, NFMA patients had a higher prevalence of secondary hypothyroidism(34% vs. 5%; p(0.02) compared to subjects with GHMA. Patients with NFMA also had a higher prevalence of more severe pituitary failure compared with acromegalic patients; 48% of the patients in this group had more than one pituitary hormone axis impaired compared to 17% in the acromegalic group(p0.03). 3. Postoperatively, NFMA patients also had a higher prevalence of secondary hypoadrenalism (52% vs. 11%; p 0.01) compared with acromegalic patients. Additionally, the prevalence who had more than one pituitary hormone axis impaired was still greater in NFMA patients than in the acromegalic group(57% vs. 22%; p=0.054). 4. No correlation was found between the severity of pituitary failure and tumor size or extension in both groups before and after surgery. CONCLUSION: These findings suggest that anterior pituitary function is relatively better preserved in patients with GHMA than those with NFMA and that this difference is independent of tumor size and extension. The mechanism underlying the lower rate of hypopituitarism in acromegalics with macroadenoma remains to be elucidated.
Adrenal Insufficiency ; Axis, Cervical Vertebra ; Humans ; Hypopituitarism ; Necrosis ; Pituitary Gland ; Pituitary Neoplasms ; Prevalence ; Retrospective Studies

PURPOSE: To evaluate the results of half-dose photodynamic therapy (PDT) and determine the correlation between morphological changes measured by spectral-domain optical coherence tomography (SD-OCT) and visual acuity in patients with chronic central serous chorioretinopathy (CSC). METHODS: Twenty-five eyes of 25 patients with chronic CSC who had received half-dose verteporfin PDT were enrolled in the present study. The best-corrected visual acuity (BCVA), outer nuclear layer (ONL) thickness, and the integrity of the photoreceptor inner and outer segment junction (IS/OS) using SD-OCT were evaluated at baseline and at 3 and 6 months after treatment. RESULTS: The neurosensory retinal detachment disappeared in all eyes 6 months after treatment. The BCVA improved significantly from 0.50 +/- 0.32 to 0.31 +/- 0.29 log MAR at 6 months (p < 0.001). The average ONL thickness at the central fovea was 88.76 +/- 19.95 microm at 6 months and the ONL thickness was well correlated with the BCVA (gamma = -0.64; p = 0.001). There was no significant correlation between the status of IS/OS and the BCVA. CONCLUSIONS: Half-dose PDT is effective in treating chronic CSC resulting in visual improvement and complete resolution of neurosensory retinal detachment. The ONL thickness which was positively correlated with the BCVA could be an indicator for visual prognosis of chronic CSC.
Central Serous Chorioretinopathy* ; Humans ; Photochemotherapy* ; Porphyrins ; Prognosis ; Retinal Detachment ; Tomography, Optical Coherence* ; Triazenes ; Visual Acuity

Metastatic tumor to the eye is the most common type of intraocular malignancy. The most common primary site of the intraocular metastatic tumor is the breast in women and the lung in men respectively and the choroid is by far the most common site for intraocular metastasis. We experienced a case of chroidal metastasis in a patient with pancreatic carcinoma which is not published in Korea. So, we review that case with the literatures related with metastatic pancreatic cancer to the choroid.
Breast ; Choroid* ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis* ; Pancreatic Neoplasms

Metastatic tumor to the eye is the most common type of intraocular malignancy. The most common primary site of the intraocular metastatic tumor is the breast in women and the lung in men respectively and the choroid is by far the most common site for intraocular metastasis. We experienced a case of chroidal metastasis in a patient with pancreatic carcinoma which is not published in Korea. So, we review that case with the literatures related with metastatic pancreatic cancer to the choroid.
Breast ; Choroid* ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis* ; Pancreatic Neoplasms

OBJECTIVE: The aim of this study was to analyse the characteristics, severity of Fitz-Hugh-Curtis syndrome (FHCS), pelvic adhesions and hematologic findings of incidentally founded FHCS in laparoscopy. METHODS: We retrospectively reviewed the medical records of 40 patients incidentally found laparoscopically as FHCS at the department of obstetrics and gynecology of Yeungnam University Hospital from Jan. 2001 to Dec. 2006. Severity of FHCS and pelvic adhesions were classified and characteristics of patients, hematologic findings, past medical histories and symptoms after surgery were analysed. RESULTS: The ages of the cases varied between 16 and 65 years old. Mean age of cases was 32.9 years. Indications of surgery were uterine myoma, benign adnexal mass, ectopic pregnancy, endometriosis, chronic pelvic pain and pelvic tuberculosis. From this study we can notice that FHCS can be found out most frequently in the patient with pelvic inflammatory disease (PID). Past medical history were pelvic inflammatory disease, ectopic pregnancy, abdominal surgery and pelvic tuberculosis. 17 patients had been suffered from RUQ pain and 10 patients (58.8%) were in good health after adhesiolysis. CONCLUSION: Laparoscopy is a confirmative tool in the diagnosis of FHCS. Direct observation of perihepatic space is the most definitive method of diagnosing this syndrome. From our study, we can find that FHCS can be diagnosed frequently in the patient with pelvic inflammatory disease, ectopic pregnancy and pelvic tuberculosis. So, We recommend that investigating the perihepatic space during surgery is a good treatment especially in patients with PID, vague abdominal discomfort and pains.
Chlamydia Infections ; Endometriosis ; Female ; Gynecology ; Hepatitis ; Humans ; Laparoscopy ; Medical Records ; Myoma ; Obstetrics ; Pelvic Inflammatory Disease ; Pelvic Pain ; Peritonitis ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Tuberculosis

OBJECTIVE: The aim of this study was to analyse the characteristics, severity of Fitz-Hugh-Curtis syndrome (FHCS), pelvic adhesions and hematologic findings of incidentally founded FHCS in laparoscopy. METHODS: We retrospectively reviewed the medical records of 40 patients incidentally found laparoscopically as FHCS at the department of obstetrics and gynecology of Yeungnam University Hospital from Jan. 2001 to Dec. 2006. Severity of FHCS and pelvic adhesions were classified and characteristics of patients, hematologic findings, past medical histories and symptoms after surgery were analysed. RESULTS: The ages of the cases varied between 16 and 65 years old. Mean age of cases was 32.9 years. Indications of surgery were uterine myoma, benign adnexal mass, ectopic pregnancy, endometriosis, chronic pelvic pain and pelvic tuberculosis. From this study we can notice that FHCS can be found out most frequently in the patient with pelvic inflammatory disease (PID). Past medical history were pelvic inflammatory disease, ectopic pregnancy, abdominal surgery and pelvic tuberculosis. 17 patients had been suffered from RUQ pain and 10 patients (58.8%) were in good health after adhesiolysis. CONCLUSION: Laparoscopy is a confirmative tool in the diagnosis of FHCS. Direct observation of perihepatic space is the most definitive method of diagnosing this syndrome. From our study, we can find that FHCS can be diagnosed frequently in the patient with pelvic inflammatory disease, ectopic pregnancy and pelvic tuberculosis. So, We recommend that investigating the perihepatic space during surgery is a good treatment especially in patients with PID, vague abdominal discomfort and pains.
Chlamydia Infections ; Endometriosis ; Female ; Gynecology ; Hepatitis ; Humans ; Laparoscopy ; Medical Records ; Myoma ; Obstetrics ; Pelvic Inflammatory Disease ; Pelvic Pain ; Peritonitis ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Tuberculosis