PURPOSE: To analyze the clinical features and prognostic factors of ocular surface squamous neoplasia (OSSN). METHODS: A total of 31 eyes of 31 patients with suspected OSSN who were treated with excision and biopsy were retrospectively reviewed. Clinical features such as patient symptoms, invasion type, morphologic feature and size of lesion were analyzed. All patients were treated with simple excision or mitomycin C combination therapy. Factors affecting recurrence were evaluated. RESULTS: The most common symptom, invasion type, morphological feature, lesion size and histological diagnosis were foreign body sensation (38.7%), combined conjunctiva and cornea type (71.0%), gelatinous type (74.2%), 5 - 10 mm in largest diameter (45.2%) and intraepithelial neoplasia (51.6%), respectively. Age, sex, morphological features, lesion size and histological diagnosis had no effect on recurrence. Mitomycin C combination therapy was significantly associated with decreased recurrence compared to simple excision (p < 0.05). CONCLUSIONS: In OSSN, intraepithelial neoplasia was the most common subtype. Mitomycin C combination therapy was effective in decreasing recurrence.
Biopsy ; Conjunctiva ; Cornea ; Diagnosis ; Foreign Bodies ; Gelatin ; Humans ; Mitomycin ; Recurrence ; Retrospective Studies ; Sensation

PURPOSE: To report a case of chronic osteomyelitis of the orbit. CASE SUMMARY: A 61-year-old woman visited the ophthalmology clinic with a 3-month history of right periorbital swelling and pain. She had a history of ondontitis treated with oral antibiotics three months previously. A hard, tender, swollen mass was palpated near the right lower eyelid extending to the floor of the right orbit. Otherwise, there were no other clinically-specific ocular signs. Orbital computed tomography and bone scan findings suggested right periorbital soft tissue inflammation with underlying osteomyelitis of maxillar and zygomatic bones involving the inferior and lateral orbital walls. The patient was admitted and treated with broad spectrum systemic antibiotics. After 7 days, periorbital soft tissue swelling and pain were improved, but the size of the hard mass was unchanged. Seven days after admission, incision and drainage of the periorbital hard mass near the lower eyelid and debridement of the necrotic and pyogenic tissue were performed. Histologic examination showed chronic granulomatous inflammation and bony necrosis of the mass. The patient was discharged after receiving systemic antibiotics for 7 more days. At the 6-month follow-up, no recurrence or abnormal findings in the right periorbital region were observed. CONCLUSIONS: Chronic orbital osteomyelitis should be treated with combined systemic antibiotics and surgical intervention.
Anti-Bacterial Agents ; Debridement ; Drainage ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Middle Aged ; Necrosis ; Ophthalmology ; Orbit* ; Osteomyelitis* ; Recurrence

The diagnosis of scrotal tumors in children can be challenging because of the rarity, vague symptoms, and varied imaging features of the tumors. The pathology and frequency of scrotal tumors that occur in children are different from tumors that arise in adults. In this pictorial essay, we illustrate the imaging findings of scrotal tumors in children with pathological correlations. In addition, we present the clinical manifestations that are valuable for a differential diagnosis. Familiarity with the imaging findings and clinical manifestations of pediatric scrotal tumors may be helpful in making an accurate diagnosis and providing proper patient management.
Adult ; Child ; Diagnosis, Differential ; Humans ; Recognition (Psychology)

Purpose: To describe the clinical characteristics and surgical outcomes of patients with myopic tractional maculopathy (MTM) who underwent macular buckling (MB) surgery using a novel L-shaped buckle. Methods: A titanium stent, a style 507 sponge, and a silicone sleeve were used to create an L-shaped macular buckle. The titanium stent was bent through 90° over the last third. The sponge was cut to about 1 cm in length and placed on the extremity. The remaining part of the stent was then covered with a 2-cm-long silicone sleeve; the total buckle length was 3 cm. The buckle was implanted supero-temporally to allow access to the macular region. Intraoperative optical coherence tomography (Zeiss Rescan 700, Carl Zeiss, Jena, Germany) was performed to ensure that the buckle was appropriately positioned. Results: Three patients with MTM underwent MB surgery under general anesthesia. In all patients, the foveae lay at the greatest distances possible from the posterior staphyloma. Given the location of the posterior staphyloma and the posterior scleral expansion, anteroposterior traction was evident in every patient. After surgery, although the extent varied, all patients exhibited reduced anteroposterior traction, evidenced by decreased retinoschisis, staphyloma flattening, and smaller macular holes. In one case, vitrectomy was added to release epiretinal membrane-induced tangential traction. No patient reported any significant ocular complication after surgery. Conclusions MB using an L-shaped buckle, safely and efficiently relieves anteroposterior traction and improves the macular anatomy in patients with MTM.

GTP-Binding Proteins ; Receptors, Thyrotropin-Releasing Hormone ; Thyrotropin-Releasing Hormone*

PURPOSE: To investigate clinical outcomes, response to treatment, and the related factors of recurrence and complication, following treatment of primary conjunctival malignant lymphoma. METHODS: The medical records of 39 patients diagnosed with primary conjunctival malignant lymphoma between January 2005 and June 2013 were retrospectively reviewed. RESULTS: The mean age of patients was 51.1 years old. The most common presenting symptom was hyperemia (33.3%). The most common anatomical location of the mass was the fornix (38.5%) and 25.6% patients had bilateral involvement. Histopathologically, mucosa-associated lymphoid tissue (MALT) lymphoma (92.3%) was the most common subtype. Every patient underwent radiotherapy (92.3%) or chemotherapy (7.7%) after surgical excision and had 100% complete remission. Local or systemic recurrence was observed in 15.4% of patients after treatment (mean 8.0 +/- 3.3 months), but was completely remitted after additional radiation or chemotherapy. International prognostic index and location of tumor were significantly related factors for predicting tumor recurrence (p < 0.01, p = 0.02, respectively). Dry eye disease (DED) was the most common ocular complication (44.4%) after radiotherapy. Total radiation dosage and location of tumor were significantly associated factors for developing DED after radiotherapy (both p = 0.04). CONCLUSIONS: Most conjunctival malignant lymphomas were low grade malignant MALT lymphomas that responded well to treatment but recurrence of tumor and development of DED after radiotherapy were common, therefore predicting and preparing these lymphomas is important.
Drug Therapy ; Eye Diseases ; Humans ; Hyperemia ; Lymphoid Tissue ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Medical Records ; Radiation Dosage ; Radiotherapy ; Recurrence ; Retrospective Studies

PURPOSE: To investigate the correlation between Glutathione-S-transferase (GST) genes and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (DM). METHODS: In this case-control study, 131 patients who were diagnosed with DR, 105 diabetic patients who did not have DR, and 45 nondiabetic controls were examined from January 2013 to November 2015. To analyze deletion of the GSTT1 and GSTM1 genes, polymerase chain reactions of DNA in a buffy coat from peripheral blood were performed via electrophoresis. RESULTS: There were no statistically significant differences in age, sex, or spherical equivalent between the 236 type 2 diabetic patients and the 45 normal controls (p > 0.05). In both univariate and multivariate analyses, the duration of type 2 DR was longer (p = 0.004, p = 0.013), and HbA1c was higher (p = 0.004, p = 0.007) in the DR group than in the non-DR group. Presence of a GSTM1 deletion is associated with a lower frequency of DR (p = 0.017, p = 0.012). CONCLUSIONS: Deletion of the GSTT1 gene is not associated with an increased risk of DR, whereas GSTM1 deletion is associated with a lower risk of DR in patients with type 2 DM in the Korean population. Additional studies with larger sample sizes and different types of GST genes are needed to confirm this study.
Case-Control Studies ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Retinopathy* ; DNA ; Electrophoresis ; Humans ; Multivariate Analysis ; Polymerase Chain Reaction ; Sample Size

PURPOSE: To determine the enhancing patterns of hepatocellular carcinoma(HCC) and the difference of enhancing patterns according to the tumor size, using spiral CT. MATERIALS & METHODS: We reviewed 213 lesions in 76patients who had been clinically or histopathologically diagnosed as HCC sufferer. The tumors were divided into three groups, according to size(&3 cm, 3-5cm and >5 cm). The enhancing patterns of tumor and capsule in the earlyand delayed phase were analysed. The enhancing patterns of the tumor were divided into five types(high, peripheralhigh, mixed, iso and low attenuation) in the early phase and four types(central high, mixed, iso, and low attenuation) in the delayed phase. The enhancing patterns of the capsule were divided into three types such asiso, low and high attenuation. RESULTS: High attenuating lesions in the early phase were as follows : below 3cm 72% ; 3-5cm., 60% ; above 5cm., 49%. Mixed attenuating lesions in the early phase were as follows : below 3cm., 1%; 3-5cm., 22% ; above 5cm., 36%. Thus, most HCCs were high attenuation type in the early phase, but as the tumorbecame larger, less high attenuation and more mixed attenuation was demonstrated(p<0.01). There was no difference of enhancing patterns according to the tumor size in peripheral high, iso and low-attenuating lesions. In the delayed phase most of the hepatomas appeared as totally hypodense lesions. For capsules, the results were as follows : below 3cm., 20% ; 3-5cm.,58% ; above 5cm., 73%. As the tumors became larger, more capsules were demonstrated(p <0.01). The capsules were visualized as iso or low attenuating rim in the early phase and high attenuating rim in the delayed phase. CONCLUSIONS: To determine the enhancing patterns of HCC using spiral CT is considered to be helpful in the diagnosis of HCC.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Tomography, Spiral Computed*

BACKGROUND AND OBJECTIVES: Infection of congenital preauricular fistula leads to preauricular abscess. Generally, the treatment for preauricular abscess is focused on subsiding abscess. Although incision & drainage is major point of therapy, the study of bacterial species and antibiotics for preauricular abscess is scant in literature. So, we investigated the most common species that cause preauricular abscess and the choice of proper antibiotics by using the databse available from the last 10 years. SUBJECTS AND METHOD: Our studies, from January, 2000 to December, 2010, included 86 patients in total (all in patients & out patients). We performed a retrospective review of bacterial species and culture analysis of each preauricular abscess. RESULTS: In this study, it was shown that most common pathogens causing preauricular fistula infection were Staphylococcus (27.9%), Enterococcus (9.3%), streptococcus and Klebsiella (5.8%) and Peptostreptococcus (4.6%). And Amoxicillin/cavulanate, Ciprofloxacin, Clindamycin had excellent effects of minimal inhibitory concentration through multiple pathogens. CONCLUSION: The choice of antibiotics for preauricular abscess will be targeted on Staphylococcus, Enterococcus, Streptococcus and anaerobic infection. Amoxicillin/clavulanate or Ciprofloxacin are the most effective antibiotics.
Abscess ; Anti-Bacterial Agents ; Ciprofloxacin ; Clindamycin ; Drainage ; Enterococcus ; Fistula ; Humans ; Klebsiella ; Peptostreptococcus ; Retrospective Studies ; Staphylococcus ; Streptococcus

BACKGROUND AND OBJECTIVES: Despite aggressive medical therapy and previous endoscopic sinus surgery, there are a subset of patients suffering from recalcitrant, persistent chronic isolated maxillary sinusitis which results from impaired mucocilliary clearance caused by long-standing inflammation. The corresponding patients underwent our newly devised Modified Inferior Meatal Mega-Antrostomy (Modified IMMA). The objective of this study was to review the clinical efficacy and complication after Modified IMMA in patients who had suffered from intractable maxillary sinusitis after endoscopic sinus surgery. SUBJECTS AND METHOD: Fourteen patients suffering from recalcitrant chronic isolated maxillary sinusitis underwent Modified IMMA between May 2010 and April 2013. The mean follow-up period was an average of about 13 months and regular intervals of postoperative 3-, 6-, 9-, 12-months were set. A retrospective review was performed to analyze the preoperative & postoperative Visual Analogue Scale score (VAS score) and Lund-Kennedy endoscopy score at each interval. VAS scores and endoscopic findings were processed statistically at the time of third postoperative month. The exclusion criteria were an obstructed ostiums, osteitis, systemic disease such as Ig A/G immunodeficiency, primary ciliary dyskinesia. RESULTS: The postoperative VAS scores and Lund-Kennedy scores, when compared with those prior to Modified IMMA, decreased from 16.5 to 2.5 and 5.0 to 1.0, respectively. Also, there was no serious complication or recurrence associated with the procedures. CONCLUSION: Our newly devised Modified IMMA could be a much effective option for surgical treatments in patients with recalcitrant chronic isolated maxillary sinusitis.
Endoscopy ; Follow-Up Studies ; Humans ; Inflammation ; Maxillary Sinus ; Maxillary Sinusitis ; Osteitis ; Recurrence ; Retrospective Studies ; Stress, Psychological