No abstract available.
Diverticulum, Esophageal*

An ipsilateral supraclavicular lymph node recurrence of breast cancer after surgery has been considered a predecessor to distant metastases. There still is a debate as to whether breast carcinoma patients with the isolated supraclavicular lymph node recurrence should be considered to have disseminated disease or if aggressive treatment, with curative intent, is justified. We report two cases of an isolated ipsilateral supraclavicular lymph node recurrence following modified radical mastectomy, and multimodality treatments with modified radical neck dissection, systemic chemotherapy and involved field radiotherapy. These patients have lived without locoregional recurrence or distant metastases for 3 and 2 years, respectively. Conclusively, we recommend aggressive combined multimodality treatments, including surgery, such as modified radical neck dissection or complete excision of the involved lymph nodes, systemic chemotherapy, and involved field radiotherapy, in patients with isolated supraclavicular lymph node recurrence, but with no other evidence of distant metastases.
Breast Neoplasms ; Drug Therapy ; Humans ; Lymph Nodes ; Mastectomy, Modified Radical ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence

Several studies have revealed an association between radioactive iodine (RAI) therapy for Graves' disease and new or worsening Graves' ophthalmopathy. In the present case, thyroid papillary cancer was incidentally detected in a 43-year-old woman who was receiving medication for Graves' disease. This patient had undergone RAI ablation using recombinant human thyrotropin (rhTSH) after total thyroidectomy. The patient subsequently complained of a unilateral eyelid abnormality at approximately 6 months after the RAI ablation, and was diagnosed with bilateral Graves' ophthalmopathy after a thorough ophthalmological examination. I report this case for its interesting clinical features, rarity of occurrence and to highlight the importance of careful observation for appropriate management of Graves' ophthalmopathy developing or worsening after RAI ablation in differentiated thyroid cancer patients.
Adult ; Eyelids ; Female ; Graves Disease ; Humans* ; Iodine* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin*

The recent prevalence of syphilis has known to be increased progressively throughout the world, since middle of 1950. In Korea, current trend of increased syphilic infection has became a major public health problem. The authors selected sero-positive patients, among the outpaients of department of dermatology, urology, OB & GY, and physical examination, and performed statistical analysis of this sero-positive patients. Results are as following; 1) Of the 2,007 patients taken physical examination, 30 patient(1.49%) were reactive to VDRL. 2) 0.71% of the total out patients of the dermatologic dcpartment were sero-positive. Annual ratio of the syphilitic patient were increased progressively. 3) Ratio of the syphilitic patients to the total outpatients of OB & GY department was 0.55% and somewhat increased since 1976. 4) In the age distribution, the third decade shared 51.8% of the total sero-positive patients 5) In the sexual ratio. male:female=l: l. 62 in the total sero-positive patients. (male:female=l: 1.06 in the dermatologic department.) 6) In the stage distribution, latent syphilis patients were 59.14% of the total syphilitic patients.
Age Distribution ; Dermatology ; Female ; Humans ; Korea ; Outpatients ; Physical Examination ; Prevalence ; Public Health ; Syphilis ; Syphilis, Latent ; Urology

PURPOSE: The present study assessed the diagnostic significance of digital infrared thermal imaging (DITI) in determining the inflammatory state of patients with nonspecific orbital inflammation. METHODS: The present study included 11 patients diagnosed with nonspecific orbital inflammation between December 2009 and March 2011 and who were followed-up for more than 6 months. All patients were all diagnosed based on computed tomography (CT), magnetic resonance image (MRI) and tissue biopsy. The grade of eyelid swelling was classified as 5 and severe compared with the temperature of location. The temperature of the upper eyelid, caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid, cornea and lateral orbit were measured with DITI. RESULTS: When comparing the normal eye with the diseased eye in patients with nonspecific orbital inflammation, the temperature of the upper eyelid and cornea were statistically significant (p = 0.003, p = 0.038, respectively, Mann-Whitney test). The correlation between the grade of eyelid swelling and the temperature of location was most highly related in the temperature of the upper eyelid (Spearman's correlation coefficient, r = 0.55, p = 0.008) and cornea (Spearman's correlation coefficient, r = 0.45, p = 0.037). CONCLUSIONS: DITI may aid in evaluating the inflammatory state of nonspecific orbital inflammation. In particular, the temperature of the upper eyelid and cornea can be very useful indicator. Future studies, including larger study population are necessary in order to confirm DITI as a diagnostic tool which can assess the results of medical treatment by comparing temperature before and after treatment.
Biopsy ; Conjunctiva ; Cornea ; Eye ; Eyelids ; Humans ; Inflammation ; Magnetic Resonance Spectroscopy ; Orbit

PURPOSE: to measure mood disturbance of Korean patients with dysthyroid ophthalmopathy according to the severity of ophthalmopathy. METHODS: Fifty patients with dysthyroid ophthalmopathy (mean age: 46.6+/-12.1 years; 32 female patients and 18 male patients) were included, and classified into 2 groups according to the disease severity. Twenty-five patients were classified with moderate/severe diseases (study group) and 25 patients classified with negligible/mild disease (control group). All patients completed a mood survey of 65 questions to assess differences in the degree of emotional distress. RESULTS: Analysis of each group showed that patients with moderate/severe ophthalmopathy had significantly greater emotional distress than patients with negligible/mild ophthalmopathy according to the Korean Profile of Mood States mean total score (p=0.03). In particular, patients with disfigurement (proptosis predominant group) had significantly worsen emotional distress compared with the control group (p=0.007), whereas patients with diplopia (diplopia predominant group) had no significant difference compared with the control group (p=0.60). CONCLUSIONS: Patients with moderate to severe ophthalmopathy have significant emotional distress, and severe mood disturbance especially when disfiguring signs are predominant. The psychological burden of the disease should be recognized, and routine follow-up recommended along with additional psychiatric consultation.
Diplopia ; Female ; Follow-Up Studies ; Graves Ophthalmopathy ; Humans ; Male

PURPOSE: To report a case of carcinoma ex pleomorphic adenoma observed during the patient's first operation. CASE SUMMARY: A 63-year-old female presented with proptosis and ptosis that was aggravated 1 year prior. On preoperative CT image, a 32 x 20 x 21 mm-sized well demarcated mass (suspected as pleomorphic adenoma) was observed and was removed entirely by anterolateral orbitotomy. The excised mass surface was uneven but the capsule appeared intact on gross examination. Hard, yellow-colored and soft, dark-colored materials were found concurrently on cross section. The histological examination showed malignant cells as part of the soft material and was diagnosed as carcinoma ex pleomorphic adenoma. CONCLUSIONS: We report a case of carcinoma ex pleomorphic adenoma of the lacrimal gland that presented with malignant change during the patient's first operation. Supposedly, during the process of mass growth, minimal rupture occurred causing malignant transformation. Clinically, although a mass is believed benign based on imaging, the possibility of malignant transformation of a tumor increasing rapidly or enlargement causing development of rapid proptosis should be considered.
Adenoma, Pleomorphic* ; Exophthalmos ; Female ; Humans ; Lacrimal Apparatus ; Middle Aged ; Mixed Tumor, Malignant ; Rupture

PURPOSE: To report a rare case of conjunctival myxoma invading the caruncle. CASE SUMMARY: A 46-year-old man presented with a medical canthal conjunctival mass in his left eye. The mass was a semi-transparent, yellowish, movable mass 10 mm x 6 mm in size in the subconjunctival space. There was no pain and no tenderness. Excisional biopsy of the mass was performed. Histopathologic examination revealed findings suggestive of myxoma. CONCLUSIONS: Relatively transparent, movable, yellowish to pinkish conjunctival masses at medial canthal area without pain or tenderness can be diagnosed as myxoma on biopsy and myxoma can be seen at caruncle.
Biopsy ; Eye ; Myxoma

Purpose: To analyze the results of secondary silicone tube insertion in patients exhibiting persistent epiphora despite acquiringanatomical patency after primary endonasal dacryocystorhinostomy. Methods: We conducted a retrospective review of 23 patients (37 eyes) seen at our department from December 2006 to April2018 for primary endonasal dacryocystorhinostomy. These patients exhibited anatomical patency but experienced persistentepiphora, requiring secondary silicone tube re-insertion. Results: The average age at reintubation with a silicone tube was 59.8 years, and the average follow-up was 14.8 months. Theinterval between the primary endonasal dacryocystorhinostomy and secondary silicone tube re-insertion was approximately24.5 months. The silicone tube re-insertion, was successful for 33 of 37 eyes with four eyes exhibiting partial improvement. Thus,there were no failed outcomes based on subjective symptoms. Conclusions After primary endonasal dacryocystorhinostomy, when tearing symptoms persist despite no evidence of anatomicalproblems, our results show that secondary silicone tube re-insertion is a safe and effective procedure for patients experiencingfunctional failure.

Purpose: We present the case of a 4-month-old boy with a large orbital cyst that caused lateral displacement of the optic nerve resulting in progressive exophthalmos of the left eye since birth.Case summary: A 4-month-old boy presented with progressive exophthalmos of the left eye since birth. Physical examination revealed marked left eye proptosis. Magnetic resonance imaging revealed microphthalmia and a 2.2 × 1.9 cm orbital cyst in the retrobulbar region. Subsequently, an anterior orbitotomy of the left eye was performed to dissect and excise the cyst. Histopathological examination revealed an orbital cyst containing neuroectodermal tissue. No complications or recurrences were observed during the 3-month post-surgery period. Conclusions Congenital microphthalmia with orbital cysts is a rare condition that does not always require surgical intervention. However, timely surgical intervention in cases of severe exophthalmos can result in favorable functional and cosmetic outcomes. We present a case that exhibited significant improvement following surgical removal of the orbital cyst.