PURPOSE: We report a case of intramuscular hemangioma (IMH) in upper eyelid-misdiagnosed as pseudotumor-along with its pathologic findings. CASE SUMMARY: A 48-year-old male patient presented with three months of upper eyelid swelling in his left eye of no symptom relief with oral corticosteroid for 5 weeks. Computed tomography findings show diffuse enhancement in left upper eyelid suggested for pseudotumor and retreated with oral corticosteroids and intralesional corticosteroid injections. However, lid inflammation was not improved. The patient underwent incisional biopsy. CONCLUSIONS: Microscopically, the lesion was composed of proliferating vessels of various sizes between the individual muscle fibers. Intramuscular hemangioma that is rarely presented benign tumor in the head and neck region can be presented by diffuse swelling mimicking the pseudotumor rather than a palpable mass.
Adrenal Cortex Hormones ; Eye ; Eyelids ; Head ; Hemangioma ; Humans ; Inflammation ; Male ; Middle Aged ; Muscles ; Neck

PURPOSE: To evaluate the corneal biomechanical properties and clinical characteristic of normal tension glaucoma (NTG) in young patients. METHODS: We compared corneal biomechanical properties using an Ocular response analyzer (ORA) of under age 40 of 37 eyes of patients with NTG and 42 eyes of normal group. RESULTS: The mean corneal resistance factor (CRF) and mean corneal hysteresis (CH) were significantly lower in NTG eyes (CRF, 9.2 +/- 2.1 mm Hg; CH, 9.8 +/- 1.8 mm Hg) than in normal eyes (CRF, 10.7 +/- 2.3 mm Hg; CH, 10.9 +/- 2.0 mm Hg; p = 0.01, p < 0.01). CH and CRF were associated with central corneal thickness (CCT) (CH; beta = 0.354, p < 0.01, CRF; beta = 0.348, p < 0.01) and glaucoma status (p < 0.01, p < 0.01). CONCLUSIONS: The CRF and CH were significantly lower in NTG group while IOP cc was not significantly different between the group. In diagnosing the NTG in young patients, ORA maybe useful for distinguishing between the glaucoma eyes and normal eyes.
Eye ; Glaucoma ; Humans ; Low Tension Glaucoma

PURPOSE: In this study, we examined the changes in corneal biomechanical parameters in patients with diabetes mellitus (DM). METHODS: Fifty patients with DM were divided into 2 subgroups, 25 diabetic patients with glycated hemoglobin (HbA1c < or = 7% and 25 diabetic patients with HbA1c > 7%) and compared with the eyes of 80 healthy subjects. Corneal biomechanical parameters were measured using ocular response analyzer (ORA). Differences in corneal biomechanical properties between healthy subjects and diabetic patients were compared. Additionally, differences in corneal biomechanical properties between diabetic patients with HbA1c < or = 7% and diabetic patients with HbA1c > 7% were compared. RESULTS: Corneal hysteresis, corneal resistance factor and central corneal thickness (CCT) were statistically significantly higher in patients with diabetes compared to healthy subjects. Goldmann tonometer, non-contact tonometer and Goldmann-correlated intraocular pressure (IOPg) were statistically significantly higher in patients with DM compared to healthy subjects, but corneal compensated IOP (IOPcc) was not statistically significantly different between healthy subjects and diabetic patients. However, corneal biomechanical parameters, which were statistically significantly different between healthy subjects and DM patients, were not statistically significantly different between diabetic patients with HbA1c < or = 7% and diabetic patients with HbA1c > 7%. CONCLUSIONS: Considering that corneal properties are different between diabetic patients and healthy subject, IOPcc measured with ORA is considered clinically useful for measuring IOP as it reflects CCT and biomechanical properties that should be revised. In diabetes, changes in corneal biomechanical properties depend on long-term glucose control rather than short-term glucose control.
Diabetes Mellitus* ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Intraocular Pressure

PURPOSE: To evaluate the choroidal thickness in patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) using spectral-domain optical coherence tomography (SD-OCT), and to explore the relationship between the choroidal thickness and glaucoma. METHODS: A retrospective analysis was performed on patients who had been diagnosed with POAG or NTG at Ewha Womans University, Mokdong Hospital. SD-OCT scans were obtained to estimate retinal nerve fiber layer (RNFL) thickness, macular thickness, and subfoveal and peripapillary choroidal thickness in groups of POAG patients, NTG patients, and normal controls. RESULTS: A total of 21 patients with POAG, 53 patients with NTG, and 42 normal subjects were enrolled in this study. RNFL thickness and macular thickness were significantly thinner in the POAG and NTG groups compared to the normal subjects. In contrast, there were no significant differences in subfoveal and peripapillary choroidal thickness among the 3 groups. There was no significant correlations between the peripapillary choroidal thickness and retinal nerve fiber layer thickness. CONCLUSIONS: Choroidal thickness does not seem to differ between glaucoma patients and normal subjects, and there were no significant correlations between the choroidal thickness and glaucomatous optic neuropathy.
Choroid* ; Female ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Low Tension Glaucoma ; Nerve Fibers ; Optic Nerve Diseases ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence*

BACKGROUND AND OBJECTIVES: Recently many studies have confirmed positive identification of patients with posterior infarction through ST segment elevation in the electrocardiogram of posterior chest leads V7 through V9. However, the ECG patterns from posterior chest leads in normal adults have not been investigated, so this study was designed to examine such patterns. SUBJECTS AND METHODS: We studied 100 patients with normal conventional 12-lead ECG, normal physical examination and without any history of cardiovascular disease. Leads V7, V8 and V9 were recorded immediately after routine 12-lead ECG at the same horizontal level as that of V6 on the posterior axillary line (lead V7), the posterior scapular line (lead V8), and the left border of the spine (ead V9). RESULTS: The upright P waves in leads V7, V8 and V9 were 99%, 99% and 95% upright, respectively, while the other P waves were isoelectric and none were inverted. The T waves were all upright in leads V7 and V8, while in lead V9, 98% were upright, 2% were isoelectric and none were inverted. None of the subjects had a Q wave duration greater than 0.04 second in any of the 3 leads. At 0.08 second after the J point, only 2 subjects (2%) showed 0.5 to 1.0 mm ST segment elevation, but ST segment elevation was not greater than 1.0 mm in any of the subjects. CONCLUSION: P wave and T wave inversion were absent in all 3 leads. Q wave duration of greater than 0.04 second was also absent in all 3 leads. ST segment elevation was not greater than 1.0 mm in any of the subjects.
Adult* ; Cardiovascular Diseases ; Electrocardiography* ; Humans ; Infarction ; Physical Examination ; Spine ; Thorax*

Floating thrombi in the aortic arch are very rare, and often go under-diagnosed. Herein, a case of an 8-cm long thrombus in the aortic arch is reported. It was a floating, highly mobile thrombus attached to the atherosclerotic plaque in the proximal aortic arch. The patient was a 59-year-old woman with a history of hypertension. The thrombus was operatively removed, with a favorable outcome.
Aorta, Thoracic* ; Arteriosclerosis ; Female ; Humans ; Hypertension ; Middle Aged ; Plaque, Atherosclerotic ; Thrombosis*

PURPOSE: To compare the parameters measured with the ocular response analyzer (ORA; Reichert Inc., Depew, NY, USA) between normal control subjects and patients with normal tension glaucoma (NTG) and to investigate clinical usefulness of ORA. METHODS: Intraocular pressure (IOP) and central corneal thickness (CCT) were measured using the Goldmann applanation tonometer (GAT) in 100 eyes of 100 normal subjects and 100 eyes of 100 NTG patients. Four types of ORA parameters, corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were also measured. RESULTS: The mean CH values were 11.2 mm Hg and 10.3 mm Hg and the mean CRF values were 10.8 mm Hg and 9.9 mm Hg in the normal subjects group and the NTG group, respectively. Mean CH and CRF were significantly lower in NTG patients (p < 0.001) and the IOPcc were higher than normal subjects (p = 0.004). IOPg was in agreement with the GAT IOP (ICC = 0.811) and IOPcc was not correlated with CCT. The cut-off value of 'IOPcc - IOPg' as the diagnostic standard parameter was -0.05 mm Hg (sensitivity; 76%, specificity; 55%). CONCLUSIONS: IOPg measurements were similar to GAT IOP, and other ORA parameters (CH, CRF, IOPcc) were significantly different between normal subjects and NTG patients. Consequently, the difference of IOPcc and IOPg could be a useful parameter in NTG diagnosis.
Diagnosis ; Humans ; Intraocular Pressure ; Low Tension Glaucoma* ; Sensitivity and Specificity

Honeybee venom consists of melittin, apamin, phospholipase A2, hyaluronidase and other biologically active substances. It can cause potentially lethal reaction after mass envenomation. But, acute renal failure following multiple bee stings is rare and its pathogenesis is not well known. The possible causes of acute renal failure due to multiple bee stings are rhabdomyolysis, hemolysis and direct nephrotoxicity of bee venom. A 60-year-old man was the victim of a bee(Apis mellifera) attack. More than 780 bee stings were found over his face, neck and upper extremities. Gross hematuria, oliguria and generalized edema was developed within a few hours. He has fully recovered after general supportive care including hemodialysis. This case demonstrates that multiple bee stings may cause rhabdomyolysis with consequent acute renal failure.
Acute Kidney Injury* ; Apamin ; Bee Venoms ; Bees ; Bites and Stings* ; Edema ; Hematuria ; Hemolysis ; Humans ; Hyaluronoglucosaminidase ; Melitten ; Middle Aged ; Neck ; Oliguria ; Phospholipases A2 ; Renal Dialysis ; Rhabdomyolysis* ; Upper Extremity ; Venoms

BACKGROUND: The problems of coronary stent thrombosis and restenosis still remain to be solved.The glycoprotein IIb/IIIa receptor blocker, Abciximab (ReoPro), plays important roles in the treatment of high-risk patient with acute platelet-rich thrombus and in the inhibition of smooth muscle cell proliferation. The aim of this study was to determine whether the use of ReoPro-coated stents could reduce the neointimal formation in a porcine coronary stent restenosis model. METHODS: ReoPro was coated on the surface of stent by means of plasma polymerization followed by chemical grafting. Stent overdilation injury was performed with control bare stent (Group I, n=13), and ReoPro-coated stents (Group II, n=14). Follow-up quantitative coronary angiogram was performed at 4 weeks after stenting and histopathologic assessment were compared in both groups. RESULTS: The diameter stenosis by QCA between two groups was significantly higher in Group I (23+/-5 % vs. 15+/-7 %, p=0.003). On histopathologic examination, no in-stent thrombus was observed. The percent area stenosis was significantly higher in Group I than in Group II (48+/-17 % vs. 30+/-16 %, p=0.01). The area of neoinima was larger in Group I than in Group II (3.2+/-1.2 mm2 vs. 2.0+/-1.0 mm2, p=0.01). By immunocytochemistry, proliferation cell nuclear antigen indices were higher in Group I (4.2+/-2.1 %, vs 2.4+/-1.8 % p=0.03). CONCLUSION: The ReoPro-coated stent is safe and effective in the prevention of in-stent thrombus and restenosis, which may be related with the inhibition of platelet thrombus and neointimal cell proliferation.
Blood Platelets* ; Cell Proliferation ; Constriction, Pathologic ; Follow-Up Studies ; Glycoproteins* ; Humans ; Immunohistochemistry ; Myocytes, Smooth Muscle ; Neointima ; Plasma ; Polymerization ; Polymers ; Stents* ; Thrombosis ; Transplants

The incidence of ischemic heart disease has been increased rapidly in Korea. However, the clinical effects of antecedent hypertension on acute myocardial infarction have not been identified. We assessed the relationship between antecedent hypertension and clinical outcomes in 7,784 patients with acute myocardial infarction in the Korea Acute Myocardial Infarction Registry during one-year follow-up. Diabetes mellitus, hyperlipidemia, cerebrovascular disease, heart failure, and peripheral artery disease were more prevalent in hypertensives (n=3,775) than nonhypertensives (n=4,009). During hospitalization, hypertensive patients suffered from acute renal failure, shock, and cerebrovascular event more frequently than in nonhypertensives. During follow-up of one-year, the incidence of major adverse cardiac events was higher in hypertensives. In multi-variate adjustment, old age, Killip class > or =III, left ventricular ejection fraction <45%, systolic blood pressure <90 mmHg on admission, post procedural TIMI flow grade < or =2, female sex, and history of hypertension were independent predictors for in-hospital mortality. However antecedent hypertension was not significantly associated with one-year mortality. Hypertension at the time of acute myocardial infarction is associated with an increased rate of in-hospital mortality.
Acute Disease ; Age Factors ; Aged ; Cerebrovascular Disorders/etiology ; Diabetes Mellitus/etiology ; Female ; Heart Failure/etiology ; Hospital Mortality ; Humans ; Hyperlipidemias/etiology ; Hypertension/*complications ; Male ; Middle Aged ; Myocardial Infarction/complications/*mortality/therapy ; Peripheral Vascular Diseases/etiology ; Predictive Value of Tests ; Registries ; Sex Factors