Constant exotropia is uncommon during the first year of life.We investigated characteristics, surgical outcome and associated ocular abnormalities in patients who had an exodeviation during the first year of life. The charts of 18 patients who were diagnosed as congenital exotropia before 1 year old were reviewed.We etrospectively analyzed 10 healthy patients who did not have associated systemic or ocular abnormalities and were followed for at least 3 months after surgery. The mean follow-up period was 1.2 years[range, 3 months to 3.5 years]and all of them had an exodeviation of 25 prism diopter[PD]or more[mean, 37.5PD, SD 10.6PD].Preoperative DVD and inferior oblique muscle overaction were found in 1 patient respectively. Surgery was performed in 9 cases and botulinum toxin was injected in 1 case.Seven patients[70%]showed stable alignment within 10PD with one operation and one patient required reoperation.Postoperative dissociated vertical deviation and inferior oblique muscle overaction were found in each 1 patients. Congenital exotropia has large deviation and may be associated with inferior oblique muscle overaction or dissociated vertical deviation as infantile esotropia and has stable alignment with single operation.But unlike infan-tile esotropia, nystagmus is extremely rare.
Botulinum Toxins ; Esotropia ; Exotropia* ; Follow-Up Studies ; Humans

Nevus lipomatosus cutaneus superficialis is a very rare skin disease which appears at birth or within the firat two decades of life. This uncommon condition is due to collections of ectopic fat cells within the upper and mid-dermis. There are two clinical forms. The first form is a lesion of zonal distribution, present from birth or childhood, usually on the buttocks or the lower back. The second form, a dome or sessile, papule, begins in adult life and is less restricted in distribution, and occurs also on the limbs Coalescence of soft, yellowish papules tends to form cerebriform plaques. The authors experienced two cases of typical nevus lipomatosus cutaneus superficialis. The first case was a 23-year male who had asymptomatic, soft, skin colored, and pea sized confluent nodules on the right lower back area since at birth. The second case was a 35-year female who had asymptomatic, multiple, soft, skin colored from rice to walnut sized confluent nodules on the coccygeal area which developed at the age of 27. Diagnosis was confirmed by clinical and histopathological findings.
Adipocytes ; Adult ; Buttocks ; Diagnosis ; Extremities ; Female ; Fluconazole ; Humans ; Juglans ; Male ; Nevus* ; Parturition ; Peas ; Skin ; Skin Diseases

OBJECTIVE: The purpose of this study was to analyze risk factors that are associated with intracranial lesion, and to propose criteria for classification of mild head injury (MHI), and appropriate treatment guidelines. METHODS: The study was based on 898 patients who were admitted to our hospital with Glasgow Coma Scale (GCS) score of 13 to 15 between 2003 and 2007. The patients' initial computerized tomography (CT) findings were reviewed and clinical findings that were associated with intracranial lesions were analyzed. RESULTS: GCS score, loss of consciousness (LOC), age and skull fracture were identified as independent risk factors for intracranial lesions. Based on the data analysed in this study, MHI patients were divided into four subgroups : very low risk MHI patients are those with a GCS score of 15 and without a history of LOC or headache; low risk MHI patients have a GCS score of 15 and with LOC and/or headache; medium risk MHI patients are those with a GCS score of 15 and with a skull fracture, neurological deficits or with one or more of the risk factors; high risk MHI patients are those with a GCS score of 15 with abnormal CT findings and GCS score of 14 and 13. CONCLUSION: A more detailed classification of MHI based on brain CT scan findings and clinical risk factors can potentially improve patient diagnosis. In light of our findings, high risk MHI patients should be admitted and treated in same manner as those with moderate head injury.
Adult ; Brain ; Craniocerebral Trauma ; Glasgow Coma Scale ; Head ; Humans ; Light ; Risk Factors ; Skull Fractures ; Unconsciousness

The purpose of this study is to evaluate the factors that may have a role in the development of postoperative exotropia with the angle of 20 prism diopters (PD) or more. The study group was subdivided into three groups depending on the amount of deviation for consecutive exotropia; group A is the angle of 20PD or more, group B is between 10PD and 18PD, and group C is orthophoria. Comparing group A with C, the presence of amblyopia(p<0.05), postoperative limitation on adduction(p<0.01), postoperative binocular vision(p<0.05) and postoperative A or V pattern(p<0.05) were statistically significant. Among the factors of group A and B, the presence of postoperative limitation on adduction(p<0.05) and refractive error of 3D or more(p<0.05) were signifi cant. We suggest that these factors may have a role to develop large consecutive exotropia, therefore close observation is necessary when these factors are found.
Esotropia* ; Exotropia* ; Refractive Errors ; Telescopes

No abstract available.
Breast Neoplasms* ; Breast* ; Estrogens* ; Humans*

PURPOSE: Tc-99m MIBI scintimammography has been validated as an useful non-invasive diagnostic tool for the primary breast cancer. But most studies have included small population of patients. We have experienced a large study population and investigated the diagnostie usefulness of Tc-99m MIBI scintimammography in detection of primary breast cancer and axillary Iymph node metastasis. MATERIALS AND METHODS: This study included 30S patients who underwent scintimammography for palpable breast masses or abnormal radiologic findings. Tc-99m MIRI scintirnammography was performed 10 minutes after intravenous injection of 925 MBq of Tc-99m MIBI. If the early image revealed abnormal finding, 3 hour delayed image was also acquired. We calculated early and delayed lesion to non-lesion ratios (L/N). The pathologic diagnosis was obtained from surgical operation or F.4AB and compared with the results of Tc-99m MIBI scintimammography. RESULTS: Malignant breast diseases were 155 and benign ones were 150. Tc-99m MIBI scintimammography revealed 132 true positive, 23 false negative, 10 false positive, and 140 true negative cases. The sensitivity, specificity, positive predictive value and negative predictive value for the primary breast cancer detection were 85.2%, 93.4%, 92.9%, and 85.9%, respectively. The sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scintimammography in detecting metastatic axillary lymph node involvement were 22%, 90.4%, 61.9% and 62.3%, respectively. Early L/N of malignant breast disease was significantly higher than that of benign one (2,44+/-0.97 vs 1.94+/-0.78, p=0.01). Delayed L/N had no significant difference between malignant an Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Humans ; Injections, Intravenous ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity

PURPOSE: The aim of this study was to investigate the diagnostic role of 99mTc-Tetrofosmin in detection of breast cancer and compared with that of 99mTc-MIBI. MATERAL AND METHODS: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had 99mTc-MIBI and 99mTc-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. RESULTS: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of 99mTc-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of 99mTc-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of 99mTc-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of 99mTc-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both 99mTc-MIBI and 99mTc-Tetrofosmin scintimammographies and its size was 0.5cm. CONCLUSION: 99mTc-Tetrofosmin and 99mTc-MIBI were non-invasive and useful in detection of breast cancer and 99mTc-Tetrofosmin was comparable to the 99mTc-MIBI in detection of primary breast cancer.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Humans ; Injections, Intravenous ; Radiopharmaceuticals ; Sensitivity and Specificity

We evaluated retrospectively the clinical characteristics of 10 esotropic patients following surgery for intermittent exotropia. The nonoperative group(NG) comprised of 5 patients with esodeviation under 16PD and the operative group(OG) of 5 patients with the angle of 18PD or more. The associated condition was one case of myopic anisometropia in the NG. In the OG, there were inferior oblique overactions in three cases and high myopia or amblyopia in two cases. The mean esodeviation at early stage was 11.8PD and 7.8PD at final stage in the NG. 4 of 5 patients showed good alignment within 10PD. In the OG, the mean early esodeviation and final deviation were 11.6PD and 19.2PD respectively. Three patients showed orthotropia in the early stage, and 2 patients revealed orthotropia in the final stage. There were no significant differences in achieving fusion and steropsis between the two groups. The results suggest that the degree of deviation and associated ocular conditions will influence the choice of therapy. We think that there will be no problem in the recovery of binocular visual function after surgery for consecutive esotropia.
Amblyopia ; Anisometropia ; Esotropia* ; Exotropia* ; Humans ; Myopia ; Retrospective Studies ; Telescopes

Myosin heavy chain 9 (MYH9) related diseases are autosomal dominant diseases characterized by macrothrombocytopenia and inclusion bodies in leukocyte, which can be accompanied by extra-hematologic symptoms such as sensorineural hearing loss, renal dysfunction, and cataract. They are often diagnosed incidentally in adulthood or misdiagnosed as idiopathic thrombocytopenic purpura (ITP), leading to unnecessary treatment with intravenous high-dose gamma-globulin, steroids, or splenectomy. Here, we report the case of a brother and sister confirmed to have a MYH9 gene mutation during follow-up. An 8-year-old boy was confirmed to have thrombocytopenia at birth and treated with intravenous gamma-globulin under suspicion of ITP or sepsis. He was discharged after showing an increase in platelet count. Subsequently, during outpatient workup, he exhibited thrombocytopenia, large platelets, and neutrophilic inclusion bodies. His 10-year-old sister also presented with the same findings. In 2021, DNA analysis revealed that they share a mutation (c.4270G> A, p. Asp1424Asn), a pathogenic variant associated with MYH9-related disorder.

Maspin is a recently described gene with tumor suppressor activity. The gene product is a 42 kD protein with homology to the serpin family of protease inhibitors and may play a role as an inhibitor of tumor cell invasion. The prior observation that invasive breast cancers and their metastases showed decreased maspin protein expression by immunostaining supports this speculation. However, the role of maspin in breast cancer progression has not been studied in detail. We, therefore, studied maspin protein expression in a series of hyperplasia, atypical ductal hyperplasia, intraductal carcinoma and invasive carcinomas. Immunohistochemical staining (IHC) for maspin was performed on paraffin sections of 136 breast specimens using a commercially available monoclonal antibody. Among the 106 cases studied were 36 moderate/florid ductal hyperplasia, 11 atypical ductal hyperplasia (ADH), 29 intraductal carcinoma (IDC) (4 low grade, 13 intermediate grade, 12 high grade) and 30 invasive ductal carcinomas. Thirty cases of normal breast were also studied as control group. IHC stains were scored using a semiquantitative scoring system. The mean IHC scores for maspin for normal, moderate/florid hyperplasia, atypical ductal hyperplasia, intraductal carcinoma, and invasive carcinoma were 5.51 1.30, 7.36 0.72, 3.82 1.60, 4.48 2.69, 3.97 3.30, respectively. These scores for each category were statistically significant (p<0.05), except between ADH and IDC. Maspin protein expression was increased in most cases of moderate/florid hyperplasia, while maspin expression was more heterogeneous in ADH and IDC. In high grade IDC, maspin protein expression was stronger than low and intermediate grade IDC, and this suggests the possibility of a compensatory cellular response against the forces driving further tumor progression. Two thirds of invasive ductal carcinomas expressed maspin protein weakly and focally. All metastatic carcinomas of lymph nodes were negative for maspin. It is possible that high grade IDC with strong maspin expression may represent a subset less likely to progress to invasive cancer. This speculation merits investigation in clinical outcome studies.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Coloring Agents ; Humans ; Hyperplasia* ; Lymph Nodes ; Neoplasm Metastasis ; Outcome Assessment (Health Care) ; Paraffin ; Protease Inhibitors