PURPOSE: To report a rare case of juvenile xanthogranuloma in the lacrimal sac. CASE SUMMARY: An 8-year-old female presented to our hospital with epiphora and palpable mass on the left medial canthal area. As a symptom, a sticky and bloody discharge through the punctum had begun on occasion 3 months previously. When pressure was applied on the left medial canthal area, a mucoid discharge through the punctum occurred, and a solid mass was palpable. The mass localized in the lacrimal sac and upper nasolacrimal duct was observed on orbit CT. No invasion into the surrounding tissue was present. The authors of the present study decided to perform endonasal dacryocystorhinostomy, and subsequently a skin-colored mass was found in the lacrimal sac. The histopathological and immunohistochemical diagnosis was histiocytic proliferation, compatible with juvenile xanthogranuloma. Six months later, the patient complained of epiphora recurrence with palpable mass on medial canthal area. The tumor recurrence was confirmed with enhanced orbit CT finding 14 months after the first surgery. A second surgery using endonasal dacryocystorhinostomy was performed to remove the mass.
Child ; Dacryocystorhinostomy ; Female ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Orbit ; Recurrence ; Xanthogranuloma, Juvenile

PURPOSE: In the present study, the effect of the inferior conjunctival transposition flap in patients with recurrent pterygium was evaluated. METHODS: This study included 60 patients (63 eyes) that received pterygium surgery with inferior conjunctival transposition flap and diagnosed with recurrent pterygium. The inferior conjunctival transposition flap obtained from lower bulbar conjunctiva was secured with 8-0 VICRYL® after removal of recurrent fibrovascular tissues. This study was retrospectively reviewed for recurrence and postoperative complications in patients with a minimum follow-up period over 6 months. RESULTS: The mean follow-up period was 5 years and 8 months (range; 6 months to 14 years). Corneal recurrence occurred in 4 eyes (6.3%) and conjunctival recurrence was observed in 2 eyes (3.1%) among a total of 63 eyes. Conjunctival recurrence was not the progressive type and limited to the limbus and suture site. One case of corneal recurrence required additional symblepharolysis and auto conjunctival graft. Although mild flap congestion, hemorrhage and granuloma were observed, these cases improved during the follow-up period. CONCLUSIONS: The inferior conjunctival transposition flap procedure can be regarded as an effective surgical treatment option for recurrent pterygium.
Conjunctiva ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Granuloma ; Hemorrhage ; Humans ; Postoperative Complications ; Pterygium* ; Recurrence ; Retrospective Studies ; Sutures ; Transplants

PURPOSE: To evaluate the effects of the modified medial spindle and the lateral tarsal strip procedure in involutional ectropion patients. METHODS: The lateral tarsal strip procedure with the modified medial spindle procedure that adjusts the size and the position of the spindle along the severity of lower eyelid eversion was performed on 17 eyes of 12 patients with involutional ectropion. The average follow-up period was 19.6 months. RESULTS: All 12 patients were male, and the mean age was 65.4 years (range 54 to 78 years). There was no recurrence in any of the 17 eyelids. However, a mild lower lid retraction and a mild punctal eversion not requiring reoperation occurred in the follow-up period. CONCLUSIONS: The lateral tarsal strip procedure combined with the modified medial spindle appears to be effective in the surgical treatment of involutional ectropion.
Ectropion ; Eye ; Eyelids ; Follow-Up Studies ; Humans ; Male ; Recurrence ; Reoperation

We report a case of sebaceous hyperplasia showing linear arrangement in a 13-year-old girl. The lesion was found at birth and became prominent gradually. Multiple small discrete yellowish papules were arranged in a linear pattern on the temporal srea of the face. Unusual, incidental histopathologic finding was a sebaceous lobule lying in a dilated infundibular portion, which appeared to represent transfollicular extrusion of sebaceous lobule as a natural phenomenon.
Adolescent ; Deception ; Female ; Humans ; Hyperplasia* ; Parturition

Pneumomediastinum is a relatively uncommon, infrequently reported entity, In the evaluation of these entity, it is important to exclude pathological causes, including Boerhaave's syndrome which carries a high mortality. Spontaneous pneumomediastinum is related to excessive intraalveolar pressure leading to rupture of perivascular alveoli in the setting of a Valsalva maneuver without communication to gut material. So, it has a benign self-limited course and rarely requires medical intervention. On the contrary, secondary pneumomediastinum caused by instrumental, traumatic, and spontaneous perforation of esophagus. Although the prognosis have been improved since the advent of broad-spectrum antibiotics and nutritional support, pneumomediastinum due to esophageal perforation still has a high morbidity and mortality. The most important prognostic factor is the time interval between perforation and initiation of therapy, and an awareness and a high clinical suspicion is critical in the early diagnosis and treatment. Recently, we have experienced 2 cases of pneumomediastinum, one case was spontaneous pneumomediastinum and the other may be caused by instrumental esophageal perforation. We report the clinical course of the patients with a current literature review.
Anti-Bacterial Agents ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Fibrinogen ; Humans ; Mediastinal Emphysema* ; Mortality ; Nutritional Support ; Prognosis ; Rupture ; Valsalva Maneuver

The purpose of this study is to evaluate the short-term results of the reconstruction of acetabular bone defect radiographically. Twenty three reconstruction with bone graft and non-cemented porous hemispherical cup and one reconstruction with bone graft and cemented polyethylene cup that had been performed in 24 patients from 1991 at Wonkwang University Hospital and had followed more than one year were included in this study. Osseous union, resorption of the graft, the amount of the migration and angle change of the acetabular components and radiolucency were checked on plain X-ray. 9 morselized grafts for contained defect showed 100% union within 6 months, without severe resorption and loosening. Of the 15 structural grafts, 11 minor column or shelf grafts showed 100% union and remodeling, and one case of radiolucency around the cup. There were two collapses of the structural graft and one migration of the cup which suggest the failure among the 4 major column grafts. For the above 3 failed cases, non-cemented porous hemispherical cups were used. In conclusion, bone graft for reconstruction of the deficient acetabular bone stock seems to be suc- cessful, but the use of cement and the delay of weight bearing should be considered for the major column graft.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Humans ; Polyethylene ; Transplants* ; Weight-Bearing

PURPOSE: To evaluate the efficacy of chemical peeling using 83% alcohol in patients with conjunctival nevus. METHODS: Chemical peeling using 83% alcohol was performed in 13 patients (13 eyes) who were clinically diagnosed with benign conjunctival nevus. Effects of procedure and recurrence were analyzed by retrospectively reviewing medical records. After topical anesthesia, conjunctival nevus was eliminated by rubbing with an alcohol-soaked cotton ball. Conjunctival nevus close to corneal limbus was removed by 15th blades of scalpel. RESULTS: A total of 13 patients, 8 males, and 5 females had a, mean age of 27 years (12-54 years). Eights of the eyes were right eyes, and 5 were left eyes. No recurrence was detected in any patient during the follow-up period (mean 54 months), and there were no cases of conjunctival scar, granuloma, or permanent conjunctival injection. All patients were satisfied with the cosmetic outcome of chemical peeling. CONCLUSIONS: Chemical peeling using alcohol for conjunctival nevus is a non-invasive technique and has benefits such as no intraoperative hemorrhage, low recurrence rate, easy method, and good cosmetic results. Based on these, this procedure is a good method for eliminating conjunctival nevus.
Anesthesia ; Cicatrix ; Female ; Follow-Up Studies ; Granuloma ; Hemorrhage ; Humans ; Limbus Corneae ; Male ; Medical Records ; Nevus* ; Recurrence ; Retrospective Studies

PURPOSE: To evaluate the efficacy and safety of the inferior conjunctival transposition flap for primary pterygium surgery. METHODS: This study reviewed 59 eyes in 59 patients with primary pterygium who were treated with pterygium excision and an inferior conjunctival transposition flap. The inferior conjunctival flap was obtained from lower bulbar conjunctiva and was secured with 8-0 vicryl. Patients were followed-up on the third day after surgery and then at 1, 2, 4 and 12 weeks postoperatively. RESULTS: The mean patient age was 55.6 (ranging from 34 to 74) years. The mean follow-up period was 24.9 (ranging from 12 to 46) months. During the follow-up period, the pterygium recurred in one (1.7%) of the 59 eyes. There were no severe complications except for mild congestion and hemorrhage of the conjunctival flap. CONCLUSIONS: Inferior conjunctival transposition flap technique may be considered as a safe and effective method that reduces complications and recurrences after primary pterygium excision.
Conjunctiva ; Estrogens, Conjugated (USP) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Polyglactin 910 ; Pterygium ; Recurrence

PURPOSE: To report a case of rhino-orbito-cerebral aspergillosis successfully treated with a combination of amphotericin B, posaconazole and amphotericin B irrigation. CASE SUMMARY: A 59-year-old male with hypertension, diabetes mellitus and hyperlipidemia was admitted to our neurology department for left facial paresthesia, pain and consulted to ophthalmology for left eyeball pain. His visual acuity was no light perception in the left eye, and fundus examination showed papilledema and a cherry-red spot. Left exophthalmos and complete ptosis with ophthalmoplegia were also observed. Orbital computed tomography revealed left maxillary and ethmoid sinusitis, and nasal endoscopic examination revealed a black eschar adjacent to the middle turbinate. Subsequent biopsy suggested mucormycosis. The patient was immediately treated with a combination of amphotericin B and posaconazole. In addition, left endoscopic sinus surgery was performed and aspergillosis was histopathologically confirmed. The patient underwent amphotericin B irrigation for 5 days after canula insertion up to orbital apex. The patient survived for 18 months and is still alive. CONCLUSIONS: A combination of amphotericin B, posaconazole and amphotericin B irrigation using the canula through the orbital apex may be helpful in treating patients with rhino-orbito-cerebral aspergillosis who refuse orbital exenteration.
Amphotericin B* ; Aspergillosis* ; Biopsy ; Diabetes Mellitus ; Ethmoid Sinus ; Ethmoid Sinusitis ; Exophthalmos ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Middle Aged ; Mucormycosis ; Neurology ; Ophthalmology ; Ophthalmoplegia ; Orbit ; Papilledema ; Paresthesia ; Turbinates ; Visual Acuity

A 31-year-old man presented with dull headache and memory disturbance lasting for one week. Computed tomographic scans revealed acute hydrocephalus. The cerebrospinal fluid contained 53 leukocytes/mm3, with a mononuclear preponderance and no erythrocytes. Magnetic resonance imaging revealed hydrocephalus and leptomeningeal enhancement. Magnetic resonance angiography and digital subtraction angiography showed supraclinoid occlusion of the right internal carotid artery, which resembled unilateral moyamoya disease. Neuroendoscopic biopsy of a lesion in the septum pellucidum revealed noncaseating granulomas, which was consistent with sarcoidosis. The patient was successfully managed with intravenous methylprednisolone and ventriculoperitoneal shunting. To our knowledge, this is the first case of moyamoya-like vasculopathy associated with neurosarcoidosis.
Adult ; Angiography, Digital Subtraction ; Biopsy ; Carotid Artery, Internal ; Central Nervous System Diseases ; Erythrocytes ; Granuloma ; Headache ; Humans ; Hydrocephalus ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Memory ; Methylprednisolone ; Moyamoya Disease ; Sarcoidosis ; Septum Pellucidum ; Ventriculoperitoneal Shunt