PURPOSE: To determine the effectiveness of lacrimal trephination to treat canalicular obstruction. METHODS: Silicone intubation following lacrimal trephination was performed in 38 eyes of 29 patients with epiphora due to canalicular obstruction between December 2005 and October 2009. Medical records were retrospectively reviewed and telephone interviews were performed. The severity of epiphora was graded by Munk's scale, and anatomical improvement was evaluated by postoperative probing and syringing. RESULTS: The procedure was successful in 73.7% of the cases (grade 0 or 1), and 68.4% of the eyes had complete resolution of epiphora (grade 0). The anatomical success rate was 81.6%. CONCLUSIONS: Lacrimal trephination is a simple and effective treatment for canalicular obstructions. Therefore, lacrimal trephination could be performed prior to attempting an invasive conjunctivodacryocystorhinostomy.
Eye ; Humans ; Interviews as Topic ; Intubation ; Lacrimal Apparatus Diseases ; Medical Records ; Retrospective Studies ; Silicones

No abstract available.
Animals ; Cerebrospinal Fluid Pressure* ; Cerebrospinal Fluid* ; Guinea Pigs* ; Guinea*

PURPOSE: To report the first domestic case of orbital lymphangioma treated with intralesional OK-432 injection. METHODS: Initial treatment with systemic corticosteroid had failed. After aspirating the blood, we injected OK-432 (0.05 mg) into the cystic space of the orbital lymphangioma. RESULTS: Although there were minor complications, such as fever and mild tenderness, the patient had an uneventful recovery. After 6 weeks, her visual axis was restored. CONCLUSIONS: We successfully treated this infant patient with an intralesional OK-432 injection. Based on this success, we suggest that treatment of orbital lymphangioma which is refractory to conservative treatment and difficult to resect, may include an intralesional OK-432 injection.
Axis, Cervical Vertebra ; Fever ; Humans ; Infant ; Lymphangioma* ; Orbit* ; Picibanil*

BACKGROUND: Local bath-PUVA(LB-PUVA) therapy has been recently tried for the treatment of palmoplantar pustular psoriasis and chronic eczema with successful results. However it has not been reported that the effectiveness of LB-PUVA was compared with that of steroid treatment which is the most available treatment. OBJECTIVES: The purpose of this study was to assess the effectiveness, symptom-free interval, recurrence rate and side effects of local bath-PUVA(LB-PUVA) therapy in palmoplantar pustular psoriasis and dyshidrotic eczema which had been resistant to conventional treatments and to compare these results with those of the steroid treatment. METHODS: Twenty four patients with palmoplantar pustular psoriasis, dyshidrotic eczema and palmoplantar keratoderma were treated with local bath-PUVA and the control group of twenty patients with systemic and topical steroid. 1. Local bath-PUVA therapy After a 15-minute bath in 1mg/L of methoxsalen solution(0.0001%), the palms or soles or both were exposed immediately to UVA radiation by UV/PUVA200. The initial standard dose was 1.5 J/cm2, and the patients were treated three times a week. 2. Systemic and topical steroid therapy The patients treated with 10-15mg of oral prednisolone once a day and high-potency steroid(Dermovate ointment) to the lesion topically for 4-8 weeks. The efficacy, symptom-free interval and side effects were assessed for 6-12 months after termination of the treatments. RESULTS: The following results were obtained from this study. 1. In the objective study, severity scores before and after treatment significantly differed in palmoplantar pustular psoriasis treated with local bath-PUVA (p<0.001). 2. In the subjective study, steroid treatment was more effective than LB-PUVA treatment for dyshidrotic eczema and palmoplantar pustular psoriasis. 3. Remission period was significantly longer (mean 9.1+/-2.8 months vs. 5.2+/-3.1 months) and recurrence rate, lower (26.7% vs. 68.9%) after LB-PUVA treatment than after steroid treatment in palmoplantar pustular psorisis and dyshidrotic eczema. 4. One patient with palmoplantar keratoderma was effectively treated by LB-PUVA. CONCLUSION: Local bath-PUVA therapy can be used as an effective and safe treatment method of palmoplantar pustular psoriasis and possibly palmoplantar keratoderma.
Baths ; Eczema ; Eczema, Dyshidrotic* ; Humans ; Keratoderma, Palmoplantar ; Methoxsalen ; Prednisolone ; Psoriasis* ; Recurrence

Tubular apocrine adenoma(TAA) is a rare tumor characterized by papillary projection and apocrine differentiation. We report two cases of tubular apocrine adenomas. One patient was a 13-year-old male who had had a finger-tip sized asymptomatic cystic mass on his scalp since birth. Microscopically, the mass was composed of various sized cystic spaces and tubular structures lined by two layers of epithelia with nonvillous intraluminal papillary projections, decapitation secretions and connection with the epidermis. The other patient was a 55-year-old female who had had a 1.3x0.3cm sized dark red hard nodule on the left forearm since birth. Histopathologic finding showed a well circumscribed dermal neoplasm that predominantly consisted of multiple tubular structures lined by double layers of epithelial cells with decapitation secretions and intraductal papillary projections, and accompanied by underlying apocrine nevus. In both cases, immunohistochemical and enzyme studies showed positive findings in EMA, CEA, pancytokeratin, lysozyme, alkaline phosphatase, GCDFP-15.
Adenoma* ; Adolescent ; Alkaline Phosphatase ; Decapitation ; Epidermis ; Epithelial Cells ; Female ; Forearm ; Humans ; Male ; Middle Aged ; Muramidase ; Nevus ; Parturition ; Scalp

BACKGROUND: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. METHODS: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. RESULTS: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. CONCLUSIONS: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.
Biopsy ; Bronchiectasis ; Bronchoscopy* ; Cytodiagnosis ; Fistula ; Humans ; Lung Neoplasms ; Respiration ; Tuberculosis

It is not uncommon that an endoscopist should differentiate metastatic or invasive cancer to the colorectum from primary colorectal cancer with its endoscopic appearances. This study reviewed the endoscopic appearances of 7 patients who were proved to have metastatic or invasive cancers to the colorectum, both clinically and pathologically. The primary cancers were uterine cervix cancers in 3 patients, advanced gastric cancers in two, and prostatic cancer in one. The endoseopic appearances of metastatic or invasive cancer showed several characteristic features with regard to those of primary colorectal cancer, as follows. 1) Multiplicity of lesions 2) Nodular lesion with unaffected mucosa or with mild degree of erosions 3) Concentric defarmities with conical extremities and the absence of shelving margins 4) Inflammatroy lesions with mucosal hyperemia, erosion, ulceration, and bleeding, but without definite mass formation.
Cervix Uteri ; Colorectal Neoplasms ; Extremities ; Female ; Hemorrhage ; Humans ; Hyperemia ; Mucous Membrane ; Prostatic Neoplasms ; Stomach Neoplasms ; Ulcer

Background/Aims: Maintaining vascular access (VA) is very important in the management of hemodialysis (HD) patients. Therefore, the identification of risk factors for decreased vascular access flow has clinical relevance. The aim of the present study was to investigate the impact of serum phosphorus (P) on autologous arteriovenous fistula flow in HD patients. Methods: Sixty-two maintenance HD patients who visited the dialysis unit of CHA Bundang Medical Center between November 2016 and December 2017 were included in the study. Serum P levels were obtained every month, and time-averaged serum P was calculated. All patients had left arm arteriovenous fistulas (AVF; side-to-side anastomosis). AVF flow was assessed by Transonic HD 03. Decreased AVF flow was defined as < 600 mL/min. Results: Decreased AVF flow was observed in 14 of 62 patients. In univariate analysis and multivariable analysis, higher serum P had a significant independent association with decreased AVF flow. Advanced age, reduced ejection fraction, low blood flow rate in dialysis, and higher serum calcium were not associated with AVF flow. Conclusions The present study demonstrated that higher serum P was an independent risk factor for decreased autologous AVF flow in maintenance HD patients. Serial monitoring of serum P may be helpful in stratifying patients by risk of AVF dysfunction, and proper management of serum P levels may be helpful in maintaining flow through autologous AVFs.

Melanosis coli is the brownish black discoloration of the colon due to accumulation of pigment containing macrophages in lamina propria. The nature and source of this pigment is controversial but many studies have suggested that the pigment is related to lipofuscin. Melanosis coli has been reported to be closely associated with prolonged administration of anthraquinone purgatives. But this condition is sometimes associated with colonic polyp colon cancer, rediation therapy or non-anthraquinone purgatives administration. Moreover the fact that melanosis coli could be found in subjects who never used purgatives suggested that, even though chronic consumption of anthraquinone purgatives seems to play a major role, other factors may be involved in the pathogenesis of melanosis coli. We presented a case of melanosis Coli in a 47-year-old female with history of rectal instillation of petroleum for control of hemorrhoids.
Administration, Rectal* ; Cathartics ; Colon ; Colonic Neoplasms ; Colonic Polyps ; Female ; Hemorrhoids ; Humans ; Lipofuscin ; Macrophages ; Melanosis* ; Middle Aged ; Mucous Membrane ; Petroleum*

BACKGROUND: Some researchers have tried to use Tc-99m MIBI (2-methoxyisobutyl isonitril) scintigraphy to evaluate breast-cancer patients. Early reports revealed that Tc-99m MIBI breast scintigraphy was useful in distinguishing malignancies from benign masses in patients for whom mammographic evaluations were difficult. Further studies suggested that functional imaging with Tc-99m MIBI in breast cancer seemed to be correlated with the levels of P-glycoprotein (Pgp) expression and angiogenesis in cancer tissues. For that reason, we evaluated whether significant relationship actually existed between the pattern of Tc-99m MIBI uptake in tumor tissue and tumoric factors including Pgp expression and angiogenesis. METHODS: Thirty-one untreated breast-cancer patients (later pathologically proved to have had invasive ductal carcinomas) were prospectively studied by using both Tc-99m MIBI scintigraphy on and immunohistochemical analyses of angiogenesis and Pgp expression in sugically removed tumor tissues. Both lateral and anterior planar images were obtained at 10 minutes and 3 hours after intravenous injection of 740 MBq Tc-99m MIBI. The tumor-to-normal breast ratio (T/N) and the washout index (WI, early T/N minus late T/N divided by early T/N) were calculated. RESULTS: A significant correlation was found between the T/N's at early and late images (r=0.54, p=0.002 on early images; r=0.47, p=0.006 on late images). The T/N's of early images were not different among the different groups of Pgp expression (p=0.3696) while those of late images were significantly different among the groups (p=0.0276). An even more significant difference was noted in the WI's among the groups (p=0.0015). A significant negative correlation was noted between the T/N of late images and Pgp expression (p=0.0276). An even stronger correlation was found between WI and Pgp expression (r=0.668, p=0.001). CONCLUSIONS: The tumoral uptake and washout of Tc-99m MIBI can be used as a simple functional test for angiogenesis and P-glycoprotein expression in untreated breast cancer.
Breast Neoplasms* ; Breast* ; Humans ; Injections, Intravenous ; P-Glycoprotein ; Population Characteristics* ; Prospective Studies ; Radionuclide Imaging*