PURPOSE: To evaluate the effect of intravitreal expansile gas (C3F8) with anti-VEGF injection for the treatment of large submacular hemorrhage (SMH) secondary to age-related macular degeneration (ARMD). METHODS: In this report, 18 eyes of 18 patients with large SMH secondary to ARMD were treated with a simultaneous injection of 0.3 cc C3F8 and 0.05 ml anti-VEGF intravitrealy. RESULTS: The mean age was 64.89 +/- 5.68 years and the mean size of SMH was 4.44 +/- 1.25 disc diameters (DD). The minimum follow-up period was 12 months (range: 12-17 months). Mean preoperative best corrected visual acuity (BCVA) was 1.72 +/- 0.56 log MAR which improved significantly to 1.01 +/- 0.68 log MAR at 12 months (p = 0.002). SMH displacement occurred in all eyes. BCVA improved 2 or more lines in 11 eyes (61.1%) and deteriorated in 1 eye (5.6%). CONCLUSIONS: In this report, intravitreal injection of an expansible gas (C3F8) with anti-VEGF produced successful results in anatomical displacement of SMH and early visual improvement.
Displacement (Psychology) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Intravitreal Injections ; Macular Degeneration ; Visual Acuity

Protozoa of the genus Cryptosporidium are small coccidian parasite known to infect the mucosal epithelium of a variety of animals including human, causing fatal course in immunodeficient patients as well as self-limited illness in healthy individuals. Various life cycle stages including trophozoite, meront, merozoite, gametocyte and oocyst in infected mucosa are a diagnostic feature. Electron microscopy (EM) provides sufficient findings for genus and species identification of this parasitic organism. The authors presented scanning and transmission EM findings of Cryptosporidium parvum infection in two children: one with acute lymphoblastic leukemia and the other without any evidence of immune compromise.
Animals ; Child ; Cryptosporidium parvum ; Cryptosporidium* ; Epithelium ; Humans* ; Intestines* ; Life Cycle Stages ; Merozoites ; Microscopy, Electron ; Mucous Membrane ; Oocysts ; Parasites ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Trophozoites

Authors had prepared the high-quality sectioned images of a cadaver head. For the delineation of each cerebral gyrus, three-dimensional model of the same brain was required. The purpose of this study was to develop the segmentation protocol of cerebral gyri by referring to the three-dimensional model on the personal computer. From the 114 sectioned images (intervals, 1 mm), a cerebral hemisphere was outlined. On MRIcro software, sectioned images including only the cerebral hemisphere were volume reconstructed. The volume model was rotated to capture the lateral, medial, superior, and inferior views of the cerebral hemisphere. On these four views, areas of 33 cerebral gyri were painted with colors. Derived from the painted views, the cerebral gyri in sectioned images were identified and outlined on the Photoshop to prepare segmented images. The segmented images were used for production of volume and surface models of the selected gyri. The segmentation method developed in this research is expected to be applied to other types of images, such as MRIs. Our results of the sectioned and segmented images of the cadaver brain, acquired in the present study, are hopefully utilized for medical learning tools of neuroanatomy.
Aged ; Cerebrum/*anatomy & histology ; Humans ; Imaging, Three-Dimensional ; Male ; *Models, Anatomic ; Software

OBJECTIVES: To investigate the effects of KCl on regulation of circadian gene CLOCK expression, we observed whether induction of CLOCK is influenced by KCl depolarization in B35 rat neuroblastoma cells. METHODS: B35 rat neuroblastoma cells were grown in Dulbecco's modified Eagle's medium supplemented with 10% FBS and 1% penicillin-streptomycin in a 37 degrees C humidified incubator with 5% CO2. Inhibitors including cycloheximide and actinomycin D were pretreated 1 hour before treatment with 50mM KCl. Immunoblotting with anti-CLOCK antibody was done. RESULTS: CLCOK is induced by 50 mM KCl in B35 Rat Neuroblastoma cells, and a maximal induction in CLOCK level reached peak at 8 to 20 hours. The pretreatment of cycloheximide and actinomycin D prevented the induction of CLOCK by 50 mM KCl. CONCLUSION: We suggest that KCl depolarization may play critical roles in several aspects of the circadian gene CLOCK expression.
Animals ; Circadian Clocks ; Cycloheximide ; Dactinomycin ; Immunoblotting ; Incubators ; Neuroblastoma* ; Rats*

Behcet's disease is a chronic inflammatory disease of an unknown etiology, and it is characterized by recurrent oral and genital ulcerations, eye lesions skin lesions, and other involvement such as gastrointestinal ulcerations and lesions of the central nervous system and major vessels. The vascular lesions include deep vein thrombosis, superficial thrombophlebitis, arterial aneurysm and arterial occlusion. Aortic aneurysm or pseudoaneurysm is a rare complication, but it is one of the most common causes of death in Behcet's disease. We report here on a case of a 43 year old female with Behcet's disease that was complicated by an abdominal aortic pseudoaneurysm, and this was all successfully treated with percutaneous endovascular stent graft insertion, steroid pulse therapy and azathioprine.
Aneurysm ; Aneurysm, False ; Aortic Aneurysm ; Azathioprine ; Cause of Death ; Central Nervous System ; Eye ; Female ; Humans ; Skin ; Stents ; Thrombophlebitis ; Transplants ; Ulcer ; Venous Thrombosis

BACKGROUND: To analyze clinical outcomes after anatomical reconstruction of distal radioulnar ligaments in patients with chronic post-traumatic instability of the distal radioulnar joint. METHODS: Anatomical reconstruction was performed in 16 patients with subluxation or dynamic instability of distal radioulnar joint following trauma. Osteotomy was performed simultaneously in 10 patients with radial malunion. The average follow-up period was 18.9 months. For clinical outcome assessment, we performed the anteroposterior stress test, measured the range of motion and grip strength, and performed radiological examination. For assessment of the pain and function, we used the Patient Rated Wrist Evaluation, the Disabilities of the Arm, Shoulder and Hand, and the Modified Mayo Wrist Score. RESULTS: Anteroposterior stress test performed at the last follow-up showed normal in 12 patients, mild laxity in 3, and residual subluxation in one. The average Patient Rated Wrist Evaluation was 9.1 for pain and 11.2 for function. The average Disabilities of the Arm, Shoulder and Hand score was 10.5. The average Modified Mayo Wrist Score was 92.8; there were 10 excellent, 5 good, and 1 poor case. The average grip strength improved from 69.7 1b to 80.9 1b. A revision osteotomy was performed on the patient with residual subluxation in order to obtain normal alignment of the joint. CONCLUSIONS: Anatomical reconstruction of the distal radioulnar ligaments is recommended to restore distal radioulnar joint stability. In addition to ligament reconstruction, realignment of the distal radioulnar joint seems critical when the instability is combined with malunion of the radius.
Adolescent ; Adult ; Female ; Hand Strength ; Humans ; Joint Instability/*surgery ; Ligaments, Articular/*surgery ; Male ; Middle Aged ; Osteotomy/methods ; Pain Measurement ; Radius/surgery ; Range of Motion, Articular ; Treatment Outcome ; Ulna/surgery ; Wrist Injuries/*surgery ; Wrist Joint/*surgery ; Young Adult

PURPOSE: We studied the patterns of FDG uptake of primary papillary thyroid microcarcinoma (PTMCa) lesions and benign thyroid nodules in dual time point (18)F-FDG PET/CT imaging. MATERIALS AND METHODS: Consecutive 134 patients (154 lesions) with PTMCa and 49 patients (61 nodules) with benign thyroid nodules equal to or less than 1.0 cm who underwent dual time point (18)F-FDG PET/CT study before surgery were enrolled. We calculated the maximum standardized uptake value of PTMCa and benign nodules in both time points, and percent change of SUVmax (delta%SUVmax) and lesion to background ratio of SUVmax (delta%L:B ratio) between both time points. The mean time interval between scans was 23.4+/-4.4 minutes (thyroid to thyroid interval: 10.7+/-4.4 minutes). RESULTS: The mean of SUVmax of PTMCa was increased from 4.9+/-4.3 to 5.3+/-4.7 (p<0.001) and delta%SUVmax was 12.3+/-23.6%. But, the mean of SUVmax of benign nodules was no definite change (2.1+/-1.0 to 2.1+/-1.3, p=0.686) and delta%SUVmax was -0.3+/-20.5%. Of the 154 PTMCa, 100 nodules (64.9%) showed an increase in SUVmax over time, while 19 (31.1%) of the 61 benign thyroid nodules showed an increase (p<0.001). The dual time point (18)F-FDG PET/CT found more PTMCa in visual assessment (62.3% vs. 76.6%, p=0.006), even in smaller than 0.5 cm (38.6% vs. 60.0%, p=0.011). CONCLUSION: Dual time time (18)F-FDG PET/CT imaging was more useful than single time point (18)F-FDG PET/CT imaging for distinction between PTMCa and benign nodule, especially when nodule showed equivocal or negative findings in single time point (18)F-FDG PET/CT imaging or was smaller than 0.5 cm.
Carcinoma, Papillary ; Humans ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

PURPOSE: In case of postburn flexion contracture of the fingers, skin graft, geometrical relaxation techniques, local flap, and free flap have been used. Among these procedures, full-thickness skin grafts from the inguinal area are widely used to reconstruct a postburn flexion contracture in the fingers. But there are many esthetic and functional problems in this procedure. Especially, hyperpigmentation of the skin-grafted fingers poses a troublesome problem, particularly in the patients who have dark colored skin. To solve the problem, we have used pulp graft which was harvested from the lateral aspect of great toe. In the present study, we report pulp graft, with which we have obtained a good result in the treatment of postburn flexion contracture of the fingers. METHODS: Between September of 2004 and August of 2006, great toe pulp graft was performed to 20 sites of 15 patients. After release of the postburn flexion contracture using Z-plasty, the composite tissue (pulp) harvested from the lateral aspect of great toe was grafted on the raw surface. Moisture dressing with ointment and foam dressing material was performed. Stratum corneum of the graft got stripped off in two to four weeks after pulp graft. The color of the pulp graft was slightly reddish, then it became similar to the adjacent tissue. RESULTS: There was complete take in all the patients who were treated with pulp graft. Great toe pulp graft provided similar color and texture to the adjacent skin, high rate of graft take, and left only a minimal scar at donor site. CONCLUSION: Thick keratin layer and inelastic nature of the pulp make this type of the graft much easier and simpler, and ensure a better take. Pulp graft is useful method for the reconstruction of the postburn flexion contracture in fingers.
Bandages ; Burns ; Cicatrix ; Contracture* ; Fingers* ; Free Tissue Flaps ; Humans ; Hyperpigmentation ; Relaxation Therapy ; Skin ; Tissue Donors ; Toes* ; Transplants*

An intrathyroid thyroglossal duct cyst (TGDC) presented as an anterior neck mass in a 62-year-old male without history of prior thyroid disease or infection. This cyst was clinically indistinguishable from a thyroid nodule. In addition to that, fine needle aspiration cytology revealed normal–looking squamous cells. Diagnosis, work-up, management approach, and treatment of intrathyroid TGDC are discussed as well as distinguishing features between intrathyrod TGDC with tract and without tract. This is the very rare case of intrathyroid TGDC in Korean population and the possibility of intrathyroid TGDC should remain in the differential diagnosis of thyroid nodule.
Biopsy, Fine-Needle ; Diagnosis ; Diagnosis, Differential ; Epithelial Cells ; Humans ; Male ; Middle Aged ; Neck ; Thyroglossal Cyst ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule

Coinfection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with other respiratory pathogens may complicate diagnosis and treatment. Since the risk of coinfection with SARS-CoV-2 is expected to increase during the influenza epidemic period, it is necessary to study the clinical course of coinfection. To our knowledge, there have been a few cases of coinfection between SARS-CoV-2 and influenza virus in neonates. Here, we report the clinical course of a neonate who was coinfected with the influenza virus and SARS-CoV-2. A 20-day-old boy born with low birth weight presented with a fever. The patient was confirmed as positive with coronavirus disease 2019 (COVID-19) and influenza B by real-time polymerase chain reaction at admission, whereas his mother was only COVID-19 positive at that time. Initial chest x-ray revealed hyperinflation and increased peribronchial markings at the right lower lung bronchus, but slightly decreased lung sounds without crackle or wheezing at admission. We administered empirical antibiotics for neonatal sepsis and oseltamivir for influenza B. On the chest x-ray follow-up, the findings showed improvement. After discharge, the patient showed a stable general condition. Children ineligible for COVID-19 vaccination who are coinfected with SARS-CoV-2 and the influenza virus are more likely to develop severe symptoms. It is necessary to detect coinfections as some can be treated with antibiotics and antivirals in young infants.