PURPOSE: To evaluate the efficacy of trabeculectomy using modified scleral flap suture technique METHODS: We retrospectively reviewed the medical records of 52 patients (55 eyes) who had undergone trabeculectomy from January 2003 to January 2007. Standard trabeculectomy was performed for 29 eyes of 27 patients, modified trabeculectomy for 26 eyes of 25 patients. We changed suture site of scleral flap corner about 1mm medially from original site and added tight suture to both lateral margins of scleral flap to prevent overflow in modified group. In both groups, most of patients were injected 0.1 ml of 0.02 mg/ml mitomycin-C (MMC) subconjunctivally and the others 0.1 ml of 0.04 mg/ml MMC. We evaluated intraocular pressure (IOP), complication, morphology of filtering bleb, cumulative success rates. RESULTS: Argon laser suturelysis was performed postoperatively in about half cases of both groups. The IOPs of modified group were consistently lower than those of standard group for 24 months except postoperative 1 day and 1 week. There was a significant difference of IOP at postoperative 2 months and 12 months (p<0.05). No significant difference of complications was found between two groups. The diffuse bleb with microcyst was found in 19 eyes (73%) of modified group and 17 eyes (59%) of standard group. From Kaplan-Meier survival analysis, cumulative success rates of modified group were higher than those of standard group (p<0.05). CONCLUSIONS: Trabeculectomy using modified scleral flap suture appears to give better IOP control than standard trabeculectomy.
Argon ; Blister ; Eye ; Humans ; Intraocular Pressure ; Medical Records ; Mitomycin ; Retrospective Studies ; Suture Techniques ; Sutures ; Trabeculectomy

PURPOSE: To report a case of a 9-year-old girl who complained of a floater symptom due to preretinal hemorrhage, subdural hemorrhage and arachnoid cyst. CASE SUMMARY: A 9-year-old girl presented to our clinic with floater symptom in her right eye and a headache. Her corrected visual acuities were 20/20 in both eyes. Preretinal hemorrhage around the optic disc in both eyes was observed. Brain MRI revealed subdural hemorrhage on the frontal, temporal, and parietal lobes, and the arachnoid cyst in the right fronto-temporal lobe. One year later, the preretinal hemorrhages were absorbed. CONCLUSIONS: Arare case of concomitant preretinal and spontaneous subdural hemorrhage with arachnoid cyst was presented. The utilization of brain MRI is recommended to determine underlying causes when fundus examination reaveals retinal hemorrhage without trauma, systemic disease and neurologic symptom.
Arachnoid ; Brain ; Child ; Eye ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Neurologic Manifestations ; Parietal Lobe ; Retinal Hemorrhage ; Visual Acuity

CD 30 positive anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's lymphoma, a tumor that is composed of mostly mast cells expressing CD30 antigens. According to the 2005 World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification, it can be classified as systemic ALCL and primary cutaneous CD30 positive T-cell lymphoproliferative disorder. Systemic ALCL can be subclassified into ALK positive and negative. There have been many cases of primary cutaneous CD30 positive T-cell lymphoproliferative disorder, but reports of systemic ALCL have been rare. We report a case of CD30 positive/ALK negative systemic anaplastic large cell lymphoma involving bone marrow in a 51 year-old-male who showed two pruritic, 1.5x1.0x0.8 cm and 1.0x0.5x0.4 cm sized, erosive, erythematous nodules on the right thigh and calf.
Antigens, CD30 ; Bone Marrow* ; Classification ; Lymphoma, Large-Cell, Anaplastic* ; Lymphoma, Non-Hodgkin ; Lymphoproliferative Disorders ; Mast Cells ; T-Lymphocytes ; Thigh ; World Health ; World Health Organization

DiGeorge syndrome is the developmental anomalies of the third and fourth pharngeal pouches. Recently, damages or abnormal development of the neural crest is suggested as a possible pathogenetic factor, because neural crest cells play a crucial role in development of pharyngeal pouch derivatives, e.g. thymus and parathyroid glands, as well as the aortic arches and conotruncal part of the heat. Most cases have abnormal findings of chromosome 22 and are sporadic, but familial cases have been described. Typical features of DiGeorge syndrome are congenital heart disease, aplasia or hypoplasia of the thymus and parathyroid glands and facial dysmorphism. The main problems and cause of death are severe congestive heart failure due to cardiac anomlies, hypocalcemic complications or immunocompromised conditions. As these results, most cases were expired at infantal period or early childhood. Recently, we have a case of Digeorge syndrome which was associated with complex cardiovascular anomalies(tetralogy of Fallot, atrial septal defect, right aortic arch, left hemitruncus), severe hypocalcemia, aplasia of thymus and facial dysmorphism.
Aorta, Thoracic ; Cause of Death ; Chromosomes, Human, Pair 22 ; DiGeorge Syndrome* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial ; Hot Temperature ; Humans ; Hypocalcemia ; Infant ; Neural Crest ; Parathyroid Glands ; Thymus Gland

OBJECTIVE: The aim of study was to review our patient population to determine whether there is a critical aneurysm size at which the incidence of rupture increases and whether there is a correlation between aneurysm size and location. METHODS: We reviewed charts and radiological findings (computed tomography (CT) scans, angiograms, CT angiography, magnetic resonance angiography) for all patients operated on for intracranial aneurysms in our hospital between September 2002 and May 2004. Of the 336 aneurysms that were reviewed, measurements were obtained from angiograms for 239 ruptured aneurysms by a neuroradiologist at the time of diagnosis in our hospital. RESULTS: There were 115 male and 221 female patients assessed in this study. The locations of aneurysms were the middle cerebral artery (MCA, 61), anterior communicating artery (ACoA, 66), posterior communicating artery (PCoA, 52), the top of the basilar artery (15), internal carotid artery (ICA) including the cavernous portion (13), anterior choroidal artery (AChA, 7), A1 segment of the anterior cerebral artery (3), A2 segment of the anterior cerebral artery (11), posterior inferior cerebellar artery (PICA, 8), superior cerebellar artery (SCA, 2), P2 segment of the posterior cerebral artery (1), and the vertebral artery (2). The mean diameter of aneurysms was 5.47+/-2.536 mm in anterior cerebral artery (ACA), 6.84+/-3.941 mm in ICA, 7.09+/-3.652 mm in MCA and 6.21+/-3.697 mm in vertebrobasilar artery. The ACA aneurysms were smaller than the MCA aneurysms. Aneurysms less than 6 mm in diameter included 37 (60.65%) in patients with aneurysms in the MCA, 43 (65.15%) in patients with aneurysms in the ACoA and 29 (55.76%) in patients with aneurysms in the PCoA. CONCLUSION: Ruptured aneurysms in the ACA were smaller than those in the MCA. The most prevalent aneurysm size was 3-6 mm in the MCA (55.73%), 3-6 mm in the ACoA (57.57%) and 4-6 mm in the PCoA (42.30%). The more prevalent size of the aneurysm to treat may differ in accordance with the location of the aneurysm.
Aneurysm ; Aneurysm, Ruptured ; Anterior Cerebral Artery ; Arteries ; Basilar Artery ; Carotid Artery, Internal ; Caves ; Choroid ; Female ; Humans ; Incidence ; Intracranial Aneurysm ; Magnetic Resonance Angiography ; Male ; Middle Cerebral Artery ; Posterior Cerebral Artery ; Rupture ; Vertebral Artery

We report a case of type IV hyperlipoproteinemia and eruptive xanthoma associated with diabetes mellitus in a 38-year-old male patient. He had multiple, erythematous, yellowish papules on the trunk, extremities and buttocks. Laboratory examinations showed an increase in serum blood glucose, cholesterol and triglyceride. Lipoprotein electrophoresis revealed increased pre-beta bands and a plasma standing test showed turbid plasma. Analysis of lipoprotein revealed an increase of triglyceride levels in the plasma. A skin biopsy from the lesion revealed a xanthoma. We diagnosed the patient as having type IV hyperlipoproteinemia with eruptive xanthoma. After 3 months of treatment with diet restrictions and fenofibrate, the serum level of triglyceride was reduced to a normal level, and the skin lesions disappeared.
Adult ; Biopsy ; Blood Glucose ; Buttocks ; Cholesterol ; Diabetes Mellitus* ; Diet ; Electrophoresis ; Extremities ; Fenofibrate ; Humans ; Hyperlipoproteinemia Type IV* ; Hyperlipoproteinemias ; Lipoproteins ; Male ; Plasma ; Skin ; Triglycerides ; Xanthomatosis*

We report a case of herpes zoster in a 9-month-old female infant, who showed multiple, grouped, erythematous papulovesicles on the right upper chest, axilla and upper back along the T4 dermatome. The patient had no history of varicella or varicella vaccination, and her mother had no contact history with varicella during pregnancy. However, the mother had been infected with the herpes zoster virus about 3 years before. Multinucleated, giant cells were shown on a Tzanck smear, and histopathologic findings were consistent with the herpes viral infection. Laboratory findings revealed that the anti-Varicella-Zoster virus IgG was positive and IgM was negative. The patient was treated with acyclovir for 7 days and papulovesicles healed without sequelae.
Acyclovir ; Axilla ; Chickenpox ; Female ; Giant Cells ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant* ; Mothers ; Pregnancy ; Thorax ; Vaccination

PURPOSE: To report a case of a full-thickness macular hole after a single intravitreal injection of ranibizumab in a patient with choroidal neovascularization associated with age-related macular degeneration. CASE SUMMARY: A 63-year-old woman presented to our department with gradually decreasing vision in her right eye. Best corrected visual acuity (BCVA) was measured as 0.7 in the right eye and 1.0 in the left eye. Examination of the macula showed a choroidal neovascularization associated with subretinal hemorrhage in the right eye. Optical coherence tomography (OCT) confirmed incomplete posterior vitreous detachment, subretinal hemorrhage and serous elevation. The patient subsequently received an intravitreal ranibizumab injection. After 1 month, the best corrected visual acuity in the right eye was decreased to 0.4, and fundus examination revealed posterior vitreous detachment and a macular hole. The patient underwent pars plana vitrectomy with internal limiting membrane peeling and fluid-air exchange, SF6 gas injection, phacoemulsification and posterior chamber intraocular lens implantation. Three months later, the macular hole had closed completely and best visual acuity was 1.0. CONCLUSIONS: Although the occurrence of a full-thickness macular hole after intravitreal ranibizumab injection is uncommon, physicians should be well acquainted with this complication.
Antibodies, Monoclonal, Humanized ; Choroidal Neovascularization ; Eye ; Female ; Hemorrhage ; Humans ; Intravitreal Injections ; Lens Implantation, Intraocular ; Macular Degeneration ; Membranes ; Phacoemulsification ; Retinal Perforations ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Vitrectomy ; Vitreous Detachment ; Ranibizumab

PURPOSE: To evaluate the clinical effectiveness of pneumatic retinopexy as a treatment method for pseudophakic retinal detachment. METHODS: A retrospective chart review was conducted of medical records of 38 patients who underwent pneumatic retinopexy using SF6 gas from January 2003 to December 2011 and who were observed during a follow-up period longer than 6 months. Primary and final success rates and final visual acuity were analyzed. Primary success was defined as retinal attachment at the last visit without additional surgery. Final success was defined as retinal reattachment at the last visit regardless of additional surgery. RESULTS: The mean patient age was 58.47 ± 17.00 years. All retinal tears were located in the upper retina (from 8 to 4 o'clock). Preoperative mean visual acuity was 1.17 ± 1.00 log MAR, and postoperative mean visual acuity was 0.42 ± 0.48 log MAR. The primary success rate was 61%, and patients with re-detached retina underwent repeat pneumatic retinopexy or other surgery such as scleral buckling or pars plana vitrectomy. At the final visit, all of the patients demonstrated successful results. CONCLUSIONS: Pneumatic retinopexy does not result in strabismus or refractive error, and the final success rate was 66% in our study. Therefore, pneumatic retinopexy can be considered as an effective management technique for some pseudophakic retinal detachment patients.
Follow-Up Studies ; Humans ; Medical Records ; Methods ; Refractive Errors ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Strabismus ; Treatment Outcome ; Visual Acuity ; Vitrectomy

Malignant eccrine poroma is a rare skin appendage tumor, originating from the intraepidermal eccrine duct. It develops either spontaneously or in an eccrine poroma of long-standing duration. It usually affects older people and is located most commonly on the lower extremities. We report a case of an 84 year old woman with a malignant eccrine poroma on the left upper eyelid, which resembled a cutaneous horn. She presented with a solitary, tender, firm, 0.4x0.4x0.9 cm-sized, silvery-white colored papule on the left upper eyelid. She was treated with surgical excision and to date shows no recurrence.
Aged, 80 and over ; Animals ; Eccrine Porocarcinoma* ; Eyelids* ; Female ; Horns* ; Humans ; Lower Extremity ; Poroma ; Recurrence ; Skin