PURPOSE: To report a case of Pott's puffy tumor from a recurrent upper eyelid abscess. CASE SUMMARY: A 73-year-old male visited our clinic with recurrent upper eyelid abscess over the previous 3 months. The patient did not have any evidence of external injuries, systemic inflammations, or any other specific findings. The best corrected visual acuity was 0.9 in the right and 0.5 in the left eye with normal IOP. Enhanced CT revealed a focal low density mass (11.3 x 12.6 x 10 mm) with peripheral enhancement. An excisional biopsy was performed. Histopathologic examination revealed chronic inflammation and granulation tissue formation and the patient was diagnosed with Pott's puffy tumor. The patient experienced no discomfort after the excision biopsy. At the 14-month follow-up, there were no signs of recurrence. CONCLUSIONS: Although rare, Pott' puffy tumor should be considered in the differential diagnosis of upper eyelid mass.
Abscess ; Biopsy ; Diagnosis, Differential ; Eye ; Eyelids ; Follow-Up Studies ; Granulation Tissue ; Humans ; Inflammation ; Male ; Pott Puffy Tumor ; Visual Acuity

PURPOSE: In this study we evaluated the changes in tear film after primary pterygium operation in patients with pterygium. METHODS: We investigated 43 eyes of 42 subjects who showed successful results 3 months after pterygium operation performed by one surgeon. The changes in tear film thickness, tear break-up time (BUT), Schirmer I test, and ocular surface disease index (OSDI) were evaluated. All values were compared before and after surgery. RESULTS: The mean age was 58.0 +/- 11.1 years (34-81 years). Preoperative tear film thickness, tear BUT, and Schirmer I test in eyes which underwent pterygium operation were 21.53 +/- 5.93 microm, 4.84 +/- 2.21 seconds, and 11.67 +/- 6.75 mm, respectively. Three months after the operation, the respective values were 24.23 +/- 4.19 microm (p < 0.05), 5.81 +/- 1.89 seconds (p < 0.05), and 13.02 +/- 7.54 mm (p = 0.094). Tear film thickness and BUT score increased significantly after pterygium operation. There was no statistically significant difference in Schirmer I test, before and 3 months after pterygium operation. The subjective parameter (OSDI) improved 3 months after pterygium operation (p = 0.015). CONCLUSIONS: Pterygium operation can partially restore the tear film function into a normal state by improving tear film thickness and tear BUT after pterygium operation.
Humans ; Pterygium* ; Tears*

PURPOSE: To report a rare case of a patient with diplopia due to a mass in the sphenoidal sinus, histologically diagnosed as carcinoma. CASE SUMMARY: A 57-year-old male visited our clinic complaining of diplopia and ptosis for 10 days. He had esotropia 45 prism diopters in the primary position, markedly limited abduction, and a 4 mm dilated pupil in the right eye compared with a 2 mm pupil in the left eye. Enhanced magnetic resonance imaging revealed a sphenoidal sinus mass extended into the pituitary gland and sella turcica with homogeneous intense enhancement. Metastatic workups, including CT of the head, neck, chest, and abdomen were unremarkable. He underwent a transsphenoidal approach mass debulking surgery followed by radiotherapy for 6 weeks. Histological findings were compatible with carcinoma. Six weeks after radiotherapy he had esotropia of 20 prism diopters in the primary position. Abduction limitation was partially recovered postoperatively. CONCLUSIONS: Diplopia may develop as a result of multiple cranial nerve palsy due to carcinoma in the sphenoidal sinus and may be improved by debulking surgery and radiation treatment.
Abdomen ; Abducens Nerve Diseases* ; Cranial Nerve Diseases ; Diplopia ; Esotropia ; Head ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; Pituitary Gland ; Pupil ; Radiotherapy ; Sella Turcica ; Thorax

PURPOSE: To evaluate the risk factors for the development of posterior capsule opacification (PCO) after cataract surgery or combined cataract and vitreoretinal surgery. METHODS: In the present study all surgical procedures were performed by the same surgeon. We retrospectively reviewed 272 consecutive eyes that received cataract surgery or combined cataract and vitreoretinal surgery. The risk factors including gender, age, diabetes, continuous curvilinear capsulorhexis (CCC) size, intraocular lens shape, intraoperative intravitreal bevacizumab, gas, and silicone oil injections were evaluated using multiple logistic regression analysis. RESULTS: PCO developed in 55 (20.2%) out of 272 eyes. The mean age was 63.3 +/- 12.1 years (range 23-85 years) and mean follow-up period was 17.3 +/- 3 months. A correlation existed between the development of the PCO and age (p < 0.05), CCC size (p = 0.009), vitreoretinal surgery (p = 0.014), intraoperative intravitreal gas (p = 0.009) and silicone oil injections (p = 0.005). However, no statistical correlation with gender, diabetes, intraocular lens shape, or intraoperative intravitreal bevacizumab injection was observed (p > 0.05). CONCLUSIONS: The risk factors associated with PCO included young age, large CCC size, combined cataract and vitreoretinal surgery, intraoperative intravitreal gas and silicone oil injections.
Capsule Opacification* ; Capsulorhexis ; Cataract* ; Follow-Up Studies ; Lenses, Intraocular ; Logistic Models ; Retrospective Studies ; Risk Factors* ; Silicone Oils ; Vitreoretinal Surgery* ; Bevacizumab

PURPOSE: To investigate the prognostic factors for neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy. METHODS: In the present study we retrospectively reviewed intraindividual and interocular differences in 14 patients (28 eyes) who underwent pars plana vitrectomy for proliferative retinopathy with vitreous hemorrhage and having only 1 eye neovascular glaucoma. The patients underwent vitrectomy between March 2008 and July 2014 at Maryknoll Hospital. The patient clinical data on preoperative, intraoperative and postoperative factors were compared. Statistical analysis was performed using the Wilcoxon matched-pairs signed-rank (Mann-Whitney) test and chi-square test to evaluate the significance of differences within the patient groups. RESULTS: The decrease of photopic b-wave amplitudes on the preoperative electroretinogram significantly correlated with the development of neovascular glaucoma after vitrectomy for proliferative retinopathy with vitreous hemorrhage (p > 0.05). CONCLUSIONS: Based on the results from the present study, decreased photopic b-wave amplitudes on preoperative electroretinogram is an effective prognostic factor for the development of neovascular glaucoma after vitrectomy for proliferative retinopathy with vitreous hemorrhage.
Diabetic Retinopathy* ; Glaucoma, Neovascular* ; Humans ; Retrospective Studies ; Vitrectomy* ; Vitreous Hemorrhage

OBJECTIVE: To evaluate the usefulness of infrared thermography in the diagnosis of unilateral carpal tunnel syndrome (CTS). METHOD: Thirty six patients confirmed electrodiagnostically as CTS and fifteen adults with normal electrodiagnostic study were included in this study. For the thermographic diagnosis, we measured the skin temperature of the palmar area of all 5 fingers, thenar area, hypothenar area and volar area of forearm bilaterally. We compared the interside peak temperature difference between median nerve innervated area and noninnervated area in three different groups (normal control, mild CTS and moderate to severe CTS groups). RESULTS: Thermography of the CTS patients showed significant temperature differences in more than one area of the median vasomotor nerve territory, and no significant temperature difference in all the areas that were not innervated by the median vasomotor nerve. When we considered interside temperature differences of more than 0.3 degrees C as abnormal findings, the sensitivity of thermography was 2.7% and the specificity was 86.6%. With more than 0.6 degrees C as abnormal, the sensitivity was 25% and the specificity was 66.6%. With more than 1.0 degrees C, the sensitivity was 8.3% and the specificity was 73.3%. There was no significant interside peak temperature difference in all groups. CONCLUSION: This study suggests that infrared thermography has low sensitivity and specificity, which implies that it is not useful for the diagnosis of CTS.
Adult ; Carpal Tunnel Syndrome ; Electrodiagnosis ; Fingers ; Forearm ; Humans ; Median Nerve ; Sensitivity and Specificity ; Skin Temperature ; Thermography

Henoch-Sch nlein purpura is a systemic small-vessel IgA dominant vasculitis involoving the capillaries, arterioles, or venules. It is characterized by the classic tetrad of abdominal pain, arthralgia, typical rash, and renal involvement, all of which can occur in any order and at any time over several days to weeks. The central nervous system and lungs may be involved. The gastrointestinal tract is involved in more than 50 percent of patients, manifested most commonly by abdominal pain and gastrointestinal bleeding. And rarely may occur intussusception, bowel nerosis, perforation and intramural hematoma of the duodenum. We report a case of intramural hematoma of the duodenum with Henoch-Sch nlein purpura in 48 year old female patient which was demostrated by upper gastrointestinal endoscopy, abdominal CT scan, hypotonic duodenography and histologic finding of duodenal biopsy. She was treated with supportive care and improved rapidly without any serious gastrointestinal complications.
Abdominal Pain ; Arterioles ; Arthralgia ; Biopsy ; Capillaries ; Central Nervous System ; Duodenum ; Endoscopy, Gastrointestinal ; Exanthema ; Female ; Gastrointestinal Tract ; Hematoma* ; Hemorrhage ; Humans ; Immunoglobulin A ; Intussusception ; Lung ; Middle Aged ; Purpura* ; Tomography, X-Ray Computed ; Vasculitis ; Venules

Hemosuccus pancreaticus is an unusual gastrointestinal hemorrhage through the main pancreatic duct. We report a rare case of hemosuccus pancreaticus due to a simple mucinous cyst of the pancreas. A 52-year-old man who had been followed-up for a suspected branch duct intraductal papillary mucinous neoplasm (IPMN) visited the emergency room due to hematochezia. Endoscopy showed active bleeding from the ampulla. Computed tomography revealed hemorrhage in a 2.0-cm cystic mass in the pancreatic body. The patient was diagnosed with hemosuccus pancreaticus caused by bleeding into the main pancreatic duct from suspected IPMN. Elective laparoscopic distal pancreatectomy was performed. The histopathological diagnosis was a simple mucinous cyst with squamous metaplasia based upon the pathological finding involving the absence of ovarian-type stroma. In conclusion, it should be recognized that a pancreatic cyst including simple mucinous cyst may cause hemosuccus pancreaticus, and these cysts should be viewed as neoplastic and approached similarly as other mucinous pancreatic neoplasms.
Diagnosis ; Emergency Service, Hospital ; Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Metaplasia ; Middle Aged ; Mucins* ; Pancreas* ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Ducts ; Pancreatic Neoplasms

This is a case of tracheomalacia associated with esophageal atresia. An 11-month-old- male boy presented with a life-threatening apneic spell after correction of esophageal atresia (Gross type C). After complete exclusion of the other possible causes of the apneic spell, the presumptive diagnosis of tracheomalacia was made with fluoroscopy and 3-dimensional chest CT. The final diagnosis was made with rigid bronchoscopy under spontaneous respiration. The aortopexy was performed with intraoperative bronchoscopic examination. The postoperative period was unremarkably uneventful. The patient was discharged 9 days after the aortopexy and has remained well to date (5 months after the aortopexy).
Bronchoscopy ; Diagnosis ; Esophageal Atresia* ; Fluoroscopy ; Humans ; Male ; Postoperative Period ; Respiration ; Tomography, X-Ray Computed ; Tracheomalacia*

OBJECTIVE: To investigate the relationship among the alcohol drinking history, autonomic symptom scores (ASS), and the autonomic functions measured with sympathetic skin response (SSR) and heart rate variability (HRV) of alcoholic patients, and to assess the difference between the values from the autonomic function tests of patients and normal controls. METHOD: SSR and HRV were measured in 44 patients and 26 controls. ASS and Toronto clinical neuropathy scoring system (TCNSS) scores were also assessed. For the HRV, the mean heart rate, standard deviation of the NN intervals (SDNN), total power (TP), very low frequency (VLF), low frequency (LF), and high frequency (HF) in both the supine and standing positions were evaluated. For the SSR, the onset latency and amplitude of both the palm and sole were measured. RESULTS: There were no significant relationships among the alcohol history, the TCNSS, and the results of the autonomic function tests. There were, however, significant relationships among their ASS and some values from autonomic function tests [i.e., the sole amplitudes, the SDNNs (supine), and the TPs (standing)]. There were significant differences between the sole amplitudes of the patients and controls. In HRV, there were significant differences between the patients and controls with respect to their SDNNs and TPs at a standing position. CONCLUSION: Autonomic function tests such as SSR and HRV are related to ASS, but not to alcohol history and TCNSS. Moreover, the values from the autonomic function tests of the alcoholic patients decreased, unlike the normal controls.
Alcohol Drinking ; Alcoholics ; Alcoholism ; Equidae ; Heart Rate ; Humans ; Skin