Histiocytosis-X is a term used to define three diseases with similar morphologic characteristics : Letterer-Siwe diseae, Hand-Schuller-Christian disease and Eosinophilic granuloma. In general, they differ in terms of their age of onset, severity of clinical course and site of involvement. Eosinophilic granuloma typically is seen in young adults. Eosinophilic granuloma is diagnosed in the presense of diffuse pulmonary infiltrate, bony involvement. However, the Pulmonary radiologic findings of eosinophilic granuloma are variable accordinary to stage of disease. therefore pathologic diagnosis of involving site is essential for confirmative diagnosis of eosinophilic grananuloma. Pathologically. the three disease are characterized by granulomatous infiltration of alveolar septa and bronchial walls and often involvement of bone. The hallmark of this disease is proliferation of the Langerhans' cell. The identifying feature is the X-body or Birbeck granule that is present in Langerhans' cells and histiocytic cells found in the lung of EG patient. We report a case of bilateral, recurrent and spontaneous pneumothoraces in a 21 year old man with pulmonary histiocytosis-X which is confined by eosinophilc granuloma in bone marrow biopsy and ultrastructural examination in cells obtained from BAL.
Age of Onset ; Biopsy ; Bone Marrow ; Diagnosis ; Eosinophilic Granuloma ; Eosinophils ; Granuloma ; Histiocytosis, Langerhans-Cell* ; Humans ; Lung ; Pneumothorax* ; Young Adult

No abstract available.
Mesenteric Artery, Superior

Mucinous ductal ectasia(MDE) is a newly described entity of mucinous neoplasm of pancreas with characteristic endoscopic and pancreatographic findings. It is charaeterized by a patulous duodenal papilla extruding mucus and a pancreatogram showing dilatation with amorphous filling defects, communication of the mass with the pancreatic duct. MDE is intraductal lesion consisting of dilated "cystified" ducts lined by mucin-producing columnar cells. The lesion is usually located in the head or uncinate process. When the radiographic appearance of the ERCP cannot provide sufficient information for definite diagnosis, additional endoscopic visualization is desirable. With the advent of pancreatoscopy, an endoscopic procedure is now available that has proven to enhance diagnostic accuracy. The 0.8-mm ultrathin pancreatoscope allows macroscopic diagnosis under direct vision. Endoscopic sphincterotomy is not required, and insertion into the pancreatic duct is feasible in most cases with the aid of guidewires. Major indications are unclear filling defects on ERCP, strictures of uncertain origin, and duct cut-offs. A limitation of this procedure are the lack of angulation, insufficient illumination, fragility of endoscopic equipment, and nonspecific findings. In addition, biopsy while directly viewing the lesion is impossible at present. We experienced one case of MDE who presented with the symptom of weight loss. Ultrathin pancreatoscopy was useful for the direct visualization af pancreatic duct in the differential diagnosis of filling defects of main pancreatic duct.
Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Diagnosis ; Diagnosis, Differential ; Dilatation ; Dilatation, Pathologic* ; Head ; Lighting ; Mucins* ; Mucus ; Pancreas ; Pancreatic Ducts ; Sphincterotomy, Endoscopic ; Weight Loss

PURPOSE: We report a case of giant conjunctival nevus and compare differential diagnosis between giant conjunctival nevus and conjunctival malignant melanoma. CASE SUMMARY: A 46-year-old male presented with brown and elevated conjunctival mass in his right eye since childhood. The mass was located at the superior bulbar conjunctiva involving the superior cornea. The mass was 16 x 9 mm in size and elevated. Feeding vessels, intrinsic vessels and various cyst sizes were observed inside the mass. Resection of the conjunctival mass and amniotic membrane transplantation were performed. The histopathological diagnosis was conjunctival nevus. CONCLUSIONS: Conjunctival nevus is a benign conjunctival tumor with excellent prognosis, often confused with conjunctival melanoma. Both conjunctival nevus and conjunctival malignant melanoma are commonly located in the bulbar conjunctiva, pigmented and often have feeder and intrinsic vessels. Conjunctival nevus has an intralesional cyst, which is a key differentiating characteristic from malignant melanoma as many other features overlap. The change in tumor size, increased pigmentation and corneal invasion are features suspect of malignant transformation and surgical excision and histologic examination are recommended for those lesions. Surgical excision for giant conjunctival nevus can cause several ocular complications such as symblepharon. Conjunctival reconstruction with amniotic membrane transplantation is useful for preventing complications.
Amnion ; Conjunctiva ; Cornea ; Diagnosis ; Diagnosis, Differential ; Humans ; Male ; Melanoma* ; Middle Aged ; Nevus* ; Pigmentation ; Prognosis

PURPOSE: To evaluate the clinical characteristics of intraorbital foreign bodies as well as the treatment outcomes. METHODS: This was a noncomparative interventional case series. Clinical data and radiographic images were gathered via retrospective chart reviews of 14 patients who underwent surgical removal of intraorbital foreign bodies by an oculoplastic surgeon at the Asan Medical Center, Seoul, Korea between July 2012 and November 2015. RESULTS: The mean age of patients was 45.1 years and 13 patients (92.9%) were male. There were 9 metallic; 3 nonmetallic, inorganic; and 2 organic intraorbital foreign bodies in this series. The most common orbital complication was orbital wall fracture (8, 57.1%), and one patient had orbital cellulitis associated with a wooden foreign body. Six patients (42.9%) underwent surgical removal of foreign bodies in a delayed setting, and 4 of them needed surgery to allow for the brain magnetic resonance image tests to evaluate neurologic problems. There were 6 patients (42.9%) who had a postoperative corrected visual acuity worse than 20/200, and all of them had poor visual acuity at the time of injury due to associated eyeball or optic nerve injuries. Four patients (28.6%) had eyeball movement limitations from the initial trauma, but only 1 patient had persistent limitations postoperatively. There were no other complications associated with surgical removal. CONCLUSIONS: The majority of patients with intraorbital foreign bodies were male who had periorbital traumas. The most common foreign body was metal, and orbital wall fractures were common. The poor visual prognosis was related to the eyeball or optic nerve injuries from the initial trauma. The urgent surgical removal should be performed for organic foreign bodies or associated orbital/ocular injuries. Metallic foreign bodies may also be considered for removal to allow for possible brain magnetic resonance image evaluations in the future.
Brain ; Chungcheongnam-do ; Foreign Bodies* ; Humans ; Korea ; Male ; Optic Nerve Injuries ; Orbit ; Orbital Cellulitis ; Prognosis ; Retrospective Studies ; Seoul ; Visual Acuity

Paratubal cysts come from paraovarium of the broad ligament between the fallopian tube and ovary. Overall, these cysts constitute 10% of all adnexal masses and are commonly incidental findings upon surgical exploration for other reasons. They more commonly occur in women between 30 and 40 years of age. We report two cases of rapidly growing, huge paratubal cysts in young women, which are presented with brief review of literature.
Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Incidental Findings ; Ovary ; Parovarian Cyst

PURPOSE: Febrile convulsions are classified into simple or complex types, the latter being characterized by increased risk of recurrence and progression to epilepsy. This study aimed to delineate the clinical characteristics of complex febrile convulsions. METHODS: Between January 2003 and December 2006, 550 children were diagnosed with febrile convulsions at the Department of Pediatrics, Ilsan Paik Hospital. Their medical records were retrospectively reviewed for comparison between simple and complex febrile convulsions, and clinical findings of complex febrile convulsions were clarified. RESULTS: Our subjects comprised a male-to-female ratio of 1.64:1; the age range was from 8 months to 8 years. Simple febrile convulsions comprised 432 cases, i.e., 4 times as many as complex febrile convulsions (118 cases). The causes of febrile illness included acute pharyngotonsillitis (357 cases, 64.9%), pneumonia (55 cases, 10.0%), acute gastroenteritis (37 cases, 6.7%), and otitis media (20 cases, 3.6%). We did not find any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsions, and cause of febrile illness. Regarding subtypes of complex febrile convulsions, repeated convulsions were the most frequent (72.0%), followed by prolonged convulsions (16.9%) and focal convulsions (5.1%). CONCLUSION: We have reported here the clinical features of complex febrile convulsions. Although the results did not show any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsion, and cause of febrile illness, further studies are essential to delineate complex febrile convulsions.
Child ; Epilepsy ; Gastroenteritis ; Humans ; Medical Records ; Otitis Media ; Pediatrics ; Pneumonia ; Recurrence ; Retrospective Studies ; Seizures ; Seizures, Febrile

PURPOSE: To determine the incidence of steroid-induced ocular hypertension following myopic vision correction. METHODS: This study retrospectively reviewed the medical records of 6,087 patients (12,164 eyes) who underwent myopic refractive surgery (laser-assisted in-situ keratomileusis [LASIK]/photorefractive keratectomy [PRK]/phakic intraocular lens [IOL] implantation) at Eyereum Eye Clinic between July 2011 and February 2013. Ocular hypertension was defined when post-operative intraocular pressure (IOP) was increased more than 30% compared to predicted IOP adjusted according to corneal thickness. All preoperative IOPs were measured using Goldmann applanation tonometer (GAT). Postoperative IOPs were measured using non-contact tonometer first and with GAT when the IOP was suspiciously increased. RESULTS: Steroid-induced ocular hypertension after a myopic refractive surgery occurred in 680 eyes (5.58%) of 404 patients (6.64%). The incidence based on surgery was LASIK (0.06%, 2/3, 514 eyes) followed by PRK (7.63%, 575/7,533 eyes) and phakic IOL implantation (9.2%, 103/1,117 eyes). The average increased IOP level in patients with steroid-induced ocular hypertension was 5.62 +/- 3.73 mm Hg after PRK and 9.35 +/- 4.95 mm Hg after phakic IOL implantation. A statistically significantly higher change in IOP was observed in the phakic IOL group (p < 0.001). However, the PRK group had a longer treatment period for ocular hypertension and used more antiglaucoma medications than the phakic IOL group (p < 0.05). Most patients with ocular hypertension were successfully treated with cessation of topical steroid or use of antiglaucoma medications. Only 2 eyes required glaucoma surgery because IOP was not controlled. CONCLUSIONS: IOP measurements should be initiated no later than 1 week after surgery because steroid-induced ocular hypertension following myopic refractive surgery can occur in approximately 5.58% of patients and most cases of ocular hypertension can be controlled with careful follow-up and use of antiglaucoma medications.
Glaucoma ; Humans ; Incidence* ; Intraocular Pressure ; Keratomileusis, Laser In Situ ; Lenses, Intraocular ; Medical Records ; Ocular Hypertension* ; Refractive Surgical Procedures* ; Retrospective Studies

PURPOSE: To determine the incidence of steroid-induced ocular hypertension following myopic vision correction. METHODS: This study retrospectively reviewed the medical records of 6,087 patients (12,164 eyes) who underwent myopic refractive surgery (laser-assisted in-situ keratomileusis [LASIK]/photorefractive keratectomy [PRK]/phakic intraocular lens [IOL] implantation) at Eyereum Eye Clinic between July 2011 and February 2013. Ocular hypertension was defined when post-operative intraocular pressure (IOP) was increased more than 30% compared to predicted IOP adjusted according to corneal thickness. All preoperative IOPs were measured using Goldmann applanation tonometer (GAT). Postoperative IOPs were measured using non-contact tonometer first and with GAT when the IOP was suspiciously increased. RESULTS: Steroid-induced ocular hypertension after a myopic refractive surgery occurred in 680 eyes (5.58%) of 404 patients (6.64%). The incidence based on surgery was LASIK (0.06%, 2/3, 514 eyes) followed by PRK (7.63%, 575/7,533 eyes) and phakic IOL implantation (9.2%, 103/1,117 eyes). The average increased IOP level in patients with steroid-induced ocular hypertension was 5.62 +/- 3.73 mm Hg after PRK and 9.35 +/- 4.95 mm Hg after phakic IOL implantation. A statistically significantly higher change in IOP was observed in the phakic IOL group (p < 0.001). However, the PRK group had a longer treatment period for ocular hypertension and used more antiglaucoma medications than the phakic IOL group (p < 0.05). Most patients with ocular hypertension were successfully treated with cessation of topical steroid or use of antiglaucoma medications. Only 2 eyes required glaucoma surgery because IOP was not controlled. CONCLUSIONS: IOP measurements should be initiated no later than 1 week after surgery because steroid-induced ocular hypertension following myopic refractive surgery can occur in approximately 5.58% of patients and most cases of ocular hypertension can be controlled with careful follow-up and use of antiglaucoma medications.
Glaucoma ; Humans ; Incidence* ; Intraocular Pressure ; Keratomileusis, Laser In Situ ; Lenses, Intraocular ; Medical Records ; Ocular Hypertension* ; Refractive Surgical Procedures* ; Retrospective Studies

Pseudohypoparathyroidism is a rare disease that is characterized by target cell resistance to the effects of parathyroid hormone and this disease is classified into various types depending on the phenotypic and biochemical findings. The patients with pseudohypoparathyroidism present with the clinical and biochemical features of hypoparathyroidism, but they have an increased serum level of parathyroid hormone. We experienced a case of pseudohypoparathyroidism in a 24 years old woman who had Graves' disease at that time. She had hypocalcemia, hyperphosphatemia, an elevated serum parathyroid hormone level and a normal urinary basal cyclic AMP(adenosine monophosphate) level. She also had a normal phenotypic appearance. Therefore, she was classified as suffering with pseudohypoparathyroidism type II. The clinical and laboratory abnormalities were improved by calcium supplementation in addition to vitamin D. To the best of our knowledge, this is the first case of pseudohypoparathyroidism combined with Graves' disease in Korea.
Calcium ; Female ; Graves Disease ; Humans ; Hyperphosphatemia ; Hyperthyroidism ; Hypocalcemia ; Hypoparathyroidism ; Korea ; Parathyroid Hormone ; Pseudohypoparathyroidism ; Rare Diseases ; Stress, Psychological ; Vitamin D