In adults, it is known that tetastatic tumor to the eye and its adnexa is rare compared with other sites. Orbital tumors can be classified as primary, secondary, and metastatic. Secondary orbital tumors are those that extend to the orbit from a contiguous structure. Metastatic tumors are those that spread to the orbit from more distant site in the body. and their prognosis for life is poor because of widespread systemic malignancy. We experienced a case of metastatic uterine cervical carcinoma of the orbit in a 33-year-old female patient who came to us with a history of sudden proptosis and decreased vision. Eighteen months earlier, the patient had been diagnosed with squamous cell carcinoma of the uterine cervix, and she had undergone chemotherapy, irradiation and surgical intervention. Lung and parametrium metastases were also found six months previously. We report a case of metastatic uterine cervical cancer of the orbit with a review of the literature.
Adult ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Exophthalmos ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Orbit* ; Prognosis ; Uterine Cervical Neoplasms

PURPOSE: To evaluate the causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted endonasal revision surgery according to the number of silicone tubes. METHODS: Sixty-seven patients (70 eyes) who underwent revision surgery using transcanalicular diode laser for failed primary endonasal DCR at Sungmo Eye Hospital between March 2007 and December 2012 were studied retrospectively. The causes of failed DCR and the time of recurrence were evaluated. The revision surgeries were endoscopic removal of granuloma and membrane and synechiolysis with intubation of 1 or 2 silicone tubes. We compared the results of revision surgery with 1 silicone tube and 2 silicone tube intubations. RESULTS: Recurrence occurred after a mean duration of 4.6 months following the first DCR. The causes of surgical failure were granuloma (35 eyes), membranous obstruction (23 eyes), synechia (7 eyes), and functional obstruction (5 eyes). We performed revision surgery with 1 silicone tube intubation in 45 eyes (group A) and 2 silicone tube intubations in 25 eyes (group B). The final success rates in groups A and B were 75.6% (34/45) and 84% (21/25), respectively (chi-square test, p = 0.828). CONCLUSIONS: Transcanalicular diode laser-assisted endonasal revision surgery with 2 silicone tubes is not recommended.
Dacryocystorhinostomy ; Granuloma ; Humans ; Intubation ; Lasers, Semiconductor ; Membranes ; Recurrence ; Retrospective Studies ; Silicones*

No abstract available.
Sinusitis*

Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern.
Abducens Nerve ; Abducens Nerve Diseases ; Aneurysm ; Aneurysm, Dissecting ; Angiography ; Arteries ; Brain Stem ; Cerebral Angiography ; Diffusion ; Dilatation ; Diplopia ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Muscle Rigidity ; Neurologic Examination ; Neurologic Manifestations ; Paresis ; Subarachnoid Hemorrhage ; Vertebral Artery

OBJECTIVES: To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. METHODS: The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. RESULTS: A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56 (overall satisfaction) to 0.90 (skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. CONCLUSIONS: The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.
Community Mental Health Centers ; Community Mental Health Services ; Humans ; Mental Health Services* ; Mental Health* ; Personal Satisfaction ; Psychotic Disorders ; Questionnaires ; Reproducibility of Results*

The occurrence of ovarian squamous cell carcinoma associated with ovarian endometriosis is extremely rare. Several studies revealed poor prognosis for ovarian squamous cell carcinoma especially when associated with endometriosis. We report a case of ovarian squamous cell carcinoma that invades the parametrium that is also associated with ovarian endometriosis. A 41-year-old woman with stage IIB ovarian squamous cell carcinoma was treated with debulking surgery followed by six courses combination chemotherapy composed of paclitaxel and carboplatin. Twenty months after the last course of chemotherapy (3 months after normal positron emission tomography–computed tomography [CT] scanning), upper abdominal pain developed and abdomen CT scan revealed multiple metastasis in liver and paraaortic lymph node. Although two cycles of paclitaxel and cisplatin was administrated, she died of disease three months after the recurrence.
Abdomen ; Abdominal Pain ; Adult ; Carboplatin ; Carcinoma, Squamous Cell* ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Electrons ; Endometriosis* ; Epithelial Cells* ; Female ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Paclitaxel ; Prognosis ; Recurrence ; Tomography, X-Ray Computed

PURPOSE: To evaluate the prognostic factors that predict visual outcome after vitrectomy for lamellar macular hole using optical coherence tomography (OCT). METHODS: This study included 26 eyes that underwent pars plana vitrectomy, epiretinal membrane removal, and internal limiting membrane peeling for lamellar macular hole. The maximum parafoveal thickness, maximum height and diameter of lamellar macular hole, maximum height and diameter of intraretinal splitting, thinnest foveal floor thickness, and inner segment/outer segment disruption length on preoperative OCT image were investigated for prognostic factors that predict visual outcome. RESULTS: The mean follow-up period was 32.2 months and the mean best corrected visual acuity improved significantly after vitrectomy from log MAR 0.47 +/- 0.32 to log MAR 0.23 +/- 0.23. The postoperative visual acuity correlated significantly with preoperative visual acuity, thinnest foveal floor thickness and inner segment/outer segment disruption length, but not with maximum parafoveal thickness, maximum height and diameter of lamellar macular hole and maximum height and diameter of intraretinal splitting. CONCLUSIONS: The thinnest foveal floor thickness and inner segment/outer segment disruption length on preoperative OCT image were significant prognostic factors.
Epiretinal Membrane ; Follow-Up Studies ; Membranes ; Retinal Perforations* ; Tomography, Optical Coherence* ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate the prognostic factors that predict visual outcome after vitrectomy for lamellar macular hole using optical coherence tomography (OCT). METHODS: This study included 26 eyes that underwent pars plana vitrectomy, epiretinal membrane removal, and internal limiting membrane peeling for lamellar macular hole. The maximum parafoveal thickness, maximum height and diameter of lamellar macular hole, maximum height and diameter of intraretinal splitting, thinnest foveal floor thickness, and inner segment/outer segment disruption length on preoperative OCT image were investigated for prognostic factors that predict visual outcome. RESULTS: The mean follow-up period was 32.2 months and the mean best corrected visual acuity improved significantly after vitrectomy from log MAR 0.47 +/- 0.32 to log MAR 0.23 +/- 0.23. The postoperative visual acuity correlated significantly with preoperative visual acuity, thinnest foveal floor thickness and inner segment/outer segment disruption length, but not with maximum parafoveal thickness, maximum height and diameter of lamellar macular hole and maximum height and diameter of intraretinal splitting. CONCLUSIONS: The thinnest foveal floor thickness and inner segment/outer segment disruption length on preoperative OCT image were significant prognostic factors.
Epiretinal Membrane ; Follow-Up Studies ; Membranes ; Retinal Perforations* ; Tomography, Optical Coherence* ; Visual Acuity ; Vitrectomy*

Bilateral abducens nerve palsy related to ruptured aneurysm of the anterior communicating artery (ACoA) has only been reported in four patients. Three cases were treated by surgical clipping. No report has described the clinical course of the isolated bilateral abducens nerve palsy following ruptured ACoA aneurysm obliterated with coil. A 32-year-old man was transferred to our institution after three days of diplopia, dizziness and headache after the onset of a 5-minute generalized tonic-clonic seizure. Computed tomographic angiography revealed an aneurysm of the ACoA. Magnetic resonance imaging showed focal intraventricular hemorrhage without brain stem abnormalities including infarction or space-occupying lesion. Endovascular coil embolization was conducted to obliterate an aneurysmal sac followed by lumbar cerebrospinal fluid (CSF) drainage. Bilateral paresis of abducens nerve completely recovered 9 weeks after ictus. In conclusion, isolated bilateral abducens nerve palsy associated with ruptured ACoA aneurysm may be resolved successfully by coil embolization and lumbar CSF drainage without directly relieving cerebrospinal fluid pressure by opening Lillequist's membrane and prepontine cistern.
Abducens Nerve ; Abducens Nerve Diseases ; Aneurysm ; Aneurysm, Ruptured ; Angiography ; Arteries ; Brain Stem ; Cerebrospinal Fluid Pressure ; Diplopia ; Dizziness ; Drainage ; Headache ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Magnetic Resonance Imaging ; Membranes ; Paresis ; Seizures ; Subarachnoid Hemorrhage ; Surgical Instruments

Spinal cord injury often leads to central neuropathic pain syndromes, such as allodynic and hyperalgesic behaviors. Electrophysiologically, spinal dorsal horn neurons show enhanced activity to non-noxious and noxious stimuli as well as increased spontaneous activity following spinal cord injury, which often called hyperexcitability or central sensitization. Under hyperexcitable states, spinal neurons lose their ability of discrimination and encoding somatosensory information followed by abnormal somatosensory recognition to non-noxious and noxious stimuli. In the present review, we summarize a variety of pathophysiological mechanisms of neuronal hyperexcitability for treating or preventing central neuropathic pain syndrome following spinal cord injury.
Animals ; Central Nervous System Sensitization ; Discrimination (Psychology) ; Neuralgia ; Neurons ; Posterior Horn Cells ; Rats ; Spinal Cord ; Spinal Cord Injuries