We report herein a case of tuberculosis cutis orificialis in a 50-year-old man. He suffered from well demarcated, 2x5cm sized, slightly tender, pus discharging, perianal ulcer with bluish edges for 3 months. The biopsy specimen from the ulcer revealed tuberculoid structure with Langhans giant cells in the deep dermis and a few acid-fast bacilli. AFB cultures from the sputum, pus, and tissue were successful. Intradermal test with PPD showed positive result. Chest roentgenographic findings disclosed advanced pulmonary tuberculosis. Almost complete healing of the perianal ulcers occurred following 2 months of therapy using antituberculosis drugs.
Biopsy ; Dermis ; Giant Cells, Langhans ; Humans ; Intradermal Tests ; Middle Aged ; Sputum ; Suppuration ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

We report herein a 53-year-old male patient with a large condyloma acuminaturn of 16 months duration on his penis. Clinically, an approximat;ely 3.5 X 2.0 Cm sized, asyrnptomatic, verrucous-surfaced, papilloma was present on his prepuce and glans. Elistological examination disclosed hyperkeratosis, marked acanthosis, papillomatosis, vacuolated upper malphigian cells, dilated capillaries, and mononuclear infiltrntes in the upper dermis. Trial of DNCB immunotherapy showed a dramatic effect on tumor regression.
Capillaries ; Dermis ; Dinitrochlorobenzene* ; Humans ; Immunotherapy ; Male ; Middle Aged ; Papilloma ; Penis

No abstract available.
Fingers* ; Replantation* ; Transplants*

No abstract available.
Fingers* ; Replantation* ; Transplants*

PURPOSE: To evaluate 25-gauge transconjunctival sutureless vitrectomy for primary repair of rhegmatogenous retinal detachment (RRD). METHODS: We performed a retrospective study of 46 consecutive eyes of 46 patients who underwent 25-gauge transconjunctival sutureless vitrectomy to repair primary RRD. Outcome measures included single surgery anatomical success rate, final anatomical success rate, postoperative visual acuity, and surgical complications. RESULTS: Forty eyes were phakic and six eyes were pseudophakic. Twenty-six eyes had superior quadrant retinal tear, 12 eyes had inferior quadrant tear and eight eyes had both. The mean operation time was 56.3 minutes. The single surgery anatomical success rate was 93.48% (43/46). Two eyes with recurrent retinal detachment underwent fluid gas exchange: one received barrier laser treatment in the outpatient clinic, and the other underwent reoperation; the final success rate was 100%. The best corrected visual acuity improved from 1.34 log MAR to 0.48 log MAR (p < 0.01) in macula - off patients (30 eyes) and from 0.32 log MAR to 0.07 log MAR (p = 0.279) in macula - on patients (16 eyes). Postoperative complications included wound leaking (two eyes), cataract progression (13 eyes), vitreous hemorrhage (one eye), transient hypotony (one eye), and increased intraocular pressure (seven eyes). CONCLUSIONS: Primary repair of RRD using 25-gauge transconjunctival vitrectomy resulted in an excellent final anatomical success rate and postoperative visual outcomes.
Ambulatory Care Facilities ; Cataract ; Humans ; Intraocular Pressure ; Outcome Assessment (Health Care) ; Postoperative Complications ; Reoperation ; Retinal Detachment* ; Retinal Perforations ; Retrospective Studies ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage ; Wounds and Injuries

PURPOSE: To investigate whether endogenous and exogenous female hormone exposures were associated with risks for age-related macular degeneration (AMD) in postmenopausal women. METHODS: This study included 4,479 postmenopausal females aged 45 years and older who completed the Korea National Health and Nutrition Examination Survey (KNHANES) V. The participants were divided into 4 groups: subjects with AMD, subjects without AMD, subjects with early AMD, and subjects with late AMD. Variables associated with endogenous and exogenous female hormone exposures were analyzed. RESULTS: Among the 4,479 participants, 516 were found to have AMD and 3,963 were normal. There was no significant difference between the AMD and normal groups execpt for age in the risk analysis. Of the total 516 AMD participants, 488 had early AMD and 28 had late AMD. Women with AMD who had used oral contraceptives longer in the past had significantly higher odds of late AMD than early AMD (odds ratio [OR] = 1.013, 95% confidence interval [CI]: 1.002–1.024). Increasing number of children was also associated with decreased odds of late AMD (OR = 0.672, 95% CI: 0.506-0.893). CONCLUSIONS: These findings suggest that exposure to endogenous and exogenous female hormones may influence the risk of AMD progression.
Child ; Contraceptives, Oral ; Female* ; Humans ; Korea ; Macular Degeneration* ; Nutrition Surveys

No abstract available.

No abstract available.
Synostosis*

Recently, research on rectal neuroendocrine tumors (NETs) has increased during the last few decades. Rectal NETs measuring <10 mm without atypical features and confined to the submucosal layer have only 1% risk of metastasis, and the long-term survival probability of patients without metastasis at the time of diagnosis is approximately 100%. Therefore, the current guidelines suggest endoscopic resection of rectal NETs of <10 mm is regarded as a safe therapeutic option. However, there are currently no clear recommendations for technique selection for endoscopic resection. The choice of treatment modality for rectal NETs should be based on the lesion size, endoscopic characteristics, grade of differentiation, depth of vertical involvement, lymphovascular invasion, and risk of metastasis. Moreover, the complete resection rate, complications, and experience at the center should be considered. Modified endoscopic mucosal resection is the most suitable resection method for rectal NETs of <10 mm, because it is an effective and safe technique that is relatively simple and less time-consuming compared with endoscopic submucosal dissection. Endoscopic submucosal dissection should be considered when the tumor size is >10 mm, suctioning is not possible due to fibrosis in the lesion, or when the snaring for modified endoscopic mucosal resection does not work well.

A variety of pharmacologic agents have been developed for the treatment of osteoarthritis. At present, however, none of them has been proven to prevent disease progression, and the medications are used only for symptomatic relief. Thus, non-pharmacologic conservative treatment such as education, weight reduction in the obese, and consistent exercise should be recommended first to maintain fitness and tolerance to physical activity. Medication is then indicated to better control symptoms provided non-pharmacologic measures prove inadequate, and a successful strategy most likely would entail a combination of these non-pharmacologic and pharmacologic approaches. Acetaminophen can be tried first because of its efficacy and relatively safe profile, especially in those with mild osteoarthritis. Nonselective non-steroidal anti-inflammatory drugs may be used in patients with moderate to severe pain, but long-term medication requires caution due to the increased risk of gastrointestinal and renal complications. Selective cyclooxygenase-2 inhibitors can be better tolerated, especially in patients with risk factors for gastrointestinal adverse events, but potential cardiac and cerebrovascular thrombotic events should be considered in those with preexisting cardiovascular disease. Tramadol and opioids are more potent analgesics. However, they are not recommended for routine use due to a high incidence of nausea, constipation, and drowsiness. These agents require close monitoring for those adverse effects, especially in a geriatric population. Lastly, the pharmacologic plan should be individualized according to the severity and duration of pain, age and gender of the patient, and concurrent comorbidities to maximize the benefit as well as to minimize the risk of adverse effects from medication.
Acetaminophen ; Analgesics ; Analgesics, Opioid ; Cardiovascular Diseases ; Comorbidity ; Constipation ; Cyclooxygenase 2 Inhibitors ; Disease Progression ; Education ; Humans ; Incidence ; Motor Activity ; Nausea ; Osteoarthritis* ; Risk Factors ; Sleep Stages ; Tramadol ; Weight Loss