Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.
Diagnosis ; Epididymis ; Hemorrhage ; Humans ; Male ; Necrosis* ; Orchiectomy ; Physical Examination ; Rare Diseases ; Spermatic Cord Torsion ; Testis* ; Ultrasonography ; Young Adult

No abstract available.
Fascia* ; Foot* ; Free Tissue Flaps* ; Hand* ; Rabeprazole*

No abstract available.
Spinal Cord Diseases*

Enchondroma is a benign tumor mainly developed in the hand and uncommon in the foot. Even if it is in the foot, most are in the phalanges and distal metatarsals of the foot. Enchondroma in the calcaneus is very rare. A 44-year-old male suffered from left heel pain for several months, authors treated it with curettage and bone graft, it was histologically confirmed as an enchondroma in the calcaneus. The authors presented a rare case presentation of an enchondroma in the calcaneus with pain.
Adult ; Calcaneus ; Chondroma ; Curettage ; Foot ; Hand ; Heel ; Humans ; Male ; Metatarsal Bones ; Transplants

Purpura fulminans is one of rare consumptive coagulopathy in children. The most common predisposing conditions of purpura fulminans are infectious disease like streptococcal infection and chickenpox. This disease is characterized by ecchymotic lesions that are usually distributed symmetrically on the lower extremities and buttocks. These ecchymotic lesions undergo necrosis, unless there is effective treatment. We experienced 3 cases of purpura fulminans which improved almost completely after early heparin administration. In the case 1, a 12 month old girl, purpura fulminans developed during sepsis and gastroenteritis. In the case 2, a 4 month old boy, purpura fulminans developed during acute sepsis. We reported 3 cases with a brief review of related literature.
Buttocks ; Chickenpox ; Child ; Communicable Diseases ; Dacarbazine ; Female ; Gastroenteritis ; Heparin ; Humans ; Infant ; Lower Extremity ; Male ; Necrosis ; Purpura Fulminans* ; Purpura* ; Sepsis ; Streptococcal Infections

OBJECTIVE: The purpose of this study was to evaluate the effects of malocclusion on the self-esteem of female university students. METHODS: The subjects were composed of 67 female university students who showed Class I molar relation, no missing or supernumerary teeth and has had no orthodontic treatment experience. Each subject was evaluated with Rosenberg's Self-esteem Scale to measure the level of self-esteem and also evaluated the degree of anterior crowding and lip protrusion through model analysis and cephalometric soft tissue profile analysis. RESULTS: The results showed that a protrusive profile and crowding of upper anterior teeth had significant reducing effects on the level of self-esteem. The protrusion and crowding groups showed no significant differences in self-esteem between groups. CONCLUSIONS: Malocclusion had significant negative effects on the self-esteem of female university students. Further research to investigate the negative psychological influence of malocclusion and the education of lay people about this influence is necessary.
Crowding ; Female ; Humans ; Lip ; Malocclusion ; Molar ; Tooth ; Tooth, Supernumerary

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.

Purpose: In the present study, the efficacy and safety of brolucizumab in refractory polypoidal choroidal vasculopathy (PCV) patients treated with aflibercept were investigated. Methods: The medical records of patients with refractory PCV treated with aflibercept were reviewed. All patients had subretinal fluid or intraretinal fluid followed by at least three consecutive injections of aflibercept on a 4–8-week dosing schedule before switching to brolucizumab. Changes in injection intervals, optical coherence tomography (OCT), and OCT angiography parameters including central macular thickness (CMT), subfoveal choroidal thickness (SFCT), polyp height, lesion area, flow density, and polyp regression rate were evaluated before and 6 months after switching to brolucizumab. Results: The study included 32 eyes of 32 patients with PCV who received brolucizumab injections as switch therapy and were followed at 6 months. After switching to brolucizumab, 53% of eyes had dry macula and the injection interval was extended from 5.4 ± 1.7 weeks to 10.8 ± 2.9 weeks. Best-corrected visual acuity remained stable over the 6 months (p = 0.166). CMT and SFCT were reduced at 6 months after switching to brolucizumab (p = 0.042 and p = 0.023, respectively). Polyp regression was complete in 12.5% and partial in 62.5% of eyes. The largest polyp height and lesion size significantly decreased (p = 0.035 and p = 0.010, respectively). However, significant difference was not found regarding flow density after switching to brolucizumab (p = 0.145). Intraocular inflammation-related adverse events were not reported. Conclusions Brolucizumab could provide additional benefits in refractory PCV treated with aflibercept by reducing leakage from polyps, branching vascular networks, and choroid.

Purpose: To evaluate the efficacy of switching to faricimab (VabysmoTM; Roche/Genentech) treatment for patients with neovascular age-related macular degeneration (nAMD) that was resistant to other anti-vascular endothelial growth factor (VEGF) therapies by assessing outcomes after 6 months. Methods: We conducted a retrospective chart review of 102 nAMD patients who were switched to faricimab due to suboptimal responses to prior anti-VEGF treatments. Patients who showed persistent fluid on optical coherence tomography despite prior anti-VEGF injections every 4 to 8 weeks were treated with faricimab. We assessed changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), subfoveal choroidal thickness, maximum pigment epithelial detachment (PED) height, and fluid status at baseline and 1, 3, and 6 months after switching to faricimab. Treatment intervals before and after switching were compared. Results: Six months after switching to faricimab, the mean BCVA improved (0.50 ± 0.12 logMAR to 0.45 ± 0.10 logMAR, p = 0.030), while the mean CST decreased from 353.3 ± 40.5 μm at baseline to 311.4 ± 35.4 μm (p = 0.012). The mean choroidal thickness did not significantly decrease after switching. The mean PED height decreased from 309.1 ± 32.1 μm at baseline to 279.1 ± 30.8 μm at 6 months (p = 0.040). The mean treatment interval extended from 5.7 ± 1.4 to 10.4 ± 1.8 weeks after switching (p = 0.001). Additionally, dry macula was achieved in 43.1% of patients, while 76.5% were classified as good responders, 6.5% as partial responders, and 17% reverted to other anti-VEGF treatments due to non-response. Conclusions Switching nAMD patients to faricimab for 6 months produced substantial improvements in visual acuity and anatomical outcomes, together with extended treatment intervals, reducing the injection burden. Faricimab could be an effective treatment option for nAMD, particularly for patients with inadequate responses to previous therapies.

Purpose: We report a case of bilateral frosted branch angiitis caused by anti-phospholipid antibody syndrome.Case summary: A 60-year-old female complained of worsening vitreous floaters and decreased visual acuity in both eyes. The initial best-corrected visual acuity (BCVA) was 0.8 in the right eye and 0.05 in the left. On slit-lamp examination, inflammatory findings were observed in the anterior chamber and vitreous body of both eyes. On fundus examination, vascular sheathing in the shape of a frosted branch was observed in the posterior pole and peripheral retina in both eyes. Optical coherence tomography indicated macular edema in the left eye. Staining and leakage of dye along the vascular sheathing were observed in both eyes with fluorescein angiography. On suspicion of panuveitis, we conducted a blood test and started eye drops and oral steroid therapy. However, vitreous inflammation, macular edema, and vascular sheathing increased; thus, we proceeded with systemic steroid therapy. We conducted blood tests at 8-week intervals; lupus anticoagulant was negative but anticardiolipin antibody and anti- ß2 glycoprotein-I antibody were positive. We diagnosed the patient with bilateral frosted branch angiitis caused by anti-phospholipid antibody syndrome. During the follow-up period, the BCVA remained steady at 0.5 in the right eye and 0.3 in the left eye, without symptom recurrence. Conclusions Bilateral frosted branch angiitis, a rare disease, is known to respond well to systemic steroid treatment. However, if accompanied by primary anti-phospholipid antibody syndrome, as in the case presented, it may have an atypical prognosis.