The clinical results of 20 patients(20 eyes) who were operated due to perforated corneal laceration with traumatic cataract between March 5, 1991 and July 14, 1994 were analysed for the predictors of postoperative good visual outcome and compared simultaneous cataract surgery and implantation with secondary implantation. The most significant predictor of postoperative good visual outcome was the location of corneal laceration. Timing of lens implantation didn't influence significantly final visual acuity and postoperative inflammation. But postoperative complication were less frequent in patients where secondary IOL implantation was performed as opposed to those simultaneous IOL implantated.
Cataract* ; Humans ; Inflammation ; Lacerations* ; Postoperative Complications ; Visual Acuity

Retinal dysplasia is an abnormal differentiation of the retina at embryonal retina stage with proliferation of its elements into rosettes, fold, and gliosis and it is very difficulat to distinguish between the various types of intraocular disease, especilaly retinoblastoma. We experienced a case of unilateral retinal dysplasia without systemic abnormalities occurring in a 5 months old boy. It was clinically suspected Retinoblastoma, which was proved to be Retinal Dysplasia by histopathologic examination.
Gliosis ; Humans ; Infant ; Male ; Retina ; Retinal Dysplasia* ; Retinaldehyde* ; Retinoblastoma

Although neutrophilia can manifest from various causes, it is important to be able to distinguish chronic neutrophilic leukemia (CNL) from neutrophilic leukemoid reactions (NLR). In this paper, we describe four cases of leukocytosis with neutrophilia, including one case of CNL with a T618I mutation in colony stimulating factor 3 receptor (CSF3R) and three cases of NLR associated with malignancy or sepsis, which were initially suspected as CNL. Of the three NLR cases, one was associated with ovarian cancer, one with monoclonal gammopathy of undetermined significance and one with multiple myeloma with sepsis. This study demonstrated that confirming the clonality of myeloid cells with CSF3R T618I could contribute to making an accurate differential diagnosis between CNL and NLR in patients with solid cancers or plasma cell neoplasms caused by paraneoplastic syndromes and/or infection.
Colony-Stimulating Factors ; Diagnosis, Differential ; Humans ; Leukemia, Neutrophilic, Chronic* ; Leukemoid Reaction* ; Leukocytosis ; Monoclonal Gammopathy of Undetermined Significance ; Multiple Myeloma ; Myeloid Cells ; Neoplasms, Plasma Cell ; Neutrophils* ; Ovarian Neoplasms ; Paraneoplastic Syndromes ; Sepsis

We report a patient with massive eosinophilia and a complex karyotype that was initially misdiagnosed as chronic eosinophilic leukemia (CEL), but later diagnosed as anaplastic large cell lymphoma (ALCL) masked by massive eosinophilia. The complex karyotype observed at initial diagnosis remained unchanged later, after the evidence of bone marrow involvement of ALCL was obtained. At diagnosis, genetic aberrations corresponding to metaphase cytogenetics were not identified by interphase fluorescence in situ hybridization, although abnormal results were noted at follow-up. Together, these observations indicate that the complex karyotype at initial work-up has been derived from a low proportion of lymphoma cells with high mitotic ability that were not identified by microscopy, rather than from massive eosinophils. These findings suggest that our patient had ALCL with secondary eosinophilia rather than CEL since initial diagnosis.
Bone Marrow ; Cytogenetics ; Diagnosis ; Eosinophilia* ; Eosinophils* ; Fluorescence ; Follow-Up Studies ; Humans ; Hypereosinophilic Syndrome* ; In Situ Hybridization ; Interphase ; Karyotype* ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic* ; Masks ; Metaphase ; Microscopy

BACKGROUND: The aim of surgical treatment for atrial septal defect is correction of anatomical and physiologic anomaly. Incidence of heart failure, cerebrovascular accident, atrial fibrillation and late mortality depend on the timing of surgery. Echocardiographic cardiac functional alteration after surgery is not surveyed sufficiently. So we intended to observe the alteration and function of cardiac anatomy after surgery. METHODS: We studied 22 patients who were undergone correction surgery of atrial septal defect at Keimyung university medical center. We devided patients into two groups according to age. Group I consists of patients who undergone surgery before 41 year old(mean age 32.25 year old, male 3, total 12). Group II comprises patients who undergone surgery after 41 year old(mean age 53.4 year old, male 1, total 10). We compared chief complaint, preoperative cardiac catheterization finding, pre- and post-operative echocardiographic finding(ejection fraction, end diastolic right and left ventricular dimension, grade of tricuspid regurgitation, paradoxical septal motion) between 2 groups. RESULTS: Preoperatively 6 patients(50%) of group I patients were diagnosed as mild congestive heart failure(according to NYHA functional class) and 2 patients(20%) of group II patients were in mild congestive heart failure. The Qp/Qs of both group were 3.5+/-1.7, 2.9+/-1.3, systolic right ventricular pressure were 42.1+/-10.5, 44.5+/-9.5mmHg, systolic pulmonary arterial pressure were 31.3+/-4.3, 36.6+/-7.3mmHg. 1 of group I patients and 2 of group II patients showed ejection fraction below 55% on postoperative echocardiography. The others showed normal ejection on echocardiography. Mean end diastolic right ventricular dimension was 3.84cm preopratively and 2.53cm postoperatively on group II patients. Mean end diastolic right ventricular dimension of group I patients was 3.94cm preoperatively and 2.81cm postoperatively. 3 of group I patients showed mild TR(tricuspid regurgitation), 5 showed moderate TR, and 4 showed severe TR preoperatively. 3 of group I patients showed loss of TR, 1 showed moderate TR, 8 showed mild TR. 3 of group II patients showed mild TR, 2 showed moderate TR, 5 showed severe TR preoperatively. 6 of group II patients showed mild TR, 3 showed moderate TR, 1 showed severe TR postoperatively. Paradoxical septal motion reflects right ventricular pressure overloading and was observed on both groups preoperatively. But after correction surgery, paradoxical septal motion persists at 6(50%) of group I patients, 6(60%) of group II patients. CONCLUSION: Conclusively, surgical correction for atrial septal defect before age of 41 is effective to prevent or slow down the manifestation of congestive heart failure, persistence of TR. Ejection fraction was improved significantly on echocardiography on both groups. But paradoxical septal motion persist after surgery, so more survey is needed.
Academic Medical Centers ; Adult* ; Arterial Pressure ; Atrial Fibrillation ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Estrogens, Conjugated (USP) ; Heart ; Heart Failure ; Heart Septal Defects, Atrial* ; Humans ; Incidence ; Male ; Mortality ; Stroke ; Tricuspid Valve Insufficiency ; Ventricular Pressure

PURPOSE: The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data. MATERIALS AND METHODS: This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016. RESULTS: A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patients was 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. CONCLUSION: Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.
Aged* ; B-Lymphocytes* ; Cause of Death ; Creatinine ; Disease Progression ; Drug Therapy ; Humans ; Hypoalbuminemia ; Korea ; Lymphoma, B-Cell* ; Multivariate Analysis ; Retrospective Studies*

Background/Aims: We evaluated the feasibility and long-term efficacy of the combination of cytarabine, idarubicin, and all-trans retinoic acid (ATRA) for treating patients with newly diagnosed acute promyelocytic leukemia (APL). Methods: We included 87 patients with newly diagnosed acute myeloid leukemia and a t(15;17) or promyelocytic leukemia/retinoic acid receptor alpha (PML-RARα) mutation. Patients received 12 mg/m2/day idarubicin intravenously for 3 days and 100 mg/m2/day cytarabine for 7 days, plus 45 mg/m2/day ATRA. Clinical outcomes included complete remission (CR), relapse-free survival (RFS), overall survival (OS), and the secondary malignancy incidence during a 20-year follow-up. Results: The CR, 10-year RFS, and 10-year OS rates were 89.7%, 94.1%, and 73.8%, respectively, for all patients. The 10-year OS rate was 100% for patients that achieved CR. Subjects were classified according to the white blood cell (WBC) count in peripheral blood at diagnosis (low-risk, WBC < 10,000/mm3; high-risk, WBC ≥ 10,000/mm3). The low-risk group had significantly higher RFS and OS rates than the high-risk group, but the outcomes were not superior to the current standard treatment (arsenic trioxide plus ATRA). Toxicities were similar to those observed with anthracycline plus ATRA, and higher than those observed with arsenic trioxide plus ATRA. The secondary malignancy incidence after APL treatment was 2.7%, among the 75 patients that achieved CR, and 5.0% among the 40 patients that survived more than 5 years after the APL diagnosis. Conclusions Adding cytarabine to anthracycline plus ATRA was not inferior to anthracycline plus ATRA alone, but it was not comparable to arsenic trioxide plus ATRA. The probability of secondary malignancy was low.