No abstract available.
Hand*

No abstract available.
Keloid*

PURPOSE: To report the clinical course and results of two cases of anterior segment manifestations associated with systemic lupus erythematosus (SLE). CASE SUMMARY: The first case was a 63-year-old female patient who was diagnosed with corneal ulcer and symblepharon on her left eye and dry eye in both eyes. Although the patient was treated with topical antibiotics, autologous serum and artificial tears, amniotic membrane transplantation and symblepharon removal were subsequently required. At 1 month after medical and surgical treatment, the corneal ulcer improved, but a descemetocele was formed because of persistent corneal thinning. The second case was a 24-year-old female patient diagnosed with filamentary keratitis and recurrent corneal erosion in both eyes and uveitis in her left eye. After treatment with therapeutic contact lenses, topical antibiotics and steroids, her symptoms were slightly improved. After 6 months of treatment, filamentary keratitis and corneal erosion recurred to being intractable. The patient received systemic evaluation and was diagnosed with SLE. After a combined therapy of oral and topical treatments, filamentary keratitis and recurrent corneal erosion improved significantly. CONCLUSIONS: Clinical manifestations of anterior segment associated with SLE rarely respond to topical treatment and are apt to recur easily; therefore, systemic treatment should be applied for better prognosis. Thus, the therapeutic strategy in intractable ocular diseases should be designed with consideration of accompanying systemic diseases.
Amnion ; Anti-Bacterial Agents ; Contact Lenses ; Corneal Ulcer ; Dimaprit ; Eye ; Female ; Humans ; Keratitis ; Keratoconjunctivitis Sicca ; Lupus Erythematosus, Systemic ; Middle Aged ; Ophthalmic Solutions ; Prognosis ; Steroids ; Transplants ; Uveitis ; Young Adult

PURPOSE: To report two cases of intractable superior limbic keratoconjunctivitis (SLK) treated with bevacizumab and triamcinolone injection. CASE SUMMARY: A 69-year-old female visited our clinic with pain in the left eye for 3 days and was diagnosed with SLK in her left eye. After 3 months of using steroid eye drops, artificial tears, and oral steroid intermittently, there was no improvement in symptoms and signs, thus this case was considered intractable with the conventional therapy. A mixture of bevacizumab (0.15 cc) and triamcinolone (0.05 cc) was injected into the sub-tenon's capsule of the left eye. After 1 week, all symptoms and signs disappeared, and there was no recurrence for 6 months. A 55-year-old female was transferred to our clinic due to SLK that did not respond to artificial tears, steroid eye drops, punctal occlusion, and botox injection for 3 months. A mixture of bevacizumab (0.15 cc) and triamcinolone (0.05 cc) was injected into the sub-tenon's capsule of the left eye. After 2 weeks, all symptoms and signs were improved, and there was no recurrence for 4 months. CONCLUSIONS: The presented 2 SLK cases are meaningful, because neovascularization disappeared and controlled inflammation was obtained following sub-tenon injection with both bevacizumab and triamcinolone.
Aged ; Female ; Humans ; Inflammation ; Keratoconjunctivitis* ; Middle Aged ; Ophthalmic Solutions ; Recurrence ; Triamcinolone* ; Bevacizumab

Effects of thoracentesis on thoracic impedance and cardiac performance were studied in patients with uncomplicated unilateral tuberculous pleural effusion. The speed of the removal of the pleural effusion in thoracentesis was essentially similar to that of a generally used for therapeutic purpose in daily practice. Thoracic impedance was measured in 23 cases before, 4 and 10 minutes after thoracentesis to the amount of pleural effusion aspirated was observed. In 11 cases out of 23, the changes in cardiac performance as assessed by stroke volume, cardiac output, heart rate, heather index and ratio of pre-ejection period to left ventricular ejection time(PEP/LVET) were observed 4 minutes after 150 ml to 1,000 ml of thoracentesis. In these cases, stroke volume, cardiac output, and Heather index were determined from impedance cardiograms, and PEP/LVET from mechanocardiograms recorded simultaneously with the former. A significant increase in thoracic impedance was observed both 4 and 10 minutes after thoracentesis. There was a slight but a significant correlation between the changes in thoracic impedance and the amount of pleural fluid aspirated only 4 minutes after thoracentesis. Thoracentesis showed no consistent influence on cardiac performance as reflected to stroke volume, cardiac output, heart rate, heart index and PEP/LVET. These facts suggest that measurement of thoracic impedance may be a useful method reflecting alterations in pleural fluid volumes, particularly when it occurs in a relatively short period of time, and the effects of thoracentesis of less than one liter on the cardiac functions as determined by the above-mentioned parameters were variable.
Cardiac Output ; Electric Impedance* ; Heart ; Heart Rate ; Humans ; Pleural Effusion ; Stroke Volume

The peripheral dose, defined as the dose outside therapeutic photom fields, Which is responsible for the functional damage of the critical organs, fetus, and radiation-nduced carcinogenesis, has been investigated for 60 Co gamma ray and 10 MV X ray. It was measured by silicon diode controlled by semiautomated water phantom without any shielding or with lead plate of HVL thickness put horizontally or vertically to shield stray radiations. Authors could obtain following results. 1. The peripheral dose was larger than 0.7% of central axis maximum dose even at 20cm distance from field margin. That is clinically significant, so it should be reduced. 2. Even for square fields of 10MV X ray, radial peripheral dose distribution did not coincide with transverse distribution, because of the position of collimator jaws. 3. Between surface and dm the peripheral dose distributions show a pattern of the dose distribution of electron beams and the maximum dose was approximately proportional to the length of a side of square filed. 4. The peripheral doses depended on radiation quality, field size, distance from field margin and depth in water. Distance from field margin was the most important factor. 5. Except for near surface, the peripheral dose from phantom was approximately equal to that from therapy unit. 6. To reduce the surface dose outside fields, therapist should shield stray radiations from therapy unit by lead plate of at least one HVL for 10 MV X-ay and by bolus equivalent to tissue of 0.5cm thickness for 60 Co. 7. To reduce the dose at depth deeper than dm, it is desirable to shield stray radiations from therapy unit by lead.
Axis, Cervical Vertebra ; Carcinogenesis ; Fetus ; Gamma Rays* ; Jaw ; Silicon ; Water

Postoperative radiotherapy of breast cancer makes it possible to reduce loco-regional recurrence of breast cancer. The treatment technique, which can low-dose region at the junction and lung, is required. To produce proper dose distribution of internal mammary chain and chest wall, authors tried to find the method to expose 60Co gamma-ray on internal mammary region and 7 MeV electron on chest wall. Exposure time of 60Co and monitor unit of 9 MeV were selected so that dose of 60Co at 4 cm depth was the same as that of 7 Mev elevtron at 80% dose depth. The position and direction of electron beam were changed for 60Co beam: 0 degrees, 5 degrees for 0 cm seperation; 0 degrees, 5 degrees, 10 degrees for 0.5 cm seperation; 5 degrees, 10 degrees, 15 degrees for 1 cm seperation. The results are as followings. 1. When the seperation of two fields was increased, dose on the axis of 60Co beam was increased and dose at the junction region decreased while the volume of lung to be exposed to high dose and hot spot size were irregularly changed. 2. The dose distribution in the target volume of internal mammary and chest wall was most ideal when the seperation of two fields was 0 - 0.5 cm and the direction of electron beam was parallel to 60Co beam.
Axis, Cervical Vertebra ; Breast Neoplasms* ; Breast* ; Lung ; Radiotherapy* ; Recurrence ; Thoracic Wall

A myxoma is a benign tumor found in the heart and in various soft tissues; however, a corneal myxoma is rare. A mucinous mass of unknown etiology was observed on the left cornea of a 32-year-old male patient. We performed deep anterior lamellar keratoplasty using acellular corneal tissue and concurrent amniotic membrane transplantation. Hematoxylin and eosin staining revealed vacuolation of the parenchyma and myxoid change in the corneal tissue that occurred in the anterior half of the corneal parenchyma. We identified a myxoid stroma by Alcian blue staining and observed collagen fibers with denatured stroma by Masson trichrome staining. The patient's visual acuity improved from light perception to 20 / 200, and the intraocular pressure remained within the normal range for one year after surgery. The transplanted cornea survived successfully with well-maintained transparency, and recurrence was not observed one year after surgery.
Adult ; *Cornea ; Corneal Stroma/cytology/*transplantation ; Corneal Transplantation/*methods ; Eye Neoplasms/diagnosis/*surgery ; Humans ; Male ; Myxoma/diagnosis/*surgery

A myxoma is a benign tumor found in the heart and in various soft tissues; however, a corneal myxoma is rare. A mucinous mass of unknown etiology was observed on the left cornea of a 32-year-old male patient. We performed deep anterior lamellar keratoplasty using acellular corneal tissue and concurrent amniotic membrane transplantation. Hematoxylin and eosin staining revealed vacuolation of the parenchyma and myxoid change in the corneal tissue that occurred in the anterior half of the corneal parenchyma. We identified a myxoid stroma by Alcian blue staining and observed collagen fibers with denatured stroma by Masson trichrome staining. The patient's visual acuity improved from light perception to 20 / 200, and the intraocular pressure remained within the normal range for one year after surgery. The transplanted cornea survived successfully with well-maintained transparency, and recurrence was not observed one year after surgery.
Adult ; *Cornea ; Corneal Stroma/cytology/*transplantation ; Corneal Transplantation/*methods ; Eye Neoplasms/diagnosis/*surgery ; Humans ; Male ; Myxoma/diagnosis/*surgery

BACKGROUND/AIMS: Recent reports have suggested that precolonoscopy bowel preparation is easier to tolerate if a small volume solution is used. The aim of this study was to compare oral sodium phosphate with polyethylene glycol solution in terms of the quality of colon cleansing, ease of preparation, and gastrointestinal intolerance. METHODS: Sixty one patients were prospectively randomized to receive either a standard 4-liter polyethylene glycol solution or a 90 ml oral sodium phosphate preparation. Before and after bowel preparation all patients were weighted, and serum electrolytes were measured. Patients were asked to record the effects of the preparation and to give it a "discomfort rating" on a scale from 1 to 5. Surgeons were blinded to the preparation used and rated the quality of bowel cleansing on a scale of 1 to 5. RESULTS: The smaller volume of oral sodium phosphate was not associated with any clinically significant problem,caused no increase in the incidence of side effects, was preferred by patients, and was effective in colonic cleansing. The incidence of sleep disturbance, abdominal pain, nausea, vomiting, anal discomfort, chest pain, chilling and dizziness associated with oral sodium phosphate was similar to that with polyethylene glycol lavage. Abdominal distension was more common with polyethylene glycol lavage and statistical difference was seen(P<0.01). There were no clinically significant changes in any biochemical parameters and vital signs caused by precolonoscopic preparation except asymptomatic hyperphosphatemia in the sodium phosphate group that was not statistically different. The decreased body weight was seen with Colonlyte(R) that was statistically different(P<0.01). CONCLUSION: The overall quality of bowel preparation with oral sodium phosphate was similar to that with polyethylene glycol lavage. Patients tolerated preparation with oral sodium phosphate to be somewhat easier than polyethylene glycol lavage. Therefore, we conclude that the use of oral sodium phosphate as a precolonoscopy bowel preparation is clinically useful.
Abdominal Pain ; Body Weight ; Chest Pain ; Colon ; Dizziness ; Electrolytes ; Humans ; Hyperphosphatemia ; Incidence ; Nausea ; Polyethylene Glycols ; Prospective Studies ; Sodium ; Therapeutic Irrigation ; Vital Signs ; Vomiting