Male breast cancer is a rare disease, representing approximately 1% of breast cancer and less than 1.5% of malignant tumors occurring in men. We report a case of cuaneous metastasis of male breast cances. a 64-year-old male who presented with multiple nodules and erythematous plaque on the right anterior chest and enlargement of the right axillary lymplinodes. The histopathologic findings of the nodule showed atypical tumor cells with a somew eat gland-like pattern. The cells showed potive reactions in PAS, DPAS and alcian blue stains, and also positive for estrogen and roiesterone receptors. Biopsy specimens taken from the plaque showed cellular arrangement in show line, referred to as Indian filing, between thiclenecin collagen bundles. He was treated not, tamoxifen, 5-fluorouracil, adriamycin, cyclophosphamide and megestrol acetate. 5 months after nitiation of the treatment, the skin lesions were improved vvith a decreased number and size or dules and decreased intensity of erythema.
Alcian Blue ; Biopsy ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Collagen ; Coloring Agents ; Cyclophosphamide ; Doxorubicin ; Erythema ; Estrogens ; Fluorouracil ; Humans ; Male ; Male* ; Megestrol Acetate ; Middle Aged ; Neoplasm Metastasis* ; Rare Diseases ; Skin ; Tamoxifen ; Thorax

PURPOSE: To evaluate morphological differences in proprioceptors in extraocular muscles between congenital exotropia, acquired exotropia and congenital nystagmus. METHODS: Nine medial recti including the myotendinous junction were resected using medial rectus resection in three congenital and five acquired exotropia patients. Two medial recti and two lateral recti were resected using the modified Kestenbaum procedure in two congenital nystagmus patients. The muscle tissues were examined under a light microscope following examination with a transmission electron microscope. RESULTS: In the congenital exotropia group, the electron microscopic findings showed degenerative changes in proprioceptors, such as decreased microtubules, axonal shrinkage and decreased myelin thickness. In the acquired exotropia group, the neural structures in the myotendinous junction were well maintained. There were no neural structures in the myotendinous junction in the congenital nystagmus group. CONCLUSIONS: Depending on the type of strabismus, there may be morphological differences in proprioceptors of extraocular muscles.
Axons ; Exotropia* ; Humans ; Microtubules ; Muscles* ; Myelin Sheath ; Nystagmus, Congenital* ; Strabismus

PURPOSE: To evaluate postoperative binocularity after surgical correction of longstanding constant-horizontal adult strabismus without both stereopsis and previous surgery. METHODS: Subjects included 43 adults over 18 years of age, who had constant-horizontal strabismus for more than 10 years without previous surgery and stereopsis. The patients were composed of 30 exotropes and 13 esotropes. Patients with a corrected visual acuity less than 20/40 in the deviating eye were excluded. After correcting for refractive error, the angle of deviation was measured, and pre- and postoperative stereopsis was assessed with the Titmus fly test and Randot stereo test. The relationship between duration of deviation and recovery of stereopsis or obtained stereoacuity were evaluated. RESULTS: The mean preoperative angle of deviation was 49.8+/-12.56 PD in exotropes and 34.7+/-12.41 PD in esotropes. All patients showed suppression of the deviating eye at distance and near before surgery. Postoperatively all patients showed orthophoria within +/-8 PD. Stereopsis was obtained in 80% of exotropes and in 30.8% of esotropes. The mean postoperative stereoacuity was 449.2+/-815.29 seconds of arc (sec) in exotropes and 1000+/-1336.66 sec in esotropes. However, there was no significant relationship between the duration of deviation and the obtained stereoacuity (p>0.05), or between the duration of deviation and the recovery of stereopsis (p>0.05). CONCLUSIONS: Adults with longstanding constant-horizontal strabismus more than 10 years obtained stereopsis with good quality after surgical correction. The recovery of stereopsis was much better in exotropes than in esotropes. Recovery was not influenced by the duration of deviation.
Adult* ; Depth Perception* ; Diptera ; Humans ; Refractive Errors ; Strabismus* ; Telescopes ; Visual Acuity

PURPOSE: We report a case of candidal endophthlmitis developed in a patient with advanced gastric cancer who recently injured by flame burn. He was treated successfully with intravitreous and intravenous antifungal agents. METHODS: A 40-year-old man visited with complaints of decreased binocular visual acuity 7 weeks after third degree flame burn injury to 25% of body surface. Indirect ophthalmoscope showed findings of fungal endophthalmitis and upper gastro-intestinal endoscopic examination diagnosed of fungal esophagitis and advanced gastric cancer. He was treated with amphotericin B intranvitreously and fluconazole and amphotericin B intravenously. RESULTS: His visual acuity was improved to 20/50 (OD), 20/30 (OS) following 4 weeks after treatment and intraocular inflammation was decreased. After 5 months, he recovered his visual acuity as 20/25 (OD), 20/20 (OS), and had no inflammation in anterior chamber and vitreous.
Adult ; Amphotericin B ; Anterior Chamber ; Antifungal Agents ; Burns* ; Endophthalmitis* ; Esophagitis ; Fluconazole ; Humans ; Inflammation ; Ophthalmoscopes ; Stomach Neoplasms* ; Telescopes ; Visual Acuity

PURPOSE: This study was to evaluate the effect of topical steroid treatment on eyes that showed myopic regression after LASIK. METHODS: A total of 26 patients (33 eyes) who showed myopic regression more than 1.00 diopter(D) confirmed by topography and pachymeter, were prospectively treated with 1% topical prednisolone acetate. Manifest refraction, Snellen uncorrected visual acuity and intraocular pressure(IOP) were measured before and after treatment. Topical steroids were administered every 2 hours for 3 days and 4 times a day for 11 days. Then the treatments were tapered in the eyes that showed over +0.50 D reversal of myopic regression. But it was immediately stopped in those eyes that showed no improvement or IOP increase. Pachymeter was taken in the improved group 4 weeks after the treatment. RESULTS: Fifteen eyes (45.5 %) showed over +0.50 D reversal of myopic regression(mean +/- SD +1.21 +/- 0.74 D, range: +0.50 ~ +2.75) and the uncorrected visual acuity increased (20/45 before treatment, 20/27 after treatment, p<0.01). The mean corneal thickness decreased (501.9 +/- 18.5 micrometer before treatment, 492.2 +/- 19.2 micrometer after treatment, p<0.01). Refractive effect of the steroid treatment remained stable with four of the eight eyes that could be followed up over six months. IOP was elevated in 3 eyes, but readily normalized with pressure-lowering agent. CONCLUSIONS: Topical steroid treatment for myopic regression after LASIK is partially effective and safe. It is recommendable to use topical steroid prior to performing surgical retreatment.
Adrenal Cortex Hormones* ; Humans ; Keratomileusis, Laser In Situ* ; Prednisolone ; Prospective Studies ; Retreatment ; Steroids ; Visual Acuity

Objective: : A distal navigation of a large bore aspiration catheter during mechanical thrombectomy (MT) is important. However, delivering a large bore aspiration catheter is difficult to a tortuous or atherosclerotic artery. We report the experience of anchoring with balloon guide catheter (BGC) and stent retriever to facilitate the passage of an aspiration catheter in MT. Methods: : When navigating an aspiration catheter failed with a conventional co-axial microcatheter delivery, an anchoring technique was used. Two types of anchoring technique were applied to facilitate distal navigation of a large bore aspiration catheter during MT. First, a passage of aspiration catheter was attempted with a proximal BGC anchoring technique. If this technique also failed, another anchoring technique with distal stent retriever was tried. Consecutive patients who underwent MT with an anchoring technique were identified. Details of procedure, radiologic outcomes, and safety variables were evaluated. Results: : A total of 67 patients underwent MT with an anchoring technique. Initial trial of aspiration catheter passage with proximal BGC anchoring technique was successful for 35 patients (52.2%) and the second trial with distal stent retriever anchoring was successful for 32 patients (47.8%). Overall, navigation of a large bore aspiration catheter was successful for all patients (100%) without any procedure related complications. Conclusion : Our study showed the usefulness of anchoring technique with proximal BGC and distal stent retriever during MT, especially in those with an unfavorable anatomical structure. This technique could be an alternative option for delivering an of aspiration catheter to a distal location

PURPOSE: To suggest a surgical normogram for lateral rectus recession in exotropia associated with unilateral or bilateral superior oblique muscle palsy (SOP). METHODS: We retrospectively reviewed the charts of 71 patients with exotropia who were successfully corrected over one year. Each patient had undergone unilateral or bilateral rectus recession associated with uni- or bilateral inferior oblique (IO) 14 mm recession, using a modified surgical normogram for lateral rectus (LR) recession, which resulted in 1 to 2 mm of reduction of LR recession. We divided all patients into 2 groups, the 34 patients who had undergone LR recession with unilateral IO (UIO) recession group and the remaining 37 patients who had undergone LR recession with bilateral IO (BIO) recession group. Lateral incomitancy was defined when the exoangle was reduced by more than 20% compared to the primary gaze angle. The surgical effects (prism diopters [PD]/mm) of LR recession were compared between the two groups using the previous surgical normogram as a reference (Parks' normogram). RESULTS: The mean preoperative exodeviation was 20.4 PD in the UIO group and 26.4 PD in the BIO group. The recession amount of the lateral rectus muscle ranged from 4 to 8.5 mm in the UIO group and 5 to 9 mm in the BIO group. Lateral incomitancy was noted as 36.4% and 70.3% in both groups, respectively (p = 0.02). The effect of LR recession was 3.23 +/- 0.84 PD/mm in the UIO group and 2.98 +/- 0.62 PD/mm in the BIO group and there was no statistically significant difference between two the groups (p = 0.15). CONCLUSIONS: Reduction of the LR recession by about 1 to 2 mm was successful and safe to prevent overcorrection when using on IO weakening procedure, irrespective of the laterality of SOP.
Child ; Exotropia/complications/physiopathology/*surgery ; Eye Movements ; Female ; Follow-Up Studies ; Humans ; Male ; *Nomograms ; Oculomotor Muscles/physiopathology/*surgery ; Ophthalmologic Surgical Procedures/*methods ; Retrospective Studies ; Treatment Outcome ; Trochlear Nerve Diseases/*complications/physiopathology/surgery

No abstract available.
Addison Disease*

No abstract available.
Brain ; Brain Neoplasms ; Cerebral Infarction ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Vasospasm, Intracranial

We report a man who presented with progressive disinhibition and through clinicoradiologic correlation using magnetic resonance imaging (MRI), aim to investigate the pathomechanism of disinhibition in neuro-Behcet's disease (NBD). A 46-year-old man presented with progressive disinhibition and apathy for 4 months. One month after his visit, additionally, he developed left partial third nerve palsy. His brain MRI showed lesions in the ventral caudate nucleus as well as left midbrain and thalamus. Taking his recurrent oral ulcers, uveitis, and erythema nodosum into consideration, he was diagnosed with NBD. We found that progressive disinhibition could be one of presenting symptoms in BD and might be associated with the caudate nucleus. This finding suggests that involvement of the basal ganglia in BD prior to the involvement of the brainstem could result in unique clinical features such as behavioral changes without extrapyramidal signs.
Apathy ; Basal Ganglia ; Brain ; Brain Stem ; Caudate Nucleus ; Erythema Nodosum ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Oculomotor Nerve Diseases ; Oral Ulcer ; Thalamus ; Uveitis