No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: To report a case of corneal edema caused by an iatrogenic lidocaine injection into the corneal stroma created while performing a local anesthetic (lidocaine) injection into the eyelid for a blepharoplasty procedure. CASE SUMMARY: A 15-year-old female visited our clinic after the onset of severe pain and decreased visual acuity while receiving a local anesthetic injection in the upper blepharon for a blepharoplasty procedure. At the first clinical visit, visual acuity was hand motion and an accurate anterior chamber examination was difficult because of corneal edema. The Seidel test was negative. On corneal optical coherence tomography, the corneal thickness was 1,580 µm without any sign of Descemet's membrane detachment. We prescribed 5% NaCl four times a day and prednisolone acetate eight times a day. On the next day after injury, the corneal edema was significantly improved (central corneal thickness: 660 µm), and Descemet's membrane detachment was still not observed. One week after injury, the naïve visual acuity was 20/20, the central corneal thickness was 560 µm, and the endothelial cell count was 3,260 cells/cm². Three weeks after injury, the corneal edema was fully resolved and only slight temporal corneal haziness remained. After 2 months, the cornea was clear without any subjective discomfort. CONCLUSIONS: Corneal edema without Descemet's membrane detachment can be resolved spontaneously without aggressive treatment such as gas or air injection. However, endothelial cell count and corneal opacity need to be monitored on follow up exam. This clinical experience suggests that severe corneal edema in anterior stromal layer could be spontaneously resolved without severe complication.
Adolescent ; Anesthesia, Local ; Anterior Chamber ; Blepharoplasty ; Cornea ; Corneal Edema ; Corneal Opacity ; Corneal Stroma ; Descemet Membrane ; Edema ; Endothelial Cells ; Eyelids ; Female ; Follow-Up Studies ; Hand ; Humans ; Lidocaine ; Prednisolone ; Tomography, Optical Coherence ; Visual Acuity

A young metastatic lung cancer patient developed empyema due to an infection with carbapenem-resistant Acinetobacter baumannii. Hydropneumothorax was detected and managed by a tube thoracotomy. However, persistent air leakage through the chest tube was observed due to the presence of a bronchopleural fistula (BPF). As hypercapnic respiratory failure had progressed and the large air leak did not diminish by conservative management, a pumpless extracorporeal lung assist (pECLA) device was inserted. The pECLA allowed the patient to be weaned from mechanical ventilation and the BPF to heal. The present case shows the effective application of pECLA in a patient with empyema complicated with BPF and severe hypercapnic respiratory failure. pECLA enabled us to minimize airway pressure to aid in the closure of the BPF in the mechanically ventilated patient.
Acinetobacter baumannii ; Bronchial Fistula ; Carbon Dioxide* ; Carbon* ; Chest Tubes ; Empyema* ; Fistula ; Humans ; Hydropneumothorax ; Hypercapnia ; Lung ; Lung Neoplasms ; Respiration, Artificial ; Respiratory Insufficiency ; Thoracotomy

Purpose: We evaluated the 3-month, postoperative clinical outcomes of patients implanted with refractive, aspheric, bifocal, Lentis Comfort (LS313-MF15, Oculentis) intraocular lenses (IOLs). Methods: Eighty-two eyes of 51 cataract patients underwent phacoemulsification and were implanted with LentisComfort IOLs. The uncorrected distant visual acuity (UCDVA), the 80-cm uncorrected intermediate visual acuity (UCIVA), the 40-cm uncorrected near visual acuity (UCNVA), and refractive values were evaluated 1 and 3 months postoperatively. At the latter time, defocus curves were drawn, contrast sensitivity tested, and satisfaction surveyed. Results: At the 3-month postoperative follow-up, the mean spherical equivalent was -0.12 ± 0.21 D; and the mean LogMAR UCDVA, 80-cm UCIVA, and 40-cm UCNVA were 0.02 ± 0.03, 0.13 ± 0.07, and 0.42 ± 0.10 respectively. The defocus curves revealed visual acuities in excess of 0.2 LogMAR at points between the distant and intermediate targets. The mean contrast sensitivity fell in the range of 90% of a normal population under both photopic and mesopic conditions. In terms of satisfaction, 71.8% of patients were satisfied or very satisfied, but about 20% reported dysphotopsia. Conclusions Implantation of the refractive, aspheric, bifocal, intraocular, LentisComfort in patients with cataracts improved both the distant and intermediate visual acuities by 3 months after surgery and the visual quality was comparable to that afforded by other IOLs both objectively and subjectively.

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Cardiovascular Diseases* ; Child* ; Cineangiography* ; Heart Defects, Congenital ; Humans

Bcl-2 oncoprotein is being localized to mitochondria and interfering with programmed cell death (apoptosis) independent of promoting cell division in the lymphoid and nonlymphoid cells. The bcl-2 oncoprotein expression has been reported in follicular lymphomas as well as in diffuse non-Hodgkin's lymphoma, leukemia and a variable propotion of Hodgkin's lymphoma cases. Recent evidence suggests that some lymphomas protected from apoptosis is conferred through expression of Epstein-Barr virus(EBV) latent membrane protein which turn to cause upregulation of bcl-2. To define the role of the bcl-2 oncoprotein and EBV in lymphoid malignancy, we tried immunohistochemical studies with anti-bcl-2 antibody and In situ hybridization (ISH) with EBV-encoded small nuclear RNAs(EBER) in the paraffin embedded sections of 46 non-Hodgkin's lymphoma (NHL) cases and 20 Hodgkin's lymphoma (HL) cases. Bcl-2 oncoprotein expression was found in 37 of 46 cases (80%) of NHL with relatively strong cytoplasmic staining, and in 14 of 20 cases (70%) of HL with weak cytoplasmic staining in limited small numbers of RS, Hodgkin and lacunar cells. The widespread presence of bcl-2 oncogene in many different types of both NHL and HL supports that the extended cell survival through overexpression of bcl-2 gene protein may be a growth advantage of neoplastic lymphoid cells. In the ISH analysis for EBV, the presence of EBV was detected in 17 of 20 cases (85%) of HL, compared to 6 of 44 cases(13.6%) of NHL. It appears to be no direct correlation between overexpression of bcl-2 oncoprotein by neoplastic lymphoid cells and the presence of EBV in NHL but it seems to be a definite association between EBV and HL.

Since human listeriosis was firstly described by Nyfeldt in 1929, Listeria monocytogenes as a cause of septic abortion has been well known. It primarily affects pregnant woman and neonates, the elderly, and persons with immune-system dysfunction due to immunosuppressive drugs, malignant tumors or AIDS. Although several large epidemic listeriosis have been reported in the English literatures, it is still an underdiagnosed and underreported cause of congenital sepsis and septic abortion, because it is not always easy to isolate the organism in culture. There are 17 cases reports of Listeria monocytogenes infection in Korea, however, most of which were described about the bascteriologically proven cases. We describe placental findings of a septic abortion caused by Listeria monocytogenes at 15 weeks gestation in a 23-year-old primigravida woman. Placental examination showed characteristic and relatively specific patterns of granulomatous microabscesses composed of necrotic nuclear debris in the center and surrounding epithelioid histocytes enmeshed in fibrin between the acutely inflamed villi. There were numerous gram positive bacilli on Brown-Brenn stain.
Pregnancy ; Female ; Infant, Newborn ; Humans

OBJECTIVE: Despite advance in the surgical treatment of the skull base lesions, reaching the ventral brain stem is not familiar to us yet. No traditional complex skull base approaches have a value not only in treating complex and unusual skull base pathology but also in providing a better and safer exposure to traditional pathology. However, a more widespread use of these complex skull base approaches is predicated on a clear understanding of the topographical areas of the skull base exposed and on how these complex approaches can improve the exposure afforded by more conventional surgical routes. PATIENTS AND METHODS: The study was performed on 43 surgical dissection with 20 embalmed cadevaric heads in which the cephalic vascular system had been injected with colored silicone material. RESULTS AND CONCLUSIONS: This paper provides an visual anatomical understanding of the areas of the skull base exposed by the approaches examined using the same cues(CT and MRI) that the surgeons use in selecting an approach when confronted with a real lesion and makes them to apply to the clinical situations properly and intimately for the optimal treatment. In addition, with the modular concept, the neurosurgeon may better understand how complex skull base approaches are derived and modified from, and improve the exposure of basic, well known conventional neurosurgical approaches as building block.
Brain Stem ; Head ; Humans ; Pathology ; Silicones ; Skull Base* ; Skull*

OBJECTIVES: Pneumocystis carinii pneumonia(PCP) is one of the most common life-threatening opportunistic infections in patients with acquired immunodeficiency syndrome(AIDS). This study reports the clinical charac teristics of PCP in the patients with AIDS and prognostic factors for short-term survival of them. METHODS: We investigated 43 patients of AIDS to evaluate the frequency of PCP in patients in AIDS by retrospective analysis, and classified the 17 patients with PCP into survivors and non-survivors to compare epide miology, clinical characteristics and laboratory findings. We also analyzed whether the these findings influenced the short-term survival in patients with PCP that was combined with AIDS. RESULTS: In this retrospective study of 43 patients of AIDS, the frequency of PCP in AIDS patients was relatively high as 17 patients(39%), of whom eight pa tients(47%) died of PCP. The epidemiologic findings such as age, route of human immunodeficiency virus(HIV) infection and co-existing disease were not significantly different between survivors and non-survivors. Coughing was the most common symptom and bilateral infiltrates of lung was the most common form in the chest X-ray examination. But these clinical features were similar in the both groups. Total lymphocyte count, CD4 cell count, serum albumin level and arterial oxygen tension were decreased and serum LDH was increased in patients with PCP that was the first episode in patients with AIDS. Lymphocyte and CD4 cell count were significantly lower in the non-survivor group (p=.002 and p=.03, respec tively). Survivors had higher serum albumin level and arterial oxygen tension than non-survivors (p=.02 and p=.04, respectively). And non-survivors were found to have higher serum LDH level than survivors (p=.02). CONCLUSION: Lymphocyte and CD4 cell counts, serum albumin and LDH, and arterial oxygen tension may be considered as the prognostic factors for short-term sur vival of patients with PCP that is combined with AIDS.
CD4 Lymphocyte Count ; Cough ; Humans ; Lung ; Lymphocyte Count ; Lymphocytes ; Opportunistic Infections ; Oxygen ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis* ; Retrospective Studies ; Serum Albumin ; Survivors ; Thorax

Gastritis cystica profunda is an uncommon benign mass that usually occurs on the gastric side of the site of a gastroenterostomy, but has also been known to develop in which has not been operated on. We report the case of stomach a 51-years-old man with pathologically proven gastritis cystica profunda. This patient had not undergone gastric surgery and CT showed a well-defined, 3 cm sized, cystic mass at the gastric antrum.
Gastritis* ; Gastroenterostomy ; Humans ; Pyloric Antrum ; Stomach