Pterygium is a common surgical ocular disease which recurs frequently. Various different techniques have been developed for the successful surgical treatment of pterygium and among them, autograft transplantation is known as the best successful surgical method. For the prevention of recurrence, the corneal epithelium must heal before the fibrovascular tissue grows and reaches to limbus. For this, we have believed that limbal transplanta- tion is more suitable than conjunctival transplantation. We had performed limbal-conjunctival autograft trasplata- tion for 52 patients with primary pterygia whose age was under 40 years old,or whose pterygia had involved above 5mm beyond limbus and had shown diffuse subconjunctival fibrovascular tissue. The recurrence rate was 1.9%and therewere no complications and no surgical problems. Therefore,we recommend this surgical technique as a safe and effective method of treating primary pterygia with the risk factors of recurrence.
Autografts* ; Epithelium, Corneal ; Humans ; Pterygium* ; Recurrence ; Risk Factors

We compared the pain produced during different phases of phacoemulsification cataract surgery using a scleral pocket incision under pinpoint anesthesia with that under intracameral anesthesia. This prospective study comprised each 100 cataract patients who had no complications influencing the degree of pain during surgery. Patients were asked about pain immediately after each phase and pain occurring during each phase was measured using 4 step verbal scale(from 0 to 4). In both anesthesia,conjunctival reposition was the most painful.Pinpoint injection was statistically significantly more painful than induction of intracameral anesthesia.The pain score during conjunctival reposition and at 1hr after surgery were significantly higher under intracameral anesthesia than under pinpoint, but during most of phases under both anesthesia,the pain score was relatively low. Intracameral anesthesia is easy,safety and dose not require additional ocular damage during induction of anesthesia,so if combined with topical anesthesia,it is very effective during cataract surgery using scleral pocket incision.
Anesthesia* ; Cataract* ; Humans ; Phacoemulsification ; Prospective Studies

Moyamoya disease is characterized by progressive stenosis of internal carotid artery and shows unique angioraphic findings. Its etiology is still unknown, and theories of immunophysiologic and inflammatory mechanisms remain unproven. These patients show various neurologic symptons by cerebral ischemia, infarction and gemorrhage. and they also show various ophthalmologic symptoms. We experienced that a 21-year-old female who was diagnosed to have moyamoya disease presented with a suddenly developed occipital headache and neurologic deficit. The etiology of her characteristic fundus findings was thought to be retinal vascular insufficiency.
Brain Ischemia ; Carotid Artery, Internal ; Constriction, Pathologic ; Female ; Financial Management* ; Headache ; Humans ; Infarction ; Moyamoya Disease* ; Neurologic Manifestations ; Retinaldehyde* ; Young Adult

For securing large, giant, and wide-neck aneurysms, conventional coil embolization has substantial limitations, such as incomplete occlusion, recanalization, and a high recurrence rate. To overcome these limitations, a novel paradigm was suggested and, as a result, flow-diverting device was developed. The flow-diverting device is an innovative and effective technique to allow securing of large, giant, and wide-neck aneurysms. In numerous studies, the flow-diverting device has shown better outcomes than coil embolization. However, the flow-diverting device has also some risks, including rupture of aneurysm, intracerebral hemorrhage, and ischemic stroke. In addition, with more experience, unexpected complications are also reported.5) 7) In the present case, we experienced a delayed ischemic stroke at 27 days after endovascular treatment. The patient had multiple aneurysms and, among them, we treated a large posterior communicating artery aneurysm using Pipeline™ Embolization Device. The patient was tolerable for 25 days, but then suddenly presented intermittent right hemiparesis. In the initial diffusion magnetic resonance imaging (MRI), there was no acute lesion; however, in the follow-up MRI, an acute ischemic stroke was found in the territory of anterior choroidal artery which was covered by Pipeline Embolization Device. We suspect that neo-intimal overgrowth or a tiny thrombus have led to this delayed complication. Through our case, we learned that the neurosurgeon should be aware of the possibility of delayed ischemic stroke after flow diversion, as well as, long-term close observation and follow-up angiography are necessary even in the event of no acute complications.
Aneurysm ; Angiography ; Arteries ; Cerebral Hemorrhage ; Choroid ; Diffusion Magnetic Resonance Imaging ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Paresis ; Recurrence ; Rupture ; Stroke* ; Thrombosis

We report a case of a 53-year-old woman with squamous cell carcinoma with lymph node metastasis who has had a recurrent painful bleeding papule on the right toe nail bed with resultant nail plate shedding over the past two years. X-ray and computer tomography examinations showed nearly total destruction of the distal phalanx of the right fifth toe and right inguinal lymph node enlargemet it. A nail bed biopsy specimen disclosed invading tumor masses composed of atypical squamous cells and multiple horn pearls. While squamous cell carcinoma of the nail bed is not usually aggresive and local removal is usually adequate, the possibility that metastasis or invasion of the adjacent phalanx or joint can occur should be kept in mind.
Animals ; Biopsy ; Carcinoma, Squamous Cell* ; Female ; Hemorrhage ; Horns ; Humans ; Joints ; Lymph Nodes* ; Middle Aged ; Neoplasm Metastasis* ; Toes

We report a case of an erythrodermic form of mycosis fungoides in a 68-year-old male, who showed generalized erythroderma with scales for 3 months. Lymphadenopathies in the inguinal and neck areas were present. Histopathological findings showed epidermotropism, perivascular atypical lymphocyte infilteration in the upper dermis, and dermatopathic lymphadenopathy in the inguinal lymph node. T cell markers were positively stained in the immunohistochemical study. These clinicopathological features were consistent with an erythrodermic form of mycosis fungoides(TNM IIl). The patient was treated with PUVA therapy and low dose chemotherapy.
Aged ; Dermatitis, Exfoliative ; Dermis ; Drug Therapy ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Male ; Mycosis Fungoides* ; Neck ; PUVA Therapy ; Weights and Measures

We investigated the effects of prolonged exposure in hot environmental condition and ingestion of fluid on various physiological variables including plasma glucose, lactate, the rating of perceived exertion (RPE), and heart rate as well as golf putting performance. Six male professional golfers were voluntarily participated in three different putting trials which were separated by seven days of time interval period. Three different putting trials were conducted at either 20degrees C or 32degrees C, or 32degrees C + Fluid ingestion. Performing 32degrees C + Fluid ingestion trial, all subject ingested sport drink as much as their body mass was decreased. For each experiment, all subjects were undertaken total 48 putting, which separated by four x 12 putting in four different time points (i.e., Rest, 1 hr, 2 hr, and 3 hr). Plasma glucose concentration was significantly decreased with hot ambient condition but it was almost fully recovered by fluid ingestion. Plasma lactate concentration was significantly higher when subjects were exposed in hot environmental condition, and it did not change with fluid ingestion. There was a no different in putting performance and psychological fatigue level (performed by GRID test) at any environmental conditions. The RPE, commonly used for evaluating of physical fatigue level, was significantly dropped by fluid ingestion which indicates lower physical fatigue level. In addition to this, heart rate (HR) was also significantly decreased after fluid ingestion. Based on these results, it was concluded that the ingestion of fluid during prolonged exposure in hot ambient condition decrease the degree of physical fatigue levels and heart rate, which will possibly improve the golf performance when exposed in extreme weather condition in summer.
Blood Glucose ; Eating* ; Fatigue* ; Golf ; Heart Rate* ; Heart* ; Humans ; Lactic Acid ; Male ; Plasma ; Sports* ; Weather

STUDY DESIGN: Case report. OBJECTIVES: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI). SUMMARY OF LITERATURE REVIEW: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. MATERIALS AND METHODS: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a 2.0×0.5 cm elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. RESULTS: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. CONCLUSION: Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.
Back Pain ; Diagnosis ; Diagnosis, Differential ; Epidural Neoplasms ; Female ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Neurologic Manifestations ; Prognosis ; Recurrence ; Sensation ; Spine ; Thigh ; Thoracic Vertebrae

OBJECTIVES: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI).SUMMARY OF LITERATURE REVIEW: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. MATERIALS AND METHODS: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a 2.0×0.5 cm elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. RESULTS: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. CONCLUSION Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.

The periodic sharp wave complexes are the most characteristic EEG abnormalities in sCJD. We report the serial EEG findings in a patient with probable sCJD. The initial EEG showed diffuse theta and delta slowings only. However, it changed to the typical periodic sharp wave complexes according to the worsening clinical state. These changes occurred during a short-term interval. The serial EEGs within the short-term interval will be helpful for the earlier diagnosis of sCJD.
Diagnosis ; Electroencephalography* ; Humans