No abstract available.
Epidermal Cyst*

No abstract available.
Trichothiodystrophy Syndromes*

PURPOSE: To report a case of cyclodialysis cleft with hypotony during Ahmed valve implantation. CASE SUMMARY: A 47-year-old male was referred for uncontrolled intraocular pressure (IOP) in the right eye. The patient had a history of ocular trauma and traumatic hyphema. He underwent pars plana vitrectomy, phacoemulsification and intraocular lens implantation 1 month prior due to rhegmatogenous retinal detachment. At the end of the Ahmed valve implantation surgery, the eye was hypotonic despite a deep anterior chamber. The hypotony continued and choroidal effusion developed. Anterior segment optical coherence tomography and gonioscopic examinations revealed small cyclodialysis clefts. After medical treatment with cycloplegics and steroids, choroidal effusion disappeared and IOP was normalized. CONCLUSIONS: Patients with previous ocular trauma or surgery could be prone to developing cyclodialysis cleft with hypotony. Inadvertent cyclodialysis cleft with hypotony can be treated with cycloplegics and steroids.
Anterior Chamber ; Choroid ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Male ; Middle Aged ; Mydriatics ; Phacoemulsification ; Retinal Detachment ; Steroids ; Tomography, Optical Coherence ; Vitrectomy

PURPOSE: To introduce autologous tragal perichondrium transplantation as a novel surgical modality for the management of intractable symptomatic bullous keratopathy. METHODS: In three eyes of three patients with painful bullous keratopathy, autologous tragal perichondria were transplanted on the corneal surface with the human amniotic membrane transplanted above. We included an additional three eyes of three patients with painful bullous keratopathy who received amniotic membrane transplantation only to serve as controls. Clinical symptom outcomes were assessed using a visual analogue scale at postsurgical months 1, 3, 5, 7, and 9. In addition, transplanted tragal perichondrium and amniotic membrane complex tissue button obtained from one patient who underwent penetrating keratoplasty was evaluated by immunohistochemical analysis of CD34, vimentin, and alcian blue staining. RESULTS: All three patients who underwent autologous tragal perichondrium and human amniotic membrane co-transplantation showed improvements in pain and tearing. However, all three patients in the control group experienced aggravation of tearing and no further improvement of pain 3 months after surgery. In addition, one patient in the control group developed premature degradation of the amniotic membrane. Histopathologic and immunohistochemical analysis showed intact surface epithelization and positive CD34, vimentin and alcian blue staining of transplanted tragal perichondria. CONCLUSIONS: The tragal perichondrium has a high mechanical structural force and high potency due to well-organized epithelization and the presence of mesenchymal stem cells. Autologous tragal perichondrium transplantation may be an effective modality for the management of painful bullous keratopathy.
Adult ; Aged ; Amnion/*transplantation ; Corneal Diseases/*pathology/*surgery ; Ear Cartilage/*transplantation ; Female ; Humans ; Keratoplasty, Penetrating/*methods ; Male ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome

Thalidomide, a potent teratogen, is Known as an angiogenic inhibitor. This study was performed to examine the effect of thalidomide on corneal angiogenesis in rabbit cornea induced by chemical cauterization. We applied Whatman filter paper disc soaked in 30% silver nitrate (AgNO3) application on corneas of 12 white rabbits. After 5days, we administered oral dose of 100mm2 thalidomide to the 6 animals everyday and examined the length and extent of neovascularization to evaluate the area of neovascularization. After 2 days of oral administration, the increase of neovascularization is 14.3+/-11.7mm2in thalidomide-treated group and 27.9+/-14.6mm2 in cotrol grop. The area of neovascularization reached to its maximum at day 9 in thalidomide-treated group compared to day 11 in control group and decreased thereafter in both groups. The increase of the area of vascularized cornea revealed 28.0+/-13.5mm2 in thalidomide-treated group and 44.4+/-12.7mm2 in control group at the day 9 (p=0.04, Wilkoxon Matched-pairs signed-rank test). This fact means that treatment with thalidomide resulted in an inhibition of the area of vascularized cornea with the median inhibition of 37.3%. On light micrographs, there were infiltration of inflammatory cell and capillary lumens in corneal stroma in both animals. Electron micrographs of thalidomide-treated animals showed loss of vascular endothelial cell junction, mitochondrial swelling and loss of cristae which were not found in control animals. This results suggest that orally-administered thalidomide has a direct effect on the growing vasculature and an inhibitory effect on corneal angiogenesis.
Administration, Oral ; Animals ; Capillaries ; Cautery ; Cornea ; Corneal Neovascularization* ; Corneal Stroma ; Endothelial Cells ; Mitochondrial Swelling ; Rabbits ; Silver Nitrate ; Thalidomide*

Purpose: To identify clinical factors associated with the early reduction of corneal sensitivity (CS) in patients with herpes zoster ophthalmicus (HZO). Methods: Total 30 subjects were divided into two groups according to the occurrence of an early reduction of CS (group 1, normal CS; group 2, decreased CS). The demographics, ocular manifestations of HZO, and the ocular surface parameters were compared between two groups. Then, the relative risks of variables were analyzed to expect the early decrease of CS by HZO using logistic regression analysis. Results: Among total 30 subjects, the CS decreased in 10 subjects (3.2 ± 1.4 cm, group 2) and the other 20 subjects revealed normal CS (6.0 ± 0.0 cm, group 1). The age was higher in the group 2 (67.0 ± 16.6 years) than in group 1 (48.0 ± 17.6 years, p = 0.013), but sex and the comorbidity of diabetes mellitus was not difference between groups. The presence of corneal punctate epithelial erosions was a single factor among the ocular manifestations of HZO, which discriminated group 1 (5%) and group 2 (60%, p = 0.002). The ocular surface staining scores (i.e., National Eye Institute scores and Sjögren’s International Collaborative Clinical Alliance ocular surface score) were higher in group 2 (p = 0.001 and p = 0.021, respectively) than in group 1. The existence of corneal punctate epithelial erosions revealed as a sole risk factor for the early reduction of CS (odds ratio = 33.085; p = 0.016). Conclusions It is necessary to pay attention to the possible occurrence of neurotrophic keratopathy especially in older patients with HZO showing an initial presence of corneal punctate epithelial erosions.

PURPOSE: Sensitization to eggs in infancy has been reported to be associated with increasing the risk of respiratory allergic diseases during childhood. So our study was designed to follow up children who have had atopic dermatitis with egg allergy and to evaluate the prognosis according to family history, early egg elimination diet, house dust mite sensitization, egg/histamine wheel ratio of skin prick test, RAST class and age tolerance to find the risk factors which might be helpful for applying some preventable measures. METHODS: Twenty three children diagnosed with egg allergy at Kangnam General Hospital between March 1988 and March 2000 were studied retrospectively. At the time of the first visit, we interviewed an feeding methods, past medical history, atopic family histories and performed skin prick tests, and total IgE and egg-white specific IgE tests (RAST). At the time of the last visit, we evaluated whether the children had allergic diseases or not, as well as prognosis and other allergen sensitization. RESULTS: Four (17.4%) children resolved allergic symptoms, Fifteen (65.2%) children had atopic dermatitis, 11 (47.8%) children had asthma, and 12 children (52.2%) had allergic rhinitis. Prognosis was good in children with early tolerance and no sensitization to house dust mites. There was no relationship between prognosis and atopic family history, early egg elimination diet, infant feeding methods, or RAST class. CONCLUSION: Because 19 (82.6%) of 23 children with egg allergy have persistent allergic diseases and related to sensitization of house dust mites, early environment intervention for house dust mites must be evaluated to prevent other allergic diseases.
Asthma ; Child* ; Comorbidity* ; Dermatitis, Atopic ; Diet ; Egg Hypersensitivity* ; Eggs ; Feeding Methods ; Follow-Up Studies* ; Hospitals, General ; Humans ; Immunoglobulin E ; Infant ; Ovum* ; Prognosis* ; Pyroglyphidae ; Retrospective Studies ; Rhinitis ; Risk Factors ; Skin

The purpose of this study was to evaluate the relation between ocular discomfort and ocular Demodex infestation, and therapeutic effects of tea tree oil (TTO) in Demodex blepharitis patients. Three hundred and thirty-five patients with ocular discomfort were evaluated for ocular Demodex infestation and subjective symptoms with ocular surface discomfort index (OSDI) score. Among them, Demodex-infested patients were randomized to receive either eyelid scrubbing with TTO (TTO group,106 patients) or without TTO (Control group, 54 patients) for 1 month. Demodex were found in 84% of patients with ocular discomfort. The number of Demodex was significantly correlated with age (P = 0.04) and OSDI score (P = 0.024). After eyelid scrub treatment, Demodex count was reduced from 4.0 +/- 2.5 to 3.2 +/- 2.3 in the TTO group (P = 0.004) and from 4.3 +/- 2.7 to 4.2 +/- 2.5 in the control group (P = 0.27). Also, OSDI score was reduced from 34.5 +/- 10.7 to 24.1 +/- 11.9 in the TTO group (P = 0.001) and from 35.3 +/- 11.6 to 27.5 +/- 12.8 in the control group (P = 0.04). In conclusion, Demodex number showed a significant positive correlation with age and subjective ocular discomfort. The tea tree oil eyelid scrub treatment is effective for eliminating ocular Demodex and improving subjective ocular symptoms.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Animals ; Anti-Infective Agents, Local/pharmacology/therapeutic use ; Blepharitis/*drug therapy/pathology ; Eye Infections, Parasitic/*drug therapy/parasitology/pathology ; Eyelids/parasitology/pathology ; Female ; Humans ; Male ; Middle Aged ; Mite Infestations/*drug therapy/parasitology/pathology ; Mites/drug effects ; Phytotherapy ; Tea Tree Oil/pharmacology/*therapeutic use ; Young Adult

Ambulstory surgery in a hospital-based setting has been practiced at Yongdong Severance Hospital since August 1983. Several factors favor ambulatory surgery over the inpatient approach, first, hospital costs are decreased, second, it is less disruptive to the patient's personal life and the risk of hospital-acquired infection can be significantly decreased. The charts of 1913 patients who were anesthetized for ambulatory surgery were analyzed retrospectively to obtain better guidance for anesthetic management in ambulatory surgical patients. The results are as follows: 1) The number of patients has been increasing since 1983. 2) A total of 1913 patients were evaluated, including 660 males and 1253 females, ranging in age from 5 months to 80 years and averaging 26 years. 3) The operations performed were grouped into: gynecologic(33.9% of the cases), otolaryngologic(33.7%), orthopaedic(10.4%), etc. The most frequent procedures were diagnostic dilation and curettage(23.7%) and excision(17.6%). 4) General anesthesia was performed for 852 patients(44.5%) and the anesthetic agents administered were intravenous narcotics in 360 cases, halothane-N2O-O2 in 289 cases, enflurane-N2O-O2 in 67 cases, etc. Nongeneral anesthesia was included regional nerve block in 76 cases(4.0%) and local infiltration in 985 cases(51.5%). 5) Anesthesia lasted less than one hour in 79.2% of the cases. Recovery time lasted less than one hour in 88.0% of the cases. 6) Only one patient was admitted for an anesthetic reason which was aspiration pneumonia. Seventeen patients were admitted for surgical reasons such as fever, bleeding, etc. From the above results, we believe that anesthetic care for ambulatory surgical patients can be provided safely and cost saving. Safety is an attitude, and when good practice is followed in selection of patients with careful preanesthetic evaluation and careful anesthetic technique, there is no reason to expect more complication than under the circumstance of hospitalization.
Ambulatory Surgical Procedures ; Anesthesia ; Anesthesia, General ; Anesthetics ; Cost Savings ; Female ; Fever ; Hemorrhage ; Hospital Costs ; Hospitalization ; Humans ; Inpatients ; Male ; Narcotics ; Nerve Block ; Pneumonia, Aspiration ; Retrospective Studies

The purpose of this study was to elucidate the origin and cellular composition of retrocorneal membranes (RCMs) associated with chemical burns using immunohistochemical staining for primitive cell markers. Six cases of RCMs were collected during penetrating keratoplasty. We examined RCMs with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS) staining and immunohistochemical analysis using monoclonal antibodies against hematopoietic stem cells (CD34, CD133, c-kit), mesenchymal stem cells (beta-1-integrin, TGF-beta, vimentin, hSTRO-1), fibroblasts (FGF-beta, alpha-smooth muscle actin), and corneal endothelial cells (type IV collagen, CD133, VEGF, VEGFR1). Histologic analysis of RCMs revealed an organized assembly of spindle-shaped cells, pigment-laden cells, and thin collagenous matrix structures. RCMs were positive for markers of mesenchymal stem cells including beta-1-integrin, TGF-beta, vimentin, and hSTRO-1. Fibroblast markers were also positive, including FGF-beta and alpha-smooth muscle actin (SMA). In contrast, immunohistochemical staining was negative for hematopoietic stem cell markers including CD34, CD133 and c-kit as well as corneal endothelial cell markers such as type IV collagen, CD133 except VEGF and VEGFR1. Pigment-laden cells did not stain with any antibodies. The results of this study suggest that RCMs consist of a thin collagen matrix and fibroblast-like cells and may be a possible neogenetic structure produced from a lineage of bone marrow-derived mesenchymal stem cells.
Adult ; Aged ; Antigens, CD/metabolism ; Cornea/*cytology/pathology ; Cytokines/metabolism ; Endothelial Cells/cytology/metabolism ; Female ; Fibroblasts/cytology/metabolism ; Hematopoietic Stem Cells/cytology/metabolism ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins/metabolism ; Male ; Mesenchymal Stromal Cells/cytology/metabolism ; Middle Aged ; Stem Cells/cytology/*metabolism