Purpose: Silicone tube intubation is the most common method for treatment of nasolacrimal drainage disorder or repair of lacerated canaliculus. However, some cases are prolapsed earlier than expected, subsequently affecting the success rate of silicone tube intubation. The author introduced a successful reposition of the prolapsed silicone tube. Methods: This study is a retrospective case series of 11 patients who were treated with reposition of prolapsed silicone tube using hole and lacrimal probe method. In all cases, the tubes were prolapsed within 2 months after the first surgery due to careless rubbing of the medial canthus by the patient. In all 11 cases, the development of a biofilm on tube was not observed at the time when the tube was prolapsed. All patients underwent immediate reposition of prolapsed tube without local anesthesia in the outpatient operating room on the day they visited. Results: In all 11 cases, the prolapsed silicone tube was repositioned without any complications using this hole and lacrimal probe method. At 6-month follow-up examination, all patients presented with a well-positioned silicone tube up to the day of extubation without replacing it with a new silicone tube. Conclusions This hole and lacrimal probe method is effective for the repositioning of prolapsed silicone tube after bicanalicular intubation of lacrimal system. This procedure includes easy performance in a short time and without local anesthesia in the outpatient operating room.

Purpose: Silicone tube intubation is the most common method for treatment of nasolacrimal drainage disorder or repair of lacerated canaliculus. However, some cases are prolapsed earlier than expected, subsequently affecting the success rate of silicone tube intubation. The author introduced a successful reposition of the prolapsed silicone tube. Methods: This study is a retrospective case series of 11 patients who were treated with reposition of prolapsed silicone tube using hole and lacrimal probe method. In all cases, the tubes were prolapsed within 2 months after the first surgery due to careless rubbing of the medial canthus by the patient. In all 11 cases, the development of a biofilm on tube was not observed at the time when the tube was prolapsed. All patients underwent immediate reposition of prolapsed tube without local anesthesia in the outpatient operating room on the day they visited. Results: In all 11 cases, the prolapsed silicone tube was repositioned without any complications using this hole and lacrimal probe method. At 6-month follow-up examination, all patients presented with a well-positioned silicone tube up to the day of extubation without replacing it with a new silicone tube. Conclusions This hole and lacrimal probe method is effective for the repositioning of prolapsed silicone tube after bicanalicular intubation of lacrimal system. This procedure includes easy performance in a short time and without local anesthesia in the outpatient operating room.

A granular cell tumor (GCT) is an uncommon mesenchymal lesion that rarely occurs in the colon and the rectum. We describe the case of 51-year-old man with a 2-cm-sized rectal GCT 10 cm above the anal verge that was incidentally detected after a screening colonoscopy. Preoperative radiologic studies demonstrated a suspicious submucosal rectal mass with mesorectal fat infiltration, but without circumferential resection margin threatening, extramural vessel invasion, and regional lymph-node enlargement. The tumor was resected by using a transanal endoscopic operation (TEO) without immediate postoperative complications. The final pathology revealed that the tumor consisted of a GCT that had invaded the subserosa with clear margins. It had no other risk factors for malignancy according to Fanburg-Smith criteria. We systematically reviewed the English literature by using PubMed and Google Scholar. This report may be the first documented case in the literature to describe a TEO for a GCT that had invaded the subserosa in the rectum.
Colon ; Colonoscopy ; Gastrointestinal Tract ; Granular Cell Tumor* ; Humans ; Mass Screening ; Middle Aged ; Pathology ; Postoperative Complications ; Rectum* ; Risk Factors

Cerebrospinal fluid (CSF) leak or shunt overdrainage is a well-known cause of orthostatic headaches and low CSF pressures. We report two cases of orthostatic headache with pneumocephalus on brain imaging. The orthostatic headache developed after drainage of spinal operation site and epidural block. Brain MRI revealed characteristic findings of CSF hypovolemia including pachymeningeal enhancement and mild subdural fluid collections. Air was also observed in the ventricular or subarachnoid space in both patients, which might enter the subarachnoid or ventricular space during a procedure via the pressure gradient or an injection.
Brain ; Drainage ; Headache ; Humans ; Hypovolemia ; Neuroimaging ; Pneumocephalus ; Subarachnoid Space

This study aimed to assess the influence of different cross-sectional area on the cyclic fatigue fracture of Ni-Ti rotary files using a fatigue tester incorporating cyclical axial movement. Six brands of Ni-Ti rotary files (ISO 30 size with .04 taper) of 10 each were tested: Alpha system (KOMET), HeroShaper (MicroMega), K3 (SybronEndo), Mtwo (VDW), NRT (Mani), and ProFile (Dentsply). A fatigue-tester (Denbotix) was designed to allow cyclic tension and compressive stress on the tip of the instrument. Each file was mounted on a torque controlled motor (Aseptico) using a 1:20 reduction contra-angle and was rotated at 300 rpm with a continuous, 6 mm axial oscillating motion inside an artificial steel canal. The canal had a 60degrees angle and a 5 mm radius of curvature. Instrument fracture was visually detected and the time until fracture was recorded by a digital stop watch. The data were analyzed statistically. Fractographic analysis of all fractured surfaces was performed to determine the fracture modes using a scanning electron microscope. Cross-sectional area at 3 mm from the tip of 3 unused Ni-Ti instruments for each group was calculated using Image-Pro Plus (Imagej 1.34n, NIH). Results showed that NRT and ProFile had significantly longer time to fracture compared to the other groups (p < .05). The cross-sectional area was not significantly associated with fatigue resistance. Fractographycally, all fractured surfaces demonstrated a combination of ductile and brittle fracture. In conclusion, there was no significant relationship between fatigue resistance and the cross-sectional area of Ni-Ti instruments under experimental conditions.
Electrons ; Fatigue ; Fractures, Stress ; Nickel ; Radius ; Steel ; Titanium ; Torque

PURPOSE: The purpose of this study is to evaluate the clinical and radiologic results of plate fixation in the Vancouver B1 and C periprosthetic femoral fracture (PFF). MATERIALS AND METHODS: Twenty patients who had sustained a Vancouver type B1 and C periprosthetic fracture after hip arthroplasty (years 2002-2012) were identified. The mean age was 66.0 years (range, 43-85 years) and the mean follow-up duration of the group was 38 months (range, 12-102 months). The dynamic compression plate (DCP) group included 12 patients and the locking compression plate (LCP) group included eight patients. Harris hip score (HHS) and walking ability, knee joint range of motion (ROM) were compared before injury and last follow-up. Fracture union rate and period were compared. RESULTS: The mean HHS score was 90.7 (64-96). There was no statistical difference between the two groups. At the last follow-up, knee joint ROM was 103.3degrees (105degrees-140degrees) in the DCP group and 118.4degrees (110degrees-140degrees) in the LCP group, showing good results in the LCP group (p=0.043). No significant difference in the fracture union rate and union periods was observed between the two groups. CONCLUSION: A better result for the postoperative knee flexion exercise capacity was observed in the LCP group. Use of LCP plate fixation is a good option in management of Vancouver classification B1 and C PFF.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Femoral Fractures ; Follow-Up Studies ; Hip ; Humans ; Knee ; Knee Joint ; Periprosthetic Fractures* ; Range of Motion, Articular ; Walking

PURPOSE: To analyze the treatment and prognosis of patients from our tertiary medical center with ocular and orbital involvement of granulomatosis with polyangiitis. METHODS: A retrospective analysis of the medical records of patients diagnosed with granulomatosis with polyangiitis that visited our single tertiary referral center from July 2008 to September 2014 was performed. RESULTS: A total of 51 patients diagnosed with granulomatosis with polyangiitis visited our center, and 21 of those patients had received an ophthalmologic examination. Of these, 9 patients (4 males, 5 females) had symptoms of the eye and orbit, and the clinical presentations were as follows: episcleritis, scleritis, marginal keratitis, orbital inflammation, orbital abscess, retinal vasculitis, and nasolacrimal duct obstruction. The patients each received treatments according to clinical presentation with topical, oral, or intravenous steroids or immunomodulatory agents such as cyclophosphamide. Nasolacrimal duct obstruction was treated with surgery in some cases. After an average follow-up period of 58 ± 30 months, all patients showed clinical improvement of their ocular and orbital involvement of granulomatosis with polyangiitis. CONCLUSIONS: Granulomatosis with polyangiitis is a relatively rare disease that sometimes has ocular or orbital involvement and can lead to blindness. Therefore, when ocular symptoms and signs present without a definitive cause, granulomatosis with polyangiitis must be ruled out, and appropriate treatment is needed. However, there are few published reports on the clinical presentation and prognosis of ocular and orbital involvement of granulomatosis with polyangiitis in Asians. This study showed that the incidence of ocular and orbital involvement in granulomatosis with polyangiitis was lower than previous reports.
Abscess ; Asian Continental Ancestry Group ; Blindness ; Cyclophosphamide ; Follow-Up Studies ; Granulomatosis with Polyangiitis* ; Humans ; Incidence ; Inflammation ; Keratitis ; Male ; Medical Records ; Nasolacrimal Duct ; Orbit ; Prognosis ; Rare Diseases ; Retinal Vasculitis ; Retrospective Studies* ; Scleritis ; Steroids ; Tertiary Care Centers

PURPOSE: To analyze the treatment and prognosis of patients from our tertiary medical center with ocular and orbital involvement of granulomatosis with polyangiitis. METHODS: A retrospective analysis of the medical records of patients diagnosed with granulomatosis with polyangiitis that visited our single tertiary referral center from July 2008 to September 2014 was performed. RESULTS: A total of 51 patients diagnosed with granulomatosis with polyangiitis visited our center, and 21 of those patients had received an ophthalmologic examination. Of these, 9 patients (4 males, 5 females) had symptoms of the eye and orbit, and the clinical presentations were as follows: episcleritis, scleritis, marginal keratitis, orbital inflammation, orbital abscess, retinal vasculitis, and nasolacrimal duct obstruction. The patients each received treatments according to clinical presentation with topical, oral, or intravenous steroids or immunomodulatory agents such as cyclophosphamide. Nasolacrimal duct obstruction was treated with surgery in some cases. After an average follow-up period of 58 ± 30 months, all patients showed clinical improvement of their ocular and orbital involvement of granulomatosis with polyangiitis. CONCLUSIONS: Granulomatosis with polyangiitis is a relatively rare disease that sometimes has ocular or orbital involvement and can lead to blindness. Therefore, when ocular symptoms and signs present without a definitive cause, granulomatosis with polyangiitis must be ruled out, and appropriate treatment is needed. However, there are few published reports on the clinical presentation and prognosis of ocular and orbital involvement of granulomatosis with polyangiitis in Asians. This study showed that the incidence of ocular and orbital involvement in granulomatosis with polyangiitis was lower than previous reports.
Abscess ; Asian Continental Ancestry Group ; Blindness ; Cyclophosphamide ; Follow-Up Studies ; Granulomatosis with Polyangiitis* ; Humans ; Incidence ; Inflammation ; Keratitis ; Male ; Medical Records ; Nasolacrimal Duct ; Orbit ; Prognosis ; Rare Diseases ; Retinal Vasculitis ; Retrospective Studies* ; Scleritis ; Steroids ; Tertiary Care Centers

Symptoms of compressive cervical myelopathy classically include spasticity and weakness, predominantly involving the lower extremities. Sensory abnormalities are reportedly common in the upper extremities, but are often vague or misleading. The sensory findings are usually localized 2-3 spinal segments below the actual spinal cord compression. In our current series, 3 patients presented with progressive symptoms of weakness and hyperreflexia involving the lower extremities without upper extremity symptoms and with a distant thoracic sensory level ranging from T10 to T12. All 3 patients were eventually found to have a cervical herniated intervertebral disc. The direct physical effects of compression and vascular compromise in the central cervical cord compression may be responsible for the reported abnormality at a distinct thoracic sensory level. Failure to diagnose cervical myelopathy because of the presence of a thoracic sensory level can delay appropriate treatment or lead to incorrect therapy.
Humans ; Intervertebral Disc* ; Lower Extremity ; Muscle Spasticity ; Reflex, Abnormal ; Spinal Cord Compression ; Spinal Cord Diseases ; Upper Extremity

A total of 11,395 animals were impounded in shelters in Seoul in 2013. The Animal Protection Division of the Seoul metropolitan government has annual contracts with local veterinary associations as well as Korean animal rescue and management organizations for providing shelter to animals, and collects monthly statistics from these groups. In 2013, the collected intake and outcome data for 25 districts were reviewed to analyze shelter capacity in terms of housing capacity (monthly daily average intake, required holding capacity, and adoption-driven capacity), staff capacity (staff hours required for daily care), and live release rate. Seasonal variations in the monthly daily average intake were observed, indicating that management of these shelters requires various strategies. This study was performed to analyze and interpret meaningful statistics for improving the efficiency of animal shelters in Seoul. However, inconsistent collection of animal statistics limited data compilation. Creation of a basic animal statistics matrix with reference to well-designed matrices from recognized professional animal shelters is essential. These complied statistical data will help plan for future animal shelter needs in Seoul.
Animal Welfare ; Animals ; Housing ; Local Government ; Seasons ; Seoul ; Statistics as Topic*