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.

Purpose: A case of a huge ethmoid sinus and orbital cyst causing ocular deviation initially diagnosed as a mucocele-like cyst and after orbitotomy eventually discovered to be a naso-orbital encephalocele is described.Case summary: A 5-year-old male with no previous medical history presented with a palpable mass in the medial canthus area with left exodeviation of the left eye. His best-corrected visual acuity was 20/25 in the right eye and 6/12 in the left eye with limitation of motion of -4 at adduction in the left eye. Brain magnetic resonance imaging scans revealed a 3.0 × 2.5 × 2.5 cm-sized cystic mass suspected as a mucocele or nasolacrimal duct cyst invading the orbital space. The cyst was removed using a Lynch and caruncle incision, and intracystic fluid was aspirated. During the excision, a small defect of the skull base was detected with cerebrospinal fluid (CSF) leakage and leaking point of dura was sealed. His pathologic result was disorganized glial and fibrous tissue, consistent with encephalocele. Three days later, CSF leakage recurred. On postoperative day 8, duroplasty was performed. A one month later, his best-corrected visual acuity was 6/12 in the left eye with orthotropic eye position. Limitation of motion was improved to -1 at adduction with enophthalmos. No other complications were detected. Conclusions Congenital naso-orbital encephalocele invading the orbit is rare. However, a cystic mass in the sinuses involving the orbit should be considered, rendering thorough physical and radiologic examinations including computed tomography scans necessary to look for bone defects.

Hemoglobin M (HbM) is a group of abnormal hemoglobin variants that form methemoglobin, which leads to cyanosis and hemolytic anemia. HbM-Milwaukee-2 is a rare variant caused by the point mutation CAC>TAC on codon 93 of the hemoglobin subunit beta (HBB) gene, resulting in the replacement of histidine by tyrosine. We here report the first Korean family with HbM-Milwaukee-2, whose diagnosis was confirmed by gene sequencing. A high index of suspicion for this rare Hb variant is necessary in a patient presenting with cyanosis since childhood, along with methemoglobinemia and a family history of cyanosis.

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*

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

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

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