Patients with a poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle to mechanically raise a droopy eyelid Frontalis suspension procedure using a temporalis fascia or Tutoplast Dura was performed on 36 ptotic eyelids of 23 patients(age range 2-37 years) with a poor or absent levator function. The author used a surgical technique based on a modified Fox`s method. Satisfactory results were achieved in 42 lids according to the criteria of Jordan after an average follow-up of 23 months. No serious complication was seen immediately postoperative and during the follow-up period. Temporalis fascia and Tutoplast Dura appear to be effective and safe alternative sling materials for frontalis suspension surgery.
Blepharoptosis* ; Eyelids ; Fascia ; Follow-Up Studies ; Humans ; Jordan

The number of pressure ulcer patients is increasing owing to the aging population and increased incidence of elderly illness. This review article aims to introduce the current knowledge on the pathogenesis and prevention of pressure ulcers. The development of a pressure ulcer is associated with external factors such as pressure, shear stress, and friction and internal factors such as age, general condition, skin condition, and nutritional status. Pressure ulcers typically develop over bone protrusions, which are most pressured by weight, but may also be caused by external pressure by medical devices or other objects applied to the patient. This tissue damage is caused by continuous deformation of the tissue due to the pressure acting perpendicular to the tissue surface and shear stress acting parallel to the tissue, either alone or in combination. Limitation of activity and mobility, skin condition, blood circulation and oxygen saturation, nutrition, humidity, body temperature, age, low pain sensitivity, blood count, and general and mental conditions are the primary risk factors for pressure ulcers. A mattress and cushion that reduce pressure and an appropriate posture are necessary to prevent pressure ulcers. In patients with urinary incontinence, contaminated skin should be washed with a mild detergent and absorbent pads and topical protective agents should be used to protect the skin from moisture. Sufficient nutrition may help prevent wounds in patients who are susceptible to pressure ulcers. Furthermore, early screening, individualized management of posture, and regular skin and nutrition monitoring are essential to prevent pressure ulcers.

PURPOSE: The majority of nasal bone fractures have been managed by routine procedure of closed reduction, intranasal packing or intranasal Kirschner wire (K-wire) splinting. But it leaves rooms for many complaints from patients such as pain, rhinorrhea and nasal obstructioon. Another option is, of course, no packing at all. The study was initiated to assess the necessity to pack or splint the nasal bone after routine closed reduction. METHODS: We analysed the medical records of 35 patients with nasal bone fracture who were operated by closed reduction in the last 2 years. We evaluated the postoperative CT scan scores and external deviation criterias 1 month after the operation. RESULTS: The postoperative deviation criteria and postoperative CT scan score were favorable and there were no serious complications using this technique. CONCLUSION: The present study demonstrates that the use of packing or splinting need not be routine in the majority of cases. The risks and discomforts associated with these procedures can often be avoided.
Humans ; Medical Records ; Nasal Bone ; Splints

BACKGROUND: Recent advances in stroke therapies require patients to be treated very early after the onset of symptoms. To reduce the delay in time upon stroke and arriving at the hospital, we assessed the time delay, stroke recognition, and awareness before and after a public education program designed to increase recognition and awareness. METHODS: Prospective standardized and structured interviews were performed in 155 patients with ischemic stroke who were admitted to the Severance hospital before and after the public education program. The educational program included local newspaper articles, distribution of pamphlets, and lectures to 119 emergency care teams. Time delay, variable factors, stroke recognition, and stroke awareness of patients were then assessed (75 pre-education and 80 post-education groups). RESULTS: 52% of the pre-education group and 52.5% of the post-education group arrived at the hospital within 24 hours. Those who arrived within 3 hours were only 21.3% and 15% respectively. A direct visit to the hospital and a cardioembolic infarction appeared to be associated with a shorter time delay. About half of the patients recognized their symptoms as a stroke before a diagnosis was made by a doctor. Most of them had known that a stroke should be treated urgently. However, the stroke recognition and awareness was not associated with an early arrival, which suggests that their knowledge was not solid. The efforts to inform the public using local newspaper articles and pamphlets geared towards the local residents for the limited time period was not effective in shortening arrival times. CONCLUSIONS: Many of the stroke patients did not arrive within the therapeutic time window. Our findings suggest that extensive and multi-directional campaigns should be performed to reduce the time delay. Our findings also suggest that educational aims should include the need for the rapid treatment of stroke and a therapeutic time window as well as stroke recognition.
Cerebral Infarction ; Cerebrovascular Disorders ; Diagnosis ; Education ; Emergency Medical Services ; Humans ; Infarction ; Lectures ; Periodicals ; Pamphlets ; Prospective Studies ; Stroke*

The authorsinvestigated the effects of UV-B and amniotic membrane graft about PRK induced inflammatory cell infiltration into corneal stroma, lipid peroxidation and keratocyte apoptosis. Total 20 white rabbits were divided into 5 groups; 1)mechanical epithelial removal, 2)epithelial removal and UV-B irradiation, 3)PRK only, 4) PRK and UV-B irradiation, 5)Amniotic membrane graft after PRK and UV-B irradiation. All corneas were harvested after 24hrs. H & E stain for PMNs infiltration, MDA immunohistochemical stain for lipid peroxidation and TUNEL stain for keratocyte apoptosis were performed. UV-B had little effect on infiltration of inflammatory cell into corneal stroma, lipid peroxidation and keratocyte apoptosis. Amniotic membrane suppressed infiltration of PMNs into corneal stroma, lipid peroxidation and keratocyte apoptosis. Environmental UV-B exposure should not be avoided after PRK. Amniotic membrane graft is beneficial to reduce keratocyte apoptosis and related corneal haze.
Amnion* ; Apoptosis* ; Cornea ; Corneal Stroma ; In Situ Nick-End Labeling ; Inflammation* ; Lipid Peroxidation* ; Membranes ; Rabbits ; Transplants

PURPOSE: Specific microorganisms, such as Chlamydia and Mycoplasma, are rarely detected in chronic pelvic pain syndrome, but fastidious and non-culturable microorganisms may be important in its etiology. The objective of this study was to evaluate the usefulness and significance of polymerase chain reaction (PCR) in the diagnosis of the etiologies of chronic pelvic pain syndrome, especially using semen as a specimen. MATERIALS AND METHODS: Between August 2005 and July 2006, 237 patients, with a mean age of 39 years (range 25-67 years), were evaluated for chronic pelvic pain syndrome. PCR testing of the semen was performed in all cases to establish the persistence of C. trachomatis, T. vaginalis, M. hominis, M. genitalium and U. urealyticum. RESULTS: Of the 237 patients, 79 (33.3%) and 158 (66.7%) were categories IIIa and IIIb, respectively. On PCR, using semen, 18 (22.8%) of the 79 category IIIa and 26 (16.5%) of the 158 category IIIb cases were found to have positive PCRs for the causative microorganisms of CPPS. In a total of 53 isolates presenting positive PCR, the common causative microorganisms were U. urealyticum, C. trachomatis, M. genitalium, T. vaginalis and M. hominis in 23 (43.4%), 16 (30.1%), 11 (20.8%), 2 (3.8%) and 1 case (1.9%), respectively. CONCLISIONS: PCR is revolutionizing the diagnosis of many infectious diseases, particularly those caused by microorganisms that are difficult to cultivate. Moreover, PCR shows nearly 100% accuracy in terms of sensitivity and specificity. PCR using semen, which can detect various microorganisms suggestive of the etiologies of chronic pelvic pain syndrome, is expected to play an important role in the diagnosis, treatment and follow up of chronic pelvic pain syndrome in urology.
Chlamydia ; Communicable Diseases ; Diagnosis ; Humans ; Mycoplasma ; Pelvic Pain* ; Polymerase Chain Reaction* ; Prostatitis ; Semen* ; Sensitivity and Specificity ; Urology

Recurrent zoster myelitis is quite rare. We present a previously healthy 27-year-old woman who developed recurrent attacks of myelopathy shortly after the characteristic skin rashes of herpes zoster. Magnetic resonance imaging studies demonstrated each lesion in the spinal cord at the same segments as the skin lesions. She had two attacks at opposite sites at the same spinal cord level and complete recovery after being treated with intravenous acyclovir. We suspect that direct invasion of varicella zoster virus was the cause of recurrent myelopathy in our patient.
Adult ; Case Report ; Female ; Herpes Zoster/complications* ; Human ; Magnetic Resonance Imaging ; Myelitis/virology* ; Myelitis/diagnosis ; Recurrence

We evaluated the safety, stability, predictability and efficacy of photorefractive keratectomy (PRK) with Schwind excimer laser for one year. We performed one-step procedures on 114 eyes of 92 patients. They were divided into three groups according to their manifest refractive error (spherical equivalent): Group ! (<-5 D, 39 eyes) , Group I (-5. 01 to -8 D, 40 eyes) , or Group III (>-8.01 D, 35 eyes). One year after PRK, uncorrected visual acuity of 0.8 or better was achieved in 95% of eyes in group I, 97% of eyes in group I and 63% of eyes in group III. In the group I , 90% of eyes were within +/-1 D of attempted correction, as were 95% in group II and 63% in group III. Complications were corneal haze above grade 2(8.8%), temporarily increased intraocular pressure (18.4%), central island (14.9%), eccentric ablation more than 0. 5mm(34.2%) and halo (0.9%). We conclude that the Schwind excimer laser PRK appears to be 8 safe and relatively accurate procedure to correct low to moderate myopia, but long-term and more frequent follow-up is needed for high myopia.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Lasers, Excimer ; Myopia ; Photorefractive Keratectomy ; Refractive Errors ; Visual Acuity

PURPOSE: The objective of this study is to present a reliable method of scrotal reconstruction. METHODS: 75 year-old-man visited the out patient department of urology for chronic itching sensation in his scrotal area, diagnosed as Bowen's disease. After the wide resection of scrotal lesion, reconstruction was carried with pedicled anterolateral thigh perforator flap. All operation procedure was done with an usual manner, previously reported. Donor site was closed primarily. RESULTS: In 6th month follow-up period, there was no event, such as flap necrosis, wound dehiscence, tumor recurrence. And tactile sensation was recovered. CONCLUSION: In the Korean literature, there have not been the report that describes the reconstruction of scrotal defect using pedicled anterolateral thigh perforator flap. Pedicled anterolateral thigh perforator flap is reliable and robust flap for scrotal reconstruction.
Bowen's Disease ; Follow-Up Studies ; Humans ; Necrosis ; Perforator Flap ; Pruritus ; Recurrence ; Sensation ; Thigh ; Tissue Donors ; Urology

Nasal dermoid sinus cyst is a rare congenital lesion. It may present extracranially as a swelling or a mass on the nose, a skin pit or a sinus. Intracranial complications can be fatal including meningitis, abscess, osteomyelitis, seizures. The treatment of choice is complete surgical excision of the cyst. There are some approaches to this goal such as vertical midline incision, external rhinoplasty approach, bicoronal approach, and endoscopic approach. In this case, we could completely excise the nasal dermoid sinus cyst on the glabella without intracranial extension only with bicoronal incision.
Abscess ; Dermoid Cyst* ; Meningitis ; Nose ; Osteomyelitis ; Rhinoplasty ; Seizures ; Skin