The resection of levator aponeurosis and its muscle through the anterior approach had been performed on 50 ptotic lids of 40 patients from April, 1985 to January, 1988. Their age ranged from 28 months to 44 years old(mean, 7.5 years old). All but one of them were congenital origin. Thirty-four per cent of eyes were associated with ocular abnormalities such as strabismus, entropion, and blepharophimosis. Three patients had inguinal hernia, tongue tie, and ventricular septal defect respectively as systemic abonrmalities. The cycloplegic refraction revealed mild hyperopia in 74%, mild myopia in 18%, and moderate or severe hyperopia in 8%. Seventy per cent of eyes had with-the-rule astigmatism, while 8% had againgt-therule astigmatism. Twenty-two per cent had no astigmatism. Amblyopia was noted in 11 patients of 31 patients in whom we could check the visual acuity. The amount of levator muscle resected, which depended on the function of levator muscle and the degree of ptosis, ranged from 15mm to 24mm (mean, 20.2mm). We also applied this procedure to the patient whose levator function was less than 2mm. Good surgical results were obtained in 45 eyes(90%). Undercorrected one eye underwent reoperation using the frontalis sling.
Amblyopia ; Astigmatism ; Blepharophimosis ; Blepharoptosis* ; Entropion ; Heart Septal Defects, Ventricular ; Hernia, Inguinal ; Humans ; Hyperopia ; Myopia ; Reoperation ; Strabismus ; Tongue ; Visual Acuity

Almost every Korean (97%) is enrolled in the National Health Insurance program, and most receive medical treatment at least once a year. Data are collected by the Health Insurance Review and Assessment Service (HIRA), and the results of the review are sent to the National Health Insurance Service (NHIS). The data handled by NHIS and HIRA cover almost the entire population and can be used for various research purposes. NHIS and HIRA support research by making these data available to researchers. The greatest advantage of these data is that they are the only data which include virtually the entire population. Both HIRA and NHIS data are provided in the form of sample data and all (customized) data. NHIS and HIRA data are similar but exhibit minor differences. HIRA data consists of five tables, including general specification details, in-hospital treatment details, disease details, out-of-hospital prescription details, and nursing institution information. NHIS data include death records (including cause of death), some medical examination records, and the socio-economic variables of the subject, such as income, in addition to all the HIRA data. Clinical results of treatments are not recorded in NHIS or HIRA. However, because public data are used for billing purposes, actual research has thus far been limited. Therefore, researchers must develop a study design that can minimize the errors or bias occurring during the course of the study. Therefore, it is necessary to clearly understand the structure and characteristics of NHIS and HIRA data when initiating research.

Background: Although cardiovascular outcome trials using sodium-glucose cotransporter-2 inhibitors (SGLT-2i) showed a reduction in risk of 3-point major adverse cardiovascular events (MACE), they did not demonstrate beneficial effects on stroke risk. Additionally, meta-analysis showed SGLT-2i potentially had an adverse effect on stroke risk. Contrarily, pioglitazone, a type of thiazolidinedione (TZD), has been shown to reduce recurrent stroke risk. Thus, we aimed to compare the effect of SGLT-2i and TZD on the risk of stroke in type 2 diabetes mellitus (T2DM) patients. Methods: Using the Korean National Health Insurance Service data, we compared a 1:1 propensity score-matched cohort of patients who used SGLT-2i or TZD from January 2014 to December 2018. The primary outcome was stroke. The secondary outcomes were myocardial infarction (MI), cardiovascular death, 3-point MACE, and heart failure (HF). Results: After propensity-matching, each group included 56,794 patients. Baseline characteristics were well balanced. During the follow-up, 862 patients were newly hospitalized for stroke. The incidence rate of stroke was 4.11 and 4.22 per 1,000 person-years for the TZD and SGLT-2i groups respectively. The hazard ratio (HR) of stroke was 1.054 (95% confidence interval [CI], 0.904 to 1.229) in the SGLT-2i group compared to the TZD group. There was no difference in the risk of MI, cardiovascular death, 3-point MACE between groups. Hospitalization for HF was significantly decreased in SGLT-2i-treated patients (HR, 0.645; 95% CI, 0.466 to 0.893). Results were consistent regardless of prior cardiovascular disease. Conclusion In this real-world data, the risk of stroke was comparable in T2DM patients treated with SGLT-2i or TZD.

OBJECTIVE: The clinical and radiographic success of a two-level discectomy and autologous iliac bone fusion with anterior cervical plate fixation (ACDFP) was compared with that of a one-level corpectomy and fusion using a titanium mesh cage (corpectomy) for the treatment of degenerative cervical disc disease. METHODS: From January 2004 to December 2007, there were 45 consecutive cases of two disc level degenerative cervical disc disease treated with either ACDFP or corpectomy. The medical records and radiological studies were reviewed, retrospectively. The clinical outcomes were measured using Odom's criteria. The radiologic assessment was performed using images showing the lordosis and bony fusion. RESULTS: Twenty-seven patients were treated with ACDFP. Eighteen patients were treated with corpectomy. The clinical outcome was excellent or good in 25 cases (93%) and 17 cases (94%) treated with ACDFP and corpectomy, respectively. The fusion rate was 96% and 94% for ACDFP and corpectomy, respectively. There was a slight increase in the cervical lordosis in both groups, but there was no significant difference between the 2 groups. There were no irriversible complications in both groups. Reversible complications were encountered in 1 case of corpectomy, and 7 cases of ACDFP, which were mainly associated with donor site. CONCLUSION: Either a ACDFP or a corpectomy provides good clinical outcome and similar bone fusion rates for degenerative disc diseases. However, absence of donor site complications makes a corpectomy better than ACDFP.
Animals ; Diskectomy ; Humans ; Lordosis ; Medical Records ; Retrospective Studies ; Tissue Donors ; Titanium

PURPOSE : The urinary tract infection associated with vesicoureteral reflux(VUR) in children may result in serious complications such as renal scarring, hypertension, proteinuria and end stage renal disease. The purpose of this study was to evaluate the factors affecting renal scar such as age, gender, grade of VUR, and ACE gene polymorphism, and body growth in the patients with and those without renal scar associated with VUR METHODS : During the period from January 1994 to July 2000, We had 93 children with urinary tract infection associated with VUR who were admitted to the Department of pediatrics of Chonbuk National University Hospital. The patients were divided into two groups according to follow up 99mTc-DMSA renal scan; patients with renal scar group and those with non-scar group. We analyzed and compared the factors associated with renal scarring between the two groups. RESULTS : There were no significant difference in gender, causative organism, ACE gene polymorphism, height and weight at diagnosis between renal scar group and non-scar group. Fifty four patients were in renal scar group and forty seven of them had VUR. The age at diagnosis was significantly higher in renal scar group (2.48 +/-2.64yr) than in non renal scar group (1.26+/-1.83yr). Especially, the infants who were less than 1 year of age with VUR developed relatively more renal scar compared with infants older than 1 year of age. The incidence of renal scarring showed a direct correlation with the severity of VUR. CONCLUSION : The factors affecting renal scar formation were age at diagnosis, presence and grade of VUR, but the other factors such as gender, causative organism, ACE gene polymorphism were not associated with renal scarring. Therefore, further evaluation about uropathogenic E. coli and follow up study about body growth associated with severity of renal scar would be necessary.
Child* ; Cicatrix* ; Diagnosis ; Follow-Up Studies ; Humans ; Hypertension ; Incidence ; Infant ; Jeollabuk-do ; Kidney Failure, Chronic ; Pediatrics ; Proteinuria ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

We present one case report of anterior urethral diverticulum in a male with giant calculi. The patient was a 56-year-old male with the complaints of base-ball sized palpable scrotal mass and post-void dribbling for 15-16 years. The diverticulum was filled with multiple whitish-yellow stones. The largest one was 8X7X6cm in size.
Calculi* ; Diverticulum* ; Humans ; Male* ; Middle Aged

We present a very rare case of spontaneous cervical spondylodiscitis and epidural abscess caused by Klebsiella pneumonia. A 45-year-old man presented with severe posterior neck pain radiating down both arms with decreased range of motion of the neck. He also complained of paresthesia of the upper extremities and a subjective weakness of his right arm. Magnetic resonance imaging (MRI) revealed spondylodiscitis and epidural abscess on the C5 and C6. In order to obtain adequate drainage of the abscess and complete removal of granulation tissues we performed a total decompressive corpectomy of C5 and C6. After drainage of the abscess, single stage autologous iliac bone graft was performed. The patient was followed by three months with antibiotic treatment confirmed to be sensitive to the organism. Klebsiella pneumonia was cultured postoperatively from the surgical biopsy samples. The patient recovered with no complications and the postoperative MRI showed improvement of the lesions.
Abscess ; Arm ; Biopsy ; Decompression ; Discitis ; Drainage ; Epidural Abscess ; Granulation Tissue ; Humans ; Klebsiella ; Magnetic Resonance Imaging ; Middle Aged ; Neck ; Neck Pain ; Paresthesia ; Pneumonia ; Range of Motion, Articular ; Transplants ; Upper Extremity

Anatomy of the pancreaticobiliary ductal system is so variable that one should think of its normal anatomy as nonexistent. But exact location of the termination of the common bile duct in important to the biliary surgeon when performing transduodenal exploration of the common bile duct, to the physician and radiologist when diagnosing pancreaticobilijary disease by ERCP. We report a case of Lnomalous termination of the common bile duct into thii. duadenal bulb diagnosed by ERCP and operative cholangiogram.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct*

Human brucellosis is an endemic zoonotic disease that is rare in Korea. However, there have been regional increases in its prevalence. Spondylodiscitis is a common osteoarticular complication of brucellar infection and is difficult to diag nose- because the clinical presentation is often variable and nonspecific. We report the case of a 56-year-old male with brucellar spondylodiscitis who was from Gyeongsangbuk-do, an endemic region of bovine brucellosis in Korea.
Animals ; Brucellosis ; Brucellosis, Bovine ; Cattle ; Discitis ; Humans ; Korea ; Male ; Middle Aged ; Prevalence

Primary hypomagnesemia is a rare inherited disorder and it is considered to be due to either a defect in the intestinal transport of magnesium or a defect in renal tubular transport. It is important to measure the urinary excretion of magnesium to differentiate the causes of magnesium deficiency. We report here an one-month-old female infant of primary hypomagnesemia who presented generalized tonic-clonic seizures. She had hypomagnesemia(<1.5mg/dL) and several seizure attacks but normal magnesium creatinine ratio in random urine and normal magnesium excretion in 24-hour urine. Continuous oral magnesium supplementation was necessary to avoid the recurrence of symptoms and maintain serum rnagnesium levels.
Creatinine ; Female ; Humans ; Infant ; Magnesium ; Magnesium Deficiency ; Recurrence ; Seizures