No abstract available.
Heart* ; Thoracic Surgery* ; Thyroid Gland*

PURPOSE: This study investigated the differences of muscle width and distance from limbus to muscle insertion site according to age and sex, and the correlation with ocular axial length and strabismus degree. METHODS: The study subjects were 100 eyes of 50 horizontal strabismus patients undergoing rectus muscles recession. Ocular axial lengths were measured at preoperation, while muscle width and distance from limbus to muscle insertion site were measured during operation. Preoperative and postoperative comparison items were retrospectively investigated with the medical records. Correlations of muscle width, distance from limbus to muscle insertion site and the comparison items were verified by ANOVA test. RESULTS: Muscle width was 10.05+/-0.86 mm in medial rectus muscle and 9.38+/-1.03 mm in lateral rectus muscle. Distance from limbus to muscle insertion site was 5.21+/-0.85 mm in medial rectus muscle and 6.37+/-1.01 mm in lateral rectus muscle. Muscle width and distance from limbus to muscle insertion site had no correlations with ocular axial length and strabismus degree, but ocular axial length was significantly longer in the older group compared to the younger group and in the male group compared to the female group. CONCLUSIONS: It is presumed that muscle width and distance from limbus to muscle insertion site have no relationship with age, sex and strabismus degree.
Female ; Humans ; Male ; Medical Records ; Muscles ; Retrospective Studies ; Strabismus*

PURPOSE: To report a case with complete ophthalmoplegia after herpes zoster ophthalmicus. METHODS: A 70-year-old male patient visited a clinic because of vesicular eruptions over the left side of his face with severe pain. Drooping and severe swelling of the left eyelid were present, along with keratitis and uveitis. While the lid swelling and uveitis were improving, external ophthalmoplegia and exophthalmos were discovered. Intramuscular injections of dexamethasone 5 mg were given for 10 days, followed by oral administration of prednisolone at a dosage of 15 mg for two weeks and 10 mg for two weeks. RESULTS: The patient was fully recovered from the complete ophthalmoplegia and exophthalmos six months after the onset of the cutaneous lesion. CONCLUSIONS: Complete ophthalmoplegia is a rare ophthalmic complication of herpes zoster infection. Therefore, an evaluation of extraocular muscle and lid function should be performed during the examination of herpes zoster patients in order to screen for ophthalmoplegia.
Severity of Illness Index ; Prednisolone/therapeutic use ; Ophthalmoplegia/drug therapy/*etiology ; Male ; Humans ; Herpes Zoster Ophthalmicus/*complications/drug therapy ; Glucocorticoids/therapeutic use ; Follow-Up Studies ; Exophthalmos/drug therapy/etiology ; Aged

PURPOSE: This study investigated the fungi of silicone tubes in the patients with nasolacrimal duct obstruction, and investigated the identification of fungi according to operation type, clinical features and detailed locations of silicone tubes. METHODS: The subjects of this study were 49 eyes of 40 patients operated on for nasolacrimal duct obstruction from July 2003 to April 2004. The removed silicone tubes were divided into the parts of conjunctiva, lacrimal drainage system and nasal cavity according to insertion state, after which fungus culture was performed using them. We classified patients into the silicone tube intubation group and the dacryocystorhinostomy group. Preoperative nasal problems, dacryolith on dacryocystorhinostomy, postoperative features of nasal cavity during the follow-up period and success of operation were retrospectively investigated with the medical records. Correlations of the results of fungus culture and clinical features were verified by Pearson Chi-Square test. RESULTS: Fungus culture rate was significantly higher in the dacryocystorhinostomy group (37.5%) than in the silicone tube intubation group (12.12%) (p-value<0.05). In total patients according to insertion site, fungus culture rate was significantly higher in the nasal cavity than in the lacrimal drainage system, and in the lacrimal drainage system than in the conjunctiva (p-value<0.05). The species of cultured fungi were in the following order: Candida, Trichosporon, Penicillium and Aspergillus. CONCLUSIONS: Fungal infection of the silicone tube in patients with nasolacrimal duct obstruction was found and fungi species were cultured. Further study is needed of fungi in the nasolacrimal duct before surgery for determining the fungal infection causing nasolacrimal duct obstruction.
Aspergillus ; Candida ; Conjunctiva ; Dacryocystorhinostomy ; Drainage ; Follow-Up Studies ; Fungi* ; Humans ; Intubation ; Medical Records ; Nasal Cavity ; Nasolacrimal Duct* ; Penicillium ; Retrospective Studies ; Silicones* ; Trichosporon

PURPOSE: Thyroglossal duct cyst (TGDC) is known to be the most common midline neck mass in children, but the adult population still has this abnormality. The most common symptom of TGDC is a simple neck mass, and differential diagnosis among other abnormalities is important. The aim of this study is to perform a retrospective view of TGDC in order to describe any differences in clinical features, diagnostic tools, treatment, and outcomes in children and adults who underwent surgery in a single institution, and to determine its clinical implications. METHODS: We performed a retrospective chart review on 75 pathologically diagnosed TGDC patients from 1995 to 2013 who were divided into two groups: children (< or =18 years) and adults. Comparison analysis was performed for age, sex, site and location of cyst, size, diagnostic tool, surgical method, and postoperative outcome. RESULTS: Our study showed frequent occurrence of TGDC in adults. There was no significant sex, site, or location difference in the occurrence of TGDC in children and adults, however, the size of cyst in adults was larger than that in children (mean, 2.80 cm vs 2.15 cm) (P<0.001). Four patients (5.3%) had postoperative recurrence of TGDC, and Sistrunk operation showed lower recurrence rate than excision (3.1% vs 18.2%) (P<0.040). Two malignancy cases were identified postoperatively in adults. CONCLUSION: Particularly in adults, the possibility of carcinoma would make it important to perform fine-needle aspiration for differential diagnosis. Sistrunk procedure will remain the treatment of choice for most TGDC patients considering recurrence risk.
Adult* ; Biopsy, Fine-Needle ; Child* ; Diagnosis, Differential ; Humans ; Neck ; Recurrence ; Retrospective Studies ; Thyroglossal Cyst*

Adult ; Airway Obstruction ; Emphysema ; Female ; Heart Failure ; Humans ; Mediastinal Emphysema ; Mediastinitis ; Mediastinum ; Molar, Third ; Pneumothorax ; Subcutaneous Emphysema ; Thorax ; Tracheostomy

Background: While accumulating evidence indicates chronic kidney disease as a risk factor for coronavirus disease 2019 (COVID-19), the association between normal or mildly decreased kidney function and COVID-19 is unaddressed. Here, we have examined the association of an increase in estimated glomerular filtration rate (eGFR) with the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes among patients within normal to mildly decreased kidney function. Methods: The patients who participated in both health screenings from period I (2017–2018) to II (2019–2020) were enrolled to our study. All participants were categorized into four groups according to the changes in eGFR stage from period I to II: 1) persistently stage G1, 2) from stage G2 to G1, 3) from stage G1 to G2, 4) persistently stage G2. In addition, the changes in eGFR value were defined by subtracting its value of period I from II. Patients were followed up for SARS-CoV-2 infection from January 1, 2021 to any diagnosis of COVID-19 or December 31, 2021, whichever happened first. In addition, those with SARS-CoV-2 infection were followed-up for one month after diagnosis to analyze severe COVID-19. Adjusted odds ratio (aOR) was calculated using multivariable-adjusted logistic regression. Results: We identified 159,427 patients with and 1,804,798 patients without SARS-CoV-2 infection. The risk of SARS-CoV-2 infection decreased when eGFR stage changed from G2 to G1 (aOR, 0.957; 95% confidence interval [CI], 0.938–0.977) and persistently maintained at G1 (aOR, 0.966; 95% CI, 0.943–0.990), compared with the persistently stage G2 group.In addition, the risk showed an inverse relationship with changes in eGFR value, which was depicted by restricted cubic spline curves. For the overall risk of severe COVID-19, the persistently stage G1 showed the lowest risk (aOR, 0.897; 95% CI, 0.827–0.972), followed by those from stage G1 to G2 (aOR, 0.900; 95% CI, 0.828–0.978) and those from stage G2 to G1 (aOR, 0.931; 95% CI, 0.871–0.995), compared with the persistently stage G2 group. Conclusion An increase in eGFR was negatively associated with the risk of SARS-CoV-2 infection and severe COVID-19 among normal or mildly decreased kidney function. For severe COVID-19, maintaining higher baseline eGFR may act as a protective factor against its risk.

Background: Current research has not investigated the effect of thyroid-stimulating hormone suppression therapy with levothyroxine on the risk for developing subsequent primary cancers (SPCs). This study aimed to investigate the association between levothyroxine dosage and the risk for SPCs in thyroid cancer patients. Methods: We conducted a nationwide population-based retrospective cohort study form Korean National Health Insurance database. This cohort included 342,920 thyroid cancer patients between 2004 and 2018. Patients were divided into the non-levothyroxine and the levothyroxine groups, the latter consisting of four dosage subgroups according to quartiles. Cox proportional hazard models were performed to evaluate the risk for SPCs by adjusting for variables including cumulative doses of radioactive iodine (RAI) therapy. Results: A total of 17,410 SPC cases were observed over a median 7.3 years of follow-up. The high-dose levothyroxine subgroups (Q3 and Q4) had a higher risk for SPC (adjusted hazard ratio [HR], 1.14 and 1.27; 95% confidence interval [CI], 1.05–1.24 and 1.17– 1.37; respectively) compared to the non-levothyroxine group. In particular, the adjusted HR of stomach (1.31), colorectal (1.60), liver and biliary tract (1.95), and pancreatic (2.48) cancers were increased in the Q4 subgroup. We consistently observed a positive association between high levothyroxine dosage per body weight and risk of SPCs, even after adjusting for various confounding variables. Moreover, similar results were identified in the stratified analyses according to thyroidectomy type and RAI therapy, as well as in a subgroup analysis of patients with good adherence. Conclusion High-dose levothyroxine use was associated with increased risk of SPCs among thyroid cancer patients regardless of RAI therapy.