Purpose: To evaluate the effects and limitations of lacrimal endoscopy without silicone tube intubation in patients with epiphora. Methods: We conducted a retrospective chart review of 64 eyes in 49 patients who underwent lacrimal endoscopy between May 2021 and May 2022. The clinical characteristics, irrigation test results, lacrimal endoscopic findings, and type of surgery were analyzed. Results: The mean duration of symptoms was 31.2 months, and was significantly longer in the failure group than in the success group (p = 0.043). Irrigation tests showed passage, partial obstruction, and complete obstruction in 20 (31.3%), 16 (25.0%), and 28 (43.7%) eyes, respectively. Lacrimal endoscopy showed narrowing, mucus, fibrosis, granulation, and stones in 41 (64.0%), 12 (18.8%), 6 (9.3%), 3 (4.7%), and 2 (3.1%) eyes, respectively. Following lacrimal endoscopy, 32 (50.0%) eyes each were included in the success and failure groups. Preoperative irrigation test results did not affect the success rate (p = 0.203). Silicone tube intubation and dacryocystorhinostomy were performed in 5 (7.8%) and 8 (12.5%) eyes, respectively, because the symptoms did not improve after lacrimal endoscopy. Conclusions Lacrimal endoscopy, performed without silicone tube intubation, was effective in improving symptoms and may guide the choice of surgical technique, if required.

PURPOSE: Febrile seizure (FS) is the most common type of seizure. The role of genetic factors in FSs has long been recognized. A positive family history can be elicited in 25-40% of patients with FSs; nonetheless, the genes responsible for FSs in the majority of the population remain unknown. Interleukin-1beta (IL-1beta) is a pro-inflammatory cytokine that acts as an endogenous pyrogen. Thus, IL-1beta could be involved in the pathophysiology of FSs. METHODS: To determine whether or not single nucleotide polymorphisms of the IL-1beta gene are associated with susceptibility to simple FSs, IL-1beta promoter -31 and -511 genotyping was performed by means of polymerase chain reaction-restriction fragment (PCR-RF) length polymorphism in 40 FS patients (20 sporadic and 20 familial FS patients) and 33 controls. RESULTS: There were no significant differences in the frequencies of -31 C/T and -511 C/T in the IL-1beta promoter gene, between simple FS patients and controls. CONCLUSION: The frequency of CT/CT increased relatively in familial FS patients. A study examining a larger number of FS patients is needed.
Humans ; Interleukin-1 ; Interleukin-1beta ; Polymorphism, Single Nucleotide ; Seizures ; Seizures, Febrile

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 54 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Society score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection. Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics. Conclusions MUA alone can yield similar clinical outcomes to ACR in refractory FS.

OBJECTIVE: The clinical outcomes according to the radiological results after cervical total disc replacement (TDR) are not well established. Here, the authors reviewed the clinical results according to the asymmetry in radiographs. METHODS: This retrospective analysis included patients after TDR (Mobi-C(R) disc) with at least 12 months follow up, and the clinical and radiological data were obtained preoperatively and postoperatively for 12 months. Clinical outcome measures numerical rating scale (NRS) score for neck pain, visual analog scale (VAS) for arm pain, and the Oswestry disability index (ODI) value. The asymmetries of TDRs were evaluated on the anterior-posterior (AP) and the lateral radiographs, and the radiographic adjacent segment degenerations were evaluated for 12 months. RESULTS: A total of 24 patients (one level cervical TDR; 10 male and 14 female; aged 41.50+/-8.35 years) were included in this study. The clinical results including NRS for neck pain, VAS for arm pain, and ODIs were similar between the normal and asymmetrized TDRs in AP and lateral radiographs. The radiographic adjacent segment degenerations were significantly increased in deviated TDRs (AP>10 mm asymmetry and lateral>10 mm asymmetry). CONCLUSION: Asymmetrical location of TDR is not related to the clinical outcomes, but related to the risk of radiographic adjacent disc segment degeneration.
Arm ; Arthroplasty* ; Axis, Cervical Vertebra* ; Female ; Follow-Up Studies ; Humans ; Male ; Neck Pain ; Outcome Assessment (Health Care) ; Retrospective Studies ; Total Disc Replacement ; Visual Analog Scale

STUDY DESIGN: Retrospective study. PURPOSE: To determine the prevalence of high risk patient with osteopenia requiring pharmacologic treatment and investigate the difference of 10-year fracture probability whether bone mineral density (BMD) include or not in Korean FRAX model. OVERVIEW OF LITERATURE: Many people with the fracture have osteopenia rather than osteoporosis, and BMD alone could be considered as a chance to prevent fracture. METHODS: Three hundred sixty-nine patients who was diagnosed as osteopenia were divided into two groups according to age (group 1, under 65 years; group 2, over 65 years), and 10-year fracture probabilities were calculated by FRAX algorithm with and without femur neck T-score. RESULTS: The high risk patients of the fracture who had above 3% of 10-year hip fracture probability were 15 cases in group 1 and 121 cases in group 2. In 193 patients of group 1, the mean 10-year fracture probability with BMD was significantly higher than the results without BMD (hip fracture: p=0.04, major osteoporotic fracture: p=0.01). Unlike the results of the group 1, the mean 10-year fracture probability without BMD was significantly higher than the results with BMD in 176 patients of group 2 (hip fracture: p=0.01, major osteoporotic fracture: p=0.01). CONCLUSIONS: Total of 136 cases (36.8%) as a high risk of the fracture with osteopenia could be overlooked treatment eligibility in Korean. The Korean FRAX model without BMD could be effective in predicting fracture risk especially in the individuals who were over 65 years.
Bone Density ; Bone Diseases, Metabolic* ; Femur Neck ; Hip ; Humans ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Retrospective Studies ; Risk Assessment

Seckel syndrome is a rare autosomal recessive disease. The characteristic features of Seckel syndrome include Intrauterine and postnatal growth deficiency, severe microcephaly, and a bird-like head. General appearance of our patient was characterized by Pre- and postnatal growth retardation, microcephaly, large eye, and a beaked nose. The patient had mental retardation with CNS anomalies. The CNS anomalies seen in the patient included cerebral dysgenesis and cerebellar atrophy. So, we report the case of CNS anomalies in Seckel syndrome.
Animals ; Atrophy ; Beak ; Head ; Humans ; Intellectual Disability ; Microcephaly ; Nose

No abstract available.
Etoposide* ; Fluorouracil* ; Stomach Neoplasms*

Ulcer in buttock is mainly a pressure sore, which is frequently occurred at the sacral region in Korea and its surgical treatment is chiefly the operation using gluteus maximus myocutaneons flaps. For the treatment of ulcerated lesion in gluteal area, various methods using gluteus maximus muscle have been developed. We reviewed and analyzed the 100 cases using gluteus maximus myocutaneous flaps in our department since 1980. The results were summarized as follows ; 1) The ratio between male and female was 3:1. 2) The prevalent age groups were between third and fifth decades. 3) The main cause was the trauma. 4) The wound culture showed the pattern of mixed infections in most cases, consisting of Staphylociccus, Pseudomonas, Enterococcus, Streptococcus, and others. 5) The postoperative complications were noted in about thirty percent of the cases. The complications were flap tip necrosis, wound infection, wound disruption, and others. 6) For the treatment of small ulcers, a pure skin flap or myoplasty may be used, but for the treatment of large one, a kind of myocutaneous flap should be selected. 7) Gluteus maximus myocutaneous flaps can be used as variable methods, but of which the island flap is ideal in deep and large ulcerated lesion.
Buttocks ; Coinfection ; Enterococcus ; Female ; Humans ; Korea ; Male ; Myocutaneous Flap* ; Necrosis ; Postoperative Complications ; Pressure Ulcer ; Pseudomonas ; Sacrococcygeal Region ; Skin ; Streptococcus ; Ulcer ; Wound Infection ; Wounds and Injuries

HELP (Heparin-mediated extracorporeal low-density lipoprotein fibrinogen precipitation) is an LDL apheresis system which has been utilized as a last therapeutic option for drug resistant hypercholesterolemia. Recently the scope of the treatment has been expanded to coronary artery obstructive disease (CAOD) or peripheral arterial obstructive disease (PAOD) with dyslipidemia. We applied six sessions of HELP therapy with a week interval to a patient with diabetic gangrene of both feet and PAOD who had elevated LDL-cholesterol and fibrinogen despite maximal drug therapy. Lipids, Lp (a) and fibrinogen were measured on plasma samples before and after treatment. Changes of symptoms and physical findings were reported before, immediately after and 3 month after treatment. In every session, LDL cholesterol level was reduced more than 40%. Mean LDL cholesterols were reduced from 133.5 mg/dL to 55.0 mg/dL (59%). Total cholesterol (104.5 mg/dL;51% decrease), triglycerides (142.0 mg/dL;47% decrease) and Lp (a) (24.3 mg/dL; 58% decrease) levels were also reduced. Mean HDL cholesterol was reduced to 6.3 mg/dL (25%) with prompt recovery to pretreatment level within one week. Mean fibrinogen decreased from 571.0 mg/dL to 253.3 mg/dL (58%) without bleeding complications. Two episodes of dizziness with spontaneous resolution were observed during or over three days after treatment. Two sessions of HELP made diabetic gangrene on toes improved. After six sessions, the gangrenes showed near-complete healing. So we report a case of a patient who had persistent diabetic gangrene of both feet despite proper revascularization, which was completely healed by HELP without significant side effects.
Arterial Occlusive Diseases ; Blood Component Removal ; Cholesterol* ; Cholesterol, HDL ; Cholesterol, LDL ; Coronary Vessels ; Dizziness ; Drug Therapy ; Dyslipidemias ; Fibrinogen* ; Foot* ; Gangrene* ; Hemorrhage ; Humans ; Hypercholesterolemia ; Lipoproteins ; Plasma ; Toes ; Triglycerides

PURPOSE: Necrotizing fasciitis is an uncommon soft tissue infection which spreads rapidly along subcutaneous fascial planes and produces overlying skin necrosis. We report a case of eyelid necrosis and periorbital necrotizing fasciitis. METHODS: A 64-year-old, previously healthy, male visited the emergency room complaining of acute facial edema. He had been using an ointment for itchy scalp lesion due to hair dye, and had multiple mosquito bites on his forehead. He took NSAIDs before the day of visit for headache. Physical examination showed erythematous swelling of soft tissue and tense fluctuant bullae on eyelid and periorbital area. On the 6th day of hospitalization bullae ruptured, and purplish discoloration and necrosis were noticed. RESULTS: Parenteral antibiotics and surgical debridement were applied. Wound cultures were positive for Staphylococcus aureus resistant to methicillin. Histology of the debrided tissue showed necrotizing inflammation. The full-thickness skin graft was performed over the exposed pretarsal and preseptal orbicularis muscle of the right eyelid. The skin defects were healed with the recovery of adequate eyelid function. CONCLUSIONS: We achieved satisfactory results with proper diagnosis and management such as parenteral antibiotics and surgical debridement in a case with eyelid and periorbital necrotizing fasciitis.
Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Culicidae ; Debridement ; Diagnosis ; Edema ; Emergency Service, Hospital ; Eyelids* ; Fasciitis, Necrotizing* ; Forehead ; Hair ; Headache ; Hospitalization ; Humans ; Inflammation ; Male ; Methicillin ; Middle Aged ; Necrosis* ; Physical Examination ; Scalp ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Transcutaneous Electric Nerve Stimulation ; Transplants ; Wounds and Injuries