BACKGROUND: The brow lift plays an essential role in upper face rejuvenation. The authors designed a new brow lift technique, the endoscope-assisted trichophytic anterior hairline brow lift. It combines the advantages of an endoscopic approach and an anterior hairline approach. This technique was applied to 13 patients with aesthetically excellent results. METHODS: A trichophytic incision line was designed within the fine hairs of the entire anterior hairline and the incision was extended to the temporal hair-bearing scalp. After the incision, most of the procedures were conducted in a similar way to the conventional endoscopic brow lift. Without direct visualization, the dissection was extended down onto the root of the nose and the forehead. An endoscope was used from 2 cm above the supraorbital notch to avoid supraorbital nerve injury. Scars were assessed with the Stony Brook Scar Evaluation Scale (SBSES) at the time the sutures were removed. The visual analogue scale (VAS) score was checked at postoperative 1-year follow-up. The surgical outcomes for brow position and subjective satisfaction were rated with the Global Aesthetic Improvement Scale (GAIS) at postoperative 1-month follow-up. The dermatome of the deep branch of the supraorbital nerve, especially around the hairline, was checked with a two-point discrimination test. RESULTS: From October 2012 through August 2015, 13 endoscope-assisted trichophytic anterior hairline brow lifts were performed. The GAIS score was 1.62 on average. The VAS score was 2.09 on average. No permanent nerve damage has been reported except for 2 cases of temporary paresthesia. These fully recovered at 1-month follow-up. CONCLUSIONS: Based on our results, we think our technique could be a safe and effective treatment option for brow ptosis patients with a high hairline.
Cicatrix ; Discrimination (Psychology) ; Endoscopes ; Follow-Up Studies ; Forehead ; Hair ; Humans ; Nose ; Paresthesia ; Rejuvenation ; Rhytidoplasty ; Scalp ; Sutures

There are many variant forms in Turner's syndrome which is characterized by female phenotype, short height, primary amenorrhea, infertility, abnormal secondary sexual development, and mental retardation. Among these 45,XO/46,XX/47,XXX form is known as rare variant of Turner's syndrome. 45,XO/46,XX/47,XXX mosaicism is characterized by normal height, possibility of normal sexual development, menstrual/pregnancy history and normal intelligence. We report a cse of 45,XO/46,XX/47,XXX Turner's syndrome associated with primary amenorrhea in 17-year old Korean female.
Adolescent ; Amenorrhea* ; Female ; Humans ; Infertility ; Intellectual Disability ; Intelligence ; Mosaicism* ; Phenotype ; Sexual Development ; Turner Syndrome

BACKGROUND AND OBJECTIVES: Qualitative oculomotor abnormalities have been reported in parkinsonian patients for many years, but conflicting results have been obtained. This study was performed to evaluate the correlation between the severity of the disease and the abnormalities of the ocular movements in idiopathic parkinson's disease. METHODS: We gave the vestibular function tests in patients with idiopathic parkinson's disease and normal controls. Eye movement recordings were made with automated electronystagmography and rotation test was performed. A total of 46 patients (mean age : 61.2+/-6.7) and 24 controls (mean age : 60.5+/-4.3) were studied. The severity of the disease was divided into two groups by modified Hoehn & Yahr staging ; H-Y stage 1 and 2 as a mild group and stage 3 and 4 as a severe group. RESULTS: Saccadic latency and accuracy, pursuitic gain and velocity, vestibulo-ocular reflex (VOR) suppression by vision were significantly altered in patients, whereas mean velocity of optokinetic nystagmus (OKN) and VOR gain in darkness were normal. Alteration of saccadic latency and accuracy, pursuitic gain and velocity, VOR suppression by vision were profound in the severe group compared with a mild group and controls, but the above parameters did not differ between a mild group and controls. In a hemiparkinson's group, saccadic latency and accuracy, pursuitic gain, OKN mean velocity and gain was not different between the both sides. CONCLUSION: The results indicate that severe Parkinson's disease damages nigrostriatal or other specific pathways which were involved in the regulation of the saccadic, pursuitic and pursuitic-mediated visual fixation system. In a hemiparkinson's group asymmetric damage of dopaminergic innervation which was involved in the regulation of ocular movements was not found.
Darkness ; Electronystagmography ; Eye Movements ; Humans ; Nystagmus, Optokinetic ; Parkinson Disease* ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests

Duodenal gastrointestinal stromal tumors (GISTs) are relatively rare tumors that commonly present with gastrointestinal bleeding. Evaluation with endoscopic ultrasonography (EUS) is a useful technique for the differential diagnosis of GISTs from other submucosal tumors. A 58-year-old man presented with melena and anemia. An esophago-gastroduodenoscopy showed the presence of a submucosal tumor in the second portion of the duodenum with central ulceration and a flat spot. EUS showed the presence of a suspicious malignant GIST that originated from the proper muscle layer, which was successfully resected. We report a case of a duodenal GIST with a bleeding ulcer. Positive reactivity for CD117 and S-100 was demonstrated by immunohistochemical staining.
Anemia ; Diagnosis, Differential ; Duodenum ; Endosonography ; Gastrointestinal Stromal Tumors ; Hemorrhage ; Humans ; Melena ; Middle Aged ; Muscles ; Ulcer

OBJECTIVES: The role of rheumatoid factor (RF) in vascular stiffness and cardiovascular risk in subjects without joint symptoms remains unclear. We investigated vascular stiffness in subjects without joint symptoms using pulse wave velocity (PWV), calculated Framingham risk scores (FRS), an estimator of cardiovascular risk, and analyzed whether vascular stiffness and FRS were affected by RF. METHODS: Two hundred forty-two subjects were included in this population-based study. RF was quantified with turbid immunometry using a cut-off of RF > 15 IU/ml to denote RF positivity. Information was then obtained on joint symptoms. Brachial-ankle PWV (baPWV) was measured using an automated device. RESULTS: Of the 242 subjects, 15 were RF-positive. RF-positive subjects without joint symptoms had a higher baPWV and FRS than RF-negative subjects without joint symptoms, but the difference did not reach statistical significance. However, when we stratified the subjects into two groups (group A – high RF: RF ≥ 40 IU/ml; group B – low RF: RF < 40 IU/ml), group A showed significantly higher baPWV (1640.7 ± 179.6 ㎝/s vs. 1405.7 ± 225.7 ㎝/s, P = 0.008) and FRS (25.7 ± 4.87 vs. 11.8 ± 9.6, P < 0.001). Multiple regression analysis was used to examine potential confounders, and RF exhibited significant but modest effects on baPWV (adjusted R-squared = 0.038, P = 0.030). CONCLUSIONS: In a sample of the general population without joint symptoms, higher levels of RF were associated with increased vascular stiffness, suggesting a pathophysiologic link between RF and endothelial dysfunction.
Joints* ; Pulse Wave Analysis ; Rheumatoid Factor* ; Vascular Stiffness*

Tumor necrosis factor alpha (TNF-alpha) inhibitors are used widely to treat patients with active rheumatoid arthritis and ankylosing spondylitis (AS). Although various cutaneous reactions can occur as side effects of TNF-alpha inhibitors, systemic vasculitis requiring withdrawal of the agent and immunosuppressive drugs is rare. A 59-year-old male with AS who had been treated with infliximab for 60 months visited us with complaints of palpable purpura on both legs and severe abdominal pain. Abdominal computed tomography showed diffuse wall thickening of the proximal jejunum and ileum and a skin biopsy revealed leukocytoclastic vasculitis. The patient was diagnosed with Henoch-Schonlein purpura (HSP). Infliximab was discontinued and systemic steroid therapy at 0.5 mg/kg resulted in prompt resolution of the HSP. Here, we report the first case of HSP in a patient with AS after infliximab treatment.
Abdominal Pain ; Antibodies, Monoclonal ; Arthritis, Rheumatoid ; Biopsy ; Humans ; Ileum ; Jejunum ; Leg ; Male ; Purpura ; Purpura, Schoenlein-Henoch ; Skin ; Spondylitis, Ankylosing ; Systemic Vasculitis ; Tumor Necrosis Factor-alpha ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

Raynaud syndrome is a medical condition that causes pain, numbness, and changes in skin color at the distal extremities. Raynaud syndrome can be subdivided into primary Raynaud's and secondary Raynaud's. The former is diagnosed when the cause is unknown and the latter is caused by an underlying condition, such as connective tissue diseases, injury, smoking, or certain medications. Both cancer chemotherapy and β-blockers are relatively common causes of Raynaud syndrome but there are no reports of its association with methimazole administration. The authors encountered a 43-year old woman with hyperthyroidism who developed digital ulcers associated with Raynaud syndrome after a methimazole treatment. Her digital ulcers and Raynaud syndrome were improved after methimazole was replaced with propylthiouracil and conventional therapy. This paper reports this case along with a review of the relevant literature.
Connective Tissue Diseases ; Drug Therapy ; Extremities ; Female ; Humans ; Hyperthyroidism ; Hypesthesia ; Methimazole* ; Propylthiouracil ; Skin Pigmentation ; Smoke ; Smoking ; Ulcer

BACKGROUND & OBJECTIVES: It was well known that benign paroxysmal positional vertigo(BPPV) was caused by the involvement of the posterior semicircular canal, but there were a few reports about horizontal canal variant of BPPV. We studied the clinical features electronystagmographic (ENG) findings and the possible mechanism of BPPV of the horizontal canal(HBPPV). METHODS: We examined 10 cases of HBPPV with episodic vertigo and intense horizontal geotropic nystagmus provoked by rotation of the head in a supine position. Six patients underwent ENG and we recorded four patients' nystagmus, provoked by rotating head from extreme lateral, mid and nose-up position to extreme contralateral direction in supine position. RESULTS: All observed horizontal nystagmus beated towards the ground on both sides and were more pronounced when head was rotated to pathological side. In rotating to pathological side, nystagmus had mean latency of 2.6+/-1.8 seconds, peak velocity of slow phase of 66,8+/-19.7 degree/second and mean duration of 24.7+/-3.4 seconds. In rotating to healthy side the nystagmus had 3. 7+/- 2.9, 38.0+/-11.5 and 22.5+/-4. Secondary phase nystagmus occurred in 2 patients and fatigue was observed in 4 patients. The slow phase velocity of nystagmus was relative to the distance of head rotation. The duration of attack is 3 to 17 days(6.9+/-5.2days). Liberatory manuever had relatively a good effect. CONCLUSION: HBPPV represents the origin of horizontal semicircular canal and has a good prognosis Above findings support that mechanism of horizontal BPPV is canalolithiasis.
Fatigue ; Head ; Humans ; Nystagmus, Pathologic ; Prognosis ; Semicircular Canals* ; Supine Position ; Vertigo*

The purpose of this study is to evaluate clinical utility of lacrimal bypass surgery using Bowman's probe In treatment of obstruction of the lacrimal apparatus. The lacrimal bone was penetrated between lacrimal sac and nasal mucosa through the incised caruncle with Bowman #0 probe. A Jones tube was Introduced over the probe into the nasal cavity and fixed at caruncle with non-absorbable suture material. Epiphora was completely resolved in 120 (96.8%) of 124 eyes for mean follow-up of 17.1 months. Only 4 eyes failed to reach resolution of epiphora. Postoperative complications were as follows. coverage of the tube with conjunctiva in 10 eyes (8.1%), recurrent migration of tube to the nasal cavity 7 eyes(5.6%), persistent chronic dacryocystitis 7 eyes(5.6%), nasal mucosal granulation 6 eyes(4.8%), septal touch by tube 6 eyes(4.8%), conjunctival granulation 3 eyes (2.4%), and tube extrusion to the conjunctiva 2 eyes (1.6%). However no clinically significant complication developed postoperatively. The above procedure has many advantage such as no operations scar, short operation time, no need of expensive instruments and simple procedure. Therefore, this procedure seems to be of value in treatment of obstruction of lacrimal apparatus.
Cicatrix ; Conjunctiva ; Dacryocystitis ; Follow-Up Studies ; Lacrimal Apparatus Diseases ; Lacrimal Apparatus* ; Nasal Cavity ; Nasal Mucosa ; Postoperative Complications ; Sutures

BACKGROUND: Current researeh indicates that making among young adults tends to persist into later life. Furthermare, numerous studies have proven the harmful effects of female stmoking on their offspring. These trends have produced a wide variety of(social, medical and economic) problems. This study is aimed at obtaining basic information to help prevent patential smokers from trying their first cigarette as well as to instruct to stop smoking. This study involves the following: a) investigating general factors affecting the smoking status of college students in addition to the deterents to smoking b) seeking to understand the familial influence on smoking status c) resesrching how smokers, ex-smokers and non-smakers perceive their familial influence on their smoking status. METHODS: In June 1998, a self-administered questiannaire was distributed to 800 students of two junior colleges by random sampling in Po'hang. 720 were returned and 642 displayed adequate respanses. The questionnaires were analyzed using SPSS and EXCEL software. RESULTS: Among the tatal of 642 subjects studied, 220 were males(34.3%) and 422 femaks(66.7%). Of the male subjets 149(67%) were smokers, 46(21% ) were ex-smokers and 25(11.3%) were non smokers. Of the female subjcts 22(5.2%) were smokers, 399(92.9%) were ex-smokers and 11(2.6%) were non smokers. The number of cigarettes smoked per day was as follows:79 subjects(46.2%) smoked 10-20 cigarettes, 55(33.2%) smoked less than 10 and 37(21.6%) smoked more than a pack of cigarette. When considering the related factors which affect student smoking it is evident that there is a growing tendency toward smoking among male students when they have dose friends who are smokers and who cansume alcohol on a weekly basis. About the motives of smoking, there was a significant difference between the following two cases. Those(36.2%) who successfully quit smoking had started to smoke through solicitation by friends, but only 2.7% were successful if they had started to smoke to relieve stress When it comes to the influence of familial factors on successful versus unsuccessful attempts to quit smoking, the status of family smokers, whether or not smokers made their habit obvious to family members and whether or not the family allowed smoking did nat have any noticeable statistical difference between continuation of smoking and smoking cessation. However there was an obviaus difference among ex-smokers, non smokers and smokers when they responded as to whether or not their family had an effect on smoking status and smoking cessation:ex-smokers(38.4%), non-smokers(30.6%) and smokers(17.0%). CONCLUSIONS: In the light of the related factors attributed to the continuation of smoking in this study, it was revealed that there was a higher possibility of current smoking when the subject were a male and have close friends who smoked and had a higher level of average alcohol cansumption. this study also indicated that the continued smoking rate was higher among irdividuals who started smoking because of stress than those who began smoking as a result of peer pressure. There was no significant relatianship between smoking status and familial influence on smoking cessation between smokers and ex-smokers, but ex-smokers and non smokers had more awarness of familial influence than smokers.
Female ; Friends ; Humans ; Male ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco Products ; Young Adult ; Surveys and Questionnaires