PURPOSE: We studied the result and cilincal significance of transscleral fixation of posterior chamber lens in complete vitrectomized eyes without capsular support. METHODS: We evaluated 30 aphakic eyes of 30 patients and according to the cause of pars plana vitrectomy, there were 9 eyes for intraocular foreign body, 8 eyes for lens dislocation, 8 eyes for retinal detachment, 3 eyes for vitreous hemorrhage, 2 eyes for endophthalmitis. RESULTS: The postoperative best-corrected visual acuity group was intraocular foreign body group and the group of lens dislocation, vitreous hemorrhage, retinal detachment, and endophthalmitis were in the descending order of visual acuity. The most common postoperative early complication was temporary hypotony and the others were hyphema, and temporary increased IOP. The most common postoperative late complication was exposed scleral fixation suture and the others were vitreous hemorrhage, cystoid macular edema, subluxation of intraocular lenses, retinal detachment. CONCLUSIONS: We experienced many postoperative temporary hypotony patients, but all cases were improved in short term period. The complication related to scleral fixation in vitrectomized eyes was imposed to smaller than the scleral fixation in vitreous support. But, in fact the development of retinal detachment or vitreous incarceration complication in the vitrectomized eye was not different from the eyes having vitreous support.
Endophthalmitis ; Foreign Bodies ; Humans ; Hyphema ; Lens Subluxation ; Lenses, Intraocular* ; Macular Edema ; Postoperative Complications ; Retinal Detachment ; Sutures ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

BACKGROUND: To evaluate clinical manifestations, endoscopic findings and response to treatment in adult Henoch-Sch?nlein purpura (HSP) patients with hemorrhagic gastroenteritis. METHODS: Twenty patients who were admitted to Kyungpook National University Hospital between 1996 and 2003 were included, based on the following criteria: 1) diagnosed as HSP according to the criteria proposed by Michel et al., 2) older than 15 years old and 3) had evidences of gastrointestinal (GI) bleeding. Thirteen HSP patients who were older than 15 years old and had no evidences of GI bleeding were recruited as controls. We evaluated the clinical features and findings of upper GI endoscopy and colonoscopy. RESULTS: Mean age and male to female ratio were not significantly different between patients with and without hemorrhagic gastroenteritis (age: 29.5 +/- 15.1 vs. 30.5 +/- 13.5; M:F=14:6 vs. 9:4, respectively). Patients with hemorrhagic gastroenteritis had a significantly higher frequency of petechiae on the upper extremities (p=0.015). In the multivariate analysis, petechial lesion on the upper extremities was a significant risk factor for hemorrhagic gastroenteritis (p=0.041). Mucosal lesions were found in 94.7% and 83.3% of patients on upper GI endoscopy and colonoscopy, showing that most patients (82.3%) had both upper and lower GI bleeding. Most patients with hemorrhagic gastroenteritis showed good response to high dose glucocorticoid therapy. Mortality and relapse rate were 10% and 5%, respectively. CONCLUSION: In adult HSP patients, presence of petechiae on upper extremities may be a risk factor for hemorrhagic gastroenteritis. The present data suggest that both upper and lower GI examinations are necessary for proper evaluation of HSP patients with hemorrhagic gastroenteritis.
Adolescent ; Adult* ; Colonoscopy ; Endoscopy ; Female ; Gastroenteritis* ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Male ; Mortality ; Multivariate Analysis ; Purpura* ; Recurrence ; Risk Factors ; Upper Extremity

Terephthaloyl chloride, a chemical of low molecular weight, is used as an intermediate by a fabric manufacturing industry. It is known to cause gastrointestinal, respiratory and skin irritation. However, it has not been reported as a cause of occupational asthma till now. We report a case of occupational asthma caused by prolonged exposure to terephthaloyl chloride in the workplace. A 38 year-old man visited at the Allergy Clinic because of cough, dyspnea and wheezing for 5 years. He had worked at a factory for 15 years where he was involved in the process of manufacturing fabrics. At presentation, he had no symptoms and showed no abnormality on physical examination. When challenged with vapor of terephthaloyl chloride, he experienced sneezing and paroxysmal cough in a couple of minutes, followed by dyspnea and wheezing at 10 min. He also experienced urticarial rashes on the face and chest. The pulmonary function tests showed an atypical prolonged immediate airway response. PC20 methacholine decreased from 5 mg/ml to 0.79 mg/ml 24 hours after the challenge. Light microscopic examination of bronchial biopsies showed loss of epithelium, thickening of basement membrane, submucosal fibrosis, and increased inflammatory cell infiltration. The immediate drop in FEV1 and urticarial rash to terephthaloyl chloride suggests the possibility of an immediate hypersensitivity immune reaction. Further studies are needed to clarify the exact mechanism of terephthaloyl chloride induced asthma.
Adult ; Asthma ; Asthma, Occupational* ; Basement Membrane ; Biopsy ; Cough ; Dyspnea ; Epithelium ; Exanthema ; Fibrosis ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Methacholine Chloride ; Molecular Weight ; Physical Examination ; Respiratory Function Tests ; Respiratory Sounds ; Skin ; Sneezing ; Thorax

Factor XI deficiency (Hemophilia C) is a very rare autosomal recessive bleeding disorder. Patients with factor XI deficiency do not typically show any spontaneous bleeding or specific symptoms. Sometimes those who have this disorder are identified during special situations such as trauma or surgery. Orthognathic surgery is particularly associated with a high bleeding risk. Therefore, great care must be taken when treating patients with bleeding disorders such as factor XI deficiency. There are a few reports that address the management of patients with bleeding disorders during orthognathic surgery. The current report describes a patient with factor XI deficiency who underwent Le Fort I osteotomy together with bilateral sagittal split osteotomy. The patient's condition was assessed using both rotation thromboelastometry (ROTEM™) and noninvasive measurements of total hemoglobin (SpHb) using Masimo Radical 7 (Masimo Co. CA, USA).
Anesthesia* ; Factor XI Deficiency* ; Factor XI* ; Hemorrhage ; Humans ; Orthognathic Surgery* ; Osteotomy ; Thrombelastography

BACKGROUND: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. METHODS: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. RESULTS: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. CONCLUSIONS: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.
Aged ; Airway Management ; Ambulatory Care Facilities* ; Dentistry ; Emergencies* ; Emergency Medical Services ; Hospital Rapid Response Team ; Hospitals, Teaching* ; Humans ; Incidence ; Korea* ; Orthodontics ; Outpatients* ; Pediatric Dentistry ; Periodontics ; Prevalence ; Prosthodontics ; Retrospective Studies* ; Surgery, Oral

OBJECTIVES: The information security management systems (ISMS) of 5 hospitals with more than 500 beds were evaluated with regards to the level of information security, management, and physical and technical aspects so that we might make recommendations on information security and security countermeasures which meet both international standards and the needs of individual hospitals. METHODS: The ISMS check-list derived from international/domestic standards was distributed to each hospital to complete and the staff of each hospital was interviewed. Information Security Indicator and Information Security Values were used to estimate the present security levels and evaluate the application of each hospital's current system. RESULTS: With regard to the moderate clause of the ISMS, the hospitals were determined to be in compliance. The most vulnerable clause was asset management, in particular, information asset classification guidelines. The clauses of information security incident management and business continuity management were deemed necessary for the establishment of successful ISMS. CONCLUSIONS: The level of current ISMS in the hospitals evaluated was determined to be insufficient. Establishment of adequate ISMS is necessary to ensure patient privacy and the safe use of medical records for various purposes. Implementation of ISMS which meet international standards with a long-term and comprehensive perspective is of prime importance. To reflect the requirements of the varied interests of medical staff, consumers, and institutions, the establishment of political support is essential to create suitable hospital ISMS.
Commerce ; Compliance ; Dietary Sucrose ; Hospitals ; Humans ; Medical Records ; Medical Staff ; Privacy

Down syndrome is a rare cause of neonatal cholestasis. Neonatal cholestasis in a patient with Down syndrome is usually associated with severe liver diseases, such as neonatal hemochromatosis, myeloproliferative disorder and intrahepatic bile duct paucity. We experienced a case of idiopathic neonatal cholestasis in a patient with Down syndrome, which resolved spontaneously.
Bile Ducts, Intrahepatic ; Cholestasis ; Down Syndrome ; Hemochromatosis ; Humans ; Infant, Newborn ; Liver Diseases ; Myeloproliferative Disorders

OBJECTIVE: Behcet's disease (BD) is a systemic vasculitis in which hyperfunction of neutrophils is one of the major pathophysiologic features. Myeloperoxidase (MPO) is an important neutrophilic lysosomal enzyme and has been implicated in tissue damage of BD. As the A allele of -463G/A polymorphism of the MPO gene is associated with diminished activity of MPO, we analyzed the association of -463G/A polymorphism of the MPO gene with BD. METHODS: We analyzed -463G/A polymorphism of the MPO gene in BD patients (n=101) and controls (n=138). Genotype of the MPO gene at position -463 was determined by PCR-RFLP assay using genomic DNA. RESULTS: The allele frequency of -463G/A polymorphism of the MPO gene did not deviate from the Hardy-Weinberg expectation in both BD patients and controls. There were no statistically significant differences in genotype distribution and allele frequency between patients and controls at position -463 (p=0.761 and p=0.549 respectively). Analysis of genotype distribution and allele frequency of the -463G/A according to sex did not show any difference between patients and controls. There were no statistically significant differences in clinical manifestations of BD among different genotypes. CONCLUSION: The present data indicate that the -463G/A polymorphism of the MPO gene was not associated with the susceptibility to and clinical manifestations of BD in Korea.
Alleles ; DNA ; Gene Frequency ; Genotype ; Humans ; Korea ; Neutrophils ; Peroxidase ; Polymorphism, Single Nucleotide ; Systemic Vasculitis

OBJECTIVE: To evaluate correlation the of histological variables and the clinical features of microinvasive cervical cancer with the depth of invasion and to establish the adequate therapeutic modality. METHODS: One hundred and thirty-seven patients with microinvasive cervical cancer diagnosed by FIGO (1994) staging were reviewed, who were treated by conization, type I hysterectomy, type II hysterectomy and type III hysterectomy, in Gil Medical center from January 1997 to December 2001. We divided the depth of invasion to three groups of less than 1 mm, 1-3 mm and 3-5 mm. RESULTS: The age of the 137 women ranged from 24 to 71 years (mean age 47.4 years). The number of patients with FIGO stage IA1 and IA2 were 112 and 24, respectively. Of surgically treated 135 patients, lymph node involvement was present in 1 patient with a depth of invasion of less than 1 mm, 2 patients with 1-3 mm and 1 patient with 3-5 mm. Lymph-vascular space involvement was present in 3 patients with 1-3 mm, 4 patients with 3-5 mm. Transient bladder dysfunction was the most common complication after surgical procedures, occupying 5.6%. Other surgical complications included lymphedema (3.6%), wound complication (3.6%), ureter injury (1.1%), lymphocele (1.1%), anal incontinence (1.1%) and dyspareunia (1.1%). CONCLUSION: A management should be individualized. Patients with a depth of invasion of less than 1mm and clear resection margin may be managed by conization. Further follow-up study for a necessity of lymphadenectomy for the group with the depth of invasion of 1-3 mm irrespective of lymph-vascular space involvement is demanded.
Conization ; Dyspareunia ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Lymphedema ; Lymphocele ; Ureter ; Urinary Bladder ; Uterine Cervical Neoplasms* ; Wounds and Injuries

Kainic acid (KA) is well-known as an excitatory, neurotoxic substance. In mice, KA administered intracerebroventricularly (i.c.v.) lead to morphological damage of hippocampus expecially concentrated on the CA3 pyramidal neurons. In the present study, the possible role of gamma-aminobutyric acid B (GABA B) receptors in hippocampal cell death induced by KA (0.1 microgram) administered i.c.v. was examined. 5-Aminovaleric acid (5-AV; GABA B receptors antagonist, 20 microgram) reduced KA-induced CA3 pyramidal cell death. KA increased the phosphorylated extracellular signal-regulated kinase (p-ERK) and Ca2+ /calmodulin-dependent protein kinase II (p-CaMK II) immunoreactivities (IRs) 30 min after KA treatment, and c-Fos, c-Jun IR 2 h, and glial fibrillary acidic protein (GFAP), complement receptor type 3 (OX-42) IR 1 day in hippocampal area in KA-injected mice. 5-AV attenuated KA-induced p-CaMK II, GFAP and OX-42 IR in the hippocampal CA3 region. These results suggest that p-CaMK II may play as an important regulator on hippocampal cell death induced by KA administered i.c.v. in mice. Activated astrocytes, which was presented by GFAP IR, and activated microglia, which was presented by the OX-42 IR, may be a good indicator for measuring the cell death in hippocampal regions by KA excitotoxicity. Furthermore, it showed that GABA B receptors appear to be involved in hippocampal CA3 pyramidal cell death induced by KA administered i.c.v. in mice.
Amino Acids, Neutral/pharmacology ; Animals ; Ca(2+)-Calmodulin Dependent Protein Kinase/metabolism ; Cell Death/drug effects ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Glial Fibrillary Acidic Protein/metabolism ; Hippocampus/anatomy & histology/*cytology/*drug effects ; Kainic Acid/*toxicity ; Mice ; Mice, Inbred ICR ; Mossy Fibers, Hippocampal/drug effects/metabolism ; Phosphorylation/drug effects ; Proto-Oncogene Proteins c-fos/metabolism ; Proto-Oncogene Proteins c-jun/metabolism ; Receptors, GABA-B/*metabolism ; Research Support, Non-U.S. Gov't