PURPOSE: While the principles of eyelid reconstruction are well established, the rapid choice of a method of upper and lower eyelid defect reconstruction is difficult. The authors present a successful case of simultaneous reconstruction of upper and lower eyelid defects with a modified paramedian forehead flap resulting from a dog bite. CASE SUMMARY: The authors report a case of a 77-year-old woman with total hyphema and extensive skin defects involving the forehead, cheek, and upper and lower eyelid resulting from a dog bite. The wound on the left periorbital area was treated with microimplantation and skin grafts from the left thigh and groin. In the weeks following, sequential failure of the flap and skin graft was observed, and exposed keratitis worsened, resulting in corneal perforation. Evisceration with hydroxyapatite implantation and paramedian forehead flap was performed. After 3 weeks, division of the pedicle, transverse division of the flap, and socket reconstruction were performed. CONCLUSIONS: Reconstruction of large, full thickness defects of both upper and lower eyelids with a paramedian forehead flap is associated with a good cosmetic outcome. Paramedian forehead flap should be considered as an effective choice for simultaneous upper and lower eyelid reconstruction.
Aged ; Animals ; Bites and Stings ; Cheek ; Corneal Perforation ; Cosmetics ; Dogs ; Durapatite ; Eyelids ; Female ; Forehead ; Groin ; Humans ; Hyphema ; Keratitis ; Skin ; Thigh ; Transplants

PURPOSE: This study analyzed the outcome of unilateral superior rectus recession in patients with asymmetrical dissociated vertical deviation (DVD) in terms of effectiveness and influence on the fellow eye. METHODS: Medical records of 40 patients (40 eyes) who had undergone unilateral superior rectus recession for the treatment of asymmetrical DVD were retrospectively reviewed from February 1993 to March 2009. The minimum follow-up period was 1 year after the operation. RESULTS: The overall success rate in the operated eye was 97.5% at 12 months and 90% at the last follow-up. However, a DVD larger than 10 PD developed in the fellow eye in 20% (8) of the patients. In patients who preoperatively had DVD in their fellow eyes, 50% developed DVD postoperatively in their fellow eyes. In patients who preoperatively did not have DVD in their fellow eyes, 14.7% developed DVD postoperatively in their fellow eyes. Furthermore, the angle of the DVD in the fellow eye increased with the surgical dosage. CONCLUSIONS: Unilateral SR recession is effective in patients with asymmetrical DVD. However, a high incidence rate of DVD in the fellow eye should be considered, especially when preoperatively there is a small DVD in the fellow eye or a large DVD angle in the operated eye, whenever monocular superior rectus recession surgery is performed.
Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Retrospective Studies

PURPOSE: To investigate levels of serum homocysteine in patients with pseudoexfoliation syndrome and the association between serum homocysteine levels and risk of coronary heart disease. METHODS: From March 2013 to September 2013, 37 patients with pseudoexfoliation syndrome and 59 age-matched patients (control group) were enrolled in this prospective study. Serum homocysteine levels were compared between the 2 groups. We compared the estimated 10-year risk of coronary heart disease based on Framingham risk score between the 2 groups. Additionally, we analyzed correlations between risk of coronary heart disease and serum homocysteine levels. RESULTS: The mean homocysteine level of patients with pseudoexfoliation syndrome was significantly higher than the control group (13.3 ± 6.8 µmol/L vs. 10.0 ± 5.2 µmol/L, p = 0.009). The rate of high risk defined as a 10-year coronary heart disease risk >20% in the patients with pseudoexfoliation syndrome was significantly higher than in the control group (21.4% vs. 4.4%, p = 0.048). Correlation between serum homocysteine levels and estimated 10-year risk of coronary heart disease was statistically significant (r = 0.578, p < 0.001). CONCLUSIONS: Hyperhomocysteinemia and high risk of coronary heart disease were observed in patients with pseudoexfoliation syndrome. Therefore, we suggest efforts to prevent coronary heart disease in pseudoexfoliation syndrome patients with hyperhomocysteinemia are necessary.
Coronary Disease* ; Exfoliation Syndrome* ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Prospective Studies

PURPOSE: This study aimed to investigate nutritional risk, physical activity, and quality of life (QoL) and the interaction of these factors in colorectal cancer patients. METHODS: Participants were colorectal cancer patients receiving follow-up treatment at the colorectal cancer outpatient clinic of Severance Hospital in Seoul. Participants were recruited from October 25 to November 30, 2010. The survey questionnaire consisted of Nutritional Risk Score (NRS), International Physical Activity Questionnaire (IPAQ) and Functional Assessment of Cancer Therapy - scales for Colorectal Cancer (FACT-C). RESULTS: NRSs were significantly higher in patients with low BMI (F=18.63, p<.001) and those who were underwent colorectal surgery within 1 month (F=5.96, p<.001). Physical activity level of the participants was 28.96METs. Lower nutritional risk was associated with a higher QoL (r= - .34, p<.001). In a multiple regression analysis, the predictors of QoL were the age, economic status, and nutritional risk of the patient (R2=40.0%). CONCLUSIONS: Targeted tailored nursing interventions are needed to assess nutritional risks in order to improve colorectal cancer patients' QoL.
Ambulatory Care Facilities ; Child ; Colorectal Neoplasms* ; Colorectal Surgery ; Follow-Up Studies ; Humans ; Motor Activity* ; Nursing ; Nutrition Disorders ; Quality of Life* ; Seoul ; Weights and Measures ; Surveys and Questionnaires

Atherosclerosis is characterized by a chronic inflammatory disease, and chemokines play an important role in both initiation and progression of atherosclerosis development. Leukotactin-1 (Lkn-1/CCL15), a new member of the human CC chemokine family, is a potent chemoattractant for leukocytes. Our previous study has demonstrated that Lkn-1/CCL15 plays a role in the initiation of atherosclerosis, however, little is currently known whether Lkn-1/CCL15 is associated with the progression of atherosclerosis. Matrix metalloproteinases (MMPs) in human coronary atherosclerotic lesions play a crucial role in the progression of atherosclerosis by altering the vulnerability of plaque rupture. In the present study, we examined whether Lkn-1/CCL15 modulates MMP-9 release, which is a prevalent form expressed by activated macrophages and foam cells. Human THP-1 monocytic cells and/or human peripheral blood monocytes (PBMC) were treated with phorbol myristate acetate to induce their differentiation into macrophages. Foam cells were prepared by the treatment of THP-1 macrophages with human oxidized LDL. The macrophages and foam cells were treated with Lkn-1/CCL15, and the levels of MMP-9 release were measured by Gelatin Zymography. Lkn-1/CCL15 significantly enhanced the levels of MMP-9 protein secretion from THP-1 monocytic cells-derived macrophages, human PBMC-derived macrophages, as well as macrophage-derived foam cell in a dose dependent manner. Our data suggest that the action of Lkn-1/CCL15 on macrophages and foam cells to release MMP-9 may contribute to plaque destabilization in the progression of atherosclerosis.
Atherosclerosis ; Chemokines ; Foam Cells ; Gelatin ; Humans ; Leukocytes ; Lipoproteins, LDL ; Macrophages ; Matrix Metalloproteinase 9 ; Matrix Metalloproteinases ; Monocytes ; Phorbols ; Rupture ; Tetradecanoylphorbol Acetate

OBJECTIVES: To determine whether there is an association between the characteristics of pain in endometriosis and chronic stress. METHODS AND MATERIALS: Fifteen women were diagnosed as endometriosis by diagnostic laparoscopy and 14 asymptomatic volunteers were enrolled. Case group was divided into two groups with their pain duration and severity. Saliva was collected four times a day with commercial collector, Salivette. Salivary cortisol was analyzed by enzyme immunoassay. Statistical association was assessed with Kruskal-Wallis test, Mann-Whitney U test, and repeated measures ANOVA test. RESULTS: In the curve showing diurnal changes of cortisol level, morning rise in cortisol level was significantly blunted among patients compared with control group (p<0.05). Among two patient groups, there was no significant correlation with disease severity, but with duration (p<0.05). CA 125 level, pain scaling score, and age showed no significant correlation. CONCLUSION: Morning rise in salivary cortisol level is blunted in women especially with chronic endometriosis. These is findings might be a small clues that the changes in the salivary cortisol level can be a sign of chronic stress state.
Endometriosis* ; Female ; Humans ; Hydrocortisone ; Immunoenzyme Techniques ; Laparoscopy ; Saliva ; Volunteers

PURPOSE: The purpose of the study was to identify differences in physiological.psychological.environmental.behavioral characteristics between obese and control children participating in a health camp and to identify the factors related to childhood obesity. METHODS: Two hundred eighty seven children aged 6 to 12 years were recruited from a health camp for elementary students in D city, Korea. Data collection was done on November 28 and 29, 2009. Anthropometric measurements, blood tests, and self-report surveys were conducted. Chi-square test, independent t-test, ANCOVA, and multiple logistic regression were performed using PASW statistics 18.0. RESULTS: Obese children had adverse conditions for both physiological and psychological characteristics. In terms of environmental and behavioral characteristics, high maternal BMI and more than two hours of TV watching were significantly associated with high risk of childhood obesity (OR=1.11, 95% CI=1.02-1.21; OR=2.05, 95% CI=1.23-3.41). CONCLUSION: Through a multi-factorial approach, the current study identified the differences between obese and control children participating in a health camp and risk factors of childhood obesity. These findings provide preliminary data and perspectives on intervention research for prevention and management of childhood obesity.
Aged ; Child ; Community Health Nursing ; Data Collection ; Hematologic Tests ; Humans ; Korea ; Logistic Models ; Obesity ; Risk Factors ; Child Health

Toxoplasma gondii ME49 infections are typically diagnosed by serological tests. However, serological diagnosis of RH strain-induced toxoplasmosis remains unknown. In order to develop seradiagnosis of above 2 kinds of infections, we generated recombinant virus-like particles (VLPs) displaying the T. gondii rhoptry protein 4 (ROP4) and evaluated their potential in T. gondii ME49 or RH strain infection diagnostics. Mice were orally infected with either the tachyzoites of T. gondii (RH) or cysts of T. gondii (ME49) at various dosages, and sera were collected at regular intervals. ELISA-based serological tests were performed to assess IgG, IgM, and IgA antibody responses against ROP4 VLP antigen and tissue lysate antigen (TLA). Compared to TLA, IgG, IgM, and IgA levels to ROP4 VLP antigen were significantly higher in the sera of T. gondii RH-infected mice 1 and 2 week post-infection (PI). T. gondii-specific IgG antibody was detected at 1, 2, 4, and 8 week PI in the T. gondii ME49-infected mice with infection dose-dependent manner. These results indicated that the ROP4 VLP antigen was highly sensitive antigens detecting T. gondii RH and ME49 antibodies at an early stage.

Transfemoral access (TFA) is a widely used first-line approach for most peripheral vascular interventions. Since its introduction in cardiologic and neurointerventional procedures, several advantages of transradial access (TRA) over TFA have been demonstrated, such as patient preference, lower complication rates, early ambulation, and shorter hospital stay. However, studies reporting the safety and efficacy of this approach for peripheral vascular interventions performed by interventional radiologists are relatively few. This review aimed to summarize the technique and clinical applications of TRA in percutaneous transcatheter visceral artery embolization and the management of complications.

Both Plasmodium spp. and Toxoplasma gondii are important apicomplexan parasites, which infect humans worldwide. Genetic analyses have revealed that 33% of amino acid sequences of inner membrane complex from the malaria parasite Plasmodium berghei is similar to that of Toxoplasma gondii. Inner membrane complex is known to be involved in cell invasion and replication. In this study, we investigated the resistance against T. gondii (ME49) infection induced by previously infected P. berghei (ANKA) in mice. Levels of T. gondii-specific IgG, IgG1, IgG2a, and IgG2b antibody responses, CD4+ and CD8+ T cell populations were found higher in the mice infected with P. berghei (ANKA) and challenged with T. gondii (ME49) compared to that in control mice infected with T. gondii alone (ME49). P. berghei (ANKA) + T. gondii (ME49) group showed significantly reduced the number and size of T. gondii (ME49) cysts in the brains of mice, resulting in lower body weight loss compared to ME49 control group. These results indicate that previous exposure to P. berghei (ANKA) induce resistance to subsequent T. gondii (ME49) infection.
Amino Acid Sequence ; Animals ; Antibody Formation ; Body Weight ; Brain ; Humans ; Immunoglobulin G ; Malaria ; Membranes ; Mice ; Parasites ; Plasmodium berghei ; Plasmodium ; Toxoplasma ; Toxoplasmosis