No abstract available.
Nasolabial Fold*

Purpose: To assess the clinical outcomes of scleral buckling (SB) without subretinal fluid drainage (SRFD) on primary rhegmatogenous retinal detachment (RRD). Methods: The medical records of patients with RRD treated via SB without SRFD from March 2009 to Feb 2018 were retrospectively reviewed. Cases with histories of previous intraocular surgery (except cataract removal) were excluded. The primary and final surgical success rates were the main outcome measures. Pre- and post-operative visual acuity and intraocular pressure (IOP), factors that might affect the surgical success rate, secondary operative procedures, re-operation rates, and complications were analyzed. Results: A total of 66 eyes of 66 patients were included. The mean patient age was 38.9 ± 18.6 years and the mean symptom duration 19.23 ± 25.14 days. The retinae were reattached after single surgeries on 57 eyes (success rate 86.36%); the final success rate was 100% after a second operation (when necessary). Of the nine eyes requiring additional surgery, seven required vitrectomy and two vitrectomy combined with buckle revision. The mean preoperative logMAR visual acuity of 0.578 ± 0.647 improved to 0.518 ± 0.512 at 1 month after surgery (p < 0.001) and to 0.262 ± 0.372 at the last follow-up visit (p < 0.001). The postoperative IOP was higher than the preoperative IOP at 3 months (p = 0.024). Conclusions Scleral buckling without SRFD used to treat primary RRD afforded a high reattachment rate (compared to those of previous reports employing vitrectomy or scleral buckling with SRFD). Given the possible complications of SRFD, our method may be a safe and feasible surgical option, affording good results with few complications in patients with primary RRD.

Purpose: To assess the clinical outcomes of scleral buckling (SB) without subretinal fluid drainage (SRFD) on primary rhegmatogenous retinal detachment (RRD). Methods: The medical records of patients with RRD treated via SB without SRFD from March 2009 to Feb 2018 were retrospectively reviewed. Cases with histories of previous intraocular surgery (except cataract removal) were excluded. The primary and final surgical success rates were the main outcome measures. Pre- and post-operative visual acuity and intraocular pressure (IOP), factors that might affect the surgical success rate, secondary operative procedures, re-operation rates, and complications were analyzed. Results: A total of 66 eyes of 66 patients were included. The mean patient age was 38.9 ± 18.6 years and the mean symptom duration 19.23 ± 25.14 days. The retinae were reattached after single surgeries on 57 eyes (success rate 86.36%); the final success rate was 100% after a second operation (when necessary). Of the nine eyes requiring additional surgery, seven required vitrectomy and two vitrectomy combined with buckle revision. The mean preoperative logMAR visual acuity of 0.578 ± 0.647 improved to 0.518 ± 0.512 at 1 month after surgery (p < 0.001) and to 0.262 ± 0.372 at the last follow-up visit (p < 0.001). The postoperative IOP was higher than the preoperative IOP at 3 months (p = 0.024). Conclusions Scleral buckling without SRFD used to treat primary RRD afforded a high reattachment rate (compared to those of previous reports employing vitrectomy or scleral buckling with SRFD). Given the possible complications of SRFD, our method may be a safe and feasible surgical option, affording good results with few complications in patients with primary RRD.

Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.
Anti-Bacterial Agents ; Child ; Esophageal Stenosis ; Esophagus ; Granuloma ; Granulomatous Disease, Chronic* ; Humans ; Recurrence ; Steroids

Isolated fractures of lower sacrum are commonly treated conservatively in most cases because of low energy damage and stable fracture. However, surgical treatment is required in displaced unstable fracture. But the surgical technique is not established and even case reports are not common. We reported a case of displaced transverse fracture of the lower sacrum that was treated with an open reduction and dual plate fixation.

No abstract available.
Hormone Replacement Therapy ; Humans ; Incheon* ; Osteoporosis* ; Physicians, Primary Care* ; Primary Health Care*

A 36-year-old female amateur cyclist developed mononeuropathy of the deep branch of the ulnar nerve due to nerve compression adjacent to the ulnar tunnel (type II Guyon’s canal syndrome) caused by prolonged bicycle riding.The patient’s signs and symptoms persisted even after refraining from cycling for 4 weeks; thus, she underwent decompression of the deep branch of the ulnar nerve in the palm and wrist. Three months postoperation, she recovered nearly full power and function of her left hand.

PURPOSE: The purpose of this study was to evaluate the usefulness of applying computer-aided diagnosis (CAD) to breast ultrasound (US), depending on the reader's experience with breast imaging. METHODS: Between October 2015 and January 2016, two experienced readers obtained and analyzed the grayscale US images of 200 cases according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and categories. They additionally applied CAD (S-Detect) to analyze the lesions and made a diagnostic decision subjectively, based on grayscale US with CAD. For the same cases, two inexperienced readers analyzed the grayscale US images using the BI-RADS lexicon and categories, added CAD, and came to a subjective diagnostic conclusion. We then compared the diagnostic performance depending on the reader's experience with breast imaging. RESULTS: The sensitivity values for the experienced readers, inexperienced readers, and CAD (for experienced and inexperienced readers) were 91.7%, 75.0%, 75.0%, and 66.7%, respectively. The specificity values for the experienced readers, inexperienced readers, and CAD (for experienced and inexperienced readers) were 76.6%, 71.8%, 78.2%, and 76.1%, respectively. When diagnoses were made subjectively in combination with CAD, the specificity significantly improved (76.6% to 80.3%) without a change in the sensitivity (91.7%) in the experienced readers. After subjective combination with CAD, both of the sensitivity and specificity improved in the inexperienced readers (75.0% to 83.3% and 71.8% to 77.1%). In addition, the area under the curve improved for both the experienced and inexperienced readers (0.84 to 0.86 and 0.73 to 0.80) after the addition of CAD. CONCLUSION: CAD is more useful for less experienced readers. Combining CAD with breast US led to improved specificity for both experienced and inexperienced readers.
Breast Neoplasms ; Breast* ; Diagnosis* ; Diagnosis, Computer-Assisted ; Information Systems ; Sensitivity and Specificity ; Ultrasonography*

STUDY DESIGN: Case control study. PURPOSE: To examine the effect of spino-pelvic sagittal parameters and back muscles on osteoporotic vertebral fracture. OVERVIEW OF LITERATURE: Low bone mass is not the only important component of the risk on osteoporotic vertebral fracture; many other risk factors also contribute to skeletal fragility. METHODS: Seventy-two patients who had a lateral radiograph of the whole spine, magnetic resonance imaging of the lumbar spine, and bone densitometry, were enrolled. The spino-pelvic sagittal parameters (pelvic incidence, pelvic tilt [PT], sacral slope, thoracic kyphosis, lumbar lordosis), age, lumbar bone mineral density, and amount of back muscle around the lumbar spine were analyzed. RESULTS: There was higher sagittal imbalance of the spine in the vertebral fracture group (p=0.011). In spinopelvic parameters, the average of PT was 22.13degrees in vertebral fracture group and 13.70degrees in the non-fracture group (p=0.002). The amount of lower back extensor muscle in the vertebral fracture group was 2,170 mm2, which was lower than the non-fracture group (3,040 mm2, p=0.001). Multiple logistic regression analysis for the risk of osteoporotic vertebral fracture was significant in lumbar bone mineral density (odds ratio [OR], 0.313; 95% confidence interval [CI], 0.139-0.706, p=0.005) and the muscle ratio of extensor back muscle (OR, 0.902; 95% CI, 0.826-0.984; p=0.020). CONCLUSIONS: These results suggest that osteoporotic vertebral fracture could be developed easily by weakness of extensor back muscle in sagittal imbalance of the spine with high pelvic tilt.
Back Muscles* ; Bone Density ; Case-Control Studies ; Densitometry ; Humans ; Incidence ; Kyphosis ; Logistic Models ; Magnetic Resonance Imaging ; Osteoporosis ; Risk Factors ; Spine

Tight junction (TJ) is recognized as a second barrier of the skin. Altered expression of TJ proteins in various skin diseases characterized by the abnormal permeability barrier such as psoriasis suggests that TJ could be affected by stratum corneum (SC) barrier status. However, the physiological relationship between SC and TJ barrier remains to be investigated. Therefore, we examined the effect of SC barrier disruption on the expression of TJ proteins, claudin (Cldn)-1 and Cldn-4, and TJ barrier function in hairless mouse skin. We also investigated whether the alterations in epidermal Ca2+ affected TJ proteins expression in vivo. Repeated tape-stripping induced a sequential change of the expression and function of TJ. As early as 15-30 minutes after tape-stripping, downregulation of Cldn-1 and Cldn-4 immunoreactivity and protein level without change in mRNA level was found. This was accompanied by the abnormal leakage of lanthanum. However, by 1 hour Cldn-1 and Cldn-4 immunolocalization recovered along with normalized lanthanum permeation pattern. Moreover, the mRNA and protein levels of Cldn-1 and Cldn-4 were increased by 1 to 6 hours after tape-stripping. Inhibition of calcium loss by immersion of barrier-disrupted skin into a high Ca2+ solution prevented the dislocation of Cldn-1 and Cldn-4. Occlusion of barrier-disrupted skin delayed the restoration of Cldn-1 and Cldn-4. Our results suggest that the alteration of epidermal Ca2+ gradient caused by SC barrier perturbation affects the TJ structure and function and the faster recovery of TJ as compared to the SC barrier may imply the protective homeostatic mechanism of skin barrier.
Animals ; Calcium/*metabolism ; Claudin-1/genetics/*metabolism ; Claudin-4/genetics/*metabolism ; Epidermis/metabolism/*physiology ; Female ; Gene Expression Regulation ; Mice ; Mice, Hairless ; Permeability ; RNA, Messenger/metabolism ; Tight Junctions/metabolism/*physiology