PURPOSE: To describe the change of lacrimal gland volumes in Korean patients with thyroid-associated ophthalmopathy (TAO) via computed tomography (CT). METHODS: A retrospective review of CT images from 217 TAO patients and 135 control subjects was performed. The TAO patients were diagnosed between May 2005 and May 2014 and had a CT performed on initial presentation (330 orbital CT scans). These images were compared with 270 orbital CT scans from the control group, obtained between May 2013 and May 2014. An open source DICOM viewer was used to calculate the volume of the lacrimal gland. RESULTS: The mean volume of the lacrimal gland in TAO patients was 0.816 cm³ in the right orbit (standard deviation [SD], 0.048) and 0.811 cm3 in the left orbit (SD, 0.051), with no significant difference between right and left (p = 0.192). However, significant differences were observed between TAO patients and healthy individuals (p < 0.001). There was no significant difference between mean lacrimal gland volumes of males (0.812 cm³; SD, 0.037) and females (0.816 cm³; SD, 0.029) (p = 0.513). There was a negative correlation between gland volume and age in TAO patients (Pearson r = -0.479, p = 0.00). The subjective tearing (right: r = 0.244, p = 0.018; left: r = 0.226, p = 0.024), corneal superficial punctate keratopathy (right: r = 0.192, p = 0.040; left: r = 0.206, p = 0.036), and exophthalmometry (right: r = 0.182, p = 0.032; left: r = 0.180, p = 0.046) correlated with lacrimal gland volume. CONCLUSIONS: This study is the first to use CT images to calculate the lacrimal gland volume of Korean TAO patients. In TAO patients, the lacrimal gland volume was notably increased compared to control subjects. The lacrimal gland volume decreased with age, but there was no difference between gender and no difference between left and right. The lacrimal gland volume correlated with subjective tearing, corneal superficial punctate keratopathy and exophthalmometry.
Computer Communication Networks ; Female ; Graves Ophthalmopathy* ; Humans ; Lacrimal Apparatus* ; Male ; Orbit ; Retrospective Studies ; Tears ; Tomography, X-Ray Computed ; Troleandomycin

PURPOSE: This study was to evaluate the beam quality of intraoral X-ray equipments used at Yonsei University Dental Hospital(YUDH) using the half value layer(HVL) and the characteristic curve of intraoral standard X-ray film. MATERIALS AND METHODS: The study was done using the intraoral X-ray equipments used at each clinical department at YUDH. Aluminum filter was used to determine the HVL. Intraoral standard film was used to get the characteristic curve of each intraoral X-ray equipment. RESULTS: Most of the HVLs of intraoral X-ray equipments were higher than the least recommended thickness, but the REX 601 model used at the operative dentistry department and the X-707 model used at the pediatric dentistry department had HVLs lower than the recommended thickness. The slopes of the characteristic curves of films taken using the PANPAS 601 model and REX 601 model at operative dentistry department, the X-70S model of prosthodontic dentistry department, and the REX 601 model at the student clinic were relatively low. CONCLUSION: HVL and the characteristic curve of X-ray film can be used to evaluate the beam quality of intraoral X-ray equipment. In order to get the best X-ray films with the least radiation exposure to patients and best diagnostic information in clinical dentistry, X-ray equipment should be managed in the planned and organized fashion.
Aluminum ; Dentistry ; Dentistry, Operative ; Humans ; Pediatric Dentistry ; Prosthodontics ; X-Ray Film

PURPOSE: Kawasaki disease is the most common cause of systemic vasculitis in children less than 5 years of age. Recent immunohistochemistry findings suggest that many vascular growth factors play a role in the formation of the coronary artery lesions. Active remodeling of the coronary artery lesions in Kawasaki disease continues in the form of intimal proliferation and neoangiogenesis for several years after the onset of the disease. Intravenous immunoglobulin (IVIG) and corticosteroid have been used in the treatment of Kawasaki disease but the exact mechanism is not clear. We have investigated that IVIG and corticosteroid inhibited vascular endothelial growth factor (VEGF)- induced tube formation of endothelial cells in vitro on Matrigel assay. METHODS: Human umbilical vein endothelial cells (HUVECs) were cultured and seeded on Matrigel coated 24 well plates in medium with or without the following agents: VEGF, VEGF plus IVIG, VEGF plus VEGF antibody, VEGF plus methylprednisolone, VEGF, IVIG plus methylprednisolone for 18 hours. The total length of tube structures in each photograph was quantified. RESULTS: IVIG significantly inhibited the proliferation of HUVECs. The inhibitory effect of IVIG was also reversible. In the meantime, VEGF induced the differentiation of HUVECs into capillary like structures on Matrigel, which was inhibited by VEGF antibody in a dose-dependent manner. Interestingly, IVIG and methylprednisolone inhibited VEGF-induced tube formation of HUVECs. IVIG was more effective in inhibition than methylprednisolone alone. CONCLUSION: We revealed that VEGF induced the differentiation of HUVECs and this effect was inhibited by IVIG and methylprednisolone.
Capillaries ; Child ; Coronary Vessels ; Endothelial Cells* ; Human Umbilical Vein Endothelial Cells ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Methylprednisolone* ; Mucocutaneous Lymph Node Syndrome ; Systemic Vasculitis ; Vascular Endothelial Growth Factor A

PURPOSE: To report a case of chronic hypotony maculopathy caused by traumatic cyclodialysis cleft and treated with 20% sulfur hexafluoride (SF6) gas tamponade with cyclocryotherapy. CASE SUMMARY: A 39-year-old woman with a history of blunt trauma developed a unilateral chronic ocular hypotony in her left eye. She was treated with topical atropine sulphate 1% for 2 months. Three years later, she was referred to our clinic for evaluation and treatment of persistent hypotony. The intraocular pressure (IOP) was 4 mm Hg and the best corrected visual acuity was 0.4. B-scan echography revealed a choroidal effusion and fundus examination showed choroidal detachment and macular folds. Gonioscopy examination revealed cyclodialysis cleft from the direction of 7 o'clock to 11 o'clock. A single bubble of SF6 20% (0.4 cc) was injected into the vitreous cavity and transconjunctival cyclocryotherapy was performed under retrobulbar anesthesia. Six months later, the IOP was 12 mm Hg and the best corrected visual acuity was 1.0. B-scan echograpy and fundus examination showed the disappearance of the choroidal effusion. CONCLUSIONS: Gas tamponade with cyclocryotherapy may be useful in cases of cyclodialysis cleft that failed to respond to medical therapy.
Adult ; Anesthesia ; Atropine ; Choroid ; Eye ; Female ; Gonioscopy ; Humans ; Intraocular Pressure ; Ocular Hypotension ; Sulfur Hexafluoride ; Visual Acuity

PURPOSE: To measure the enophthalmos corrective effect after inferior orbital wall reconstruction, we compared preoperative and intraoperative exophthalmometric values with postoperative exophthalmometric values. METHODS: From January 2014 to April 2016, 60 eyes of 60 patients who underwent surgery for inferior orbital wall fracture were included. In Group 1, the exophthalmometric value was measured before surgery, during the operation, and 6 months after surgery using the Naugle exophthalmometer. In Group 2, the value was measured before surgery and 6 months after surgery using the Hertel exophthalmometer. The thickness of implants was determined by preoperative exophthalmometric values and overcorrection of 0.5 mm was performed in Group 1 patients with relatively large fractures. RESULTS: The mean age of the patients was 32.4 years in Group 1 and 34.3 years in Group 2. The mean duration between injury and surgery was 4.2 weeks in Group 1 and 2.3 weeks in Group 2. There was no statistically significant difference between preoperative exophthalmometric values in Group 1 (−1.78 ± 0.31 mm) and Group 2 (−1.81 ± 0.26 mm), but postoperative exophthalmometric values between Group 1 (−0.25 ± 0.78 mm) and Group 2 (−0.53 ± 0.46 mm) were statistically different (p = 0.034). CONCLUSIONS: The exophthalmometric values and wall fracture size are important factors for determining implant thickness of inferior orbital wall reconstruction. Intraoperative measurement of exophthalmometric values should be considered in inferior orbital wall reconstruction for enophthalmos correction.
Enophthalmos* ; Humans ; Orbit*

Peripartum cardiomyopahty(PPCM) is an uncommon myocardial disease arising in the last month of pregnancy or within 5 months after delivery, in the absence of obvious cause and without prior evidence of heart disease. The risk of recurrence of PPCM is considered low when left ventricular size and function return to normal. But we experienced a case of peripartum cardiomyopathy recurred in subsequent pregnancy despite the return to normal heart size and function. This case was summarized here with a brief review of the related literatures.
Cardiomyopathies* ; Heart ; Heart Diseases ; Peripartum Period* ; Pregnancy ; Recurrence

Perforation after foreign body ingestion is rare. We report a 25-month-old girl who was diagnosed with a stomach perforation with secondary localized peritonitis caused by long, sharp bamboo. On admission, she had abdominal pain and fever. Simple abdominal erect & supine X-ray, abdominal ultrasonogram and computed tomography scan were normal. On the 6 th hospital day, gastrofiberoscopy was performed because a sharp mass was palpated by doctor on abdominal examination. Endoscopic findings revealed a 8 cm-long sharp bamboo tip was pierced to the posterior wall of antrum. This foreign body was removed with Olympus FG-8L alligator forcep. She was managed with NPO and prompt intravenous antibiotics and discharged with clinical improvement.
Abdominal Pain ; Alligators and Crocodiles ; Anti-Bacterial Agents ; Child, Preschool ; Eating ; Female ; Fever ; Foreign Bodies ; Humans ; Peritonitis* ; Stomach* ; Surgical Instruments ; Ultrasonography

Familial hemophagocytic lymphohistiocytosis (FHL) is a fatal illness with a median life expectancy of 2 months if not treated. However, with the recent employment of allogeneic bone marrow transplantation in the treatment of FHL, even complete cure might be anticipated. We report here a case of prolonged remission following autologous peripheral blood stem cell transplantation (Auto-PBSCT) which was first attempted for FHL in Korea. A 4-month-old girl presented with high fever and a huge hepatosplenomegaly. Bone marrow examination revealed the proliferation of both non-malignant histiocytes engulfing red blood cells and lymphocytes. Her brother died at the age of 18 months showing quite similar manifestations. A diagnosis of FHL was made. Following 8 courses of chemotherapy with multiple drugs, Auto-PBSCT was performed. She has been well without any evidence of disease over 8 months of post- transplant period. This case illustrates that it might be worth trying Auto- PBSCT in the treatment of FHL.
Bone Marrow Examination ; Bone Marrow Transplantation ; Diagnosis ; Drug Therapy ; Employment ; Erythrocytes ; Female ; Fever ; Histiocytes ; Humans ; Infant* ; Korea ; Life Expectancy ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Peripheral Blood Stem Cell Transplantation* ; Siblings

PURPOSE: Foreign body swallowing is common in children. Most of foreign bodies passed upper esophagus are removed spontaneously. But recently, therapeutic endoscopy in children is widely used. In this study, we reviewed gastric foreign bodies regarding types, location, interval from swallowing, complications, and treatment or method of removal. METHODS: We reviewed medical records of 96 cases with foreign bodies in gastrointestinal tract at Department of Pediatrics in Gyeongsang National University Hospital (GNUH) from Feb 1987 to Feb 2002. RESULTS: The peak age of patients (male=60, female=36) with foreign bodies in gastrointestinal tract was 2 to 5 years of age. Sixty two patients (64.5%) were asymptomatic. The location of foreign bodies in gastrointestinal tract were detected by simple X-ray in eighty one patients (86.0%), barium study (1 case), and gastroduodenoscopy in 37 cases. The most common location was stomach (63.5%). The most common foreign body was coin (41.7%). In thirty seven cases (38.5%), foreign bodies were removed with flexible gastroduodenoscopy. Fifty four patients (56.3%) visited GNUH in 24 hours after swallowing foreign bodies. The long interval (over 24 hours) of swallowing of foreign bodies is related with high frequency of endoscopic removal. CONCLUSION: The flexible gastroduodenoscopy was effective in diagnosis and removal of foreign bodies. Further studies for indication and validity of endoscopic removal of foreign bodies in upper gastrointestinal tract are needed.
Barium ; Child ; Deglutition ; Diagnosis ; Endoscopy ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Humans ; Medical Records ; Numismatics ; Pediatrics ; Stomach ; Upper Gastrointestinal Tract

Kimura disease is rare chronic inflammatory disorder of an unknown etiology and it has a predilection for males of Asian descent. It typically presents with non-tender subcutaneous swellings in the head and neck region, peripheral eosinophilia and an elevated immunoglobulin E level. We present here the case of 8-year-old boy with a past history of food allergy, and he developed swelling of the left neck and incidental eosinophilia. Kimura disease was diagnosed on the basis of the clinical and histological findings. The serum IgG titer of cysticercosis was twice the normal level. After surgical excision of the subcutaneous lesion, the patients eosinophilia was dramatically decreased. We suggest that allergy and remote parasite infection may be the causality or a triggering factor for Kimura disease.
Angiolymphoid Hyperplasia with Eosinophilia* ; Asian Continental Ancestry Group ; Child ; Cysticercosis ; Eosinophilia ; Food Hypersensitivity ; Head ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins ; Male ; Neck ; Parasites*