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

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PURPOSE: The aim of this study was to investigate the safety and effectiveness of tadalafil 5 mg once daily (quaque die [everyday], QD) among Korean men with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) in a real-world clinical setting. MATERIALS AND METHODS: This was a single-country, prospective, observational cohort study in which patients newly prescribed tadalafil 5 mg QD for the treatment of BPH/LUTS were followed-up for 12±2 or 24±2 weeks, or to the last treatment, during post-marketing surveillance. Safety was evaluated in terms of the frequency of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). Effectiveness was assessed by changes in the International Prostate Symptom Score (IPSS) from baseline to each endpoint. RESULTS: All patients receiving ≥1 dose of tadalafil 5 mg QD (N=637) were included in the safety population. Two percent of patients (n=13) experienced 15 TEAEs of mild (n=10; 66.7%) or moderate (n=5; 33.3%) severity. No severe TEAEs and no SAEs were reported. Effectiveness evaluations included all patients receiving tadalafil who had both baseline and endpoint observations (12-week, N=265; 24-week, N=44). Compared with baseline, the mean IPSS total score (±standard error) significantly improved by 4.7±0.3 and 6.4±0.7 points at the 12- and 24-week endpoints, respectively (p<0.0001), with significant improvements also observed on the storage, voiding, and quality of life subscores. In total, 69.1% of the patients had a clinically meaningful ≥3-point improvement in the IPSS total score. CONCLUSIONS: Tadalafil 5 mg QD was well tolerated and effective in Korean men with BPH/LUTS in a real-world clinical setting.
Cohort Studies ; Humans ; Lower Urinary Tract Symptoms ; Male ; Phosphodiesterase 5 Inhibitors ; Prospective Studies ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Tadalafil* ; Urinary Tract*

OBJECTIVETo study the epidemiology of human metapneumovirus (hMPV) infection in children and its relations with meteorological conditions in Suzhou.

METHODSamples obtained from 6655 children hospitalized with acute respiratory tract infections (ARIs) during the period from 2006 to 2009, were tested for virus pathogens. Nasopharyngeal aspirates were obtained from the children according to a standard protocol and were tested for respiratory syncytial virus (RSV), influenza viruses (IFV) A and B, parainfluenza virus (PIV) types 1, 2, and 3 and adenovirus (ADV) with direct immunofluorescence assay. Samples were tested for hMPV with reverse transcription polymerase chain reaction (RT-PCR). Meteorological conditions including mean temperature, relative humidity, rainfall amount, sum of sunshine and mean wind velocity were collected monthly. The relationship between activity of the virus and meteorological conditions was analyzed by linear regression and stepwise regression analysis.

RESULTViral pathogens were identified in 32.2% of 6655 specimens. The positive rate of hMPV was 8.9%, RSV was 15.7%, IFV, PIV and ADV detection rates were less than that of hMPV. The annual positive rate of hMPV from 2006 to 2009 was 8.2%, 8.1%, 12.7%, 7.4% respectively (χ(2) = 33.23, P < 0.05). The hMPV positive rate of the four seasons was 11.6%, 7.6%, 4.7% and 11.7%, respectively, detection rate in winter and spring was significantly higher than those in summer and autumn (χ(2) = 74.67, P < 0.001). The positive rate of hMPV and the monthly mean temperature was moderately correlated (r = -0.43), and the monthly average rainfall (r = -0.29), monthly mean relative humidity (r = -0.27), monthly average sunshine duration (r = -0.11), the monthly average wind speed (r = -0.13) had low correlations.

CONCLUSIONhMPV was the second most common viral pathogen of acute respiratory tract infection in children in Suzhou, which prevailed predominantly in the winter and spring. Climatic factors, especially temperature and rainfall may affect the prevalence of hMPV.

Child ; Child, Preschool ; China ; epidemiology ; Climate ; Female ; Humans ; Infant ; Male ; Metapneumovirus ; Respiratory Tract Infections ; epidemiology ; virology ; Seasons

Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy.
Bronchi ; Bronchoscopy ; Diagnosis ; Dyspnea ; Granulation Tissue ; Humans ; Lung Injury ; Pulmonary Atelectasis* ; Rupture* ; Thorax

Capsule endoscopy is being increasingly recognized as a gold standard for diagnosing small bowel disease, but along with the increased usage, capsule retention is being reported more frequently. We report a case of capsule endoscopy retention in a diverticulum of the duodenal proximal third portion, which we treated by esophagogastroduodenoscopy. A 69-year-old male visited hospital with hematochezia. He had hypertension and dyslipidemia for several years, and was taking aspirin to prevent heart disease. CT and colonoscopy revealed a diverticulum in the third portion of the duodenum, rectal polyps, and internal hemorrhoids. Capsule endoscopy was performed but capsule impaction occurred. The capsule was later detected by CT in the diverticulum. Endoscopy was performed a day later and the capsule was removed using a net. A small bowel series was conducted after capsule removal, and no stenosis was found. The patient fully recovered and no recurrence of hematochezia was observed at his one month exam. This is the first case in Korea of capsule retention in a duodenal diverticulum, with successful removal by endoscopy.
Abdomen/diagnostic imaging ; Aged ; Capsule Endoscopy ; Diverticulum/*diagnosis/diagnostic imaging ; Endoscopy, Digestive System ; Humans ; Male ; Tomography, X-Ray Computed

Bezoars are persistent concretions of indigestible material that are usually found in the stomach. With the significant development of endoscopic techniques, many authors have reported the removal of bezoars using methods such as endoscopic forceps, snares, electrohydraulic lithotripsy, laser. However, there are no reports of using argon plasma to remove a bezoar in Korea. Argon plasma coagulation is a non-contact electrosurgical technique, which is an inexpensive, easily learned, and effective method in gastrointestinal endoscopy. In addition, this method is associated with a decreased risk of perforation and tissue damage by maintaining a controllable depth of coagulation. We report a 71-year-old man with a 11x11x8 cm sized huge gastric phytobezoar found by endoscopy. The bezoar was broken into pieces using the argon plasma coagulator. Endoscopic forceps and a basket were then used to crush and extract its fragments. The bezoar was removed safely without any complications. We report this case with a review of the relevant literature.
Aged ; Argon Plasma Coagulation ; Argon* ; Bezoars ; Endoscopes* ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Korea ; Lithotripsy, Laser ; Plasma* ; SNARE Proteins ; Stomach ; Surgical Instruments

Peptic ulcer which extend beyond the serosa of the bowel wall may not perforate freely into the peritoneal cavity but instead penetrate adjacent structures (confined perforation). It has been reported that the frequency of penetration of peptic ulcer has been estimated around 20 percent in patients undergoing laparotomy for peptic ulcers. A 46-year- old male was admitted with chief complaint of hematemesis. Endoscopic examination revealed submucosal tumor like lesion with central ulcer and active bleeding which was located at the upper body, posterior wall of the stomach. Angiography demonstrated hypervascular tumor like lesion supplied by left gastric artery and short gastric branches of splenic artery. Postoperative biopsies showed inflammatory cell infiltration at the typical ulcer base and no evidence of malignancy. There was loss of acinus structure and fibrous adhesion with omentum at the pancreas. We report a case of gastric ulcer penetrating into pancreas, spleen with hypervascular nature with brief review of literatures.
Angiography ; Arteries ; Biopsy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Omentum ; Pancreas ; Peptic Ulcer ; Peritoneal Cavity ; Serous Membrane ; Spleen ; Splenic Artery ; Stomach ; Stomach Ulcer* ; Ulcer

PURPOSE: This study evaluated the efficiency and safety of the Foley catheter for esophageal removal of coins in children, compared to standard endoscopic extraction with respect to success rate, sedation, promptness and cost. METHODS: Twenty four children with coin lodgement in esophagus were managed with either a Foley catheter (n=14) or endoscopic extraction (n=10) from January 2007 through August 2010 at Kyungpook National University Hospital. A retrospective review of medical records and radiological findings was performed. RESULTS: Of the 14 patients who underwent Foley catheter extraction, successful and complication-free removal was achieved in 10 cases (71.4%). Of the 10 patients who underwent endoscopic extraction, all cases were successful (p=0.114). Sedation rate in the Foley catheter and endoscopic extraction group was 6/14 and 10/10 (p=0.006). The average wait time before the procedure and average hospital charge (US$) were 2.0+/-1.1 hours and 18.1+/-13.7 hours, and $113 and $428 for Foley catheter extraction and endoscopic extraction, respectively. CONCLUSION: Foley catheter extraction may be tried for the removal of esophageal coins in uncomplicated children. The technique is effective, safe, inexpensive and free of general anesthesia.
Anesthesia, General ; Catheters ; Child ; Endoscopy ; Esophagus ; Hospital Charges ; Humans ; Medical Records ; Numismatics ; Retrospective Studies

Recombinant DNA vaccines, based on plasmid vectors expressing an antigen under the control of a strong promotor, have several advantages over traditional vaccines. They have been shown to induce a full spectrum of immune responses for humoral and cellular systems and to secure the higher safety and the simplicity of administration. Thus, establishment of DNA vaccines against Newcastle disease virus (NDV) in poultry has been widely investigated using various virus strains and vector systems. In this study, the F and HN genes of NDV CBP-1 strains isolated from diseased pheasants and attenuated by serial passages in egg embryos were cloned using pSLIA vector and constructed two recombinants of pSLIA-tsF and pSLIA-tsHN. The recombinant plasmids were transfected into COS-7 cell and the expression of HN and F proteins were verified by immunofluorescence, SDS-PAGE and Western blot. The recombinant plasmids were injected intramuscularly and intradermally into C57B/6 mouse and a significant increment of HN and F antibodies was detected by ELISA. According to the results, it was implicative that the recombinant DNA could be utilized for development of recombinant DNA vaccine for NDV.
Animals ; Antibodies ; Blotting, Western ; Clone Cells ; COS Cells ; DNA, Recombinant* ; Electrophoresis, Polyacrylamide Gel ; Embryonic Structures ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique ; Mice ; Newcastle disease virus* ; Newcastle Disease* ; Ovum ; Plasmids ; Poultry ; Serial Passage ; Vaccines ; Vaccines, DNA