Acquired nasolacrimal duct obstruction may result from chronic infection, lacrimal stones, anatomical variations such as aberrant ethmoid cells, facial fractures, or complications following nasal surgery. In Korea, there has been no reported case of secondary nasolacrimal duct obstruction due to a retention cyst in the lacrimal sac. Recently, the authors encountered a 65-year-old female patient who presented with epiphora, was diagnosed with a lacrimal sac retention cyst, and was successfully treated with endoscopic marsupialization.

The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome; 14(25.9%) vs 7(9.72%), ventilatory support; 18(33.3%) vs 5(6.9%), neonatal seizure; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.
Apgar Score ; Bronchopulmonary Dysplasia ; Counseling ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Incidence ; Infant, Newborn ; Length of Stay ; Maternal Age ; Parity ; Parturition ; Pregnancy ; Pregnancy, Triplet ; Pregnancy, Twin* ; Reproductive Techniques, Assisted* ; Seizures ; Triplets*

PURPOSE: Late-onset sepsis (LOS) is a serious problem in the neonatal intensive care unit (NICU). This study was undertaken to investigate clinical features of LOS (occurring after 72 hours of age) with fatal outcome (lethal within 72 hours of onset) in early phase of infection in NICU patients and impact of initial antibiotic therapy. METHODS: Retrospective analysis of the medical records was conducted to find LOS in patients in a NICU of university hospital over an 8-year period (2001-2008). RESULTS: There were 455 episodes of blood culture-proven LOS in 388 (6.9%) of 5,608 infants who survived beyond 3 days of age. Gram-positive bacteria were the most common pathogen, accounting for 265 cases (58.2%), and were followed by fungi with 101 cases (22.2%) and Gram-negative bacteria with 89 cases (19.6%). Fatal outcome in early phase of infection occurred in 14 cases (3.1%), and the most prevalent organism of fatal infection was Klebsiella, accounting for 7 cases (50%). Both Candida and S. aureus caused 2 cases of sepsis with fatal outcome, and also Acinetobacter, E. coli and Enterococcus caused 1 case respectively. The fatal outcome was more frequently developed in patients with Gram-negative sepsis than those with Gram-positive or fungal infections (10.1% vs. 2.0% vs. 1.1%; P <0.05). In clinical findings of patients with fatal outcome, the median of age at onset of infection was 19 days (range: 6-94 days), and the interval between onset and death was 29 hours (range: 10-58 hours). Severe sepsis at onset of infection was developed in 7 cases (50.0%), and the use of adequate empirical antibiotics was done in 10 cases (71.4%) of them. CONCLUSION: LOS by Gram-negative bacteria may easily complicate with fatal outcome in neonates. It cannot be prevented with adequate empirical antibiotic therapy, and additional countermeasures against fatal infection are necessary in NICU.
Accounting ; Acinetobacter ; Anti-Bacterial Agents ; Candida ; Enterococcus ; Fatal Outcome ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Klebsiella ; Medical Records ; Retrospective Studies ; Sepsis

OBJECTIVE: This study was designed to report the status of assisted reproductive technology (ART) therapy in South Korea between January 1, 2012 and December 31, 2012. METHODS: A localized online survey, originally developed by the International Committee Monitoring Assisted Reproductive Technologies, was first launched and provided to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized as standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI. Thawed embryo transfer (TET) and other related procedures, including surgical sperm retrieval, were surveyed. RESULTS: Data from 33,956 ovum pick-up procedures were provided by 75 clinics in 2012. Of the 33,088 cycles in which ovums were retrieved, a complete transfer was performed in 90.5% (29,932 cycles). In addition, 10,079 FET cycles were confirmed to have resulted in clinical pregnancy, representing a pregnancy rate of 30.5% per ovum pick-up and 33.7% per ET. The most common number of embryos transferred in FET was 2 (41.6%), followed by 3 (34.0%), and non-elective single ETs (10.0%). Of the 10,404 TET cycles in which transfer was completed, 3,760 clinical pregnancies (36.1%) were confirmed by ultrasonography. CONCLUSION: The overall clinical pregnancy rate for FET and TET cycles in 2012 was higher than in 2011 (33.7% vs. 33.2% and 36.1% vs. 31.1%, respectively). The most common number of embryos transferred in FET cycles was 2, unlike in 2011.
Electronic Mail ; Embryo Transfer ; Embryonic Structures ; Fertilization in Vitro ; Korea* ; Ovum ; Pregnancy ; Pregnancy Rate ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Ultrasonography

Purpose: Epidemiological data on injuries resulting from ice hockey and their management are lacking in Korea. A comprehensive analysis of such data is crucial for the effective prevention and management of ice hockey injuries. This study aimed to determine the epidemiological profile of ice hockey injuries and their management among elite Korean players. Methods: The descriptive epidemiological study involved three semiprofessional male ice hockey teams and used a retrospective self-reported questionnaire for assessment. The data collected included demographic characteristics such as player positions and stick-side preferences, injured body parts, injury types, treatment methods, and the decision-maker for returning to sports. Results: A total of 68 players were included in the study, of whom 58 (85.3%) experienced moderate-to-severe orthopedic injuries. Among the reported injuries, 93 (77.5%) occurred during the games, with player-to-player contact being the most frequent cause of such injuries. The decision to return to sports in 53 cases (44.2%) was made by the medical staff, whereas players and nonmedical staff made that decision in 67 cases (55.8%). The decision-making process of the medical staff for allowing players to return to sports was significantly associated with the player’s position and whether the injury required surgery. Conclusion The study emphasizes the high prevalence of orthopedic injuries among elite ice hockey players in Korea and the importance of injury prevention strategies. It also highlights the need for increased involvement of medical staff in return-to-play decisions to ensure successful recovery of players and their reintegration into the competition.

Background : Carcinoma of the pancreas is a fatal malignant disease with limited therapeutic options. Cyclooxygenase-2 (COX-2) and c-erbB-2 are known to be involved in the carcinogenesis, differentiation and invasiveness of various neoplasms. We studied the immunohistochemical expressions of c-erbB-2 and COX-2 and the correlation between these expressions and the clinicopathologic parameters and the relation between the expressions. Methods : Immunohistochemical staining for c-erbB-2 and COX-2 were performed on the paraffin embedded sections of 36 cases of surgically resected ductal adenocarcinoma of the pancreas and 10 cases of non-neoplastic pancreas tissue. Results : The non-neoplastic control group showed a c-erbB-2 expression in the acini (8/10) and ducts (2/10), and a COX-2 expression in the acini (6/10) and ducts (3/10). The overexpression of c-erbB-2 was observed in 58% (21/36) of the carcinoma specimens. No significant correlation was found between c-erbB-2 and age, gender, tumor size, gross type, histologic grade, vascular invasion, perineural invasion, lymph node metastasis, and the TNM stage. The overexpression of COX-2 was observed in 41.7% (15/36) of the carcinoma specimens. The COX-2 expression was significantly high in the lymph node metastasis group (p<0.05), but it was not correlated with the other clinicopathologic parameters. Also there was no significant correlation between the c-erbB-2 and COX-2 expressions. Conclusions : In pancreatic ductal adenocarcinomas, c-erbB-2 and COX-2 were frequently overexpressed, and COX-2 overexpression was correlated with lymph node metastasis.
Adenocarcinoma* ; Carcinogenesis ; Cyclooxygenase 2* ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts* ; Paraffin ; Receptor, erbB-2

PURPOSE: We evaluated clinical characteristics, sperm retrieval rates, and birth rates in a relatively large number of infertile patients with Y chromosome microdeletions. MATERIALS AND METHODS: We retrospectively reviewed clinical data from 213 patients with nonobstructive azoospermia (NOA) and 76 patients with oligoasthenoteratozoospermia (OATS) who were tested for Y chromosome microdeletion from March 2004 to June 2011. RESULTS: Of the 289 patients, 110 patients presented with Y chromosome microdeletion and 179 patients presented with no microdeletion. Among the patients with Y chromosome microdeletions, 83/110 (75.4%) were NOA patients and 27/110 (24.5%) were OATS patients. After subdividing the patients with Y chromosome microdeletion, 29 had azoospermia factor (AZF)b-c microdeletion and 81 had AZFc microdeletion. The sperm retrieval rate was similar between patients with Y chromosome microdeletion and those with no microdeletion (26.6% vs. 25.6%, p=0.298) after multiple testicular sperm extraction (TESE). Excluding 53 patients who did not undergo TESE, 30 patients were analyzed. All of the 9 men with AZFb-c microdeletion had a complete absence of sperm despite multiple TESE. However, multiple TESE was successful for 9 of 21 patients with only AZFc microdeletion (p=0.041). Twenty patients with Y chromosome microdeletion gave birth. CONCLUSIONS: In NOA and OATS patients, no significant difference in the sperm retrieval rate was shown between patients with Y chromosome microdeletion and those with no microdeletion. Patients with short Y chromosome microdeletion such as AZFc microdeletion have better prognoses for sperm retrieval and an increased chance of conception than do patients with larger microdeletions such as AZFb-c microdeletion.
Avena ; Azoospermia ; Birth Rate ; Chromosome Deletion ; Chromosomes, Human, Y ; Fertilization ; Humans ; Infertility, Male ; Male ; Parturition ; Prognosis ; Reproductive Techniques, Assisted ; Retrospective Studies ; Sex Chromosome Aberrations ; Sex Chromosome Disorders of Sex Development ; Sperm Retrieval ; Spermatozoa ; Y Chromosome

PURPOSE: The aim of this study is to investigate the renal ultrasonographic findings in children with vesicoureteral reflux (VUR). METHODS: We retrospectively reviewed the medical records of 83 patients who were diagnosed with VUR and underwent ultrasonography at Ilsan hospital between January 2000 and December 2010. RESULTS: Among 166 renal units, 108 (65.0%) were found to have vesicoureteral reflux (VUR). Fifty-one (73.9%) had VUR in renal units with abnormal ultrasonography (USG), whereas 57 (58.7%) had VUR in renal units with normal USG. Abnormal USG findings were independent risk factors for VUR (Odds ratio, 1.98; 95% CI, 1.01-3.89; P=0.045). In renal units with VUR, the number of normal USG finding was 52.8%, and the abnormal findings were as follows; increased cortical echogenicity 16.7%, hydronephrosis 17.6%, megaureter or ureter dilatation 8.3%, hydronephrosis and ureter dilatation 1.9%, duplication of ureter 1.9%, and atrophic kidney 0.9%. The prevalence of VUR was relatively higher in renal units with hydronephrosis (23/19, 82.6%), ureter dilatation (9/9, 100%), duplication of ureter (2/3, 66.6%), and atrophic kidney (1/1, 100%). CONCLUSION: Our study indicates that VUR was associated with abnormal USG findings. When there are abnormal USG findings such as hydronephrosis, ureter dilatation, duplication of ureter, and atrophic kidney in children with UTI, VCUG is recommended to detect VUR after controlling UTI.
Child ; Dilatation ; Humans ; Hydronephrosis ; Kidney ; Medical Records ; Prevalence ; Retrospective Studies ; Risk Factors ; Ureter ; Vesico-Ureteral Reflux

Radiologic findings of Middle East respiratory syndrome (MERS), a novel coronavirus infection, have been rarely reported. We report a 30-year-old male presented with fever, abdominal pain, and diarrhea, who was diagnosed with MERS. A chest computed tomographic scan revealed rapidly developed multifocal nodular consolidations with ground-glass opacity halo and mixed consolidation, mainly in the dependent and peripheral areas. After treatment, follow-up imaging showed that these abnormalities markedly decreased but fibrotic changes developed.
Adult ; Coronavirus Infections/pathology/*radiography ; Fever/virology ; Fibrosis ; Humans ; Male ; *Middle East Respiratory Syndrome Coronavirus ; Radiography, Thoracic/*methods ; Republic of Korea ; Tomography, X-Ray Computed/*methods

PURPOSE: To evaluate the prevalence of vesicoureteral reflux (VUR) according to the timing of voiding cystourethrography (VCUG) in infantile urinary tract infection (UTI). METHODS: The data of 134 infants (1-12 months) with renal cortical defect in 99mTc-2, 3-dimercaptosuccinic acid (99mTc-DMSA) scan with a diagnosis of UTI in two hospitals from 2000 to 2010 were retrospectively analyzed. The VCUG was performed after 2 weeks from the diagnosis of UTI in Group I (n=68), and the VCUG was performed within 2 weeks from the diagnosis of UTI in Group II (n=66). RESULTS: There were no significant differences between the two groups in the duration of fever, white blood cell count, C-reactive protein levels, and abnormalities in ultrasonography (P>0.05). There was no significant difference between the two groups in the prevelence of VUR, bilateral VUR, and severe VUR. VCUG-induced UTI was detected 16 (23.5%) of patients in whom the procedure was performed 2 weeks after the diagnosis, and none of VCUG-induced UTI occurred in those in whom the procedure was performed 2 weeks within the diagnosis. CONCLUSION: We conclude that the prevalence of VUR according to the timing of VCUG did not differ between the two groups in infantile UTI with renal cortical defect in DMSA scan. We also found that performing VCUG with antibiotics can decrease risk of VCUG-induced UTI.
Anti-Bacterial Agents ; C-Reactive Protein ; Fever ; Humans ; Infant ; Leukocyte Count ; Prevalence ; Retrospective Studies ; Succimer ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux