A retrospective analysis of 122 consecutive of rhegmatogenous retinal detatchment cases which obtained successful surgical results was performed. All the cases were followed for longer than 1 year postoperatively. 15 eyes (12.3%) developed macular pucker. There was no significant difference in sex distribution and mean age was 43.7 years. The mean lapse time between surgery and the development of macular pucker was 7.2 months. Significant factors for developing macular pucker were multiple operation, preoperative macular detachment, and duration of retinal detachment (longer than 1 month). Other factors such as subretirial fluid drainage and myopia were not significant. 9 of 15 eyes with macular pucker were treated with vitrectomy and visual acuity improved in 66.7% of surgically treated eyes. These results suggest that success with single surgical procedure, operation before macular detachment, and early treatment of retinal detachment are important for preventing postsurgical macular pucker.
Drainage ; Myopia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Sex Distribution ; Visual Acuity ; Vitrectomy

Scrub typhus is an acute febrile illness with focal or general vasculitis that is caused by Orientia tsutsugamushi. The spectrum of clinical severity ranges from mild to severe with potentially fatal complications including acute renal failure, gastrointestinal bleeding, meningitis, myocarditis, and pneumonia. However, myofascitis with scrub typhus has not been reported to date. We report a case of pneumonia, meningitis, and myofascitis in a 56-year-old male patient with scrub typhus due to the Taguchi strain of O. tsutsugamushi.
Acute Kidney Injury ; Fasciitis ; Hemorrhage ; Humans ; Male ; Meningitis ; Middle Aged ; Myocarditis ; Orientia tsutsugamushi* ; Pneumonia ; Scrub Typhus* ; Vasculitis

PURPOSE: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. MATERIALS AND METHODS: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (alpha=.05). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. RESULTS: The pre-loading reverse torque values were 26.0 +/- 0.30 Ncm (ready-made abutment; Transfer abutment) and 26.3 +/- 0.32 Ncm (CAD-CAM custom-made abutment; CustomFit abutment) and 24.7 +/- 0.67 Ncm (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. CONCLUSION: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.
Computer-Aided Design* ; Torque

Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.
Cleft Lip ; Cleft Palate* ; Congenital Abnormalities ; Deglutition ; Humans ; Mastication ; Mouth ; Nasal Cavity ; Palatal Obturators* ; Palate ; Palate, Soft ; Velopharyngeal Insufficiency*

Purpose: This study aimed to determine the correlation between various clinical results, including recurrence in patients with breast cancer, and preoperative blood composition ratio and postoperative pathological results. Methods: A total of 444 patients who underwent surgery were included, and the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and postoperative pathological results were classified into postoperative cancer stages to confirm the association with various clinical results, including recurrence. Results: The median age of the patients was 51 years. The stages were divided into 1, 2, 3, and 4. Additionally, stages 1 and 2 comprised one group and stages 3 and 4 comprised another group. The cut-off values of the NLR, PLR, and MLR were confirmed to be 1.43, 158.84, and 0.21, respectively. It was noted that the association with recurrence was higher in the group with hormone receptor negative (p<0.001), higher stage (p<0.001), and underwent neoadjuvant chemotherapy (p<0.001). In the association with blood composition ratio and recurrence, survival was high in the PLR group with a high cut-off value (p=0.004). There was no significant relationship in the NLR and MLR groups. In the disease-free survival and overall-survival curves, only the PLR group showed a significant association of 0.003 and 0.001, respectively. The NLR and MLR groups did not show any significant result. Conclusion No significant association with recurrence and mortality was confirmed in the NLR and MLR groups. However, the preoperative blood test in the high PLR group showed recurrence and mortality rate were high.

Purpose: Breast cancer is the most common cancer in Korean women and the number of cases is increasing. We have found various histopathological differences in breast cancer and are using this knowledge for treatment. Various factors may help determine the progression of cancer in patients. The expression of lymphovascular invasion, a pathologic factor, denotes a poor prognosis. We analyzed the characteristics of patients showing lymphatic invasion. Methods: Data from 606 patients with breast cancer who underwent surgery between 2006 and 2016 were collected. We analyzed various pathologic factors in patients with or without lymphatic invasion expression. Results: Mean age was 52.0±11.2 years (range 29-83 years) and mean follow-up duration was 57.3 months (range 3−125 months). Pathologically, breast cancer types were invasive ductal carcinoma (552, 91.2%), invasive lobular carcinoma (21, 3.4%), and other pathologies (33, 5.4%). Number of patients in stages I, II, III, and IV were 299 (49.3%), 223 (36.8%), 82 (13.7%), and 2 (0.02%), respectively. Immunohistochemistry revealed 396 (65.3%) estrogen receptor (ER)-positive cases, 287 (47.3%) progesterone receptor (PR)-positive cases, and 139 (22.9%) human epidermal growth factor receptor 2 (HER2)-positive cases. Seven patients had local recurrence and 41 patients had distant metastasis, which included 14 bone, 7 lung, 5 liver, and 15 multiple metastases. Seventeen patients showed lymphatic invasion, while 24 patients were without lymphatic invasion. Significant association was observed between T and N stages and lymphatic invasion (p<0.001). No significant correlation was observed between lymphatic invasion and ER (p=0.073), HER2 (p=0.553). However, there was a significant correlation between lymphatic invasion and PR (p=0.044). Overall survival and disease free survival rates were significantly worse in the presence of lymphatic invasion (p<0.01, 0.011, respectively). Conclusion Lymphatic invasion was associated with T and N stages, overall survival and disease free survival. More careful observation and treatment strategy is needed, especially in locally advanced breast cancer.

PURPOSE: The ultrasonography (USG) and computed tomography (CT) are popular diagnostic tools for the diagnosis of acute appendicitis in children, but there are many debates about their clinical significance. The purpose of this study is to clarify the clinical significance of USG, CT and follow-up CT performed subsequently to USG, especially in perforated acute appendicitis in children. METHODS: We have reviewed 419 cases of surgically confirmed acute appendicitis in children under the age of sixteen, who had been treated in Inje University Ilsan Paik Hospital from March 2002 to February 2006. All the clinical data including the results of USG and CT were collected and analyzed. RESULTS: Sensitivity, specificity, positive and negative predictive values of USG were 98.7%, 96.8%, 98.1%, 97.8% in non-perforation group and 90.8%, 100%, 100%, 81.9% in perforation group. Those of CT were 96.4%, 100%, 100%, 96.5% and 86.6%, 100%, 100%, 87.5% respectively. Those of follow-up CT after USG were 100%, 100%, 100%, 100% and 87.5%, 100%, 100%, 92.0% respectively. The duration of using antibiotics in seven patients showed positive correlation with the interval between two imaging studies (r=0.0472, p=0.019). There was no statistical significance of correlation when these imaging studies performed within 30 hours together. CONCLUSION: In most of the cases, single choice between USG and CT would be enough to diagnose the acute appendicitis in children. But, it may be helpful to perform CT as early as possible subsequently to USG when there is discrepancy between initial USG and clinical impression.
Anti-Bacterial Agents ; Appendicitis* ; Child* ; Diagnosis ; Follow-Up Studies* ; Humans ; Sensitivity and Specificity ; Ultrasonography

This study was intended to investigate the sodium-related perception, dietary behavior, and practicability of methods for reducing sodium intake(RSI) according to the stage of change in consumers. The survey was conducted to 770 housewives, among them 553 subjects who answered the key questions for the stage of change were categorized into ''aintenance (M)' stage (maintaining reduced salt intake for more than 6 months; n = 287, 51.90%), 'Action (A)' stage (maintaining reduced salt intake for less than 6 months; n=139, 25.14%), and 'Pre-Action (P)'stage (not starting reduced salt intake; n = 127, 22.97%). The subjects in M and A were significantly older than those in P (p < 0.01). The scores of desirable dietary habit and dietary balance were the highest in M followed by A and P. When eating out, the subjects in P considered 'price' more and 'healthiness of food' less than those in M and A did. Among the guidelines for RSI, 'Avoid Processed Foods', 'Eat enough vegetables and fruits' and 'Add little amount of dipping sauce for fried food' were selected as the three easiest items to perform. With regard to the sodium-related perception, the subjects in M considered eating-out food to be more salty than homemade dishes, read nutrition labels more, avoided table salt or dipping sauce for fried food more, and had 'own low-sodium recipe' than those in P (p < 0.001). It is suggested that practicability of actions for RSI and the stage of change should be considered to develop effective personalized education program and nutrition guidance.
Eating ; Food Habits ; Humans ; Sodium ; Sodium Chloride, Dietary ; Vegetables

A 71-year-old female who was diagnosed with nonobstructive hypertrophic cardiomyopathy since 1999 presented with dyspnea and severe edema on both legs. For the management of her symptom, cardiac surgery including tricuspid annuloplasty, Maze operation and right atrial reduction plasty was performed. During follow-up after cardiac surgery, a plasma α-galactosidase activity was checked for the screening of Fabry disease and the result was around lower normal limit. DNA analysis was implemented for confirmation and it revealed a heterozygote α-galactosidase mutation at exon 6 [c.901C>T (p.Arg301Ter)]. This case suggests that Fabry disease might be easily undetected, and clinical suspicion is critical.
Aged ; Cardiomyopathy, Hypertrophic* ; DNA ; Dyspnea ; Edema ; Exons ; Fabry Disease* ; Female ; Follow-Up Studies ; Heterozygote ; Humans ; Leg ; Mass Screening ; Plasma ; Thoracic Surgery ; Tricuspid Valve Insufficiency*

This study was performed to analyze the efficacy of the prophylactic use of octreotide (Novartis, Stein, Switzerland) for pancreatic fistula following a pancreaticoduodenectomy. The medical records of 190 patients who underwent a pancreaticoduodenectomy at the Samsung Medical Center in Seoul, Korea between January 2000 and December 2002 were reviewed. Patients were divided into either the octreotide (n = 81) or control group (n = 109). The octreotide group received subcutaneous injections of 100 microgramg of octreotide every 12 hours for more than five days after surgery. The control group was not treated with octreotide. The criterion of pancreatic fistula was the drainage of the amylase rich fluid, over 500 U/mL in the three days after surgery. The morbidity and mortality rates were 32.1% and 1.2% in the octreotide group and 31.2% and 0% in the control group, respectively. Pancreatic fistula was the second most common complication (8.4%). In the univariate analysis, octreotide was ineffective in reducing pancreatic fistula (p = 0.26). However, in the multivariate regression analysis, combined gastrectomy (p = 0.018), cellular origin of the disease (p = 0.049), and use of octreotide (p = 0.044) were the risk factors that increased the frequency of pancreatic fistula. Therefore, the routine use of octreotide after a pancreaticoduodenectomy should be avoided until a worldwide consensus is established.
Postoperative Complications/*prevention & control ; Pancreaticoduodenectomy/*adverse effects ; Pancreatic Fistula/*prevention & control ; Octreotide/*therapeutic use ; Middle Aged ; Male ; Humans ; Female