No abstract available.
Laparotomy* ; Nephrectomy*

Esophageal ulcers induced by doxycycline is a rare complication. These patients usually complain of sudden onset of symptoms, ie acute substernal or chest pain and odynophagia without prior hietory of esophageal syraptoms. On esophagoscopic examination, there are upper or midesophageal ulcers, which heal after diseontinuation of the drug within 2 weeks. A history of ingestion of the doxycycline,with liquid jost before bedtime can be elicited. The exact eause of the xaucosal ulceration is not clear, but a direct irritant effeet on esophageal mucosa seems most likely. We report 5 cases of esophageal uleeration secondary to the ingestion of doxycydine. Esophagoscopy revealed esophageal ulcers in all patients and the patients hecame asymptomatic following stopping of tbe drugs and taking antacids.
Antacids ; Chest Pain ; Doxycycline* ; Eating ; Esophagoscopy ; Humans ; Mucous Membrane ; Ulcer*

Objectives: Cheyne-Stokes respiration (CSR) is frequently found in critically ill patients and is associated with poor prognosis. However, CSR has not been evaluated in neurocritical patients. This study investigated the frequency and prognostic impact of CSR in neurocritical patients using biosignal big data obtained from intensive care units. Methods: This study included all patients who received neurocritical care at the tertiary hospital from January 2018 to December 2019. Clinical information and biosignal data of intensive care units were used and analyzed. The respiratory curve was visually assessed to determine whether CSR and obstructive sleep apnea (OSA) were present, and a heart rate variability (HRV) was obtained from the electrocardiogram. Results: CSR was confirmed in 166 of 406 patients (40.9%). Patients with CSR were older, had a higher frequency of cardiovascular risk factors as well as heart failure, and had a poor outcome (modified Rankin scale ≥4). As a result of multiple regression analysis adjusted for other variables, CSR was significantly associated with poor outcome with an odds ratio of 2.27 times higher (95% confidence interval 1.25–4.14, p=0.007). HRV analysis demonstrated that CSR and OSA had distinct autonomic characteristics. Conclusions This study first revealed the substantial frequency of CSR in neurocritical patients and suggests that it can be used as a predictor of poor prognosis in neurocritical care.

Purpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal bevacizumab injections. Methods: We retrospectively analyzed patients who underwent intravitreal bevacizumab injection in both eyes on the same day from January 2015 to June 2019. The patients were followed up at 1 day, 1 week, and 1 month after the injection. Results: A total of 281 patients (153 males and 128 females) and 562 eyes were included in the study, and 950 bilateral same-day intravitreal bevacizumab injections were performed. The mean age of patients was 58.87 ± 13.44 years. The most common cause of bilateral injection was that of complications due to diabetic retinopathy, which accounted for 66.3%, followed by age-related macular degeneration at 22.2%, retinal vein occlusion at 5.1%, and central serious chorioretinopathy at 2.1%. There were 0 cases of endophthalmitis after 950 injections, 13 cases of subconjunctival hemorrhage, and 17 patients with a temporary elevation of intraocular pressure. There were 11 patients with acute intraocular inflammation after bilateral injection, but none in both eyes. Patients with acute intraocular inflammation were followed up at short-term intervals until they improved. All patients showed complete improvement within 2 weeks after injection. Comparing the patients’ condition before and after injection, visual acuity improved (p < 0.001). Conclusions In terms of the frequency of short-term ophthalmic adverse events, bilateral same-day intravitreal bevacizumab injection is a safe procedure with fewer side effects and is more convenient for both the patient and the doctor.

Purpose: To investigate the influence of intraocular pressure (IOP)-lowering eye drops on myopic retinoschisis. Methods: We investigated myopic retinoschisis patients with high myopia (defined as a myopic refractive error more than -8.0 dioptersor an axial length longer than 26.5 mm), who were suspected of having glaucomatous optic neuropathy, using IOP-loweringeye drops between April 2014 and December 2018. We retrospectively analyzed the changes in optical coherence tomographyfindings after 6 months using IOP-lowering eye drops. The progression of retinoschisis was assessed by analyzing retinalvolume changes. A decrease in the total retina volume and a decrease in volume more than 10% in one section out of five withoutmore than a 10% volume increase in any other section was defined as resolution of myopic retinoschisis. The opposite casewas defined as an aggravation. Results: We analyzed 17 eyes of 15 patients with high myopia. Six of 17 eyes (35.3%) showed a resolution of myopic retinoschisisat 6 months after using IOP-lowering eye drops. Of the 17 eyes, two (11.8%) experienced progression of myopicretinoschisis. Seven out of 14 eyes (50.0%) who were followed-up over 1 year showed resolution of myopic retinoschisis, andtwo eyes (14.3%) experienced progression of myopic retinoschisis. There was no macular hole development or posterior vitreousdetachment during the follow-up period in the seven eyes, and there was no significant correlation between the absolute valueof the initial IOP, axial length, IOP change, and degree of improvement of myopic retinoschisis. Conclusions The use of IOP-lowering eye drops on highly myopic eyes with retinoschisis showed a significant improvement ofmyopic retinoschisis, when compared to previous studies. These findings suggest the possibility of IOP-lowering eye drops delayingor improving the natural course of myopic retinoschisis.

Purpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal bevacizumab injections. Methods: We retrospectively analyzed patients who underwent intravitreal bevacizumab injection in both eyes on the same day from January 2015 to June 2019. The patients were followed up at 1 day, 1 week, and 1 month after the injection. Results: A total of 281 patients (153 males and 128 females) and 562 eyes were included in the study, and 950 bilateral same-day intravitreal bevacizumab injections were performed. The mean age of patients was 58.87 ± 13.44 years. The most common cause of bilateral injection was that of complications due to diabetic retinopathy, which accounted for 66.3%, followed by age-related macular degeneration at 22.2%, retinal vein occlusion at 5.1%, and central serious chorioretinopathy at 2.1%. There were 0 cases of endophthalmitis after 950 injections, 13 cases of subconjunctival hemorrhage, and 17 patients with a temporary elevation of intraocular pressure. There were 11 patients with acute intraocular inflammation after bilateral injection, but none in both eyes. Patients with acute intraocular inflammation were followed up at short-term intervals until they improved. All patients showed complete improvement within 2 weeks after injection. Comparing the patients’ condition before and after injection, visual acuity improved (p < 0.001). Conclusions In terms of the frequency of short-term ophthalmic adverse events, bilateral same-day intravitreal bevacizumab injection is a safe procedure with fewer side effects and is more convenient for both the patient and the doctor.

OBJECTIVE: Recently some behavioral features and affective traits are considered important for the phenotype of obsessive-compulsive disorder (OCD). The purpose of this study was to assess some specific behavioral, temperamental, emotional features of OCD patients and to investigate if there is any change in patterns of temperament-character after 4-month pharmacotherapy. METHODS: Fifty-six patients with OCD and 70 normal controls were enrolled in this study. Four self-report questionnaires were employed to assess temperamental characteristics and affective traits: The behavioral inhibition system and behavioral activation system scale, the Baratt impulsiveness scale, state-trait anger expression inventory, emotional intelligence inventory. Among 56 OCD patients, 21 subjects started pharmacotherapy and 4 months later, they repeated 4 self-report tests as the same above and Yale-Brown obsessive compulsive scale (Y-BOCS). And then we investigated the changes from initial results. RESULTS: Patients with OCD showed significantly greater expression of behavioral inhibition system (p<0.0001), more cognitive impulsiveness (p<0.0001), motor impulsiveness (p=0.0067) and increased level of state anger (p<0.0001), trait anger (p<0.0001) than healthy controls. Compared to the controls, the OCD patients also expressed significantly lower level of emotional intelligence for using to facilitate thinking (p<0.0001) and managing emotions (p<0.0001). After 4-month pharmacotherapy for 21 OCD patients, Y-BOCS scores significantly decreased while self-report tests showed no meaningful differences from baseline assessments. CONCLUSION: Our results suggest that patients with OCD may have some differences in behavioral and affective tendencies including behavioral inhibition, impulsiveness, anger experiences, and emotional patterns. And short term pharmacotherapy during 4 months improved the severity of obsessive-compulsive symptoms but didn't influence these traits. These results provide some perspectives about possible vulnerability or trait markers of OCD. Further research is needed to examine the effects of long term treatment and other investigation might be helpful to assess the relationships between these behavioral and affective aspects and clinical phenotypes of OCD.
Anger ; Emotional Intelligence ; Humans ; Obsessive-Compulsive Disorder ; Phenotype ; Surveys and Questionnaires ; Temperament ; Thinking

Some individuals may demonstrate a secondary phase nystagmus (SPN) following the caloric irrigation. It has been stated that if a SPN begins prior to 140 seconds after the onset of caloric stimulation and if the magnitude of the slow phase velocity is greater than 6 degrees/sec, then a premature reversal caloric nystagmus (PRCN) is said to exit. Thus far, there have been no reports describing PRCN in Korea. We described a typical PRCN in a patient with medulloblastoma within the 4th ventricle. The patient had a gaze-evoked horizontal and upbeating nystagmus. However, there was no indication of spontaneous nystagmus. A monothermal caloric test was administered. The initial left beating primary phase nystagmus was subsided at 60 seconds after right cold water stimulation and at 110 seconds, a right beating SPN with 14 degrees/sec of slow phase velocity was appeared and was continuous for 240 seconds. Although the precise mechanism of PRCN is unknown, vestibular nuclei damage may be related.
Caloric Tests ; Humans ; Korea ; Medulloblastoma ; Nystagmus, Physiologic* ; Vestibular Nuclei ; Water

Hidradenitis suppurativa (HS) is a chronic inflammatory condition with an unclear etiopathogenesis that is considered to be a follicular occlusive disease. We present a case of HS that was suspected to have developed as a complication of subdermal excision. A 19-year-old man who had undergone subdermal excision due to osmidrosis presented 7 months after surgery with a persistent painful mass in his left axilla. Despite medical treatment, incision, and drainage, a painful enlarged abscess recurred in the left axilla and was cured completely by deroofing surgery. However, 15 months after subdermal excision, he revisited the hospital because of a painful mass in the right axilla. The patient’s condition met the diagnostic criteria of HS. After several recurrences, a cure was achieved by radical wide excision. Mechanical stress like that associated with subdermal excision is considered to be a possible etiological factor of HS. In addition, pathological changes at the sebofollicular junction allow rupture and leakage of folliculopilosebaceous units upon exposure to mechanical stress, which may result in the aggressive subcutaneous extension of inflammation. We suggest that HS should be considered in patients with a recurrent abscess after subdermal excision, and recommend surgical treatment as a possible option if conservative treatment is clinically ineffective.

BACKGROUND AND OBJECTIVES: This study is aimed to investigate the efficacy of dexamethasone and methylprednisolone when used for Intratympanic steroid injection (ITSI) concurrent with systemic steroid as primary therapy. SUBJECTS AND METHOD: We undertook a retrospective study of 106 patients diagnosed with Idiopathic Sudden Sensorineural Hearing Loss at our institution. These patients were divided into the following groups based on their intratympanic steroid medications: Group 1 (which received dexamethasone for ITSI) and Group 2 (which received methylprednisolone for ITSI). The severity of pain after ITSI was also compared using Visual Analogue Scale. RESULTS: The therapeutic results of both groups showed no significant difference. The improvement of pure tone audiometry average threshold were 18.3±19.5 dB for Group 1 and 22.4±25.8 dB for Group 2, with no significant differences (p=0.402). The recovery rate according to Siegel's criteria were 34/70 (48.6%) and 18/36 (50.0%) respectively, with no significant differences (p=0.889). The degree of pain after ITSI were 1.51±1.06 and 3.92±1.63 for Group 1 and 2, respectively, showing significant differences (p<0.001). Again, there were no significant differences even when accompanying symptoms or severity of initial hearing loss were considered. CONCLUSION: There was no significant difference between efficacy of dexamethasone and methylprednisolone when used as primary therapy. Methylprednisolne caused more severe pain after ITSI, suggesting the choice of dexamethasone. Further studies are needed about the concentration of injected steroid.
Audiometry ; Dexamethasone ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Injection, Intratympanic ; Methods ; Methylprednisolone ; Retrospective Studies ; Steroids