PURPOSE: We report a case of superior orbital fissure syndrome induced by penetrating orbital injury caused by a steel wire and analyzed the clinical outcomes. CASE SUMMARY: A 49-year-old female visited our clinic after a penetrating orbital injury through the right inferolateral conjunctiva caused by a steel wire. The best corrected visual acuity of the right eye was 0.8 and a fixed dilated pupil was detected. Partial ptosis and ophthalmoplegia were observed in the right eye. The computed tomography image revealed no sign of orbital wall fracture, retrobulbar hemorrhage or foreign body. Slightly increased signal intensity was observed on the magnetic resonance image but other abnormal findings of the extraocular muscle and optic nerve were not detected. Under the impression of superior orbital fissure syndrome, systemic steroid was administered orally. After 1 month, ptosis and ophthalmoplegia were partially improved. After 3 months, the pupil size and response were normalized. CONCLUSIONS: The oral steroid treatment was given to reduce the edema without orbital wall fracture after the penetrating orbital injury, which caused the superior orbital fissure syndrome. The symptom was relieved 3 months after the injury.
Conjunctiva ; Edema ; Female ; Foreign Bodies ; Humans ; Middle Aged ; Ophthalmoplegia ; Optic Nerve ; Orbit* ; Pupil ; Retrobulbar Hemorrhage ; Steel ; Visual Acuity

Reports of osteomyelitis in the proximal humerus with pyogenic glenohumeral arthritis of adjacent joints mostly involve pediatric patients. Nowadays, osteomyelitis that is secondary to adjacent pyogenic glenohumeral arthritis is extremely rare, even more so in adults than in pediatrics. We report a rare case of the pyogenic glenohumeral arthritis followed by osteomyelitis of the proximal humerus in an elderly patient. Initially, we diagnosed a case of pyogenic glenohumeral arthritis only, which, despite arthroscopic synovectomy, did not resolve and severe pain continued. Subsequent radiological imaging, performed after our suspicion of a secondary involvement, allowed us to diagnose osteomyelitis combined with the pyogenic glenohumeral arthritis, which we had overlooked because of the extreme rarity of the condition in adults since the antibiotic era began.
Adult ; Aged* ; Arthritis* ; Arthritis, Infectious ; Humans ; Humerus* ; Joints ; Osteomyelitis* ; Pediatrics ; Shoulder

The malignant transformation of fibrous dysplasia is a rare condition and the incidence is estimated at 0.4% for fibrous dysplasia and 4% for Albright's syndrome. And fronto-orbital fibrous dysplasia can have a devastating outcome with high rates of recurrence and blindness, especially following incomplete resection. So a radical and extensive approach to treatment is recommended. We report the case of a multiostotic fronto-orbital fibrous dysplasia in a 54-year-old male patient which had a malignant transformation to osteosarcoma. There had been a recurrence after partial removal and no effect by chemotherapy. Although we had have a favorable outcome in functional and aesthetic aspects without any evidences of recurrence by total removal and reconstruction with titanium mesh, the patient died with lung metastasis 4 and half years later after the first operation.
Blindness ; Drug Therapy ; Fibrous Dysplasia, Polyostotic ; Humans ; Incidence ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Osteosarcoma ; Recurrence ; Titanium

PURPOSE: To analyze the findings of carotid Doppler and lipid profiles in patients with ischemic ocular disease and as well as the risk and correlation between cardiovascular and ischemic ocular diseases. METHODS: We analyzed the intima-media thickness (IMT) and existence of vascular stenosis using carotid Doppler and blood lipid profiles of the study patients diagnosed with anterior ischemic optic neuropathy (AION group, n = 45), central retinal vein occlusion (CRVO group, n = 34), central retinal artery occlusion (CRAO group, n = 23), or ocular ischemic syndrome (OIS group, n = 27). The study patients who visited Chonbuk National University Hospital from January, 2010 to June, 2013 were compared with healthy control (control group, n = 107). RESULTS: The average age of the study patients was 60.0 +/- 14.1 years and 56.1 +/- 9.1 years for the controls. Ipsilateral common carotid artery-IMT was thicker in the OIS and CRAO groups than the control group (p < 0.01 and <0.01, respectively). The number of patients with carotid stenosis was highest in the OIS group (n = 17, 62.9%) followed by the CRAO group (n = 5, 21.7%), CRVO group (n = 2, 5.9%), and AION group (n = 1, 2.2%). No significant stenosis was found in the control group. Total blood cholesterol was not significantly different between the study patients and controls. Low-density lipoprotein cholesterol was higher in every patient group than the control group (p < 0.01, <0.01, <0.05 and <0.01, respectively). CONCLUSIONS: The ischemic ocular disease likely precedes carotid artery disease and dyslipidemia. Therefore, general examinations such as carotid Doppler, lipid profile and risk factor evaluations are needed in patients with ischemic ocular disease.
Carotid Artery Diseases ; Carotid Stenosis ; Cholesterol ; Constriction, Pathologic ; Dyslipidemias ; Humans ; Jeollabuk-do ; Lipoproteins ; Optic Neuropathy, Ischemic ; Retinal Artery Occlusion ; Retinal Vein ; Risk Factors

No abstract available.
Epilepsy ; Migraine Disorders ; Migraine with Aura*

PURPOSE: In case of facial injury, a canalicular injury is common. Many methods and materials have been used for reconstruction of lacrimal canaliculi. Silicone tube is the most widely used material, generally with pigtail probe or stainless steel probe. But it has still many problems. The authors guess that reconstruction using Mini Monoka(R) will reduce those problems and will be more successful. METHODS: From July, 2003 to November, 2006 in 24 patients with canalicular injury, 11 cases were reconstructed with former silicone tube and 13 cases were treated with Mini Monoka(R). RESULTS: The mean follow-up period was 3 months. The results of reconstruction were classified into three groups(Normal, Fair, Poor). In 13 cases with Mini Monoka(R) stent, 10 cases were normal, 3 were fair, and no poor cases. But in 11 cases with bicanaliculus silicone stent, 6 cases were normal, 3 were fair, and 2 were poor. CONCLUSION: Compared with bicanaliculus silicone stent, Mini Monoka(R) stent is fixed well, has no aesthetic problems, makes less foreign body sensation. And the results were successful.
Facial Injuries ; Follow-Up Studies ; Foreign Bodies ; Humans ; Sensation ; Silicones ; Stainless Steel ; Stents

OBJECTIVES: Monitoring viability of flap is important. The flap survival depends on the vascularity of the flap, on which the skin temperature depends. The authors applied digital infrared thermographic imaging (DITI) for monitoring the vascular supply of the flap and for the prediction of the prognosis of the flap survival. METHODS: Eight male New Zealand white rabbits with average weight of 3kg were used. A 10 x 10 cm unipedicled fasciocutaneous island flap was elevated based on the left superficial inferior epigastric vessel. The surface temperatures on designed flap were checked with DITI for 24 hours after the operation. On 14th day after the operation, the surviving area was measured and compared with DITI image which was taken on 24 hours after the operation using digital analysis software ImageJ. Statistical analysis was evaluated by paired T-test. RESULTS: On DITI image 24 hours after the flap elevation, distal portion of the flap showed remarkable color change. The average percentage and the standard deviation of the survival area of the flap which is predicted by DITI and the average percentage and the standard deviation of the survival area of the flap which was actually measured 2 weeks after flap elevation were 55.3 (16.6), 56.2 (18.0), respectively. This shows no significant difference between the two. CONCLUSIONS: This study shows that DITI system could be used in evaluation of flap vascularity with ease, quickness and safety for patient and flap. Thus, it could be used clinically for the prediction of flap survival.
Humans ; Male ; Prognosis ; Rabbits ; Skin Temperature* ; Skin*

In perforator flap reconstruction, vascular mapping using preoperative computed tomography (CT) angiography is widely used to confirm the existence and location of an appropriate perforator. This study proposes a rapid, accurate, and convenient method for marking the perforator location on the skin surface. For 12 patients who underwent perforator flap reconstruction between November 2011 and November 2013, metal clips were fixed on the skin surface at the anticipated perforator locations, which were decided using a handheld Doppler. CT angiography was used to compare the location between the metal clip and the actual perforator. The metal clip was moved and repositioned, if needed, on the basis of the CT images. The locations of the appropriate perforator and the metal clip, which were observed during the surgery, were then compared. In CT angiography, the mean distance between the metal clip and the perforator was 3+/-3.9 mm, and the mean distance that was measured during surgery was 0.8+/-0.8 mm. In conclusion, we report a simple, rapid, and precise technique to indicate the accurate location of the appropriate perforator on the skin surface.
Angiography* ; Humans ; Multidetector Computed Tomography ; Perforator Flap* ; Skin ; Ultrasonography, Doppler

Pyoderma gangrenosum is a rare inflammatory reactive dermatosis marked by painful cutaneous ulcers. Diagnosis of pyoderma gangrenosum is usually made based on past medical history and after the exclusion of other possible diseases based on the clinical manifestations of the lesion. Diseases that show rapid progression to necrosis and that should not be misdiagnosed as pyoderma gangrenosum include malignant neoplasms and necrotizing fasciitis. Immunosuppressive agents such as steroids and cyclosporine are considered first-line therapy. Surgical removal of the necrotic tissues is contraindicated, as it may further induce immune reaction and promote ulcer to enlarge. Here, we present a case to encourage plastic surgeons to consider pyodermagangrenosum in the differential diagnosis of idiopathic ulcers. Satisfactory outcomes for patients with pyodermagangrenosum may be expected when using steroids and immunosuppressive agents during the early stage of the disease.
Cyclosporine ; Diagnosis* ; Diagnosis, Differential ; Fasciitis, Necrotizing ; Humans ; Immunosuppressive Agents ; Necrosis ; Pyoderma Gangrenosum* ; Skin Diseases ; Steroids ; Ulcer

Acute phlegmonous gastritis is an uncommon disease, often fatal condition characterized by suppurative bacterial infection of the gastric wall. It has a high mortality rate mainly because the diagnosis is usually made late. Until recently, gastrectomy in combination with antibiotics was recommended. We had experienced a case of 66-year-old man presented with epigastric pain, nausea, vomiting, and hematemesis, followed by aspiration pneumonia. At upper gastrointestinal endoscopy, the gastric lumen was narrow, and the mucosa was severely inflamed, which was erythematous, swelled, and showed necrotic areas covered with purulent exudate. Klebsiella oxytoca and Acinetobacter lwoffii were isolated in the gastric tissue culture. Contrast-enhanced computerized tomography scan of abdomen demonstrated diffuse gastric wall thickening and an intramural abscess in the gastric antral wall. Although delayed gastric emptying by gastroparesis prolonged the in-hospital period, the only medical treatment with antibiotics alone successfully cured the patient without gastrectomy.
Acinetobacter/isolation & purification ; Acute Disease ; Aged ; Anti-Bacterial Agents/*therapeutic use ; Anti-Infective Agents/therapeutic use ; Cefotaxime/therapeutic use ; Ceftriaxone/therapeutic use ; Ciprofloxacin/therapeutic use ; Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Gastritis/*diagnosis/drug therapy/microbiology ; Gastroparesis/*diagnosis/microbiology ; Gastroscopy ; Humans ; Imipenem/therapeutic use ; Klebsiella oxytoca/isolation & purification ; Male ; Ofloxacin/therapeutic use ; Pneumonia/diagnosis/drug therapy ; Tomography, X-Ray Computed