PURPOSE: we studied the clinical outcome of a step-by-step treatment approach for congenital nasolacrimal duct obstruction (CNDO). METHODS: we analyzed 186 patients (222 eyes) who had been treated for CNDO between January 1996 and December 2000. According to age, conservative treatment, nasolacrimal duct probing and silicone intubation were applied systematically until a successful outcome was achieved. Patients were grouped according to their age at the time of first visit.: Group 1 (0~6 months), Group 2 (7~12 months), Gruop 3 (13~24 months), Group 4 (25~72 months). Treatment efficacy was determined according to age and success rate was compared. RESULTS: Conservative treatment was applied only in children less than 1 year of age and was successful in 75.9% of Group 1 and 47.3% of Group 2. The difference between these two success rates was significant (p=0.0001). The overall success rate for first probing in all groups was 65.2% with a range 75.8% in Group 1, 62.1% in Group 2, 65.0% in Group 3, and 40.0% in Group 4. After second probing, the overall cure rates for the entire cohort were 82.6% with a range 87.9% in Group 1, 89.7% in Group 2, 80.0% in Group 3, and 50.0% in Group 4. There was no real difference in first probing cure rate relative to age (p=0.208). But after second probing, overall cure rate was significantly decreased when the age of the patients was over 12 months (p=0.027). Silicone intubation was performed in 4 of Group 1, 3 of Group 2, 4 of Group 3, and 5 of Group 4 and was successful in all cases. CONCLUSIONS: Systematic treatment approach to CNDO including conservative treatment, nasolacrimal duct probing, and silicone intubation, was highly successful. In this study, the cure rate for this combined approach was 100% in 186 patients (222 eyes).
Child ; Cohort Studies ; Humans ; Intubation ; Nasolacrimal Duct* ; Silicones ; Treatment Outcome

PURPOSE: We evaluated the risk factors and related results of residual diplopia and enophthalmos in patients who had orbital wall fracture repair. METHODS: 50 patients with orbital wall fracture who were followed up for at least 6 months postoperatively were included in this study. We analyzed effects of the patient age, timing of surgery, size and location of fracture on development of postoperative diplopia and enophthalmos. RESULTS: 32 patients had diplopia and 16 patients had enophthalmos greater than 2 mm. Among 32 patients with preoperative diplopia, 9 patients experienced postoperative diplopia. Among 16 patients with preoperative enophthalmos, 5 patients experienced postoperative enophthalmos. Delayed timing of surgery was a significant factor for development of postoperative diplopia and enophthalmos. Age of the patients and fracture size were not significant factors for development of postoperative diplopia and enophthalmos. CONCLUSIONS: Early surgical repair of orbital wall fractures decreases the incidence of residual diplopia and enophthalmos. Preoperative assessment of multiple variables could help to achieve cosmetical and functional better results.
Diplopia* ; Enophthalmos* ; Humans ; Incidence ; Orbit* ; Risk Factors

To evaluate the effect of adjunctive use of mitomycin C on endoscopic endonasal dacryocystorhinostomy(DCR), a total of 75 eyes of 66 patients diagnosed with naso-lacrimal duct obstruction were assigned randomly to either a mitomycin C group or a control group.The surgical procedures in both groups were exactly the same, except in the patients of mitomycin C group, a topical 0.2 mg/ml solution of mitomycin was applied to the osteotomy site intraoperatively for 5 minutes. Mean follow-up period was 6.8 months in the mitomycin C group and 7.2 months in the control group. The success rate of endoscopic DCR with intraoperative mitomycin C was 89% whereas the success rate of endoscopic DCR without mitomycin C was 79%. Membranous obstruction, causing failure of surgery occurred in five eyes in the control group while it occurred in two eyes in the mitomyicn C group. Synechia with middle turbinate was found in one eye in the control group, but there was no such synechia found in the patients in the mitomycin C group. Granulation tissue formation also occurred in two eyes in the mitomycin C group as well as in two eyes in the control group. During follow-up period, no complications such as mucosal necrosis, or infection were noted in any patients of mitomycin C group. Adjunctive use of mitomycin C as a wound healing inhibitor is considered to increase the success rate of endoscopic endonasal DCR.
Follow-Up Studies ; Granulation Tissue ; Humans ; Mitomycin* ; Necrosis ; Osteotomy ; Turbinates ; Wound Healing

Electroretinograms (ERGs) were measured in 65 patients with diabetes and 10 control subjects. The single flash ERGs were recorded as a function of the stimulus intensity. A Naka-Rushton-type function was fit to b-wave amplitudes, measured as a function of stimulus intensity, to evaluate changes in ERG amplitude and sensitivity. We also measured the temporal aspects of the ERG b-waves. The ERG sensitivity tended to decrease as the retinopathy progressed. An average sensitivity loss in eyes with diabetic retinopathy was statistically significant. However, the eyes of diabetic patients without visible retinopathy did not show significant ERG sensitivity loss. There was less variability in temporal compared with amplitude measurements of ERG components, and significantly prolonged b-wave implicit times were found in all stages of retinopathy and in eyes of diabetic patients without retinopathy.
Adolescent ; Adult ; Aged ; Diabetic Retinopathy/*physiopathology ; Electroretinography ; Humans ; Middle Aged ; Retina/physiology ; Sensitivity and Specificity ; Sensory Thresholds/physiology

This study investigated factors affecting the subjective experience of oral symptoms among 2,285 elementary school students in the fourth and sixth grades using the Korean survey on the Health of Youth and Children in 2010. After conducting chi-square and Mann-Whitney U tests, we performed multiple logistic regression analysis to determine the factors affecting children's experience of oral symptoms. We found that the factors most frequently associated with the subjective experience of more oral symptoms were lower tooth brushing frequency, greater intake of foods that cause dental caries, higher stress levels, and lower levels of support from friends. In conclusion, determinants of children's oral health, such as children's oral health behaviors and psychological factors must be considered in a multifaceted approach to developing programs to promote oral health among children.
Adolescent ; Child ; Dental Caries ; Friends ; Humans ; Logistic Models ; Oral Health ; Psychology* ; Social Determinants of Health ; Tooth

PURPOSE: We report a case of acute dacryocystitis diagnosed with abscess and rupture of lacrimal sac and fistula to posterior orbit during the operation. CASE SUMMARY: A 71-year-old woman visited our clinic with edema and pain in the eyelid from three days ago. For past four months, there was viscous of the left eye and tears. The patient had severe conjunctival chemosis and hyperemia, compared with the left eyelid edema and redness. Orbital CT scan showed orbital cellulitis, which was followed by systemic antibiotics and steroid therapy. On the 4th day of therapy, orbital abscess formation was observed in orbit MRI and surgical drainage was planned. During surgery, we found rupture of the posterior part of lacrimal sac and fistula to posterior orbit. Pseudomonas aeruginosa was identified in the bacterial cultures, and after the administration of appropriate antibiotics, the disease showed improved progress, and then additional dacryocystorhinostomy was performed. CONCLUSIONS: In our case, acute dacryocystitis rarely spread in orbit, which may lead to delayed diagnosis, orbital cellulitis and abscess, resulting in serious complications of vision threat. So, we think that it is necessary to consider surgical treatment more actively in the stage of chronic dacryocysitis.
Abscess ; Aged ; Anti-Bacterial Agents ; Dacryocystitis ; Dacryocystorhinostomy ; Delayed Diagnosis ; Drainage ; Edema ; Eyelids ; Female ; Fistula ; Humans ; Hyperemia ; Magnetic Resonance Imaging ; Nasolacrimal Duct ; Orbit ; Orbital Cellulitis ; Pseudomonas aeruginosa ; Rupture ; Tears ; Tomography, X-Ray Computed

Paraneoplastic encephalitis associated with an ovarian teratoma has been related to the development of antibodies to specific heteromers of the N-methyl-D-aspartate receptor (NMDAR). The disorder, known as anti-NMDAR encephalitis, is characterized by psychiatric symptoms, seizures, mood and behavioral changes as well as involuntary movement. Since the NMDAR is the target of many anesthetic drugs, the presence of anti-NMDAR antibodies might influence the requirements of anesthetics or their effects. We report the presentation and anesthetic experience of a young patient with anti-NMDAR encephalitis undergoing surgical excision of two ovarian teratomas, and we also review the relevant literature.
Anesthesia, General ; Anesthetics ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Antibodies ; Dyskinesias ; Encephalitis ; Humans ; N-Methylaspartate ; Paraneoplastic Syndromes ; Seizures ; Teratoma

PURPOSE: Most terminally ill cancer patients die from cancer anorexia-cachexia syndrome. This study evaluated a prognostic role of plasma leptin levels in terminally ill cancer patients. METHODS: This study enrolled 69 terminally ill cancer patients who were aged above 20 years old from July 2009 to July 2010. For univariate analysis, an association between leptin levels and patient's characteristics or other variables was examined using Spearman's correlation analysis, Wilcoxon's rank-sum test or Kruskal-Wallis test, as appropriately. For multivariable analysis, Cox's proportional hazard regression model was used to evaluate a clinical significance of plasma leptin levels as a prognostic factor and to determine factors which affect the risk of death in terminally ill cancer patients. RESULTS: A statistically significant positive correlation between plasma leptin levels and survival time was found. Univariate Cox's proportional hazard regression analyses also showed a moderately significant association between plasma leptin levels and survival time. However, after adjusting variables for sex, white blood cell counts, total bilirubin, AST, ALT, albumin and CRP levels, plasma leptin levels were not significantly associated with survival time. CONCLUSION: No significant association was found between plasma leptin levels and survival time in terminally ill cancer patients. However, this study suggested a prognostic value of plasma leptin levels in gastrointestinal cancer patients.
Aged ; Bilirubin ; Gastrointestinal Neoplasms ; Hospice Care ; Humans ; Leptin ; Leukocyte Count ; Life Expectancy ; Plasma ; Survival Rate ; Terminally Ill

PURPOSE: We report a case of intraocular Thelazia callipaeda infestation in a patient with panuveitis who had a successful recovery after pars plana vitrectomy. METHODS: A 73-year-old female patients complained of a floating sensation and gradually decreasing visual acuity in her right eye. On slit lamp examination, severe intraocular inflammatory reaction was observed. Fundus examination revealed severe vitreous haze with mobile linear structure. Three-port pars plana vitrectomy was performed and then the worm was removed. RESULTS: The worm was confirmed to be Thelazia callipaeda. At postoperative 2 months, the patient's visual acuity was 0.6 and intraocular pressure 14 mmHg. There was no evidence of intraocular inflammatory reaction. CONCLUSIONS: Thelazia callipaeda usually lie in the conjunctival sac or lacrimal apparatus, causing ocular surface disease, but intraocular infestation rarely occurs. If intraocular infestation does occur, early surgical removal should be performed.
Aged ; Female ; Humans ; Intraocular Pressure ; Lacrimal Apparatus ; Panuveitis ; Sensation ; Thelazioidea ; Visual Acuity ; Vitrectomy

BACKGROUND AND OBJECTIVES: To determine the frequency of the histologic types of nasal polyp in Korea and their relationships with respect to age, laterality, asthma, allergic rhinitis (AR) and expression of vascular endothelial growth factor (VEGF). SUBJECTS AND METHOD: Tissue slides obtained from 282 patients with nasal polyps were examined; polyps were classified either as eosinophilic polyp or chronic inflammatory polyp. VEGF expression was determined using immunohistochemical staining. RESULTS: Of the 282 subjects, 169 (59.9%) had chronic inflammatory polyps, 113 (40.1%) had eosinophilic polyps, and 232 (82.3%) had bilateral polyps. Twenty-two subjects (7.8%) had asthma and 23 (8.2%) had AR. There was no statistical relationship between nasal polyp type and laterality or the presence of asthma or AR. Of 10 children, 9 (90%) had chronic inflammatory polyps. VEGF expression was significantly higher in eosinophilic polyps than in chronic inflammatory polyps, and significantly higher in the samples of each polyp type from the subjects with AR than those without AR. In subjects with asthma, however, the VEGF expression did not differ between eosinophilic polyps and chronic inflammatory polyp samples. CONCLUSION: In the Korean population, chronic inflammatory nasal polyps are more common than eosinophilic nasal polyps. VEGF expression was the highest in eosinophilic polyps of the subjects with AR, suggesting that VEGF might contribute to the polyp formation via local allergic action.
Asthma ; Child ; Eosinophils ; Humans ; Hypersensitivity ; Inflammation ; Korea ; Nasal Polyps ; Polyps ; Rhinitis ; Rhinitis, Allergic, Perennial ; Vascular Endothelial Growth Factor A