A 74-year-old man presented with pain and progressively worsening vision from 20 days ago in the left eye. His ophthalmological history was significant for cataract extraction, scleromalacia, and three surgeries for pterygium removal in the left eye. Slit-lamp examination was remarkable for a 4.5×4.0 mm sized epithelial defect, with corneal stromal infiltration and melting and a surrounding feathery margin. Corneal scraping was performed, and culture of specimen demonstrated mold that grew on Sabouraud dextrose agar. The isolate was finally identified as Corynespora cassiicola based on DNA sequencing analysis of internal transcribed spacer (ITS) with maximum identity of 100%. The patient was treated successfully with intracameral amphotericin B injection and topical voriconazole and amphotericin B. To the best of our knowledge, this is the first reported case of mycotic keratitis caused by a plant pathogen, Corynespora cassiicola, in Korea.

OBJECTIVES: Studies on oral health care in North Korea are being pursued in South Korea. However, the covertness of North Korea offers substantial resistance to the access of information from the country, including in the field of oral health care. In this study, we explored North Korea's oral health care policy and its status in the Kim Jong-Un Era. METHODS: We used existing information from Internet searches and also interviewed three health care professionals who had recently contact with North Korea. RESULTS: At present, there are four development policies of oral health care in North Korea: expansion of dental institutions and resource support, strengthening the prevention and treatment of dental diseases, improvement of dental prosthetics, and increasing the responsibility and role of the dental workforce. In addition, there has been an increasing interest in children's oral health with the development of a few programs. CONCLUSIONS In order to improve overall oral health care, cooperation is required from North Korea in accessing relevant information in the field of children's oral health, dental prosthetics, and dental materials. For this to occur, there should be a preliminary trust building process between North Korea and South Korea as well as access to information from reliable sources.

Several recent studies have reported that reactive oxygen species (ROS), superoxide anion and hydrogen peroxide (H2O2), play important roles in various cellular signaling networks. NADPH oxidase (Nox) isozymes have been shown to mediate receptor-mediated ROS generation for physiological signaling processes involved in cell growth, differentiation, apoptosis, and fibrosis. Detectable intracellular levels of ROS can be induced by the electron leakage from mitochondrial respiratory chain as well as by activation of cytochrome p450, glucose oxidase and xanthine oxidase, leading to oxidative stress. The up-regulation and the hyper-activation of NADPH oxidases (Nox) also likely contribute to oxidative stress in pathophysiologic stages. Elevation of the renal ROS level through hyperglycemia-mediated Nox activation results in the oxidative stress which induces a damage to kidney tissues, causing to diabetic nephropathy (DN). Nox inhibitors are currently being developed as the therapeutics of DN. In this review, we summarize Nox-mediated ROS generation and development of Nox inhibitors for therapeutics of DN treatment.

PURPOSE: To Analyze the Clinical Results of the Total Knee Arthroplasty without Patellar Resurfacing. MATERIALS AND METHODS: One hundred and eight Total Knee Arthroplasties (Nexgen(R), Zimmer, USA) without resurfacing of the patella, were performed between February 1995 and September 1999, and 89 cases followed up for more than 36 months were analyzed in this study. The follow up period ranged from 36 to 70 months (average 52 months). The diagnosis was degenerative joint disease in 83 cases (93%), rheumatoid arthritis in 5 cases (6%) and avascular necrosis of medial femoral condyle in 1 case (1%). The clinical results were evaluated according to Knee Society Clinical Rating System. RESULTS: The mean preoperative knee score was 34 points (range 5-63 points) according to the Knee Society Clinical Rating System, and the mean preoperative functional score was 38 points (range, 10-61 points). The mean postoperative knee score was 91 points (range 65-98 points) and the mean postoperative functional score 89 points (range, 63-100 points). The current study shows that patellar complications associated with unresurfacing did not occur, with the exception of 2 cases of persistent peripatellar pain, which resolved by a postoperative 6 months with conservative treatment. The patellofemoral joint space was also well preserved even at the 3 and 5 year follow-ups. CONCLUSION: Complications of total knee arthroplasty, such as patellar dislocation or subluxation, rupture of the patellar tendon, and fracture of the patella, can be avoided by not resurfacing the patella. On the basis of our results, there is little evidence to support routine patellar resurfacing in total knee arthroplasty.
Arthritis, Rheumatoid ; Arthroplasty* ; Diagnosis ; Follow-Up Studies ; Joint Diseases ; Knee* ; Necrosis ; Patella ; Patellar Dislocation ; Patellar Ligament ; Patellofemoral Joint ; Rupture

A 41-year-old woman with a 2-month history of diffused swelling and persistent dull pain in her right shoulder was examined. Magnetic resonance imaging (MRI) findings revealed subdeltoid bursitis and rice bodies with normal surrounding tissue and shoulder joint. Arthoscopic debridement and biopsy of the subdeltoid bursa were performed. Histologic examination of the bursal tissue showed granulomatous tissue with typical caseous necrosis. A positive culture of Mycobacterium tuberculosis confirmed the diagnosis of tuberculosis. We report on the clinical, radiological and athological findings in a patient with tuberculous subdeltoid bursitis accompanied by multiple rice body formation without coexisting active bone and joint tuberculosis, and conduct a literature review.
Adult ; Bursitis/diagnosis/*pathology/surgery ; Case Report ; Female ; Human ; Magnetic Resonance Imaging ; Tuberculosis, Osteoarticular/diagnosis/*pathology/surgery

PURPOSE: Superior oblique myokymia is intermittent spontaneous contractions of the superior oblique muscle presenting as rapid and small-amplitude intorsions and depressions of the eye. The authors report a case of superior oblique myokymia that was objectively and quantitatively diagnosed with slit lamp examination and video-oculography and completely resolved with medical treatment. CASE SUMMARY: A 44-year-old woman presented with a seven-year history of intermittent oscillopsia which continued for few seconds. She had no history of head trauma or systemic ocular disease, and the anterior segment and fundus examination were unremarkable. Right eye intorsion lasting for a few seconds as detected by slit lamp examination. Eye movements were recorded using video-oculography, which showed a torsional nystagmus of 5 to 10 degrees with 2 to 5 vertical components in the right eye. Based on these findings, the patient was diagnosed with superior oblique myokymia. The patient was prescribed topical timolol ophthalmic solution, one drop twice per day, but the symptoms persisted. Timolol ophthalmic solution was stopped and replaced with carbamazepine, 200 mg twice a day, which resolved her symptoms. CONCLUSIONS: Slit lamp examination and video-oculography can be used as objective and quantitative diagnostic tools in order to confirmed a diagnosis and lead to proper treatment.
Adult ; Carbamazepine ; Craniocerebral Trauma ; Depression ; Diagnosis* ; Eye Movements ; Female ; Humans ; Slit Lamp ; Timolol ; Trochlear Nerve Diseases*

BACKGROUND: To determine the benefit of an extensively porous coated femoral stem in patients receiving revision total hip arthroplasty. METHODS: This study reviewed the results of 35 patients who received a revision total hip arthroplasty with extensively porous coated femoral stem between August, 1996, and December, 2002. The mean follow-up period was 77.5 months. The clinical and radiological results were evaluated by the Harris hip score and serial roentgenographic findings. RESULTS: The preoperative and postoperative Harris hip score was 68.3 and 92.5, respectively. Radiographically, none of the acetabular components showed any evidence of migration, tilt, rotation, or shedding of metal particles. In addition, none of the femoral components showed evidence of subsidence, pedestal, or shedding of metal particles. Twenty-two hips had a mild stress shield and 2 hips had a moderate stress shield. The perioperative complications encountered were deep vein thrombosis (1 case), mild heterotopic ossification (4 cases), intraoperative periprosthetic fractures (1 case), and nonunion of the trochanteric osteotomy site (2 cases). CONCLUSIONS: Extensively porous coated femoral stems and acetabular components produce excellent clinical and radiological results in revision total hip arthroplasty.
Aged ; *Arthroplasty, Replacement, Hip ; *Coated Materials, Biocompatible ; Female ; *Hip Prosthesis ; Humans ; Male ; Middle Aged ; Porosity ; Reoperation

PURPOSE: In the present study, a case of IgG4-related ophthalmic disease which met the 2015 IgG4-related ophthalmic disease diagnostic criteria is reported and literature review performed. CASE SUMMARY: A 51-year-old female presented with both upper eyelid swelling, redness, and a palpable mass. Eye movements were normal and exophthalmos was not observed. Facial computed tomography showed both lacrimal gland hypertrophy. The patient underwent left anterior orbitotomy with incisional biopsy. Immunostained biopsy showed the ratio of IgG4+ to IgG+ cells was 50% and the mean number of IgG4-positive plasma cells was approximately 150 per high-power field. Hematological examination showed elevated serum IgG4 concentrations of 6,930 mg/dL, however, other organs were not involved. The patient satisfied the diagnostic criteria for IgG4-related ophthalmic disease. The patient was given an oral steroid and immunosuppressant and the symptoms improved. CONCLUSIONS: IgG4-related ophthalmic disease is currently receiving increased attention. The authors of the present study report a case of IgG4-related ophthalmic disease which met the 2015 IgG4-related ophthalmic disease diagnostic criteria.
Biopsy ; Exophthalmos ; Eye Movements ; Eyelids ; Female ; Humans ; Hypertrophy ; Immunoglobulin G ; Lacrimal Apparatus ; Middle Aged ; Plasma Cells

OBJECTIVES: This study aimed to estimate the financial budget of light-curing composite resin fillings based on the expanded coverage of the National Health Insurance Service (NHIS), called “Moon Care.” METHODS: The estimated population with dental caries and the amount of light-curing composite resins used were determined. The fees for the resin fillings per tooth were considered for the calculations. The expected budget for the next five years for children and adolescents aged 5–12 and 5–19 years were calculated. RESULTS: During the first year of the coverage, the budget for children and adolescents aged <19 years was estimated to be 201.8 billion South Korean won (5–9 years, 17.9 billion South Korean won; 10–14 years, 76.6 billion South Korean won; and 15–19 years, 107.3 billion South Korean won). The total budget for the next five years for children and adolescents aged <19 years was estimated at 946.4 billion South Korean won. Likewise, the budget for children aged <12 years during the first year of the coverage was estimated at 63.9 billion South Korean won (5–9 years, 17.9 billion South Korean won and 10–12 years, 46 billion South Korean won), and the total budget for the next five years was estimated at 315.9 billion South Korean won. CONCLUSIONS: Government healthcare plans should be established based on treatment needs and financial estimations. All the items in the NHIS, including the light-curing composite resin filling, should be considered based on their contribution to oral health promotion. Furthermore, in the long term, the coverage for preventive health services should be included in the health insurance.
Adolescent ; Budgets ; Child ; Composite Resins ; Delivery of Health Care ; Dental Caries ; Fees and Charges ; Humans ; Insurance, Health ; National Health Programs ; Oral Health ; Preventive Health Services ; Tooth

Objective: To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses. Methods: The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines. Results: The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1–2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age. Conclusions The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.