PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.
Aged ; Anesthesia ; Anterior Chamber ; Conjunctiva ; Cryotherapy ; Female ; Glaucoma ; Humans ; Ischemia* ; Mannitol ; Muscles ; Ophthalmic Artery ; Paracentesis ; Retinal Artery Occlusion ; Retinal Detachment ; Retinal Perforations ; Young Adult

To examine the relationship between birth characteristics and childhood cancer mortality, a retrospective cohort study of Korean children was conducted using data collected by the national birth register between 1995 and 2006, which were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until their death or until December 31, 2006. Poisson regression analyses were used to calculate rate ratios of childhood cancer deaths according to birth characteristics. A total of 1,469 cancer deaths were noted and the childhood cancer mortality rate was found to be 3.43 per 100,000 person-years in Korea during the period of 1995-2006. The birth characteristics examined in this study (i.e. , birth weight, gestational age, multiple births, parental ages, and number of siblings) were generally found to be not significantly associated with childhood cancer mortality, and the associations did not vary meaningfully with gender nor with cancer sites. However, among children aged 5-11 yr, higher birth weight was associated with elevated childhood cancer mortality (rate ratio = 1.28, 95% confidence interval 1.04-1.58). Our results offer no overall associations between childhood cancer mortality and birth characteristics, but suggest that the association may be specific to age group.
Birth Weight ; Child ; Child, Preschool ; Cohort Studies ; Gestational Age ; Humans ; Multiple Birth Offspring ; Neoplasms/*mortality ; Parents ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Siblings ; Socioeconomic Factors

BACKGROUND AND OBJECTIVES: Transcanal antrotomy approach (TCA) enables not only good exposure but also minimal incision approach required for pediatric congenital cholesteatoma (CC). The addition of "CO2 laser enabled ablation and resection (CLEAR)" would facilitate safe and complete removal of CC from stapes. This study evaluates the clinical results of surgically removing CC through TCA with CLEAR (minimal incision approach with CO2 laser, MICL). SUBJECTS AND METHOD: The medical records of patients who underwent endaural extended tympanostomy, MICL, or postauricular approach for CC removal from January 2009 to September 2011 were reviewed in this study. RESULTS: MICL was performed in 37 patients of Potsic I, II CC. It was effective in surgical exposure and reducing the chance of residual CC. MICL could satisfactorily avoid postauricular tympanomastoidectomy, which allowed preservation of healthy mastoid air cells for almost all Potsic III CC, including posterior CC (14 patients). MICL was also useful for 6 cases of Potsic IV CC that extended beyond the incus posterosuperiorly to the auditus ad antrum. Children were not committed to second look operation because the attic was exteriorized with-out the cavity problem and the complete removal of CC from the stapes was facilitated with CLEAR. CONCLUSION: MICL enabled sufficient exposure with less invasive approach as well as complete CC removal, which reduced the postoperative complications and needs for second look operation. This surgical technique could be widely used for Potsic stage I, II, III, and some IV CC.
Child ; Cholesteatoma ; Ear Neoplasms ; Humans ; Incus ; Lasers, Gas ; Mastoid ; Medical Records ; Middle Ear Ventilation ; Postoperative Complications ; Stapes

OBJECTIVES: Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.
Adult ; Agriculture/*statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure/prevention & control/*statistics & numerical data ; *Pesticides ; Protective Clothing ; Self Report

Background: Since image-based fracture prediction models using deep learning are lacking, we aimed to develop an X-ray-based fracture prediction model using deep learning with longitudinal data. Methods: This study included 1,595 participants aged 50 to 75 years with at least two lumbosacral radiographs without baseline fractures from 2010 to 2015 at Seoul National University Hospital. Positive and negative cases were defined according to whether vertebral fractures developed during follow-up. The cases were divided into training (n=1,416) and test (n=179) sets. A convolutional neural network (CNN)-based prediction algorithm, DeepSurv, was trained with images and baseline clinical information (age, sex, body mass index, glucocorticoid use, and secondary osteoporosis). The concordance index (C-index) was used to compare performance between DeepSurv and the Fracture Risk Assessment Tool (FRAX) and Cox proportional hazard (CoxPH) models. Results: Of the total participants, 1,188 (74.4%) were women, and the mean age was 60.5 years. During a mean follow-up period of 40.7 months, vertebral fractures occurred in 7.5% (120/1,595) of participants. In the test set, when DeepSurv learned with images and clinical features, it showed higher performance than FRAX and CoxPH in terms of C-index values (DeepSurv, 0.612; 95% confidence interval [CI], 0.571 to 0.653; FRAX, 0.547; CoxPH, 0.594; 95% CI, 0.552 to 0.555). Notably, the DeepSurv method without clinical features had a higher C-index (0.614; 95% CI, 0.572 to 0.656) than that of FRAX in women. Conclusion DeepSurv, a CNN-based prediction algorithm using baseline image and clinical information, outperformed the FRAX and CoxPH models in predicting osteoporotic fracture from spine radiographs in a longitudinal cohort.

In this study, we investigated profiles of the cytokines IFN-g, IL-12, and IL-10 in active pulmonary tuberculosis (EAPTB) patients, HIV-negative patients with multidrug-resistant tuberculosis (MDR-TB) and in healthy tuberculin reactors (HTR). We studied the responses of peripheral blood mononuclear cells (PBMC) from 12 EAPTB patients and 15 MDR-TB patients to stimulation with a purified protein derivatives (PPD) antigen (Ag), and compared them with those from 14 HTR. Using ELISA, IFN-g production was found to be significantly depressed, while IL-10 was significantly elevated in both MDR-TB and EAPTB after in vitro stimulation with PPD, compared with those in HTR. Although there was no significant difference in IL-12 production among the three groups, mean IL-12 production was highest in patients with MDR-TB. In these patients, IL-12 production was significantly correlated with IL-10 expression, but not IFN-g production. In addition, neutralization of endogenous IL-10 led to enhanced IFN-g and IL-12Rb2 mRNA expression in TB patients. Our findings suggest that both groups of TB patients may have a similar disregulated pattern of IL-12, IL-10, and IFN-g production during M. tuberculosis infection. Furthermore, the results suggest a potentially pathogenic role for IL-10 in impaired Th1 immune responses in TB patients.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interferon-gamma ; Interleukin-10* ; Interleukin-12* ; Mycobacterium tuberculosis ; RNA, Messenger ; Tuberculin ; Tuberculosis ; Tuberculosis, Multidrug-Resistant* ; Tuberculosis, Pulmonary