PURPOSE: To identify the characteristics of adult patients who develop acute concomitant esotropia during adulthood. METHODS: Using a retrospective noncomparative method, this study evaluated the medical charts of 10 adults who were diagnosed with acute onset esotropia between January 2003 and May 2005. All patients presented the symptoms of estotropia when they were older than age 18. All patients in the study group had no previous ocular history, no cause of interruption of fusion, no history of systemic disease or head trauma, and no abnormal findings on neurologic examination. RESULTS: The average follow-up period was 10.8 months (range, 5 ~ 17 months). The mean age was 44.7 years (range, 18 ~ 62 years). The average refractive error was -1.43 diopter (range, -5.50 ~ +0.50 diopter). An operation was performed in one case. The prism diopter decreased according to follow-up in other patients. CONCLUSIONS: There are characteristics of acute onset esotropia of adulthood that differentiate it from existing esotropia. Almost all patients were myopic, showed nearly the same prism diopter between near and far vision, and deviation improved with follow-up.
Adult ; Craniocerebral Trauma ; Esotropia* ; Follow-Up Studies ; Humans ; Neurologic Examination ; Refractive Errors ; Retrospective Studies

PURPOSE: To study the relationship between the concentration of ascorbic acid in the anterior chamber and the complications of an experimental alkali burn in rabbit corneas. METHODS: Standardized corneal alkali wounds were induced in both eyes of 33 albino rabbits by applying a 5.5 mm-sized round filter paper, soaked in 1N NaOH for 20 seconds. Then, the control group (22 eyes) was given Tears Natural II(R) (Alcon), treated group A (22 eyes) was given ascorbic acid (10%) for 2 hours, and treated group B (22 eyes) was given ascorbic acid (10%) for 6 hours. The concentrations of ascorbic acid in the anterior chamber were measured using a microplate assay immediately post-injury, and at 5 days, 15 days, and 30 days post-injury. During the experiment, clinical observation was performed to detect complications such as corneal ulcer or perforation. RESULTS: The incidence of ulceration was significantly lower between control group and treated groups A and B (p<0.05). The incidence of perforation was significantly lower in treated group A compared to the control group B (p<0.05). In addition, a higher concentration of ascorbic acid in the anterior chamber and a lower severity of corneal injury was significant (sigma=-0.302, P<0.05). CONCLUSIONS: Higher concentrations of ascorbic acid in the anterior chamber were associated with fewer complications in experimental alkali burns in rabbit corneas.
Alkalies ; Anterior Chamber* ; Ascorbic Acid* ; Burns ; Cornea ; Corneal Ulcer ; Incidence ; Rabbits ; Ulcer ; Wounds and Injuries

Here we present the first report of a gangliocytic paraganglioma arising in a tailgut cyst; it occurred in a 56-year-old man. Tailgut cysts are uncommon congenital hamartomatous lesions that arise in the retrorectal presacral space in infants or adults. Benign or malignant tumors associated with tailgut cysts are rarely described; the most common tumors are adenocarcinomas and carcinoid tumors. A gangliocytic paraganglioma is a rare benign tumor that occurs nearly exclusively in the second portion of the duodenum. Rare cases have been reported at other locations, but a tailgut cyst has never been described. In our case, a resected 3.9 x 3.3 x 3 cm mass was composed predominantly of a solid yellow white neuroendocrine tumor within the area of a tailgut cyst. The neuroendocrine component of this tumor was different from previously described carcinoid tumors with respect to the histologic findings of neural differentiation as well as the intermixed typical gangliocytic features highlighted by immunohistochemical stains for S-100 protein and neurofilament. Although an intermixed area of the tailgut cyst and gangliocytic paraganglioma were found in some areas, the pathogenesis of this tumor remains to be elucidated.
Adenocarcinoma ; Adult ; Carcinoid Tumor ; Coloring Agents ; Duodenum ; Hamartoma ; Humans ; Infant ; Middle Aged ; Neuroendocrine Tumors ; Paraganglioma ; S100 Proteins

Background and Objectives: Cancer organizations worldwide have recently released care guidelines for cancer patients with coronavirus disease 2019 (COVID-19). Several studies have reported higher mortality rates in cancer patients with COVID-19. However, drawing robust conclusions remains challenging due to a lack of research on clinical prognostic factors in this patient group. Methods: A comprehensive literature search was conducted using the PubMed, Embase, and Cochrane databases. We searched the keywords in the following combination: (“COVID-19” or “coronavirus” or “wuhan virus”) and (“cancer”). The search was performed on August 1, 2020, and only papers written in English were included in this study. We collected data from 3,215 cancer patients with COVID-19 from 16 studies and analyzed overall mortality after COVID-19 infection in cancer patients compared to controls, as well as prognostic factors for severity and mortality after COVID-19 infection. The prognostic factors analyzed encompassed demographics, comorbidities, symptoms, cancer treatment within 4 weeks of COVID-19 diagnosis, and treatment for COVID-19 infection. Results: This meta-analysis evaluated mortality rates and related prognostic factors in cancer patients infected with COVID-19. First, 15 of the 16 studies reported mortality data; 663 patients died among a total of 3,215 people, resulting in a combined mortality rate of 21%. Second, the following poor prognostic factors were identified: male sex, older age (≥65 years), respiratory symptoms (e.g., cough and dyspnea), and other comorbidities (e.g., cardiovascular disease, hypertension, and chronic obstructive pulmonary disease). Conclusion The mortality of cancer patients infected with COVID-19 can reach about 20%.

No abstract available.

No abstract available.
Adhesives*

The subaxial screw fixation technique is commonly used for fixation in a wide range of cervical diseases, including traumatic, degenerative, and neoplastic diseases, rheumatoid arthritis (RA), and spondyloarthropathy. Although it is regarded as a relatively safe procedure, several complications may be encountered during surgery, such as vertebral artery (VA) and nerve root injuries, facet violation, and mass fracture. We report a case of endovascular embolization after VA injury during a high cervical spinal surgery. A 48-year-old woman was scheduled for C-1-2-3 posterior fixation. Plain radiography of the cervical spine revealed a severely unstable state. During dissection around the C1 lateral mass on the right side, sudden brisk arterial bleeding was observed. On vertebral angiography, flow voiding was noted above the right V3 portion. After checking patent collateral flow from the contralateral VA, routine coil embolization was performed to pack the V3 segment. Iatrogenic vascular injuries due to spinal surgery are rare but serious complications. For patients with RA, we recommend careful preoperative evaluation before a high cervical surgical procedure to avoid iatrogenic VA injury and endovascular interventions that are safe and effective in the diagnosis and treatment of such vascular injuries.

Transarterial chemoembolization (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC). It is considered relatively safe. However, fatal complications such as pulmonary edema and liver abscesses can occur. Spinal infarction due to local embolism of the central nervous system after TACE is a very rare, but fatal complication. Here, we report a case of spinal cord infarction after TACE for ruptured HCC. Paraplegia occurred at the T10 sensory level 6 hours after the procedure. The patient received steroid megadose therapy but died 5 days later due to exacerbation of metabolic acidosis and blood loss. This case demonstrates the need for a comprehensive and extensive study of arterial blood flow prior to angiography.

Objective: Subdural hygroma (SDG) is a complication of traumatic brain injury (TBI). In particular, the outcome and outpatient treatment period may vary depending on the occurrence of SDG. However, the pathogenesis of SDG has not been fully elucidated. Therefore, this study aimed to identify the risk factors associated with the occurrence of SDG after mild TBI. Methods: We retrospectively analyzed 250 patients with mild TBI admitted to a single institution between January 2021 and December 2021. The SDG occurrence and control groups were analyzed according to the risk factors of SDG, such as age, history, initial computed tomography (CT) findings, and initial laboratory findings. Results: The overall occurrence rate of SDG was 31.6% (n=79). A statistically significant association was found between preoperative diagnoses and the occurrence of SDG, such as subarachnoid hemorrhage (odds ratio [OR], 2.36; 95% confidence interval [CI], 1.26–4.39) and basal skull fracture (OR, 0.32; 95% CI, 0.12–0.83). Additionally, age ≥70 years (OR, 3.20; 95% CI, 1.74–5.87) and the use of tranexamic acid (OR, 2.12; 95% CI, 1.05–4.54) were statistically significant factors. The prognostic evaluation of patients using the Glasgow Outcome Scale (GOS) did not show any statistical differences between patients with and without SDG. Conclusion SDG was not associated with the prognosis of patients assessed using the GOS. However, depending on the occurrence of SDG, differences in patient symptoms may occur after mild TBI. Therefore, the early evaluation of patients with mild TBI and determination of the probability of developing SDG are important.