PURPOSE: This study is executed to identify and report the treatment effects of oral mucosa grafting of prosthetic eye patients who have shallow conjunctival socket caused by socket contraction. METHODS: Conjunctival sac reconstruction was performed by using the lower lip mucosa to 11 eyes of 11 patients diagnosed with contracted conjunctival sac at the ophthalmic clinic from August 2009 to May 2015, and a retrospective analysis was performed with medical record data from the patients who were followed-up after surgery. RESULTS: Within the follow-up period, prosthetic eye insertion was possible for all 11 eyes of the 11 patients. All of them were satisfied in an aesthetic aspect, and were able to maintain deep conjunctival sac without receving findings of graft absorption, or re-contracted or shallow conjunctival sac during the follow-up period. On the donor region, normal epithelialization occurred. Concerning the donor region for the first week after surgery, the mean score of the patients' pain was 3.18 +/- 0.94 points measured by a numerical rating scale, and no infection, bleeding, contraction, or cicatrix was revealed during the follow-up period. There were hypoesthesia, pararthria, and paresthesia (tingling sense) for post-complications from the donor region, and four patients out of the 11 patients complained of discomfort resulting from post-complications; whereas the remaining seven patients did not complain of discomfort. CONCLUSIONS: Oral mucosa can be considered as a good graft for contracted conjunctival sac reconstruction for patients who cannot wear a prosthetic eye.
Absorption ; Cicatrix ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypesthesia ; Lip ; Medical Records ; Mouth Mucosa* ; Mucous Membrane ; Paresthesia ; Retrospective Studies ; Tissue Donors ; Transplants*

No abstract available.
Compressed Air* ; Explosions* ; Orbit* ; Orbital Cellulitis*

PURPOSE: To investigate the clinical presentation and treatment outcomes of recurrent corneal erosion patients. METHODS: Retrospective analysis was performed on the medical records of 48 patients (53 eyes) diagnosed with recurrent corneal erosion by our ophthalmology department between January 2008 and March 2015. Patient age, gender, lesion location, and cause of disease were analyzed against occurrence of disease. Patients were classified by treatment method into group A, which was treated with eye drops; group B, which was treated with therapeutic contact lenses and eye drops; group C, which was treated with amniotic membrane transplantation; and group D, which was treated with other procedures, and the recurrence rates were compared. RESULTS: The mean age of patients was 45.6 ± 14.3 years (19-76 years), with no significant difference in recurrence rates dependent on gender or eye. Patients in their 50s were most affected, excluding refractive surgery patients. The most frequent lesion location was the inferior area of the cornea (58.5%), followed by the central area (30.2%), and the most common cause of disease was trauma, followed by unknown causes, past refractive surgery, and complications from other eye diseases. Group A had 11 eyes (20.8%), while groups B, C, and D had 30 eyes (56.6%), 8 eyes (15.1%) and 4 eyes (7.3%), respectively. The recurrence rates according to treatment method were 27.3% in group A, 23.3% in group B, and 12.5% in group C. The lower recurrence rate in the group treated with amniotic membrane transplantation was not significant compared to that of conservatively treated groups. CONCLUSIONS: Recurrent corneal erosion mostly affects patients in their 50s, excluding refractive surgery patients, and occurs frequently in the inferior area of the cornea due to mild trauma. Surgical treatment including amniotic membrane transplantation should be considered instead of conservative treatment in order to prevent reoccurrence.
Amnion ; Contact Lenses ; Cornea ; Eye Diseases ; Humans ; Medical Records ; Ophthalmic Solutions ; Ophthalmology ; Recurrence ; Refractive Surgical Procedures ; Retrospective Studies

PURPOSE: To investigate the clinical presentation and treatment outcomes of recurrent corneal erosion patients. METHODS: Retrospective analysis was performed on the medical records of 48 patients (53 eyes) diagnosed with recurrent corneal erosion by our ophthalmology department between January 2008 and March 2015. Patient age, gender, lesion location, and cause of disease were analyzed against occurrence of disease. Patients were classified by treatment method into group A, which was treated with eye drops; group B, which was treated with therapeutic contact lenses and eye drops; group C, which was treated with amniotic membrane transplantation; and group D, which was treated with other procedures, and the recurrence rates were compared. RESULTS: The mean age of patients was 45.6 ± 14.3 years (19-76 years), with no significant difference in recurrence rates dependent on gender or eye. Patients in their 50s were most affected, excluding refractive surgery patients. The most frequent lesion location was the inferior area of the cornea (58.5%), followed by the central area (30.2%), and the most common cause of disease was trauma, followed by unknown causes, past refractive surgery, and complications from other eye diseases. Group A had 11 eyes (20.8%), while groups B, C, and D had 30 eyes (56.6%), 8 eyes (15.1%) and 4 eyes (7.3%), respectively. The recurrence rates according to treatment method were 27.3% in group A, 23.3% in group B, and 12.5% in group C. The lower recurrence rate in the group treated with amniotic membrane transplantation was not significant compared to that of conservatively treated groups. CONCLUSIONS: Recurrent corneal erosion mostly affects patients in their 50s, excluding refractive surgery patients, and occurs frequently in the inferior area of the cornea due to mild trauma. Surgical treatment including amniotic membrane transplantation should be considered instead of conservative treatment in order to prevent reoccurrence.
Amnion ; Contact Lenses ; Cornea ; Eye Diseases ; Humans ; Medical Records ; Ophthalmic Solutions ; Ophthalmology ; Recurrence ; Refractive Surgical Procedures ; Retrospective Studies

Thyrotoxic periodic paralysis (TPP) is a transient illness characterized by muscle weakness often associated with hypokalemia during thyrotoxic state. Hypokalemia is induced by thyroid hormone excess through stimulation of Na-K ATPase which pumps extracellular potassium ions into the cell. Muscle weakness resolves when serum potassium level is corrected, but the condition may recur when there is thyrotoxicosis. TPP is most commonly reported in Asian males aged between 20 to 40 years and it is rare in children and adolescents. We report a 16-year-old patient previously diagnosed with Graves' disease who showed recurrent episodes of TPP.
Adenosine Triphosphatases ; Adolescent ; Aged ; Asian Continental Ancestry Group ; Child ; Graves Disease ; Humans ; Hyperthyroidism ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Ions ; Male ; Muscle Weakness ; Paralysis ; Potassium ; Thyroid Gland ; Thyrotoxicosis

Thyrotoxic periodic paralysis (TPP) is a transient illness characterized by muscle weakness often associated with hypokalemia during thyrotoxic state. Hypokalemia is induced by thyroid hormone excess through stimulation of Na-K ATPase which pumps extracellular potassium ions into the cell. Muscle weakness resolves when serum potassium level is corrected, but the condition may recur when there is thyrotoxicosis. TPP is most commonly reported in Asian males aged between 20 to 40 years and it is rare in children and adolescents. We report a 16-year-old patient previously diagnosed with Graves' disease who showed recurrent episodes of TPP.
Adenosine Triphosphatases ; Adolescent ; Aged ; Asian Continental Ancestry Group ; Child ; Graves Disease ; Humans ; Hyperthyroidism ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Ions ; Male ; Muscle Weakness ; Paralysis ; Potassium ; Thyroid Gland ; Thyrotoxicosis

OBJECTIVE: To determine the safety and efficacy of immune ablation followed by autologous hematopoietic stem cell transplantation (HSCT) in refractory systemic lupus erythematosus (SLE). METHODS: Three patients who had been refractory to steroid and one or more immunosuppressive drug were included. Peripheral blood stem cells were mobilized with cyclophosphamide (CTX, 3 g/m(2)), followed by granulocyte-colony stimulating factor (5mug/kg/day). T lymphocytes were depleted from the graft by selection of CD34 positive cells. Conditioning regimens composed of high dose CTX (total dose 200 mg/kg) and anti-thymocyte globulin (total dose 90 mg/kg) in 2 patients and BEAM (BCNU 300 mg/m(2), etoposide 200 mg/m(2), cytarabine 200 mg/m(2), melphalan 200 mg/m(2)) in 1 patient. Stored stem cells were reinfused 48 hours after conditioning. RESULTS: Among 3 patients, first patient had lupus nephritis, second patient had overlap syndrome combined with rheumatoid arthritis (rhupus) and the last patient had severe thromobocytopenia and intractable polyserositis. No life threatening complications were observed during the treatment. All patients demonstrated rapid and marked improvement in organ function and quality of life just after HSCT. Previous massive proteinuria in first patient was decreased to less than 500 mg/day with 6 months follow up. Rhupus patient satisfied American college of rheumatology 70% response criteria with 3 months follow up. But third patient improved polyserositis dramatically 1 month after HSCT and relapsed at 9 weeks. CONCLUSION: In refractory SLE patients, HSCT can be performed safely with marked improvement and sustained withdrawal of all immunosuppressive medication. A further randomized trial is needed to confirm the efficacy and durability of remission.
Antilymphocyte Serum ; Arthritis, Rheumatoid ; Cyclophosphamide ; Cytarabine ; Etoposide ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Melphalan ; Proteinuria ; Quality of Life ; Rheumatology ; Stem Cells ; T-Lymphocytes ; Transplants

BACKGROUND: Rosacea is a common and well known chronic cutaneous disease. The typical symptoms are cosmetic problems, and the recurrent nature of rosacea requires long term treatments that might have a profound effect on the quality of life (QOL) and mental health of these patients. However, there have been only epidemiological studies on Rosacea in the Korean dermatologic literature. OBJECTIVE: The aim of this study was to evaluate the QOL, psychosocial stress, anxiety and depression levels in Korean patients with rosacea and to determine the factors that have an impact on the QOL of rosacea patients. METHODS: A cross-sectional study was conducted on thirty-three adults with rosacea and who had visited our department and thirty-five healthy volunteers with no dermatologic disease or other chronic illness. The rosacea patients were diagnosed by dermatologists who decided the rosacea subtypes before the patients were enrolled in this study. The patients' subjective perceptions of severity were assessed using the Likert scales and the QOL was assessed using Skindex-29. The mental health interview included the psychosocial well-being index-short form (PWI-SF), the trait anxiety inventory (TAI) and the Beck depression inventory (BDI) as measures of psychosocial stress, anxiety and depression, respectively. The QOL, PWI-SF, TAI and BDI scores of the rosacea patients were compared with those of the controls. The subjective perceptions of severity, QOL and the PWI-SF, TAI and BDI scores were also compared between the erythemato-telangiectatic type patients and the papulopustular type rosacea patients. RESULTS: As compared with the controls (n=35), the rosacea patients (n=33) had a significantly decreased QOL (p=0.000). The scores of the PWI-SF, TAI and BDI for patients with rosacea were higher than those of the controls, meaning the rosacea patients had more psychosocial stress, anxiety and depression (p=0.000, 0.000, 0.001). No significant differences in the subjective perception of severity, QOL and mental health were found between the erythemato-telangiectatic and papulopustular type patients (p=0.825, 0.438, 0.268, 0.631). The high self-reported subjective perception of severity, psychosocial stress and anxiety showed significant correlations with low QOL. CONCLUSION: These results indicate that rosacea has a large impact on the patients' QOL and mental health. Taking into account the patients' subjective perception of disease severity and mental health as potential determinants of the QOL of rosacea patients, more attention and effort should be given to develop Korean versions of rosacea-specific QOL instruments as these might more accurately and objectively indicate the severity of the disease.
Adult ; Anxiety ; Chronic Disease ; Cosmetics ; Cross-Sectional Studies ; Depression ; Epidemiologic Studies ; Humans ; Mental Health ; Quality of Life ; Rosacea ; Weights and Measures

Toxocariasis is an important cause of secondary hypereosinophilia in Korea. Here, we describe a rare case of toxocariasis presenting as transient global amnesia due to secondary hypereosinophilia. A 44-year-old male visited the Emergency Department (ED) for transient global amnesia. He ate raw cow liver and omasum 2 weeks before the ED visit. The initial peripheral blood eosinophil count was 15,250/µL and serologic test for serum specific IgG antibodies to Toxocara canis larval antigen was positive. Radiologic studies revealed multiple small embolic infarctions of brainwithout cardioembolic sources or vascular abnormalities. He was treated with systemic corticosteroid, and neither neurologic deficit nor motor deficit was left. In our current case, the patient have a history of frequently eating raw cow liver and omasum, and his total IgE level was extremely high (>5,000 IU/mL). Thus, the patient was diagnosed as having toxocariasis and secondary hypereosinophilia. Toxocariasis should be considered in the differential diagnosis in patients with eosinophilia and atypical neurologic symptoms, such as transient amnesia.
Adult ; Amnesia ; Amnesia, Transient Global* ; Antibodies ; Cerebral Infarction ; Diagnosis, Differential ; Eating ; Emergency Service, Hospital ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Infarction ; Korea ; Liver ; Male ; Neurologic Manifestations ; Omasum ; Serologic Tests ; Toxocara canis ; Toxocariasis*

BACKGROUND/AIMS: Low-dose aspirin therapy is widely used to prevent cardiovascular thrombotic events. However, the safety of low-dose aspirin therapy in the gastrointestinal tract is uncertain. Our aim was to evaluate endoscopic findings in patients taking low-dose aspirin. METHODS: Sixty-two patients who received 100 mg enteric coated aspirin daily more than 30 days were included in this study. Patients' medical records and endoscopic data were reviewed retrospectively. As controls, 70 of age- and gender-matched patients who received an endoscopy without gastrointestinal symptoms were employed. RESULTS: The overall prevalence of gastroduodenal mucosal injury was higher in the aspirin group than in the control group. Erosive gastritis was noted more frequently in the aspirin group than in the control group. However, the prevalence of ulcer was not different between the aspirin group and the control group. CONCLUSIONS: Patients treated with low-dose aspirin therapy are more likely to have endoscopic evidence of mucosal damage. Our study suggests that even a low-dose aspirin therapy can induce a gastroduodenal mucosal injury. In the future, a prospective randomized control study is needed.
Aged ; Aspirin/administration & dosage/*adverse effects ; Cardiovascular Diseases/prevention & control ; Esophagitis/chemically induced ; Female ; Gastritis/chemically induced ; Gastrointestinal Diseases/*chemically induced ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/administration & dosage/*adverse effects ; Tablets, Enteric-Coated/adverse effects