Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes.
Diagnosis ; Inlays ; Orbit* ; Orbital Fractures ; Surgical Procedures, Operative

Mind-body medicine (MBM) is a field of medicine concerned with the ways that the mind and emotions influence the body and physical health. It may be more accurate to think of mind/body as a single entity, with the health of one part necessarily influencing that of the other. The National Institutes of Health (NIH) defines MBM techniques (MBT) as interventions that use a variety of techniques designed to facilitate the mind's capacity to affect bodily functions and symptoms. MBT offers patients with greater control in their treatment, cheaper alternatives, effective options for managing chronic conditions, and methods for maintaining wellness. Mind-body approaches include guided imagery, meditation, hypnosis, and movement therapies such as dance, tai chi, chi gong, and yoga as well as music and chanting. Such approaches are as old as traditional oriental healing systems and as widespread as seen in Chinese, Indian, and East Asians. Modern Western medicine is now beginning to give MBTs recognition in its importance as well as efficacy. This article reviews the medical literatures on the techniques that have been studied the most: relaxation therapy, meditation, hypnosis, cognitive-behavioral therapy guided imagery, and biofeedback.
Asian Continental Ancestry Group ; Biofeedback, Psychology ; Humans ; Hypnosis ; Imagery (Psychotherapy) ; Integrative Medicine ; Meditation ; Mind-Body Therapies ; Music ; National Institutes of Health (U.S.) ; Relaxation Therapy ; Singing ; Tai Ji ; Yoga

Mice deficient in the toll-like receptor (TLR) or the myeloid differentiation factor 88 (MyD88) are resistant to acute liver failure (ALF) with sudden death of hepatocytes. Chalcone derivatives from medicinal plants protect from hepatic damages including ALF, but their mechanisms remain to be clarified. Here, we focused on molecular basis of piperidylmethyloxychalcone (PMOC) in the treatment of TLR/MyD88-associated ALF. C57BL/6J mice were sensitized with D-galactosamine (GalN) and challenged with Escherichia coli lipopolysaccharide (LPS, TLR4 agonist) or oligodeoxynucleotide containing unmethylated CpG motif (CpG ODN, TLR9 agonist) for induction of ALF. Post treatment with PMOC sequentially ameliorated hepatic inflammation, apoptosis of hepatocytes, severe liver injury and shock-mediated death in ALF-induced mice. As a mechanism, PMOC inhibited the catalytic activity of TGF-β-activated kinase 1 (TAK1) in a competitive manner with respect to ATP, displaced fluorescent ATP probe from the complex with TAK1, and docked at the ATP-binding active site on the crystal structure of TAK1. Moreover, PMOC inhibited TAK1 auto-phosphorylation, which is an axis in the activating pathways of nuclear factor-κB (NF-κB) or activating protein 1 (AP1), in the liver with ALF in vivo or in primary liver cells stimulated with TLR agonists in vitro. PMOC consequently suppressed TAK1-inducible NF-κB or AP1 activity in the inflammatory injury, an early pathogenesis leading to ALF. The results suggested that PMOC could contribute to the treatment of TLR/MyD88-associated ALF with the ATP-binding site of TAK1 as a potential therapeutic target.
Adenosine Triphosphate ; Animals ; Apoptosis ; Catalytic Domain ; Chalcone ; Death, Sudden ; Escherichia coli ; Hepatocytes ; In Vitro Techniques ; Inflammation ; Liver ; Liver Failure, Acute* ; Mice ; Myeloid Differentiation Factor 88 ; Phosphotransferases ; Plants, Medicinal ; Toll-Like Receptors

The purpose of this research was to understand the current status of hospital information system(HIS) in Korea. Our main interests were when hospitals adopted each component of HIS and how they developed and managed the system. Structured questionnaires were applied to the department of each hospital in charge of managing information system. All hospitals, 276 in 1997, were included, and among them 93.5% responded. The HIS has been rapidly developed to include medical record management system, order communication system, laboratory information system, and picture archiving and communication system. The software for HIS was developed extramurally in more than half of all hospitals, and usually hardware was secured by buying than leasing them. Recently more hospitals has separated departments for His as independent units in hospital.
Clinical Laboratory Information Systems ; Hospital Information Systems* ; Information Systems ; Korea ; Medical Records ; Surveys and Questionnaires

beta-Glucans are naturally occurring polysaccharides that are produced by bacteria, yeast, fungi, and many plants. Although their pharmacological activities, such as immunomodulatory, anti-infective and anti-cancer effects, have been well studied, it is still unclear how beta-glucans exert their activities. However, recent studies on the beta-glucan receptors shed some light on their mechanism of action. Since beta-glucans have large molecular weights, they must bind surface receptors to activate immune cells. In this review, we summarize the immunopharmacological activities and the potential receptors of beta-glucans in immune cells.
Bacteria ; beta-Glucans ; Fungi ; Light ; Molecular Weight ; Polysaccharides ; Receptors, Immunologic ; Yeasts

BACKGROUND AND OBJECTIVES: The scent survey for screening (SSS) test is a subjective olfactory questionnaire devised for this study. We demonstrated the correlation of the SSS test with other olfactory tests and the efficacy of the SSS test as an olfactory screening test compared to KVSSII. SUBJECTS AND METHOD: A total of 363 patients who visited our ORL outpatient department underwent the SSS test, VAS, and KVSS I and II. The patients were divided into two groups, a group with normal olfactory function and a group with olfactory dysfunction according to the KVSS II test. In each group, the correlations between the olfactory tests were studied, and the cut-off value of the SSS test as a screening test was investigated. RESULTS: There was positive correlation between CCSIT and KVSS I, II, T, D, and I tests and the SSS test in the total group and in the olfactory dysfunction group (p<0.05). The identification test in the KVSS II showed the highest positive correlation. While the cut-off value of normal olfactory function in the KVSS II is 28, the SSS test showed the highest specificity and sensitivity of 74 under an ROC curve. CONCLUSION: The SSS test showed very high correlation with other olfactory tests, especially in an olfactory dysfunction group. This result indicates that the SSS is appropriate as a screening test to select people with olfactory disorder.
Humans ; Mass Screening* ; Methods ; Olfaction Disorders ; Outpatients ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. METHODS: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. RESULTS: Flap survival rate was 53.41%±5.43%, 58.16%±4.80%, 57.08%±5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70±8.40, 35.43±6.41, 37.23±7.15, and 27.20±4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. CONCLUSION: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.
Animals ; Capillaries ; Carbon Dioxide ; Carbon ; Lasers, Gas ; Lidocaine ; Neutrophils ; Rats ; Skin ; Survival Rate ; Vascular Endothelial Growth Factor A

Aloe has been widely used as folk medicine for centuries, especially for skin injury and burns. The aloes consisted of various substances including highly sensitizing agent, anthraquinone and there are few reports of hypersensitivity to aloe in the medical literatures. We report herein a case of hypersensitivity associated with oral aloe agent. A 36-year-old woman was referred for recurrent pruritic hives on various parts of her body 3 days ago. She had been admitted with acute urticaria and hepatitis in another hospital 20 days previously and discharged 1 week ago. On detailed medication history, she had been consuming oral aloe agent since 1 month ago and developed pruritic hives and athralgia following ingestion of oral aloe agent. Abnormalities of liver function were also shown. The patient underwent allergic skin test and showed positive response to aloe.
Adult ; Aloe* ; Burns ; Eating ; Female ; Hepatitis ; Humans ; Hypersensitivity* ; Liver ; Medicine, Traditional ; Skin ; Skin Tests ; Urticaria

BACKGROUNDS/AIMS: There are controversies on the role of iron overload in the mechanism of liver injury in nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the prevalence of peripheral iron overload, and to study the presence of HFE mutations (C282Y, H63D, S65C) in a cohort of Korean NAFLD patients. METHODS: 255 patients with NAFLD were included. The patients had been diagnosed as having NAFLD by the criteria of elevated aminotransferase levels, compatible ultrasonographic findings and exclusion of other etiologies. Blood samples were tested for chemistry, iron profile, and mutational analysis for HFE gene (C282Y, H63D, S65C). RESULTS: Of the 255 NAFLD patients, the prevalence of peripheral iron overload was 19.2% according to the cutoff level of transferrin saturation (TS) > 45%, and 3.9% of NAFLD patients were having hyperferritinemia over 400 ng/mL. Hyperferritinemia was significantly associated with elevated serum levels of fasting glucose, AST and TS. We found the presence of H63D mutation, either heterozygote or homozygote, among the NAFLD patients with peripheral iron overload. CONCLUSIONS: The prevalence of peripheral iron overload in the Korean NAFLD patients was not rare, and the presence of H63D mutation among NALFD patients was identified. Further studies on the significance of iron overload or HFE mutation in the pathogenesis of NAFLD are needed.
Adult ; Cohort Studies ; Fatty Liver/*etiology/genetics ; Female ; Heterozygote ; Histocompatibility Antigens Class I/*genetics ; Homozygote ; Humans ; Iron Overload/complications/*epidemiology ; Korea ; Male ; Membrane Proteins/*genetics ; Middle Aged ; Point Mutation ; Prevalence ; Transferrin/metabolism

BACKGROUND: Various surgical methods for repairing medial orbital wall fractures have been introduced. The conventional technique requires total separation of the displaced orbital bones from the orbital soft tissues. However, subperiosteal dissection around the fracture can cause additional damage. The aim of the present study is to introduce a method of reconstructing medial orbital wall fractures without subperiosteal dissection named the “push-out” technique. METHODS: Six patients with post-traumatic enophthalmos resulting from an old medial orbital wall fracture and 10 patients with an acute medial orbital wall fracture were included. All were treated with the push-out technique. Postoperative computed tomography (CT) was performed to assess the correct positioning of the implants. The Hertel scale and a comparison between preoperative and postoperative orbital volume were used to assess the surgical results. RESULTS: Restoration of the normal orbital cavity shape was confirmed by examining the postoperative CT scans. In the old fracture group, the median orbital volume of the fractured side was 29.22 cm3 preoperatively, and significantly improved postoperatively to a value of 25.13 cm3. In the acute fracture group, the median orbital volume of the fractured side was 28.73 cm3 preoperatively, and significantly improved postoperatively to a value of 24.90 cm3. Differences on the Hertel scale also improved, from 2.13 mm preoperatively to 0.25 mm postoperatively in the old fracture group and from 1.67 mm preoperatively to 0.33 mm postoperatively in the acute fracture group. CONCLUSIONS: The push-out technique can be considered a good alternative choice for old medial orbital wall fractures with posttraumatic enophthalmos, acute medial orbital wall fractures including large fractured bone segments, and single-hinged greenstick fractures.
Enophthalmos ; Humans ; Methods ; Orbit* ; Orbital Fractures ; Orbital Implants ; Tomography, X-Ray Computed