Background/Aims: Anti-hepatitis B virus (HBV) therapy is required for patients with HBV infection receiving biologics because of the high risk of HBV reactivation. However, it is unclear when to start biologics after anti-HBV treatment. We investigated the risk of HBV reactivation according to the timing of biologics initiation after anti-HBV treatment in immune-mediated inflammatory disease (IMID) patients with HBV infection. Methods: We retrospectively evaluated the incidence of HBV reactivation in IMID patients who received biologics between July 2005 and April 2020. The patients were divided into two groups (within 1-week and after 1-week) according to the timing of biologics initiation after anti-HBV treatment. The cumulative probabilities and factors associated with HBV reactivation were evaluated. Results: A total of 60 hepatitis B surface antigen-positive patients with IMID received biologics (within 1-week group, n=23 [38%]; after 1-week group, n=37 [62%]). During a median follow-up of 34 months (interquartile range, 20 to 74 months), three patients (5%) developed HBV reactivation. In univariate analysis, the timing of biologics after anti-HBV treatment was not significantly associated with the risk of HBV reactivation (hazard ratio, 0.657; 95% confidence interval, 0.059 to 7.327; p=0.733). The cumulative probabilities of HBV reactivation did not significantly differ according to the timing of biologics (p=0.731). Conclusions The risk of HBV reactivation was not significantly associated with the timing of biologics administration after anti-HBV treatment. Thus, biologics may be initiated early in patients with IMID undergoing treatment for HBV.

BACKGROUND: Midface concavity is a relatively common facial feature in East Asian populations. Paranasal augmentation is becoming an increasingly popular procedure for patients with mild concavity and normal occlusion. In this study, we evaluate clinical outcomes following a series of paranasal augmentation. METHODS: A retrospective review was performed for patients with Class I occlusion who had undergone bilateral paranasal augmentation using custom-made silicone implants, between October 2005 and September 2013. Patient charts were reviewed for demographic information, concomitant operations, and postoperative complications. Preoperative and postoperative (1-month) photographs were used to evaluate operative outcome. RESULTS: The review identified a total of 93 patients meeting study criteria. Overall, aesthetic outcomes were satisfactory. Five-millimeter thick silicone implant was used in 81 cases, and the mean augmentation was 4.26 mm for this thickness. Among the 93 patients, 2 patients required immediate implant removal due to discomfort. An additional 3 patients experienced implant migration without any extrusion. Nine patients complained of transient paresthesia, which had resolved by 2 weeks. There were no cases of hematoma or infection. All patients reported improvement in their lateral profile and were pleased at follow-up. Complications that arose postoperatively included 9 cases of numbness in the upper lip and 3 cases of implant migration. All cases yielded satisfactory results without persisting complications. Sensations were fully restored postoperatively after 1 to 2 weeks. CONCLUSION: Paranasal augmentation with custom-made silicone implants is a simple, safe, and inexpensive method that can readily improve the lateral profile of a patient with normal occlusion. When combined with other aesthetic procedures, paranasal augmentation can synergistically improve outcome and lead to greater patient satisfaction.
Asian Continental Ancestry Group ; Follow-Up Studies ; Hematoma ; Humans ; Hypesthesia ; Lip ; Paresthesia ; Patient Satisfaction ; Postoperative Complications ; Retrospective Studies ; Sensation ; Silicon* ; Silicones*

Soft tissue filler injection has been a very common procedure worldwide since filler injection was first introduced for soft tissue augmentation. Currently, filler is used in various medical fields with satisfactory results, but the number of complications is increasing due to the increased use of filler. The complications after filler injection can occur at any time after the procedure, early and delayed, and they range from minor to severe. In this review, based on our experience and previously published other articles, we suggest a treatment algorithm to help wound healing and tissue regeneration and generate good aesthetic results with early treatment in response to the side effects of filler. Familiarity with the treatment of these rare complications is essential for achieving the best possible outcome.
Algorithms ; Biocompatible Materials/*therapeutic use ; Connective Tissue/*surgery ; Face/surgery ; Guided Tissue Regeneration/*methods ; Humans ; Hyaluronic Acid/administration & dosage ; Injections ; Skin Aging ; Surgery, Plastic/*methods ; Tissue Engineering/*methods ; Wound Healing

Calves can be easily seen in daily life and are an important part of the body contour. Asymmetric calves can develop from unbalanced distribution and deposition of fat and muscles between the legs. Calf asymmetry may be due to congenital factors, disease (e.g., poliomyelitis, cerebral palsy, or infection), spinal cord injury, or the effects of surgical treatment and may have severe adverse psychological and social implications. Generally, an asymmetric calf is diagnosed when the difference of the longest circumference between both calves is more than 2 cm. Several surgical methods have been introduced for the correction of an asymmetric calf. Implant insertion or fat injection is used to augment a hypotrophic calf. Selective neurectomy, liposuction, muscle resection, radiofrequency, and botulinum toxin injection are used to treat a hypertrophic calf. With the development of microsurgery, the authors planned to use a latissimus dorsi musculocutaneous free flap (LDMC free flap) with silicone implant to add calf volume to obtain natural calf contour. The authors present the first successful case of correction of a severely asymmetric calf using an LDMC free flap and customized silicone implant.
Botulinum Toxins ; Cerebral Palsy ; Free Tissue Flaps* ; Leg ; Lipectomy ; Lower Extremity ; Microsurgery ; Muscles ; Poliomyelitis ; Silicones* ; Spinal Cord Injuries ; Superficial Back Muscles*

Botulinum toxin type A has an inhibitory action not only on neuromuscular junctions, but also postganglionic sympathetic and cholinergic autonomic parasympathetic acetylcholine release at the secretary end of the salivary gland. Use of botulinum toxin to treat sialorrhea was first reported in 1997 by Bushara. Parotid duct or gland injuries with parotid fistula are uncommon but troublesome complications of surgical trauma. Here, we report two patients with constant leakage of serous fluid and a swelling cheek after facelift surgery. Each patient underwent an amylase test, starch iodine test, and sialography. After diagnosis of parotid fistula, a total of 50 units botulinum toxin was injected into the parotid gland. Facial bandage, scopolamine, and minimizing temporomandibular joint motion were instructed. Leakage volume decreased gradually, and symptoms subsided within 2 weeks. Neither functional problems nor complications occurred. In conclusion, a parotid fistula after facial surgery can be treated effectively with botulinum toxin; this treatment option should be considered before proceeding with invasive surgical treatment.
Acetylcholine ; Amylases ; Bandages ; Botulinum Toxins ; Botulinum Toxins, Type A* ; Cheek ; Diagnosis ; Fistula* ; Humans ; Iodine ; Neuromuscular Junction ; Parotid Gland ; Rhytidoplasty* ; Salivary Glands ; Scopolamine Hydrobromide ; Sialography ; Sialorrhea ; Starch ; Temporomandibular Joint

BACKGROUND/AIMS: The pathophysiologic mechanism of rectal hyposensitivity (RH) is not well documented, and the significance of RH in biofeedback therapy (BFT) has not been evaluated. Thus, we aimed to assess the effect of BFT in constipated patients according to the presence of RH. METHODS: Five hundred and ninety constipated patients (238 males and 352 females) underwent anorectal physiologic assessments. Of these, anorectal manometry was performed before and after BFT in 244 patients (63 RH and 181 non-RH patients). RESULTS: The success rate of BFT was 56% in the RH and 61% in the non-RH group (p=0.604). The measurements of resting pressure, squeezing pressure, desire to defecate volume, urge to defecate volume, and maximum volume were decreased after BFT in the RH group (p<0.05), whereas only resting and squeezing pressures were decreased in the non-RH group (p<0.05). Among the RH group, individuals who responded to BFT showed decreased resting pressure, squeezing pressure, desire to defecate, urge to defecate, and maximum volume and increased balloon expulsion rate; among those who did not respond to BFT, only desire to defecate volume was improved. CONCLUSIONS: In constipated patients with RH, changes of anorectal manometric findings differed in comparison to patients without RH. The responses to BFT showed both anorectal muscle relaxation and restoration of rectal sensation.
Biofeedback, Psychology ; Constipation ; Humans ; Male ; Manometry ; Muscle Relaxation ; Rectum ; Sensation

Lectins are glycoproteins of plant and animal origin that have the ability to bind specific carbohydrate residues of cell glycoconjugates, particularly in terminal positions. In this study, the binding of lectins, Dolichos biflorus agglutinin (DBA), soybean agglutinin (SBA), Bandeiraea simplicifolia BS-1 (isolectin B4), Triticum vulgaris (WGA), Arachis hypogaea (PNA), and Ulex europaeus (UEA-I), was studied in the reproductive systems of male thoroughbred horses.DBA was detected in the stereocilia of the caput and corpus epididymis, and in the vas deferens. It was weakly detected in connective tissue of the corpus epididymis. Strong SBA staining was seen in epithelial cells in the testis, stereocilia of the corpus and cauda epididymis, and in the vas deferens. There were intense positive reactions for isolectin B4 in interstitial cells in all tissue and serosa of the vas deferens. PNA staining was seen only in stereocilia in the caput and corpus epididymis, and in the vas deferens. Strong WGA staining was seen throughout the testis, except in Sertoli cells, stereocilia, and connective tissue. UEA-I was detected in secondary spermatids, stereocilia, and epithelial cells of the cauda epididymis.These results show that degenerating cells in the testis, epididymal tubules, and vas deferens have differential affinities for lectins, and suggest that lectins play a role in the reproductive system of the horse. The heterogeneity of the lectin staining pattern in the reproductive tubules of adult horses suggests that the carbohydrate composition of each cell type is region specific.
Animals ; Epididymis/cytology/*metabolism ; Horses/*metabolism ; Immunohistochemistry/veterinary ; Lectins/*metabolism ; Male ; Testis/cytology/*metabolism ; Vas Deferens/cytology/*metabolism

Lectins are glycoproteins that specifically bind carbohydrate structures and may participate in the biodefense mechanisms of fish. In this study, the binding of three lectins, Dolichos biflorus agglutinin (DBA), soybean agglutinin (SBA), Bandeiraea simplicifolia BS-1 (isolectin B4), Triticum vulgaris (WGA), Arachis hypogaea (PNA) and Ulex europaeus (UEA-I) were studied in the gill, liver, intestine, kidney, heart, and spleen of the flat fish Paralichthys olivaceus. DBA was detected in intestinal mucous cells, as well as in gill epithelial and mucous cells. It was weakly detected in renal tubule epithelial cells and in bile duct epithelial cells. The strong SBA staining was seen in the intestinal club cells, in bile duct epithelial cells and renal tubule epithelial cells. There were intense positive reactions for isolectin B4 in gill epithelial and mucous cells, and the strong isolectin B4 staining was seen in epithelial cells of the bile duct and intestine. The strong WGA staining was seen in the gill mucosal cells, sinusoid, renal tubule epithelial cells and mucosal cells of the intestine. UEA-I was detected in the gill epithelial and mucosal cells, bile duct epithelial cells and renal tubular epithelial cells. These results suggest that the six lectins examined were localized in the covering epithelia of the various organs of the flat fish and they may participate in the biodefense mechanism of the intra body surface in which is exposed to various antigens.
Animals ; Epithelial Cells/metabolism ; Flatfishes/*metabolism ; Histocytochemistry/veterinary ; Lectins/*metabolism ; Mucus/metabolism ; Peanut Agglutinin/metabolism ; Plant Lectins/metabolism ; Soybean Proteins/metabolism ; Wheat Germ Agglutinins/metabolism

The use of erythropoietin for correction of anemia in maintenance hemodialysis patients affects dialyzer reuse, dialysis efficacy and other clinical parameters. This study showed the change of Kt/Vurea, nPCR, pre-dialysis BUN, body weight, ultrafiltration volume, pre-dialysis blood pressure, heparin dosage, the number of dialyzer reuse caused by the administration of erythropoietin in reuse(n=11) and first use(n=9) patients who were started erythropoietin since January, 1995. 1) In 20 all patients, hematocrit increased significantly after EPO treatment 20.7+/-0.8%, 27.8+/-0.7%, ultrafiltration volume increased from 2.0+/-0.3L to 2.5+/-0.2L(P<0.05). However no significant changes were noted in Kt/Vurea, nPCR and other parameters 2) In patients of dialysis reuse, the number of reuse was not affected by EPO treatment(8.4+/-1.7, 9.6+/-1.5, P=0.67). No significant differences were observed in all parameters except hematocrit in case of first use and reuse. 3) Entire patients were reclassified into low baseline protein intake group(nPCR<1.0g/kg/day) and high baseline protein intake group(nPcR>1.0/kg/ day) and then pretreatment versus posttreatment nPCR, pre-dialysis BUN and ultrafiltration volume were compared. In low baseline protein intake group, significant increases of ultrafiltration volume, nPCR were observed. However, pre-dialysis BUN were not changed significantly. In high protein intake group, nPCR, pre-dialysis BUN, ultrafiltration volume were changed without significance. In conclusion, EPO treatment did not affect Kt/Vurea, dialyzer reuse, nPCR, predialysis blood pressure, heparin dosage. But ultrafiltration volume increased significantly after EPO treatment. Maybe increased appetite in low baseline protein intake group caused the increased posttreatment ultrafiltration volume.
Anemia ; Appetite ; Blood Pressure ; Body Weight ; Dialysis* ; Erythropoietin* ; Hematocrit ; Heparin ; Humans ; Renal Dialysis ; Ultrafiltration

Many methods have been developed for the reduction of the isolated zygomatic arch fracture. Even though the reduction of isolated zygomatic arch fracture can be made well according to the various methods, the Gillies' method has been selected as the 1st choice. But long term follow-up study of this method was not reported. So long term follow up of zygomatic arch fracture was performed in 35 patients who were treated by Gillies' method. Authors divided isolated zygomatic arch fractures into three classes (Type A : a simple fracture with one fracture line and one greenstick fracture, TyPe B : medially depressed fracture with three fracture lines, Type C : a medially depressed fracture segment with two fracture lines) and followed up the reduced isolated zygomatic arch fracture cases using Gillies' method by radiographes and interview. The depression of lesion site was estimated by comparing with tracing the zygomatic arch shadow of normal side. The results were as follows: 1. The mean follow up time was 33.4 month. 2. The isolated zygomatic fractures were classified by three group. A: a simple fracture (16 cases) B: the central fracture point was a medially depressed fracture (14 cases) C: fracture with a medially depressed segment (5 cases) 3. The mean depression of lesion site was 2.3 mm. (Type A: 2.0 mm, Type B: 3.2 mm, Type C: 2.4 mm and difference between A and B was significant statistically (p < 0.037)). 4. The mean depression of zygomatic arch fracture was 2.1 mm in excellent group, 2.4 mm in good group and 5.2 mm in poor group and difference between excellent and poor, and between good and poor group were statistically significant (p < 0.0001). 5. On result of subjective satisfaction, number of excellent case was 17(48.6%), it of good case was 15(42.9%) and it of poor case was 3(8.6%) (Type A: 9, 7, 0, Type B: 5, 7, 2 and Type C: 3, 1, 1 excellent, good and poor in sequence). 6. The mean depression of overcorrection group(17, 8, 1 excellent good and poor in sequence) and nonovercorrection group(2, 5 and 2 in excellent, good and poor in sequence) was 2.26 and 3.6 mm in each other(p < 0.004). After reviewing all of results, it is concluded that Gillies' method is acceptable as the 1st choice for the reduction method of an isolated zygomatic arch.
Depression ; Follow-Up Studies* ; Humans ; Zygoma* ; Zygomatic Fractures