Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Noonan syndrome is an autosomal dominant, multisystem disorder. Autoimmune thyroiditis with hypothyroidism is an infrequent feature in patients with Noonan syndrome. A 16-year-old boy was admitted because of chest discomfort and dyspnea; an echocardiogram revealed pericardial effusion. Additional investigations led to a diagnosis of severe hypothyroidism due to Hashimoto thyroiditis. The patient was treated with L-thyroxine at 0.15 mg daily. However, during admission, he developed symptoms of cardiac tamponade. Closed pericardiostomy was performed, after which the patient's chest discomfort improved, and his vital signs stabilized. Herein, we report a case of an adolescent with Noonan syndrome, who was diagnosed with Hashimoto thyroiditis with an unusual presentation of cardiac tamponade.
Adolescent ; Cardiac Tamponade* ; Diagnosis ; Dyspnea ; Hashimoto Disease* ; Humans ; Hypothyroidism ; Male ; Noonan Syndrome* ; Pericardial Effusion ; Pericardial Window Techniques ; Thorax ; Thyroiditis, Autoimmune ; Thyroxine ; Vital Signs

Total anomalous pulmonary venous return (TAPVR) is a rare and critical congenital vascular anomaly that requires an early operation. However, initial symptoms of TAPVR may be non-specific, and cardiovascular findings may be minimal. The heart may not be enlarged and there is often no cardiac murmur. Without cardiac murmur, these symptoms are similar to those of respiratory distress syndrome in newborns. Therefore, a high degree of suspicion and an early diagnosis of TAPVR are important. This condition generally occurs without a family history and has a low recurrence rate, but several familial cases, including siblings, have been reported worldwide. Additionally, several chromosomal or gene abnormalities associated with TAPVR have been reported. In the case presented here, two brothers with a 6-year age gap were diagnosed with TAPVR. Surgery was performed without cardiac or neurological complications. This is the first report on TAPVR in siblings in Korea.
Early Diagnosis ; Heart ; Heart Murmurs ; Humans ; Infant, Newborn ; Korea ; Recurrence ; Scimitar Syndrome* ; Siblings*

In Crohn's disease, mild gastrointestinal bleeding often occurs; however massive gastrointestinal hemorrhage, which can have a dramatic effect on a patient's vital sign, is rare. This could result in potentially life-threatening complications, which can lead to death. Massive hemorrhagic Crohn's disease is not well known and for this reason, they are a diagnostic and therapeutic challenge. Various diagnostic and therapeutic methods are currently being developed and used. The surgical method is often used only as a last measure since this approach has the risk of serious complications that may endanger patients. However, if massive bleeding continues even after all therapeutic methods are used, the surgical method must be implemented. In this case, all therapeutic methods were found to be ineffective; therefore, surgery was used as a last option. Ultimately, the surgical method was found to be successfully used to treat life-threatening hemorrhagic Crohn's disease.
Crohn Disease ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Vital Signs

BACKGROUND: Hypercalciuria is one of the most common causes of unexplained isolated hematuria. The diagnostic methods for hypercalciuria have not yet been standardized. The aim of this study was to assess whether random urinary calcium/creatinine ratio could be used as a screening tool for hypercalciuria in children with hematuria. METHODS: This prospective study included 264 children with primary hematuria for whom both random and 24 hr urinary evaluations were performed. Pearson correlation and ROC curve were used to assess the correlations. A multiple linear regression model was used to analyze effects of age, weight, height, body mass index, and body surface area on random urinary calcium/creatinine ratio. RESULTS: There was a moderately strong correlation between random urinary calcium/creatinine ratio and 24 hr urinary calcium excretion (r=0.584, P<0.001). The most appropriate cutoff value of random urinary calcium/creatinine ratio for the estimation of hypercalciuria was 0.075 mg/mg (sensitivity, 77.8%; specificity, 64.3%; area under the curve, 0.778). Body mass index and 24 hr urinary calcium excretion significantly affected random urinary calcium/creatinine ratio with a low coefficient of determination (r2=0.380, P<0.001). CONCLUSIONS: Random urinary calcium/creatinine ratio is not suitable for screening hypercalciuria in children with hematuria. Twenty-four hour urinary analysis should be performed to diagnose hypercalciuria in children with hematuria.
Adolescent ; Area Under Curve ; Body Mass Index ; Calcium/*urine ; Child ; Child, Preschool ; Creatinine/*urine ; Female ; Hematuria/*complications ; Humans ; Hypercalciuria/*complications/*diagnosis ; Linear Models ; Male ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity

Chronic pancreatitis is a progressive inflammatory disease resulting from repeated episodes of acute pancreatitis that impair exocrine function and eventually produce endocrine insufficiency. Some causes of chronic pancreatitis appear to be associated with alterations in the serine-protease inhibitor, Kazal type 1 (SPINK1), cationic trypsinogen (PRSS1), and cystic fibrosis-transmembrane conductance regulator (CFTR) genes, or with structural disorders in the pancreaticobiliary ductal system, such as pancreatic divisum or anomalous pancreaticobiliary ductal union (APBDU). However, it is unusual to observe both genetic alteration and structural anomaly. Here, we report 2 cases with both APBDU and a mutation in the SPINK1 genes, and we discuss the implications of these findings in clinical practice.
Pancreatitis ; Pancreatitis, Chronic ; Trypsinogen

PURPOSE: Indomethacin has been reported as the prophylaxis and initial treatment of preterm infants with patent ductus arteriosus (PDA). However, there was controversy over indomethacin treatment in full-term infants with symptomatic PDA. Therefore, we evaluate the effect of indomethacin as a treatment of full-term infants with symptomatic PDA. METHODS: A retrospective study was performed to evaluate the effectiveness of indomethacin in full-term infants who had birth weight > or =2,500 g and a gestational age > or =37 weeks with symptomatic PDA at Chonnam National University Hospital between January 2007 and December 2009. According to responsiveness of indomethacin, we classified them into three groups: 1) complete responder which were completely closed after indomethacin treatment, 2) partial responder which were incompletely closed but symptoms were improved, 3) non responder which were conducted surgical ligation because did not respond. RESULTS: Among the total 29 full-term infants treated with indomethacin, 13 (44.8%) were complete responder, 8 (27.6%) were partial responder, and 8 (27.6%) were non responder. There were no significant differences in birth weight, narrow diameter of PDA, and dose of indomethacin between three groups. However, the age at initiation of treatment using indomethacin of complete (4.8+/-4.5 days, P=0.03) and partial responder (6.3+/-2.0 days, P=0.04) were earlier than those of non responder (13.8+/-8.1 days). CONCLUSION: Indomethacin can expect an effective treatment of PDA in full-term infants prior to surgical ligation.
Birth Weight ; Ductus Arteriosus, Patent* ; Gestational Age ; Humans ; Indomethacin* ; Infant* ; Infant, Newborn ; Infant, Premature ; Jeollanam-do ; Ligation ; Retrospective Studies

PURPOSE: Childhood obesity is associated with nonalcoholic fatty liver disease (NAFLD), and it has become one of the most common causes of childhood chronic liver diseases which significant as a cause of liver related mortality and morbidity in children in the United States. The development of simpler and easier clinical indices for medical practice is needed to identify advanced hepatic fibrosis in childhood NAFLD instead of invasive method like liver biopsy. FibroScan and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) have been proposed as a simple and noninvasive predictor to evaluate hepatic fibrosis in several liver diseases. APRI could be a good alternative to detect pathologic change in childhood NAFLD. The purpose of this study is to validate the efficacy of APRI for assessing hepatic fibrosis in childhood NAFLD based on FibroScan. METHODS: This study included 23 children with NAFLD who underwent FibroScan. Clinical, laboratory and radiological evaluation including APRI was performed. To confirm the result of this study, 6 patients received liver biopsy. RESULTS: Factors associated with hepatic fibrosis (stiffness measurement >5.9 kPa Fibroscan) were triglyceride, AST, alanine aminotransferase, platelet count, APRI and collagen IV. In multivariate analysis, APRI were correlated with hepatic fibrosis (>5.9 kPa). In receiver operating characteristics curve, APRI of meaningful fibrosis (cutoff value, 0.4669; area under the receiver operating characteristics, 0.875) presented sensitivity of 94%, specificity of 66%, positive predictive value of 94%, and negative predictive value of 64%. CONCLUSION: APRI might be a noninvasive, simple, and readily available method for medical practice to predict hepatic fibrosis of childhood NAFLD.
Alanine Transaminase ; Aspartate Aminotransferases ; Aspartic Acid ; Biopsy ; Child ; Collagen ; Fatty Liver ; Fibrosis ; Humans ; Liver ; Liver Diseases ; Multivariate Analysis ; Obesity ; Platelet Count ; ROC Curve ; Sensitivity and Specificity ; United States