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Purpose@#To evaluate the reliability and validity of the Cataract-related Visual Function Questionnaire (CVFQ). @*Methods@#A prospective cross-sectional study of 141 cataract patients was conducted from March 2022 to June 2022. The questionnaire was created based on a literature review and advice from an expert panel. This study determined its construct validity, criterion validity, internal consistency, and test-retest reliability. @*Results@#The CVFQ consists of 15 items distributed among five categories: overall visual quality, overall visual function, distance vision, near vision, and glare. In the exploratory factor analysis of validity, the first three principal components explained 77.8% of the variance. The p-values in the Spearman correlation test comparing the pre- and postoperative total CVFQ score and best-corrected visual acuity (BCVA) were 0.006 and 0.004, respectively. In the reliability analysis, Cronbach’s alpha was > 0.9 for internal consistency and the p-values of each subcategory were all significant in the analysis of test-retest reliability. @*Conclusions@#Our results indicate that the CVFQ is useful for measuring the visual quality and visual function of cataract patients in Korea.
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Purpose@#To evaluate the long-term outcome and prognostic factors according to the degree of obstruction after silicone tube intubation in patients with nasolacrimal duct obstruction (NLDO). @*Methods@#From March 2016 to July 2020, the medical records of 145 eyes of 107 patients with NLDO who underwent silicone tube intubation and had been followed for more than 6 months were analyzed retrospectively. The preoperative lacrimal irrigation and degree of obstruction were classified into three groups, and the surgery outcome was also evaluated. Successful surgery was defined as a case in which the epiphora improved, the height of the tear meniscus decreased, and there was no reflux in the postoperative lacrimal irrigation. Risk factors for recurrence were analyzed using a Cox proportional hazards model and Kaplan-Meier survival analysis. @*Results@#Surgery was successful in 99 eyes (68.3%), while recurrence occurred in 46 eyes (31.7%) after silicone tube removal. The average follow-up period was 23.09 months. The recurrence rate was 30.4%, 29.3%, and 50.0% for functional, partial, and total NLDO, respectively, and did not differ significantly (p = 0.300). The risk of recurrence was higher at older age (adjusted hazard ratio [aHR] = 1.079, p < 0.001) and with a history of facial palsy (aHR = 4.031, p = 0.019), and was lower in the functional NLDO group than in the total NLDO group (aHR = 0.368, p = 0.040). In the Kaplan–Meier survival analysis, the total NLDO group differed significantly from the functional NLDO group (log-rank, p = 0.011). @*Conclusions@#Age, a history of facial palsy, and the degree of preoperative obstruction were associated with the prediction of recurrence after silicone tube intubation in patients with NLDO.
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Percutaneous balloon dilation with or without placement of an external biliary drain is a nonoperative alternative method for treating benign bilioenteric anastomotic strictures. Although this procedure has a high technical success rate, outcomes are less optimal when attempting to dilate refractory tight strictures. For the stricture, cutting balloon can be an option. We present four patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation. To the patients, a peripheral cutting balloon over-the-wire system was inflated, following subsequent conventional non-compliant balloon dilation. After the balloon dilation treatment, an external drainage catheter was placed through the stricture site and maintained for up to 30 days. Technical and end-treatment success was achieved in all four patients. In conclusion, the use of cutting balloon dilation may appear to be a safe and effective alternative method of treatment in patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation.
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Purpose@#We report the process of treating persistent corneal epithelial defects due to limbal deficiency in a patient who underwent surgery for ptosis, recurrent pterygium, and senile cataract for 3 weeks.Case summary: A 65‐year‐old male patient underwent cataract surgery 4 months ago and visited this hospital with persistent inflammation of the left cornea that started 2 months ago. The patient underwent blepharoplasty and pterygium surgery at the same time 3 weeks before cataract surgery. At the first visit, severe conjunctival injection and an oval‐shaped corneal epithelial defect with a size of 3 × 5 mm in the center of the cornea were seen. As the result of the eyelid eversion test, fibrotic scar tissue due to the non‐absorbable suture used during the upper eyelid blepharoplasty was observed and surgically removed. The corneal epithelial defect site became smaller, but the atrophy of the corneal stroma was sustained, and the amniotic membrane was tripled and permanent amniotic membrane transplantation was performed. Corneal epithelial defects have improved with postoperative best‐corrected visual acuity of 0.15. @*Conclusions@#Sufficient recovery period between serial multiple surgeries is required to reduce the occurrence of complications like persistent epithelial defects.
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Purpose@#To report the clinical features of patients with opacification of hydrophilic acrylic intraocular lens (IOL) after cataract surgery in neovascular glaucoma. @*Methods@#This retrospective case series included 11 eyes of 10 patients with IOL opacification and neovascular glaucoma (NVG) between January 2006 and December 2010. We included and analyzed cases with opacification of hydrophilic acrylic IOL. An IOL exchange was performed in three cases, and the explanted IOLs were examined grossly and evaluated by light microscopy. Sagittal sections of the optics of the IOLs were evaluated by Von Kossa staining, scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). @*Results@#All 11 eyes of 10 patients were implanted with hydrophilic acrylic IOLs. In addition, there were no cases of hydrophobic acrylic IOL opacification. Nine patients of the 10 patients had diabetic retinopathy and one patient had central retinal artery occlusion. The mean period of IOL opacification after IOL implantation was 19.45 ± 8.52 months and the mean period of IOL opacification after the occurrence of NVG was 14.37 ± 8.51 months. The deposits of the explanted IOLs were shown to consist of calcium by von Kossa staining. The explanted IOLs showed fine whitish irregular granular deposits on the entire anterior surface of the optics by SEM and the presence of calcium deposition was confirmed by EDX analysis. @*Conclusions@#Care is required when using hydrophilic acrylic IOLs in patients with risk of neovascular glaucoma, such as those with diabetic retinopathy or central retinal artery occlusion.
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Acinar cell cystadenoma, also known as an acinar cystic transformation of the pancreas, is an exceedingly rare but benign pancreatic lesion. A 51-year-old woman was transferred to Inje University Busan Paik Hospital because of an 8 cm-sized calcified, multiseptated, and multilocular cystic mass in the pancreatic tail observed during abdominal CT performed at another hospital. The patient did not complain of abdominal pain or other symptoms, and her laboratory findings were normal. MRI showed that the cyst was not connected to the main pancreatic duct. A pancreatic serous cystadenoma was suspected, and a laparoscopic distal pancreatectomy was performed. The resected mass was composed of variable sized multilocular cysts with incomplete septa and focally lined by epithelium with acinar differentiation. The patient was diagnosed with acinar cell cystadenoma and is currently being followed up regularly. No complications or recurrences have been observed.
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Acinar cell cystadenoma, also known as an acinar cystic transformation of the pancreas, is an exceedingly rare but benign pancreatic lesion. A 51-year-old woman was transferred to Inje University Busan Paik Hospital because of an 8 cm-sized calcified, multiseptated, and multilocular cystic mass in the pancreatic tail observed during abdominal CT performed at another hospital. The patient did not complain of abdominal pain or other symptoms, and her laboratory findings were normal. MRI showed that the cyst was not connected to the main pancreatic duct. A pancreatic serous cystadenoma was suspected, and a laparoscopic distal pancreatectomy was performed. The resected mass was composed of variable sized multilocular cysts with incomplete septa and focally lined by epithelium with acinar differentiation. The patient was diagnosed with acinar cell cystadenoma and is currently being followed up regularly. No complications or recurrences have been observed.
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Purpose@#We report a case of visual loss caused by occlusion of multiple branches of the ophthalmic artery after triamcinolone injection into the nasal septum.Case summary: A 62-year-old male was referred to our ophthalmology clinic because of marked loss of vision in the right eye immediately after triamcinolone injection into the nasal septum. His corrected visual acuity was hand motion in the right eye and the intraocular pressure was 20 mmHg. His pupil was mid-dilated, fixed, and did not respond to light. Fundus examination revealed multiple, white steroidal emboli in the terminal retinal artery and capillaries. Fundus photography revealed macular edema, ischemic retinal whitening, and a cherry-red spot in the posterior pole of the retina. Optical coherence tomography (OCT) revealed inner-layer whitening and swelling and OCT-angiography revealed reduced numbers of terminal capillaries and a low vascular density. Anterior chamber paracentesis and ocular massage were immediately performed. Wide fluorescein angiography revealed diffuse choroidal hypofluorescence in the early phase and fluorescein leakage around the posterior pole in the late phase. Visual acuity improved to 1.0, but retinal whitening was still evident below the macula on fundus examination 3 months after symptom onset. @*Conclusions@#Multiple branches of the ophthalmic artery may become occluded after an intranasal, septal triamcinolone injection. The condition improves with immediate management.
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Purpose@#To investigate the tomographic structural changes in the retinal layers after internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (ERM). @*Methods@#Sixty-nine eyes treated with vitrectomy and ILM peeling for idiopathic ERM were analyzed. Parafoveal retinal thickness was measured at baseline and 6 months after surgery. @*Results@#Total retinal thickness decreased significantly in the nasal and temporal subfields after surgery (p < 0.001), whereas the inner nuclear layer and outer nuclear layer showed nasal thickening (all, p < 0.001). The postoperative temporalasal subfield thickness ratio of each layer was significantly lower than that of fellow eyes. Eyes with larger ILM peeling showed a significantly lower temporalasal subfield thickness ratio (p = 0.033) than those with smaller sizes. @*Conclusions@#The retinal thickness of each layer showed anatomical changes from ILM peeling and ERM removal. Nasal parafoveal thickening and temporal thinning occurred in the inner retinal architecture, which might be affected by ILM peeling size.
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Purpose@#We report a rare case of injected silicone oil migration into the upper eyelid, accompanied by lipogranulomatous inflammation and ptosis, after vitrectomy using a silicone oil tamponade.Case summary: An 83-year-old female presented to our clinic with left upper eyelid swelling and ptosis 2 months in duration. Five months prior, she had undergone 23-gauge pars plana vitrectomy combined with Ahmed valve implantation to treat neovascular glaucoma. Four months prior, only about half the original volume of intraocular silicone oil remained, and a second oil injection was thus administered after removal of the remaining original oil. We found a mass in front of the left orbital septum; this was associated with gradual progression of the left upper eyelid swelling and ptosis. We resected the mass via a left upper eyelid skin incision 2 months after presentation. Histological examination of the excised tissue revealed necrotic fat consistent with lipogranulomatous inflammation. One week after excision, the ptosis disappeared. At the 4-month follow-up, the left upper eyelid was normal with no sign of recurrence. @*Conclusions@#To the best of our knowledge, this is the first report in South Korea of lipogranulomatous inflammation and ptosis induced by migration of injected silicone oil into the upper eyelid. Clinicians should be aware that swelling of the upper eyelid and a substantial decrease in the silicone oil level in the vitreous cavity, reflecting silicone oil leakage, maybe one of complications of vitrectomy.
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Purpose@#We report a rare case of injected silicone oil migration into the upper eyelid, accompanied by lipogranulomatous inflammation and ptosis, after vitrectomy using a silicone oil tamponade.Case summary: An 83-year-old female presented to our clinic with left upper eyelid swelling and ptosis 2 months in duration. Five months prior, she had undergone 23-gauge pars plana vitrectomy combined with Ahmed valve implantation to treat neovascular glaucoma. Four months prior, only about half the original volume of intraocular silicone oil remained, and a second oil injection was thus administered after removal of the remaining original oil. We found a mass in front of the left orbital septum; this was associated with gradual progression of the left upper eyelid swelling and ptosis. We resected the mass via a left upper eyelid skin incision 2 months after presentation. Histological examination of the excised tissue revealed necrotic fat consistent with lipogranulomatous inflammation. One week after excision, the ptosis disappeared. At the 4-month follow-up, the left upper eyelid was normal with no sign of recurrence. @*Conclusions@#To the best of our knowledge, this is the first report in South Korea of lipogranulomatous inflammation and ptosis induced by migration of injected silicone oil into the upper eyelid. Clinicians should be aware that swelling of the upper eyelid and a substantial decrease in the silicone oil level in the vitreous cavity, reflecting silicone oil leakage, maybe one of complications of vitrectomy.
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Influenza B virus infections appear to be more common extra-respiratory tract symptoms, compared to influenza A virus infections. Benign acute childhood myositis (BACM) is a benign disease that is caused mainly by many viruses like influenza A or B virus infection. Usually BACM is fully cured with only supportive treatment without unnecessary investigation or invasive procedure. This report describes an eight-year-old boy with acute bilateral calf pain and walking difficulty who diagnosed with BACM after influenza B virus infection.
Subject(s)
Child , Humans , Male , Herpesvirus 1, Cercopithecine , Influenza A virus , Influenza B virus , Influenza, Human , Myositis , WalkingABSTRACT
Adipsic hypernatremia is a rare disease where patients do not feel thirst even in the increased serum osmotic pressure and results in electrolyte imbalance, severely increased osmotic pressure and neurologic symptoms like nausea, vomiting, and seizures. We report a 12-year-old male patient who had underwent a trans-sphenoidal surgery for craniopharyngioma newly diagnosed with adipsic hypernatremia after having growth hormone replacement for growth hormone deficiency. The patient visited emergency room complaining of generalized weakness, tremor in both legs, and poor oral intake including water after starting growth hormone replacement therapy. Laboratory test revealed serum sodium 168 mmol/L and serum osmolality 329 mOsm/kg, despite the patient didn't feel any thirst at all. We treated him with scheduled water intake of 2.5 L a day with intranasal vasopressin. He admitted to Soonchunhyang University Gumi Hospital and Soonchunhyang University Seoul Hospital for 4 times during the following 8 months and serum sodium level and osmolality was controlled by scheduled water intake combined with intranasal vasopressin treatment. It is still unclear whether growth hormone replacement worked as a trigger of hypernatremia.
Subject(s)
Child , Humans , Male , Craniopharyngioma , Drinking , Emergency Service, Hospital , Growth Hormone , Hypernatremia , Leg , Nausea , Neurologic Manifestations , Osmolar Concentration , Osmotic Pressure , Rare Diseases , Seizures , Seoul , Sodium , Thirst , Tremor , Vasopressins , Vomiting , WaterABSTRACT
PURPOSE: This report describes the results of a survey of the characteristics of pertussis in children from a single institution and compares it to data from the Korea Centers of Disease Control (KCDC). METHODS: We retrospectively evaluated the medical records of 17 and 6 patients diagnosed with pertussis and parapertussis, respectively, at Soonchunhyang University Bucheon Hospital from January 2005 to January 2017. RESULTS: Of the 17 patients with pertussis, 9 were under 1 year of age (52.9%), 3 were aged between 1 and 10 years (17.6%), and 5 were over 10 years of age (29.4%). Seven patients (41.2%) had never received diphtheria-tetanus-acellular pertussis vaccines, of which 5 were infants below 2 months of age and 2 were 10 years old and lived in China. Four patients showed the initial symptoms of cough in China. The sources of infection were the parents (2 cases) and the siblings (8 cases). All patients showed prolonged severe cough and the average duration of cough was 26 days. Severe symptoms, including dyspnea, cyanosis, apnea, and seizures, were observed in the children under 2 months of age. According to the recent 10-year KCDC data, the highest rate of pertussis diagnosis was noted in infants (47.8%), followed by adolescents (18.7%). Six patients with parapertussis also presented with prolonged severe cough without any other severe symptoms. Lymphocytosis was not found, unlike the patients with pertussis. CONCLUSION: The possibility of pertussis and parapertussis should be considered among patients with prolonged severe cough, especially in infants and adolescents.
Subject(s)
Adolescent , Child , Humans , Infant , Apnea , Bordetella parapertussis , Bordetella pertussis , China , Cough , Cyanosis , Diagnosis , Diphtheria-Tetanus-acellular Pertussis Vaccines , Dyspnea , Korea , Lymphocytosis , Medical Records , Parents , Retrospective Studies , Seizures , Siblings , Whooping CoughABSTRACT
Rib fixations for flail chest or displaced rib fractures are not a new technique. However, reports on rib fixations involving costal cartilage fractures are very few and surprisingly there are no reports of internal fixations involving only the costal cartilage in the English literature. The diagnosis is difficult and the necessity of the procedure may be quite controversial. Placing plates in screws into the costal cartilage alone may seem unstable and easily dislodged or stripped through the cartilage. We report a 31-year-old male scuba diver instructor who underwent rib fixations over his 7th and 8th costal cartilage ribs for severe pain. The procedure was done with conventional plates and screws. He had the plates and screws removed 2 months later due to lingering pain, but with them removed he is now quite happy with the results without pain. The procedure for fixation of painful overlapped costal cartilage is quite simple and can be done with the usual conventional methods, fixating plate and screws directly over the cartilage alone without fixation over the bony rib.
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Delayed esophageal rupture due to blunt injury is not new. However, rupture due to suspected barotrauma is very rare. We describe a case of esophageal rupture in a male 24-year-old patient after diving in shallow waters. The patient was quadriplegic and could not experience the typical chest pain related to rupture and resulting mediastinitis. The rupture was discovered 4 days after emergency decompressive laminectomy and fusion for his cervical spine. The rupture was evidently caused by barotrauma and was discovered four days after admission. He underwent primary closure and pericardial flap as a life-saving procedure.
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Increasingly, autologous blood transfusion has been arousing concern owing to awareness of adverse effects of allogenic blood transfusion, blood shortage and patients, having religious or personal issues. With the development of medicine, Cell Salvage and Acute normovolemic hemodilution (ANH) has been proposed as an alternative to allogenic blood transfusion. This review looked at the use of ANH and cell salvage and evaluated the benefits and usefulness based on the strengths and indications. Although not consistent with all cases of ANH, there were benefits in the amount of hemorrhage and transfusion, and no supplementary plasma or platelet transfusion was needed after surgery when employing ANH. But, it showed a cutoff value only for massive bleeding surgery (at least 500 mL). In the case of cell salvage, the amount of blood transfusion was reduced in most cases and platelet or plasma transfusion was not required in most cases. When the Leukoreduction filter (LDF) was utilized, it showed the effect of removing bacterial infection or tumor cells. Nonetheless, the effectiveness and benefits for patients in certain condition of cell salvage and ANH is ambiguous with discrepancies among studies or patients. Therefore, the aim of this study is to provide clinical knowledge relative to the procedure, measure the efficacy and usefulness of peri-operative blood management mentioned above and discuss the forthcoming prospects and challenges.
Subject(s)
Humans , Bacterial Infections , Blood Platelets , Blood Transfusion , Blood Transfusion, Autologous , Hemodilution , Hemorrhage , Operative Blood Salvage , Plasma , Platelet TransfusionABSTRACT
OBJECTIVE: Rotavirus and norovirus are the most common pathogens causing acute gastroenteritis in children. As the incidence of noroviral gastroenteritis increases, it is becoming more important to identify the clinical features of noroviral infection. We compared the clinical features of noroviral gastroenteritis and rotaviral gastroenteritis. METHODS: This study included 79 children with noroviral and 151 children with rotaviral gastroenteritis, who were admitted to the Soonchunhyang University Gumi Hospital between January 2013 and December 2014. We reviewed their medical records and compared the clinical features of gastroenteritis between the two groups respectively. RESULTS: In those belonging to the norovirus group, the mean age was 29.65 months, which was younger than that of the rotavirus group, at 34.74 months. Patients suffering from noroviral gastroenteritis experienced more vomiting (5.6 episodes/day) than diarrhea (3.5 episodes/day). Vomiting, diarrhea, and fever were all less severe in those suffering from noroviral gastroenteritis. It is commonly noted that patients with noroviral infection have vomiting and diarrhea without fever (55.0%), while those with rotaviral infection present with vomiting, diarrhea, and fever (44.3%). CONCLUSION: Although noroviral gastroenteritis is less severe than rotaviral gastroenteritis, the incidence of noroviral infection is increasing, and the mean age group infected with this virus is getting younger; thus, noroviral infection must be considered in the differential diagnoses in young patients with gastroenteritis.
Subject(s)
Child , Humans , Diagnosis, Differential , Diarrhea , Fever , Gastroenteritis , Incidence , Medical Records , Norovirus , Rotavirus , VomitingABSTRACT
BACKGROUND: We compared the clinical outcomes of cardiac valve surgery in adult Jehovah's Witness patients refusing blood transfusion to those in non-Jehovah's Witness patients without any transfusion limitations. METHODS: From 2005 to 2014, 25 Jehovah's Witnesses (JW group) underwent cardiac valve surgery using a blood conservation strategy. Twenty-five matched control patients (non-JW group) were selected according to sex, age, operation date, and surgeon. Both groups were managed according to general guidelines of anticoagulation for valve surgery. RESULTS: The operative mortality rate was 4.0% in the JW group and 0% in the non-JW group (p = 1.000). There was no difference in postoperative major complications between the groups (p = 1.000). The overall survival rate at 5 and 10 years was 85.6% ± 7.9% and 85.6% ± 7.9% in the JW group, respectively, and 100.0% ± 0.0% and 66.7% ± 27.2% in the non-JW group (p = 0.313). The valve-related morbidity-free survival rates (p = 0.625) and late morbidity-free survival rates (p = 0.885) were not significantly different between the groups. CONCLUSIONS: Using a perioperative strategy for blood conservation, cardiac valve surgery without transfusion had comparable clinical outcomes in adult patients. This blood conservation strategy could be broadly applied to major surgeries with careful perioperative care.
Subject(s)
Adult , Humans , Blood Transfusion , Bloodless Medical and Surgical Procedures , Heart Valves , Jehovah's Witnesses , Mortality , Perioperative Care , Survival RateABSTRACT
No abstract available.