Sjögren syndrome is a chronic autoimmune inflammatory disease characterized by lymphocytic infiltration of exocrine glands, predominantly the parotid and lacrimal glands, thereby resulting in oral and ocular dryness. It has been reported to occur most frequently in women between 40 and 50 years of age. Sjögren syndrome has an insidious onset, is slowly progressive, and presents a wide range of clinical manifestations, leading to delays or challenges in the diagnosis. Early diagnosis of this condition is essential to prevent the associated complications that affect patients' quality of life. This report presents 3 cases of Sjögren syndrome in female patients aged between 40 and 75 years who presented with complaints of persistent dry mouth and burning sensation. The cases highlight the diagnostic value of 3-dimensional cone-beam computed tomographic sialography in the detection of salivary gland pathologies at an early stage.
A two-year-old, spayed female, Bichon Frise, was referred for severe corneal edema and corneal ulcer in the left eye (OS). The cornea had gradually swelled over one week after phacoemulsification performed a month prior, and that was refractory to 5% sodium chloride eye drop instillation or temporary partial tarsorrhaphy. A complete ophthalmic examination was performed. Severe corneal edema with intrastromal bullae and moderate anterior chamber flare was found on slit-lamp biomicroscopy in the OS, which obstructed the fundus examination. Corneal thickness was measured using high-resolution ultrasound biomicroscopy. The thickness of the OS cornea was 2.74 mm. The "letter-box" conjunctival flap was planned. Dorsal and ventral superficial keratectomy followed by a hood conjunctival flap was performed. Topical and systemic antibiotics and 5% sodium chloride eye drops were prescribed. Decreased corneal thickness was observed at one week, two weeks, and two months postoperatively (1.53 mm, 1.32 mm, and 0.92 mm, respectively). There were no postoperative complications, such as ocular discomfort or recurrent corneal ulcers. The "letter-box" conjunctival flap, a type of superficial keratectomy and conjunctival advancement hood flap, effectively relieved the severe irreversible corneal edema. This could be a simple but effective surgical intervention for patients with endothelial cell damage especially after phacoemulsification.
Journal of the korean academy of Pediatric Dentistry
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v.51
no.2
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pp.109-131
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2024
This review aims to examine safety concerns in pediatric dental care and underscore the need for comprehensive patient safety initiatives within the Korean Academy of Pediatric Dentistry. Drawing insights from the prevailing patient safety policies of the American Academy of Pediatric Dentistry, case reports, and systematic reviews, this review elucidates issues such as dental fires during sedation, ocular complications from local anesthesia, and surgical emphysema. This review highlights the significance of safety toolkits encompassing infection control, medical error reduction, dental unit waterline infection, and nitrous oxide safety in pediatric dental settings, underscoring the need to foster a safety culture. Furthermore, this study explores the curriculum for pediatric dentistry residency programs, emphasizing concepts such as high-reliability organizations and mortality and morbidity conferences. The study suggests the need for initiatives to enhance patient safety, including establishing safety committees, expanding reporting systems, policy development, and supporting research related to patient safety. In conclusion, this study underlines key messages, emphasizing the utmost priority of patient safety, acknowledging the inevitability of human error, promoting effective communication, and cultivating a patient safety culture. These principles are vital for advancing patient safety in pediatric dental care and improving outcomes among pediatric patients.
Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
Clinical and Experimental Pediatrics
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v.52
no.6
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pp.674-679
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2009
Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.
Gu, Ja Hea;Won, Chang Hoon;Dhong, Eun-Sang;Yoon, Eul-Sik
Archives of Craniofacial Surgery
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v.11
no.2
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pp.85-90
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2010
Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.
Journal of the Korea Academia-Industrial cooperation Society
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v.10
no.10
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pp.2873-2878
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2009
Since Germany was unified in 1990, Korea became the only country that has the division in the world. This division has various bad effects on Korea's status with not reliable security, forfeited national impression, loss of tourism income and so on. Kim Jung-Il national defense committee chairman is the current dictator of North Korea which is a socialist state. Even if he is getting old, his successor is not proclaimed. In this situation, his sudden aggravation of health can cause seriously bad effects on diplomatic relations especially with South Korea. Therefore, the health information about Kim Jung-Il national defense committee chairman will be very important information. In order to deal this problem, we propose the method of extracting the Kim Jung-Il national defense committee chairman's health from his pictures which are recently open to the public by employing the diagnosis Ocular Inspection used in Oriental medicine. n order to get an accurate result, revising the Kim Jung-Il national defense committee chairman's pictures, which are not taken in a controled equal situation, is necessary. Therefore we employed the color analysis process with color revising and color differential comparing process without color revising. With these processes, we can make diagnosis of his diabetes and complications.
Jo, Hyun-Joo;Jeong, Yong-Seon;Chae, Byung-Moo;Jung, Tae-Young;Park, Sang-Jun
Maxillofacial Plastic and Reconstructive Surgery
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v.32
no.6
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pp.563-566
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2010
Retrobulbar abscess is a rare, but severe complication of paranasal sinusitis. The clinical presentations are eyelid swelling, erythema, proptosis, conjunctival chemosis, restricted ocular movement, and decreased visual acuity. Diagnostic methods available for evaluating retrobulbar abscess include sinus X-ray, ultrasonography, computed tomography (CT), and bacterial culture. For the treatment of retrobulbar abscess, immediate surgical drainage and systemic antibiotic therapy are needed. Proper diagnosis and treatments are necessary for preventing visual loss, cavernous sinus thrombosis, subdural abscess, and other lifethreatening complications. A patient, a 30-year-old man, was admitted to our hospital because of progressive eyelid swelling, erythema, ptosis and decreased visual acuity on the right eye after endodontic treatment. The sinusitis occurred secondary to the infection from an upper molar tooth. The spread of the infection led to the orbit via ethmoidal sinus and posterior orbital wall. Immediate surgical intervention was performed and systemic antibiotics was administrated. The symptoms and signs are improved after treatments, so we present our case with a brief review of the literature.
Journal of the Korea Academia-Industrial cooperation Society
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v.10
no.12
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pp.3919-3924
/
2009
To evaluate clinical results of silicone oil injection for retinal detachment. The 45 eyes of 44 patients underwent vitrectomy and silicone oil injection from 1999 to 2002. 1.There were no history of previous retinal surgery and ocular trauma. In 24 of the 45 eyes(53%) visual acuity increased and stabilized in 18 of the 45 eyes(40%). 2. 1 of 16 eyes(6.3%) had recurred retinal detachment after silicone oil removal. 3. Final retinal reattachment was achieved in 44 eyes(97%). Postoperative complications were cataract(16 eyes), glaucoma(10 eyes), emulsification of silicone oil(5 eyes), keratopathy(2 eyes) and recurrent retinal detachment(1 eye). These results show that silicone oil injection for primary retinal detachment yields a high rate of anatomic success and the good visual outcome
Allergic rhinitis is a common disease of childhood characterized by nasal, throat, and ocular itching, rhinorrhea, sneezing, nasal congestion. Those affected with allergic rhinitis often suffer from associated inflammatory conditions of the mucosa, such as allergic conjunctivitis, rhinosinusitis, asthma, otitis media with effusion, and other atopic conditions, such as eczema and food allergies. Allergic rhinitis must be diagnosed and treated properly to prevent complications and impaired quality of life. Despite a high prevalence, allergic rhinitis isoften undiagnosed and inadequately treated, especially in the pediatric population. The first step in treatment is environmental control when appropriate. It may be difficult to eliminate all offending allergens effectively to reduce symptoms, so medications are often required. Many different classes of medications are now available, and they have been shown to be effective and safe in a large number of well-designed, clinical trials. Antihistamines are effective in treating immediate symptoms of sneezing, pruritus, watery eyes, and rhinorrhea. Second generation antihistamines are the preferred antihistamines because of their superior side effect profile. Thus, decongestants are commonly used with oral antihistamines. Intranasal corticosteroids are the most effective therapy for allergic rhinitis. Leukotriene modifier may be as effective as antihistamines in treating allergic rhinitis symptoms. Cromolyn sodium is an option for mild disease when used prophylactically, and ipratropium bromide is effective when rhinorrhea is the predominant symptom. When avoidance measures and medications are not effective, specific immunotherapy is an effective alternative. Only immunotherapy results in sustained changes in the immune system. Because of improved understanding of the pathogenesis, new and better therapies may be forthcoming. The effective treatment of allergic rhinitis in children will reduce symptoms and will improve overall health and quality of life, making a happier, healthier child.
Myasthenia gravis is a functional neuromuscular disorder with characteristic voluntary muscle weakness. The role of thymus in pathogenesis of this disorder has become apparent that thymectomy in treatment has gained acceptance. Between January 1976 and June 1987, twenty patients underwent thymectomy for myasthenia gravis at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University. A clinical study that is focused on the factors affecting the operative results was analyzed and the following results were obtained. Among the 20 patients, male to female ratio was 8:12 and the age of onset was ranged from 3 years to 67 years. The chief complaints in order of frequency were as follows; ocular symptoms such as ptosis and diplopia[7 cases], general weakness[4 cases], swallowing difficulty[3 cases], dyspnea[3 cases], dysphasia[1 case], headache[1 case] and dizziness[1 case]. The severity of disease was classified by modified Osserman`s method that Group IIa was 8 cases, Group IIb; 7 cases, Group IIc; 3 cases and Group I; 2 cases. In histopathology of thymus, the most frequent finding was hyperplasia[11 cases] followed by thymoma[4 cases], normal tissue[3 cases] and malignant` thymoma[2 cases]. There were two cases of postoperative complications; one case was wound infection and the other was mediastinitis. One case of malignant thymoma died due to respiratory failure with pulmonary metastasis. There was 16 cases[80%] of improvement after thymectomy as follows; complete remission was 4 cases[20%], marked improvement was 9 cases[45%] and subjective improvement only was 3 cases[15%]. The effect of severity and duration of disease on operative result has statistically significant. The effect of thymus histopathology on operative result was not statistically significant. But there were comparable results between thymoma cases and non-thymoma cases.
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