etection of infectious hypodermal and hematopoietic necrosis virus and white spot syndrome virus in whiteleg shrimp (Penaeus vannamei) imported from Vietnam to South Korea

n this study, whiteleg shrimp (Penaeus vannamei) imported from Vietnam were collected from South Korean markets, and examined for 2 viruses: infectious hypodermal and hematopoietic necrosis virus (IHHNV, recently classified as decapod penstyldensovirus-1), and white spot syndrome virus (WSSV). Among 58 samples, we detected IHHNV in 23 samples and WSSV in 2 samples, using polymerase chain reaction and sequencing analyses.This is the first report of IHHNV and WSSV detection in imported shrimp, suggesting that greater awareness and stricter quarantine policies regarding viruses infecting shrimp imported to South Korea are required.

Impact of Cataract Surgery on Foveal Avascular Zone Detected by Optical Coherence Tomography Angiography

Purpose@#To investigate the influence of cataract surgery on detection of a foveal avascular zone (FAZ) and retinal capillary density (RCD) by optical coherence tomography angiography (OCTA). @*Methods@#In this study, 64 eyes of 64 patients with cataracts who underwent surgery were included and studied retrospectively. All patients underwent cataract surgery of the included eye and a FAZ was detected on OCTA preoperatively and postoperatively using one of two kinds of OCTA devices. The FAZ and RCD were compared before and after cataract surgery using paired t-test. @*Results@#Using the Cirrus Angioplex OCTA device, there was no significant pre- or post-operative difference in the FAZ area (p = 0.060), perimeter (p = 0.052) and circularity (p = 0.190). It also revealed no significant difference between the central (p = 0.310), inner (p = 0.310), and outer (p = 0.310) zones and full RCD (p = 0.228) before and after cataract surgery The Spectralis OCTA device also showed no significant difference in the FAZ area (p = 0.239) before and after cataract surgery. @*Conclusions@#Cataract surgery does not affect detection of the FAZ and RCD on OCTA. Although patients who have a FAZ-related retinal disorder such as diabetic retinopathy and undergo cataract surgery are followed up regularly, it seems that the results gained by OCTA are reliable and comparable to the preoperative result.

Hemi-Thyroidectomy versus Total Thyroidectomy in Patients with Low-Risk Papillary Thyroid Carcinoma Sized 2 cm or Less

BACKGROUND AND OBJECTIVES: The controversy over the optimal extent of thyroidectomy for papillary thyroid carcinoma (PTC) has persisted over a long time period. Particularly, there is a lack of consensus in low-risk PTC sized >1 cm and ≤2 cm. In this retrospective study, we analyzed the oncologic outcomes between hemi-thyroidectomy and total thyroidectomy in patients with low-risk PTC sized 2 cm or less.MATERIALS AND METHODS: A retrospective chart review of 1107 patients who were diagnosed as unilateral low-risk PTC with maximal tumor size 2 cm or less and initially underwent either hemi-thyroidectomy (n=550) or total thyroidectomy (n=557) was conducted. All patients underwent ipsilateral prophylactic central neck dissection. Patients had no evidence of gross extrathyroidal extension or lymph node metastasis. Clinicopathologic factors and recurrence rate were compared according to the surgical extent and factors correlated to recurrence were analyzed.RESULTS: While the total thyroidectomy group had more aggressive clinicopathologic factors such as minimal extrathyroidal extension, multifocality, and lymph node metastasis, recurrence rate was higher in the hemi-thyroidectomy group (p=0.006). However, when the contralateral lobe recurrence was excluded there was no difference in recurrence between the two groups (p=0.597). In patients with tumor sized >1 cm and ≤2 cm there was no significant difference in recurrence between the two groups (p=0.100).CONCLUSION: Total thyroidectomy may not decrease recurrence in patients with PTC presented with unilateral tumor sized >1 cm and ≤2 cm. Hemi-thyroidectomy could be considered the treatment of choice in these patients when they are presented as a low-risk group.

A Case of a Visual Field Defect with Optical Coherence Tomography Changes after Sildenafil Citrate Overdose

PURPOSE: A case of a transient visual field defect and a change in spectral-domain optical coherence tomography (SD-OCT) after an overdose of sildenafil citrate is described. CASE SUMMARY: A 67-year-old male with no previous medical history presented with a bluish tinge and visual field defect in both eyes. He had consumed eight tablets of sildenafil citrate (800 mg) 3 days before the visit. His best-corrected visual acuity was 14/20 in the right eye and 20/20 in the left eye. No specific finding was noted on slit-lamp examination. Fundus examination and fundus photography revealed focal foveal hypopigmentation in both eyes. He underwent SD-OCT imaging with the Cirrus HD-OCT (Carl Zeiss Meditec, Oberkochen, Germany), and thickening of the ellipsoid zone and choroid was revealed by SD-OCT scans. He was advised not to take any more sildenafil citrate and was followed for 1 week after the first visit. Central scotomas of both eyes were revealed by a visual field test, and thickening of the ellipsoid zone and choroid remained. His eyes were re-evaluated 1 and 3 months after the first visit, and although the symptoms nearly disappeared, abnormalities in the visual field test and on SD-OCT remained, albeit with some degree of improvement. He revisited us 4 months after the first visit, at which time the visual field test and SD-OCT scans showed results within normal ranges. CONCLUSIONS: Sildenafil citrate overdose can result in a color anomaly (bluish tinge), visual field defects, and thickening of the ellipsoid zone and choroid on SD-OCT scans.

A Case of Unilateral Focal Pigmented Paravenous Retinochoroidal Atrophy

PURPOSE: We report a case of unilateral, focal, pigmented paravenous retinochoroidal atrophy (PPRCA). CASE SUMMARY: A 46-year-old female visited our clinic in complaint of a vague problem with her right eye identified during a general medical examination. The visual acuity (without correction) of both eyes was 1.0. Slit-lamp examination of both eyes revealed no specific signs. Fundus examination of the right eye revealed focal, bony-spicule-shaped retinochoroidal atrophy with pigmentation along the course of the superior retinal vein. A fundus autofluorescence examination revealed principally hypofluorescence with some hyperfluorescence at the margin of the atrophic retinochoroidal lesion. Optical coherence tomography revealed mixed clumping and atrophy of the retinal pigment epithelium (RPE) layer and thinning of the choriocapillaris layer. Fluorescence angiography revealed a window defect and blockage at the site of the lesion (the fluorescent material did not enter the lesion). The site of the window defect was in correlation with the atrophic RPE region. The site of the blockage at lesion also matched with the site of the regional pigment clumping. No definite leakage was observed. CONCLUSIONS: To the best of our knowledge, this is the first case of unilateral focal PPRCA reported from Korea.

Two Cases of Intraoperative Acute Opacification of Hydrophilic Intraocular Lens

PURPOSE: In the present study, two cases of intraoperative acute opacification of hydrophilic intraocular lens were reported. CASE SUMMARY: (Case 1) A sixty-seven year-old female presented with chronic visual impairment. Slit lamp examination revealed nuclear cataract of the left eye. Cataract surgery for her left eye was performed. A hydrophilic intraocular lens was checked before implantation and no defect was noted. Immediately after the implantation of the intraocular lens, acute whitish opacification of the intraocular lens occurred. However, the intraocular lens was not explanted, and the opacification cleared after one day. (Case 2) A 65 year-old male presented with chronic visual impairment of the left eye. Nuclear cataract of his left eye was noted, and he went through cataract surgery of the left eye. After the implantation of intraocular lens, acute whitish opacification of the intraocular lens was noted but it disappeared a day after. CONCLUSIONS: Intraoperative acute opacification of intraocular lens seems to occur due to radical temperature change. There is no need to remove or exchange the intraocular lens as opacification tends to clear within a day. No structural or mechanical change of intraocular lens was noted after opacification. Careful management of temperature for intraocular lens storage is necessary for prevention of intraoperative intraocular lens clouding.

A Case of Double Fovea Artifact Detected with Spectral-domain Optical Coherence Tomography

PURPOSE: In the present study, a case of double fovea artifact on spectral-domain optical coherence tomography (SD-OCT) was reported. CASE SUMMARY: A nine-year-old male presented with blurred vision of both eyes. His best corrected visual acuity (BCVA) was 20/20 in both eyes, and complete ophthalmologic evaluation including fundus examination and fundus photography revealed no abnormality in both eyes. He underwent SD-OCT imaging with the Cirrus HD-OCT. The Macular Cube 512 × 128 protocol of his right eye revealed an unusual pseudo-duplication of the fovea in the vertical meridian. The same protocol in his left eye also rendered a pseudo-duplication of two foveas in the vertical and horizontal meridians on the retinal thickness map. Re-examination with the same OCT system and protocol was performed two weeks later after the patient received counseling on fixation during the examination, and it revealed normal contour of the fovea in both eyes. CONCLUSIONS: Double fovea artifact seen in SD-OCT is a rare artifact that can possibly lead to misdiagnosis and inappropriate clinical treatment. Since the artifact was resolved with better fixation of the patient, repeating the scan with better patient compliance is necessary when such an artifact is encountered.

Orbital Cellulitis Following Strabismus Surgery

PURPOSE: To report a case of sudden orbital cellulitis presenting 2 weeks after strabismus surgery in a patient who had previously undergone retinal surgery for rhegmatogenous retinal detachment. CASE SUMMARY: A 45-year-old male visited the ophthalmology clinic with a 3-day history of left eye pain and lid swelling which suddenly developed 2 weeks after left lateral rectus muscle recession surgery for secondary sensory exotropia. The patient had undergone trans pars plana vitrectomy twice, scleral encircling, oil injection and removal for rhegmatogenous retinal detachment 1.3 years prior. His best corrected visual acuity was 0.2 in his left eye and physical examination revealed eyelid edema, chemosis, and subconjunctival hemorrhage of the left eye. The next day, eye movements were moderately restricted. Computed tomography scanning with contrast enhancement demonstrated diffuse periorbital soft tissue swelling and enhanced fat stranding suggesting left orbital cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. He was discharged after a 5-day course of intravenous antibiotic treatment, but readmitted for symptom aggravation and purulent discharge from the left conjunctival fornix. Culture of conjunctival fornices revealed penicillin-resistant staphylococcus aureus. Intravenous anitibiotics were maintained for 11 days additionally and left eye swelling, tenderness and ocular movement restrictions were improved. The patient was discharged from the hospital with a best corrected visual acuity of 0.2.

Ancient schwannoma in oral cavity: a report of two cases

This paper reports two cases of schwannomas arising from the oral cavity. One is an intraoral ancient schwannoma located at the left cheek, which evolved over a period of 13 years. The tumor was a well-demarcated buccal mass, which was located in the left lower first premolar area, with an obliterated the buccal vestibule, leaving the overlying mucosa intact. The second case was a central intraosseous schwannoma located from the left lower 1st molar periapical area to the left 3rd molar periapical area. Pathologically, the first mass was composed of the spindle shaped tumor cells with wavy nuclei beneath the fibroconnective tissue of the gingiva but second case mass was not. Occasional nuclear pleomorphism was observed but mitosis or necrosis was absent. There were Antoni A and B areas along with strong, diffuse staining with the S-100 protein. Ancient schwannomas were diagnosed. Schwannoma is a slow-growing benign tumor, and an ancient schwannoma that shows cellular atypism is a variant of a schwannoma caused by purely degenerative changes. To date, only limited cases of ancient schwannomas in the oral cavity have been reported.

Retromandibular Approach versus an Endoscope-assisted Transoral Approach to Treat Subcondylar Fractures of the Mandible

Surgical and Orthodontic Treatment of Unicystic Ameloblastoma Related to an Impacted Molar Tooth in the Mandible: Case Report

Evaluation of characteristics on titanium surface treatment for absorption of functional groups / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In order to bind or fix bioactive materials directly to the surface of a Ti implant, the prior binding process of functional groups (FGs, -COOH and -OH) to the implant surface is necessary. Conventional binding processes are so high-cost and complex, so it is essential to find a simple and effective procedure for Ti-FG binding.</p><p><b>METHODS</b>Various electrolyte compositions and electrochemical processing were adopted in this study to develop a relatively simple and effective Ti-FG binding process. The ability of Ti-FG binding and calcium (Ca)/phosphorous (P) absorption and corrosion resistance were evaluated according to various titanium surface treatment in electrolyte involving -COOH and -OH ion by using X ray photoelectron spectroscopy (XPS), field emission scanning electron microscope (FE-SEM) and potentiodynamic scan method respectively.</p><p><b>RESULTS</b>In cases of -COOH, the anodic oxidation process (AN) showed an effective binding ability between -COOH and Ti surface. On the other hand, in cases of -OH, there were no significant differences in the result between the conditions used. In regard to the absorption of Ca and P on Ti surface, there was a minimal amount of Ca absorbed but no P was absorbed. The anodic oxidation series showed homogenous corrosion, whereas the electrolyte immersion (EL) series showed unstable corrosion. Although EL-OH showed a novel corrosion potential, the EL-COOH series showed good corrosion resistance over the anodic potential range.</p><p><b>CONCLUSIONS</b>The ability of binding between FG and the Ti surface and Ca/P absorption were strongly associated with the surface potential (ζ potential), which was dependent on the pH of the electrolyte. Accordingly, in order to achieve the effective absorption of various FGs on the Ti surface, it is needed to develop the combination process in addition to the electric affinity, relation with the ζ potential.</p>

Carcinoma ex pleomorphic adenoma of the parotid gland: Case report

Carcinoma ex pleomorphic adenoma is transformed at the incidence of 1-20% in pleomorphic adenoma and frequently recurred. It accounts for 10% of all malignant salivary tumors and its average age of occurrence is 60s. It will present in a large, long-standing pleomorphic adenoma or in one that was previously treated but has recurred. According to cell composition in malignant cell carcinoma, and clear cell adenocarcinoma. Most (75%) occur in parotid gland, while about 20% occur in the minor gland of the oral mucosa. The metastasis rate to regional lymph node is about 25%, and to distant organs about 33% and the 5-year survival rates are 40%. Though the treatment of the carcinoma ex pleomorphic adenoma is not established, it is treated ideally with and extensive resection, neck dissection, postoperative radiotherapy, and chemotherapy. When occurred in parotid gland, facial paralysis is reported. With a review of literatures, we report a case of carcinoma ex pleomorphic adenoma which operated with total parotidectomy and supraomohyoid neck dissection.

A RETROSPECTIVE CLINICAL STUDY OF PERIAPICALLY INFECTED TEETH TREATED WITH PERIAPICAL SURGERY

Clinical Follow-up of Conjunctival Malignant Melanoma

PURPOSE: To investigate the clinical features and course of conjunctival malignant melanoma in Korea. METHODS: The medical records of 15 patients, 5 males and 10 females, diagnosed with conjunctival malignant melanoma who had been treated at Severance Hospital from May 1991 to March 2004 were reviewed retrospectively. The clinical parameters of the patients, tumors, and treatment were analyzed for their relation to outcome measures. RESULTS: The mean age at the time of diagnosis was 53.4 years (+/-11.7 years). In all cases, the disease was unilateral and all patients had experienced at least one recurrence. Local lymph node metastasis was found in 3 patients (20%) and the mean time to metastasis was 3.5 years. Systemic metastasis was found in 6 patients (40%) and the mean time to metastasis was 9.3 years. There were 5 cases of tumor-related death (33.3%), 4 of which were attributed to systemic metastasis. The Kaplan-Meier estimates of cumulative survival rate were 90% at 30 months and 56.6% at 70 months. CONCLUSIONS: Although conjunctival malignant melanoma is a rare disease, it is life-threatening and complete tumor excision at an early stage is mandatory, as is additional therapy to prevent local recurrence and systemic metastasis.

Evaluation of the Difference between the Predicted and Actual Refraction Among Different Types of Intraocular Lenses

PURPOSE: To evaluate the difference between the predicted and actual refraction among the intraocular lenses having different materials and shapes of optic and haptic. METHODS: We retrospectively analyzed the cases of 680 eyes with normal range of axial length (21-26mm), which underwent phacoemulsification and posterior chamber IOL implantation, and had at least 2 months follow up period, divided by 4 groups according to the types of IOL used. RESULTS: Mean age of the subjects was 68.9+/-10.8 years with 197 eyes (29%) of male and 483 eyes (71%) of female. The difference between the predicted and 2 month-postoperative refraction was +0.01 (SI40NB), -0.01 (LI61U), -0.45 (C31UB), +0.05 (MA60BM) diopters, respectively. C31UB group represented the myopic shift of -0.45D range and other groups showed no statistically significant difference. CONCLUSIONS: There was no effect of optic materials on the acquisition of goal diopter. MA60BM, SI40NB, LI61U showed high accuracy of predictiveness. The cause of myopic shift represented in C31UB group might be the differences of the haptic material, optic-haptic junction, or overall diameter.

Survivor Ship Analysis of Lumbar Microdiscectomy / 대한정형외과학회잡지

PURPOSE: To analyze the post-operative clinical results of lumbar microdiscectomy with respect to time, and to evaluate the causes of fail-ure by survivor ship analysis. MATERIALS AND METHODS: The clinical results of 162 patients were evaluated using MacNab's criteria and the survival rate was analyzed by using Kaplan-Meier survivor ship analysis. Several factors suspected of influencing survival were evaluated. RESULTS: Survival was 93.7% at 12 months after the operation, and showed annual decrements to reach 84.7% at 60 months but did not change thereafter until the final follow up. There were total 18 failed cases and the failure rate after 5 years was 0%. Statistically significant factors influencing the survival rate were, the type and level of disc herniation. The causes of early failure, which occurred within 12 months of surgery, were usually due to residual or recurrent radiating pain, whereas the major cause of late failure, which occurred after 12 months, was usually residual back pain. CONCLUSION: The failure rate was relatively high during the early post-operative period, but this decreased with time. Since long-term survival was relatively high, lumbar microdiscectomy could be considered an effective and satisfactory surgical technique.

Massive Rotator Cuff Tear / 대한정형외과학회잡지

PURPOSE: To report our experience of massive rotator cuff tear and evaluate the final outcome and factors influencing the final results. MATERIALS AND METHODS: We have performed 25 repairs (24 patients) of the massive rotator cuff tear. The average age 58 years old, mean follow-up was 22 months. Acromioplasty alone was performed in 7 cases and acromioplasty with direct repair was performed in 18 cases. We statistically analyzed the results by Student's T-test. RESULTS: Postoperative pain and UCLA score improved 2.2, 32 from 7.4, 14 respectively. The gain of 32 degrees in forward flexion, 8 degrees in external rotation could be obtained. Six (24%) was excellent, sixteen (64%) was good and three (12%) was poor and eigthy-four percent of our series was satisfied. Preoperative range of motion (P=0.040) , the degree of degeneration and the magnitude of tendon retraction (P=0.013) influenced the final results, but age (P=0.232) , duration and severity of pain (P=0.370) did not. There was a significant difference between acromioplasty only and acromioplasty with direct repair even though this discrepancy is very small (P=0.046) . Retear was revealed in 8 cases (44%) among repaired rotator cuff. CONCLUSION: Acromioplasty by itself could get a pain relief and functional improvement and a patient satisfaction in the treatment of massive rotator cuff tear regardless a reparability, but a more favorable result could be expected when a torn rotator cuff was repaired if possible.

Measurements of Lid Movements During Blinking: Video Measurement Technique

Understanding the kinetics of normal blinking is helpful for assessing ptosis, third and seventh cranial nerve palsy. Many different techniques have been used to measure the kinetics of blinking. These techniques require expensive tools and specific clinical environment. And they are invasive and difficult to apply to children because of lack of cooporation. We videotaped the eyelid movements of normal subject using video camera which can be used in uncooperative children and is noninvasive manner. There was no significant difference in the mean velocity and the time of eye closure and opening according to the age and sex(p>0.05). But the greater the levator palpebra function, the faster the mean velocity of eye opening and the faster the mean velocity of eye closure, the lesser the D ratio. We took standard data of eyelid movement of normal subject. Therefore, we may expect the diagnostic value of eyelid movement measurement using video camera in eyelid movement disorders.

Removal of Yersinia enterocolitica from Packed RBCs with WBC-Reduction Filters / 대한임상병리학회지

BACKGROUND: Aseptic technique and cold storage of blood can reduce the incidence of transfusion-associated infections. But, none of these precautions eliminates the potential of drawing contaminated blood from an asymptomatic carrier with psychrophilic organisms such as Yersinia enterocolitica. We evaluated the ability of WBC-reduction filters to prevent the growth of bacteria in packed RBCs that are artificially inoculated with Y. enterocolitica. METHODS: Twenty units of packed RBCs donated from 20 healthy individuals were divided into 4 groups. Group A and B were inoculated with 10 CFU/mL of Y. enterocolitica and group C and D were inoculated with 100 CFU/mL of Y.enterocolitica. After 24 hours of cold storage, group A and C were filtered through WBC-reduction filter (Sepacell R 500A: Asai medical, Japan) and returned them to storage. Group B and D served as unfiltered controls. We collected blood weekly from day 1 to day 35 of storage. Bacterial growths were compared between 4 groups. RESULTS: The prefiltration WBC count was 8,880/ L (SD 1464.2/ L, n=20). After filtration residual WBC count was 210/ L (SD 99.8/ L, n=10). All cases of group B & D (10 & 100 CFU/mL inoculation without filtration) showed growth over 105 CFU/mL after 3 weeks storage. But in filtered groups, only 1/5 (20%) of group C (100 CFU/mL inoculation with filtration) and 4/5 (80%) of group A (10 CFU/mL inoculation with filtration) showed growth over 105 CFU/mL after 3 weeks. CONCLUSIONS: The use of WBC-reduction filter have ability to reduce the risk of transfusion transmitted bacteremia in packed RBCs.