• 제목/요약/키워드: Ocular complications

검색결과 69건 처리시간 0.043초

Three-dimensional cone-beam computed tomographic sialography in the diagnosis and management of primary Sjögren syndrome: Report of 3 cases

  • Thomas, Nithin;Kaur, Aninditya;Reddy, Sujatha S.;Nagaraju, Rakesh;Nagi, Ravleen;Shankar, Vidya Gurram
    • Imaging Science in Dentistry
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    • 제51권2호
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    • pp.209-216
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    • 2021
  • 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.

"Letter-Box" Conjunctival Flap in a Dog with Severe Corneal Edema after Phacoemulsification

  • Sunhyo Kim;Dohyoung Kwon;Kangmoon Seo;Seonmi Kang
    • 한국임상수의학회지
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    • 제40권2호
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    • pp.152-157
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    • 2023
  • 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.

Ensuring Patient Safety in Pediatric Dental Care

  • Daewoo Lee
    • 대한소아치과학회지
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    • 제51권2호
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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.

단일기관의 장기추적 결과 (Bilateral retinoblastoma: Long-term follow-up results from a single institution)

  • 최상열;김동환;이강민;이현재;김미숙;이태원;최상욱;김동호;박경덕;이준아
    • Clinical and Experimental Pediatrics
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    • 제52권6호
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    • pp.674-679
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    • 2009
  • 목 적 : 양측성 망막모세포종 환자들의 치료 후 장기후유증을 분석하고자 하였다. 방 법 : 1987년 10월부터 1998년 10월까지 원자력병원에서 치료를 받고 10년 이상 장기추적관찰 중인 양측성 망막모세포종 환자 22명의 의무기록을 분석하였다. 진단시 연령, 치료지연, Reese-Ellsworth (RE) 분류, 국소치료방법 등의 임상 변수와 생존율, 안구합병증을 포함한 장기후유증의 발생과의 관계를 알아보았다. 결 과 : 진단 시 정중 연령은 7.0 개월로(범위, 1.7-31.6개월), 백색동공으로 내원한 경우가 가장 많았다. 44개 안구의 RE 분류는 각각 group II (n=4), III (n=14), IV (n=4), V (n=22)이었다. 추적관찰 141개월째인 현재 20명이 생존하여 있으며, 10년 안구생존율은 $56.8{\pm}7.5%$이었다. 임상변수 중, 3개월 이상의 치료지연이 재발과 관련이 있었다. 방사선 치료 후 백내장, 망막박리, 안구로, 안면비대칭 등의 합병증이 관찰되었으며 현재까지 이차성 종양의 발생은 없었다. 결 론 : 안구생존율을 향상시키기 위해서는 종양을 조기에 발견하도록 노력하고 진단즉시 치료를 시작해야 할 것이다. 이와 더불어 장기적인 후유증의 발생여부에 대해서도 세심한 추적관찰이 필요하다.

광범위한 안와파열골절에서 Titanium Mesh Plate와 Porous Polyethylene (Medpor®) 동시 사용의 유용성 (Treatment of Blow-out Fractures Using Both Titanium Mesh Plate and Porous Polyethylene (Medpor®))

  • 구자혜;원창훈;동은상;윤을식
    • 대한두개안면성형외과학회지
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    • 제11권2호
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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.

안면 영상처리를 통한 김정일 국방위원장의 건강 상태 분석 (Health Analysis of Kim Jung-Il National Defense Committee Chairman Using Face Image Processing)

  • 이세환;김봉현;가민경;조동욱
    • 한국산학기술학회논문지
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    • 제10권10호
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    • pp.2873-2878
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    • 2009
  • 1990년 동독과 서독이 독일로 통일 된 후 우리나라만이 세계에서 유일한 분단국가로 남아있다. 이로 인해 전 세계적인 관심 및 안전에 대한 의구심을 야기하여 국가 이미지 실추 및 관광 수입의 저하 등 여러 분야로 나쁜 영향을 미치고 있는 것이 현 실정이다. 북한은 사회주의체제 국가로서 국방위원장에 의한 독재 체제를 유지하고 있으며 현재 김정일 국방위원장이 정권을 장악하고 있으나 근래 들어 건강에 대한 이상설과 후계자 미결정으로 정치적 불안감이 커져감에 따라 외교 및 남북 관계에 대한 걱정이 증가하고 있다. 따라서 이 같은 상황에서 김정일 위원장에 대한 건강 정보는 대단히 중요한 자료가 된다. 이를 위해 본 논문에서는 한의학의 진단법인 망진 기법을 적용하여 최근 공개된 김정일 국방위원장의 사진에서 안면 분석을 행하여 실제 김정일 국방위원장의 건강에 대한 정보를 추출해 보고자 한다. 그러나 김정일 국방 위원장의 영상의 경우 동일한 환경에서 촬영된 영상이 아니고 여러 가지 분석을 방해하는 요소가 많기 때문에 색상 보정을 통한 분석 방법과 색상 보정 없이 안면 각 부위에 따른 색차의 차이에 대한 비교를 통해 가장 큰 의혹을 받고 있는 당뇨합병증에 대한 분석을 수행하고자 한다.

급성 치성상악동염으로 인한 안구후농양: 증례보고 (Retrobulbulbar Abscess Due to Acute Odontogenic Sinusitis: a Case Report)

  • 조현주;정용선;채병무;정태영;박상준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권6호
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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.

망막박리에서 일차수술로 유리체절제술과 실리콘 주입술에 대한 임상결과 분석 (Clinical Results of Silicone Oil Injection following Vitrectomy as a Primary Procedure in Retinal Detachment)

  • 길현경;이무식;황혜정
    • 한국산학기술학회논문지
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    • 제10권12호
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    • pp.3919-3924
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    • 2009
  • 본 연구는 망막박리에서 실리콘 기름주입술에 대한 임상적 결과를 분석한 것이다. 1999년부터 2002년까지 유리체절제술과 실리콘기름 주입술를 받은 44명 환자의 45안을 연구하였다. 결과는 다음과 같다. 1. 유리체절제술 후 시력이 두 줄 이상 호전된 경우는 45안 중 24안(53%)이었으며, 45안 중 18안(40%)에서는 시력의 변화가 없었다. 2. 실리콘기름 주입술 후 16안(6.3%)에서 실리콘기름을 제거하였으며 그 중 1안에서 망막박리가 재발되어 실리콘기름 재주입술을 시행하여 망막재유착을 이루었다. 3. 재수술을 포함하여 해부학적인 재유착은 45안 중 44안(97%)에서 이루었다. 4. 실리콘기름주입 후 발생한 합병증은 백내장(16안), 녹내장(10안), 실리콘기름의 유화(5안), 각막병증(2안), 재발성 망막박리 (1안)이었다. 결론적으로 망막박리 환자에게 일차수술로 유리체 절제술 후 유리체 대용물로 실리콘 기름을 사용하는 것은 여러 합병증의 발생에도 불구하고 높은 해부학적 성공률과 시력 개선효과를 보여주었다.

소아 알레르기 비염의 진단과 치료 (Allergic rhinitis in children : diagnosis and treatment)

  • 나영호
    • Clinical and Experimental Pediatrics
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    • 제49권6호
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    • pp.593-601
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    • 2006
  • 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.

중증 근무력증의 외과적 치료 (Surgical Treatment of Myasthenia Gravis)

  • 손영상
    • Journal of Chest Surgery
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    • 제21권3호
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    • pp.454-461
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    • 1988
  • 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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