Publications by authors named "Michael Yoon"

Purpose: The purpose of this study is to assess the surgical costs of enucleations and eviscerations and their relation to current reimbursement rates using time-driven activity-based costing.

Methods: This is a retrospective study of patients undergoing enucleation and evisceration surgeries with attachment of muscles (Current Procedural Terminology 65105 and 65093) for a diagnosis of blind, painful eye, from January 1, 2019, to December 31, 2023, at a single, tertiary level, teaching hospital. A time-driven activity-based cost analysis for day of surgery was performed.

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  • The study investigates the occurrence of suture granulomas, a complication in canthal surgery, focusing on their incidence and risk factors.
  • A total of 758 surgeries were reviewed, revealing that 2.4% resulted in granulomas, mainly linked to specific suture materials, particularly uncoated polyester.
  • Results suggest that using absorbable or monofilament sutures can significantly reduce the risk of developing suture granulomas after surgery.
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  • - Leprosy, or Hansen disease, is an airborne illness characterized by symptoms like skin lesions, nerve damage, and eye issues, caused by specific bacteria.
  • - A patient with a history of tuberculoid leprosy developed severe tear duct issues four years after finishing treatment, leading to surgery to correct the blockage.
  • - Post-surgery, analysis revealed ongoing inflammation linked to the earlier leprosy infection, but the patient has been symptom-free for six months after the procedure.
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  • Previous studies on teprotumumab for thyroid eye disease used absolute millimetres to measure proptosis reduction, which may not reflect its true clinical effects for all patients.
  • In a new retrospective study involving 119 patients, 87.4% of eyes showed an average proptosis reduction of 14.4% from their pre-treatment values, translating to about 3.3 mm on average.
  • The study suggests that reporting proptosis reduction as a percentage of pre-treatment values offers a clearer picture of teprotumumab's effectiveness in treating thyroid eye disease.
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  • The study aimed to analyze how patients with radiation-induced acquired lacrimal duct obstructions (RALDO) were managed and their outcomes, using data from a single surgeon's retrospective chart review over five years.* -
  • Out of 16 patients with an average age of 63.3 years, most experienced epiphora symptoms about 9.5 months after radiation treatment related to various tumor types, with significant differences in the involvement of the right and left lacrimal drainage systems.* -
  • Surgical management of RALDO included various techniques based on the type and location of the obstruction, leading to tailored treatments like silicone tube placement and dilatation, with a variety of radiation therapies provided prior to the development of so
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Purpose: To review the efficacy and safety of the use of intraoperative image guidance (IIG) in orbital and lacrimal surgery.

Methods: A literature search of the PubMed database was last conducted in November 2023 for English-language original research that assessed the use of any image guidance system in orbital and lacrimal surgery that included at least 5 patients. The search identified 524 articles; 94 were selected for full-text analysis by the panel.

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Schistosomiasis is a neglected disease of poverty that affects over 200 million people worldwide and relies on a single drug for therapy. The cathepsin B1 cysteine protease (SmCB1) of has been investigated as a potential target. Here, a structure-based pharmacophore virtual screening (VS) approach was used on a data set of approved drugs to identify potential antischistosomal agents targeting SmCB1.

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Purpose: The initial management of patients presenting with orbital inflammatory syndromes varies-with some pursuing a diagnostic workup while others treat without any testing. The evidence behind this rationale is limited. A review of patients with orbital inflammation is performed with an analysis of diagnostic testing to develop a workflow for such patients.

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We report the case of an 80-year-old man with restrictive strabismus in lateral gaze following multiple oculoplastic procedures for idiopathic epiphora. Despite excellent initial response to nasal conjunctival recession with lysis of adhesions and a miminal recession of the medial rectus muscle, the patient suffered recurrence of diplopia associated with limitation of abduction due to aggressive, deep, subconjunctival scarring. Given the history of oral lichen planus (LP), the patient was diagnosed with ocular involvement of LP.

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Background: No widely accepted, validated instrument currently exists to measure clinical outcomes in patients who undergo dacryocystorhinostomy (DCR) for treatment of epiphora.

Objective: To develop a patient-reported outcome measure applicable to this population.

Methods: Psychometric evaluations, consultation with experts, and review of the literature informed item generation of a 12-question questionnaire to incorporate the most relevant symptoms experienced by patients with nasolacrimal duct obstruction.

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Purpose: The current study queries the American Academy of Ophthalmology (AAO) Intelligent Research in Sight (IRIS) registry for data on the epidemiology, work-up, and management patterns of autoimmune orbital inflammation.

Methods: Analysis and description of patient data from the IRIS registry between 2013 and 2019 reviewing patients with autoimmune or idiopathic orbital inflammation with filters based on International Classification of Disease (ICD) and Current Procedural Terminology (CPT) codes. Patients with thyroid eye disease, orbital cellulitis, and orbital abscess were excluded.

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  • Two cases of necrotizing Sweet syndrome (nSS), a rare skin condition resembling soft tissue infections, are detailed in the text.
  • The first case involved a 74-year-old woman with myelodysplastic syndrome who had nSS around her eyes, effectively treated with corticosteroids and skin grafting.
  • The second case presented a 40-year-old woman with leukemia whose nSS was complicated by herpes zoster infection but improved with chemotherapy and corticosteroids, emphasizing the need for careful diagnosis to prevent misdiagnosis.
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Purpose: Despite the high prevalence, treatment challenges, and significant impact of eyelid retraction on vision and quality of life among patients with thyroid eye disease, the effects of teprotumumab on eyelid retraction are not fully understood. This study evaluated change in upper eyelid position after teprotumumab.

Methods: A retrospective study of all patients who completed eight teprotumumab infusions at one institution from January 1 2020 to December 31 2022.

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Protecting groups (PGs) in peptide synthesis have inspired advanced design principles that incorporate "orthogonality" for selective C- and N-terminus and side-chain deprotections. The conventionally acid-stable 9-fluorenylmethoxycarbonyl (Fmoc) group is one of the most widely used N-protection groups in solid- and solution-phase synthesis. Despite the versatility of Fmoc, deprotection by the removal of the Fmoc group to unmask primary amines requires the use of a basic secondary amine nucleophile, but this stratagem poses challenges in sensitive molecules that bear reactive electrophilic groups.

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Purpose: This study analyzed the degree and timing of proptosis regression after teprotumumab therapy.

Methods: A retrospective study of all patients who completed 8 teprotumumab infusions at 1 institution from January 1, 2020 to December 31, 2022. Change in proptosis was assessed in millimeters and percentages compared with immediate post-treatment and pretreatment proptosis.

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A 25-year-old woman with a history of acute lymphoblastic leukemia with Philadelphia chromosome (BCR 22q11.2-ABL1 (9q34)) presented with progressively worsening swelling and pain in her left upper eyelid of 3 months' duration. Magnetic resonance imaging showed a heterogeneously enhancing mass lesion in the left lacrimal gland.

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Traumatic inferior rectus muscle rupture secondary to blunt injury in the absence of associated orbital or ocular fractures or injury is rarely encountered, and there are limited published reports on subsequent surgical repair. We present the case of a 74-year-old man with complete inferior rectus transection following a fall with facial strike. A computed tomography scan of the face was unremarkable.

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The biological and pathological functions of cathepsin B occur in acidic lysosomes and at the neutral pH of cytosol, nuclei, and extracellular locations. Importantly, cathepsin B displays different substrate cleavage properties at acidic pH compared to neutral pH conditions. It is, therefore, desirable to develop specific substrates for cathepsin B that measure its activity over broad pH ranges.

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  • The study aimed to assess how functional upper blepharoplasty affects the perceived age of patients before and after the procedure.
  • Sixty-seven patients participated, with a slight overall decrease in perceived age from 68.9 years to 67.1 years post-surgery, indicating an average reduction of 1.8 years.
  • Results showed varying effects based on gender and ethnicity, with women experiencing a 1.9-year decrease in perceived age, and whites seeing the most significant change at 2.1 years.
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Orbital cellulitis in the pediatric population is treated primarily with antibiotic therapy. This leaves the inflammatory component unchecked. Corticosteroid therapy has been used to accelerate recovery and decrease the long-term morbidity in other infectious conditions.

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A 77-year-old Asian female with a history of left orbit exenteration and lid-sparing reconstruction for recurrent sebaceous carcinoma presented with fluid-like sensation of the left orbit. Magnetic resonance imaging (MRI) demonstrated bright T2 signal and a cyst-like cavity within the exenterated orbit. Decision was made to proceed with surgical exploration and excision.

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