It is known that optic disc morphology is different between high tension glaucoma[HTG]and normal tension glaucoma[NTG]. We quantitatively evaluated optic nerve head by confocal scanning laser ophthalmoscope [CSLO]to determine if substantial morphological differences between the HTG and the NTG could be identified. 21 patients[21 eyes]in the early NTG and 32 patients[32 eyes]in the early HTG were matched for visual field defect[MD>-10dB].The optic nerve head was evaluated by Heidelberg Retina Tomograph[HRT]and 12parameters provided by HRT were compared between NTG and HTG. The mean age of patients was 56.6 +/-13.6 years in NTG and 48.9 +/-14.7 years in HTG, respectively[p>0.05].Mean MD was -5.4 +/-1.9dB in the NTG, -5.0 +/-2.5dB in the HTG, respectively[p>0.05]. Disc area was slightly lager in the NTG than in the HTG, but the difference did not reach statistical significance[p>0.05].The neuroretinal rim area was significantly larger in the NTG than in the HTG[p<0.05], whereas the mean cup depth was significantly smaller in the NTG than in the HTG[p<0.05].Among the 12 parameters, cup area, rim area, cup volume, mean cup depth, and maximum cup depth in the NTG had significant correlations with CPSD in the visual field index.These findings further support the hypothesis that there may be different mechanisms in the glaucomatous optic nerve damage.
Evaluation Studies as Topic* ; Head* ; Humans ; Low Tension Glaucoma* ; Ophthalmoscopes ; Optic Disk ; Optic Nerve ; Retina ; Visual Fields

It is known that humidity in the laser room might affect the outcomes of excimer laser refractive surgery. This study evaluated the outcomes of laser in situ keratomileusis (LASIK)according to humidity changes in laser room. Hinged flap was made by SCMD turbokeratome and photoablation was performed by utilizing VISX 20/20 excimer laser system. The differences between targeted refraction and actual refractive error, namely, refractive correction errors (defined by authors)were calculated. We have divided LASIK patients into two groups. Group A consisting of 61 eyes of 31 patients underwent LASIK when laser room humidity was over 70% (average 73%) and Group B includes 49 eyes of 28 patients when laser room humidity was under 40% (average 35%). Each group was broken into two subgroups, that is high myopia (> or= -6 D)and mild to moderate myopia (< -6 D). The mean refractive correction errors in the high myopia (> or= -6 D)was 1.28+/-1.42 D in the group A (n=46 eyes)and 1.99 +/-1.38 D in the group B (n= 26 eyes). In both groups, the difference between two subgroups was statistically significant and high myopes group B was overcorrected compared with ones in group A (t-test, p<0.05). The mean refractive correction errors in the low to moderate myopia (< -6 D)was 0.38 +/-0.49 D in the group A (n=15 eyes)and 0.4 +/-0.38 D in the group B (n=23 eyes). In both subgroups, there was no statistically significant difference in mean refractive correction errors (t-test, p>0.05). The proper room humidity is critical for LASIK results, particularly in the high myopia (> or= -6 D)because humidity can affect outcomes of LASIK. Therefore, the humidity should be maintained properly for enhancement of surgical outcome predictability in the high myopia.
Humans ; Humidity* ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Refractive Errors ; Refractive Surgical Procedures

V. parahaemolyticus was isolated from blood culture of a 34-year old female patient with HCV viral hepatitis and liver cirrhosis. V. parahaemolyticus is one of the frequent causative agents of gastrointestinal infection, but rarely causes septicemia. This case is thought to be the 3rd report of V. parahaemolyticus septicemia in Korea.
Adult ; Female ; Hepatitis ; Humans ; Korea ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio parahaemolyticus* ; Vibrio*

BACKGROUND: It has been reported that Mentha arvensis water extract (MAWE) inhibited systemic anaphylaxis and histamine release from the rat peritoneal mast cells (RPMC) by compound 48/80. OBJECTIVE AND METHOD: This study was undertaken to determine the inhibitory effects of immunoglobulin E (IgE)-mediated anaphylactic reaction by MAWE. This paper deals with an evaluation of the effect of MAWE on the anti-dinitrophenyl (DNP) IgE antibody induced anaphylactic reaction in rats. We also investigated the influence of MAWE on anti-DNP IgE antibody-induced tumor necrosis factor-alpha (TNF-alpha) production. RESULTS: MAWE inhibited passive cutaneous anaphylaxis (PCA) when intravenously, intrap- eritoneally, and orally administered. MAWE dose-dependently inhibited histamine release from RPMC activated by anti-DNP IgE antibody. Moreover, MAWE had an inhibitory effect on anti-DNP IgE antibody induced TNF-alphaproduction from RPMC. CONCLUSION: These results suggest that MAWE inhibits the IgE-mediated anaphylactic reaction in rats.
Anaphylaxis* ; Animals ; Histamine Release ; Immunoglobulin E ; Immunoglobulins ; Mast Cells ; Mentha* ; Passive Cutaneous Anaphylaxis ; Rats* ; Tumor Necrosis Factor-alpha ; Water

A 60-year-old male with continuous ambulatory peritoneal dialysis was admitted because of abdominal discomfort and turbid dialysate. He had a history of chronic renal failure due to diabetic nephropathy. His WBC count of perpheral blood was 8,500/mm3 (neutrophil 92%), and that of dialysate was 1,400/mm3 (polymorphonuclear leukocyte 69%, lymphocyte 31%). Pure growth of Leclercia adecarboxylata was isolated from dialysate. The L. adecarboxylata isolate was susceptible to ampicillin, ampicillin/sulbactam, cephalothin, cefoperazone, cefoxitin, cefotaxime, ceftazidime, aztreonam, imipenem, gentamicin, tobramycin, amikacin, tetracycline, trimethoprim- sulfamethoxazole and ciprofloxacin. Cephalothin & amikacin were added into dialysate, and his clinical symptoms and turbidity of dialysate were resolved. L. adecarboxylata has been rarely isolated from clinical specimens. To our knowledge, this is the first report of L. adecarboxylata isolated from clinical specimen in Korea. On review of the world literature, we found only 7 cases of L. adecarboxylata infections. This microorganism has been isolated from lower extremity wounds and sputum as part of a mixed flora in 3 cases and 1 case, respectively, but it was the only microorganism isolated from cultures of blood in 3 cases. These 3 patients with bacteremia due to L. adecarboxylata had severe underlying diseases, and clinical symptoms were developed after invasive procedures. All of the L. adecarboxylata isolates from clinical specimens were susceptible to antimicrobial agents tested, and the responses to antibiotic therapy were excellent. It is difficult to identify this organism because its biochemical reactions are similar to those of Escherichia coli, therefore careful identification is required. And additional studies are necessary to determine the pathogenic potential and route of infection of this organism.
Amikacin ; Ampicillin ; Anti-Infective Agents ; Aztreonam ; Bacteremia ; Cefoperazone ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cephalothin ; Ciprofloxacin ; Diabetic Nephropathies ; Enterobacteriaceae* ; Escherichia coli ; Gentamicins ; Humans ; Imipenem ; Kidney Failure, Chronic ; Korea ; Leukocytes ; Lower Extremity ; Lymphocytes ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory* ; Sputum ; Sulfamethoxazole ; Tetracycline ; Tobramycin ; Wounds and Injuries

A case of renal amyloidosis with crescentic glomerulonephritis associated with rheumatoid arthritis is described. A 60-year-old female with 15 years' history of rheumatoid arthritis developed nephrotic syndrome followed by rapid deterioration of renal function. Glomerular amyloid deposition and sclerotic change was present in kidney biopsy specimen and crescentic change was found in 85% of the glomerulus. Electron microscopic finding of glomerulus showed randomly oriented, rigid-appearing, long nonbranching fibrils. The patient was treated with intravenous high-dose methylprednisolone pulses combined with intravenous cyclophosphamide followed by oral corticosteroids. Three months after the above treatment, renal function gradually improved, reaching serum creatinine level to 2.5 mg/dL. But the nephrotic range proteinuria persisted.
Adrenal Cortex Hormones ; Amyloidosis* ; Arthritis, Rheumatoid* ; Biopsy ; Creatinine ; Cyclophosphamide ; Female ; Glomerulonephritis* ; Humans ; Kidney ; Methylprednisolone ; Middle Aged ; Nephrotic Syndrome ; Plaque, Amyloid ; Proteinuria

BACKGROUND AND OBJECTIVES: Acute epiglottitis is a life-threatening condition that can result in airway obstruction. The present study reports clinical features, management and patient outcomes in an acute epiglottitis.SUBJECTS AND METHOD: Included in our retrospective study were 315 patients who were admitted with the diagnosis of acute epiglottitis between January 2006 and July to the department Otolaryngology-Head and Neck surgery, Hallym University Sacred Heart Hospital 2018. The diagnosis of acute epiglottitis was established by confirmation of inflamed epiglottis using laryngoscope or computed tomography. RESULTS: Among 315 patients, 89 cases (28%) and 83 cases (26%) were found in the fifth and fourth decades, respectively. The mean age of patients was 45.0±13.94 years. The male to female ratio was 1.33:1. A total of 75 patients (23.8%) had co-morbidities, with hypertension (13.6%) being the most common. Fever was relatively uncommon, whereas most patients complained of sore throat. Ceftriaxone was the most common empirical antibiotic regimen prescribed and the use of steroids did not affect the length of hospital stay. Nine patients required airway intervention, including eight who underwent endotracheal intubation and one emergency tracheostomy. In patients who need airway intervention, systolic blood pressure, body temperature, respiratory rate, heart rate, white blood cells and the proportion of dyspnea were significantly higher in comparison to the patients without airway intervention. CONCLUSION Although acute epiglottitis often has nonspecific symptoms, it may lead to sudden dyspnea and unstable vital signs, so an in-depth understanding of this disease is needed.

BACKGROUND AND OBJECTIVES: This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. MATERIALS AND METHODS: The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. RESULTS: Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p < 0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p < 0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). CONCLUSION: Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.
Edema ; Humans ; Medical Records ; Microsurgery ; Noise ; Papilloma ; Polyps ; Prognosis ; Retrospective Studies ; Vocal Cords ; Voice

BACKGROUND AND OBJECTIVES: Acute epiglottitis is a life-threatening condition that can result in airway obstruction. The present study reports clinical features, management and patient outcomes in an acute epiglottitis. SUBJECTS AND METHOD: Included in our retrospective study were 315 patients who were admitted with the diagnosis of acute epiglottitis between January 2006 and July to the department Otolaryngology-Head and Neck surgery, Hallym University Sacred Heart Hospital 2018. The diagnosis of acute epiglottitis was established by confirmation of inflamed epiglottis using laryngoscope or computed tomography. RESULTS: Among 315 patients, 89 cases (28%) and 83 cases (26%) were found in the fifth and fourth decades, respectively. The mean age of patients was 45.0±13.94 years. The male to female ratio was 1.33:1. A total of 75 patients (23.8%) had co-morbidities, with hypertension (13.6%) being the most common. Fever was relatively uncommon, whereas most patients complained of sore throat. Ceftriaxone was the most common empirical antibiotic regimen prescribed and the use of steroids did not affect the length of hospital stay. Nine patients required airway intervention, including eight who underwent endotracheal intubation and one emergency tracheostomy. In patients who need airway intervention, systolic blood pressure, body temperature, respiratory rate, heart rate, white blood cells and the proportion of dyspnea were significantly higher in comparison to the patients without airway intervention. CONCLUSION: Although acute epiglottitis often has nonspecific symptoms, it may lead to sudden dyspnea and unstable vital signs, so an in-depth understanding of this disease is needed.
Airway Obstruction ; Anti-Bacterial Agents ; Blood Pressure ; Body Temperature ; Ceftriaxone ; Clinical Study ; Diagnosis ; Dyspnea ; Emergencies ; Epiglottis ; Epiglottitis ; Female ; Fever ; Heart ; Heart Rate ; Humans ; Hypertension ; Intubation, Intratracheal ; Korea ; Laryngoscopes ; Length of Stay ; Leukocytes ; Male ; Methods ; Neck ; Pharyngitis ; Respiratory Rate ; Retrospective Studies ; Steroids ; Tracheostomy ; Vital Signs

PURPOSE: We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). MATERIALS AND METHODS: We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors). The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. RESULTS: Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve = 0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve =0.860), but there was no statistical differerence in sensitivity, specificity and accuracy between the combined method and a single modality. CONCLUSION: It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer.
Breast Neoplasms* ; Breast* ; Complement System Proteins ; Diagnosis* ; Diagnosis, Differential ; Humans ; ROC Curve ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography*