PURPOSE: To compare the levels of serum homocysteine, vitamin B12, vitamin B6 and folate in patients with normal-tension glaucoma, pseudoexfoliation glaucoma and high-tension glaucoma. METHODS: Thirty-two healthy subjects, 35 patients with normal-tension glaucoma, 22 patients with pseudoexfoliation glaucoma and 31 patients with high-tension glaucoma were included in the present study. Fasting venous samples were collected from all the participants. The levels of serum homocysteine, vitamin B12, vitamin B6 and folate were measured. One-way analysis of variance was used for the comparison of homocysteine, vitamin B12, vitamin B6 and folate levels among the 4 groups. RESULTS: The mean homocysteine levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.91 +/- 5.11 and 17.60 +/- 3.89 micromol/l, respectively, which were significantly higher than that of the control group (p = 0.014, p = 0.013, respectively). The mean vitamin B6 levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.67 +/- 14.32 and 17.00 +/- 10.58 nmol/l, respectively, which were significantly lower than that of the control group (p = 0.026, p = 0.008, respectively). CONCLUSIONS: Hyperhomocysteinemia may play a role as a risk factor in the development or progression of pseudoexfoliation glaucoma and high-tension glaucoma.
Fasting ; Folic Acid* ; Glaucoma* ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Risk Factors ; Vitamin B 12* ; Vitamin B 6*

PURPOSE: To report a case of cataract after long-term use of clonazepam in a young patient, with a similar appearance to cataract induced by other psychotropic agents. CASE SUMMARY: A 37-year-old woman complained of a visual disturbance in both eyes. The best-corrected visual acuity was 0.8 in the right eye and 0.6 in the left eye. Bilateral cortical cataract was observed on slit-lamp examination, and no other ophthalmic abnormalities were found. Potential risk factors for cataract were investigated, including past medical and family history, revealing a 20-year history of oral clonazepam (0.5-1 mg/day), for the neurological diagnosis of "chorea of unknown etiology". Detailed medication history did not reveal long-term use of any other drugs which could have induced the cataract. CONCLUSIONS: Because clonazepam use may induce cortical cataract, regular ophthalmologic examinations are necessary during long-term oral psychotropic therapy.
Adult ; Benzodiazepines ; Cataract ; Clonazepam ; Eye ; Female ; Humans ; Risk Factors ; Visual Acuity

The clinical syndrome of venoocclusive disease of the liver is one of several manifestations of regimen-related toxicity that can occur after high-dose cytoreductive therapy. Hepatic dysfunction after bone marrow transplantation may result from a number of causes such as pretransplant chemoradiation, graft-versus host disease, drugs for prophylaxis of graft-versus host disease, venoocclusive disease, various infections, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each cause is also quite different. Therefore the diagnosis of veno-occlusive disease is important. Veno-occlusive disease affects zone 3 of the liver acinus and produces a syndrome of jaundice, painful hepatomegaly, and fluid retention. Veno-occlusive disease occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. In Korea, there are a few case reports on venoocclusive disease after BMT which were only confirmed by clinical symptoms. This is a first report of two cases of hepatic veno-occlusive disease after allogenic BMT, which were proven by laparoscopic liver biopsy in our country.
Biopsy* ; Bone Marrow Transplantation* ; Bone Marrow* ; Diagnosis ; Hepatic Veno-Occlusive Disease* ; Hepatomegaly ; Humans ; Jaundice ; Korea ; Leukemia ; Liver* ; Mortality

The clinical syndrome of venoocclusive disease of the liver is one of several manifestations of regimen-related toxicity that can occur after high-dose cytoreductive therapy. Hepatic dysfunction after bone marrow transplantation may result from a number of causes such as pretransplant chemoradiation, graft-versus host disease, drugs for prophylaxis of graft-versus host disease, venoocclusive disease, various infections, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each cause is also quite different. Therefore the diagnosis of veno-occlusive disease is important. Veno-occlusive disease affects zone 3 of the liver acinus and produces a syndrome of jaundice, painful hepatomegaly, and fluid retention. Veno-occlusive disease occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. In Korea, there are a few case reports on venoocclusive disease after BMT which were only confirmed by clinical symptoms. This is a first report of two cases of hepatic veno-occlusive disease after allogenic BMT, which were proven by laparoscopic liver biopsy in our country.
Biopsy* ; Bone Marrow Transplantation* ; Bone Marrow* ; Diagnosis ; Hepatic Veno-Occlusive Disease* ; Hepatomegaly ; Humans ; Jaundice ; Korea ; Leukemia ; Liver* ; Mortality

OBJECTIVE: Recently, the prevalence of gall stone related with metabolic syndrome is increasing in Korea. The aim of this study was to reveal a relationship between components of metabolic syndrome and the development of gall bladder stones. METHODS: Among the subjects who visited a health promotion center of Soonchunhyang University Hospital from March 2009 to March 2010, a total of 5,201 adults were examined. Among them, the final 5,052 (male 3,403, female 1,649) adults were included. Sex, age, body mass index, waist circumference, blood pressure, fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol levels, and the presence of gall stones were measured. Metabolic syndrome was defined by criteria of 2004 American Heart Association/Updated National Cholesterol Education Program Adult Treatment Panel III. Analyses were adjusted by age and sex. RESULTS: This study showed that the prevalence of gall stone was 1.6% and metabolic syndrome was 19.3%. The results didn't show an association between gall stone risk and components of metabolic syndrome. But gall stone risk was increased according to aging, high total cholesterol in the abnormal body mass index group. In normal body mass index group, waist circumference was related with the development of gall stone. Total cholesterol level was related with the development of gall stone in overweight group. CONCLUSION: This study showed total cholesterol levels and waist circumference related with prevalence of gall stone in specific body mass index group.
Adult ; Aging ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Fasting ; Female ; Gallstones ; Health Promotion ; Heart ; Humans ; Korea ; Overweight ; Prevalence ; Risk Factors ; Urinary Bladder ; Waist Circumference

PURPOSE: This study evaluated the diagnosis, treatment and related results for cases with a deep infection after instrumented posterior fusion. MATERIALS AND METHODS: Among the 306 cases of posterior instrumented spinal fusion, Seventeen cases who developed deep infection were reviewed retrospectively. RESULTS: The incidence of deep infections was 5.6% and the mean age of the cases with a deep infection was 55 years old. Nine out of 17 cases had the preoperative risk factors such as old age, diabetes, malnutrition, obesity, etc. The mean duration to diagnosis of a postoperative infection was 12.9 days (4-8 days). The clinical manifestations were fever, night pain and abscess drainage. In all cases, the value of the WBC, ESR and CRP were elevated. All cases were treated surgically as soon as possible with abscess drainage, debridement and the insertion of antibiotics-mixed cement beads without the removal of the instrument. The most common bacterial organisms were Coagulase negative Staphylococcus aureus in 11 cases. Vancomycin was used as the antibiotic. During the follow-up period, 2 cases were treated with the removal of the instruments due to metal failure and a delayed deep infection with loosening. The average follow-up was 32 months (12-56 months). 15 cases were controlled successfully without needing to remove the instruments and without complications. CONCLUSION: The meticulous care for a deep infection after posterior instrumented spinal fusion is essential. Favorable results can be achieved by surgery with drainage, debridement, and the insertion of antibiotics-mixed cement beads along with systemic antibiotics as soon as possible without removing the instruments.
Abscess ; Anti-Bacterial Agents ; Coagulase ; Debridement ; Diagnosis ; Drainage ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Malnutrition ; Middle Aged ; Obesity ; Retrospective Studies ; Risk Factors ; Spinal Fusion ; Spine ; Staphylococcus aureus ; Vancomycin

Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is a well-established intervention to palliate malignant pain. We report a patient who developed hepatic and splenic infarction and bowel ischemia following EUS-CPN. A 69-year-old man with known lung cancer and pancreatic metastasis was transferred for debilitating, significant epigastric pain for several months. The patient underwent EUS-CPN to palliate the pain. After the procedure, the patient complained continuously of abdominal pain, nausea, and vomiting; hematemesis and hematochezia were newly developed. Abdominal computed tomography revealed infarction of the liver and spleen and ischemia of the stomach and proximal small bowel. On esophagogastroduodenoscopy, hemorrhagic gastroduodenitis, and multiple gastric ulcers were noted without active bleeding. The patient expired on postoperative day 27 despite the best supportive care.
Abdominal Pain ; Celiac Plexus ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage ; Humans ; Infarction ; Ischemia ; Liver ; Lung Neoplasms ; Nausea ; Neoplasm Metastasis ; Spleen ; Splenic Infarction ; Stomach ; Stomach Ulcer

PURPOSE: To identify the prevalence and clinical features of detrusor underactivity (DU) in elderly men and women presenting with lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: We reviewed 1,179 patients aged over 65 years who had undergone a urodynamic study for LUTS with no neurological or anatomical conditions. DU was defined as a bladder contractility index <100 and a maximal flow rate (Qmax) < or =12 ml/s combined with a detrusor pressure at Qmax < or =10 cmH2O for men and women, respectively. RESULTS: Of the patients, 40.2% of men and 13.3% of women were classified as having DU (p<0.001). Types of clinical symptoms were not significantly different between patients with and without DU. In men, whereas the prevalence of bladder outlet obstruction (BOO) was constant across the age spectrum, the prevalence of DU and detrusor overactivity (DO) increased with age, and 46.5% of men with DU also had DO or BOO. In women, the prevalence of DU also increased with age, and the trend was more remarkable in women aged over 70 years. DU was accompanied by DO or urodynamic stress urinary incontinence (USUI) in 72.6% of the women with DU. Women with DU were found to have lower cystometric capacity and exhibited a greater incidence of reduced compliance than did women without DU. CONCLUSIONS: DU was a common mechanism underlying LUTS in the elderly population, especially in men. One half of the men and three quarters of the women with DU also had other pathologies such as DO, BOO, or USUI.
Aged ; Compliance ; Female ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Male ; Prevalence ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urinary Tract ; Urination Disorders ; Urodynamics

No abstract available.
Delivery of Health Care* ; Influenza, Human* ; Seasons*

PURPOSE: To evaluate the efficacy and safety of the tension-free placement of a monofilament polypropylene mesh for the repair of an anterior vaginal wall prolapse (AVWP). MATERIALS AND METHODS: Women aged > or = 30 years with an AVWP stage of II or greater were included. Forty-nine women underwent trans-vaginal repair using a Gynemesh(TM) PS. Forty-six women who had symptomatic stress urinary incontinence received a midurethral sling (MUS). At the 12-month follow-up, evaluations were made for changes in the Pelvic Organ Prolapse Quantification (POP-Q) stage and Pelvic Floor Distress Inventory. Cure was defined as a POP-Q stage of 0 and improvement as a stage of I. Complications were also evaluated. RESULTS: The cure rate was 71.4%, and the improvement rate was 18.4%. Obstructive/discomfort, irritative, and stress subscale scores of the Urinary Distress Inventory anterior and posterior subscale scores of the POP Distress Inventory and the obstructive subscale score of the Colo-Rectal-Anal Distress Inventory were significantly improved. Thirty-two of the 46 women (69.6%) who received MUS procedures reported no leakage after surgery. Complications were 2 cases of increased intraoperative bleeding and 1 case of vaginal erosion. CONCLUSIONS: Trans-vaginal repair using a Gynemesh(TM) PS is a feasible and effective procedure for the treatment of AVWP with no significant complications.
Aged ; Animals ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Lower Urinary Tract Symptoms ; Mice ; Pelvic Floor ; Pelvic Organ Prolapse ; Polypropylenes ; Prolapse ; Suburethral Slings ; Urinary Incontinence