No abstract available.
Catheters* ; Transurethral Resection of Prostate*

OBJECTIVE: The purpose of this study was to determine the normal value of cervical motion in Korean adults. METHOD: Five hundred healthy subjects, 250 men and 250 women between third decades and seventh decades completed this study. The Cervical Range of Motion (CROM) instrument was used to measure six cervical motions and horizontal head motion. RESULTS: The elderly group had significantly less motion than the younger group for all six motions and horizontal head motions (p<0.05). Women had greater range of cervical motions than men in all cervical motions (p<0.05). CONCLUSION: The method using the CROM instrument seems to be useful for primary and follow up test of cervical disease.
Adult* ; Aged ; Female ; Head ; Humans ; Male ; Range of Motion, Articular* ; Reference Values

PURPOSE: To evaluate the change of the sensitivity and resistance to ciprofloxacin of isolates in bacterial ocular disease, bacterial keratitis and conjunctivitis. METHODS: From January 1992 to December 1999 in KyungHee Medical Center, we carried out direct smear and culture from conjunctiva and cornea and studied retrospectively. RESULTS: A total of 420 bacteria and fungi were isolated and 39 strains were identified. Antibiotic sensitivity test was done in isolated bateria and fungi. Gram-positive bacteria accounted for 324 of all bacteria, gram-negative organisms for 81 in isolated causative organisms. Major causative organisms of bacterial ocular disease, bacterial keratitis and conjunctivitis are coagulase-negative staphylococcus, Staphylococcus aureus, Pseudomonas aeruginosa in that order. Among 420 isolates, 405 bacteria and 15 fungi was isolated. In vitro examination for susceptibility and resistance of causative organisms to ciprofloxacin was done in 67 of 420 isolates. Of the 67 isolates, 57 were sensitive to ciprofloxacin and 10 were resistant to ciprofloxacin. All resistant cases to ciprofloxacin was 2 cases in 1994, 7 cases in 1998, and 1 case in 1999. CONCLUSIONS: The resistance to ciprofloxacin has a increasing tendency. Therefore, ciprofloxacin should be used carefully, when used for prevention of infection and primary treatment in mild ocular diseases.
Bacteria ; Ciprofloxacin* ; Conjunctiva ; Conjunctivitis ; Cornea ; Fungi ; Gram-Positive Bacteria ; Keratitis ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

OBJECTIVE: To assess what are the predictive factors that differentiate between medical and surgical group and, to determine the group that can be treated more efficiently with early surgical intervention than with conservative medical management. METHODS: Clinical and epidemiologic factors from the medical records of 85 selected patients who had either medical (n=52) or surgical (n=33) treatments for Tubo-ovarian abscess in Dongguk university hospital from February 1998 to May 2003 were evaluated retrospectively. RESULTS: Prognosis was predictable on the basis of response to the medical therapy and the extent of the disease at the time of the diagnosis. There was apparent association with the age, parity factors and CRP values where higher the variables, surgical intervention was needed. Same results were obtained with the large size of the abscess according to the sonography and the usage of the intrauterine devices (p<0.005). No statistical significance was noted, however, with leukocytosis, ESR, previous PID or D and C history, or high body temperatures (all ranging p>0.05). CONCLUSION: Medical therapy in the patients with high parity or old age is most likely to fail if the size of the abscess is more than 6 cm, increased CRP value or using IUD as a contraceptive. These prognostic factors should be considered in the early surgical interventions to prevent the subsequent complications from the delay of treatments and also to reduce the duration.
Abscess* ; Body Temperature ; Diagnosis ; Epidemiologic Factors ; Female ; Humans ; Intrauterine Devices ; Leukocytosis ; Medical Records ; Parity ; Prognosis ; Retrospective Studies

OBJECTIVE: To assess what are the predictive factors that differentiate between medical and surgical group and, to determine the group that can be treated more efficiently with early surgical intervention than with conservative medical management. METHODS: Clinical and epidemiologic factors from the medical records of 85 selected patients who had either medical (n=52) or surgical (n=33) treatments for Tubo-ovarian abscess in Dongguk university hospital from February 1998 to May 2003 were evaluated retrospectively. RESULTS: Prognosis was predictable on the basis of response to the medical therapy and the extent of the disease at the time of the diagnosis. There was apparent association with the age, parity factors and CRP values where higher the variables, surgical intervention was needed. Same results were obtained with the large size of the abscess according to the sonography and the usage of the intrauterine devices (p<0.005). No statistical significance was noted, however, with leukocytosis, ESR, previous PID or D and C history, or high body temperatures (all ranging p>0.05). CONCLUSION: Medical therapy in the patients with high parity or old age is most likely to fail if the size of the abscess is more than 6 cm, increased CRP value or using IUD as a contraceptive. These prognostic factors should be considered in the early surgical interventions to prevent the subsequent complications from the delay of treatments and also to reduce the duration.
Abscess* ; Body Temperature ; Diagnosis ; Epidemiologic Factors ; Female ; Humans ; Intrauterine Devices ; Leukocytosis ; Medical Records ; Parity ; Prognosis ; Retrospective Studies

Purpose: To investigate the cytokine concentrations of aqueous humor in patients with exudative age-related macular degeneration (AMD) and diabetic macular edema (DME). Methods: Fifty-seven subjects were included in the exudative AMD, DME and control groups, each group has 19 patients. Aqueous levels of cytokines epidermal growth factor (EGF), vascular endothelial growth factor-C (VEGF-C), monocyte chemoattractant protein-1 (MCP-1), hepatocyte growth factor (HGF), interleukin (IL)-3, IL-8, IL-6, IL-12p40, intercellular adhesion molecule 1 (ICAM-1) were investigated in each groups. Kruskal-Wallis test and Mann-Whitney U test were performed to compare cytokine concentrations. Results: Aqueous levels of EGF, VEGF-C, MCP-1, HGF, IL-3, IL-8 were significantly higher in exudative AMD group than control group (p = < 0.0001, < 0.0001, 0.004, 0.015, < 0.0001, 0.014) and EGF, VEGF-C, IL-3, IL-8 were significantly higher in DME group than control group (p = < 0.0001, < 0.0001, < 0.0001, 0.005). In the comparison between the exudative AMD and DME groups, EGF was significantly higher in the exudative AMD group (p = 0.001). Conclusions Various cytokines were increased in patients with exudative AMD and DME. In particular, EGF showed a higher level in exudative AMD than in DME.

Background: A bloodstream infection is a life-threatening medical emergency, with a mortality rate of up to 30%. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) can be used to identify pathogens directly from positive blood cultures. Two commercial preparation kits, SepsiTyper (Bruker Daltonics, Germany) and SepsiPrep (ASTA Corp., Korea), and two MALDI-TOF MS systems, MALDI Biotyper Sirius (Bruker Daltonics, Germany) and VITEK MS PRIME (bioMérieux, France), are available in Korea. We examined these kits and MALDI-TOF MS systems to analyze their performance. Methods: We assessed the effectiveness of direct identification using 47 blood cultures and 3 bile cultures positive for microbial growth. The VIRTUO system (bioMérieux, France) was used to incubate the samples after they were collected in Bact/ALERT aerobic and anaerobic bottles. The manufacturers’ protocols were followed for both the SepsiTyper and SepsiPrep kits. Results: The SepsiTyper yielded considerably more accurate identifications than did the SepsiPrep, when utilized in MALDI-TOF MS systems (P = 0.0044). However, the SepsiPrep was easier to use and the results more quickly obtained than with the SepsiTyper. The MALDI Biotyper Sirius produced more accurate identifications with the SepsiTyper than did the VITEK MS PRIME (P = 0.0736). The SepsiTyper enabled the accurate identification of five of six polymicrobial cases, utilizing either the MALDI-TOF MS systems. Conclusions Among the pathogen ID kits tested in this study, the SepsiTyper with MALDI Biotyper Sirius performed the best. In clinical laboratories utilizing VITEK MS PRIME, it is recommended that the either the SepsiTyper or SepsiPrep kit be used for direct identification, while considering certain limitations in terms of performance.

PURPOSE: To report a case of bilateral chorioretinal injury by needleless jet injector misuse. CASE SUMMARY: In a dermatology department, the patient was diagnosed as having total alopecia and was scheduled to be injected on her eyelash by needleless jet injector for treatment but inexpert doctor injected on the eyelid, not eyelash, by mistake. She then suddenly complained of blurred vision and a floater just after that procedure and was referred to the ophthalmology department. Bilateral vitreous hemorrhage and preretinal hemorrhage were seen during indirect ophthalmoscopic examination and bilateral prophylactic argon laser photocoagulation was done around the suspicious tear site. Then bilateral vitreous hemorrhage and preretinal hemorrhage were absorbed and we found a partial retinal rupture lesion and choroidal rupture lesion in the right eye and a retinal injury lesion in the lefteye. Therefore we observed the lesions of both eyes continuously without further treatment. Her clinical symptoms improved. CONCLUSIONS: Needleless jet injector has many advantages, especially less pain and injury than a normal needle injector and is usually used in clinic as preoperative local anesthesia and steroid injection in many medical fields. In this case, the needleless injector was accidentally misused inducing both direct and indirect choroidal rupture and retinal injury. In general, while a needleless jet injector is used in ophthalmology department, we have to use it with the greatest care.
Alopecia ; Anesthesia, Local ; Argon ; Choroid ; Dermatology ; Eye ; Eyelids ; Hemorrhage ; Humans ; Light Coagulation ; Needles ; Ophthalmology ; Retinaldehyde ; Rupture ; Vision, Ocular ; Vitreous Hemorrhage

PURPOSE: To measure choroidal thickness in healthy myopic eyes and to evaluate the relationship among choroidal thickness and refractive power and axial length. METHODS: Eighty healthy myopic eyes were evaluated in the present study. The refractive power was measured using an automatic refractor and the axial length using A-scan. The subjects were divided into two groups based on refractive power (> or =-6.0 D and <-6.0 D) and axial length (> or =25 mm and <25 mm). The choroidal thickness was measured using spectral domain (SD) optical coherence tomography (3-dimensional [3D] OCT-2000, Software Version 6.01; Topcon Corp., Tokyo, Japan), and the statistical relationship between the two groups was analyzed. RESULTS: A statistically significant difference was found in choroidal thickness according to refractive power and axial length between the two groups (p < 0.001 and p < 0.05, respectively). CONCLUSIONS: Refractive power and axial length had a significant relation to choroidal thickness measured by OCT. When excluding eyes with pathologic myopia, high myopia in healthy eyes may cause choroidal thinning.
Choroid ; Eye ; Myopia ; Tokyo ; Tomography, Optical Coherence

OBJECTIVE: The purpose of this study was to evaluate the feasibility of vaginal hysterectomy on contraindicated cases. MATERIAL AND METHODS: We examined the medical records of 154 patients who underwent vaginal hysterectomy and 139 patients who underwent abdominal hysterectomy from March 1999 to March 2002. Among vaginal hysterectomy group, 77 patients (Group I) were found to have more than one contraindication for vaginal hysterectomy such as large uterus (>280 g), nulliparous or no previous vaginal delivery, and previous pelvic laparotomy. Remaining 77 patients (Group II) had no contraindications for vaginal hysterectomy. These two groups were compared with 139 abdominal hysterectomy patients (Group III) regarding preoperative surgical indication, uterus size, operative time, bleeding volume, hospital stay, pain duration and postoperative complications. RESULTS: 1. The Group II patients were older than the other groups (Group I 45.9 years; Group II 53.4 years; Group III 45.9 years) and had history of higher parity by vaginal delivery (Group I 2.5; Group II 3.5; Group III 2.1). 2. The most common indication of hysterectomy was myoma in Group I (59.7%) and Group III (71.9%) and uterine prolapse in Group II (41.6%). 3. The average bleeding volume during the operation was greater in Group III (308.6 ml) than Group I (123.4 ml) and Group II (116.2 ml)(p<0.01). 4. The operative time was longer in Group III (105.4 min) than the other groups (P<0.01). 5. Hospital stay was shorter in Group I (7.6 days) and II (7.6 days) than Group III (8.8 days)(P<0.01). 6. The pain duration was shorter in Group I (1.53 days) and Group II (1.59 days) than in Group III (2.23 days)(P<0.01). 7. The incidence of postoperative major and minor complications was significantly higher in Group III (38.8%) than the other groups (Group I 24.6%; Group II 19.5%)(P<0.01). CONCLUSION: The vaginal hysterectomy is still safe and effective procedure for the patients who have contraindications such as a large uterus, nulliparity or no previous vaginal delivery and previous laparotomy except the cases with immobility of uterus by severe pelvic adhesion.
Female ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Incidence ; Laparotomy ; Length of Stay ; Medical Records ; Myoma ; Operative Time ; Parity ; Postoperative Complications ; Uterine Prolapse ; Uterus