PURPOSE: To report a case of corneal ulcer caused by Achromobacter xylosoxidans in a farmer. CASE SUMMARY: A previously healthy 68-year-old man presented with unilateral redness and irritation after his eye was grazed by a cow's tail. The patient had previously been treated in a local clinic for four days without improvement. Bacterial staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of A. xylosoxidans. The patient was treated with moxifloxacin and ceftazidime eyedrops. After three months of treatment, the infection was resolved with mild scarring. CONCLUSIONS: Although it is a rare pathogen, A. xylosoxidans should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil or animal feces and having a slowly progressive disease and localized infiltrate but showing Gram-negative bacilli on smear examination.
Achromobacter ; Achromobacter denitrificans ; Aged ; Animals ; Aza Compounds ; Ceftazidime ; Corneal Ulcer ; Eye ; Feces ; Humans ; Keratitis ; Ophthalmic Solutions ; Quinolines ; Soil ; Tail

PURPOSE: To analyze and compare the clinical characteristics of patients with herpes zoster ophthalmicus (HZO) by age groups on the basis of the age of 60. METHODS: Medical records of patients with HZO who visited Chonbuk National University Hospital from February 1, 2002 to February 28, 2011 were reviewed. The patients with follow-up of three months or more were divided into two groups: patients under 60 and patients with 60 years old and over. The clinical characteristics between two groups were examined through the analysis of their medical records. RESULTS: Among a total of 63 patients, 29 patients (46%) were under 60 years old, and 34 patients (54%) were 60 years old and over. Incidence of HZO highest in the sixties. The sex and intrusion of each group showed no difference. Younger patients had a higher incidence of pseudodendrite by HZO (86.2% vs. 58.8%, p = 0.014) compared with older patients who showed a higher incidence of post herpetic neuralgia (13.8% vs. 35.3%, p = 0.046). As patients showed Hutchinson's sign, they often had more ocular complications such as pseudodendrite (100% vs. 64.7%, p < 0.05), uveitis (41.7% vs. 7.8%, p = 0.04), and conjunctivitis (100% vs. 90.2%, p = 0.02). CONCLUSIONS: Herpes zoster ophthalmicus shows different clinical characteristics according to patients' age and requires appropriate treatment. Especially elderly patients showing Hutchinson's sign should be treated early and aggressively enough.
Aged ; Conjunctivitis ; Follow-Up Studies ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Incidence ; Medical Records ; Neuralgia ; Neuralgia, Postherpetic ; Uveitis

PURPOSE: We compared the outcomes of laser iridotomy and primary phacoemulsification when treating acute angle-closure glaucoma. METHODS: This study was conducted with 61 patients diagnosed with acute angle closure glaucoma from January, 2005 to January, 2015. The patients received either laser iridotomy or primary phacoemulsification. The age and gender of each patient, differences of intraocular pressure (IOP) before and after treatment, visual acuity, need for IOP lowering agents and complications were analyzed retrospectively at 1-day, 1-month, 6-month and 12-month after the treatment. Patients who received laser iridotomy with phacoemulsification or trabeculectomy were excluded from this study. Additionally, we included only cases in which treatments were given within 3 days after the onset of symptom. RESULTS: Among the 61 patients, 45 patients received laser iridotomy and 16 patients received primary phacoemulsification. One day after the treatment the laser iridotomy group showed better outcome in their visual acuity (log MAR 0.62 +/- 0.51; p = 0.048). At 6-month postoperatively, the primary phacoemulsification group showed better visual acuity (log MAR 0.07 +/- 0.15; p = 0.013). However, at 12-month postoperatively, the visual acuities were not significantly different between the 2 groups. Regarding IOP, at postoperative 1-month, the group of primary phacoemulsification shows significantly lower IOP (9.5 +/- 1.3 mm Hg), compared with the group of laser iridotomy. A significant difference was observed in the number of IOP lowering agents that patients at 12 month after the treatment. There were no severe complications in either group. CONCLUSIONS: Following the initial treatment of acute angle-closure glaucoma, the primary phacoemulsification showed no significant differences in postoperative visual acuity, IOP and complications compared to the outcomes of laser iridotomy. Additionally, the need for IOP lowering agents was less in the primary phacoemulsification groups at 1 year after the operation.
Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Phacoemulsification* ; Retrospective Studies ; Trabeculectomy ; Visual Acuity

PURPOSE: To report the clinical manifestations and prognoses in 5 cases of mixed Candida and bacterial keratitis and present a literature review on mixed fungal and bacterial keratitis. CASE SUMMARY: Five eyes of 5 patients (1 male, 4 female) diagnosed as mixed Candida and bacterial keratitis by corneal smear and culture were included in the present study. Patient mean age was 62.80 years. All patients had preexisting ocular or systemic conditions as predisposing factors for mixed Candida and bacterial keratitis. The most common Candida species isolated was Candida albicans (3 eyes, 60%), while Staphylococcus (3 eyes, 60%) was the most common mixed bacterial species. The average size of ulceration was 7.02 mm2. In 2 eyes (40%), the lesions were located at the corneal center. The depth of the infiltration was significant in all cases, and hypopyon was present in 2 eyes (40%). On the initial visit, the visual acuity was counting fingers or worse in all cases. Four eyes (80%) unresponsive to the topical and systemic treatment underwent surgical intervention but only 1 eye (20%), which had responded to the topical and systemic treatment, showed acuity improvement of more than 1 line on the final visit. CONCLUSIONS: In managing chronically compromised cornea, the possibility of mixed infections with Candida and bacterial organisms should be considered as keratitis shows poor prognosis.
Bacteria ; Candida ; Candida albicans ; Coinfection ; Cornea ; Eye ; Fingers ; Humans ; Keratitis ; Male ; Prognosis ; Staphylococcus ; Ulcer ; Visual Acuity

BACKGROUND: There are many rating scales for assessment of geriatrics. But each of these scales were not sufficient to evaluate comprehensive geriatric assessment, physical and psychologic efforts for care. METHODS: We developed new scales to comprehensive geriatric assessment for care of geriatric patients. The Geriatrics Physical Support Scale(GPSS) evaluates physical effort consists of 10 areas and the Geriatrics Global Support Scale(GGSS) evaluates general condition of patients consist of 6 areas. Eighty probable and possible AD patients received the Clinical Dementia Rating Rating Scale(CDR), Korearn version of Mini-Mental State Examination(K-MMSE), Barthel Activity of Daily Living Index(B-ADL) GPSS, GGSS. We tested internal consistency, correlation among dementia rating scales. RESULTS: The GPSS correlated to CDR -0.63(p<0.01), B-ADL -0.90(p<0.01) and the GGSS correlated to CDR -0.60(p<0.01), B-ADL -0.75(p<0.01). The internal consistency were 0.69(GGSS), 0.92(GPSS). CONCLUSION: The Geriatrics Global Support Scale evaluate general condition of patients and the Geriatrics Physical Support Scale evaluate physical efforts needed for care of geriatric patients. These scales an also brief and easy rating scales to grade degree of caregiver`s burden.
Dementia ; Geriatric Assessment ; Geriatrics* ; Humans ; Physical Exertion ; Reproducibility of Results* ; Weights and Measures

PURPOSE: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. METHODS: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. RESULTS: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG (χ²=6.15, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. CONCLUSION: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.
Aged* ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Blood Pressure* ; Blood Sedimentation ; Body Temperature Regulation ; Body Temperature* ; C-Reactive Protein ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypothermia ; Incheon ; Incidence ; Inflammation* ; Korea ; Shivering*

No abstract available.
Durapatite*

PURPOSE: To assess factors which are related to consecutive esotropia after surgery of intermittent exotropia. METHODS: We reviewed medical records of intermittent exotropia patients who had undergone surgery from January 1995 to February 2002, and followed for over 3 months. Patients who developed consecutive esotropia of more than 10 prism diopters (PD) were included in this study. RESULTS: Postoperatively esotropia deveolped in 101 of 1222 patients (8.3%), and persisted for more than 3 months in 32 patients (2.6%). Mean age at operation was 6.02 +/- 2.21 years old. Mean angle of exodeviation at operation was 29.67 +/- 6.16 PD. The incidence of esotropia was high when the angle of preoperative exodeviation was 30-35 PD, and age at operation was less than 6 years. Duration of esotropia was longer when the preoperative exodeviation angle was 30-35 prism diopter, and age at operation was more than 7 years. There was no significant relationship between overcorrected esotropia and amblyopia, inferior oblique muscle overaction, lateral incommitance, or stereopsis. CONCLUSIONS: Factors related to prolonged consecutive esotropia following surgery of intermittent esotropia were the preoperative exodeviation angle of 30-35 PD, and age at operation of more than 7 years.
Amblyopia ; Depth Perception ; Esotropia* ; Exotropia* ; Humans ; Incidence ; Medical Records

PURPOSE: This study was undertaken to determine the adequate cutoff value of the neonatal screening test to decrease recall and false-positive rates. METHODS: During the period of January 1999 through December in Asan Medical Center, newborn screening tests for phenylketonuria, congenital hypothyroidism, congenital adrenal hyperplasia, and galactosemia were performed in 3,775, 3,707, 3,783, and 3,806 newborns respectively using commercial ELISA kits. We reviewed and analyzed the recall rate at currently used cutoff values. RESULTS: 1)In neonatal screening test for congenital hypothyroidism, using a current cutoff value, 17 microIU/mL, the recall rate was 0.9% and using a 99.7% cutoff value, 21.3 microIU/mL, the predictive recall rate was 0.4%. There were no significant differences in the other reports that suggest adequate recall rate. 2)In neonatal screening test for phenylketonuria, using a current cutoff value, 3.6 mg/dL, the recall rate was 1.5% which was no significant difference compared with expected presumptive positive rate, 1.44%. 3)In neonatal screening test for congenital adrenal hyperplasia and galactosemia, the recall rate was high when using current cutoff value. But all results were within normal limits in reevaluation. CONCLUSION: The cutoff values of screening test which are currently recommended by manufacturers of commercial kits for congenital hypothyroidism, congenital adrenal hyperplasia and galactosemia, are needed to be reset to decrease the recall rate by false-positive results on the basis of data from an individual newborn screening laboratory.
Adrenal Hyperplasia, Congenital ; Chungcheongnam-do ; Congenital Hypothyroidism ; Enzyme-Linked Immunosorbent Assay ; Galactosemias ; Humans ; Infant, Newborn ; Mass Screening ; Neonatal Screening* ; Phenylketonurias

PURPOSE: To investigate the risk factor, clinical manifestations, treatment results, and prognosis in Alternaria keratitis. METHODS: Thirteen eyes of 13 patients who were diagnosed as Alternaria species by corneal smear and culture were included. The past history, visual acuity, location and size of ulceration, hypopyon, treatment results, and prognosis were analyzed retrospectively. RESULTS: Nine (69.2%) were women, and 4 were men. The mean age was 65.23+/-8.70 years. Eleven eyes (84.6%) had previous history of corneal traumas by soil or plant material. In 7 eyes (53.8%), the lesions were located at the corneal center. The average size of ulceration was 13.90+/-21.80 mm2. Four eyes (30.8%) had hypopyon. The initial visual acuity was less than 0.1 in 10 eyes (76.9%). The final visual acuity improved more than 2 lines in 10 eyes (76.9%) and more than 1 line in 12 eyes (92.3%), and did not change in 1 eye (7.7%). The treatment success was achieved in 12 eyes (92.3%). CONCLUSIONS: Early diagnosis and specific antifungal treatments of Alternaria keratitis can lead to a good prognosis.
Alternaria* ; Early Diagnosis ; Female ; Humans ; Keratitis* ; Male ; Plants ; Prognosis* ; Retrospective Studies ; Risk Factors ; Soil ; Ulcer ; Visual Acuity