BACKGROUND: Cellulitis is one of the most common infectious skin diseases in primary care units of military service in which personal hygiene could be easily neglected under special circumstances such as outdoor training. OBJECTIVE: This study was designed to elucidate the probable causes of the high incidence rate of cellulitis in military service. METHODS: We prospectively evaluated the clinical findings of 59 patients with cellulitis who were hospitalized in the medical detachment of the 1st Infantry Division of the ROK Army from May, 1995 to April, 1996. RESULTS: The mean age of patients was 21(19-25). Analysing the rank of the patients, the number of recruits was 3(5%), private 26(44%), private first class 17(29%), corporal 11(19%) and sergeant 2(3%). Seventy eight percent of them were included in ranks below corporal. The recurrence rate of cellulitis during the 2 1/2 year follow-up period was only 4%. Skin lesions noted were erythema(100%), tenderness(98%), swelling(98%), local heating(97%), lymphadenopathy(73%), pus (63%), fluctuation(32%), ulcer(27%), lymphangitis(14%), bullae(8%), etc. The most common route of infection was the previous wounds(46%) which allows a portal for invasion of microorganisms. Tinea pedis was also found to be in 39% of patients with cellulitis of the lower leg. The pus culture performed on 7 patients who had not been responsive to primary antibiotics resulted in 6 positive cases of Staphylococcus aureus. CONCLUSION: Considering the ranks of the patients and the routes of infection, we found that the incidence of cellulitis in the military service of the ROK Army could be reduced if more attention would be paid to preventive counterplans for secondary infection and tinea pedis.
Anti-Bacterial Agents ; Cellulitis* ; Coinfection ; Follow-Up Studies ; Humans ; Hygiene ; Incidence ; Leg ; Military Personnel ; Primary Health Care ; Prospective Studies ; Recurrence ; Skin ; Skin Diseases, Infectious ; Staphylococcus aureus ; Suppuration ; Tinea Pedis

PURPOSE: The present study evaluated the changes in tear film, cornea and ocular surface according to the duration of soft contact lens wear. METHODS: A total 65 patients with 130 eyes were enrolled the present study, and were divided into 4 grous. The control group (group A) was composed of 32 eyes of 16 patients who had not worn soft contact lenses, group B, (34 eyes of 17 patients), had worn soft contact lenses less than 5 years, group C, (32 eyes of 16 patients), had worn soft contact lenses for 5 to 10 years and group D, (32 eyes of 16 patients), had worn soft contact lenses for more than 10 years. The tear break-up time (BUT), Schirmer's test, corneal sensitivity test, central corneal thickness, ocular surface disease index (OSDI), corneal fluorescein staining score, specular microscopy and conjunctival impression cytology were analyzed. The results were compared between the control group and the soft contact lens groups. RESULTS: In group B, BUT significantly decreased, but corneal fluorescein staining score and squamous metaplasia significantly increased (p < 0.05). In group C, OSDI and snake-like chromatin pattern significantly increased, but corneal thickness and goblet cell density significantly decreased (p < 0.05). In group D, the coefficient of variation for endothelium significantly increased, but corneal sensitivity and hexagonality significantly decreased (p < 0.05). CONCLUSIONS: Duration of soft contact lens wear influences changes in tear film, cornea and ocular surface.
Chromatin ; Contact Lenses, Hydrophilic ; Cornea ; Endothelium ; Eye ; Fluorescein ; Goblet Cells ; Humans ; Metaplasia ; Microscopy ; Tears

BACKGROUND AND OBJECTIVES: It has been suggested that the indices based on tissue doppler and color M-mode echocardiography reflect the left ventricular end-diastolic pressure. These include the early diastolic transmitral velocity (E) to early myocardial velocity ratio measured by tissue doppler (E') and the E to the wave propagation velocity (Vp) ratio measured from color M-mode images. However, these indices have not been well validated in congestive heart failure patients. SUBJECTS AND METHODS:Thirty one congestive heart failure patients who underwent simultaneous cardiac catheterization and echocardiography, and had normal sinus rhythm were enrolled in this study. The left ventricular end-diastolic pressure obtained from the left heart catheterization was compared with the diastolic indices using pulsed doppler, tissue doppler and color M-mode echocardiography. RESULTS: The left ventricular end-diastolic pressure (LVEDP) ranged from 3.3 to 23 mmHg. Some parameters showed a significant correlation with the LVEDP. The propagation velocity showed a significant correlation with the LVEDP (r=0.382, p=0.034), and the E to propagation velocity ratio (E/Vp) showed a good correlation with the LVEDP(r=0.408, p=0.023). In addition, the E to early diastolic velocity of the mitral annulus (E') ratio had an insignificant correlation with the LVEDP(r=0.322, p=0.078). Among the patients with ischemic congestive heart failure, the E to the propagation velocity ratio (E/Vp) showed a marginal correlation with the LVEDP (r=0.461, p=0.047). CONCLUSION: In patients with congestive heart failure, the Vp and E/Vp showed a good correlation with the LVEDP. In the subgroup of patients with ischemic congestive heart failure, only the E/Vp showed a significant correlation with the LVEDP.
Blood Flow Velocity ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Heart Failure ; Humans ; Mitral Valve ; Ventricular Pressure

PURPOSE: To evaluate the clinical outcomes of patients with diffractive multifocal toric intraocular lens (IOL) implantation. METHODS: Thirty-four eyes of 26 patients underwent diffractive multifocal toric IOL. Uncorrected visual acuity (UCVA) at distant, intermediate and near and residual refractive astigmatism were measured on the first day, at 2 weeks, and 1, 3 and 6 months postoperatively. Optical quality obtained using the Optical Quality Analysis System II (OQAS II), high-order aberrations (HOA) and patient satisfaction questionnaire were evaluated 3 months postoperatively. RESULTS: At the 6 month postoperative visit, the mean UCVA at distant, intermediate (63 cm, 100 cm) and near were 0.06 +/- 0.07, 0.18 +/- 0.11, 0.16 +/- 0.12 and 0.03 +/- 0.06 (log MAR), respectively. The refractive astigmatism decreased significantly from -1.66 +/- 1.04 D to -0.54 +/- 0.32 D at 6 months postoperatively (p < 0.01). The means of objective scatter index, modulation transfer function (MTF) cut-off value, Strehl ratio and pseudo-accommodation range measured by OQAS II were 1.33 +/- 0.67, 37.24 +/- 9.67 cdp, 0.22 +/- 0.09 and 3.08 +/- 0.53 D, respectively. HOA scores for 5 mm and 6 mm were 0.30 +/- 0.09 and 0.49 +/- 0.15, respectively; 82.3% of the patients were satisfied with the postoperative results, 79.4% of the patients reported they would recommend the procedure to others, and 14.7% of patients reported moderate or severe visual disturbance at night. CONCLUSIONS: Implantation of a diffractive multifocal toric IOL in patients with cataract and corneal astigmatism provided excellent distant, intermediate, and near visual outcomes, good optical quality and high patient satisfaction.
Astigmatism ; Cataract ; Cytidine Diphosphate ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular ; Patient Satisfaction ; Surveys and Questionnaires ; Visual Acuity

Vertigo due to primary cardiac disease, known as cardiogenic vertigo, has been rarely reported. We report one case showing recurrent vertigo episodes due to sick sinus syndrome. A 77-year-old female presented to our department because of long history of intermittent brief episodes of rotatory vertigo and non-vertiginous dizziness. She had no past medical history. There was no abnormal sign in neurological examination. Cardiac murmur, finally confirmed as grade 4 ejection systolic and grade 3 decrescendo diastolic murmurs, was found on physical examination. Brain magnetic resonance imaging and auditory evoked potential did not show any abnormal findings. She was consulted to a cardiologist for the evaluation of cardiac murmur. After the evaluation using electrocardiogram, echocardiography, and holter monitoring, she was diagnosed as sick sinus syndrome. After then, a ventricle ventricle inhibited (VVI) pacemaker was inserted. She did not complain of vertigo and dizziness for 3 months after the insertion of a VVI pacemaker. This case shows the need of auscultation for patients with recurrent vertigo episodes although there is rare cardiogenic vertigo.
Aged ; Auscultation ; Brain ; Dizziness ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Evoked Potentials, Auditory ; Female ; Heart Diseases ; Heart Murmurs ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Physical Examination ; Sick Sinus Syndrome ; Vertigo

PURPOSE: To evaluate the effect of 0.05% cyclosporine A on the ocular surface after photorefractive keratectomy (PRK). METHODS: This retrospective study included 50 patients who underwent PRK. Patients were divided into two groups: 25 patients in group I were treated with topical 0.05% cyclosporine A with conventional medication, and 25 patients in group II were treated with conventional medication. Visual acuity (VA), tear break-up time (BUT), fluorescein staining score (F-stain), Schirmer I test, and ocular surface disease index (OSDI) were evaluated before surgery and 2 weeks, 1 month, 2 months, and 3 months after surgery. RESULTS: F-stain was significantly lower in group I than in group II at 2 weeks and 1 month (p < 0.05). There was no significant difference in uncorrected VA, BUT, Schirmer I test, or OSDI between the groups. However, group I showed a more effective pattern in dry eye. CONCLUSIONS: Combination treatment with 0.05% cyclosporine A was helpful for early ocular surface stability in patients with dry eye after PRK.
Cyclosporine* ; Fluorescein ; Humans ; Photorefractive Keratectomy* ; Refractive Surgical Procedures ; Retrospective Studies ; Tears ; Visual Acuity

PURPOSE: To describe a case of bilateral acute myopia and acute angle-closure associated with phentermine hydrochloride, a drug used for obesity treatment. CASE SUMMARY: A 25-year-old woman visited our hospital with blurry vision and ocular pain after taking phentermine hydrochloride for three weeks. Manifest refraction accompanied myopic shift in the both eyes, slit-lamp examination showed forward displacement of the lens-iris diaphragm and fundus examination revealed retinal folds. Suspecting phentermine hydrochloride induced acute myopia and acute angle closure, discontinuation of the drug and administration of cycloplegic agents and antiglaucomatic agent successfully resolved the symptoms. CONCLUSIONS: Although the exact mechanism is unknown, phentermine hydrochloride may generate ciliochoroidal effusion and ciliary edema, lead to acute myopia and acute angle closure resulting from forward displacement of the lens-iris diaphragm.
Adult ; Diaphragm ; Displacement (Psychology) ; Edema ; Eye ; Female ; Humans ; Myopia ; Obesity ; Phentermine ; Retinaldehyde ; Vision, Ocular

MELAS syndrome is typically a multisystemic disorder. We report one case of MELAS showing both maternally transmitted type II diabetes mellitus (DM) and deafness. A 41-year-old woman was admitted because of severe headache and vomiting. She developed type II DM at age 26 and was followed by bilateral sensorineural type hearing loss at age 37. Family history revealed that her mother and two sisters suffered from similar disorders. MELAS with A3243G point mutation was confirmed in the patient and her daughter.
Adult ; Deafness* ; Diabetes Mellitus* ; Female ; Headache ; Hearing Loss ; Humans ; MELAS Syndrome* ; Mothers ; Nuclear Family ; Point Mutation ; Siblings ; Vomiting

Polymerase chain reaction was performed to determine he types of human papillomavirus (HPV) causing condylomata acuminata in frozen tissues and paraffinembedded tissues of condylomata acuminata. HPV DNA was detected in 31 of 32 patients with condylomata aciminata. HPV 6 and/or 11, low-risk types in genital carcinogenesis, were present in all cases in whieh HPV was detected. Both types were present in 5 cases. It is, therefore, supposed that there is not much risk of this disease to transform to the invasive cancer in Korean and polymerase chain reaction can be used to deteet HPV and identify its type from paraffin-embedded tissues.
Carcinogenesis ; Condylomata Acuminata* ; DNA ; Human papillomavirus 6 ; Humans* ; Polymerase Chain Reaction*

PURPOSE: To report the clinical results after the implantation of intrastromal corneal ring segments (Intacs(R)) by manual tunnel creation for the correction of keratoconus. METHODS: This retrospective case series was comprised of 10 eyes of 8 consecutive keratoconic patients. Visual acuity, refractive outcome, keratometric values, anterior chamber depth, central corneal thickness, and endothelial cell density were evaluated before and at 1 month, 3 months, and 6 months postoperatively. In addition, the implanted ring segment depth was measured by anterior segment optical coherence tomography at postoperative 6 months. Any postoperative complications were also recorded. RESULTS: Visual acuity was improved in 9 out of 10 eyes. Spherical equivalent and keratometric values were decreased in all eyes. There was no significant difference in central corneal thickness, but endothelial cell density and anterior chamber depth were slightly decreased. The depth of ring segments was almost constant at superior, middle, and inferior. There was a single case of descented implanted ring segments and 6 cases of stromal infiltration around ring segments, but visual acuity was unaffected. In addition, 1 case showed implanted ring exposure, thus the superior ring segment was removed at postoperative 4 months. CONCLUSIONS: Intrastromal corneal ring segment implantation (Intacs(R)) by manual tunnel creation appears to be effective in improving the visual acuity and stabilizing corneal refractive power in keratoconic patients.
Anterior Chamber ; Endothelial Cells ; Eye ; Humans ; Keratoconus ; Postoperative Complications ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity