Purpose: This study analyzed the microorganisms identified in donor corneas and their clinical significance. Methods: The medical records of 94 patients (114 eyes) who underwent keratoplasty and microbiological tests of the donor corneas from October 2008 to December 2020 at our hospital were reviewed retrospectively. During keratoplasty, we conducted microbiological tests of the corneoscleral rim of the donor cornea and preserving solution Optisol™-GS (Bausch & Lomb, Rochester, NY, USA), and examined the antibiotic susceptibility of bacterial isolates from the cultures. Results: Some isolates of domestic donor corneas revealed bacteria, but none of the imported corneas did. Gram-negative bacilli were detected from the corneoscleral rim in three eyes (2.6%): two cases of Acinetobacter baumannii/haemolyticus and one case of Pseudomonas aeruginosa. In one case (0.9%), Acinetobacter baumannii/haemolyticus was identified from preserving solution, with no bacteria found in the corneoscleral rim. Antibiotic susceptibility tests showed multi-drug resistance, except to colistin. In all cases where bacteria were detected, there was no keratitis or endophthalmitis after corneal transplantation. Conclusions Although rare, bacteria can be identified from donor corneas or the preserving solution used in corneal transplantation. Therefore, caution is needed in all processes dealing with donor corneas. Empirical antibiotics that have sufficient antimicrobial activity to suppress multi-drug resistant bacteria should be selected in corneal transplantation.

Behcets syndrome is a multisystem disorder presenting with recurrent oral and genital ulcers as well as uveitis, Gastrointestinal involvement associated with ileal ulcer is rare, but its outcome may by fatal. We have recently experienced a 43-year-old man who had Behcets syndrome with ileal ulcer penetrated to 3rd portion of the duodenum. He had been updergone right hemicolectomy and ileocolostomy for ileal inflammation of unknown etiology 20 years ago. Thereafter he had had relapsing oral and genital ulcers, and abdominal pain intermittently. From 15 days ago before visiting our hospital, he had severe abdominal pain and dark blood-colored stool. The colonofiberscopic finding revealed a large, deep penetrating ulcer and multiple shallow ulcers on the ileum. Deal segmental resection, gastro-jejunostomy and jejunal patch at 3rd portion of the duodenum were performed with marked improvement.
Abdominal Pain ; Adult ; Behcet Syndrome ; Duodenum* ; Humans ; Ileum ; Inflammation ; Ulcer* ; Uveitis

BACKGROUND: Death from coronary heart disease is increasing and this study is to evaluate the effect of longitudinal changes of lifestyle and biological parameters on the blood lipid levels, as the risk factor of the coronary heart disease. METHODS: Total cholesterol and total cholesterol to HDL-cholesterol ratio (atherosclerogenic index) as an indicator for risk of coronary heart disease were examined longitudinally in a sample (n = 463) of middle-aged men by 2 years. The independent variables were body mass index, smoking, alcohol, exercise, diastolic blood pressure, uric acid. All data was drawn from questionnaire, blood chemistry, and review of chart. RESULTS: ANOVA test according to categorized variables revealed that for total cholesterol, uric acid (P<0.01) and diastolic blood pressure (P<0.01), and for atherosclerogenic index, and body mass index (P<0.001) were significant. In correlation analysis, total cholesterol was associated with uric acid (r=0.20, P<0.001), diastolic blood pressure (r=0.15, P <0.001) and body mass index (r=0.03, P<0.05), and for atherosclerogenic index so was body mass index (r=0.18, P<0.001). In regression, uric acid (beta=6.07, P <0.001), diastolic blood pressure (beta=0.36, P <0.01) for total cholesterol, and body mass index (beta=0.22, P <0.001) for atherosclerogenic index were significant. But changes in alcohol consumption, smoking, and exercise were not statistically significant. CONCLUSION: In order to reduce risks of coronary heart disease, the more aggressive medical intervention for the uric acid, DBP, and BMI, would be essential. This study was done without medical intervention. So, further study with intervention, adequate duration and intensity for parameters modification is required.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Chemistry ; Cholesterol ; Coronary Disease ; Humans ; Life Style* ; Male ; Middle Aged* ; Risk Factors ; Smoke ; Smoking ; Uric Acid ; Surveys and Questionnaires

BACKGROUND AND AIMS: To further understand the relationship between the cagA gene and gastric cancer, the positive rates of the cagA gene in cancer and non-cancer tissues were investigated separately in patients with gastric cancer. METHODS: The cagA gene was detected by PCR and the ureC gene was analyzed as a positive control for the presence of Helicobacter pylori. Each of two endoscopic biopsies were obtained from cancer and non-cancer tissues of 41 patients with gastric cancer. RESULTS: 1) The positive rate of the cagA gene in cancer tissues was 29.3% (12/41), which was significantly lower than that in non-cancer tissues (63.4%). 2) Twelve (29.3%) out of 41 were positive for the cagA gene in both cancer and non-cancer tissues, 14 were positive in only non-cancer tissues, none were positive in only cancer tissues, and 15 (36.6%) were negative in both sites. 3) The ureC gene was negative in cancer tissue in 12 (85.7%) among 14 cases who were cagA gene negative in the cancer tissue but positive in the non-cancer tissue. 4) There was no difference in the positive rate of the cagA gene according to age, stage, site, and pathologic cell type. CONCLUSIONS: These findings indicate that the positive rate of the cagA gene in cancer tissue was lower than that in non-cancer tissues and this might be related to a low infection rate of H. pylori in cancer tissue rather than the presence of cagA negative H. pylori in cancer tissues.
Biopsy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Stomach Neoplasms*

On view of the absent or minimal osmotic diuresis in end stage renal disease, hyperglycemia on maintenance hemolysis as compared to nonketotic hyperosmolar status without underlying advanced renal failure has been noted to show a wide clinical spectrum form severe manifestations by hypertonicity to no clinical manifestations at all. We experienced a 60-year-old man with a known history of type 2 diabetes mellitus on maintenance hemodialysis for 2 years, who was admitted 4 times within 1 year with hyperglycemia (>500 mg/dL) accompanied by recurrent nausea and vomiting at each admission. However, the calculated effective osmolality (tonicity) in this case ranged only from 286 to 303 mOsm/kg H2O. During the past 6 months following meticulous education for the importance of compliance to medication, especially prokinetics for diabetic gastroparesis, he developed no further episode of hyperglycemia or nausea and vomiting.
Compliance ; Diabetes Mellitus, Type 2 ; Diuresis ; Gastroparesis ; Hemolysis ; Humans ; Hyperglycemia ; Kidney Failure, Chronic ; Middle Aged ; Nausea ; Osmolar Concentration ; Renal Dialysis ; Renal Insufficiency ; Vomiting

Among the various side effects of anticonvulsant medication, the anticonvulsant hypersensitivity syndrome (AHS) is underrecognized. This condition developed frequently with aromatic anticonvulsants, but with new antiepileptic drugs as well. We experienced three lamotrigine-induced AHS cases with symptoms such as fever, rash, leukopenia, eosinophilia and lymphadenopathy, which subsided after withdrawal of lamotrigine.
Anticonvulsants ; Eosinophilia ; Exanthema ; Fever ; Hypersensitivity* ; Leukopenia ; Lymphatic Diseases

BACKGROUND AND OBJECTIVES : Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery (AICA) is known to be associated with vertigo, nystagmus, facial weakness, and gait ataxia. There have been few reports on deafness associated with the AICA infarction. Furthermore, previous neurological reports have not emphasized the inner ear as a localization of sudden deafness. The aim of this study was to investigate the incidence of deafness associated with the AICA infarction and the sites predominantly involved in deafness. MATERIALS AND METHOD : During two years we prospectively identified 12 consecutive patients with unilateral AICA infarction diagnosed by brain MRI. Pure tone audiogram, speech discrimination testing, stapedial reflex testing, and auditory brainstem responses were performed to localize the site of lesion in the auditory pathways. Electronystagmography was also performed to evaluate the function of the vestibular system. RESULTS :The most common affected site on brain MRI was the middle cerebellar peduncle (11). Four patients had vertigo and/or acute auditory symptoms such as hearing loss or tinnitus as an isolated manifestation from 1day to 2 months prior to infarction. Audiological testings confirmed sensorineural hearing loss in 11 (92%) patients, predominantly involved the cochlea in 6 and retrocochlear in 1. The other 4 patients had a severe to profound hearing loss most likely of cochlear origin. Electronystagmography demonstrated no response to caloric stimulation in 10 (83%) patients. CONCLUSIONS : In our series, sudden deafness was an important sign for the diagnosis of the AICA infarction. Audiological examinations suggest that sudden deafness in AICA infarction is usually due to dysfunction of the cochlea, resulting from ischemia to the inner ear.
Arteries* ; Auditory Pathways ; Brain ; Cochlea ; Deafness ; Diagnosis ; Ear, Inner ; Electronystagmography ; Evoked Potentials, Auditory, Brain Stem ; Gait Ataxia ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Incidence ; Infarction* ; Ischemia ; Magnetic Resonance Imaging ; Prospective Studies ; Reflex ; Speech Discrimination Tests ; Stroke ; Tinnitus ; Vertigo

Peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) remains a major problem. Peritonitis due to Cryptococcus neoformans is an unusual complication. A 68-year-old woman on prednisolone for Behcets disease and adrenal insufficiency was admitted with chronic renal failure and CAPD was initiated. During her stay in hospital, she was treated with multiple antibiotics for urinary tract infection and CAPD peritonitis with methicillin resistant Staphylococcus aureus (MRSA). She was deteriorated insidiously and C. neoformans was cultured in the dialysate but not in the blood, urine and stool. After three days, she died. We reviewed 385 organisms isolated from 1,325 peritoneal dialysate specimens between 1990 and 2002. Staphylococcus aureus was most frequently isolated (22.6%). Fungus comprises 10.1% of the isolated organisms.
Adrenal Insufficiency ; Aged ; Anti-Bacterial Agents ; Cryptococcus neoformans ; Female ; Fungi ; Humans ; Kidney Failure, Chronic ; Methicillin Resistance ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Prednisolone ; Staphylococcus aureus ; Urinary Tract Infections

No abstract available.
Aminoquinolines

PURPOSE: Measurement of testicular volume is useful for the evaluation of puberty and testicular development in boys. Four mililiter of testicular volume means Tanner stage 2, the beginning of puberty, and its ethnic differences were reported. However, there is no reference value for Korean children. We tried to establish the standard testicular volume for Korean boys. METHODS: The subjects were selected among the children who visited the out-patient clinic of Kangdong Sacred Heart Hospital and Korea Cancer Center Hospital for the evaluation of growth from 2003 to 2008. Three hundred seventy two healthy Korean boys, 3 to 17 years of age, were included. We excluded the patients who were diagnosed as precocious puberty, delayed puberty, hypopituitarism, adrenal disorder and other endocrinologic disorder. The testicular volume was determined with Prader orchidometer. Clinical data were collected from patient's chart retrospectively. RESULTS: Right and left testicular volumes were 3.65 +/- 1.82 mL and 3.55 +/- 1.80 mL at 10 (10.0 - 10.9) year of age (n = 53), 6.17 +/- 3.60 mL and 6.13 +/- 3.69 mL at 11 (11.0 - 11.9) year of age (n = 52), respectively. There was no significant difference between right and left testicular volumes. CONCLUSION: The time when testicular volume reached 4 mL seemed to be not changed than previous Korean data. However, further study will be required to determine the secular trend of pubertal timing in Korean boys.
Child ; Heart ; Humans ; Hypopituitarism ; Korea ; Outpatients ; Puberty ; Puberty, Delayed ; Puberty, Precocious ; Reference Values ; Retrospective Studies