PURPOSE: To report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi. CASE SUMMARY: A 53-year-old female complained of pain and secretion in her right eye, which started 6 weeks before her visit. She applied steroid ointment, which was received from the dermatologist, to her eyelid 7 days prior to her visit but this treatment worsened her symptoms. At the initial visit, the visual acuity of the right eye was light perception, and purulent secretions were observed. Using a slit lamp, severe conjunctival hyperemia, hypopyon, and a ring-shaped central corneal ulcer were observed. The anterior chamber and fundus were not observed due to corneal lesions but ultrasonography showed no intraocular inflammation. Infectious keratitis was suspected and cultured by corneal scraping. During the incubation period, 0.5% moxifloxacin, 2% voriconazole, and 1% cyclopentolate were administered. A total of 400 mg of moxifloxacin and 100 mg of doxycycline were given orally. In the primary culture, Pseudomonas aeruginosa and Acinetobacter baumannii were identified so 5% ceftazidime, which was sensitive for the antibiotic susceptibility results was further instilled. Thereafter, the keratitis improved but the keratitis again worsened while maintaining the topical treatment. A secondary culture was positive for Ochrobactrum anthropi. Treatment with 1.4% gentamicin, which was sensitive for the antibiotic susceptibility test was added and the keratitis improved. A conjunctival flap was performed because of the increased risk of perforation. CONCLUSIONS: We report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi for the first time in the Republic of Korea.
Acinetobacter baumannii ; Acinetobacter ; Anterior Chamber ; Ceftazidime ; Corneal Ulcer ; Cyclopentolate ; Doxycycline ; Eyelids ; Female ; Gentamicins ; Humans ; Hyperemia ; Inflammation ; Keratitis ; Middle Aged ; Ochrobactrum anthropi ; Ochrobactrum ; Pseudomonas aeruginosa ; Pseudomonas ; Republic of Korea ; Slit Lamp ; Ultrasonography ; Visual Acuity ; Voriconazole

PURPOSE: We analyzed time series changes in cataract surgeries in Korea, and provide basic data to enhance the efficiency of medical services for cataract surgery. METHODS: Among cataract surgery statistics registered in the Korean National Health Insurance Cooperation from 2006 to 2012, we used data regarding the number of patients and operations and the number of patients and operations per 100,000 people. We analyzed various time series changes, including differences by sex and age. RESULTS: The total numbers of patients from 2006 to 2012 by year were 207,370; 228,170; 250,289; 268,548; 289,867; 308,111; and 302,182, respectively. The total numbers of operations from 2006 to 2012 by year were 272,920; 305,807; 338,332; 365,874; 398,338; 428,158; and 420,905, respectively. The number of patients and operations per 100,000 people were highest in men 80 to 84 years old and women 75 to 79 years old. Comparing the number of operations in 2006 and after, the patient age group with the highest increase rate changed from over 85 years old to 75–79 years old since 2010 in men and from over 85 years old to 50–54 years old since 2009 in women. For each year investigated, the number of operations performed was higher than the number of patients who received operations. CONCLUSIONS: Over the study period, the number of cataract surgeries increased, while the age of cataract patients decreased. Additionally, the number of cataract-related surgeries increased in relation to the number of patients.
Cataract Extraction ; Cataract* ; Epidemiology ; Female ; Humans ; Korea* ; Male ; National Health Programs

BACKGROUND: Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. METHOD: We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. RESULTS: 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was 14.2 15.5 hour and initial peak expiratory flow rate was 166.7 68.3L/min.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. CONCLUSION: As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.
Adult ; Asthma ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Korea ; Male ; Mortality ; Peak Expiratory Flow Rate ; Prognosis ; Referral and Consultation ; Respiratory Tract Infections ; Retrospective Studies ; United Nations

The purpose of this study are to delineate the temporal and spatial changes of bone mineralization at the distraction gap and adjacent parent bone, and to investigate the effect of microaxial dynamization on regenerate bone healing and on development of regional osteopenia at the adjacent parent bone, during callotasis. Sixteen Korean adult mongrel dogs underwent bilateral tibial lengthening by callotasis. To the right hindlimbs, no dynamization was applied and served as control group (group I, and axial elastic dynamization was conffered to the left hindlimbs (group II). Bone mineral density(BMD) was measured by dual X-ray absorptionmetry(DXA) at immediate post-operative day, post-operative 12 day, 22 day, 36 day, 50 day, 65 day, and 85 day. Quantitative computed tomogram(Q-CT) was also taken after sacrifice to analyze temporal changes of mineralization pattern in the distraction gap. The following results were obtained; 1. In both group I and II, the BMD was lowest at the interzone in the distraction gap and increased linearly toward the corticotomy surface. This pattern did not change with time until the consolidation of the distraction gap, but the difference of BMD between the interzone and adjacent parent bone decreased with progress of consolidation. 2. During the distraction period, BMD increased progressively at the distraction gap and adjacent parent bone in both group I and II. During consolidation period, although BMD of the distraction gap still increased progressively, that of the adjacent parent bone decreased progressively in group I; the more distant from the corticotomy surface, the more decreased the relative BMD. in group II, the decrease in BMD of the adjacent parent bone was less than that in group I which was statistically significant in mid-consolidation period. In conclusion, the new bone in the distraction gap during callotasis appeared to form in bilateral direction with linear gradient from interzone toward corticotomy surface. Dynamization during callotasis not only stimulated regenerate bone healing in the distraction gap, but also prevented the occurrence of transient regional osteopenia at the distant part of the adjacent bone during midconsolidation period.
Adult ; Animals ; Bone Density ; Bone Diseases, Metabolic ; Calcification, Physiologic ; Dogs ; Hindlimb ; Humans ; Miners ; Osteogenesis, Distraction ; Parents ; Tibia

To explore the effect of follow-up management after health examination for the cerebro-cardiovascular disease risk, a survey applied with the KOSHA cerebro-cardiovascular disease risk assessment tool was conducted with 500 workers in small scale enterprise less than 50 employees. They were provided two types of health services; post-examination management and health consultation, and finally compared the cerebro-cardiovascular disease risk changes between 2014 and 2015. In normal group in 2014, only 18.7% of workers who received the follow-up management had elevated risks, while 23.8% of workers who received the health consultation had elevated risks in 2015. In risk group in 2014, only 2.8% of workers who got follow-up management had elevated risks, while 7.7% of workers who got only health consultation had elevated risks in 2015. After adjustment for gender, age, exercise, body mass index, nationality and type of industry, negative correlation was found in association to the follow-up management (odds ratio = 0.87). This study shows that workers with cerebro-cardiovascular disease or who are at high cerebro-cardiovascular risk in small scale enterprise should receive early detection and management using counselling and regular follow-up after periodic health examination. Also the health counselling including preventive education for cerebro-cardiovascular disease is needed for all workers to improve their self-management for health.
Body Mass Index ; Education ; Ethnic Groups ; Follow-Up Studies* ; Health Services ; Humans ; Risk Assessment ; Self Care

OBJECTIVES: The aim of this study was to investigate factors associated with heart rate variability in firefighters working in a metropolitan city in South Korea. METHODS: Self-administered questionnaires including Korean Occupational Stress Scale (KOSS) as well as surveys collecting socio-demographic characteristics and work-related factors were given to 962 firefighters. After exclusion for missing data, 645 firefighters were included, and analysis of covaiance adjusted for the general risk factors and job characteristics were used to assess the relationship between heart rate variability and associated factors. RESULTS: SDNN and RMSSD and were decreased in the area of occupational climate of the group with high job stress (p = 0.027, p = 0.036). HF(ln) was decreased in the area of organizational system and occupational climate of the group with high stress that statistically significant level (p = 0.034, p = 0.043). CONCLUSIONS: Occupational climate and organizational system are associated with reduction of heart rate variability. Preventive medical care plans for cardiovascular disease of firefighters through the analysis and evaluation of job stress factors are needed.
Cardiovascular Diseases ; Climate ; Firefighters* ; Heart Rate* ; Heart* ; Humans ; Korea ; Risk Factors

PURPOSE: Authors studied the injection method of contrast medium in routine chest spiral CT scan to obtain the best image in the mediastinum. MATERIALS AND METHODS: Dynamic static scan had been performed in 5 normal volunteers as a pilot study. In consideration of the result of pilot study, Chest spiral CT was performed in 217 patients by three different methods. We used 100cc nonionic contrast medium. Average attenuation of great vessels in the mediastinum were assessed in various injection methods. Image quality was graded with three levels of score by two radiologists. RESULTS: Peak enhancement time of the great vessels on pilot at dynamic static scan were as follows :52 sec at ascending aorta, 45 sec at pulmonary artery, and 40 sec at SVC. In the study of spiral CT, the highest attenMarion in the great vessels was obtained after injection of 100cc of contrast medium(2cc/sec, with 35-40 second scan delay), althrough artifact from highly enhancing SVC was most common in this method. Image quality were highest in the scans obtained with other methods(3-2-1cc/sec for 10-15-40 seconds, with 40 second scan delay). CONCLUSION: For chest spiral CT, authors recommend that scans should be obtained after infusion of 70--80cc of contrast medium during 35--40sec to obtain maximal vascular enhacement of mediastinum.
Aorta ; Artifacts ; Healthy Volunteers ; Humans ; Mediastinum ; Pilot Projects ; Pulmonary Artery ; Thorax* ; Tomography, Spiral Computed*

PURPOSE: We investigated whether periurethral injections of muscle- derived stem cells (MDSC) and chitosan/hydroapatite after denervation of rat's pudendal nerve could increase the leak point pressure over a long time period in a rat model of urinary incontinence. MATERIALS AND METHODS: Muscle-derived stem cells isolated from the gastrocnemius muscle of normal female rats were purified to obtain a myogenic population by using the preplate technique. The N group was the normal female rats, the D Group was the pudendal nerve transected group and the M Group was the MDSC/chitosan/hydroapatite composite gel injected group after pudendal nerve transection. The MDSC/chitosan/hydroapatite composite gel was injected into the proximal periurethral area. At 2 and 4 weeks, visually identified leak point pressure measurement was done with using the vertical tilt/intravesical pressure clamp model of urinary incontinence. The rats were then sacrificed and the periurethral tissues harvested for histological examination. RESULTS: The leak point pressure was significantly lower in the D group at each time compared with the N group, and the leak point pressure in the N and M groups were significantly higher than those in the D group at both 2 and 4 weeks. The persistence of MDSC over the period of study was verified by histological examination. CONCLUSIONS: MDSC/chitosan/hydroapatite injection into the denervated external urethral sphincter in female rats increased the leak point pressure at 2 and 4 weeks. This MDSC/chitosan/hydroapatite composite gel can be an alternative injection method for treating urinary incontinence in the future.
Animals ; Denervation ; Female ; Humans ; Models, Animal* ; Muscle, Skeletal ; Pudendal Nerve ; Rats* ; Stem Cells ; Urethra ; Urinary Incontinence*

The main feature of acute renal failure is a decline in the glomerular filtration rate. However, urine leakage into the peritoneal cavity due to bladder rupture may cause pseudo-renal failure. This is a situation in which renal function is normal, along with the presence of elevated serum creatinine. A 47-year-old woman presented with abdominal distension and pretibial pitting edema on both lower extremities. She had no traumatic history. She did not complain of abdominal pain, and exhibit neither oliguria nor anuria. Her blood urea nitrogen (BUN) and serum creatinine was 105 and 11.2 mg/dL. Ascites showed that urea nitrogen and creatinine were 160 and 29 mg/dL, respectively. We confirmed bladder rupture by an abdominal CT scan and retrograde cystography. She underwent an emergency laparotomy to repair the ruptured bladder. Azotemia was normalized 2 days after the operation. Here we present a rare case of uremia due to bladder rupture.
Abdominal Pain ; Acute Kidney Injury ; Anuria ; Ascites ; Azotemia ; Blood Urea Nitrogen ; Creatinine ; Edema ; Emergencies ; Female ; Glomerular Filtration Rate ; Humans ; Laparotomy ; Lower Extremity ; Middle Aged ; Nitrogen ; Oliguria ; Peritoneal Cavity ; Rupture ; Urea ; Uremia ; Urinary Bladder

PURPOSE: To determine how clinical and angiographic factors relate to the amount of subarachnoid blooddetected by computerized tomography in patients with a ruptured aneurysm. MATERIALS AND METHODS: Between January1996 and December 1997, 22 patients with a posterior communicating artery aneurysm were retrospectively evaluated. RESULTS: Oval(three of four cases), funnel(both cases), and daughter-sac (four of five cases) types of aneurysmalsac were found among the 13 patients with a large amount of subarachnoid blood ; eight of these had a past historyof hypertension or diabetes. Seven of eleven cases of cylindrical-type aneurysmal sac were found among the 9patients with a small amount of sularachnoid blood ; eight of these had no past history of hypertension ordiabetes. The average S/N ratio (ratio of maximum sac length to neck diameter) of patients with a small amount ofblood was higher than that of patients with a large amount of blood(2.72 vs 2.07). CONCLUSION: Although manyfactors influence the amount of subarachnoid blood in an aneurysmal rupture, we found that a large amount of bloodwas frequently present in the oval, funnel and daughter sac types of aneurysm, when S/N ratio was low, and when anunderlying disease such as hypertension or diabetes was present. Conversely, a small amount of blood was presentin the cylindrical type, when S/N ratio was high, and where there was no of underlying disease.
Aneurysm ; Aneurysm, Ruptured ; Humans ; Hypertension ; Intracranial Aneurysm* ; Neck ; Nuclear Family ; Retrospective Studies ; Rupture