Mucormycosis is a relatively uncommon opportunistic fungal infection that occurs more commonly in patients with immunosuppression and diabets mellitus, particularly those with ketoacidosis. Successful therapy for rhinoorbital mucormycosis requires early diagnosis, correction of predisposing conditions, prompt use of amphotericin B, and aggressive surgical debridement. We experienced a 56-years-old poorly controlled diabetic woman with rhinoorbital mucormycosis that was successfully treated with intraconal amphotericin B irrigation and packing without exenteration.
Abscess* ; Amphotericin B* ; Debridement ; Drainage* ; Early Diagnosis ; Female ; Humans ; Immunosuppression ; Ketosis ; Mucormycosis*

The purpose of this study was to determine whether preoperative topical antiglaucomatous therapy influences the outcome of subsequent trabeculectomy. We investigated 50 eyes of 36 patients with primary open anlge glaucoma(POAG)and 86 eyes of 77 patients with primary angle closure glaucoma (PACG), who had undergone trabeculectomy. All the patients had received topical antiglaucomatous therapy preoperatively and had been followed up for at least 6 months postoperatively. Both groups, POAG and PACG were divided into two subgroups according to the duration of preoperative antiglaucomatous therapy: (a)for less than 1 month and (b)for more than 6 months. The criterion for success was maintenance of postoperative intraocular pressure(IOP)below 21 mmHg without medication. The rates of success were compared at 1 week, 1 month, 3 months, and 6 months postoperatively. In POAG patients, the overall success rate was clinically significantly higher in subgroup (a)than in subgroup (b)(P<0.05). The success rate in subgroup (a)of POAG patients remained higher irrespective of class of antiglaucomatous medications(P<0.05). In PACG patients, the success rate was also higher in subgroup A, but it failed to reach clinical significance. Postoperative mean IOP was slightly lower in subgroup (a)of all the participants, but it was not clinically significant. Our study suggests that long-term use topical antiglaucoma medications can affect adversely the result of filtering surgery in POAG.
Filtering Surgery ; Glaucoma, Angle-Closure ; Humans ; Trabeculectomy*

OBJECTIVES: To evaluate the factors that limit post-cochlear implantation (CI) speech perception in prelingually deaf children. METHODS: Patients with CI were divided into two groups according to Category of Auditory Performance (CAP) scores 3 years post-CI: the poor performance group (poor performance group, CAP scores≤4, n=41) and the good performance group (good performance group, CAP scores≥5, n=85). The distribution and contribution of the potential limiting factors related to post-CI speech perception was compared. RESULTS: Perinatal problems, inner ear anomalies, narrow bony cochlear nerve canal (BCNC), and intraoperative problems was significantly higher in the poor performance group than the good performance group (P=0.010, P=0.003, P=0.001, and P=0.045, respectively). The mean number of limiting factors was significantly higher in the poor performance group (1.98±1.04) than the good performance group (1.25±1.11, P=0.001). The odds ratios for perinatal problems and narrow bony cochlear nerve canal in the poor performance group in comparison with the good performance group were 4.878 (95% confidence interval, 0.067 to 0.625; P=0.005) and 4.785 (95% confidence interval, 0.045 to 0.972; P=0.046). CONCLUSION: This study highlights the comprehensive prediction of speech perception after CI and provides otologic surgeons with useful information for individualized preoperative counseling of CI candidates.
Child ; Cochlear Implantation ; Cochlear Implants* ; Cochlear Nerve ; Counseling ; Deafness* ; Ear, Inner ; Hearing Loss, Sensorineural ; Humans ; Language Development ; Odds Ratio ; Prognosis ; Speech Perception ; Surgeons

BACKGROUND: Auditory evoked potentials (AEPs) have assumed an essential role in the clinical practice of auditory and several other professions. AEP classification and nomenclature systems are generally based on such aspects as the time domain (short, middle, long), anatomic origin, stimulus-response relationship. The P300 component of the human event related potential is an endogenous positive wave with a latency of 300msec or greater. OBJECTIVES: Our purpose of this study was to estimate normal values of auditory late response (ALR) and P300 in adults and use them in mapping of the brain. MATERIALS AND MEHTODS: An auditory evoked potential was performed on 40 normal adults, and a scalp surface electrode with 30 electrodes was attempted. Forty adults with normal hearing were divided into 2 groups, one consisting of thirty persons under 30 years of age and the other consisting of ten persons over 30 years of age. RESULTS: The latencies of P1, N1, P2, N1-P2 were 53.17 +/- 19.57 msec, 98.25 +/- 32.68 msec, 166.12 +/- 44.0 msec, 65.12 +/- 23.68 msec, respectively, in the whole group and 54.23 +/- 20.86 msec, 98.7 +/- 34.35 msec, 160.93 +/- 44.02 msec 62.23 +/- 25.36 msec, respectively, in the group under 30 years old, and 50.0 +/- 15.57 msec, 96.9 +/- 28.69 msec, 181.7 +/- 42.28 msec 73.8 +/- 15.69 msec, respectively, in the group over 30 years old. The P300 latencies for the whole group and the two groups were 299.37 +/- 34.01 msec, 295.16 +/- 33.36 msec, 312.0 +/- 34.49 msec, respectively. There was no significant difference in the latency and amplitude of the ALR and P300 between the two groups (p>0.05). CONCLUSION: ALR and P300 were measured in 40 normal adults. Description of the normal topography of P300 may facilitate the examination of the P300 topography in cognitive disorders. Such an examination might help ALR and P300 to serve as better diagnostic tools of cognitive disorder in adults.
Adult* ; Brain ; Brain Mapping ; Classification ; Electrodes ; Event-Related Potentials, P300 ; Evoked Potentials ; Evoked Potentials, Auditory ; Hearing ; Humans ; Reference Values ; Scalp

OBJECTIVE: Although several ginsenosides have been reported to have anti-arthritic activity, few in vivo studies of the anti-arthritic effects of compound K (CK), a major metabolite of ginsenosides, have been conducted. Therefore, we investigated the preventative and therapeutic effects of CK on collagen-induced arthritis (CIA). METHODS: CK was administered to CIA mice preventively and therapeutically and post-treatment bone microarchitectural characteristics, histopathological changes, and serum levels of anti-collagen antibodies, tumor necrosis factor-alpha, and interleukin (IL)-17 were investigated. We also examined cytokine production by type II collagen (CII)-stimulated splenocytes and mRNA expression of matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinase (TIMP)-1, receptor activator of nuclear factor-kappaB ligand (RANKL), and osteoprotegerin (OPG) in the joint tissues. RESULTS: CK reduced the severity of CIA preventively and therapeutically (all p<0.05). Additionally, CK dose-dependently decreased histopathological signs of arthritis and improved microarchitectural characteristics (all p<0.05) at 10 to 20 mg/kg/d in CIA mice. CK treatment significantly decreased the serum levels of anti-CII immunoglobulin G (p<0.01) and the secretion of interferon-gamma and IL-2 from stimulated splenocytes (all p<0.05). Furthermore, MMP-3/TIMP-1 and RANKL/OPG ratios were suppressed in CK treated mice (all p<0.01). CONCLUSION: CK attenuated CIA via suppression of the humoral immune response and modulation of joint-destructive mediators. These results suggest that CK has therapeutic potential in rheumatoid arthritis.
Animals ; Antibodies, Neoplasm ; Arthritis ; Arthritis, Experimental* ; Arthritis, Rheumatoid ; Collagen Type II ; Ginsenosides* ; Immunity, Humoral ; Immunoglobulin G ; Interferon-gamma ; Interleukin-2 ; Interleukins ; Joints ; Matrix Metalloproteinases ; Mice* ; Necrosis ; Osteoprotegerin ; Panax ; RANK Ligand ; RNA, Messenger

OBJECTIVES: The aim of this study was to assess toxicities of cryoprotectants. METHODS: Toxicities of two cryoprotectants, dimethyl sulfoxide (DMSO) and 1,2-propanediol (PROH), were investigated using a murine embryo model. Female F-1 mice were stimulated with gonadotropin, induced ovulation with hCG and mated. Two cell embryos were collected and cultured after exposure to either DMSO or PROH. Embryo development was evaluated up to the blastocyst stage. Blastocysts were stained with bis-benzimide to evaluate the cell count and with terminal deoxynucleotidyl transferase mediated dUTP nick labeling (TUNEL) to assess apoptosis. RESULTS: The total cell count of blastocysts that were treated with DMSO at the 2-cell stage was significantly lower than that were treated with PROH (75.9+/-27.0) or the control (99.0+/-18.3) (p<0.001). On comparison of two cryoprotectant treated groups, the DMSO treated group showed a decreased cell count compared with the PROH treated group (p<0.05). Both DMSO (14.2+/-1.5) and PROH (11.2+/-1.4) treated groups showed higher apoptosis rates of cells in the blastocyst compared with the control (6.2+/-0.9, p<0.0001). In addition, the DMSO treated group showed more apoptotic cells than the PROH treated group (p<0.001). CONCLUSIONS: The potential toxicity of cryoprotectants was uncovered by prolonged exposure of murine embryos to either DMSO or PROH at room temperature. When comparing two cryoprotective agents, PROH appeared to be less toxic than DMSO at least in a murine embryo model.
Animals ; Apoptosis ; Blastocyst ; Cell Count ; Cryoprotective Agents ; Dimethyl Sulfoxide ; DNA Nucleotidylexotransferase ; Embryonic Development* ; Embryonic Structures* ; Female ; Gonadotropins ; Humans ; Mice ; Ovulation ; Pregnancy ; Propylene Glycol

PURPOSE: Novel influenza H1N1 A virus developed pandemic infection, and patients requiring hospitalization have rapidly increased because of severe clinical symptoms and signs. We describe the clinical features of hospitalized pediatric patients with novel influenza virus infection. METHODS: We reviewed the medical charts of 128 pediatric patients under the age of 16 who were hospitalized in Dongguk University Ilsan Hospital between September 2009 and February 2010. We compared the clinical features of the pneumonia and non-pneumonia groups of patients, and analyzed clinical difference according to M. pneumoniae coinfection and severity of pneumonia. RESULTS: The male to female sex ratio of the subjects was 2.2:1, and the average age was 6.2 years. Sixty-five patients (50.8%) had pneumonia and their average age was 6.7 years. Variables including duration of admission, total WBC counts, neutrophil percentage and CRP were significantly different between the 2 groups, however, the other variables were not. The number of patients diagnosed with severe pneumonia was 20 (30.8%). M. pneumoniae coinfection occurred in 24.6% of patients in the pneumonia group, however, it did not influence the severity of pneumonia. Underlying asthma was more significantly associated with severe pneumonia than with mild pneumonia. There was no death case. CONCLUSION: In this study, 2009 novel influenza infection was more prevalent in school-age boys. M. pneumoniae coinfection occurred frequently, however, it did not seem to influence disease severity. Patients with underlying asthma tend to develop severe pneumonia more frequently.
Asthma ; Coinfection ; Female ; Hospitalization ; Humans ; Influenza, Human ; Male ; Mycoplasma pneumoniae ; Neutrophils ; Orthomyxoviridae ; Pandemics ; Pneumonia ; Sex Ratio ; Viruses

BACKGROUND: Paradoxical puborectalis syndrome (PPS) is a complex and poorly understood entity characterized by contraction rather than relaxation of the pelvic floor muscles during attempted evacuation. Anal electromyography (EMG) and cinedefecography (CD) are the most commonly used tests for the diagnosis of PPS. Therefore, the aim of this study was to prospectively assess the correlation of EMG and CD in the diagnosis of PPS. METHODS: All patients with symptoms of obstructed evacuation who underwent EMG and CD between September 1998 and February 1999, were evaluated. The clinical criteria for PPS included incomplete or difficult evacuation, straining, tenesmus, and the need for an enema or digitation. The EMG criteria included failure to achieve a significant decrease in the electrical activity of the puborectalis during attempted evacuation. The CD criteria included either paradoxical contraction or failure of the puborectalis to relax along with incomplete evacuation. RESULTS: Twenty-nine (29) patients had clinical evidence of PPS, 8 males and 21 females with a mean age of 42.6 years (range, 19-75 years), and underwent CD and EMG. The mean duration of symptoms was 7.2 years (range, 3 months-30 years). Nineteen patients (65.5%) had evidence as having PPS on CD and/or EMG. Of these patients, six patients (20.7%) were diagnosed as having PPS on both tests, five patients (17.2%) were only diagnosed on CD, and eight patients (27.6%) were only diagnosed on EMG. The remaining ten patients had normal puborectalis muscle relaxation on CD and EMG. Therefore, the correlation rate between the two tests was 55.2%. If EMG was considered as the ideal test for the diagnosis of PPS, CD had a sensitivity of 42.9% and a specificity of 66.7%. Conversely, if CD was considered as the ideal test, EMG had a sensitivity of 54.5% and a specificity of 55.6%. CONCLUSIONS: The sensitivity and the specificity values of EMG and CD for the diagnosis of PPS are suboptimal, and a low correlation existed between the two tests. This result suggests that the diagnosis of PPS should not be based upon only one test.
Constipation ; Diagnosis* ; Electromyography* ; Enema ; Female ; Humans ; Male ; Muscle Relaxation ; Muscles ; Pelvic Floor ; Prospective Studies ; Relaxation ; Sensitivity and Specificity

Chinese herb medicines have traditionally been used to treat or alleviate the symptom of various diseases. The rationale for use of certain herbs to certain disorder is now getting unveiled by modern technology. In the present study, we investigated whether herb mix extract (HMX), which is alleged to be useful for gastric ulcer, protects stomach from oxidative stress. Rats were allowed to normal diet with and without HMX (1, 5, 10 mg/kg) for 30 days. To induce gastric ulcer, ethanol (75%, 1.5 ml) or acidified aspirin (100 mg/kg in 0.2 N HCl) was administered by oral route in 24 h-fasted rats and examined the gastric ulceration (bleeding) by measuring the size 1 h after the treatment. Results indicated the area of gastric bleeding was significantly less in HMX fed rats than in normal diet fed ones, and it was dependent on the duration and amount of HMX. To investigate the underlying mechanism by which HMX protects stomach from oxidative stress, expression of enzymes like heme oxygenase (HO), cyclooxygenase (COX), and inducible nitric oxide (iNOS) were investigated in MKN-74 cells, where aspirin or H. pylori was introduced. The results were compared with RAW 264.7 cells to check if there's cell specificities exist. The expression of HO-1 but not COX-2, iNOS was significantly increased by HMX. Furthermore, HO-1 inhibitor, SnPP IX reduced the HO-1 activity and reversed the survival rate in HMX-treated MKN-74 cells. There's no difference between RAW 264.7 cells and MKN-74 cells. We, thus, concluded that HMX is beneficial for protection from oxidative injury, and induction of HO-1 by HMX in gastric cells is, at least, responsible for protection from oxidative stress such as ethanol, aspirin and possibly H. pylori infection.
Animals ; Asian Continental Ancestry Group ; Aspirin* ; Cell Survival* ; Diet ; Ethanol* ; Heme Oxygenase (Decyclizing) ; Heme Oxygenase-1* ; Heme* ; Hemorrhage* ; Humans ; Nitric Oxide ; Oxidative Stress ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Reactive Oxygen Species ; Stomach Ulcer ; Stomach* ; Survival Rate

PURPOSE: This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. METHODS: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/mm3. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. RESULTS: Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. CONCLUSION: Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; C-Reactive Protein ; Chorioamnionitis ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Inflammation ; Intensive Care, Neonatal ; Leukemoid Reaction ; Medical Records ; Mothers ; Neutrophils ; Parturition ; Pregnancy ; Prognosis ; Retinopathy of Prematurity ; Retrospective Studies ; Steroids ; Ventilators, Mechanical