PURPOSE: Introduction of phacoemulsification and development of foldable artificial lens has facilitated smaller incisions, even micro-coaxial incisions. However, there have been several studies showing that micro-coaxial incision has no benefit compared with the conventional small incision method. Cases where Ellips ultrasound was used have not yet been reported. Therefore, we compared the postoperative results between 2.2-mm and 2.8-mm incision groups using Ellips ultrasound. METHODS: Among 49 eyes receiving cataract surgery from March, 2012 to August, 2012, 27 eyes in the 2.2-mm group and 22 eyes in the 2.8-mm group were examined to obtain cumulated dissipated energy (CDE), use of balanced salt solution (BSS), best-corrected visual acuity (BCVA), corneal endothelial cell count (ECC), corneal thickness at center and incision site, and keratometric astigmatism before and after surgery. RESULTS: There were no statistically significant differences between the 2.2-mm and 2.8-mm groups in CDE (2.5 +/- 2.0 vs. 2.5 +/- 2.3) and use of BSS (188 +/- 127 vs. 138 +/- 43 mL) during the surgery, BCVA (-0.45 +/- 0.62 vs. -0.55 +/- 0.79 log MAR), ECC (-178 +/- 210 vs. -99 +/- 114 cells/mm2), corneal thickness at center (23 +/- 23 vs. 27 +/- 23 microm) and incision site (24 +/- 19 vs. 27 +/- 19 microm) and keratometric astigmatism before and after the surgery. CONCLUSIONS: A 2.2-mm micro-coaxial incision using Ellips ultrasound showed no statistically significant differences in BCVA, ECC, corneal thickness at center and incision site, and keratometric astigmatism compared with 2.8-mm small incision.
Astigmatism ; Cataract* ; Endothelial Cells ; Phacoemulsification ; Ultrasonography* ; Visual Acuity

Two cases of congenital osteogenesis imperfecta were presented with review of literatures. Summary of the two cases were as follows; Case I:A 22day old female newborn has had problems of curved both thigh, short extreremities and irritability following manipulations since birth. Roentgenographical study showed multiple deformities at skull, spine, ribs and abnormal healing process/ Case II: A 5 month old male infant has had problems of growth retardation and limitation of movemenrs of the lower estremities since birth. He had blue sclera and both inguinal hernia. His bone X-ray findings were similar, but severe than cause I. Laboratory data of both cases were within normal limits.
Congenital Abnormalities ; Female ; Hernia, Inguinal ; Humans ; Infant ; Infant, Newborn ; Male ; Osteogenesis Imperfecta* ; Osteogenesis* ; Parturition ; Ribs ; Sclera ; Skull ; Spine ; Thigh

This is a clinical observation of congenital anomalies in 97newborn infants associated with hydramnios. These infants were born at severance Hospital, Wonju Christian Hospital and Jeonju Presbyterian Hospital from Jan. 1966 to Aug. 1975. The results were as follows: 1. The frequency of hydramnios was 86 cases in 25,566 deliveries in that period, which was 0.34%. 40infants (41.2%) has congenital anomlies of 97 infants associated with hydramnios by adding twin babies. 2. Hydramnios was associated with high incidence of prematurity and low-birth-weight infant. Who also has high incidence of anomalies 3. The incidence of associating anomalies was 77.8%(75 cases) and multiple anomaly was noticed in 37.5%(15 cases)of these infants. The most common organ involved with these anomalies was central nervous system in 32.0% (24 cases). 13 cases of anencephaly was included. 4. The perinatal mortality rate was 46.4%(45cases) and 60.0%(27cases) of these were associated with congenital anomalies. 20 (60.0%) of 33 live-births with congenital anomalies were died in neonatal period.
Anencephaly ; Central Nervous System ; Gangwon-do ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Jeollabuk-do ; Perinatal Mortality ; Polyhydramnios* ; Protestantism ; Twins

The authors have experienced a case of Duchenne type of progressive muscular dystrophy in a 9 year old boy who was presented with significantly increased serum enzymes related to this disedase and musle biopsy findings compatible with muscular dystrophy, reported with review of literatures concerned.
Biopsy ; Child ; Humans ; Male ; Muscular Dystrophies*

OBJECTIVE: To compare the perinatal outcomes of pregnant women with 100 g oral glucose tolerance test (OGTT) proven impaired glucose tolerance (IGT), with normal control and gestational diabetes mellitus (GDM) groups. METHODS: 159 pregnant women who had visited our medical center between March 2002 and March 2004, positive (> or = 140 g) for 50 g OGTT were included in this study. IGT was defined by the presence of one abnormal 100 g OGTT glucose value, and they were compared with the control group, and the GDM group(with at least 2 abnormal glucose values). The maternal and neonatal outcomes were assessed among three groups. RESULTS: Even though familial history of DM was significantly higher in the IGT and GDM group (p<0.001) compared with the control group, no difference was observed in the frequency of previous GDM. The rate of fetal macrosomi a (>4 kg) and hypoglycemia was significantly increased in GDM group than other groups. The difference in the frequency of i) large for gestational age birthweight (>90 percentile) ii) preterm delivery, iii) APGAR score (1-min and 5-min), iv) shoulder dystocia, and v) congenital anomalies among the three groups was not notable-however, the incidence of neonatal hyperbilirubinemia was significantly higher and duration of NICU admission is significantly longer in the IGT group, compared to the control group (p<0.001). In maternal outcomes, whereas no significant difference was observed concerning the frequency of i) polyhydramnios (>95%) ii) infections (genitourinary and surgical wounds) in the three groups, the prevalence of preeclampsia was significantly higher in the IGT (p=0.018) and GDM group (p=0.023), compared with the control group. CONCLUSION: Neonatal hyperbilirubinemia, as well as maternal preeclampsia were significantly elevated in the IGT group. The results obtained thus far demonstrate the possibility of the need for active perinatal care with therapeutic intervention in pregnant women with IGT.
Apgar Score ; Diabetes, Gestational ; Dystocia ; Female ; Gestational Age ; Glucose Tolerance Test* ; Glucose* ; Humans ; Hyperbilirubinemia, Neonatal ; Hypoglycemia ; Incidence ; Perinatal Care ; Polyhydramnios ; Pre-Eclampsia ; Pregnancy ; Pregnant Women* ; Prevalence ; Shoulder

Cytomegalovirus (CMV) infections commonly develop between the second and sixth month after renal transplantation. The incidence of CMV infection in renal transplant recipients, which depends on their serological status regarding CMV antibody and the use of immunosuppressants, is reported to be 38~67%. However, CMV infection after renal transplantation has been rarely reported in Korea. Recently, we experienced 4 cases of symptomatic CMV infection after renal transplantation, which were diagnosed by CMV antigenemia assay. With the development of more sensitive diagnostic methods, CMV infection may become recognized more commonly among renal transplant recipients.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation* ; Korea ; Transplantation

Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. Escherichia coli was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, Staphylococcus aureus (15.2%), coagulase-negative Staphylococcus (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.
Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy/*epidemiology/microbiology/mortality ; Community-Acquired Infections/drug therapy/*epidemiology/microbiology/mortality ; Cross Infection/drug therapy/*epidemiology/microbiology/mortality ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult

BACKGROUND/AIMS: As bacterial resistance to antimicrobial agents has grown due to the increasing use of antimicrobial agents, we sought to evaluate the suitability of ceftriaxone usage (representative of third generation cephalosporins) at 10 university hospitals in Korea. METHODS: We prospectively evaluated the appropriateness of antibiotic usage in 400 adult patients who received ceftriaxone between February 1, 2006 and June 30, 2006. Drug utilization evaluation (DUE) methods were based on standards set forth by the American Society of Hospital Pharmacists. The DUE criteria used in this study were modified to be more suitable in our hospital setting: justification of drug use, critical and process indications, complications, and outcome measures. RESULTS: The average patient age was 64.4 years. The utilization of ceftriaxone was appropriate in 262 cases (65.5%) for the justification of use, while inappropriate use was observed in 138 cases (34.5%). Common reasons for inappropriate use of ceftriaxone included continued empiric use for presumed infections, prophylactic perioperative injection, and empiric therapy for fever. Most of the critical indications showed a high rate of suitability (66.5-98.5%). Complications occurred in 37 cases (9.3%). With respect to outcome measures, clinical responses were observed in 60.7% of cases, while only 15.7% of cases showed evidence of infection eradication via negative cultures. CONCLUSIONS: Appropriate use (65.5%) of ceftriaxone was higher than inappropriate use (34.5%) at university hospitals in Korea. Inappropriate utilization, however, including continued empiric use for presumed infections and prophylactic perioperative injection remained high. Intensification of educational programs and antibiotic control systems for ceftriaxone is needed to improve the suitability of antimicrobial use.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*therapeutic use ; Ceftriaxone/adverse effects/*therapeutic use ; Child ; Child, Preschool ; *Drug Utilization Review ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome

Solid organ transplantation has been established as an accepted treatment modality for end-stage diseases. Although the prognosis for organ recipients has improved with the development of surgical technical skills and the application of newly developed immunosuppressive agents, opportunistic infections remain the major cause of death in these patients. Invasive aspergillosis is one of the most common fungal infections in solid organ transplantation, and it carries a high mortality rate. In Korea, eight sporadic cases of invasive aspergillosis after kidney or heart transplantation have been reported. Recently, we experienced five cases of invasive aspergillosis after liver or heart transplantation over a four year period. Among these five patients, three died of uncontrollable aspergillosis and one died of heart failure and graft rejection. Early diagnosis and treatment are essential for the improvement of the prognosis for invasive aspergillosis after solid organ transplantation.
Aspergillosis* ; Cause of Death ; Early Diagnosis ; Graft Rejection ; Heart Failure ; Heart Transplantation ; Humans ; Immunosuppressive Agents ; Kidney ; Korea ; Liver ; Mortality ; Opportunistic Infections ; Organ Transplantation* ; Prognosis ; Transplants*

BACKGROUND: Despite the widespread emergence of antimicrobial resistance among pneumococcal strains worldwide, clinical implications of in vitro resistance still remain an open question. To evaluate the clinical impact of pneumococcal resistance in Asian countries where the prevalence of pneumococcal resistance was reported to be highest in the world, ANSORP has performed a prospective, multinational surveillance study with cases with invasive pneumococcal diseases in Asian countries. METHODS: In vitro susceptibility of pneumococcal isolates was determined by broth microdilution tests with 16 antimicrobial agents. All enrolled cases of pneumococcal infections were analyzed with regard to demographic data, clinical features, risk factors and mortality. RESULTS: A total of 646 patients with pneumococcal infections were enrolled from 14 centers in 12 countries between the period from November 1999 to August 2001. Pneumonia (58.4%) was the most common clinical disease followed by bacteremia (33.4%), otitis media (10.4%), and meningitis (10.2%). Among 646 isolates, 347 (53.7%) were penicillin non-susceptible (intermediate 23.1%, resistant 30.7%). MIC90s for penicillin ranged from 0.03 (India) to 4.0 microgram/mL (Korea, Taiwan, Vietnam, and Hong Kong). Overall mortality from pneumococcal diseases by penicillin non-susceptible strains was not different from that by susceptible strains. Pneumococcal pneumonia caused by penicillin- or erythromycin-resistant strains showed similar mortality, severity of illness, or complications to that by susceptible strains. Mortality from pneumococcal meningitis caused by penicillin non-susceptible strains was also similar to that by susceptible strains. CONCLUSION: Data suggest that current situation of in vitro resistance to penicillin or macrolides may not affect the mortality from pneumococal pneumonia or meningitis caused by antibiotic-resistant strains.
Anti-Infective Agents ; Asian Continental Ancestry Group* ; Bacteremia ; Humans ; Macrolides ; Meningitis ; Meningitis, Pneumococcal ; Mortality ; Otitis Media ; Penicillins ; Pneumococcal Infections ; Pneumonia ; Pneumonia, Pneumococcal ; Prevalence ; Prospective Studies ; Risk Factors ; Taiwan ; Vietnam