PURPOSE: This study attempted to investigate the frequency, duration, and risk factors of antibiotic-associated diarrhea (AAD) in infants hospitalized due to febrile urinary tract infection (UTI). This is a basic research on the probiotics used in the prevention and treatment of AAD in infants. METHODS: Medical records of the infants aged 3-6 months hospitalized in Gachon University Gil Hospital from January 2008 to September 2010 due to the febrile UTI were retrospectively reviewed. The episodes of loose or watery stool were investigated for frequency, onset, and duration. Those who had AAD and those who did not (non-AAD) were compared. The antibiotic regimens and the episodes of diarrhea were investigated in AAD group. RESULTS: Total 147 infants were included. Fifty-four (36.7%) showed AAD. Intravenous third-generation cephalosporin (3rd CS) single therapy was used for 102 patients (69.4%), the 3rd CS and non-3rd CS combination therapy for 24 (16.3%), and non-3rd CS combination therapy for 21 (14.3%). There was no significant difference in the dose of cefotaxime between AAD and non-AAD group (P=0.601). According to the antibiotic therapies above, in AAD group, there was no significant difference in the onset and duration of diarrhea respectively (P=0.717, P=0.830). Although the frequency of diarrhea was higher for the 3rd CS and non-3rd CS combination therapy subgroup with 9.25+/-5.30 times/day than the other two subgroups (7.58+/-2.97 times/day in 3rd CS single therapy subgroup, 6.75+/-4.40 times/day in non-3rd CS combination therapy subgroup), there was no statistical significance (P=0.078). CONCLUSION: AAD seems common to the infants aged 3-6 months with febrile UTI, regardless of regimen and amount of antibiotics in usual dosage. Further research on the effects of probiotics used in the prevention and treatment of AAD in infants is warranted.
Aged ; Anti-Bacterial Agents ; Cefotaxime ; Child ; Diarrhea ; Humans ; Infant ; Medical Records ; Probiotics ; Retrospective Studies ; Risk Factors ; Urinary Tract ; Urinary Tract Infections

A case of multiple hemangioendothelioma of the cauda equina nerve roots and conus medullaris is described. This case is the first report of intradural multiple hemangioendothelioma in Korea. A 74-year-old woman presented with a 4-month history of progressive bilateral leg weakness and lancinating leg pain especially at night. Magnetic resonance image revealed multiple enhancing nodular masses in the cauda equina nerve roots and pial surface of the conus medullaris. We performed total removal of conus medullaris mass and partial removal of two nerve rootlets masses. Two lesions were histologically examined and found to be hemangioendotheliomas
Aged ; Cauda Equina* ; Conus Snail ; Female ; Hemangioendothelioma* ; Humans ; Korea ; Leg ; Spinal Cord*

Stroke results in sudden loss of function related to its damaged portion. When this occurs in temporal lobe, the function of hearing and listening may be affected, although receptive language processing is affected while hearing perception is relatively spared. This is called as “central deafness.” It has been known that hearing ability is seldom impaired in the case of temporal lobe stroke except in the case of bilateral lesions. However, we experienced a 72-year-old, right-handed woman who presented with both sudden hearing difficulty due to unilateral temporal lobe infarctions after suddenly not being able to respond to any verbal questions except environmental sounds. Pure-tone audiometry showed both flat sensorineural hearing loss of mild degree in both ears but she could not understand any verbal sound. Brain MRI demonstrated extensive ischemic infarcts in the left temporal lobes involving primary auditory cortex. She was diagnosed as verbal auditory agnosia and has received speech-language therapy.

PURPOSE: To investigate the clinical outcomes of combined vitrectomy and intrascleral fixation of a new posterior chamber intraocular lens (PC IOL) as a treatment for IOL dislocation. METHODS: We conducted a retrospective interventional study at our medical facility from January 2015 to January 2017. Posteriorly dislocated IOLs were removed with pars plana vitrectomy. Two intrascleral tunnels, 2.0 mm in length, were created 1.5 mm to the limbus at 6 and 12 o'clock positions. Both haptics of new foldable acrylic 3-piece IOLs were inserted into the tunnel until the IOL was secured in a central position. We analyzed the preexisting ocular condition, visual acuity (VA), and refractive error preoperatively and postoperatively, and recorded postoperative complications. RESULTS: Forty-nine patients (50 eyes) were enrolled in the study. The mean follow-up period was 12.8 ± 6.6 months. A best-corrected VA of 6/12 or better was achieved in 43 eyes (86%). The mean VA significantly improved from 0.32 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.18 logMAR at last follow-up (p = 0.03). The refractive status after intrascleral fixation of the PC IOL revealed a mean hyperopic shift of +1.09 ± 1.28 diopters from the predicted spherical equivalent. Postoperative vitreous hemorrhages occurred in six cases and were cleared without visual compromise. Cystoid macular edema was well-controlled by topical nonsteroidal anti-inflammatory drugs (NSAID) medications in two cases. In two cases, IOL dislocation recurred and required re-operation. There were no serious adverse events of suture-related complications, retinal detachment, corneal compromise, or endophthalmitis in any of the patients. CONCLUSIONS: Our data revealed that use of combined vitrectomy and intrascleral fixation of PC IOLs is a safe and efficient technique to correct IOL dislocation. We observed good visual outcomes with only minor complications.
Dislocations ; Endophthalmitis ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Macular Edema ; Postoperative Complications ; Refractive Errors ; Retinal Detachment ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To determine influences of intraoperative foveal traction during membrane peeling in idiopathic epiretinal membrane (ERM) surgery. METHODS: This retrospective observational study included 46 eyes of 46 patients with idiopathic ERM who underwent pars plana vitrectomy with ERM and internal limiting membrane peeling from February 2015 to September 2015. The presence of intraoperative foveal traction during membrane peeling was reviewed using video records. The main outcome measures were best-corrected visual acuity (BCVA), central foveal thickness (CFT), foveal contour, and photoreceptor inner segment/outer segment junction disruption using optical coherence tomography at baseline and at 1, 3, 6, and 12 months after surgery. RESULTS: Group 1 (ERM with intraoperative foveal traction) included 22 eyes, and group 2 (ERM without intraoperative foveal traction) included 24 eyes. Preoperatively, convex pattern ERM was observed more often in group 1. Group 1 had a significantly thicker CFT and a lower BCVA compared to group 2 at baseline and during the first 6 months, but the final postoperative BCVA and CFT were not significantly different between the groups at 12 months. Among 22 eyes, 12 eyes (54.5%) were restored to flat or concave ERM patterns at an average of 5.4 months after surgery in group 1, and 18 out of 24 eyes (75%) recovered at 2.4 months (p < 0.01) in group 2. CONCLUSIONS: Preoperative thick CFT and convex pattern ERM indicated a high possibility of intraoperative foveal traction in idiopathic ERM surgery. There were no differences in long-term BCVA and restoration of foveal configuration according to foveal traction during membrane peeling.
Epiretinal Membrane ; Humans ; Membranes ; Observational Study ; Outcome Assessment (Health Care) ; Retrospective Studies ; Tomography, Optical Coherence ; Traction ; Visual Acuity ; Vitrectomy

PURPOSE: To evaluate changes in subfoveal choroidal thickness (SFCT) after patterned panretinal photocoagulation (PRP) using pattern scan laser (PASCAL) in patients with diabetic retinopathy. METHODS: This study included 39 patients (50 eyes) treated with patterned PRP using PASCAL and who were followed for at least 3 months. Patients were classified into 2 groups according to severity: severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. SFCT was measured by enhanced depth imaging of spectral-domain optical coherence tomography. The change in SFCT was analyzed at 1 and 3 months after PRP. RESULTS: SFCT was 270.42 ± 61.44 µm before PRP, 264.52 ± 60.78 µm at 1 month, and 255.74 ± 56.89 µm at 3 months after PRP. Significant change of SFCT was found at 3 months after PRP. Central macular thickness was 275.56 ± 50.61 µm before PRP and increased to 295.18 ± 52.80 µm and 293.10 ± 57.24 µm at 1 and 3 months post-treatment, respectively. There were no significant differences between groups in SFCT at baseline or in the amount of change in SFCT after PRP. CONCLUSIONS: SFCT significantly decreased after patterned PRP using PASCAL.
Choroid* ; Diabetic Retinopathy* ; Humans ; Light Coagulation* ; Tomography, Optical Coherence

BACKGROUND: Composite grafts are frequently used for facial reconstruction. However, the unpredictability of the results and difficulties with large defects are disadvantages. Adipose-derived stem cells (ADSCs) express several cytokines, and increase the survival of random flaps and fat grafts owing to their angiogenic potential. METHODS: This study investigated composite graft survival after ADSC injection. Circular chondrocutaneous composite tissues, 2 cm in diameter, from 15 New Zealand white rabbits were used. Thirty ears were randomly divided into 3 groups. In the experimental groups (1 and 2), ADSCs were subcutaneously injected 7 days and immediately before the operation, respectively. Similarly, phosphate-buffered saline was injected in the control group just before surgery in the same manner as in group 2. In all groups, chondrocutaneous composite tissue was elevated, rotated 90 degrees, and repaired in its original position. Skin flow was assessed using laser Doppler 1, 3, 6, 9, and 12 days after surgery. At 1 and 12 days after surgery, the viable area was assessed using digital photography; the rabbits were euthanized, and immunohistochemical staining for CD31 was performed to assess neovascularization. RESULTS: The survival of composite grafts increased significantly with the injection of ADSCs (P<0.05). ADSC injection significantly improved neovascularization based on anti-CD31 immunohistochemical analysis and vascular endothelial growth factor expression (P<0.05) in both group 1 and group 2 compared to the control group. No statistically significant differences in graft survival, anti-CD31 neovascularization, or microcirculation were found between groups 1 and 2. CONCLUSIONS: Treatment with ADSCs improved the composite graft survival, as confirmed by the survival area and histological evaluation. The differences according to the injection timing were not significant.
Adult Stem Cells ; Cytokines ; Ear* ; Graft Survival ; Humans* ; Microcirculation ; Photography ; Rabbits ; Skin ; Stem Cell Transplantation ; Stem Cells* ; Transplants* ; Vascular Endothelial Growth Factor A

BACKGROUND: Composite grafts are frequently used for facial reconstruction. However, the unpredictability of the results and difficulties with large defects are disadvantages. Adipose-derived stem cells (ADSCs) express several cytokines, and increase the survival of random flaps and fat grafts owing to their angiogenic potential. METHODS: This study investigated composite graft survival after ADSC injection. Circular chondrocutaneous composite tissues, 2 cm in diameter, from 15 New Zealand white rabbits were used. Thirty ears were randomly divided into 3 groups. In the experimental groups (1 and 2), ADSCs were subcutaneously injected 7 days and immediately before the operation, respectively. Similarly, phosphate-buffered saline was injected in the control group just before surgery in the same manner as in group 2. In all groups, chondrocutaneous composite tissue was elevated, rotated 90 degrees, and repaired in its original position. Skin flow was assessed using laser Doppler 1, 3, 6, 9, and 12 days after surgery. At 1 and 12 days after surgery, the viable area was assessed using digital photography; the rabbits were euthanized, and immunohistochemical staining for CD31 was performed to assess neovascularization. RESULTS: The survival of composite grafts increased significantly with the injection of ADSCs (P<0.05). ADSC injection significantly improved neovascularization based on anti-CD31 immunohistochemical analysis and vascular endothelial growth factor expression (P<0.05) in both group 1 and group 2 compared to the control group. No statistically significant differences in graft survival, anti-CD31 neovascularization, or microcirculation were found between groups 1 and 2. CONCLUSIONS: Treatment with ADSCs improved the composite graft survival, as confirmed by the survival area and histological evaluation. The differences according to the injection timing were not significant.
Adult Stem Cells ; Cytokines ; Ear* ; Graft Survival ; Humans* ; Microcirculation ; Photography ; Rabbits ; Skin ; Stem Cell Transplantation ; Stem Cells* ; Transplants* ; Vascular Endothelial Growth Factor A

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis