PURPOSE: To report a case of a Comamonas acidovarans corneal ulcer treated with antibiotics in Korea. Comamonas acidovarans corneal ulcer has not been previously reported to our knowledge. METHODS: A 70-year-old woman visited our clinic complaining of left ocular pain and decreased visual acuity for six days. We performed a smear and culture on the corneal lesion and treated it with topical and systemic antibiotics. RESULTS: Comamonas acidovorans was cultured from ulcer lesion. Corneal ulcer improved with the administration of ciprofloxacin and tobramycin.
Aged ; Anti-Bacterial Agents ; Ciprofloxacin ; Comamonas* ; Corneal Ulcer* ; Delftia acidovorans* ; Female ; Humans ; Korea ; Tobramycin ; Ulcer ; Visual Acuity

From March, 1988 to August, 1989, the authors performed nasolacrimal duct reconstruction with Pyrex glass tube without bony perforation in 26 eyes of 25 patients who has chronic dacryocystitis with nasolacrinal duct obstruction. This method is implantation of permanent indwelling pyrex glasstube from base of the sac through the interosseous canal into the vault of inferior nasal meatus and there are several advantages in this method; The technique is more simple and less traumatic than other dacryocystorhinostomy, tear drainage inferioly prevents pooling of tear in inferior portion of lacrimal sac after surgery, normal anatomic relationships are retained and less postoperative care is required. The results were as follows: 1. Success was achieved in 24 of 26 cases including partial success. 2. Postoperative complications were developed that hypertrophic scar 2 cases, superficial punctate keratitis 1 case, wound infection 1 case, nasal bleeding 1 case.
Cicatrix, Hypertrophic ; Dacryocystitis ; Dacryocystorhinostomy ; Drainage ; Epistaxis ; Glass* ; Humans ; Keratitis ; Nasolacrimal Duct* ; Postoperative Care ; Postoperative Complications ; Tears ; Wound Infection

PURPOSE: The effects of 5HT3 receptor agonist and antagonist on rabbit intraocular pressure (IOP) and pupil size were evaluated. METHODS: A 5HT3 receptor agonist, I-Phenylbiguanide (PBG, 1%) and a 5HT3 receptor antagonist, 3-Tropanyl-indole-carboxylate methiodide (ICS-205,930) were applied topically to the rabbit eye, and intraocular pressure and pupil diameter were checked with a Tono-PenTM XL and a ruler. RESULTS: Topical application of 1% PBG significantly increased IOP by 4.6+/-1.2 mmHg (p<0.001) over a period of up to 2 hours, the IOP maximum reached at 1 hour and caused pupil dilatation by 3.3+/-0.3mm (p<0.001) over a period of up to 5 hours, the dilation maximum reached at 2 hour. Topical preadministration of 1% ICS-205,930 prevented a rise in IOP but did not counteract on the pupil dilatation brought about by 5HT3 receptor agonist. CONCLUSIONS: These findings indicate that topically applied 5HT3 receptor agonist could raise IOP and dilate pupil.
Dilatation ; Intraocular Pressure* ; Pupil* ; Rabbits*

A retrospective clinical study to evaluate the use of the argon and Nd: YAG laser in sequential combination for iridotomy was carried out on 29 eyes of 19 patients with angle closure glaucoma. The argon laser settings were standardized at 0.01-0.02 second duration and 50 micrometerspot size. The total mean energies for the argon and Nd: YAG stages were 2.7 +/-1.49J and 9.0 +/-5.83 mJ respectively. Mean postoperative decrease of intraocular pressure(IOP)was 26.4 +/-20.14 mmHg. Postoperative complications were bleeding at iridotomy site (3 eyes),transient increse in IOP (2 eyes),and posterior synechia (1 eye),but there was no lenticularopacity,and no closure of the iridotomy site. The laser iridotomy using sequential argon and Nd: YAG laser is an effective method in dark irides, lowering the mean total energy delivered per eye by the argon and YAG laser repectively, combining the advantages of both laser procedures while avoiding most of the disadvantages. We think that it is the more safe and effective method with the decreased mean total energy of argon laser at 0.01-0.02 second duration, 50 micrometerspot size followed by YAG laser.
Argon* ; Glaucoma, Angle-Closure* ; Hemorrhage ; Humans ; Lasers, Solid-State* ; Postoperative Complications ; Retrospective Studies

OBJECTIVE: We compared the one-year rehospitalization rates of first-episode bipolar manic patients who were discharged while being treated with atypical antipsychotics in combination with mood stabilizers. METHODS: We monitored the rehospitalization status of the first-episode bipolar manic patients who were discharged between 1 January 2003 and 31 December 2008 while they were taking risperidone (n=34), olanzapine (n=26) or quetiapine (n=32) in combination with mood stabilizers. Rehospitalizations were tracked over a 1-year period using the Kaplan-Meier method and Cox regression model was used to analyze covariates thought to affect time to rehospitalization. RESULTS: The rehospitalization rates during the 1-year follow-up period for patients taking atypical antipsychotics plus mood stabilizers were 22.8% (n=21). There were no significant differences in rehospitalization estimated using the Kaplan-Meier formula among the patients treated with risperidone (29.4%), olanzapine (23.1%) or quetiapine (15.6%). The psychotic symptoms, previous depressive episodes, lower Global Assessment of Functioning (GAF) score at discharge and less length of first hospitalization contributed to the risk of rehospitalization. CONCLUSION: The 1-year rehospitalization rates of first-episode bipolar manic patients taking risperidone, olanzapine, or quetiapine do not differ and the psychotic symptoms and previous depressive episodes affect time to rehospitalization.
Antipsychotic Agents ; Benzodiazepines ; Bipolar Disorder ; Dibenzothiazepines ; Follow-Up Studies ; Hospitalization ; Humans ; Inpatients ; Risperidone ; Track and Field ; Quetiapine Fumarate

PURPOSE: To compare the accuracy and reproducibility of central corneal thickness measured by non-contact specular microscopy, ultrasound pachymetry, and Orbscan in the post-penetrating keratoplasty eyes. METHODS: Central corneal thickness was prospectively measured in eyes that had recieved penetrating keratoplasty at least 1 month before. One experienced technician measured all eyes using three methods; non-contact specular microscopy (Topcon SP-2000P; Topcon Corporation, Tokyo, Japan), Orbscan IIz (Orbtek; Bausch & Lomb, Rochester, USA), and ultrasound pachymetry (AL-2000; Tomey, Erlangen, Germany). Three consecutive measurements were performed using each method and the mean values and coefficient of variation were compared. RESULTS: The mean values of central corneal thickness were 550.7+/-63.3 micrometer with specular microscopy, 548.2+/-72.5 micrometer with ultrasound pachymetry, and 472.5+/-151.7 micrometer with Orbscan. There was no significant difference between the measurements obtained by specular microscopy and ultrasound pachymetry (p=0.53), and both methods showed high reproducibility. The corneal thickness measured by Orbscan was remarkably variable and in some patients, Orbscan was unable to measure corneal thickness. CONCLUSIONS: Non-contact specular microscopy appears to be an effective technique, potentially replacing ultrasound pachymetry for measuring central corneal thickness in the post-penetrating keratoplasty eyes.
Corneal Transplantation ; Humans ; Keratoplasty, Penetrating ; Microscopy ; Prospective Studies ; Ultrasonography

BACKGROUND AND OBJECTIVES: Magnetic resonance (MR) imaging has resulted in a tremendous advance in the technology of medical diagnosis. However, even with all positive advances, there are usually some negative aspects, especially noise. It is well known that loud sounds can induce a hearing loss. This study was performed to determine the acoustic characteristics of MRI noise and whether or not the sound exposure resulting from routine MRI examinations is capable of altering the auditory thresholds of patients. MATERIALS AND METHOD: Digital Impulse Sound Level Meter was placed at patient's head level and at a 2m distance. Frequency of MRI noise was recorded by Digital audio tape and analyzed by Computerized Sound Lab (CSL). A total of 53 adults (106 ears) who were scheduled for MR imaging studies were included in the study. Pure-tone air-conductive auditory threshold was determined bilaterally in each patient before and after MRI. RESULTS: The noise levels at head level ranged from 80.8 dB to 86.0 dB, and at a 2 m distance, from 71.9 dB to 75.9 dB. The frequency ranged from 60 Hz to 2500 Hz. Nine of the 106 ears had a hearing loss of at least 10 dB at one frequency. CONCLUSION: The noise generated by the MRI is sufficiently intense to cause some temporary threshold shifts (TTS). TTS may transform to permanent threshold shifts. Therefore, it is important to devise a method to minimize the risk of these shifts, for example, by using earplug.
Acoustics* ; Adult ; Auditory Threshold ; Diagnosis ; Ear ; Ear Protective Devices ; Head ; Hearing Loss* ; Hearing* ; Humans ; Magnetic Resonance Imaging* ; Noise*

Purpose: To find out the incidence and predictors for late high-grade genitourinary (GU) toxicity following salvage radiotherapy (SRT), we investigated the consecutive patients who were treated with SRT after radical prostatectomy. Materials and Methods: Patients who underwent SRT for biochemical recurrence after radical prostatectomy were reviewed. The incidence of GU toxicity was assessed and risk factors for grade ≥2 and ≥3 GU toxicity were evaluated. The STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guided the reporting of this study. Results: Among the total of 217 patients, 88 patients (40.5%) showed late grade ≥2 GU toxicity. The incidence of late grade ≥3 GU toxicity was 11.5%. The presence of grade ≥2 baseline GU dysfunction (hazard ratio [HR], 6.097; 95% confidence interval [CI], 3.280–11.333; p<0.001) and short interval (<1 year) from surgery to SRT (HR, 1.994; 95% CI, 1.182–3.365; p=0.01) were associated with late grade ≥2 GU toxicity. A short interval from surgery to SRT was an independent predictor of late grade ≥3 GU toxicity (HR, 2.975; 95% CI, 1.135–7.794; p=0.027). Conclusions The incidence of late high-grade GU toxicity was not uncommon after SRT. Thus, care should be taken when we consider SRT in patients with baseline urinary dysfunction and a short interval from surgery to SRT, to determine an optimal treatment strategy with balancing quality of life and oncologic outcome of patients.

OBJECTIVE: In this study, we determined the prevalence of bipolarity in patients with treatment resistant depression (TRD) by investigating demographic and clinical characteristics, diagnostic subtypes, and illness outcome. METHOD: A medical record review of patients admitted to a university hospital with the diagnosis of major depressive disorder (MDD) was conducted. DSM-IV diagnoses at index hospitalization and six months after discharge and detailed clinical information were obtained. We categorized subjects into a TRD group or a non-TRD group and re-evaluated the patients using the recently proposed criteria for bipolar spectrum disorder (BSD). Patients in the TRD group were compared with patients in the non-TRD group with regard to the prevalence rate of BSD at the index hospitalization and at the end of the follow up period. RESULTS: There were 281 patients diagnosed as MDD. At discharge, the number of patients who fulfilled the criteria for BSD was higher (p<.001) in the TRD group (32/68, 47.1%) than in the non-TRD group (8/213, 3.8%). At the end of six-month follow-up period, the diagnoses of 38 patients changed ; 18 (26.5%) in the TRD group were subsequently classified as having bipolar disorder, and seven (3.3%) in the non-TRD group (p<0.001). There was no difference between these two groups in other clinical and demographic variables. CONCLUSION: The findings suggest that a large number of patients with TRD have a bipolar diathesis.
Bipolar Disorder ; Depressive Disorder, Major ; Depressive Disorder, Treatment-Resistant* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Disease Susceptibility* ; Follow-Up Studies ; Hospitalization ; Humans ; Medical Records ; Prevalence

Duodenal gastrointestinal stromal tumors (GISTs) are relatively rare tumors that commonly present with gastrointestinal bleeding. Evaluation with endoscopic ultrasonography (EUS) is a useful technique for the differential diagnosis of GISTs from other submucosal tumors. A 58-year-old man presented with melena and anemia. An esophago-gastroduodenoscopy showed the presence of a submucosal tumor in the second portion of the duodenum with central ulceration and a flat spot. EUS showed the presence of a suspicious malignant GIST that originated from the proper muscle layer, which was successfully resected. We report a case of a duodenal GIST with a bleeding ulcer. Positive reactivity for CD117 and S-100 was demonstrated by immunohistochemical staining.
Anemia ; Diagnosis, Differential ; Duodenum ; Endosonography ; Gastrointestinal Stromal Tumors ; Hemorrhage ; Humans ; Melena ; Middle Aged ; Muscles ; Ulcer